Comparison of marginal and internal fit of 3-unit ceramic fixed dental prostheses made with either a conventional or digital impression.

STATEMENT OF PROBLEM: For 20 years, the intraoral digital impression technique has been applied to the fabrication of computer aided design and computer aided manufacturing (CAD-CAM) fixed dental prostheses (FDPs). Clinical fit is one of the main determinants of the success of an FDP. Studies of the clinical fit of 3-unit ceramic FDPs made by means of a conventional impression versus a digital impression technology are limited. PURPOSE: The purpose of this in vitro study was to evaluate and compare the internal fit and marginal fit of CAD-CAM, 3-unit ceramic FDP frameworks fabricated from an intraoral digital impression and a conventional impression. MATERIAL AND METHODS: A standard model was designed for a prepared maxillary left canine and second premolar and missing first premolar. The model was scanned with an intraoral digital scanner, exporting stereolithography (STL) files as the experimental group (digital group). The model was used to fabricate 10 stone casts that were scanned with an extraoral scanner, exporting STL files to a computer connected to the scanner as the control group (conventional group). The STL files were used to produce zirconia FDP frameworks with CAD-CAM. These frameworks were seated on the standard model and evaluated for marginal and internal fit. Each framework was segmented into 4 sections per abutment teeth, resulting in 8 sections per framework, and was observed using optical microscopy with x50 magnification. Four measurement points were selected on each section as marginal discrepancy (P1), mid-axial wall (P2), axio-occusal edge (P3), and central-occlusal point (P4). RESULTS: Mean marginal fit values of the digital group (64 +/-16 mum) were significantly smaller than those of the conventional group (76 +/-18 mum) (P<.05). The mean internal fit values of the digital group (111 +/-34 mum) were significantly smaller than those of the conventional group (132 +/-44 mum) (P<.05). CONCLUSIONS: CAD-CAM 3-unit zirconia FDP frameworks fabricated from intraoral digital and conventional impressions showed clinically acceptable marginal and internal fit. The marginal and internal fit of frameworks fabricated from the intraoral digital impression system were better than those fabricated from conventional impressions.