Marginal Adaptation and Fracture Resistance of 3D Printed and CAD/CAM Milled Definitive Resin Matrix Ceramic Crowns.

Abstract

To evaluate and compare the marginal adaptation and fracture resistance of resin matrix ceramic crowns fabricated using 3-dimensional (3D) printing and computer aided design/computer aided manufacturing (CAD/CAM) milling technology. Thirty extracted human maxillary first premolars were prepared to receive crown restorations and grouped into 3 groups according to 3 different crown materials (n = 10): VE: teeth restored with milled Vita Enamic, CS: teeth restored with milled Cerasmart 270 and VSC: teeth restored with 3D-printed VarseoSmile Crown Plus. Marginal analysis was performed with the aid of a digital microscope at (230x) magnification, both before and after cementation with self-adhesive resin cement and analyzed with Image J analysis software. The fracture loads for each sample were then recorded using a universal testing machine in a single load-to-failure test up until the crowns failed. The lowest marginal gap values were recorded for VSC before (8.03 μm) and after (15.07 μm) cementation with significant difference compared to the other crown materials (p <0.05), while the differences between the milled groups were non-significant both before, (CS (11.35 μm) and VE (11.86 μm)), and after cementation, (CS (20.01 μm) and VE (21.08 μm)). In terms of fracture resistance, VE recorded significantly lower fracture load values (727.8 N) (p <0.05) than the crowns fabricated from CS (1213.8 N) and VSC (1181.5 N), which showed no statistically significant differences between each other. 3D printed definitive crowns outperformed CAD/CAM milled crowns in terms of marginal adaptation, along with comparable fracture resistance values.