Comparison of the Accuracy of Fit of Metal, Zirconia, and Lithium Disilicate Crowns Made from Different Manufacturing Techniques.

Abstract

To evaluate the accuracy of fit of metal, lithium disilicate, and zirconia crowns, which were produced using different manufacturing techniques. Ten patients in need of a molar crown were recruited. Eight crowns were fabricated for each patient: 2 zirconia, 3 lithium disilicate (e.max), and 3 metal-ceramic crowns using conventional, conventional/digital, and digital techniques. Marginal, axial, and occlusal gaps were measured using a replica technique. Replicas were sectioned mesiodistally and buccolingually and were observed under a stereomicroscope. A total of 32 measurements for each crown replica at 3 different points (12 marginal, 12 axial, and 8 occlusal) were performed. Statistical analysis was performed using two-way ANOVA and Tukey HSD tests. Marginal means ranged from 116.39 ± 32.76 µm for the conventional metal-ceramic group to 147.56 ± 31.56 µm for the digital e.max group. The smallest axial gap was recorded for the digital zirconia group (76.19 ± 23.94 µm), while the largest axial gap was recorded for the conventional e.max (101.80 ± 19.81 µm) and conventional/digital metal-ceramic groups (101.80 ± 35.31 µm). The conventional e.max crowns had the smallest occlusal mean gap (185.59 ± 59.09 µm), while the digital e.max group had the largest occlusal mean gap (295.38 ± 67.80 µm). Type of crown had no significant effect on marginal (p = 0.07, f = 2.71), axial (p = 0.75, f = 0.29), or occlusal fit (p = 0.099, f = 2.4), while fabrication method had a significant effect on axial gap only (p = 0.169, f = 1.82, p = 0.003, f = 6.21, and p = 0.144, f = 2 for marginal, axial, and occlusal fit, respectively). Digital fabrication produced significantly smaller axial gaps than the conventional method (p = 0.02), and the conventional digital method (p = 0.005). The type of crown and method of manufacturing had no effect on the marginal and occlusal gap of single posterior crown, while the method of manufacturing had a significant effect on the axial gap. The digital method produced the smallest axial fit in comparison with the other methods, while the type of crown had no effect on the axial gap.