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The aim of this in vitro study was to compare the quality of digital workflows generated by different scanners (Intra-oral digital scanners (I.O.S.s)) focusing on marginal fit analysis. A customized chrome-cobalt (Cr-Co) implant abutment simulating a maxillary right first molar was fixed in hemi-maxillary stone model and scanned by eight different I.O.S.s: Omnicam ® (Denstply Sirona, Verona, Italy) CS3500 ® , CS3600 ® , (Carestream Dental, Atlanta, GA, USA), True Definition Scanner ® (3M, St. Paul, MN, USA), DWIO ® (Dental Wings, Montreal, Quebec, Canada), PlanScan ® (Planmeca Oy, Helsinki, Finland), 3D PROGRESS Plus ® (MHT, Verona, Italy), TRIOS 3 ® (3Shape, Copenhagen, Denmark). Nine scans were performed by each tested I.O.S. and 72 copings were designed using a dental computer-assisted-design/computer-assisted-manufacturing (CAD/CAM) software (exocad GmbH, Darmstadt, Germany). According to CAD data, zirconium dioxide (ZrO₂) copings were digitally milled (Roland DWX-50, Irvine, CA, USA). Scanning electron microscope (SEM) direct vision allowed for marginal gap measurements in eight points for each specimen. Descriptive analysis was performed using mean, standard deviation, and median, while the Kruskal⁻Wallis test was performed to determine whether the marginal discrepancies were significantly different between each group (significance level p < 0.05). The overall mean marginal gap value and standard deviation were 53.45 ± 30.52 μm. The minimum mean value (40.04 ± 18.90 μm) was recorded by PlanScan ® , then 3D PROGRESS Plus ® (40.20 ± 21.91 μm), True Definition Scanner ® (40.82 ± 26.19 μm), CS3500 ® (54.82 ± 28.86 μm) CS3600 ® (59,67 ± 28.72 μm), Omnicam ® (61.57 ± 38.59 μm), DWIO ® (62.49 ± 31.54 μm), while the maximum mean value (67.95 ± 30.41 μm) was recorded by TRIOS 3 ® . The Kruskal⁻Wallis tests revealed a statistically significant difference ( p -value < 0.5) in the mean marginal gaps between copings produced by 3D PROGRESS Plus ® , PlanScan, True Definition Scanner, and the other evaluated I.O.S.s. The use of an I.O.S. for digital impressions may be a viable alternative to analog techniques. Although in this in vitro study PlanScan ® , 3D PROGRESS Plus ® and True Definition Scanner ® may have showed the best performances, all I.O.S.s tested could provide clinically encouraging results especially in terms of marginal accuracy, since mean marginal gap values were all within the clinically acceptable threshold of 120 μm.

This study aimed to compare the vertical marginal gap of teeth restored with lithium disilicate crowns fabricated using CAD/CAM or by pressed ceramic approach. Twenty mandibular third molar teeth were collected after surgical extractions and prepared to receive full veneer crowns. Teeth were optically scanned and lithium disilicate blocks were used to fabricate crowns using CAD/CAM technique. Polyvinyl siloxane impressions of the prepared teeth were made and monolithic pressed lithium disilicate crowns were fabricated. The marginal gap was measured using optical microscope at 200× magnification (Keyence VHX-5000, Japan). Statistical analysis was performed using Wilcoxon test. The lithium disilicate pressed crowns had significantly smaller (p = 0.006) marginal gaps (38 ± 12 μm) than the lithium disilicate CAD/CAM crowns (45 ± 12 μm). This research indicates that lithium disilicate crowns fabricated with the press technique have measurably smaller marginal gaps compared with those fabricated with CAD/CAM technique within in vitro environments. The marginal gaps achieved by the crowns across all groups were within a clinically acceptable range.

Statement of Problem: The marginal and internal discrepancies of computer-aided design and computer-aided manufacturing (CAD-CAM) endocrowns are unknown., Purpose: The purpose of this in vitro study was to evaluate the marginal and internal discrepancies of endocrowns with different cavity depths by measuring them with microcomputed tomography (μCT)., Material and Methods: Endocrowns (n=48) of 2 different cavity depths (2 mm and 4 mm) were fabricated in 2 different chairside CAD-CAM systems (CEREC AC and E4D). A μCT scan was made before and after cementation. For analysis of the marginal and internal discrepancies, reference points were selected in 2-dimensional views of 3 buccolingual cross-sections and 3 mesiodistal cross-sections. To calculate the total discrepancy volume, the μCT sections were reconstructed 3-dimensional views, and changes in volume and surface area were examined. Statistical analysis was performed using 2-way ANOVA with Bonferroni correction (α=.05)., Results: An endocrown with a 4-mm cavity showed a larger marginal and internal volume than one with a 2-mm cavity. Cementation did not show significant differences in total discrepancy thickness. Discrepancies on the pulpal floor were largest in other sites. Both chairside CAD-CAM systems showed similar discrepancy in the endocrowns., Conclusions: Based on the present study, marginal and internal discrepancies increased depending on cavity depth. Cementation did not increase the dimension of the discrepancy between the restoration and the cavity wall. The discrepancy on the pulpal floor appeared to affect these results., (Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Objective: This study investigated the marginal and internal adaptation of individual dental crowns fabricated using a CAD/CAM system (Sirona's BlueCam), also evaluating the effect of the software version used, and the specific parameter settings in the adaptation of crowns., Material and Methods: Forty digital impressions of a master model previously prepared were acquired using an intraoral scanner and divided into four groups based on the software version and on the spacer settings used. The versions 3.8 and 4.2 of the software were used, and the spacer parameter was set at either 40 μm or 80 μm. The marginal and internal fit of the crowns were measured using the replica technique, which uses a low viscosity silicone material that simulates the thickness of the cement layer. The data were analyzed using a Friedman two-way analysis of variance (ANOVA) and paired t-tests with significance level set at p<0.05., Results: The two-way ANOVA analysis showed the software version (p<0.05) and the spacer parameter (p<0.05) significantly affected the crown adaptation. The crowns designed with the version 4.2 of the software showed a better fit than those designed with the version 3.8, particularly in the axial wall and in the inner margin. The spacer parameter was more accurately represented in the version 4.2 of the software than in the version 3.8. In addition, the use of the version 4.2 of the software combined with the spacer parameter set at 80 μm showed the least variation. On the other hand, the outer margin was not affected by the variables., Conclusion: Compared to the version 3.8 of the software, the version 4.2 can be recommended for the fabrication of well-fitting crown restorations, and for the appropriate regulation of the spacer parameter.

Statement of Problem: Prosthetic crown fit to the walls of the tooth preparation may vary depending on the material used for crown fabrication., Purpose: The purpose of this study was to compare the marginal and internal fit of crown copings fabricated from 3 different materials., Material and Methods: The selected materials were zirconia (ZirkonZahn system, group Y-TZP), lithium disilicate (IPS e.max Press system, group LSZ), and nickel-chromium alloy (lost-wax casting, group NiCr). Five specimens of each material were seated on standard dies. An x-ray microtomography (micro-CT) device was used to obtain volumetric reconstructions of each specimen. Points for fit measurement were located in Adobe Photoshop, and measurements were obtained in the CTAn SkyScan software environment. Marginal fit was measured at 4 points and internal fit at 9 points in each coping. Mean measurements from the 3 groups were compared by analysis of variance (ANOVA) at the 5% significance level, and between-group differences were assessed with the Tukey range test., Results: The nickel-chromium alloy exhibited the best marginal fit overall, comparable with zirconia and significantly different from lithium disilicate. Lithium disilicate exhibited the lowest mean values for internal fit, similar to zirconia and significantly different from the nickel-chrome alloy., Conclusions: The marginal and internal fit parameters of the 3 tested materials were within clinically acceptable range., (Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: To review methods used to investigate marginal adaptation of crowns and fixed dental prostheses (FDPs), and to discuss testing variables employed and their influence on results., Methods: Online libraries including PubMed, Scopus, and Ovid were searched for articles evaluating the marginal adaptation of crowns and FDPs using a combination of the keywords: "marginal accuracy," "marginal fit," "marginal gap," "marginal discrepancy," "fitting accuracy," "crown," and "FPD." Peer-reviewed publications in English in the period 1970 to December 2011 were collected, evaluated by their abstract, and included if they met the inclusion criteria. The criteria involved studies evaluating marginal adaptation of crowns and FDPs through clear experimental protocols. Exclusion criteria involved longitudinal prospective and retrospective clinical evaluations, studies using subjective tactile sensation, and other predefined criteria., Results: A total of 277 papers were identified; only 183 met the inclusion criteria. Direct view technique was used by 47.5% of the articles followed by cross-sectioning (23.5%), and impression replica (20.2%) techniques. The marginal gap values reported by these techniques varied among individual crown systems and across different systems because of variations in study type (in vivo vs. in vitro), sample size and measurements per specimen, finish line design, and stage at which the marginal gap was measured., Conclusion: There was a substantial lack of consensus relating to marginal adaptation of various crown systems due to differences in testing methods and experimental protocols employed. Direct view technique was the most commonly used method of reproducible results. Also, conducting an experimental set-up of testing a minimum of 30 specimens at 50 measurements per specimen should produce reliable results. Additionally, using a combination of two measurement methods can be useful in verification of results., (© 2012 by the American College of Prosthodontists.)

Purpose: Marginal and internal gaps of NobelProcera crown zirconia were clinically evaluated using silicone materials., Materials and Methods: Ninety-one crowns were examined before final cementation, and white and black silicone materials were used to record the marginal and internal fit. The silicone materials were sectioned bucco-lingually and mesio-distally, and the thickness of the silicone layers was measured using a microscope. Sixteen reference points were measured on each specimen, and mean marginal and internal gaps were obtained. Mean marginal gaps among anterior, premolar, and molar tooth groups, in addition to mean gaps at the reference points within the groups, were compared using two-way ANOVA and Games-Howell analysis., Results: The marginal mean values were the smallest among all tooth groups, and the largest were at the rounded shoulders. There were no significant differences in the mean marginal gaps among the three tooth groups, while there were significant differences in the mean marginal and internal gaps of each tooth group., Conclusions: The mean marginal gap of the NobelProcera crown zirconia was 44.2 μm, which is within clinically accepted standards., (Copyright © 2010 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.)

Purpose: The aim of this in vitro study was to compare the marginal adaptation of a pressed ceramic material, when used with and without a metal substructure, to a traditional feldspathic porcelain-fused-to-metal restoration with a porcelain butt margin., Materials and Methods: A maxillary central incisor typodont tooth was prepared with a 1.5 mm 360 degrees shoulder with rounded internal line angle, and 30 polyether impressions were made. Dies were poured in type IV dental stone, and 30 restorations were fabricated: 10 metal ceramic restorations (MCR) with porcelain butt joints, 10 pressed to metal restorations (PTM), and 10 all-ceramic restorations (PCR). All restorations were evaluated on their respective dies at 45x magnification using an Olympus SZX-12, measurements of the marginal openings were made, and ANOVA and Scheffé post hoc tests were used to evaluate the data., Results: The mean marginal opening was 72.2 +/- 5.9 microm for MCR, 49.0 +/- 5.9 microm for PTM, and 55.8 +/- 5.9 microm for PCR. The post hoc tests showed that there was a statistical difference between the marginal adaptation of the PTM and MCR groups (p < 0.05). There was no significant difference in marginal adaptation between the PTM and the PCR groups, or the PCR and the MCR groups., Conclusions: The PTM group demonstrated a smaller mean marginal opening than the MCR group. The mean marginal openings of all three groups were within a clinically acceptable range.

The success of a crown greatly relies on its margin. An ill-fitted crown with an open margin will be susceptible to leakage and recurrent decay. If it remains undetected, it will eventually cause serious problems. This report looks at the finish line consistency of 73 "clinically acceptable" impressions made by dental students and working casts poured in the laboratory section. Findings show a number of possible inaccuracies in preparations, impressions, or a combination of both.

Statement of Problem: Fabricating a feldspathic porcelain margin on a metal-ceramic restoration with a clinically acceptable marginal fit has proven to be a technique-sensitive procedure. Pressable ceramics are advocated to solve this problem., Purpose: The purpose of this in vitro study was to compare the marginal adaptation of a pressable ceramic system when used with both all-ceramic and metal-ceramic crowns, with a traditional metal-ceramic restoration., Material and Methods: A 1.5-mm, 360-degree chamfer margin was prepared on a typodont maxillary central incisor. Polyether impressions were made and poured in a Type IV dental stone, and the following crowns were fabricated on individual dies: 15 metal ceramic restorations (MCR) (Ceramco II, Ceramco, and Argelite 60), 15 pressed-to-metal restorations (PTM) (CPC-MK, and Argelite 60), and 15 pressed ceramic restorations (PCR) (CPC-MK). The marginal fit of the crowns was evaluated every 90 degrees around the crown margin circumference under a microscope at original magnification x 45. A 1-way analysis of variance (ANOVA) was used to compare data (alpha=.05)., Results: The mean marginal discrepancy for MCRs was 94 +/- 41 microm, for PTMs, 88 +/- 29 microm, and for PCRs, 81 +/- 25 microm. The 1-way ANOVA showed no significant difference between groups ( P =.568)., Conclusion: The marginal fit of pressed-to-metal (PTMs) and pressed all-ceramic crowns (PCRs) was similar to that of traditional metal-ceramic crowns (MCRs).

Statement of Problem: One of the most important criteria for the clinical acceptability and longevity of cast restorations is marginal adaptation. However, there is limited information on the accuracy of commonly practiced evaluation techniques., Purpose: This study assessed the effect of preparation design on marginal adaptation. In addition, sensitivity and specificity of clinical evaluations of marginal adaptations of cast restorations were assessed and compared to stereomicroscopy., Material and Methods: Three Ivorine molar teeth of differing designs were prepared: (1) a complete crown preparation with a chamfer finish line, (2) a complete crown preparation with a buccal shoulder and beveled finish line, and (3) a three-quarter crown preparation with proximal boxes and beveled finish line. Twenty-four castings (n = 8) were prepared (Ney technique casting metal). Twelve circumferential sites were identified for examination on each casting using a stereomicroscope, which was interpreted using software (Bioquant 98). The clinical examinations included explorer examination to detect marginal gap by tactile feel, followed by examination with a disclosing media (GC FitChecker). Chi-square tests of independence were used to evaluate the effect of preparation design and compare agreement between examination methods for detection of marginal gap size of greater than or equal to 30 microm (alpha=.05)., Results: The overall marginal adaptation of preparation designs was not significantly different. Results of explorer examination at 30-microm sensitivity and specificity were 46% and 97%, respectively. Similar values for disclosing media at 30 microm were 12% sensitivity and 97% specificity. The overall percent agreement with the stereomicroscope using the explorer was 58.3%, with 23.6% correct acceptance rate and 34.7% correct rejection rate. With respect to detection of marginal fit, the combination of disclosing material with explorer data did not yield significantly improved results (59.4%), as compared to explorer alone. A receiver operator characteristic curve yielded satisfactory sensitivity (0.8) and specificity (0.9) at a gap size value of 124 microm., Conclusion: Within the limitations of this study, the preparation design did not significantly affect the marginal adaptation. Clinical detection, with similar sensitivity and specificity as the stereomicroscope, occurred at marginal openings greater than or equal to 124 microm. Therefore, commonly used clinical evaluation techniques using an explorer and disclosing media may be inadequate for assessments of marginal accuracy.

The in vitro marginal fit of three all-ceramic crown systems (In-Ceram, Procera, and IPS Empress) was compared. All crown systems were significantly different from each other at P = 0.05. In-Ceram exhibited the greatest marginal discrepancy (161 microns), followed by Procera (83 microns), and IPS Empress (63 microns). There were no significant differences among the various stages of the crown fabrication: core fabrication, porcelain veneering, and glazing. The facial and lingual margins exhibited significantly larger marginal discrepancies than the mesial and distal margins.