Marginal Adaptation of Provisional CAD/CAM Restorations Fabricated Using Various Simulated Digital Cement Space Settings.

Abstract

The ideal digital cement space value for the fabrication of provisional computer-aided design/computer-aided manufacturing (CAD/CAM) crowns with clinically acceptable marginal adaptation is not well known. The aim of this study was to evaluate the effect of different simulated cement space settings on the marginal fit of poly(methyl methacrylate) (PMMA) provisional CAD/CAM restorations. An extracted premolar tooth was prepared using ceramic crown preparation guidelines and represented both natural teeth and/or custom implant abutments. The prepared tooth abutment was scanned with a three-dimensional (3D) laboratory scanner (D900, 3Shape). CAD design software was used to subsequently design a premolar crown core with three different simulated cement space settings (20 to 40 μm, 20 to 50 μm, 20 to 60 μm). PMMA blocks were used to mill the specimens (n = 9, N = 27). Using a stereo zoom microscope, a total of 36 images for each of the 3 groups (9 crowns per group, 4 sites per crown) were captured to measure the mean vertical marginal discrepancy for every group. One-way analysis of variance (ANOVA) was used to analyze the data, and the post hoc Tukey multiple comparison test was performed. The marginal gap values of the PMMA cores fabricated using the three cement space settings were significantly different from each other (P < .001). The marginal gap was smaller with a 20- to 60-μm setting compared with 20 to 50 μm and 20 to 40 μm, and the 20- to 50-μm setting allowed for smaller marginal gaps compared with 20 to 40 μm (P < .001). Within the limitations of this study, the marginal gaps of CAD/CAM-fabricated PMMA cores were smaller when the cement space was larger. The smallest marginal gaps were achieved when a 20- to 60-μm cement space was used (P < .001).