Lost-wax or laser sintering? Findings on marginal and internal adaptation of metallic copings

Marginal and internal adaptation are parameters of crucial importance to the success of prosthetic crowns. Automatized process creates an expectative of superior or equivalent results compared to restorations manufactured ​​by conventional lost-wax technique. The purpose of this study was to evaluate the marginal adaptation and internal adaptation (cement space) of metal-ceramic crown copings produced by lost-wax (LW) and direct metal laser sintering (DMLS) techniques. An artificial lower first molar was prepared for a full crown, duplicated in plaster and scanned. Twenty metal-ceramic crown copings were fabricated in cobalt-chromium by the two techniques (n=10). The copings were filled with low viscosity silicone and seated on the prepared tooth, resulting in a replica of the internal space. The pellicle formed was embedded in heavy body silicone, sectioned and captured by means of a stereomicroscope at 50x magnification, according to replica technique (RT). Shapiro-Wilk test followed by Holm-Sidak test were used for statistical analysis (α=.05). Marginal adaptation presented no difference between LW (101.5 ± 41.6) and DMLS (86.3 ± 39.9) groups (p=0.24). Conventional LW technique showed significantly lower occlusal (p<0.008) and axial spaces (p<0.03). Measurements of all regions showed numerically larger adaptation values than that defined during design​​ for DMLS group. Both the LW technique and the DMLS technique are within the clinically acceptable.

Impact of Resin Composite Viscosity and Fill-technique on Internal Gap in Class I Restorations: An OCT Evaluation

SUMMARY The aim of this in vitro study was to quantitatively evaluate the internal gap of resin composites of high-and low-viscosity used in single- and incremental-fill techniques in Class I cavities exposed to thermal cycling (TC) using optical coherence tomography (OCT). Cavities of 4-mm depth and 3-mm diameter were prepared in 36 third molars randomly distributed into four groups, according to viscosity of restorative resin-based composite (high or low viscosity, all from 3M Oral Care) and technique application (bulk or incremental fill) used (n=9): RC, high-viscosity, incremental-fill, resin-based composite (Filtek Z350 XT Universal Restorative); BF, high-viscosity, bulk-fill, resin-based composite (Filtek One Bulk Fill); LRC, low-viscosity, incremental-fill, resin-based composite (Filtek Z350 XT Flowable Universal Restorative); and LBF, low-viscosity, bulk-fill, resin-based composite (Filtek Flowable Restorative). Single Bond Universal Adhesive system (3M Oral Care) was used in all the experimental groups. The incremental-fill technique was used for RC and LRC groups (2-mm increments), and a single-layer technique was used for BF and LBF groups, as recommended by the manufacturer. The internal adaptation of the resin at all dentin walls was evaluated before and after TC (5000 cycles between 5°C and 55°C) using OCT images. Five images of each restored tooth were obtained. Images were analyzed using ImageJ software that measured the entire length of the gaps at the dentin–restoration interface. The length of gaps (μm) was analyzed using two-way repeated measures ANOVA and the Tukey tests (α=0.05). There was a significant interaction between material types and TC (p=0.006), and a significant difference among all material types (p&lt;0.0001), before and after TC (p&lt;0.0001). Increased internal gaps at the dentin–restoration interface were noticed after TC for all groups. RC presented the lowest value of internal gap before and after TC, while LBF showed the highest values of internal gap after TC. In conclusion, TC negatively affected the integrity of internal gap, whereas high-viscosity, incremental-fill, resin-based composite presented better performance in terms of internal adaptation than low-viscosity, bulk-fill materials in Class I cavities.

Effect of Finish Line Design on the Fit Accuracy of CAD/CAM Monolithic Polymer-Infiltrated Ceramic-Network Fixed Dental Prostheses: An In Vitro Study

A polymer-infiltrated ceramic network (PICN) material has recently been introduced for dental use and evidence is developing regarding the fit accuracy of such crowns with different preparation designs. The aim of this in vitro study was to evaluate the precision of fit of machined monolithic PICN single crowns in comparison to lithium disilicate crowns in terms of marginal gap, internal gap, and absolute marginal discrepancies. A secondary aim was to assess the effect of finish line configuration on the fit accuracy of crowns made from the two materials. Two master metal dies were used to create forty stone dies, with twenty each for the two finish lines, shoulder and chamfer. The stone dies were scanned to produce virtual models, on which ceramic crowns were designed and milled, with ten each for the four material–finish line combinations (n = 10). Marginal gaps and absolute marginal discrepancies were evaluated at six pre-determined margin locations, and the internal gap was measured at 60 designated points using a stereomicroscope-based digital image analysis system. The influence of the material and finish line on the marginal and internal adaptation of crowns was assessed by analyzing the data using two-way analysis of variance (ANOVA), non-parametric, and Bonferroni multiple comparison post-hoc tests (α = 0.05). ANOVA revealed that the differences in the marginal gaps and the absolute marginal discrepancies between the two materials were significant (p < 0.05), but that those the finish line effect and the interaction were not significant (p > 0.05). Using the Mann–Whitney U test, the differences in IG for ‘material’ and ‘finish line’ were not found to be significant (p > 0.05). In conclusion, the finish line configuration did not seem to affect the marginal and internal adaptation of PICN and lithium disilicate crowns. The marginal gap of PICN crowns was below the clinically acceptable threshold of 120 µm.

Comparison of Marginal and Internal Adaptation in Endocrowns Milled from Translucent Zirconia and Zirconium Lithium Silicate

Purpose. This study aimed to compare marginal and internal adaptation in endocrowns made from translucent zirconia and zirconium lithium silicate using CAD-CAM technology. Materials and Methods. Twenty-eight freshly extracted upper molars were mounted in acrylic resin and underwent root canal therapy and endocrown preparation up to 2 mm above the cementoenamel junction. Endocrowns were CAD-CAM milled from zirconium lithium silicate (ZLS) and translucent zirconia (Zr). Internal and marginal adaptation was assessed by the replica technique before cementation. Marginal adaptation was evaluated by a stereomicroscope (×32) before and after cementation and also after thermomechanical aging. Results. The ZLS group showed significantly higher internal adaptation compared to the Zr group ( P = 0.028), while the marginal adaptation differences, at different times with different methods, were not statistically significant ( P > 0.05). Axiomarginal angle had the highest and axiopulpal angle showed the lowest adaptation in both groups. The cementation process and thermomechanical aging increased the marginal gap in both groups significantly ( P < 0.001). The marginal gap assessed by the replica technique before cementation was 7.11 µm higher than direct view under a stereomicroscope with intraclass correlation coefficient of 0.797. Conclusion. Zirconia seems to be an acceptable material for endocrown with comparable internal and marginal adaptation to ZLS. Cementation and thermomechanical aging had significantly negative effects on marginal gap. The marginal gap assessed by the replica technique was higher than direct view under the stereomicroscope technique.

Accuracy in marginal and/or internal adaptation of full-coverage fixed prostheses made with digital versus conventional impressions: an overview of systematic reviews and meta-analysis

Review question / Objective: Is the accuracy (marginal adaptation and / or internal adaptation) of fixed full coverage prostheses made with digital impressions better than conventional impressions? Eligibility criteria: Inclusion criteria• Systematic reviews and / or meta-analyzes that evaluated the precision (marginal adaptation and / or internal adaptation) of full coverage fixed prostheses on natural teeth in clinical studies and on tooth replicas in in vitro studies.• Systematic reviews and / or meta-analyzes comparing digital impressions with an intraoral scanner versus conventional impressions taken with any impression material.• Systematic reviews and / or meta-analyzes of randomized clinical trials (RCTs), prospective comparative and in vitro and non-randomized clinical trials.Exclusion criteria:• Systematic literature reviews, case reports, pilot studies• Studies evaluating the seating of crowns on implants and partial restorations• Studies with no response from the author to the requested information query.