Marginal and Internal Gap of Handmade, Milled and 3D Printed Additive Manufactured Patterns for Pressed Lithium Disilicate Onlay Restorations.

Abstract

On a pressed lithium disilicate restoration, the building up of a wax pattern of the future restoration is a necessary step on the fabrication process. Conventionally, a wax pattern can be produced by handmade or milled procedures; however, the development of additive manufacturing technologies allows a new fabrication method. The present study measured the marginal and internal gap of handmade, milled and additive manufactured patterns for an onlay restoration. A preparation of an onlay restoration was made on an extracted mandibular tooth. A definitive cast was fabricated from a conventional silicone impression of the prepared tooth. Three groups were established: handmade (HM), milled (ML) and additive manufactured (AM); 4 specimens per group were obtained. The marginal and internal gap of each pattern was measured on the extracted molar through a computed tomography test. Sixty measurements were done to measure the marginal gap and another 60 measurements were calculated to analyze the internal gap on each pattern on the prepared tooth. A total of 1.440 measurements were completed. Mann-Whitney and Turkey statistical tests were used for pairwise comparison. The mean of the marginal and internal gap was of 67.56 ± 6.08 μm and 80.62 ± 3.26 μm for the HM group, 85.28 ± 2.17 μm and 96 ± 1.97 μm for the ML group and 86.49 ± 1.74 μm and 91.86 ± 2.88 μm for the AM group, respectively. The HM group presented significantly lower marginal (p=0.029) and internal (p=0.029) gap compared to the ML and AM groups. There was no statistical significant difference (p=0.486) on the marginal gap between the ML and the AM groups, but the AM group, showed significantly (p=0.029) smaller internal gap than the ML group. All the groups presented less than 100 μm marginal and internal gap, which is a considered clinically acceptable. The three fabrication processes are viable option for manufacturing patterns for lithium disilicate onlay restorations, but the best marginal and internal fit was still obtained by the conventional handmade procedures.