Evaluation of the Marginal Fit of CAD/CAM Crowns Fabricated Using Two Different Chairside CAD/CAM Systems on Preparations of Varying Quality.

PURPOSE This study evaluated the marginal gap of crowns fabricated using two new chairside computer-aided design/computer-aided manufacturing systems on preparations completed by clinicians with varying levels of expertise to identify whether common preparation errors affect marginal fit. The null hypothesis is that there is no difference in the mean marginal gaps of restorations of varying qualities and no difference in the mean marginal gap size between restorations fabricated using the PlanScan (D4D, Richardson, TX, USA) and the CEREC Omnicam (Sirona, Bensheim, Germany). MATERIAL AND METHODS The fit of 80 lithium disilicate crowns fabricated with the E4D PlanScan or CEREC Omnicam systems on preparations of varying quality were examined for marginal fit by using the replica technique. These same preparations were then visually examined against common criteria for anterior all-ceramic restorations and placed in one of four categories: excellent, good, fair, and poor. Linear mixed modeling was used to evaluate associations between marginal gap, tooth preparation rating, and fabrication machine. RESULTS The fit was not significantly different between both systems across all qualities of preparation. The average fit was 104 μm for poor-quality preparations, 87.6 μm for fair preparations, 67.2 μm for good preparations, and 36.6 μm for excellent preparations. CONCLUSION The null hypothesis is rejected. It can be concluded that preparation quality has a significant impact on marginal gap regardless of which system is used. However, no significant difference was found when comparing the systems to each other. CLINICAL SIGNIFICANCE Within the limitations of this in vitro study, it can be concluded that crown preparation quality has a significant effect on marginal gap of the restoration when the clinician uses either CEREC Omnicam or E4D PlansScan.

[1]  W. Mörmann,et al.  Marginal and internal fit of all-ceramic CAD/CAM crown-copings on chamfer preparations. , 2005, Journal of oral rehabilitation.

[2]  A. Keshvad,et al.  Marginal gap, internal fit, and fracture load of leucite-reinforced ceramic inlays fabricated by CEREC inLab and hot-pressed techniques. , 2011, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[3]  Lothar Borchers,et al.  Marginal accuracy of four-unit zirconia fixed dental prostheses fabricated using different computer-aided design/computer-aided manufacturing systems. , 2009, European journal of oral sciences.

[4]  M H Walter,et al.  Non-cast titanium restorations in fixed prosthodontics. , 1992, Journal of oral rehabilitation.

[5]  B. Lang,et al.  Precision of fit: the Procera AllCeram crown. , 1998, The Journal of prosthetic dentistry.

[6]  J A Sorensen,et al.  A rationale for comparison of plaque-retaining properties of crown systems. , 1989, The Journal of prosthetic dentistry.

[7]  In-Sung Yeo,et al.  In vitro marginal fit of three all-ceramic crown systems. , 2003, The Journal of prosthetic dentistry.

[8]  J Dejou,et al.  Clinical evaluation of the marginal fit of cast crowns--validation of the silicone replica method. , 2007, Journal of oral rehabilitation.

[9]  S N White,et al.  In vivo marginal adaptation of cast crowns luted with different cements. , 1995, The Journal of prosthetic dentistry.

[10]  K. Boening,et al.  Clinical fit of Procera AllCeram crowns. , 2000, The Journal of prosthetic dentistry.

[11]  J. Strub,et al.  Evaluation of the marginal accuracy of different all-ceramic crown systems after simulation in the artificial mouth. , 1999, Journal of oral rehabilitation.

[12]  G Oilo,et al.  The fit of metal-ceramic crowns, a clinical study. , 1985, Dental materials : official publication of the Academy of Dental Materials.

[13]  Richard van Noort,et al.  Evaluation of the marginal fit of three margin designs of resin composite crowns using CAD/CAM. , 2007, Journal of dentistry.

[14]  Z. Yu,et al.  In vivo microleakage of luting cements for cast crowns. , 1994, The Journal of prosthetic dentistry.

[15]  S N White,et al.  Effect of adhesive luting agents on the marginal seating of cast restorations. , 1993, The Journal of prosthetic dentistry.

[16]  Kazumichi Wakabayashi,et al.  Marginal and internal fit of Cerec 3 CAD/CAM all-ceramic crowns. , 2003, The International journal of prosthodontics.

[17]  Carl J Drago,et al.  Volumetric misfit in CAD/CAM and cast implant frameworks: a university laboratory study. , 2011, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[18]  G. Thomas,et al.  3D and 2D marginal fit of pressed and CAD/CAM lithium disilicate crowns made from digital and conventional impressions. , 2014, Journal of prosthodontics : official journal of the American College of Prosthodontists.

[19]  D. Edelhoff,et al.  Marginal and internal fit of four-unit zirconia fixed dental prostheses based on digital and conventional impression techniques , 2013, Clinical Oral Investigations.

[20]  Kyu-Bok Lee,et al.  Marginal and internal fit of all-ceramic crowns fabricated with two different CAD/CAM systems. , 2008, Dental materials journal.

[21]  S. Bayne,et al.  Considerations in measurement of marginal fit. , 1989, The Journal of prosthetic dentistry.

[22]  P Pera,et al.  In vitro marginal adaptation of alumina porcelain ceramic crowns. , 1994, The Journal of prosthetic dentistry.

[23]  S Karlsson,et al.  The fit of Procera titanium crowns. An in vitro and clinical study. , 1993, Acta odontologica Scandinavica.

[24]  Walter Renne,et al.  Predicting marginal fit of CAD/CAM crowns based on the presence or absence of common preparation errors. , 2012, The Journal of prosthetic dentistry.

[25]  Ece Tamac,et al.  Clinical marginal and internal adaptation of CAD/CAM milling, laser sintering, and cast metal ceramic crowns. , 2014, The Journal of prosthetic dentistry.

[26]  Stefan Wolfart,et al.  The clinical accuracy of single crowns exclusively fabricated by digital workflow—the comparison of two systems , 2013, Clinical Oral Investigations.

[27]  José F L Lozano,et al.  A comparison of the marginal vertical discrepancies of zirconium and metal ceramic posterior fixed dental prostheses before and after cementation. , 2009, The Journal of prosthetic dentistry.

[28]  J. Schmitt,et al.  Clinical fit of four-unit zirconia posterior fixed dental prostheses. , 2008, European journal of oral sciences.

[29]  S E Sorensen,et al.  Gingival and alveolar bone reaction to marginal fit of subgingival crown margins. , 1986, Scandinavian journal of dental research.

[30]  M. Bottino,et al.  Vertical marginal discrepancy of ceramic copings with different ceramic materials, finish lines, and luting agents: an in vitro evaluation. , 2004, The Journal of prosthetic dentistry.

[31]  J. Mclean,et al.  The estimation of cement film thickness by an in vivo technique , 1971, British Dental Journal.