Comparison of Conventional and Digital Workflows for Implant-supported Screw-retained Zirconia FPD Bars: Fit and Cement Gap Evaluation Using SEM Analysis

Purpose: To assess the fit and cement gap of fixed partial dentures supported by two implants made using conventional and digital workflows.

Materials And Methods: Patients requiring fixed partial dentures supported by two implants were included in the study. Forty-eight zirconia fixed partial denture bars supported by two implants (AnyOne, MegaGen, Daegu, South Korea) were produced using a conventional (n = 24, group C) and digital (n = 24, group D) workflow. All implants had the same internal connection prosthetic platform. Silicone open tray impressions with splinted copings (group C) and digital impressions using a Trios 3 intraoral scanner (3Shape, Copenhagen, Denmark) (group D) were taken for each patient. The fit and cement gap were assessed by scanning electron microscopy on the verified master cast. The distance between reference points on the titanium base and implant analogue was measured with and without tightening the prosthetic screw. The difference in distance was calculated and represented the misfit (Dmisfit). The cement gap (Dcement) was measured as the shortest vertical distance from the inferior edge of the bar to the top edge of the titanium base.

Results: The median Dmisfit values (interquartile range) differed significantly (P < 0.05) between the groups, with 59 (60) µm for group C and 78 (88) µm for group D. Fixed partial dentures fabricated using a digital workflow presented lower Dcement values (35 [26] µm) than the conventional group (38.9 [23] µm) (P < 0.05).

Conclusions: Both workflows produced different levels of fit and differently sized cement gaps when measured on the master casts using scanning electron microscopy. A cast-free digital workflow was associated with a smaller cement gap, but larger misfit was detected when measuring on the verified master cast.