Dental Crowns Research Articles

Low Dose Sophora flavescens Polysaccharide Promote the Migration and Osteogenic Differentiation of Dental Pulp Stem Cells and Up-Regulate the Expression of Osteogenic Genes

This work aimed to investigate the effect of Sophora flavescens polysaccharide on proliferation and osteogenic differentiation of dental pulp stem cells. The dental pulp stem cells were isolated from rat dental crown tissue and the surface biomarkers were identified by flow cytometry. The osteogenic differentiation of dental pulp stem cells was assessed by alizarin red staining and alkaline phosphatase staining. The dental pulp stem cells were treated with different doses of Sophora flavescens polysaccharide for different time points and cell viability was assessed by cell counting kit 8. Cell migration was detected by Transwell and wound healing assay. The expression of collagen I, osteocalcin I, runt-related transcription factor 2 and beta-catenin were measured by quantitative real time polymerase chain reaction assay and Western blotting assay. The cluster of differentiation 90 was highly expressed and cluster of differentiation 45 expressions was relatively low on surface of isolated dental pulp stem cells. Sophora flavescens polysaccharide suppressed the proliferation of dental pulp stem cells. The treatment with low dose Sophora flavescens polysaccharide (0.2 mg/ml) promoted the migration and osteogenic differentiation of dental pulp stem cells, but higher concentration of Sophora flavescens polysaccharide (1 and 10 mg/ml) suppressed the migration and osteogenic differentiation of dental pulp stem cells. Treatment with low concentration of Sophora flavescens polysaccharide up-regulated the expression of osteogenic biomarkers. Low dose Sophora flavescens polysaccharide can promote the migration and osteogenic differentiation of dental pulp stem cells and up-regulated the expression of osteogenic genes.

An in vitro comparison of the marginal fit of provisional crowns using the virtual tooth preparation workflow against the traditional technique.

This study investigates the effectiveness of an innovative virtual tooth preparation workflow for the fabrication of dental crowns using cone-beam computed tomography (CBCT) and intraoral scanners (IOSs) with conventional workflow using extraoral/laboratory scanners. This in vitro experimental study was conducted in the laboratory of a university in Chennai, India. The dental laboratory and research facilities at the institution were utilized for the fabrication of the temporary crowns and the data acquisition process. Institutional approval was obtained from the university. It was basically a comparison between the virtual prep technique using CBCT and IOS and the conventional digital technique using extra oral scanners (EOS) for temporary crown fabrication. The sample size was estimated using an effect size of 1.5004, assuming a normal distribution, a significance level of 0.05, and a power of 0.95 in G power software. Based on this calculation, an extracted second lower molar was used to fabricate 10 samples in each group. The samples were divided into three groups: the CBCT (Group 1), the IOS (Group 2), and laboratory scanner (Group 3 as control) groups. The vertical marginal gap of all the surfaces of the crown was evaluated using a scanning electron microscope. Data were analyzed using one-way ANOVA using the SPSS software version 26.0, IBM, Armonk, NY, USA. Acceptable marginal discrepancy values were obtained in all three groups. There was no significant difference in the marginal discrepancy recorded (P = 0.113). Virtual tooth preparation using CBCT and IOSs can be used as an alternative to the conventional workflow for provisional crown and bridge fabrication.

Efeito do tempo e do substrato dental na resistência de união de um sistema adesivo universal: estudo in vitro

Abstract Introduction Dentin adhesives provide union between the dental substrate and composite resin, but this union can be influenced by the cleaning agent. Objective Evaluate the use of ozonated water as a cavity cleaning solution. Material and method 40 bovine dental crowns were selected, divided into four groups: AD (dentin cleaning with distilled water) and AO (dentin cleaning with ozonized distilled water). Each group was divided into two storage periods (24h and 30 days) kept at 37 °C. The selected universal system adhesive was employed according to the manufacturer's instructions and light cured for 20 seconds. At that time, three cylinders were made (Tygon matrix with an internal diameter of 2 mm and a height of 2 mm) of composite resin in the crowns in the cervical, médium, and incisal regions and light cured for 30 seconds. After storage, the bonding strength was tested by micro-shear, and fracture type analysis was performed. The data were submitted to statistical analysis using the Shapiro-Wilk test with a significance level of 95%, ANOVA, and Turkey. Result There was a statistically significant difference between the bond strength values, only in the intergroup analysis for the time of 24 hours, between the middle third of the groups (LDAO24 = 2.70 (± 2.39); LDAO30 = 3.82 (± 2.31)). The predominant fracture type for both groups was an adhesive fracture, except in the medium and incisal thirds of the AD, which was a cohesive dentin fracture. Conclusion The utilization of ozone did not change the bond strength adhesive.

Análise tridimensional de elementos finitos de três geometrias implante-abutment cônicos internos

ABSTRACT Objective: The aim of this study was to compare the stress distribution in internal tapered connection implants with different adaptation geometries submitted to oblique load simulation using the Finite Element Analysis (FEA) method. Methods: Three different internal tapered implant-abutment assemblies were modeled by varying only the diameter of the abutment body in the cone region. The dimensions of the implants were 4.0 mm in diameter and 13 mm in length. Oblique loads of 210 N angled 30 degrees to the long axis of the implant were applied to a hemispherical body positioned over the abutments simulating a dental crown. The stress generated by the implant-abutment assembly was analyzed by the FEA method using the von Mises criterion. Results: A higher concentration of stress in the coronal region (collar) and implant body on the opposite side of the load application was shown, as well as in the body region of the abutments and in the screw threads. The cervical region of the implants showed the highest von Mises stress values, the highest values being observed in G3 (1034 MPa), followed by G2 (841 MPa) and G1 (702 MPa). Conclusion: According to the results presented, it can be concluded that the stress distribution was more homogeneous and less concentrated in the G1 implant-abutment assembly. Therefore, the use of abutments with dimensions standardized by the implant manufacturer is recommended.

Novel approach to assessing the primary stability of dental implants under functional cyclic loading in vitro: a biomechanical pilot study using synthetic bone.

This pilot study was conducted to develop a novel test setup for the in vitro assessment of the primary stability of dental implants. This was achieved by characterising their long-term behaviour based on the continuous recording of micromotions resulting from dynamic and cyclic loading. Twenty screw implants, each 11 mm in length and either 3.8 mm (for premolars) or 4.3 mm (for molars) in diameter, were inserted into the posterior region of 5 synthetic mandibular models. Physiological masticatory loads were simulated by superimposing cyclic buccal-lingual movement of the mandible with a vertically applied masticatory force. Using an optical 3-dimensional (3D) measuring system, the micromotions of the dental crowns relative to the alveolar bone resulting from alternating off-centre loads were concurrently determined over 10,000 test cycles. The buccal-lingual deflections of the dental crowns significantly increased from cycle 10 to cycle 10,000 (P<0.05). The deflections increased sharply during the first 500 cycles before approaching a plateau. Premolars exhibited greater maximum deflections than molars. The bone regions located mesially and distally adjacent to the loaded implants demonstrated deflections that occurred synchronously and in the same direction as the applied loads. The overall spatial movement of the implants over time followed an hourglass-shaped loosening pattern with a characteristic pivot point 5.5±1.1 mm from the apical end. In synthetic mandibular models, the cyclic reciprocal loading of dental implants with an average masticatory force produces significant loosening. The evasive movements observed in the alveolar bone suggest that its anatomy and yielding could significantly influence the force distribution and, consequently, the mechanical behaviour of dental implants. The 3D visualisation of the overall implant movement under functional cyclic loading complements known methods and can contribute to the development of implant designs and surgical techniques by providing a more profound understanding of dynamic bone-implant interactions.

Marginal adaptation and fracture resistance of milled and 3D-printed CAD/CAM hybrid dental crown materials with various occlusal thicknesses.

To evaluate the marginal adaptation and fracture resistance of three computer-aided design/computer-assisted manufacturing hybrid dental materials with different occlusal thicknesses. Ninety single-molar crowns were digitally fabricated using a milled hybrid nanoceramic (Cerasmart, CE), polymer-infiltrated ceramic network (PICN, Vita Enamic, VE), and 3D-printed materials (Varseosmile, VS) with occlusal thicknesses of 0.8, 1, and 1.5 mm (10 specimens/group). Anatomical 3D-printed resin dies (Rigid 10K) were used as supporting materials. A CEREC MCX milling unit and a DLP-based 3D printer, Freeform Pro 2, were utilized to produce the crown samples. Before cementation, the marginal adaptation, absolute marginal discrepancy (AMD), and marginal gap (MG) were assessed using micro-CT scanning. After cementation with self-adhesive resin cement, fracture resistance was evaluated using a universal testing machine. The number of fractured crowns and the maximum fracture values (N) were recorded. Data were statistically analyzed using both one- and two-way ANOVA, followed by Tukey's honestly significant difference (HSD) test. For all occlusal thicknesses, the VS crowns demonstrated the lowest AMD and MG distances, significantly different from those of the other two milling groups (P < 0.05), whereas CE and VE did not differ significantly (P > 0.05). All VS crowns were fractured using the lowest loading forces (1480.3±226.1 to 1747.2±108.7 N). No CE and 1 and 1.5 mm VE crowns fractured under a 2000 N maximum load. All hybrid-material crowns demonstrated favorable marginal adaptation within a clinically acceptable range, with 3D printing yielding superior results to milling. All materials could withstand normal occlusal force even with a 0.8 mm occlusal thickness.

Evaluation of Artifacts Produced by Different Dental Crown Materials on Ultrashort Echo Time Magnetic Resonance Imaging

Objectives: Many patients with metallic objects in the head and neck region may require magnetic resonance imaging (MRI). The aim of this study was to assess the artifacts produced by different dental crown materials on ultrashort echo time (UTE) MRI. Materials and Methods: Cobalt-chromium (Co-Cr) and zirconia (Zr) crown and fixed bridges were included and embedded in agar gel. UTE sequence by 1.5T MRI was performed and the artifact area produced by these materials, were measured within the region of interest (ROI). Mean artifact areas were recorded. Results: Mean artifact area produced by Co-Cr and Zr was 140.055 mm2 and 102.349 mm2, respectively. Zr material produced less artifacts than metal restoration. It was stated that the amount of artifact increased as the number of elements increased. Conclusions: Co-Cr metal restorations have stronger effect than Zr material on UTE MRI. UTE sequence is useful in evaluating susceptibility artifacts from different materials. Knowing the amount of artifact produced by different materials will help to produce new materials that cause less artifact formation or to improve the properties of existing materials.

Validation of pairs of antagonist teeth for the evaluation of shortened dental arch in epidemiological studies.

The aim of this study was to evaluate the accuracy of pairs of antagonist teeth (epidemiological criterion) for defining pairs of teeth in occlusal contact (clinical criterion) and to estimate the agreement between the prevalence of "shortened dental arch" (SDA) and "functional dentition" (FD) when occlusal units (OUs) or posterior occluding pairs (POPs) are defined by the epidemiological or clinical criterion. Data were collected in an epidemiological oral health survey conducted in a municipality in Minas Gerais, Brazil. OUs and POPs were defined by the epidemiological criterion (dental crown status) or clinical criterion "gold standard" (carbon paper record of occlusal contacts during habitual maximum intercuspation). SDA corresponded to the presence of an intact anterior region and three to five OUs. FD was based on the concomitant presence of ≥ 1 tooth in each arch, 10 teeth in each arch, 12 anterior teeth, ≥ 3 premolar POPs, and ≥ 1 molar POP bilaterally. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of the epidemiological criterion were calculated. The study included 197 adults. Sensitivity, specificity, PPV, and NPV were 88.5, 87.9, 92.5, and 81.9%, respectively, and accuracy was 88.3%. The epidemiological criterion proved to be valid and could be used in epidemiological studies to calculate the prevalence of reduced dental configurations that consider POPs. The assessment of oral functionality is an aspect that should be included in the diagnosis of the clinical condition of patients, contributing to a more effective individual and collective oral health care plan.

ОЦЕНКА ЭСТЕТИЧЕСКОГО РЕЗУЛЬТАТА ПРОТЕЗИРОВАНИЯ НА ОДИНОЧНОМ ДЕНТАЛЬНОМ ИМПЛАНТАТЕ

Objective: A comparative assessment of the aesthetic result of a single dental implant (DI) prosthetics using standard or custom abutments. Methods: A customized gingival former and a custom abutment were applied in patients of the main group, while patients of the control group received a standard gingival former and a stock abutment. The aesthetic assessment was carried out on photographs using the Pink Esthetic Score (PES) and White Esthetic Score (WES) scales. Results: Better aesthetic results were obtained in the main group compared to the control one. At subsequent stages of the study, a further aesthetical improvement was observed compared with the initial assessment result. Conclusion: The formation of a marginal gingiva matching the anatomical shape of the neck of the missing tooth enables to fabricate a customized abutment and a dental crown of the correct anatomical shape. The physiological dimensions and the correct eruption profile of the prosthetic crown contribute to the formation of interdental papillae where they were originally absent. The listed advantages of this method improve the RES and PES results of prosthetics on a single-unit DI. Keywords: Prosthetics on dental implants, crown on a single-unit dental implant, custom abutment, gingival papilla, pink aesthetics, white aesthetics.

History of the dental crown

A crown is a cap covering a tooth's entire surface. This is part of The Encyclopedia of History of Dentistry.

Rekonstruksi Lingkungan Prasejarah Situs Gua Pawon, Jawa Barat Berdasarkan Kajian Identifikasi Gigi Hewan

Excavations at the Pawon Cave Site in 2019 and 2021 from boxes T2U1, T2S1, T3U1, T3S1, and T4S1 led to the discovery of 976 specimens of animal teeth that could be used to reconstruct the past of the Pawon’s Cave Site environment. To determine the level of animal taxa to the location of the teeth, taxonomic and anatomical analyses were carried out, while environmental reconstruction was carried out through environmental analysis based on the distribution of faunal functional groups by Julien Louys (2012). The research method consists of six steps, namely formulation, implementation, data collection, data processing, analysis, and interpretation. As a result, 120 individual animals from 13 different families were found at the Pawon Cave site with the dominance of the Cercopithecidae family in each four units of analysis. However, it is also necessary to the contribution of protein produced, so that large animals (megafauna), such as the Families Suidae, Bovidae, and Cervidae, have more potential to become main game animals for consumption, while the Families Cercopithecidae and Hystricidae become a complement to a variety of foods consumed. In addition, jewelry from shark teeth and canine teeth of Carnivora, Cercopithecidae and Suidae were also found with traces of modification in the form of perforation of the roots of the teeth and sharpening of the dental crowns. Thus, the human inhabitants of Pawon Cave are hunters who can utilize all the potential of animals from terrestrial, arboreal and aquatic habitats around the Pawon’s Cave Site.

Flapless Decoronation: A Minimally Invasive Approach

Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis is a common complication, leading to adverse effects on the developing alveolar bone and interfering with the eruption of the adjacent teeth. The decoronation procedure was suggested in 1984 to reduce these side effects related to ankylosis. The objective of the current publication is to describe a minimally invasive, flapless decoronation procedure aimed to minimize and simplify the surgical procedure of decoronation, and ease its clinical acceptance, particularly in young children. The technique is described in a detailed protocol and demonstrated in two cases. Under local anesthesia, the dental crown is removed, and the root is reduced by 1.5-2.0 mm apically to the marginal bone crest. The root canal content is then removed, allowing it to fill with blood. The socket is coronally sealed with a porcine-derived collagen matrix (PDCM) sutured using the "parachute" technique over the resected root, allowing close adaptation to the surrounding soft tissue. In conclusion, the presented technique of flapless decoronation is a modification of the classic decoronation procedure, which can be used as a minimally invasive technique to simplify the surgical procedure and the post-operative process.

Bleaching intracoronal gigi insisif pertama pasca perawatan endodontik (Laporan Kasus)

Background: Non-vital anterior tooth discoloration is a common concern in everyday clinics. Increased patient demand for affordable and excellent results makes bleaching treatment for discolored teeth one of the most popular treatment options. Bleaching offers a more conservative and aesthetic solution compared to treatments like dental crown. Objective: To restore the color of the upper right maxillary incisor after endodontic treatment using internal bleaching with 35% hydrogen peroxide. Case: A 22-year-old male patient came with a complaint of discoloration of upper right maxillary incisor. On clinical examination, upper right maxillary incisor was discolored. On radiographic examination, radiolucency was observed in the periapex. Endodontic treatment was performed with biomechanical preparation using circumferential filing technique and obturation of root canals using a thermoplastic injection technique. At the next visit, an intraoral photo was taken, and the color upper right maxillary incisor was determined using a shade guide. Intracoronal bleaching was performed using 35% hydrogen peroxide bleaching gel. After the color of upper right maxillary incisor has blend well, then the teeth were restored using a composite resin. Conclusion: Intracoronal bleaching treatment with 35% hydrogen peroxide is a conservative and aesthetic treatment to restore the color of the tooth with an excellent result.

Effect of artificial crowns on periodontal tissues (Literature Review)

Dental crowns are artificial teeth that are permanently attached to teeth that have been prepared to repair part or all of the damaged tooth surface and to replace toothloss. Making a crown must consider several factors, including being able to maintain and pro-tect existing teeth and surrounding tissues. This literature review isaimed to describe the effect of crown use on periodontal tis-sue. A total of 20 articles collected from various electronic databases and manual searches wereincluded in this literature. Plaque is a major etiologic factor of gingival inflammation and inadequate crown design can lead to plaque accumulation. Dental crowns can cause inflammation of the periodontal tissues, if cervical endings and preparation margins as well as oral hygiene principles are not observed during the crown fabrication process. It is concluded that crown design plays a very important role in determi-ning the condition of periodontal tissues. Appropriate designand good oral hygiene are important to reduce the occurrence of periodontal disease.

Effect of Almond Milk on Tooth Enamel Surface Hardness

Introduction: Enamel is the hardest substance in the human body and serves as the wear-resistant outer layer of the dental crown. Demineralization releases mineral ions which cause a decrease in the enamel surface hardness. Demineralization could be neutralized to recover minerals, and this process is called remineralization. Almond milk was an alternative to cow’s milk, supporting tooth enamel surface remineralization. Purpose: To determine the effect of almond milk on enamel hardness. Methods: Twenty maxillary premolars were divided into group A (control) and group B (almond milk). Before treatment, samples were soaked in 1% citric acid. Enamel hardness was tested with Vickers Hardness Tester. The statistical tests used in this study were Paired t-test and Independent Sample t-Test. Results: The results of the paired sample test got significant results in groups A and B in the comparison of pretest - 1% citric acid, and 1% citric acid - posttest, which means that there was a significant difference in enamel hardness values. However, the results obtained were not substantial in groups A and B in the posttest- pretest comparison. There was no significant difference between Group A and Group B in the independent sample test results. There was an increase before and after, but it was not much different when compared to the control. Conclusion: Almond milk can increase enamel surface hardness but cannot reverse the initial enamel surface hardness value.

Finite element analysis of FGM dental crowns using phase-field approach

Functionally graded materials (FGMs) – categorized in advanced composite materials – are specially designed to reduce the stresses and failure due to material mismatches. Advances in manufacturing techniques have brought FGMs into use in a variety of applications. However, the numerical analysis is still challenging due to the difficulties in simulations of non-homogeneous material domains of complex parts. Presenting a numerical procedure that both facilitates the implementation of material non-homogeneity in geometrically complex mediums, and increases the accuracy of the calculations using a phase-field approach, this study investigates the usage of FGMs in dental prostheses. For this purpose, a porcelain fused to metal (PFM) mandibular first molar FGM crown is simulated and analyzed under the maximum masticatory bite force, and eventually the results are compared to a PFM crown prepared conventionally.

Optimization of 3D Printing Technology for Fabrication of Dental Crown Prototype Using Plastic Powder and Zirconia Materials.

This research was aimed at developing a dental prototype from 3D printing technology using a synthetic filament of polylactic acid (PLA) and zirconium dioxide (ZrO2) with glycerol and silane coupling agent as a binder. A face-centered central composite design was used to study the effects of the filament extrusion parameters and the 3D printing parameters. Tensile and compressive testing was conducted to determine the stress-strain relationship of the filaments. The yield strength, elongation percentage and Young's modulus were also calculated. Results showed the melting temperature of 193 °C, ZrO2 ratio of 17 wt.% and 25 rpm screw speed contributed to the highest ultimate tensile strength of the synthetic filament. A Nozzle temperature of 210 °C and an infill density of 100% had the most effect on the ultimate compressive strength whilst the printing speed had no significant effects. Differential scanning calorimetry (DSC) was used to study the thermal properties and percentage of crystallinity of PLA filaments. The addition of glycerol and a silane coupling agent increased the tensile strength and filament size. The ZrO2 particles induced the crystallization of the PLA matrix. A higher crystallization was also obtained from the annealing treatment resulting in the greater thermal resistance performance of the dental crown prototype.

One Visit Endodontic with Internal Bleaching on Tooth 12 Post Trauma: A Case Report

Introduction: Post-traumatic non-vital teeth is one of the indications for One Visit Endodontic. Trauma to the teeth may arise from conditions that cause the teeth to become necrotic so that the teeth will look darker and experience discoloration. Clinical conditions that indicate the death of the dental pulp and teeth require endodontic treatment. This situation will cause discoloration of the teeth that occur as a result of the metamorphosis of calcified pulp. Internal whitening is a treatment that can be done after the first treatment. Purpose: To provide information about discolored teeth management after trauma which causes pulp necrosis by doing root canal treatment and internal bleaching to change tooth color. Case: A 31-year-old woman came to the RSKGMP Universitas Airlangga with a referral from the orthodontics department where her teeth were darker in color and interfered with her appearance. In the previous history, the patient had an accident and trauma 10 years ago. Case Management: The first step is access opening and a good glide path. Root canal preparation was performed using the Crown Down Pressureless technique. The obturation technique used is Single Cone. The results were good and there were no symptoms during the control. Conclusion: One visit endodontic can be a treatment option for post-traumatic non-vital teeth. Internal bleaching with Walking Bleach Technique is also proven effective in restoring the original tooth color without excessive reduction of the dental crown.

Altered expression of SOCS genes periodontitis

Suppressor of cytokine signalling (SOCS) family comprises a group of proteins that impede JAK/STAT signalling, thus being involved in the pathogenesis of immune-related conditions. In the present work, we aimed at identification of the role of SOCS genes in the pathogenesis of periodontitis through evaluation of their expression levels both in the circulation and in the affected tissues of patients. Thus, we measured expression levels of SOCS1-3 and SOCS5 transcripts in the blood and gingival samples of patients with periodontitis in comparison with control samples obtained during dental crown lengthening. Expressions of SOCS1, SOCS2, SOCS3 and SOCS5 genes were similar between gingival tissues of patients and controls. However, our results demonstrated under-expression of SOCS1 in blood samples of patients compared with controls (Ratio of mean expression (RME) = 0.47, P value = 0.04). The same pattern was observed among female subjects (RME = 0.38, P value = 0.04). SOCS2 was down-regulated in blood samples of female patients compared with female controls (RME = 0.22, P value = 0.04). SOCS3 was also under-expressed in the circulation of total cases versus total controls (RME = 0.29, P value = 0.02) and in female patients compared with female controls (RME = 0.19, P value = 0.04). Expression of SOCS5 was not different between blood samples two study groups. SOCS2 had the best function in separation of affected tissues from unaffected ones (AUC = 0.66, sensitivity = 0.39, specificity = 0.83). SOCS3 was superior to other transcripts in differentiation of blood samples of patients from normal blood samples (AUC = 0.69, sensitivity = 0.81, specificity = 0.68). Combination of transcript levels of SOCS1, SOCS2, SOCS3 and SOCS5 genes enhanced the AUC values to 0.64 and 0.67 in tissue and blood specimens, respectively. Taken together, certain SOCS genes have been found to be dysregulated in the circulation of patients with periodontitis.

Clinical evaluation of 3D-printed zirconia crowns fabricated by selective laser melting (SLM) for posterior teeth restorations: Short-term pilot study

Background/purposeZirconia crowns (ZrC) without veneering porcelain have become an effective alternative in clinical practice. Monolithic zirconia restorations fabricated by the dry milling method do not have acceptable clinical properties. This study evaluated the periodontal qualities of three-dimensional printed ZrC using the modified United States Public Health Service (USPHS) criteria. Materials and methodsA total of 15 patients who required dental crowns were recruited, and all 15 teeth were restored with digital 3D-printed ZrC. All crowns were assessed at the time of crown placement and 2, 6, and 24 weeks post-placement. Clinical parameters, including plaque index, gingival index, probing depth, crown marginal integrity, and attrition of the antagonist's teeth, were evaluated and recorded. ResultsAccording to the Modified California Dental Association quality evaluation system, 100% of the crowns received satisfactory grades. Despite the significant increase in plaque index and gingival index at two weeks post-ZrC placement, there was no deterioration in probing depth. Moreover, there was discard usage of ZrC on the antagonist's teeth at 24 weeks posttreatment. Of the 15 crowns, one tooth had to be extracted due to a vertical root fracture. Overall, the digital 3D-printed crowns showed no adverse effects on periodontal tissues after 24 weeks of follow-up. ConclusionThe 3D-printed ZrC showed no periodontal problems. It can serve as an alternative for patients, particularly those with high esthetic expectations.