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

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 (α=.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.