Evaluation of the Marginal Fit of CAD/CAM Crowns Fabricated Using Two Different Chairside CAD/CAM Systems on Preparations of Varying Quality

The influence of different cement spaces on the marginal gap of lithium disilicate crowns constructed by two scanner and milling unit combinations

BACKGROUND

This study compared the marginal gaps of CAD/CAM lithium disilicate (LDS) crowns constructed using a contemporary and older scanner/milling unit combination at three different cement spaces.

METHODS

Twenty-four undergraduate students prepared a Columbia model lower left first molar for an LDS crown in a simulated environment. From each crown preparation, one LDS crown was constructed using an E4D scanner/E4D milling unit (E4DS/E4DM) and TRIOS 3 scanner/Sirona inLab MC X5 milling unit (TRIO/MCX5) at cement space settings of 50, 100 and 200 μm. Each LDS crown was positioned onto the original crown preparation, and then a stereomicroscope was used to make three vertical marginal gap measurements at four locations (mid-buccal, mid-lingual, mid-mesial and mid-distal). The mean marginal gap (MMG) was calculated for each crown and each individual tooth surface.

RESULTS

The MMGs of CAD/CAM LDS crowns constructed by TRIO/MCX5 were 72.31 at 50, 63.73 at 100 μm and 46.23 μm at 200 μm, which were smaller than E4DS/E4DM at each cement space.

CONCLUSIONS

Increasing the cement space decreased the MMG in both scanner/milling unit combinations. The smallest MMG was found using the newer scanner/milling unit at the 200 μm cement space. © 2024 Australian Dental Association.

3D-printed versus conventionally milled zirconia for dental clinical applications: Trueness, precision, accuracy, biological and esthetic aspects

OBJECTIVES

This systematic review aimed to compare the clinical outcome, internal gap, trueness, precision, and biocompatibility of 3D-printed (AM) compared to milled (SM) zirconia restorations.

DATA SOURCE

A thorough search of Internet databases was conducted up to September 2023. The search retrieved studies compared AM zirconia to SM zirconia restorations regarding clinical outcome, fit, trueness, precision, and biocompatibility.

STUDY SELECTION

Of 1736 records, only 59 were screened for eligibility, and 22 records were included in this review. The quality of studies was assessed using the revised Cochrane risk-of-bias tool (ROB2), and the Modified Consort Statement. One clinical study exhibited a low risk of bias. All laboratory studies revealed some bias concerns. Short-term observation showed 100 % survival with no signs of periodontal complications. 3D-printed zirconia crowns showed statistically significant lower ΔE and a better match to adjacent teeth (p ≤ 0.5). The fit, trueness, and precision vary with the printing technique and the tooth surface.

CONCLUSIONS

3D-printed zirconia crowns provide better aesthetic color and contour match to adjacent natural teeth than milled crowns. Both 3D printing and milling result in crowns within the clinically acceptable internal and marginal fit. Except for nanoparticle jetting, the marginal gap of SM crowns was smaller than AM crowns, however, both were clinically acceptable. Laminate veneers might be more accurately produced by 3D printing. 3D-printed axial surface trueness was better than milled axial surfaces. Long-term RCTs are recommended to confirm the clinical applicability of 3D-printed restorations.

CLINICAL SIGNIFICANCE

Internal fit and gap, precision, and trueness are fundamental requirements for successful dental restorations. Both techniques produce restorations with clinically acceptable marginal and internal fit. Axial surfaces and narrow or constricted areas favored 3D-printed than conventionally milled zirconia.

Comparison of loupes versus microscope-enhanced CAD-CAM crown preparations: A microcomputed tomography analysis of marginal gaps

STATEMENT OF PROBLEM

Long-term restoration success depends on a precision marginal fit to prevent marginal leakage and caries. The successful fit of a computer-aided design and computer-aided manufactured (CAD-CAM) crown may be affected by different workflow variables, including preparation, scanning, crown design, milling, sintering, and cementation. Discrepancies in any of these steps may result in poor marginal and internal fit. Evidence suggests that tooth preparation may be the most important step in the workflow for a successful outcome. Compared with the traditional means of crown preparation using the naked eye or loupes, the dental operating microscope provides higher magnification and more direct illumination. However, the impact of high magnification during preparation on the marginal quality of CAD-CAM crowns is unclear.

PURPOSE

The purpose of this in vitro study was to compare marginal fits of CAD-CAM crowns fabricated after initial preparation with loupes and subsequent preparation refinement with either loupes or a microscope. The null hypothesis was that no significant difference would be found in the marginal gap between the preparations with loupes and those with a microscope.

MATERIAL AND METHODS

Mounted extracted molars (N=18) received initial crown preparations with a coarse grit, rounded shoulder, diamond rotary instrument with loupes of ×3.0 magnification. The teeth were then randomly divided into 2 groups and refined for an additional 2 minutes with fine grit, rounded shoulder, diamond rotary instruments with either loupes (LOUP) or a microscope up to ×10.0 magnification (DOM). The prepared teeth were scanned with an intraoral scanner to fabricate zirconia-reinforced lithium silicate crowns manufactured with a 4-axis milling machine, sintered in a dental furnace in accordance with the manufacturer's instructions, and cemented with self-adhesive resin cement. All teeth with crowns were mounted and scanned with a microcomputed tomography (μCT) system at 21-μm nominal voxel size. The resulting Digital Imaging and Communications in Medicine (DICOM) images were imported into a semiautomatic segmentation software program. Marginal and absolute gaps were measured at 24 consistent circumferential points per specimen. Absolute gaps were labeled, and the total volume was calculated. Paired and unpaired t tests were used for statistical analysis (α=.05).

RESULTS

The mean marginal gap was 145.0 ±259.6 μm for LOUP and 35.6 ±110.6 μm for DOM, with a statistically significant difference (P<.001). The mean gap volume for LOUP was 0.975 ±0.811 mm3, and 0.250 ±0.477 mm3 for DOM, also statistically significantly different (P=.023). A significant difference was found between the absolute and marginal gaps for LOUP (P=.007), but for DOM, the difference was not significant (P=.063).

CONCLUSIONS

This study demonstrated that the higher magnification used during tooth preparation played a significant role in the size of marginal gaps present around CAD-CAM crowns. Crown preparations finished by using fine grit diamond rotary instruments with a microscope at higher magnification than loupes resulted in a more precise marginal fit with smaller gaps.

Digital measurement method for comparing the absolute marginal discrepancy of three-unit ceramic fixed dental prostheses fabricated using conventional and digital technologies

BACKGROUND

In clinical practice, control of the marginal fit of fixed dental prostheses is hindered by evaluation method, which needs to be further improved to increase its clinical applicability. This study aimed to quantitatively analyze the absolute marginal discrepancy of three-unit ceramic fixed dental prostheses fabricated by conventional and digital technologies using a digital measurement method based on the digital impression technology and open source software.

METHODS

A digital workflow and the conventional impression combined with the lost-wax heat-pressed technique were adopted to separately fabricate 10 glass ceramic fixed dental prostheses. Three-dimensional data for the abutments, fixed dental prostheses, and fixed dental prostheses seated on the abutments, were obtained using a dental scanner. The two datasets were aligned using registration technology, specifically "multi-points registration" and "best fit alignment," by reverse engineering software. Subsequently, the three-dimensional seated fit between the fixed dental prostheses and abutments were reconstructed. The margin of the abutment and crown was extracted using edge-sharpening and other functional modules, and the absolute marginal discrepancy was measured by the distance between the margin of the abutment and crown. One-way analysis of variance was used to statistically analyze the measurement results.

RESULTS

Using the digital measurement method, the mean value of absolute marginal discrepancy for fixed dental prostheses fabricated by the conventional method was 106.69 ± 6.46 μm, and that fabricated by the digital workflow was 102.55 ± 6.96 μm. The difference in the absolute marginal discrepancy of three-unit all-ceramic fixed dental prostheses fabricated using the two methods was not statistically significant (p > 0.05).

CONCLUSIONS

The digital measurement method for absolute marginal discrepancy was preliminarily established based on open source software and applied in three-unit ceramic fixed dental prostheses. The absolute marginal discrepancy of three-unit ceramic fixed dental prostheses fabricated using digital technology was comparable to that of conventional technique.

Evaluation of the marginal and internal fit of CAD/CAM crowns designed using three different dental CAD programs: a 3-dimensional digital analysis study

OBJECTIVES

The purpose of this in vitro study was to assess and compare the marginal and internal fit of machine-milled crowns designed using three different CAD software programs.

MATERIALS AND METHODS

Digital impressions of the master zirconia casts containing the prepared molar were obtained using an intraoral scanner. The obtained standard tessellation language (STL) files were imported into three CAD software programs (Multi-CAD, Blue-Sky CAD, and InLab), and crown designs were generated. Crown design digital STL files were used to mill crowns with a five-axis dental milling machine. The internal and marginal fits of the fabricated crowns over the master-prepared tooth were assessed using the triple-scan protocol and digital analysis techniques. The 3D marginal and internal fit values of the fabricated crowns from the designs generated by the three CAD programs were evaluated and statistically compared using one-way analysis of variance (ANOVA) and post hoc Tukey's tests (α = 0.05).

RESULTS

There were no significant differences in the internal fit of the crowns designed by the three CAD programs (p > 0.05). However, there were significant differences in the mean marginal fit (p = 0.009) of the crowns. The marginal fit values for the InLab-designed crowns were significantly better than those for Multi-CAD (p = 0.03) and Blue-Sky CAD (p = 0.012) groups.

CONCLUSIONS

All three CAD programs can design clinically acceptable crowns in terms of internal and marginal fit. InLab crowns outperformed the Multi-CAD and Blue-Sky CAD programs in terms of marginal fit.

CLINICAL RELEVANCE

It is critical to test the ability of newly released CAD programs to design acceptable virtual crowns that can be transformed into actual crowns with optimal marginal and internal fit to existing clinical tooth preparations/conditions to ensure the high technical quality and long-term success of fabricated crowns.

The marginal gaps of sequentially milled lithium disilicate crowns using two different milling units

BACKGROUND

The purpose of this study was to compare the marginal gaps of sequentially milled lithium disilicate (LDS) crowns using two different milling units.

METHODS

One lower left first molar typodont tooth prepared for an LDS crown by an undergraduate student in a simulation clinic was selected. The crown preparation was scanned by a TRIOS 3 scanner and twelve LDS crowns milled by an E4D (E4DM) and a Sirona inLab MC X5 (MCX5) milling unit using identical settings. The crowns were seated onto the original crown preparation and three vertical marginal gap measurements were taken at four locations (mid-buccal, mid-lingual, mid-mesial and mid-distal) using a stereomicroscope. The mean marginal gap (MMG) was calculated for each individual tooth surface and each crown.

RESULTS

The MMG for the E4DM (100.40 μm) was not significantly different to the MCX5 (101.08 μm) milling unit (P = 0.8809). In both units, there was a statistically significant trend of increasing MMG with sequentially milled crowns using the same burs (E4DM P = 0.0133; MCX5 P = 0.0240).

CONCLUSIONS

The E4DM and MCX5 milling units produced LDS crowns with similar MMG's and within a clinically acceptable range but with a trend of increasing MMG when analysed sequentially. © 2022 Australian Dental Association.

Consensus on the preparation margin and restoration margin in ceramic esthetic rehabilitation

In esthetic rehabilitation, methods used to enhance the margin quality have always been the focus and difficulty of improving the level of diagnosis and treatment, prevention and treatment of complications, and collaboration between clinicians and technicians. However, it is impeded by the ambiguous definition and classification of margin, unstandardized tooth preparation, manufacturing process of restoration, and lack of reliable means of checking the quantitative requirements of preparation or restoration. The digital technologies that are increasingly applied, such as intra-oral scanner, impression scanner, and computerized numerical control cutting machine, have strict requirements about margin quality. Failure of recognizing margins by these scanners will hinder the digital process of diagnosis and treatment. Even if these sharp and narrow margins are successfully scanned, they cannot be milled accurately. To overcome these problems, this article demonstrated the clear and complete definition of preparation margin and restoration margin, as well as their subclassifications, by analyzing the target restoration space from a geometric perspective. Practical approaches to measuring the margin width and inspecting the margin quality were proposed. The new and full understanding and proposal about preparation margin and restoration margin characterized by measurements will effectively support the thoroughly digitalized process of esthetic rehabilitation using porcelain in fixed prosthodontics, which is based on the guidance of values.

The marginal gaps of lithium disilicate crowns constructed by different scanner and milling unit combinations

BACKGROUND

The purpose of this study was to compare the marginal gaps of CAD/CAM lithium disilicate (LDS) crowns constructed using three different scanner and milling unit combinations.

METHODS

Twenty-four Columbia model lower left molars were prepared for LDS crowns by undergraduate students in a simulated environment. One LDS crown was constructed for each crown preparation using each of the following intraoral scanner/milling unit combinations: TRIOS 3 scanner/E4D milling unit (TRIO/E4DM); TRIOS 3 scanner/Sirona inLab MC X5 milling unit (TRIO/MCX5); E4D scanner/E4D milling unit (E4DS/E4DM). The crowns were seated onto the original crown preparations and three vertical marginal gap measurements taken at four locations (mid-buccal, mid-lingual, mid-mesial and mid-distal) using a stereomicroscope. The mean marginal gap (MMG) was calculated for each crown and each individual tooth surface.

RESULTS

The TRIO/MCX5 scanner/milling unit combination produced the smallest MMG of 63.73 ± 47.38 μm followed by E4DS/E4DM (88.64 ± 106.51 μm) and TRIO/E4DM (107.41 ± 76.47 μm). There was a significant effect of milling unit (p < 0.0001) on MMG but no significant effect of scanner (p = 0.070) or location (p = 0.182).

CONCLUSIONS

The newer scanner/milling unit combination produced LDS crowns with the smallest MMG. All scanner/milling unit combinations produced LDS crowns within a clinically acceptable MMG.

Effect of various digital cement space settings on the adaptation of CAD/CAM occlusal veneer "micro-ct evaluation"

The aim was to evaluate the adaptation of CAD/CAM occlusal veneer with different cement space settings using micro CT scan. Three groups of IPS e.max-CAD lithium disilicate occlusal veneers with different cement space settings (30, 40, and 50 µm) were produced. A circle with 20 different diameters was centered at the center of the same image position of every scanned specimen using micro CT scan to measure four different locations [Occlusal (OCG), axial (AXG), Marginal (MAG), and absolute marginal discrepancy values (AMD)]. Kruskal-Wallis test revealed that there were no statistical differences between (OCG), (AXG), and (AMD) tested groups (p>0.05), and statistical differences between (MAG) group and other two groups (p<0.05). An increase in the digital cement space significantly improved the marginal fit of IPS e.max-CAD occlusal veneer.

Accuracy of CAD/CAM Digital Impressions with Different Intraoral Scanner Parameters

The advancement of intraoral scanners has allowed for more efficient workflow in the dental clinical setting. However, limited data exist regarding the accuracy of the digital impressions produced with various scanner settings and scanning approaches. The purpose of this in vitro study was to compare the accuracy of digital impressions at the crown preparation margin using different scanning resolutions of a specific intraoral scanner system. An all-ceramic crown preparation of a mandibular first molar was constructed in a typodont, and a scan (n = 3) was created with an industrial-grade laboratory scanner (3Shape D2000) as the control. Digital impressions were obtained with an intraoral scanner (3Shape TRIOS 3) under three settings—high resolution (HR), standard resolution (SR), and combined resolution (SHR). Comparative 3D analysis of scans was performed with Geomagic Control X software to measure the discrepancy between intraoral scans and the control scan along the preparation finish line. The scan time and number of images captured per scan were recorded. Statistical analysis was performed by one-way ANOVA, two-way repeated measures ANOVA, Pearson’s correlation, and Dunnett’s T3 test (α = 0.05). Significant differences were observed for scan time and for number of images captured among scan resolution settings (α < 0.05). The scan time for the SR group was, on average, 34.2 s less than the SHR group and 46.5 s less than the HR group. For discrepancy on the finish line, no significant differences were observed among scanning resolutions (HR: 31.5 ± 5.5 μm, SHR: 33.2 ± 3.7 μm, SR: 33.6 ± 3.1 μm). Significant differences in discrepancy were observed among tooth surfaces, with the distal surface showing the highest discrepancies. In conclusion, the resolution of the intra-oral scanner is primarily defined by the system hardware and optimized for default scans. A software high-resolution mode that obtains more data over a longer time may not necessarily benefit the scan accuracy, while the tooth preparation and surface parameters do affect the accuracy.

Evaluation of marginal adaptation in three-unit frameworks fabricated with conventional and powder-free digital impression techniques

PURPOSE

The purpose of this in vitro study was to evaluate the marginal misfits of three-unit frameworks fabricated with conventional and digital impressions techniques.

MATERIALS AND METHODS

Thirty brass canine and second premolar abutment preparations were fabricated by using a computer numerical control machine and were randomly divided into 3 groups (n=10) as follows: conventional impression group (Group Ci), Cerec Omnicam (Group Cdi), and 3shape TRIOS-3 (Group Tdi) digital impression groups. The laser-sintered metal frameworks were designed and fabricated with conventional and digital impressions. The marginal adaptation was assessed with a stereomicroscope at ×30 magnification. The data were analyzed with 1-way analysis of variances (ANOVAs) and the independent simple t tests.

RESULTS

A statistically significant difference was found between the frameworks fabricated by conventional methods and those fabricated by digital impression methods. Multiple comparison results revealed that the frameworks in Group Ci (average, 98.8 ± 16.43 µm; canine, 93.59 ± 16.82 µm; premolar, 104.10 ± 15.02 µm) had larger marginal misfit values than those in Group Cdi (average, 63.78 ± 14.05 µm; canine, 62.73 ± 13.71 µm; premolar, 64.84 ± 15.06 µm) and Group Tdi (average, 65.14 ± 18.05 µm; canine, 70.64 ± 19.02 µm; premolar, 59.64 ± 16.10 µm) (P=.000 for average; P=.001 for canine; P<.001 for premolar). No statistical difference was found between the marginal misfits of canine and premolar abutment teeth within the same groups (P>.05).

CONCLUSION

The three-unit frameworks fabricated with digital impression techniques showed better marginal fit compared to conventional impression techniques. All marginal misfit values were clinically acceptable.

Analysis of vertical marginal discrepancy in feldspathic porcelain crowns manufactured with different CAD/CAM systems: Closed and open

Objective:

The objective of this study is to compare the marginal adaptation of feldspathic porcelain crowns using two computer-aided design/computer-aided manufacturing systems, one of them is open and the other is closed.

Materials and Methods:

Twenty identical titanium abutments were divided into two groups: open system (OS), where ceramic crowns were created using varied equipment and software, and closed system (CS), where ceramic crowns were created using the CEREC system. Through optical microscopy analysis, we assess the marginal adaptation of the prosthetic interfaces. The data were subjected to the distribution of normality and variance. The t-test was used for the analysis of the comparison factor between the groups, and the one-way ANOVA was used to compare the variance of crown analysis regions within the group. A significance level of 5% was considered for the analyses.

Results:

There was a significant difference between the systems (P = 0.007), with the CS group having the higher mean (23.75 μm ± 3.05) of marginal discrepancy when compared to the open group (17.94 μm ± 4.77). Furthermore, there were no differences in marginal discrepancy between the different points between the groups (P ≥ 0.05).

Conclusions:

The studied groups presented results within the requirements set out in the literature. However, the OS used presented better results in marginal adaptation.

Comparative Study of the Trueness of the Inner Surface of Crowns Fabricated from Three Types of Lithium Disilicate Blocks

This study set out to compare the three-dimensional (3D) trueness of crowns produced from three types of lithium disilicate blocks. The working model was digitized, and single crowns (maxillary left second molar) were designed using computer-aided design (CAD) software. To produce a crown design model (CDM), a crown design file was extracted from the CAD software. In addition, using the CDM file and a milling machine (N = 20), three types of lithium disilicate blocks (e.max CAD, HASS Rosetta, and VITA Suprinity) were processed. To produce a crown scan model (CSM), the inner surface of each fabricated crown was digitized using a touch-probe scanner. In addition, using 3D inspection software, the CDM was partitioned (into marginal, axis, angular, and occlusal regions), the CDM and CSM were overlapped, and a 3D analysis was conducted. A Kruskal–Wallis test (α = 0.05) was conducted with all-segmented teeth with the root mean square (RMS), and they were analyzed using the Mann–Whitney U-test and the Bonferroni correction method as a post hoc test. There was a significant difference in the trueness of the crowns according to the type of lithium disilicate block (p < 0.001). The overall RMS value was at a maximum for e.max (42.9 ± 4.4 µm), followed by HASS (30.1 ± 9.0 µm) and then VITA (27.3 ± 7.9 µm). However, there was no significant difference between HASS and VITA (p = 0.541). There were significant differences in all regions inside the crown (p < 0.001). There was a significantly high trueness in the angular region inside the crown (p < 0.001). A correction could thus be applied in the CAD process, considering the differences in the trueness by the type of lithium disilicate block. In addition, to attain a crown with an excellent fit, it is necessary to provide a larger setting space for the angular region during the CAD process.

Accuracy of marginal fit and axial wall contour for lithium disilicate crowns fabricated using three digital workflows

STATEMENT OF PROBLEM

Comparative assessment of the effectiveness of computer-aided design and computer-aided manufacturing (CAD-CAM) technologies used to fabricate complete-coverage restorations is needed. A quantitative assessment requires precise documentation of the marginal adaptation and external surface contour of fabricated restorations. Limited information is currently available regarding the effects of milling mode on marginal adaptation and reproduction of the external surface contour for CAD-CAM-fabricated restorations.

PURPOSE

The purpose of this in vitro study was to evaluate the outcomes for 3 different digital workflows on the marginal gap and the external surface contour reproducibility of CAD-CAM-fabricated lithium disilicate complete-coverage restorations.

MATERIAL AND METHODS

Twelve Ivorine molars were prepared to receive lithium disilicate crowns. The preparations were digitally recorded using 2 intraoral scanners (TRIOS 3; 3Shape A/S and Planmeca PlanScan; E4D Technologies), and the restorations were designed using their associated design software with reference to the anatomy of an unprepared tooth. The designed restorations were then manufactured from lithium disilicate blocks using a 3-axis milling machine. Twelve restorations were manufactured using the detailed mode (Planmeca PlanScan detailed mode [PPD-D]), and 12 using the standard mode for the Planmeca system (Planmeca PlanScan standard mode [PPD-S]). Restorations from the 3Shape system were fabricated using the detailed mode (TRIOS 3Shape detailed mode [T3S-D]). The restorations were secured on their associated preparation with an elastomeric material. The marginal gap of each restoration was then measured in the ImageJ software using images captured by a stereo microscope at ×20 magnification. External surface reproducibility was evaluated by measuring undercut at 4-line angles using a dental surveyor. Differences in the marginal gaps of restorations fabricated using the 3 different workflows were compared by Brown-Forsythe robust ANOVA, followed by a post hoc test (α=.05). Chi-square analysis (α=.05) was used to evaluate differences in the contours of the external surface of the restorations, resistance form, and marginal integrity produced using the 3 workflows.

RESULTS

The mean marginal gap for restorations fabricated using the T3S-D workflow was 60 μm, a distance significantly lower (P<.05) than that of PPD-D and PPD-S workflows, which yielded a marginal gap of 95 μm for the detailed mode and 124 μm for the standard mode of milling. Restorations fabricated using PPD-D and PPD-S workflows produced a significantly more reproducible external surface contour than those fabricated using the T3S-D workflow.

CONCLUSIONS

Restorations fabricated using the T3S-D workflow produced the smallest marginal gap. However, reproducibility of the external surface contour for this workflow was the worst of the three workflows analyzed.

A comparative evaluation of vertical marginal fit of provisional crowns fabricated by computer-aided design/computer-aided manufacturing technique and direct (intraoral technique) and flexural strength of the materials: An in vitro study

Background:

With the advent of new provisional crown materials, it has become imperative to evaluate their marginal fit and strength to select the ideal provisional crown material.

Aim:

The purpose of this in vitro study was to evaluate and compare the vertical marginal fit and flexural strength of provisional crowns prepared using computer-aided design-computer-aided manufacturing (CAD-CAM) temporary material versus those fabricated using bis-acrylic composite-based autopolymerizing resin material.

Materials and Methods:

Eighty samples were divided into two equal Groups (I and II). Group I consisted of forty samples that were evaluated for flexural strength and Group II consisted of forty samples that were evaluated for their vertical marginal fit. Group I was subdivided as Group IA, i.e., bis-acrylic composite-based autopolymerizing resin material (Protemp™ 4) blocks and Group IB, i.e., CAD/CAM provisional material blocks. Similarly, Group II was subdivided as Group IIA, i.e., bis-acrylic composite-based autopolymerizing resin material (Protemp™ 4) crowns and Group IIB, i.e., CAD/CAM provisional material crowns. Marginal adaptation was evaluated using stereomicroscope and image analyzing software to measure the amount of marginal gap. For flexural strength, all specimens were subjected to a standard compression load in the universal testing machine until fracture occurred. Data were analyzed using Student's t-test (P = 0.001).

Results:

CAD/CAM provisional crowns showed better marginal adaptation (34.34 μm) as compared to bis-acrylic composite-based autopolymerizing resin material (Protemp™ 4) crowns (63.42 μm) (P < 0.001). The flexural strength of CAD/CAM blocks (94.06 megapascals [MPa]) was not statistically different from bis-acrylic composite-based autopolymerizing resin material (Protemp™ 4) blocks (101.41 MPa) (P > 0.001).

Conclusion:

Protemp™ 4 and CAD/CAM provisional materials have comparable flexural strength. However, the marginal fit of temporary crowns fabricated by CAD/CAM was found to be superior to the ones fabricated using bis-acrylic composite-based autopolymerizing resin material (Protemp™ 4).