This randomized clinical trial studied the clinical performance of a CAD/CAM-generated veneer zirconia crown (Lava DVS/3M ESPE) compared to a hand-layered veneer zirconia crown (Lava/3M ESPE). The baseline placement of the crowns was used to evaluate the fit and internal adaptation of the crowns.
Method:
Two clinicians placed 100 zirconia crowns with the surface veneer fabricated with two different processes. The first 25 cases of each crown type had two identical crowns made; one from a conventional polyvinylsiloxane impression (PVS) and the other from a digital impression (Lava COS/3M ESPE). The time required to adjust and repolish both crowns for cementation was recorded. A light body PVS impression material was injected in the crown to record the cement space. After removing the crown/PVS, a heavy body PVS material was added over the light body PVS. The PVS impression material die was sectioned faciolingually into three pieces. The sections were measured with a measuring microscope at 20X for margin fit, axial wall adaptation, and occlusal wall adaptation.
Result:
A two-way ANOVA indicated no significant difference in crown fit between the two types of crowns (p>0.05) but there was a significant difference based on impression technique (p<0.05). A T-Test indicated a significant difference in impression technique for each category (p<0.05).
microns |
Margin |
Axial |
Occlusal |
PVS crowns |
78.62+25.62 |
93.75+35.89 |
162.03+47.22 |
Digital crowns |
51.45+18.59 |
79.06+23.98 |
119.91+38.18 |
A two-way ANOVA indicated no significant difference in adjustment time between the two types of crowns or impression techniques (p >0.05).
minutes |
Proximal Contacts |
Margins |
Occlusion |
Repolish |
Total |
PVS crowns |
1.70+2.83 |
0.53+0.62 |
2.37+2.40 |
2.03+1.94 |
6.63+5.04 |
Digital crowns |
1.66+2.06 |
0.49+0.43 |
2.17+2.37 |
1.72+1.63 |
6.04+4.76 |
Conclusion:
The crowns made from digital impressions fit significantly better than crowns made from PVS impressions. The time required to adjust the crowns was equivalent This study was supported by a grant from 3M ESPE.
Keywords: CAD/CAM, Ceramics, Digital Impressions and Impression materials