Marginal and internal fit and fracture resistance of three-unit provisional restorations fabricated by additive, subtractive, and conventional methods.

Abstract

To compare the marginal and internal fit and fracture resistance of three-unit provisional fixed dental prostheses (FDPs) fabricated by additive, subtractive, and conventional methods. Eighty 3-unit FDPs were fabricated on metal dies of the maxillary right second premolar and second molar by four different techniques (n = 20): The direct method by using autopolymerizing polymethyl methacrylate (PMMA), indirect method by the compression molding technique, subtractive manufacturing by using PMMA blocks, and additive manufacturing by using digital light processing technology. The adaptation of restorations at the marginal, axial, cuspal, and fossa areas was assessed by using the silicone replica technique. After thermocycling and cyclic loading, the fracture resistance was measured by a universal testing machine. Data were analyzed by atwo-wayanalysis of variance (ANOVA), ANOVA, and Tukey test (α = .05). The mean gap measured in the additive group was lower than that in all other groups at all points (p < .05); however, the difference in the marginal gap with the subtractive group was not significant (p = .995). The mean marginal and axial gaps in the subtractive group were significantly lower than the corresponding values in both conventional groups (p < .05). A significant difference existed between all groups regarding the mean cuspal and fossa gaps (p < .05). The mean fracture resistance of the additive group was significantly higher than that of indirect (p = .018) and direct (p < .001) groups, and the fracture resistance of the subtractive group was significantly higher than that of the direct group (p = .020). The digitally fabricated provisional FDPs showed superior marginal and internal fit and higher fracture resistance than the conventionally fabricated FDPs. Between the digital methods, the additive technique yielded superior internal fit.