Marginal Adaptation of Cerec 3 CAD/CAM Composite Crowns Using Two Different Finish Line Preparation Designs

Abstract

The purpose of this study was to compare marginal discrepancies of Cerec 3 CAD/CAM composite crowns, fabricated on human prepared teeth with two different finish line designs, chamfer and shoulder. Sixteen human molar teeth were used to prepare full crowns. Eight teeth were prepared with a 1-mm-wide chamfer finish line and the other eight with a 1.2- to 1.5-mm circumferential shoulder. Cerec 3 crowns were fabricated from optical impressions using Paradigm MZ100 composite polymer. Marginal adaptation was evaluated in two ways: (1) using modified United States Public Health Service (USPHS) criteria to evaluate eight preselected sites on each crown margin, and (2) using scanning electron microscopy (SEM) to measure marginal gaps on all four axial walls with 15 measurements on each wall (60 measurements per crown). An evaluation of the number of acceptable crowns, determined by having all measured sites per tooth with margin gap size less than 100 microm, as a function of finish line design was also conducted. In both chamfer and shoulder groups, there were only two crowns (out of eight) with clinically acceptable ratings for all eight measurement sites according to USPHS criteria. Fisher's chi-square analysis showed that there was no statistically significant difference in marginal adaptability as a function of finish line design ( p>0.05). With SEM imaging, overall mean marginal gaps for the chamfer group were 65.9+/-38.7 microm (range 35.0 to 130.0 microm), and for the shoulder group were 46.0+/-9.2 microm (range 26.3 to 55.6 microm); this difference was not found to be statistically significant ( p>0.05). While crown assessment based on mean marginal discrepancy measurements indicated that both the chamfer and shoulder groups were considered clinically acceptable (<100 microm); crown acceptability based on all measurement sites being less than 100 mum indicated that in the chamfer and shoulder groups there were four and three acceptable crowns out of eight, respectively. The Fisher's chi-square test indicated no statistically significant difference between the groups ( p>0.05). An agreement rate of 81.2% was calculated between the two evaluation methods, modified USPHS criteria and SEM measurements. Based on mean marginal discrepancy measurements, the typical marginal assessment technique, Cerec 3 Paradigm MZ100 crown restorations appear to have acceptable marginal adaptability (mean discrepancies <100 microm). Thus, the evidence from this investigation would suggest that the finish line preparation design had no effect on marginal adaptation for Cerec 3 composite crowns.