Influence of Conventional, CAD-CAM, and 3D Printing Fabrication Techniques on the Marginal Integrity and Surface Roughness and Wear of Interim Crowns

The aim is to assess the influence of fabrication techniques—conventional (CN), CAD-CAM (CC), and 3D printing (3D)—on the marginal fit, adaptation, surface roughness, and wear of interim restorations of crowns. Thirty interim crowns were fabricated using CN, CC, and 3D techniques. Sixty discs were fabricated to evaluate surface wear and surface roughness properties, with 10 disc samples in each group (n = 10). Internal adaptation and marginal integrity of interim crowns were analyzed with micro CT to detect microgaps at selected points. Average surface micro-roughness (Ra) was calculated in micrometers (μm) using an optical non-contact surface microscope under cyclic loading. Surface wear was evaluated by surface area measurements (mm3) using a micro CT. Analysis of variance (ANOVA) and Tukey’s post hoc comparison tests with Pearson correlation were performed for data analysis. The highest adaptation means were for CN (269.94 ± 64 μm), and the lowest mean value was observed for 3D (197.82 ± 11.72 μm) crowns. CN and CC specimens showed comparable adaptation (p > 0.05), which were significantly higher (p < 0.05) than 3D crowns. CN crowns showed significantly higher marginal misfit compared to 3D (p < 0.05) and CC (p < 0.05) crowns. The highest mean surface roughness was observed in the 3D crowns (5.61 ± 0.33 µm), whereas the lowest was found in CC crowns (3.28 ± 0.34 µm). Better restoration Ra was observed using the CC method followed by CN. CN had the highest wear (17.79 ± 2.78 mm3), and the lowest wear was observed in the 3D (10.81 ± 2.00 mm3) specimen. Low surface wear was observed using 3D printing, followed by CN and CC techniques. The printed specimen showed comparable outcomes to CAD-CAM restoration; however, they were better than CN restoration. A positive correlation between adaptation and surface roughness was observed, indicating an effect of the fabrication technique on material physical property.

Comparative evaluation on clinical success rate of prefabricated zirconia crowns and stainless steel crowns in primary molars

To compare the clinical success rate of Prefabricated Zirconia crowns and stainless steel crowns on primary molars: It is an in-vivo study which was performed on 52 pulpally treated primary molars of children aged 4–9 years were randomly divided into two equal groups of stainless steel crown and Prefabricated Zirconia crowns. Tooth preparation was done according to the manufacturer’s recommendations and crowns were cemented. All crowns were cemented with Type I Glass ionomer cement (GIC) luting cement. Crowns were evaluated clinically for its crown retention, marginal integrity and gingival health at 3 months and 6 months.: Clinical success for stainless steel crowns and Prefabricated Zirconia crowns towards crown retention and marginal integrity were similar with no statistical difference between them. All Prefabricated Zirconia crowns showed healthy gingiva whereas 53.8% (14 out of 26) Stainless Steel crowns showed mild gingival inflammation at 3 and 6 months which was statistically significant (P ≤0.01). Both prefabricated zirconia and stainless steel crowns showed no statistical difference for crown retention and marginal integrity throughout the study. Gingival health was significantly higher for Prefabricated Zirconia crowns compared with stainless steel crowns. Therefore clinical success rate for Prefabricated Zirconia crowns were better when compared to stainless steel crowns. So Prefabricated Zirconia crowns can be considered as an esthetic alternative in future.

Effect of Heat Softening versus Ultrasonic Removal of Root-End Gutta-Percha on the Quality of Root-End Preparation for Endodontic Microsurgery

This study is aimed at comparing the efficacy of heat softening and ultrasonic removal of root-end gutta-percha during retrograde preparation for root apical microsurgery. Recently extracted single-rooted premolars ( n = 40 ) were prepared with standardized endodontically treated and root-end resection and then randomly divided into four groups that received root-end cavity preparation using four different instruments: a diamond-coated ultrasonic tip (AS3D; SACTEON, Paris, France), AS3D with the modified plugger of cordless heat carrier (MSE; B&L Biotech, Bala Cynwyd, PA, USA), stainless steel ultrasonic tip (Jetip-2; B&L Biotech, Bala Cynwyd, PA, USA), or Jetip-2 with MSE. The time required for root-end preparation was recorded. The root apex samples were examined by scanning electron microscopy to assess root surface microcracks and marginal integrity. The remnants of gutta-percha on the cavity walls were evaluated using a stereomicroscope. Statistical analysis was performed using Student’s t -test and Wilcoxon rank-sum test ( P < 0.05 ). Usage of MSE with Jetip-2 significantly reduced preparation time from 99.8 ± 6.8 s to 32.4 ± 1.0 s ( P = 0.009 ), the number of microcracks from 42 to 13 ( P = 0.036 ), and the remnants of gutta-percha from 80% to 20% ( P = 0.041 ). Similar results were observed for AS3D with MSE. The heat softening of MSE was effective in cleaning gutta-percha, thus greatly improving the efficiency of the root-end preparation, thereby producing a root-end cavity with fewer microcracks and better marginal integrity.

One Year Clinical Evaluation of Milled BioHPP Polyetheretherketone (PEEK)-Based versus Metal Ceramic Single Crowns (Randomized Controlled Clinical Trial)

Objective: To evaluate the clinical behavior of milled BioHPP PEEK copings veneered with Visio.lign composite resin in comparison with metal copings veneered with feldspathic porcelain as single posterior crowns. Material and Methods: Twenty Four full coverage posterior crowns were fabricated for endodontically treated molars divided into 2 groups according to the material used. Twelve milled BioHPP PEEK-based crowns (Group 1) and Twelve Porcelain Fused to Metal (PFM) crowns (Group 2). The preparations were standardized with an equi-gingival, deep chamfer finish line for all teeth. BioHPP PEEK and metal copings were fabricated by CAD/CAM technology and lost wax technique respectively. These coping were veneered according to manufactures instructions either by special composite resin or low fusing glass ceramic respectively. The restorations were cemented then clinical evaluation of these crowns was assessed regarding mechanical failure, marginal integrity and patient satisfaction every two months for one year. Results: Although two PEEK crowns were fractured, both PEEK and PFM crowns showed similar fracture (mechanical failure) and marginal integrity without significant difference (P > 0.05). BioHPP PEEK-based crowns showed statistically significantly lower patient satisfaction than PFM crowns after six months (P-value = 0.013, Effect size = 1.157) but all the patients were generally satisfied. Conclusion: BioHPP PEEK-based crowns showed clinically similar and accepted mechanical behavior and marginal integrity but less patient’s satisfaction than PFM crowns after six months. So BioHPP PEEK-based crowns may be used as an alternative tooth-colored metal-free fixed restoration for one year. Keywords BioHPP; Metal ceramic; Patient satisfaction; PEEK; PFM.

Marginal Integrity of CAD/CAM Ceramic Crowns Using Two Different Finish Line Designs

Statement of problem- Research on evaluation of crowns made by the latest CAD/CAM systems for their marginal adaptation is scarce. Purpose- The purpose of this in vitro study was to evaluate the marginal integrity of crowns fabricated by the latest Chairside Economical Restorations of Esthetic Ceramic (CEREC) system using two different finish line preparation designs: Chamfer and Shoulder. Material and methods- Typhodont teeth were equally divided into two groups, group A and B. The teeth were prepared for full coverage crowns with a shoulder (group A) and chamfer finish line design (group B). An experienced prosthodontist prepared all crown preparations. Evaluation of six sites per sample was completed by two calibrated, experienced prosthodontists using the modified United States Public Health Services (USPHS) criteria. The descriptive statistics and Z-test were used to evaluate the results. Results- A total of 180 teeth were included in the study (90 teeth in each group). Only two crowns in group A and one crown in group B were clinically unacceptable. There was no statistical significance (p=0.282) between the two groups regarding finish-line design. Conclusions- CEREC system provides clinically acceptable crowns and can safely be utilized in dental treatment. Therefore, Contemporary Dental Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) restorations should be considered as a safe treatment modality by dental professionals.