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Comparison of fit and trueness of zirconia crowns fabricated by different combinations of open CAD-CAM systems

  • Eun-Bin Bae (Department of Prosthodontics, Dental Research Institute, Dental and Life Sciences Institute, Education and Research Team for Life Science on Dentistry, School of Dentistry, Pusan National University) ;
  • Won-Tak Cho (Department of Prosthodontics, Dental Research Institute, Dental and Life Sciences Institute, Education and Research Team for Life Science on Dentistry, School of Dentistry, Pusan National University) ;
  • Do-Hyun Park (Department of Prosthodontics, Dental Research Institute, Dental and Life Sciences Institute, Education and Research Team for Life Science on Dentistry, School of Dentistry, Pusan National University) ;
  • Su-Hyun Hwang (Department of Prosthodontics, Dental Research Institute, Dental and Life Sciences Institute, Education and Research Team for Life Science on Dentistry, School of Dentistry, Pusan National University) ;
  • So-Hyoun Lee (Department of Prosthodontics, Dental Research Institute, Dental and Life Sciences Institute, Education and Research Team for Life Science on Dentistry, School of Dentistry, Pusan National University) ;
  • Mi-Jung Yun (Department of Prosthodontics, Dental Research Institute, Dental and Life Sciences Institute, Education and Research Team for Life Science on Dentistry, School of Dentistry, Pusan National University) ;
  • Chang-Mo Jeong (Department of Prosthodontics, Dental Research Institute, Dental and Life Sciences Institute, Education and Research Team for Life Science on Dentistry, School of Dentistry, Pusan National University) ;
  • Jung-Bo Huh (Department of Prosthodontics, Dental Research Institute, Dental and Life Sciences Institute, Education and Research Team for Life Science on Dentistry, School of Dentistry, Pusan National University)
  • Received : 2023.03.31
  • Accepted : 2023.06.20
  • Published : 2023.06.30

Abstract

PURPOSE. This study aims to clinically compare the fitness and trueness of zirconia crowns fabricated by different combinations of open CAD-CAM systems. MATERIALS AND METHODS. Total of 40 patients were enrolled in this study, and 9 different zirconia crowns were prepared per patient. Each crown was made through the cross-application of 3 different design software (EZIS VR, 3Shape Dental System, Exocad) with 3 different processing devices (Aegis HM, Trione Z, Motion 2). The marginal gap, absolute marginal discrepancy, internal gap(axial, line angle, occlusal) by a silicone replica technique were measured to compare the fit of the crown. The scanned inner and outer surfaces of the crowns were compared to CAD data using 3D metrology software to evaluate trueness. RESULTS. There were significant differences in the marginal gap, absolute marginal discrepancy, axial and line angle internal gap among the groups (P < .05) in the comparison of fit. There was no statistically significant difference among the groups in terms of occlusal internal gap. The trueness ranged from 36.19 to 43.78 ㎛ but there was no statistically significant difference within the groups (P > .05). CONCLUSION. All 9 groups showed clinically acceptable level of marginal gaps ranging from 74.26 to 112.20 ㎛ in terms of fit comparison. In the comparison of trueness, no significant difference within each group was spotted. Within the limitation of this study, open CAD-CAM systems used in this study can be assembled properly to fabricate zirconia crown.

Keywords

Acknowledgement

This work was supported by the Industrial Strategic Technology Development Program (No. 10062635) and funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea).

References

  1. Beuer F, Schweiger J, Edelhoff D. Digital dentistry: an overview of recent developments for CAD/CAM generated restorations. Br Dent J 2008;204:505-11.  https://doi.org/10.1038/sj.bdj.2008.350
  2. Jang D, Son K, Lee KB. A comparative study of the fitness and trueness of a three-unit fixed dental prosthesis fabricated using two digital workflows. Appl Sci 2019;9:2778. 
  3. Kricheldorf F, Bueno CRS, Amaral WDS, Junior JFS, Filho HN. Analysis of vertical marginal discrepancy in feldspathic porcelain crowns manufactured with different CAD/CAM systems: Closed and open. Eur J Dent 2018;12:123-8.  https://doi.org/10.4103/ejd.ejd_368_17
  4. Alqahtani F. Marginal fit of all-ceramic crowns fabricated using two extraoral CAD/CAM systems in comparison with the conventional technique. Clin Cosmet Investig Dent 2017;9:13-8.  https://doi.org/10.2147/CCIDE.S130856
  5. Hunter AJ, Hunter AR. Gingival margins for crowns: a review and discussion. Part II: Discrepancies and configurations. J Prosthet Dent 1990;64:636-42.  https://doi.org/10.1016/0022-3913(90)90286-L
  6. Valderrama S, Van Roekel N, Andersson M, Goodacre CJ, Munoz CA. A comparison of the marginal and internal adaptation of titanium and gold-platinum-palladium metal ceramic crowns. Int J Prosthodont 1995;8:29-37. 
  7. Felton DA, Kanoy BE, Bayne SC, Wirthman GP. Effect of in vivo crown margin discrepancies on periodontal health. J Prosthet Dent 1991;65:357-64.  https://doi.org/10.1016/0022-3913(91)90225-L
  8. Wang CJ, Millstein PL, Nathanson D. Effects of cement, cement space, marginal design, seating aid materials, and seating force on crown cementation. J Prosthet Dent 1992;67:786-90.  https://doi.org/10.1016/0022-3913(92)90583-V
  9. Piemjai M. Effect of seating force, margin design, and cement on marginal seal and retention of complete metal crowns. Int J Prosthodont 2001;14:412-6. 
  10. Ahn JJ, Bae EB, Lee JJ, Choi JW, Jeon YC, Jeong CM, Yun MJ, Lee SH, Lee KB, Huh JB. Clinical evaluation of the fit of lithium disilicate crowns fabricated with three different CAD/CAM systems. J Prosthet Dent 2022;127:239-47.  https://doi.org/10.1016/j.prosdent.2020.06.031
  11. Bjorn AL, Bjorn H, Grkovic B. Marginal fit of restorations and its relation to periodontal bone level. II. Crowns. Odontol Revy 1970;21:337-46. 
  12. Paffenbarger GC, Beall JR. American dental association specification No. 8 for dental zinc phosphate cement. J American Dent Assoc Dent Cosmos 1937;24:2019-23.  https://doi.org/10.14219/jada.archive.1937.0388
  13. Sorensen SE, Larsen IB, Jorgensen KD. Gingival and alveolar bone reaction to marginal fit of subgingival crown margins. Scand J Dent Res 1986;94:109-14.  https://doi.org/10.1111/j.1600-0722.1986.tb01373.x
  14. McLean JW, von Fraunhofer JA. The estimation of cement film thickness by an in vivo technique. Br Dent J 1971;131:107-11.  https://doi.org/10.1038/sj.bdj.4802708
  15. Kydd WL, Nicholls JI, Harrington G, Freeman M. Marginal leakage of cast gold crowns luted with zinc phosphate cement: an in vivo study. J Prosthet Dent 1996;75:9-13.  https://doi.org/10.1016/S0022-3913(96)90411-4
  16. Schriwer C, Skjold A, Gjerdet NR, Oilo M. Monolithic zirconia dental crowns. Internal fit, margin quality, fracture mode and load at fracture. Dent Mater 2017;33:1012-20.  https://doi.org/10.1016/j.dental.2017.06.009
  17. Tinschert J, Natt G, Hassenpflug S, Spiekermann H. Status of current CAD/CAM technology in dental medicine. Int J Comput Dent 2004;7:25-45. 
  18. Lee KB, Park CW, Kim KH, Kwon TY. Marginal and internal fit of all-ceramic crowns fabricated with two different CAD/CAM systems. Dent Mater J 2008;27:422-6.  https://doi.org/10.4012/dmj.27.422
  19. Zimmermann M, Mehl A, Reich S. New CAD/CAM materials and blocks for chairside procedures. Int J Comput Dent 2013;16:173-81. 
  20. Naveau A, Rignon-Bret C, Wulfman C. Zirconia abutments in the anterior region: A systematic review of mechanical and esthetic outcomes. J Prosthet Dent 2019;121:775-81.  https://doi.org/10.1016/j.prosdent.2018.08.005
  21. Deng Y, Lawn BR, Lloyd IK. Characterization of damage modes in dental ceramic bilayer structures. J Biomed Mater Res 2002;63:137-45.  https://doi.org/10.1002/jbm.10091
  22. Kelly JR, Denry I. Stabilized zirconia as a structural ceramic: an overview. Dent Mater 2008;24:289-98.  https://doi.org/10.1016/j.dental.2007.05.005
  23. Mously HA, Finkelman M, Zandparsa R, Hirayama H. Marginal and internal adaptation of ceramic crown restorations fabricated with CAD/CAM technology and the heat-press technique. J Prosthet Dent 2014;112:249-56.  https://doi.org/10.1016/j.prosdent.2014.03.017
  24. Rodiger M, Heinitz A, Burgers R, Rinke S. Fitting accuracy of zirconia single crowns produced via digital and conventional impressions-a clinical comparative study. Clin Oral Investig 2017;21:579-87.  https://doi.org/10.1007/s00784-016-1924-y
  25. Holmes JR, Bayne SC, Holland GA, Sulik WD. Considerations in measurement of marginal fit. J Prosthet Dent 1989;62:405-8.  https://doi.org/10.1016/0022-3913(89)90170-4
  26. Son K, Yu BY, Yoon TH, Lee KB. Comparative study of the trueness of the inner surface of crowns fabricated from three types of lithium disilicate blocks. Appl Sci 2019;9:1798. 
  27. ISO 12836. Dentistry - Digitizing devices for CAD/CAM systems for indirect dental restorations - Test methods for assessing accuracy. International Standards Organization (ISO); Geneva; Switzerland, 2015. Available at: https://www.iso.org/standard/68414.html 
  28. Bindl A, Mormann WH. Fit of all-ceramic posterior fixed partial denture frameworks in vitro. Int J Periodont Restor Dent 2007;27:567-75. 
  29. Sorensen JA. A standardized method for determination of crown margin fidelity. J Prosthet Dent 1990;64:18-24.  https://doi.org/10.1016/0022-3913(90)90147-5
  30. Rahme HY, Tehini GE, Adib SM, Ardo AS, Rifai KT. In vitro evaluation of the "replica technique" in the measurement of the fit of Procera crowns. J Contemp Dent Pract 2008;9:25-32. 
  31. Pera P, Gilodi S, Bassi F, Carossa S. In vitro marginal adaptation of alumina porcelain ceramic crowns. J Prosthet Dent 1994;72:585-90.  https://doi.org/10.1016/0022-3913(94)90289-5
  32. Koo JY, Lim JH, Cho IH. Marginal fidelities according to the margin types of all ceramic crowns. J Korean Acad Prosthodont 1997;35:445-57. 
  33. Boitelle P, Mawussi B, Tapie L, Fromentin O. A systematic review of CAD/CAM fit restoration evaluations. J Oral Rehabil 2014;41:853-74.  https://doi.org/10.1111/joor.12205
  34. Reich S, Uhlen S, Gozdowski S, Lohbauer U. Measurement of cement thickness under lithium disilicate crowns using an impression material technique. Clin Oral Investig 2011;15:521-6.  https://doi.org/10.1007/s00784-010-0414-x
  35. Ahrberg D, Lauer HC, Ahrberg M, Weigl P. Evaluation of fit and efficiency of CAD/CAM fabricated all-ceramic restorations based on direct and indirect digitalization: a double-blinded, randomized clinical trial. Clin Oral Investig 2016;20:291-300.  https://doi.org/10.1007/s00784-015-1504-6
  36. Pradies G, Zarauz C, Valverde A, Ferreiroa A, Martinez-Rus F. Clinical evaluation comparing the fit of all-ceramic crowns obtained from silicone and digital intraoral impressions based on wavefront sampling technology. J Dent 2015;43:201-8.  https://doi.org/10.1016/j.jdent.2014.12.007
  37. White SN, Yu Z, Kipnis V. Effect of seating force on film thickness of new adhesive luting agents. J Prosthet Dent 1992;68:476-81.  https://doi.org/10.1016/0022-3913(92)90414-6
  38. Lee B, Oh KC, Haam D, Lee JH, Moon HS. Evaluation of the fit of zirconia copings fabricated by direct and indirect digital scanning procedures. J Prosthet Dent 2018;120:225-31.  https://doi.org/10.1016/j.prosdent.2017.08.003
  39. Reich S, Wichmann M, Nkenke E, Proeschel P. Clinical fit of all-ceramic three-unit fixed partial dentures, generated with three different CAD/CAM systems. Eur J Oral Sci 2005;113:174-9.  https://doi.org/10.1111/j.1600-0722.2004.00197.x
  40. Carbajal Mejia JB, Yatani H, Wakabayashi K, Nakamura T. Marginal and internal fit of CAD/CAM crowns fabricated over reverse tapered preparations. J Prosthodont 2019;28:e477-84.  https://doi.org/10.1111/jopr.12715
  41. Bornemann G, Lemelson S, Luthardt R. Innovative method for the analysis of the internal 3D fitting accuracy of Cerec-3 crowns. Int J Comput Dent 2002;5:177-82. 
  42. Wang W, Yu H, Liu Y, Jiang X, Gao B. Trueness analysis of zirconia crowns fabricated with 3-dimensional printing. J Prosthet Dent 2019;121:285-91.  https://doi.org/10.1016/j.prosdent.2018.04.012
  43. Moldovan O, Luthardt RG, Corcodel N, Rudolph H. Three-dimensional fit of CAD/CAM-made zirconia copings. Dent Mater 2011;27:1273-8.  https://doi.org/10.1016/j.dental.2011.09.006
  44. Alghazzawi TF. Advancements in CAD/CAM technology: Options for practical implementation. J Prosthodont Res 2016;60:72-84.  https://doi.org/10.1016/j.jpor.2016.01.003
  45. Kirsch C, Ender A, Attin T, Mehl A. Trueness of four different milling procedures used in dental CAD/CAM systems. Clin Oral Investig 2017;21:551-8.  https://doi.org/10.1007/s00784-016-1916-y
  46. Bosch G, Ender A, Mehl A. A 3-dimensional accuracy analysis of chairside CAD/CAM milling processes. J Prosthet Dent 2014;112:1425-31.  https://doi.org/10.1016/j.prosdent.2014.05.012
  47. Ben-Izhack G, Shely A, Koton O, Meirowitz A, Levartovsky S, Dolev E. (In-vitro comparison between closed versus open CAD/CAM systems) Comparison between closed and open CAD/CAM systems by evaluating the marginal fit of zirconia-reinforced lithium silicate ceramic crowns. Appl Sci 2021;11:4534. 
  48. Kunii J, Hotta Y, Tamaki Y, Ozawa A, Kobayashi Y, Fujishima A, Miyazaki T, Fujiwara T. Effect of sintering on the marginal and internal fit of CAD/CAM-fabricated zirconia frameworks. Dent Mater J 2007;26:820-6.  https://doi.org/10.4012/dmj.26.820
  49. Park JY, Bae SY, Lee JJ, Kim JH, Kim HY, Kim WC. Evaluation of the marginal and internal gaps of three different dental prostheses: comparison of the silicone replica technique and three-dimensional superimposition analysis. J Adv Prosthodont 2017;9:159-69.  https://doi.org/10.4047/jap.2017.9.3.159
  50. Ahn JJ, Bae EB, Lee WS, Cho WT, Huh JB. Comparison of clinical fit of three-unit zirconia fixed prostheses fabricated using chairside and labside CAD/CAM systems. J Dent Sci 2020;15:239-42. https://doi.org/10.1016/j.jds.2020.01.005