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Objectives: To investigate the effects, digital impression procedures can have on the three-dimensional fit of ceramic partial crowns in vitro., Methods: An acrylic model of a mandibular first molar was prepared to receive a partial coverage all-ceramic crown (mesio-occlusal-distal inlay preparation with reduction of all cusps and rounded shoulder finish line of buccal wall). Digital impressions were taken using iTero (ITE), cara TRIOS (TRI), CEREC AC with Bluecam (CBC), and Lava COS (COS) systems, before restorations were designed and machined from lithium disilicate blanks. Both the preparation and the restorations were digitised using an optical reference-scanner. Data were entered into quality inspection software, which superimposed the records (best-fit-algorithm), calculated fit-discrepancies for every pixel, and colour-coded the results to aid visualisation. Furthermore, mean quadratic deviations (RMS) were computed and analysed statistically with a one-way ANOVA. Scheffé's procedure was applied for multiple comparisons (n=5, α=0.05)., Results: Mean marginal (internal) discrepancies were: ITE 90 (92) μm, TRI 128 (106) μm, CBC 146 (84) μm, and COS 109 (93) μm. Differences among impression systems were statistically significant at p<0.001 (p=0.039). Qualitatively, partial crowns were undersized especially around cusp tips or the occluso-approximal isthmus. By contrast, potential high-spots could be detected along the preparation finishline and at central occlusal boxes., Conclusions: Marginal and internal fit of milled lithium disilicate partial crowns depended on the employed digital impression technique., Clinical Significance: The investigated digital impression procedures demonstrated significant fit discrepancies. However, all fabricated restorations showed acceptable marginal and internal gap sizes, when considering clinically relevant thresholds reported in the literature., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Objectives: Machined restorations have been investigated for their preciseness before, while detailed information on the milling-step itself are lacking. Therefore, the aim of this laboratory study was to quantify the effect of a novel milling-procedure on the marginal and internal fit of ceramic restorations., Methods: An acrylic model of a lower left first molar was prepared to receive a ceramic partial crown and was duplicated by one step dual viscosity impressions. Gypsum casts were formed and laser-scanned to realize virtual datasets, before restorations were designed, exported (PRE) and machined from lithium disilicate blanks. Crowns were digitized by a structure-light-scanner to obtain post-milling-data (POST). PRE and POST were virtually superimposed on the reference tooth and subjected to computer-aided-inspection. Visual fit-discrepancies were displayed with colors, while root mean square deviations (RMSD) and degrees of similarity (DS) were computed and analysed by t-tests for paired samples (n=5, α=0.05)., Results: The milling procedure resulted in a small increase of the marginal and internal fit discrepancies (RMSD mean: 3μm and 6μm, respectively). RMSD differences were not statistically significant (p=0.495 and p=0.160 for marginal and internal fit, respectively). These results were supported by the DS data., Significance: The products of digital dental workflows are prone to imprecisions. However, the present findings suggest that differences between computer-aided designed and actually milled restorations are small, especially when compared to typical fit discrepancies observed clinically. Imprecisions introduced by digital design or production processes are small., (Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)

Objectives: A novel three-dimensional scanning technique was used to investigate the effects a one-step and a two-step impression methods can have on the three-dimensional fit of ceramic partial crowns., Methods: An acrylic model of a mandibular first molar was prepared to receive a partial coverage all-ceramic crown (mesio-occlusal-distal inlay preparation with reduction of all cusps and rounded shoulder finish line of buccal wall). Type IV plaster replicates were cast based on one-step single viscosity (OS/SV), one-step dual viscosity (OS/DV), and two-step dual viscosity (TS/DV) impressions. Five partial crowns were fabricated per impression method using hot-pressed lithium disilicate ceramics. Then, preparation and restorations were digitized using a non-contact, white-light scanner featuring self-calibrating optics (overall measurement uncertainty of <5μm). Data were entered into quality inspection software which superimposed the records (best-fit-algorithm), calculated fit-discrepancies for every pixel, and colour-coded the results to aid visualization. Furthermore, mean quadratic deviations (RMS) were computed and analyzed statistically with a 1-way ANOVA. Scheffé's procedure was applied for multiple comparisons (α=0.05)., Results: Mean RMS-values for marginal (internal) surfaces were: OS/SV 70 (20)μm, OS/DV 78 (34)μm, and TS/DV 107 (52)μm. Differences among impression techniques were statistically significant at p=0.006 (0.001). Qualitatively, occlusal ridges and preparation finish lines were over contoured, whereas inner occlusal boxes and the proximal-occlusal isthmus were under contoured., Conclusions: OS/SV and OS/DV impressions resulted in statistically significantly smaller marginal and internal discrepancies than the two-step technique., Clinical Significance: Marginal and internal fit of hot-pressed lithium disilicate partial crowns depended on the employed impression technique. One-step impressions are preferred over two-step techniques in many day-to-day clinical situations, especially for the fabrication of partial coverage crown restorations., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Objectives: The objective of this in vitro study was to visualize and to quantify the marginal and internal fit of heat-pressed ceramic restorations by a novel three-dimensional procedure. Accuracy and reproducibility of the employed measuring method were determined., Methods: An acrylic model of a lower left first molar was prepared to receive a partial crown and duplicated by single step dual viscosity impressions. Corresponding working casts were formed from Type IV die stone and indirect restorations were fabricated from heat-pressable lithium disilicate ceramics (IPS e.max Press, Ivoclar Vivadent AG, Schaan, Liechtenstein). The acrylic tooth model and the ceramic partial crowns were digitized by a structure light scanner with a measurement-uncertainty of 4 μm and subjected to computer-aided quality inspection. Visual discrepancies in marginal and internal fit were displayed with colors. For quantitative analysis, mean quadratic deviations (RMS) were computed and analyzed by Student's t-test (n=5, α=0.05)., Results: Mean RMS-values for accuracy (reproducibility) ranged from 34 (14) μm for internal areas to 78 (23) μm for marginal surfaces. Differences in accuracy (p=0.003) and reproducibility (p<0.001) were statistically significant. In general, areas with sharp internal line angles such as occlusal ridges and the preparation finish line exhibited oversized dimensions, whereas areas with rounded and soft internal line angles were undersized., Significance: The viability of a computer-aided and three-dimensional approach for assessing marginal and internal fit of indirect restorations was demonstrated. Thereby, the obtained results track complex form changes as they occur during laboratory processing., (Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.)