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 x100-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 (alpha = 0.05). The mean VMDs on premolar ranged between 44 and 55 microm (median: 43-55 microm) in 3DL, and 74 and 100 microm (median: 72-93 microm) in CBCT; and on the molar, between 47 and 114 microm (median: 46-114 microm) in 3DL, and 91 and 162 microm (median: 93-156 microm) 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.