Clinical evaluation of all-ceramic crowns

Deniz Gemalmaz, DDS, PhD,a and Şule Ergin, DDSb

Faculty of Dentistry, Marmara University, Istanbul, Turkey
Statement of problem. There are few in vivo studies on the clinical performance of all-ceramic
crowns.
Purpose. The aim of this study was to evaluate the clinical performance of IPS Empress crowns.
Material and methods. Thirty-seven all-ceramic IPS Empress crowns were placed in 20 patients.
Twenty crowns were luted with Variolink II low-viscosity resin cement in combination with Syntac Classic
dentin adhesive; the remaining 17 were luted with Variolink II in combination with Syntac Single
Component. All procedural steps were performed by the same prosthodontist. Using the California
Dental Association’s (CDA) quality evaluation system, 2 calibrated evaluators examined the crowns for
margin integrity, anatomic form, surface, and color for a period of 12 to 41 months, with a mean of
24.56 months after insertion. Kaplan-Meier statistical analysis was used to calculate the survival rate of the
crowns. Values obtained for plaque and gingival conditions were compared to control teeth with use of
the Wilcoxon signed ranks test (P<.05).
Results. Based on the CDA criteria, 94.6% of the crowns were rated satisfactory. Fracture was registered
in only 1 crown. One endodontically treated tooth failed due to the dislodgement of the prefabricated
dowel. No significant difference was observed in the gingival health status of crowns that had margins
placed above or at the level of the gingival margin. However, in crowns that had subgingival margin finish
lines, the percentage of bleeding on probing was significantly higher than that of the contralateral control
teeth.
Conclusion. In this in vivo study, IPS Empress crowns luted with both dentin bonding agents func-
tioned satisfactorily with a relatively low fracture rate over a mean evaluation period of 24.56 months.
(J Prosthet Dent 2002;87:189-96.)

CLINICAL IMPLICATIONS
Multiple- and single-step dentin adhesives used on cemented IPS Empress crowns pro-
vided acceptable survival. The slight overextension observed just above the cervical
margin of crowns with subgingival finish lines contributed to increased bleeding on
probing. The results of this study suggest that the risk of gingival inflammation can be
reduced by placing the crown margins above or at the level of the gingival margins
when possible.

O ver the past decade, increased demand for

esthetically pleasing restorations has led to the devel-
opment of all-ceramic systems. There are 3 primary
modes of manufacturing all-ceramic crowns: conven-
tional sintering techniques, fabrication by casting or
with a pressure technique, and various direct milling
techniques.
Numerous ceramics have excellent biocompatibility,
a natural appearance, and improved physical bonding
with resin composite luting agents. However, the brit-
tle nature of ceramics has been a major factor in their
restriction for universal usage.1-3 Although many in
vitro studies2-7 have evaluated the fracture resistance of
all-ceramic materials, markedly fewer studies8-12 have
aAssociate Professor, Department of Prosthodontics.
bResearch Assistant, Department of Prosthodontics.
observed the clinical performance of such systems in
vivo. It has been stated that traditional fracture tests of
single-unit, all-ceramic prostheses are inappropriate
since they do not create failure mechanisms equivalent
to those seen in retrieved clinical specimens.13 Thus,
to validate the actual performance of all-ceramic sys-
tems, clinical studies are needed.
The introduction of new bonding techniques and
materials has improved the bond strength of dental
ceramics to dentin with strengths that approximate the
bond to enamel.14,15 Most current dentin adhesive
systems are composed of an acidic conditioner and a
solution of polymerizable hydrophobic and
hydrophilic reactive monomers. After the acid is rinsed
from enamel and dentin, the monomers are applied in
several coats on the etched enamel and dentin surface.
Recently developed 1-bottle dentin adhesives that
combine primer and adhesive resin into a single solu-

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THE JOURNAL OF PROSTHETIC DENTISTRY GEMALMAZ AND ERGIN

Table II. Number of IPS Empress crowns according to eval-

uation time
Number of crowns
Evaluation time (mo) Incisors Premolars Molars Total

12 1 — 1
13 — — 1 1
17 — 1 — 1
18 4 1 — 5
19 — 1 — 1
20 — 1 1 2
21 2 1 1 4
24 2 1 — 3
Fig. 1. Labial view of prepared left central and lateral 26 4 1 — 5
incisors. 27 — 2 2 4
29 4 — — 4
31 2 1 — 3
Table I. Distribution, mean age, and age range (in months) 33 — — 1 1
of the IPS Empress crowns evaluated 41 2 — — 2
No. Mean age Age range

Incisors 21 25.61 12-41

Canines — — — replacement due to secondary caries, fracture, or esthet-
Premolars 10 23.0 17-31
Molars 6 23.5 13-33
Total 37 24.56 12-41
tion have received considerable attention from clini-
cians, who often select the material that is easiest to
use. The use of 1-step adhesives may be advantageous
for reducing working time during cementation since,
in most cases, the application of a rubber dam is not
possible with crowns that have subgingival finish lines.
In some in vitro studies16,17 the use of 1-bottle
adhesives resulted in lower bond strengths than those
obtained with conventional adhesive systems. The
clinical relevance of these bond strengths, however,
has not been proven.
The injection molded, all-ceramic IPS Empress is a
leucite-reinforced ceramic material composed primari-
ly of glass. The crystalline leucite strengthens the
ceramic without significantly diminishing its translu-
cency.18 This enables the IPS Empress system to match
the translucency of natural teeth better than all-ceram-
ic crowns that use opaque, high-strength cores.19 This
study evaluated the clinical performance of IPS
Empress crowns luted with a resin cement and com-
pared the effects of 2 dentin adhesives used for
cementation.
MATERIAL AND METHODS
A total of 37 IPS Empress crowns (Ivoclar, Schaan,
Liechtenstein) were placed in 20 patients (9 women and
11 men, ages 19 to 36; mean age 24.7). Two crowns
were placed because of primary caries, 5 to replace
defective amalgam or composite restorations, 1 to
restore a fractured tooth, and 29 because of crown
ic inadequacy. Eighteen of the restored teeth were
nonvital. Of the 18 endodontically treated teeth,
14 were restored with prefabricated screw-shaped posts
(Gold plated anchorage post; Svenska Dental
Instrument AB, Stockholm, Sweden) and cores manu-
factured with a resin composite (Charisma; Kulzer,
Werheim, Germany). No crown had occlusal contact
with another. The distribution of crowns on molars,
premolars, and incisors and the age ranges and mean age
for each group of teeth are presented in Tables I and II.
For preparation design, a circumferential shoulder
with rounded internal line angles was used (Fig. 1).
Dental caries were excavated, and gross tooth prepara-
tion was performed with medium and coarse diamond
burs (No. 88805, FT12, FT18, LR23; Ultradent
Products, Inc, South Jordan, Utah). After preparation
margins were finished with a fine diamond bur
(856EF012; Komet, Lemgo, Germany), the width of
the shoulder was 1.2 to 1.5 mm. The occlusal reduc-
tion was 2 mm for posterior and 1.5 mm for anterior
crowns. The location of crown margins was recorded
both before cementation and at the recall appoint-
ment. Initially, 55% of the cervical margins were
located subgingivally, 25% were located at the gingival
margin, and 20% were located supragingivally.
Retraction cord (Stay-put; Roeko, Langenau,
Germany) was used to isolate subgingival finish lines.
Complete-arch impressions were made with a sili-
con impression material (Speedex; Coltène AG,
Altstätten, Switzerland), and irreversible hydrocolloid
impressions (Kromopan, Firenze, Italy) were made of
the opposing dentition. All tooth preparations were
restored with provisional crowns (Dentalon plus;
Kulzer). IPS Empress anterior crowns were fabricated
in 2 licensed dental laboratories with the layering tech-

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Table III. Criteria for CDA rating

Score
Category Acceptable Unacceptable Criteria

Margin integrity
Excellent No visible evidence of crevice along margin that explorer would
penetrate. No evidence of ditching along margin.
SCR Visible evidence of slight marginal discrepancy with no evidence of
decay; repair possible but perhaps unnecessary. Explorer gets stuck in
one direction.
SDIS Discoloration of margin between restoration and tooth structure.
TFAM Faulty margins cannot be properly repaired.
TPEN Penetrating discoloration along margin of restoration in pulpal direction.
TCEM Retained excess cement.
VMO Mobile restoration.
VFR Fractured restoration.
VCAR Caries continuous with margin of restoration.
VTF Fractured tooth structure.
Anatomic form
Excellent Restoration contour in functional harmony with adjacent teeth and soft
tissues within good individual anatomic form.
SOCO Restoration slightly overcontoured.
SUCO Restoration slightly undercontoured.
SOH Occlusion not completely functional.
SMR Margin ridges slightly undercontoured.
SCO Contact slightly open.
SFA Facial flatting present.
SLG Lingual flatting present.
TUCO Restoration grossly undercontoured.
TOCO Restoration grossly overcontoured.
TET Occlusion affected.
TOC Contact faulty.
TOV Marginal overhang present.
VTO Traumatic occlusion.
VUO Gross underocclusion.
VPN Restoration caused unremitting pain in tooth or adjacent tissue.
VDM Damage to tooth, soft tissue, or supporting bone.
Color and surface
Excellent No mismatch in color shade and/or translucency between restoration(s)
and adjacent teeth. Restoration surface smooth. No irritation of
adjacent tissue.
SMM Slight mismatch between shade of restoration(s) and adjacent tooth or teeth.
SRO Restoration surface slightly rough but can be polished.
TGI Grossly irregular surface not related to anatomy and not subject to correction.
TMM Mismatch between restoration(s) and adjacent tooth or teeth outside
normal range of color, shade, and/or translucency.
VSF Fractured surface.
VGP Gross porosities in crown material.
VSD Shade in gross disharmony with adjacent teeth.

nique, which is intended primarily for esthetic results
in the anterior region; posterior crowns were produced
with the shading technique.20 The gingival margins
surrounding the abutment teeth were completely
healthy with no signs of color change or bleeding at
the cementation appointment.
The operation field was isolated with cotton rolls
and high-velocity evacuation during cementation. The
internal surface of the ceramic crowns was etched with
5% hydrofluoric acid (IPS Ceramic etching gel;
Vivadent, Schaan, Liechtenstein) for 2 minutes and
then silanated with Monobond-S (Vivadent) for
60 seconds. The preparation surfaces were cleaned
with pumice slurry and conditioned with 37% phos-
phoric acid gel (Email Preparator GS; Vivadent) for
30 seconds. Two different dentin adhesives were used.

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THE JOURNAL OF PROSTHETIC DENTISTRY
Fig. 2. Labial view of IPS Empress crowns in maxillary left
central incisor and lateral incisor after 41 months of clinical
service.
Fig. 3. Occlusal view of IPS Empress crown in maxillary left
second premolar after 31 months of clinical service.
In 20 crowns (14 anterior and 6 posterior), dentinal
surfaces were primed with Syntac Classic dentin adhe-
sive. In 17 crowns (7 anterior and 10 posterior),
dentinal surfaces were primed with Syntac Single
Component (Vivadent). A bonding agent
(Heliobond; Vivadent) was brushed on both the inter-
nal and preparation surfaces of the crowns. The
bonding agent was air thinned, and cementation was
performed immediately. All crowns were luted with
Variolink II low viscosity resin cement (Vivadent).
Excess cement was removed with a dental probe and
waxed dental floss. Light-polymerization was per-
formed with an energy density of 480 mW/cm2
(Optilux; Demetron Inc, Danbury, Conn.) for
40 seconds from each margin. The occlusion and artic-
ulation of the IPS Empress crowns were controlled
carefully during the try-in procedure and after the
crowns were luted.21 All procedural steps from prepa-
ration to luting were performed by the same
prosthodontist.
The all-ceramic IPS Empress crowns were examined
in accordance with the California Dental Association’s
quality evaluation system22 (Table III) with a mirror, a
probe, radiographs, and photographs. Medical and
192
GEMALMAZ AND ERGIN
dental histories and symptoms reported by patients,
such as postoperative inconveniences, were registered
according to a routine protocol. The restorations were
evaluated for a period of 12 to 41 months, with a
mean of 24.56 months after insertion (Fig. 2). Two
evaluators examined the crowns for margin integrity,
anatomic form, surface, and color. The evaluators were
calibrated in the use of this evaluation system and
worked independently.
Initial interexaminer agreement was 97%. After dis-
agreements were resolved through discussion,
agreement rose to 99%. Disagreements occurred main-
ly in connection with color ratings; more specifically,
there was some uncertainty as to whether the color
match to natural teeth should have been rated SMM
or excellent.
Plaque23 and gingival24 index scores were recorded
for the ceramic restorations and corresponding surfaces
of the control teeth. Corresponding surfaces of the
homologous tooth were used as control surfaces for
evaluation. When the homologous tooth was also fitted
with an IPS Empress crown or restored with any other
material, the adjacent tooth or tooth adjacent to the
intact homologous tooth was used as a reference.
Molars were always compared to molars, premolars to
premolars, and canines or incisors to canines or incisors.
Evaluated crowns were evenly distributed between
minimum and maximum time intervals. Otherwise,
interpretation of the results according to the stated
mean evaluation time would be misleading. Kaplan-
Meier25 statistics were used to analyze the survival
rates of the crowns. Values obtained for plaque and
gingival conditions were compared to control teeth
with use of the Wilcoxon signed ranks test for differ-
ence of proportions at a significance of P<.05.
RESULTS
Of the 37 IPS Empress crowns evaluated, 94.6%
were rated satisfactory at the end of the mean evalua-
tion period of 24.56 months. Fracture was recorded in
only 1 crown (13 months after insertion). Bulk frac-
ture was observed on a nonvital maxillary first molar
crown luted with Variolink II in combination with
Syntac Single Component dentin adhesive. Of the
14 endodontically treated teeth restored with a pre-
fabricated screw post and core of resin composite,
1 failed due to fracture of the existing coronal dentin
and dislodgement of the prefabricated dowel. The
most common findings among the remaining
35 crowns were a slight mismatch in color between the
restoration and tooth structure (37%) (Fig. 3), slight-
ly overcontoured restorations (20%), and slight margin
discrepancy with no evidence of decay (19%)
(Table IV).
There was no significant difference between the
2 dentin adhesives used in regard to the failure rates
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GEMALMAZ AND ERGIN THE JOURNAL OF PROSTHETIC DENTISTRY

Fig. 4. Kaplan-Meier survival statistics for IPS Empress crowns adhered with Syntac Classic (n
= 20) or Syntac Single Component (n = 17).

obtained (P=.7907, log rank test). On the basis of the Table IV. Percentage of crowns that did not receive an
failure rates obtained and the Kaplan-Meier statistics, excellent rating for margin integrity, anatomic form, or
the estimated survival rate at 2 years was 95% and color and surface (n = 37 for margin integrity; n = 35 for
94.1% for crowns luted with Syntac Classic and Syntac other categories because of crown and tooth substance
Single Component, respectively (Fig. 4). fractures)
Among 19 crowns applied on vital teeth, 1 maxil- Rating No. (%)
lary lateral incisor exhibited occasional sensitivity to Margin integrity
cold and heat. This sensitivity was present from the SCR 7 (19)
time the crown was luted (18 months previously). No SDIS 4 (11)
outstanding findings were registered among the VFR 1 (3)
remaining crowns with regard to anamnesis. VTF 1 (3)
Table V lists the percentages for plaque and gingi- Anatomic form
val indices scores of crowns and controls. Two of the SOCO 7 (20)
37 crowns did not function due to failure; the occur- SOH 1 (3)
rence of plaque and gingival health therefore was Color and surface
SMM 13 (37)
calculated on the basis of 35 IPS Empress crowns and
35 intact control teeth. For no crown was severe
plaque growth or gingival inflammation (Score 3)
observed. The Wilcoxon signed ranks test revealed sig-
nificant differences in plaque growth between crowns DISCUSSION
and control teeth (Table VI). IPS Empress crowns
exhibited significantly less plaque growth than controls The major problem with clinical follow-up studies is
(P<.05). Significant differences also were observed incomplete patient records. If all treated patients did
between the gingival health of IPS Empress crowns not attend evaluations at ordered time sequences, the
and contralateral control teeth. existence or absence of baseline records will determine
Comparison of the gingival health status of IPS whether a retrospective10 or prospective study26 can
Empress crowns in accordance with margin finish line be performed. Although these studies are complicated
locations revealed the following: The gingival index by the use of records obtained at different times, the
scores of crowns with margins placed at or above the population can be considered a random sample if the
gingival margin were similar to those of controls. mean and range of clinical evaluation times are provid-
However, in crowns with subgingival margin finish ed.10,26 Table II shows that the number of crowns in
lines, the percentage of bleeding on probing (Score 2) this study was evenly distributed over the evaluation
was significantly higher for IPS Empress surfaces than period of 12 to 41 months.
for control surfaces (P<.05) (Tables V and VI). Given the conditions of this study, a conventional

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THE JOURNAL OF PROSTHETIC DENTISTRY GEMALMAZ AND ERGIN

Table V. Plaque and gingival index scores of IPS Empress crowns and control teeth (%)
Plaque index Gingival index
Location of crown margin No. 0 1 2 0 1 2

Mesial Subgingival 30 77 6 3 14 46 26
At level 3 8 — — 9 — —
Supragingival 2 — 6 — — 5 —
Total 35 85 12 3 23 51 26
Control 35 60 29 11 28 63 9
Distal Subgingival 29 71 11 — 14 49 20
At level 5 11 — 3 3 11 —
Supragingival 1 — 3 — — 3 —
Total 35 82 14 3 17 63 20
Control 35 31 57 11 23 54 23
Buccal Subgingival 10 29 — — 9 14 6
At level 19 54 — — 48 6 —
Supragingival 6 14 3 — 14 3 —
Total 35 97 3 — 71 23 6
Control 35 74 17 9 74 23 3
Lingual Subgingival 8 11 11 — — 20 3
At level 8 23 — — 23 — —
Supragingival 19 38 17 — 34 20 —
Total 35 62 28 — 57 40 3
Control 35 63 37 — 66 34 —

Table VI. P values of the Wilcoxon signed-ranks test on

plaque and gingival indices scores of crowns and con-
tralateral control teeth
Index Location of margin finish line in crowns
Plaque Subgingival
At gingival level
Supragingival
Total
Gingival Subgingival
At gingival level
Supragingival
Total
*Significantat P<.05.
†Significant
differences imply presence of more plaque on the natural tooth
than on the restored crown surface.
survival data analysis method was used to assess the
survival rate of all-ceramic crown fractures luted with
2 different dentin adhesives. The structural durability
of an all-ceramic crown is known to be affected by the
type of ceramic material, luting system, and occlusal
loading on the crown.13 In previous clinical studies on
all-ceramic crowns,10,12 the uniqueness of location,
preparation, and morphology among crowns placed in
the same individual led to the use of crowns, rather
than patients, as the unit of analysis. Likewise, in this
study, the 37 crowns were considered the statistical
units for Kaplan-Meier analysis.
For crown fractures, the failure rate in this study
was 2.7% after mean of 24.56 months of clinical ser-
vice. Lehner et al8 reported a fracture rate of 5% in a
follow-up study on 78 IPS Empress crowns after
19.7 months of clinical service. In another study on
P value
144 IPS Empress crowns, a fracture rate of 3.5% was
.0001*† reported after 37 months.9 A fracture rate of 6% at
.0051*† 43.2 months was reported for 110 IPS Empress
.91 crowns in a recent study by Sjögren et al.10
.0001*† Consideration of these results leads to the conclusion
.0027* that the fracture rate of IPS Empress crowns is moder-
.1088 ate within the first 3 years of clinical service. However,
.1797
the uneven distribution of both clinical service times
.0517
and luting systems in these studies makes a definite
prognosis of IPS Empress crowns impossible. More
studies with extended observation times are needed.
No rating that indicated dislodgement or mobile
restoration was assigned to any of the 37 crowns. In
1 crown, dislodgement was observed after 19 months
due to failure of the prefabricated post. Because dis-
lodgement was caused by the fracture of the abutment,
this situation should not be counted as crown fracture. It
is apparent that this typical failure occurred due to a high
stress concentration on the extensively damaged maxil-
lary premolar during insertion of the prefabricated post.
All crowns cemented with multiple- or single-step
dentin adhesives demonstrated successful retention
within a mean clinical use period of 24.56 months.
Although relatively lower bond strength values have
been reported for single-step dentin adhesives,16,17 the
clinical durability of crowns treated with Syntac Single
Component in this study did not appear to be com-
promised.

194 VOLUME 87 NUMBER 2

GEMALMAZ AND ERGIN
Plaque index scores indicated that less plaque was
associated with ceramic surfaces than with nonrestored
control surfaces in this study. The relationship between
plaque retention and dental materials has been contro-
versial. Four previous studies concluded that the
plaque-retention capacity of ceramics is less than that
of other materials or natural teeth27-30; other studies
reported no significant differences in plaque reten-
tion.10,31 When the data of different clinical studies is
interpreted, it should be remembered that oral
hygiene habits can change over time and vary among
individuals. The reduced plaque associated with IPS
Empress surfaces may be attributed to the special
interest of patients in crowns that were subjected to
periodic evaluations.
Significant differences in gingival index scores were
found between the controls and IPS Empress crowns
only for crowns with subgingival finish lines. The large
number of crowns with subgingival finish lines that
were judged to be slightly overcountered (20%)
(Table IV) had slightly edematous gingiva. The slight
overextension may have contributed to increased
bleeding on probing of the IPS Empress crowns.32,33
In a comparable study conducted on IPS Empress
crowns, no significant differences were observed
between the gingival health status of experimental
crowns and controls.10 That unchanged gingival sta-
tus, which is in conflict with the results of this study,
can be attributed to the fact that crown margins were
reportedly at the gingival margin. In this study and
previous investigations, even minute overcontouring
markedly influenced the degree of inflammation
around the gingival margin of restorations and impli-
cated subgingival margins in the etiology of
destructive periodontal disease.34,35 It therefore is rec-
ommended that crown margins be placed at or above
the gingival margin when possible.
In this study, all steps from preparation to luting of
the crown were peformed by the same dentist, a spe-
cialist in prosthodontics. This may have influenced the
results. Other, more significant limitations of the study
include the small sample and large number of variables
for assessing the quality of crowns. Although some
noteworthy conclusions can be drawn from the results,
they should be interpreted with caution due to the
experimental design.
CONCLUSIONS
Within the limitations of this study, the following
conclusions were drawn: Of the 37 IPS Empress
crowns evaluated, 94.6% were rated satisfactory
according to CDA criteria within an average clinical
evaluation period of 24.56 months. Fracture was seen
in 1 molar crown 13 months after insertion. Less
plaque was associated with IPS Empress surfaces than
with contralateral control tooth surfaces. However,
FEBRUARY 2002
THE JOURNAL OF PROSTHETIC DENTISTRY
the gingival status of abutments with IPS Empress
crowns was poorer than that of the controls when sub-
gingival crown margins were placed and slight
overextension was observed just above the cervical
margin of the crown.
We thank Drs Ender Kazazoǧlu, Alper Çomut, and Atilla Sertgöz
for their help with the statistical analyses reported in this manu-
script.
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Response of three types of cast posts and cores to static

Noteworthy Abstracts loading.
of the Martinez-Gonzalez A, Amigo-Borras V, Fons-Font A, Selva-
Current Literature Otaolaurruchi E, Labaig-Rueda C. Quintessence Int
2001;32:552-60.

Purpose. Opaque metal posts and cores, when used in conjunction with all-ceramic crowns, may
not be acceptable if they impart a grayish color to the final restoration. This study examined the
influence of continuous compression loading on 3 different types of cast posts and cores.
Material and methods. Thirty extracted maxillary canines were prepared for cast posts and cores
and divided into 3 groups of 10 teeth each. Post spaces were standardized to a diameter of 1.2
mm and a depth of 10 mm. A guideline was cut for crown restoration with a chamfer margin 1.5
to 2 mm from the coronal surface. Each group received a cast post and core of one of the fol-
lowing types: chrome-nickel alloy, acetalic resin, or IPS-Empress porcelain. Metallic cast crowns
were luted to the cores with zinc phosphate cement under 10 kg pressure for 1 minute. To ensure
that loading conditions were the same for all specimens, a 0.3-mm-deep and 1-mm-wide notch
was made above the cingulum. Specimens were placed under compression at an angulation of 45°
and loaded until tooth or restoration failure. After failure, the restoration was sectioned along its
long axis and examined under ×40 magnification.
Results. The mean load to failure for the tooth/restoration units was as follows: chrome-nickel
alloy = 2120 N, acetalic resin = 2139 N, and IPS Empress = 1491 N. Microscopically, the frac-
ture of the tooth occurred in the region apical to the post in 46% of the specimens, usually in
coincidence with the upper or middle third of the tooth.
Conclusion. Chrome-nickel and acetalic resin cast posts and cores possessed the same resistance
to continuous loading. 38 References.—ME Razzoog

196 VOLUME 87 NUMBER 2