Evaluation of Marginal Fit Of CAD/CAM Restorations Fabricated Through Cone Beam Computerized Tomography and Laboratory Scanner Data

Abstract

Statement of problem. Whether cone beam computed tomography (CBCT) images can be used for the fabrication of computer-aided design/computer-aided manufacturing (CAD/CAM) restorations is unknown.

Purpose. The purpose of this in vitro study was to evaluate the marginal fit of CAD/CAM restorations fabricated by using data from CBCT scans with 3 different voxels and laser scanner images.

Material and methods. A crown preparation was made on an extracted premolar tooth according to ceramic crown preparation guidelines. The prepared tooth was scanned with a 3-dimensional (3D) extraoral laser scanner (D900; 3Shape), and CBCT scans were also made with an i-CAT cone beam 3D imaging system at 3 different voxel resolution settings: 0.125 mm, 0.20 mm, and 0.30 mm. The 3D images obtained from the laser scanner and CBCT scans were sent to CAD software, and a crown design was completed. Information was sent to CAM software to mill the crowns from poly(methyl methacrylate) (PMMA) blocks (n=9 from the laser scanner and 27 from 3 different CBCT scans). A total of 144 images (4 groups, 9 crowns per group, 4 sites per crown) were measured for vertical marginal discrepancy under a stereoscopic zoom microscope. One-way analysis of variance (ANOVA) was used to analyze the data. According to the assumption of homogeneity of variance, the post hoc Tukey multiple comparison test was performed (alpha=.05).

Results. The marginal gap values of crowns fabricated with an extraoral laser scanner were significantly lower than those of crowns fabricated with 0.3-, 0.2-, and 0.125-voxel CBCT images (P<.001). The marginal gap was greater when 0.3- and 0.2-voxel CBCT images were used than when 0.125-voxel CBCT images were used (P<.001).

Conclusions. Crowns fabricated with the laser scanner images had lower and clinically acceptable marginal discrepancies than crowns fabricated with CBCT images in 3 different voxels. Of all the CBCT scans, only images with 0.125 voxel produced crowns with clinically acceptable marginal discrepancy.