Prosthetic complications with mandibular bar-retained implant overdentures having distal attachments and metal frameworks: A 2- to 12-year retrospective analysis.

STATEMENT OF PROBLEM: Long-term reports on 2-implant-retained overdentures having metal frameworks and bars containing distal attachments are scarce. PURPOSE: The purpose of this retrospective study was to evaluate prosthetic complications with 2-implant-retained mandibular overdentures with metal frameworks having either screw- or cement-retained cantilevered bars with distal attachments. MATERIAL AND METHODS: Seventy-three edentulous study participants who had been treated with mandibular overdentures with 2 implants were included. The parameters assessed were acrylic resin fractures (base fracture, fracture at midline), debonding of teeth, opposing prosthesis fracture, need for relining or rebasing, abutment and bar screw loosening and fracture, ball or bar attachment or clip wear, fracture or detachment, bar fracture, and implant loss. Statistical analysis was performed by using the Mann-Whitney U test as the data were not normally distributed. The categorical variables between the groups were analyzed by using the Fisher exact test (α=.05). RESULTS: Twenty-seven prostheses had a cement-retained bar, and 46 bars were screw-retained. Of 73 overdentures, 68 were metal-reinforced. The mean observation time was 5.9 years with a range between 2 and 12 years. The most common complication was wear of the Rhein 83 polymer attachment followed by bar screw loosening. The cumulative survival rate for overdentures was 91.9% at 6.8 years. The service life of cement-retained prostheses was significantly longer (P<.05). Bar, resin base, and mid-line fractures were only seen with cement-retained prostheses. The number of times an attachment change was required did not differ between cement- and screw-retained bars. Of 191 implants, 3 were lost, and the cumulative survival rate was 93.5% at 7.5 years. No significant difference was found between retention types in terms of implant loss (P>.05). CONCLUSIONS: Based on the participant population observed, the survival rates of 2-implant-retained mandibular overdentures and their implants in the medium term were high. Wear of the polymer attachment was commonly seen. Overdentures with cement-retained bars had bar or acrylic resin fractures. Mandibular 2-implant-retained overdentures with a screw-retained bar containing bilateral distal attachments had fewer prosthetic complications and high implant survival in the medium term.

Marginal fit of 3-unit CAD-CAM zirconia frameworks fabricated using cone beam computed tomography scans: an experimental study.

Whether cone beam computed tomography (CBCT) scans can be used for the fabrication of computer-aided design and computer-aided manufacturing (CAD-CAM) fixed dental prostheses (FDPs) is not known. The purpose of the present study was to compare the marginal fit of 3-unit zirconia FDPs fabricated by using CBCT or 3-dimensional (3D) laboratory scanning. Extracted second premolar and molar teeth in a maxillary typodont model were prepared. The first molar was removed and the typodont model was scanned with a laboratory or a CBCT scanner to generate two virtual 3D cast groups (3DL and CBCT). Forty four 3-unit zirconia FDPs were designed on virtual casts and milled. The vertical marginal discrepancy (VMD) was measured by ×100-magnification microscopy at seven locations on each abutment. A total of 616 measurements were made at 14 fixed locations in two groups of 22 specimens. The VMD data for 3DL and CBCT groups were statistically analyzed using the Mann-Whitney U test (α = 0.05). The mean VMDs on premolar ranged between 44 and 55 µm (median: 43-55 µm) in 3DL, and 74 and 100 µm (median: 72-93 µm) in CBCT; and on the molar, between 47 and 114 µm (median: 46-114 µm) in 3DL, and 91 and 162 µm (median: 93-156 µm) in CBCT. There was a significant difference between the gaps in 3DL and CBCT groups (p < 0.001). FDPs fabricated using 3D laboratory scanner had significantly smaller VMDs. Nevertheless, the 3-unit zirconia FDPs fabricated using CBCT scans presented promising marginal integrity.

Marginal fit of CAD-CAM monolithic zirconia crowns fabricated by using cone beam computed tomography scans.

STATEMENT OF PROBLEM: Information regarding the precision of monolithic zirconia crowns fabricated by using a standard computer-aided design and computer-aided manufacturing (CAD-CAM) workflow is available. However, information on the effect of a modified workflow using 3D laboratory scanning and/or cone beam computed tomography (CBCT) for monolithic zirconia crown fabrication is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different scans on the marginal fit of CAD-CAM monolithic zirconia crowns fabricated by 3D laboratory scanning and CBCT. MATERIAL AND METHODS: An extracted maxillary left first molar was prepared and digitized by using a 3D laboratory scanner (D900; 3Shape A/S) (control group). The tooth was also scanned by CBCT (i-CAT; Imaging Sciences) to generate a second virtual 3D model (CBCTscan group). A tooth cast out of polyurethane (PU) (Zenotec Model; Wieland) was reproduced from the CBCT data by using a CAD software program (Dental System 2.6; 3Shape A/S) and milling machine (CORiTEC 550i; imes-icore) and further scanned by using the 3D laboratory scanner to generate a third virtual 3D model to represent a clinical scenario where a patient's cast is needed (PU3DLab group). A monolithic zirconia crown design (cement space: margin 40 µm, 1 mm above 70 µm) was used on the virtual models, and crowns were fabricated out of presintered zirconia blocks (ZenostarT4; Wieland) by using a 5-axis milling machine (CORiTEC 550i; imes-icore). The crowns were sintered (Sinterofen HT-S Speed; Mihm-Vogt), and the vertical marginal discrepancy (VMD) was measured by ×100-magnification microscopy. Measurements were made at 384 points in 3 groups of 16 specimens. The measurements for each specimen were averaged, and VMD mean values were calculated. The Kruskal-Wallis test was used for the statistical analysis (α=.05). The Mann-Whitney U test and Bonferroni adjustment were further used to compare the pairs (α=.017). RESULTS: The mean VMD value was 41 µm (median: 38 µm) for the control group, 44 µm (median: 42 µm) for the CBCTscan, and 60 µm (median: 58 µm) for the PU3DLab. No significant difference was found between control and CBCTscan groups (P=.274). However, there was a significant difference between control and PU3DLab and CBCTscan and PU3DLab groups (P<.001). CONCLUSIONS: Marginal fit of the crowns fabricated by using the 3D laboratory scanner and through the direct use of CBCT was better than that of the crowns fabricated by using the workflow that combined the use of CBCT, PU cast, and 3D laboratory scanner. All tested protocols enabled the fabrication of monolithic zirconia crowns with a marginal discrepancy smaller than 120 µm.

Marginal Adaptation of Provisional CAD/CAM Restorations Fabricated Using Various Simulated Digital Cement Space Settings.

PURPOSE: The ideal digital cement space value for the fabrication of provisional computer-aided design/computer-aided manufacturing (CAD/CAM) crowns with clinically acceptable marginal adaptation is not well known. The aim of this study was to evaluate the effect of different simulated cement space settings on the marginal fit of poly(methyl methacrylate) (PMMA) provisional CAD/CAM restorations. MATERIALS AND METHODS: An extracted premolar tooth was prepared using ceramic crown preparation guidelines and represented both natural teeth and/or custom implant abutments. The prepared tooth abutment was scanned with a three-dimensional (3D) laboratory scanner (D900, 3Shape). CAD design software was used to subsequently design a premolar crown core with three different simulated cement space settings (20 to 40 µm, 20 to 50 µm, 20 to 60 µm). PMMA blocks were used to mill the specimens (n = 9, N = 27). Using a stereo zoom microscope, a total of 36 images for each of the 3 groups (9 crowns per group, 4 sites per crown) were captured to measure the mean vertical marginal discrepancy for every group. One-way analysis of variance (ANOVA) was used to analyze the data, and the post hoc Tukey multiple comparison test was performed. RESULTS: The marginal gap values of the PMMA cores fabricated using the three cement space settings were significantly different from each other (P < .001). The marginal gap was smaller with a 20- to 60-µm setting compared with 20 to 50 µm and 20 to 40 µm, and the 20- to 50-µm setting allowed for smaller marginal gaps compared with 20 to 40 µm (P < .001). CONCLUSION: Within the limitations of this study, the marginal gaps of CAD/CAM-fabricated PMMA cores were smaller when the cement space was larger. The smallest marginal gaps were achieved when a 20- to 60-µm cement space was used (P < .001).

Effect of fabrication stages and cementation on the marginal fit of CAD-CAM monolithic zirconia crowns.

STATEMENT OF PROBLEM: Monolithic zirconia crowns fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology have recently become an alternative dental prosthetic treatment. The marginal fit of monolithic zirconia crown may be affected by different stages of the fabrication procedures in the laboratory and cementation. Information regarding the accuracy of fit of monolithic zirconia crowns at different stages of fabrication and cementation is limited. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different stages of fabrication and cementation on the vertical marginal discrepancy (VMD) of CAD-CAM fabricated monolithic zirconia crowns. MATERIAL AND METHODS: Six ivorine right maxillary first molar typodont teeth with standardized anatomic preparations for complete coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed using CAD software and milled from presintered monolithic zirconia blocks in a 5-axis dental milling machine. A cement space of 25 µm for the margins and a 50-µm space starting 1 mm above the finish lines of the teeth were virtually set in the CAD software. A total of 144 measurements were performed on 6 specimens with 8 measurement locations in 3 different stages using stereoscopic zoom microscopy; after initial production of the crowns (post-sintering group), after glazing (post-glazing group), and after cementation (post-cementation group). The VMD values were statistically analyzed with 1-way repeated measures ANOVA and the Holm-Sidak method (α=.05). RESULTS: Different stages of fabrication and cementation significantly affected the VMD of tested crowns (P=.003). The mean VMD was 38 µm for post-sintering group, 38 µm for post-glazing group, and 60 µm for post-cementation group, with statistical differences between the post-sintering group, the post-cementation group (P<.002), and the post-glazing group and post-cementation group (P<.003); there were no statistical differences between the post-sintering group and the post-glazing group (P=.966). CONCLUSIONS: Within the limitations of this in vitro study, glazing did not significantly change the VMD of CAD-CAM monolithic zirconia crowns. Cementation significantly increased the VMD values.

Effect of cement space on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns.

STATEMENT OF PROBLEM: Monolithic zirconia crowns fabricated with computer-aided design and computer-aided manufacturing (CAD-CAM) have recently become a common practice for the restoration of posterior teeth. The marginal fit of monolithic zirconia crowns may be affected by different cement space parameters set in the CAD software. Information is scarce regarding the effect of cement space on the marginal fit of monolithic zirconia crowns fabricated with CAD-CAM technology. PURPOSE: The purpose of this in vitro study was to evaluate the effect of cement space on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns before cementation. MATERIAL AND METHODS: Fifteen right maxillary first molar typodont teeth with standardized anatomic preparations for complete-coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed 3-dimensionally using software and then milled from presintered monolithic zirconia blocks in a computer numerical control dental milling machine. The cement space was set at 25 µm around the margins for all groups, and additional cement space starting 1 mm above the finish lines of the teeth was set at 30 µm for group 25-30, 40 µm for group 25-40, and 50 µm for group 25-50 in the CAD software. A total of 120 images (3 groups, 5 crowns per group, 8 sites per crown) were measured for vertical marginal discrepancy under a stereoscopic zoom microscope and the data were statistically analyzed with 1-way analysis of variance, followed by the Tukey honestly significant difference test (α=.05). RESULTS: The results showed that different cement space values had statistically significant effect on the mean vertical marginal discrepancy value of tested crowns (P<.001). The mean marginal discrepancy was 85 µm for group 25-30, 68 µm for group 25-40, and 53 µm for group 25-50. CONCLUSIONS: Within the limitations of this in vitro study, it was concluded that the cement space had a significant effect on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns. The marginal fit improved as the cement space decreased.

Evaluation of marginal fit of CAD/CAM restorations fabricated through cone beam computerized tomography and laboratory scanner data.

STATEMENT OF PROBLEM: Whether cone beam computed tomography (CBCT) images can be used for the fabrication of computer-aided design/computer-aided manufacturing (CAD/CAM) restorations is unknown. PURPOSE: The purpose of this in vitro study was to evaluate the marginal fit of CAD/CAM restorations fabricated by using data from CBCT scans with 3 different voxels and laser scanner images. MATERIAL AND METHODS: A crown preparation was made on an extracted premolar tooth according to ceramic crown preparation guidelines. The prepared tooth was scanned with a 3-dimensional (3D) extraoral laser scanner (D900; 3Shape), and CBCT scans were also made with an i-CAT cone beam 3D imaging system at 3 different voxel resolution settings: 0.125 mm, 0.20 mm, and 0.30 mm. The 3D images obtained from the laser scanner and CBCT scans were sent to CAD software, and a crown design was completed. Information was sent to CAM software to mill the crowns from poly(methyl methacrylate) (PMMA) blocks (n=9 from the laser scanner and 27 from 3 different CBCT scans). A total of 144 images (4 groups, 9 crowns per group, 4 sites per crown) were measured for vertical marginal discrepancy under a stereoscopic zoom microscope. One-way analysis of variance (ANOVA) was used to analyze the data. According to the assumption of homogeneity of variance, the post hoc Tukey multiple comparison test was performed (α=.05). RESULTS: The marginal gap values of crowns fabricated with an extraoral laser scanner were significantly lower than those of crowns fabricated with 0.3-, 0.2-, and 0.125-voxel CBCT images (P<.001). The marginal gap was greater when 0.3- and 0.2-voxel CBCT images were used than when 0.125-voxel CBCT images were used (P<.001). CONCLUSIONS: Crowns fabricated with the laser scanner images had lower and clinically acceptable marginal discrepancies than crowns fabricated with CBCT images in 3 different voxels. Of all the CBCT scans, only images with 0.125 voxel produced crowns with clinically acceptable marginal discrepancy.

Using the "final-on-four" concept to deliver an immediate metal-resin implant-fixed complete dental prosthesis.

In traditional dental implant therapy, the time between implant placement and delivery of the definitive prosthesis can be long and uncomfortable for a patient wearing a conventional removable denture on an atrophied ridge. New clinical protocols, often with tilted implants, are being used to immediately restore mandibular implants with interim restorations, thus shortening the patient's return to function. However, these conversion type interim restorations do not decrease the time to definitive prosthetic rehabilitation. The Ohio State University (OSU) developed an immediate load surgical and prosthetic protocol to compensate for the disadvantages of previous techniques. With this protocol, a custom, definitive, screw-retained metal-resin fixed prosthesis can be delivered 2 to 4 days postoperatively and has been described using 5 implants. This clinical report presents the OSU immediate loading protocol, combined with a tilted implant technique, for the fabrication of a mandibular metal-resin implant fixed complete dental prosthesis (MRIFCDP) in 3 days postoperatively and with only 4 implants. Replacing the mandibular dentition with an immediate load-fixed metal-resin prosthesis by means of the "final-on-four" technique resulted in a custom, definitive, and functional restorative solution immediately after surgery.

Digital evaluation of the accuracy of impression techniques and materials in angulated implants.

OBJECTIVES: The aim of this study was to investigate the accuracy of 2 different impression techniques and 3 different impression materials in models simulating parallel and angulated implants. METHODS: Three master models simulating partial edentulous mandible with 2 implants at the sites of second premolars (parallel) and second molars with different angulations (parallel, 10° or 20° angulated) were fabricated. Two different impression techniques [splinted direct (D), indirect (I)] and 3 different monophase impression materials [polyether (PE), vinyl polysiloxane (VPS), vinyl polyether silicone (VPES)] were used for each master model and a total of 180 impressions were made (n=10). Master model and casts were scanned by a modified laser scanner and data were transferred to VRMesh software. Master model and duplicate cast scans were digitally aligned observing the superposition of anatomic markers. Angular and coronal deviations between master and duplicated copings were calculated and data were statistically analyzed. RESULTS: Mean angular and coronal deviations were in a range of 0.205-0.359° and 22.56-33.33µm, respectively. Statistical analysis revealed that the angulation of implant affected both coronal and angular deviations of the impression copings (P<0.05). According to statistical analyses, for parallel implants, the accuracy of impression materials and techniques were ranging as VPS-D=PE-D>VPS-I=PE-I>VPES-D>VPES-I from most accurate to the least. For 10° and 20° angulated implants the most accurate material and technique was VPS-D whereas the least accurate combination was VPES-I (P<0.05). CONCLUSION: Angulation, impression technique and material were found to be effective on the accuracy of implant impressions. CLINICAL SIGNIFICANCE: Clinicians may prefer VPS impression material and splinted direct technique for impressions of both parallel and up to 20° angulated implants.

An alternative impression technique for complete dentures.

This article describes a technique for creating adequate space for an even thickness of polyvinyl siloxane (PVS) impression material at the periphery during complete denture impression making. A PVS border molding material is injected around the borders of a custom tray, a 17-µm-thick stretch wrap film is folded into 4 layers, and a tray-shaped piece slightly larger than the size of the custom tray is placed on the tray covering the borders. After the border molding procedure is completed, the film is removed and the definitive impression completed with a medium-viscosity PVS impression material.

Depigmented skin and phantom color measurements for realistic prostheses.

PURPOSE: The purpose of this study was to test the hypothesis that regardless of human skin phototype, areas of depigmented skin, as seen in vitiligo, are optically indistinguishable among skin phototypes. The average of the depigmented skin measurements can be used to develop the base color of realistic prostheses. METHODS AND MATERIALS: Data was analyzed from 20 of 32 recruited vitiligo study participants. Diffuse reflectance spectroscopy measurements were made from depigmented skin and adjacent pigmented skin, then compared with 66 pigmented polydimethylsiloxane phantoms to determine pigment concentrations in turbid media for making realistic facial prostheses. RESULTS: The Area Under spectral intensity Curve (AUC) was calculated for average spectroscopy measurements of pigmented sites in relation to skin phototype (P = 0.0505) and depigmented skin in relation to skin phototype (P = 0.59). No significant relationship exists between skin phototypes and depigmented skin spectroscopy measurements. The average of the depigmented skin measurements (AUC 19,129) was the closest match to phantom 6.4 (AUC 19,162). CONCLUSION: Areas of depigmented skin are visibly indistinguishable per skin phototype, yet spectrometry shows that depigmented skin measurements varied and were unrelated to skin phototype. Possible sources of optical variation of depigmented skin include age, body site, blood flow, quantity/quality of collagen, and other chromophores. The average of all depigmented skin measurements can be used to derive the pigment composition and concentration for realistic facial prostheses.

A clinical comparison of cordless and conventional displacement systems regarding clinical performance and impression quality.

STATEMENT OF PROBLEM: It is not clear whether newly introduced cordless displacement systems are better able to manage gingiva than conventional systems. PURPOSE: The purpose of this in vivo study was to evaluate the gingival management ability of 4 different displacement methods with a standardized subgingival preparation finish line. MATERIAL AND METHODS: The effects of 4 displacement techniques on gingival management and impression quality were evaluated by means of 6 evaluation criteria. A subgingival preparation finish line of between 1 and 2 mm was ensured, and the buccal aspects of 252 (n=63) teeth were clinically assessed for ease of application, time spent, bleeding, remnants, and dilatation. The complete reproduction of the preparation finish line and the bubble and void formations on polyether impressions were also evaluated. The data were statistically analyzed with the χ(2) test (α=.05). The Bonferroni correction was used to control Type I error for the pairwise comparison groups (α=.008). RESULTS: Statistically significant differences were found for all criteria among the groups (P<.05). The nonimpregnated displacement cord group was the least effective group in terms of bleeding and impression quality (P<.008). The aluminum chloride impregnated cord group and the displacement paste with cap group were found to be comparable in terms of remnants, dilatation, and impression quality (P>.008). The retraction cap with paste group showed better results for ease of application, time spent, and bleeding than the aluminum chloride impregnated cord group (P<.008). Although the group with aluminum chloride impregnated cord, displacement paste, and cap showed better results for dilatation, it was time consuming and difficult (P<.008). CONCLUSIONS: Except for the nonimpregnated cord group, all of the groups were comparable and clinically useful, with perfect or acceptable impression qualities.

Salvaging an angled implant abutment with damaged internal threads: a clinical report.

This clinical report describes a technique to fit an existing fixed detachable implant-supported prosthesis to a zygomatic implant abutment with stripped internal threads. The threads of the abutment were retapped and a wide diameter/wide head retaining screw was used to secure the existing prosthesis on the abutment. Care is needed in the retrieval of broken screws so as not to damage the internal threads of the implants, which might lead to irreversible complications.

Galvanic gold plating for fixed dental prosthesis.

Metal ceramic partial fixed dental prostheses have been commonly used for the replacement of missing teeth for many years. Because of an increase in the price of gold, base metal alloys have been the choice of alloy for the fabrication of metal ceramic restorations in many dental clinics. Some major disadvantages of base metals are their corrosion and the dark coloration they may cause at the crown margins. This article describes a galvanic gold-plating technique, which is used to minimize corrosion and improve the esthetics of metal ceramic restorations fabricated with Cr-Co base metal alloys. This technique involves the deposition of a 6 µm to 8 µm 24 K gold layer directly onto the Cr-Co cast prosthesis framework. The technique improves metal surface properties, making them more biocompatible and usable, however, requires additional equipment and experienced laboratory technicians. Clinical studies should be performed to corroborate the long term success of this technique.

Two-piece impression procedure for implant-retained orbital prostheses.

Obtaining an accurate impression of facial tissues with undercuts and extraoral implants has always been a challenge for both clinicians and patients. This report describes a three-step, two-piece technique that enables an accurate and comfortable impression of undercut tissues and extraoral implants in an orbital defect. An impression of the basal tissue surface of the defect area was made using a medium-body polyether impression material followed by an impression of the entire face of the patient made with a polyvinyl siloxane (PVS) impression material. First, the PVS impression material was removed; second, the impression posts were removed from the magnets; and third, the polyether impression was removed from the defect. The impression posts were attached to the implant analogs and placed in the negative spaces in the polyether impression. The polyether impression, which carries the implant analogs and impression posts, was placed in the PVS impression through the negative spaces. This technique minimizes trauma to the soft tissues and implants during impression making and also does not require additional materials.

Effect of different prosthetic materials on radiation dose distribution in an orbital defect: a clinical report.

It is challenging to treat and irradiate empty cavities with external-beam radiation therapy (EBRT) because body contour irregularities can result in dose heterogeneities. The use of compensator materials to fill the empty cavities can provide a more homogeneous radiation dose distribution. The purposes of this clinical report are to describe the use of 3 different materials (elastomeric material, water-filled balloon, and acrylic resin) in an orbital defect and compare the dosimetric parameters and photon-electron dose distribution during EBRT.

A functional open-tray impression technique for implant-retained overdenture prostheses.

Several implant impression techniques with different materials have been described in the literature. Generally, border molding, functional, and final impressions have been made with 3 different materials, which makes the procedure technique-sensitive and time-consuming. A combination of open-tray and functional impression techniques is described in this technical report. Border molding and functional impression procedures are made at the same time using a vinyl polysiloxane impression material, which makes this technique a simple and time-efficient alternative for clinicians.

Color change during the surface preparation stages of metal ceramic alloys.

STATEMENT OF PROBLEM: Even though metal ceramic restorations (MCRs) are widely used by clinicians, the influence of the metal on the color of overlaying porcelain is unknown. PURPOSE: The purpose of this study was to analyze the color alterations of different types of metal ceramic alloys during several stages of metal surface preparation and to determine the effect of those changes on the resulting color of opaque porcelain (OP). MATERIAL AND METHODS: Seven different types of alloys (3 base metal, 3 noble, and 1 high noble) were used to prepare disk-shaped specimens (1 mm × 10 mm, n=3), followed by OP application (0.1 mm). L*a*b* values of specimens were recorded after different stages of metal surface preparation (ingot, after casting, after oxidation, and after the OP application) in addition to the shade tab of OP B1 (target shade). L*a*b* values of alloys were measured from the ingot structure to the OP application stage and statistically analyzed (Repeated measures ANOVA, and Bonferroni corrected paired t test, α=.05). L*a*b* values of OP applied groups and the OP shade tab (target shade) were analyzed (1-way ANOVA with Dunnett's multiple comparison test, α=.05). The color differences of the target shade both before and after OP application were calculated and statistically analyzed (1-way ANOVA, Ryan-Einot-Gabriel-Welsch Multiple Range Test, α=.05). RESULTS: The L* values of all alloys changed significantly after each stage except for 2 alloys (V-Deltaloy SF (N-VDSF)) and (Gnathos Plus (HN-GP)) after casting and airborne-particle abrasion (P<.05). The a* value of all alloys increased after casting. Changes in the a* coordinate were significant except for one of the base metal alloys (P<.05). The a* coordinate changes of alloys showed variation in direction after oxidation and OP application (P<.05). The b* coordinate changes of alloys showed variation in direction after each stage (P<.05). The L*a*b* values of some OP applied alloys were significantly different from that of the OP shade tab (P<.05). Color difference values (ΔE (OP applied alloy-target shade)) of 2 OP-applied alloys (Cerapall 2 (N-CP2) and Ceradelta (N-CD)) were significantly different (P<.05) and higher than the other OP-applied alloys. CONCLUSIONS: The achromatic color behavior of different alloys was all in the same direction at all metal surface preparation stages. The chromatic behavior of the different alloys was primarily towards the same direction after casting and airborne-particle abrasion, whereas it varied after oxidation and OP application. The color difference of OP for all alloys, regardless of their type, was not visually perceivable when compared to the target shade (ΔE<2.6).