Marginal adaptation of ceramic crowns:

A systematic review
Mathieu Contrepois, DDS,a Arnaud Soenen, DDS,b
Michel Bartala, DDS, PhD,c and Odile Laviole, DDS, PhDd
Faculty of Dentistry, University of Bordeaux Segalen, Bordeaux, France
Statement of problem. After the development of a variety of ceramic restorative systems over the past 20 years, the fabri-
cation of fixed dental prostheses has undergone considerable change. Esthetics and resistance to fracture are two of the main
determinants of the success of a restoration; the third is marginal adaptation. Therefore, a systematic review of the literature
dedicated to the marginal accuracy of ceramic systems is indicated.

Purpose. This study reviewed the current scientific literature that pertains to the marginal fit of ceramic crowns fabricated with
different systems and investigated the factors that influence marginal adaptation.

Material and methods. An electronic search was completed by using the PubMed and Scopus databases with the following
combination of key words: (discrepancy or fit or gaps or adaptation) and (disilicate or ceramic) and (copings or crowns). The
search was limited to English-language peer-reviewed articles published before April 15, 2012. Titles and abstracts were read
to identify articles that fulfilled the inclusion criteria designed for this review.

Results. Of 469 studies identified, 54 satisfied the selection criteria and were included in this review. All were published
between 1994 and 2012. A total of 17 ceramic systems were tested in 48 in vitro and 6 in vivo studies. Of all the marginal
gaps measured, 94.9% were in the range of clinical acceptability. Study heterogeneity made it impossible to conduct a proper
meta-analysis of research findings and to compare and rank the various systems in terms of marginal fit. Four parameters
were found to influence marginal adaptation: finish line configuration, value of the predefined cementing space, veneering
process, and cementation.

Conclusions. The systems evaluated in the selected articles generally provide a clinically acceptable marginal fit. The
current state of research does not allow for a proper comparison of the various systems in terms of marginal fit. The
use of computer x-ray microtomography is recommended for further research on marginal adaptation. (J Prosthet
Dent 2013;110:447-454)

Clinical Implications
Selection of a system should not be based primarily on marginal
accuracy, as the marginal adaptation of ceramic crowns from the various
systems is generally clinically acceptable, but rather on a system’s ability
to produce the type of ceramics best adapted to existing clinical
conditions and esthetic expectations.

Achieving esthetically and function-
ally ideal restorations has been the goal
of dental clinicians, prosthodontists,
and manufacturers throughout the his-
tory of dentistry. Ceramic crowns have
a natural appearance and excellent
biocompatibility, and their clinical use
has now been extended to the complete
arch.1 The success of a dental restora-
tion is determined by 3 main factors:
esthetic value, resistance to fracture,
and marginal adaptation.2-6 Inade-
quate fit leads to plaque accumula-
tion,2,7,8 which increases the risk of
carious lesions,9,10 and can cause
microleakage and endodontic inflam-
mation.11 Plaque accumulation may
also cause periodontal diseases,2 espe-
cially with subgingival margins.5,12,13
Finally, misfit could contribute to
cement dissolution,14 particularly when

a
Instructor, Department of Prosthodontics.
b
Assistant Professor, Department of Prosthodontics.
c
Associate Professor, Department of Prosthodontics.
d
Associate Professor, Department of Prosthodontics.

Contrepois et al
448
zinc phosphate cements are used.15-20
Until the late 1980s, investigators who
evaluated marginal fit did not always
measure the same distances. Holmes
et al21 proposed a clear terminology in
1989 (Fig. 1). Marginal fit is generally
evaluated by measuring the marginal
gap or the absolute marginal discrep-
ancy.21-23
The American Dental Association
states in Specification No. 8 that the
film thickness of the zinc phosphate
cement should not exceed 25 mm for
Type 1 cements and 40 mm for Type 2
cements.24 However, studies that
examined marginal adaptation have
shown that this goal was seldom
reached.25 Gardner3 observed that,
even under ideal conditions, it was rare
to achieve this level of accuracy. After a
5-year study conducted on more than
1000 restorations, McLean and von
Fraunhaufer26 concluded that 120 mm
was the maximum tolerable marginal
opening.
The fabrication of ceramic crowns
may involve such different methods as
traditional slip casting, hot pressing,
or computer-aided design/computer-
aided manufacturing (CAD/CAM).1,27,28
The objective of this systematic review
was to study the marginal adaptation of
crowns manufactured by various systems
and to identify the factors that influence
marginal fit.
MATERIAL AND METHODS
The PubMed and Scopus electronic
databases were explored for dental
articles with the following combination
of key words: (discrepancy or fit or
gaps or adaptation) and (disilicate or
ceramic) and (copings or crowns). The
last search was conducted on April 15,
2012. Studies considered for this re-
view were English-language articles
from peer-reviewed publications that
focused on the evaluation of the
marginal fit of ceramic single crowns.
Measurements had to match the
description provided by Holmes et al21
for either the marginal gap or the
absolute marginal discrepancy. Both
in vivo and in vitro studies were
The Journal of Prosthetic Dentistry
Path of Withdrawal
h d
Overextended
Casting
e
c b
f discrepancy
g Tooth
h f. Horizontal marginal
1 Casting misfit terminology.21
reviewed. Studies that examined resto-
rations at the coping or crown stage
were included.
Articles that focused on the marginal
fit of restorations other than ceramic
crowns were considered ineligible for
this review. This excluded studies of
partial fixed dental prostheses, veneers,
inlays, onlays, partial crowns, direct
restorations, cast crowns, metal ceramic
crowns, and implant-supported resto-
rations. Studies that measured the
marginal fit of ceramic crowns manu-
factured by less popular or outdated
systems were excluded.
The titles and abstracts identified
through the electronic search were
evaluated for appropriateness by 2
investigators (MC and AS) indepen-
dently. Upon identification of an
abstract for possible inclusion, the
full text of the article was reviewed
and subjected to predefined inclusion
and exclusion criteria. The electronic
search was supplemented by manual
searching through the references
of the selected articles, and those
articles were reviewed for possible
inclusion. Any discrepancies were re-
solved by discussion between the 2
reviewers.
The following data were extracted
from each article: type of system
Volume 110 Issue 6
Underextended
Casting
a
g eb
Tooth
f
a. Internal gap
b. Marginal gap
a c. Overextended margin
d. Underextended margin
e. Vertical marginal
discrepancy
g. Absolute marginal
discrepancy
h. Seating discrepancy
studied, stage of completion of the
restoration, sample size, type of finish
line, occurrence of cementation, exam-
ination method, number of sites where
measurements were made, location
where measurements were made (die
or abutment tooth), and value of the
absolute marginal discrepancy or
marginal gap measured.
RESULTS
Among 469 reports identified
through the electronic search, 54 were
selected, all published between 1994
and April 2012. Searching through the
references of the selected articles did
not provide any additional articles.
Forty-eight articles reported in vitro
studies and 6 in vivo studies. Forty-
three measured the marginal gap, 8
measured the absolute marginal
discrepancy, and 3 measured both.
Seventeen fabrication processes were
described (Table I). Nineteen studies
compared different systems, whereas
35 tested only one (Supplemental
Table I).20,22,23,25,29-78 Excluded sys-
tems and related studies are listed in
Table II.25,73,79-93 An overall review of
the data retrieved for marginal gap
showed that 94.9% of the values
measured were less than or equal to
Contrepois et al
December 2013 449
Table I. Methods of forming ceramic crowns
Fabrication No.
Method System Articles Specifications Composition

Slip casting In-Cerama 13 In-Ceram Alumina (12) Glass-alumina

In-Ceram Zirconia (1) Glass-alumina-PS zirconia
b
Wolceram 1 In-Ceram Alumina (1) Glass-alumina
c
Hot pressing IPS 10 Empress I (3) Leucite-glass
Empress II (6) Lithium disilicate-glass
e.max Press (2) Lithium disilicate-glass
d
CAD/CAM Procera 19 AllCeram (15) Alumina
All Zirkon (4) Y-TZP (presintered)
e
Cercon 9 Cercon CAM (4); Cercon Y-TZP (presintered)
CAD/CAM (6)
Celayf 6 In-Ceram Alumina (6)a Glass-alumina
a
Vita Celay (1) Feldspathic
Cerec 3g 6 Vitablocs Mark II (3)a Feldspathic
c
e.max CAD (1) Lithium disilicate-glass
a
In-Ceram Yz (1) Y-TZP (presintered)
NA (1)
Cerec inLabg 6 In-Ceram Alumina (2)a Glass-alumina
a
In-Ceram Zirconia (2) Glass-alumina-PS zirconia
a
Vitablocs Mark II (1) Leucite-glass
a
In-Ceram Yz (1) Y-TZP (presintered)
Empress CAD (1)c Leucite-glass
h
Lava 4 Lava (4); Lava C.O.S. (1) Y-TZP (presintered)
i
Decim 2 Denzir Y-TZP (densely sintered)
Precidentj 2 DC-Zirkon Y-TZP (densely sintered)
k
Digident 1 Digizon Y-TZP (densely sintered)
l
Everest 1 HPC Zircon (ZrSiO4)
m
Katana 1 Y-TZP (presintered)
Zirkonzahnn 1 ICE Zirkon Y-TZP (presintered)
o a
GN1 1 In-Ceram Alumina Glass-alumina
p c
Decsy 1 ProCad Leucite-glass

CAD/CAM, computer-aided design/computer-aided manufacturing; NA, not available.

a
Vita Zahnfabrik; bWol-Dent; cIvoclar-Vivadent; dNobel Biocare; eDentsply-Ceramcop; fMikronaTechnologie; gSirona; h3M ESPE; iDentronic AB;
j
DCS Dental AG; kGirrbach; lKaVo; mNoritake Dental Supply Co Ltd; nZirconzahn; oGC Corporation; pMedia/Digital Process.

120 mm. The widest marginal gap
measured was 174 mm, and the small-
est was 3.7 mm.
The selected articles displayed a
significant heterogeneity in terms of
experimental protocols, which led to
different discrepancies being measured,
sometimes even for the same system,
and this made it impossible to provide
a strict ranking of the different systems
in terms of accuracy or to perform a
meta-analysis. The majority of crowns
Contrepois et al
manufactured by the various ceramic
systems satisfied requirements in terms
of marginal adaptation. Various factors
may influence marginal adaptation.
Type of tooth
Of the 9 studies that examined
the type of tooth that received the
ceramic crown,29,30,34,37,40,44,46,68,71
only 2 found that tooth type affected
marginal fit. One reason for the effect
that was sometimes observed may be
the complexity of preparing and mak-
ing a good impression of a posterior
tooth.37
Tooth side
Eight studies23,32,36,37,50,60,61,76 com-
pared marginal fit on each side of the
tooth: buccal, lingual, mesial, or distal.
Only one study32 found that it varied
significantly.
450 Volume 110 Issue 6
Table II. Excluded systems and related studies convergence angle of between 10 and 22
degrees or the slightly narrower range of
System Studies 10 to 20 degrees recommended by
Goodacre et al.97
Dicora or/and Cerestoreb Davis79; Schaerer et al80; Abbate et al81; Hung et al82;
Ferrari83; Vahidi et al84; Weaver et al85; Holmes et al86;
Alkumru et al87; Hoard88; Clark89 Porcelain veneering and firing cycles
c 90
Cerec 2 Bindl et al
NA Mitchell et al91 Eight studies25,29,31-33,36,48,61 con-
cluded that the impact of porcelain
CPC-MKd Goldin et al92
veneering on marginal fit was not signif-
Authentice Holden et al93
icant. In contrast, 5 studies52,58,63,76,78
f
Turkom-Cera Al-Makramani et al73; Bhowmik and Parkhedkar25 found that porcelain veneering substan-
NA, not available. tially widened the marginal gap. One
a
Dentsply Intl; bCeramco Inc; cSirona; dCPC-MK, Chemlich; eCeramay; fTurkom-Cera SDN. other study66 observed that marginal fit
can significantly vary, depending on the
Finish line configuration results indicated that the value of the veneering material used.
predefined cement space could influ- As was suggested for metal ceramic
Ten of the reviewed articles investi- ence the marginal fit of ceramic crowns. crowns,98 a contamination of the in-
gated a possible relation between A small cement space could lead to ternal surface of the coping by the
finish line design and marginal ad- premature contacts between the in- veneering material could cause a
aptation. Three compared chamfer ternal surface of the crown and the widening of the marginal gap. Balkaya
finish lines with straight shoulder abutment tooth38 and hinder the et al99 prevented the contamination of
finish lines.29,31,67 Chamfer finish lines evacuation of excess cement from the internal surface of the coping by the
yielded better results than straight the occlusal surface of the tooth, thus porcelain and still found that marginal
shoulders. It should be noted that the widening the marginal gap.74 adaptation was significantly affected
latter are not indicated for ceramic after firing. The widening of the mar-
restorations. Angulation of the preparation ginal gap was attributed by some in-
The other articles provided a com- vestigators52,63 to distortions of the
parison between shoulder margins with The term ‘angulation’ refers to the copings by the manufacturing process.
a rounded internal angle and cham- angle of preparation, that is, the angle For Fahmy,66 one possible explanation
fer finish lines. For various sys- that the prepared axial surface makes in the case of multilayered crowns with
tems,22,41,48,76 no significant difference with the tooth’s axis, or to the total different coefficients of thermal expan-
was noted between the 2 finish line occlusal convergence, that is the angle sion is that the cooling of the restora-
designs. However, studies of others of convergence between 2 opposing tions can lead to substantial stress,100
systems41,75,78 showed that chamfer prepared axial surfaces, whose value is which can cause deformation.101 The
finish lines resulted in significantly double that of the angle of preparation. effect sometimes observed was likely to
wider marginal gaps than rounded Six studies measured the variation of have multiple causes and to be limited
shoulders. marginal fit according to the angle of to double-layer ceramic crowns; single-
preparation. They were conducted layer crowns do not require conven-
Cement space in vitro to achieve the exact angles tional laboratory work and should not
required. All of them involved CAD/ be affected in the same way.52
Creating a space between the die CAM systems. Four studies38,45,53,67
and the prosthesis for the cement layer were conducted before cementation; of Cementation
is known to significantly improve these, 3 found that angulation did not
adaptation.94 Eames et al95 advised influence the marginal fit.38,45,67 How- Jorgensen and Petersen102 showed
coating the die, but not the marginal ever, in one55 of the 2 studies55,57 con- that cementation could significantly
area, with a spacer varnish. This ducted on cemented restorations, it was compromise marginal adaptation by
coating is required in ceramic systems noted that crown cementation coupled specifying that fine-grained cements
that do not involve CAD/CAM. With with a low preparation angulation could should yield comparatively better re-
CAD/CAM systems, the cement space result in a higher hydraulic pressure and sults. Accordingly, a number of in-
was set through the software interface. hinder the discharge of excess cement. In vestigators attempted to test the effects
Some of the reviewed studies measured the absence of certainty, it generally of cementation on marginal fit. Four
the impact of programming different seems better to retain, for all systems, studies20,51,72,74 attempted to deter-
settings on the resulting marginal and the angulation values recommended by mine whether the type of cement
internal fit.38,45,53,74 Analysis of the Shillingburg et al96 with a total occlusal used had an impact on marginal fit.
The Journal of Prosthetic Dentistry Contrepois et al
December 2013
Three29,65,78 compared restoration
adaptation before and after cemen-
tation. Four studies35,41,42,47 tested
both parameters. Five29,35,41,47,65 of 7
studies found a significantly higher
marginal fit value after cementation.
This might have been caused by
hydraulic pressure and the problematic
discharge of excess cement. Three20,51,74
of 8 studies have shown that the type of
cement used had a substantial impact.
This result was attributed to a difference
in thickness and viscosity. Analysis of
these findings suggest that cementation
could significantly increase the marginal
gap.
DISCUSSION
Some of the factors that derive
from the particular organization of
each system may also influence
marginal accuracy. Techniques thus
were deemed more or less sensitive.32
Direct human intervention in the
manufacturing of the crown could
play a role according to the skill of
the dental laboratory technician and
the relative importance of his
contribution.23 The number of steps
involved in the process was another
important element32,41,65,69 because
the probability of error increased with
each additional step required.64 For
example, non-CAD/CAM systems
required the use of a die spacer applied
by a technician, and the traditional
In-Ceram slip-casting system was
described as singularly technique sen-
sitive.39 Generally, CAM systems were
at risk of more dimensional variations
than CAD/CAM systems.57,65,69,77
Direct CAD/CAM systems involved few
steps.64,65 The coping, and sometimes
even the crown, could be completed
without the use of a die through
intraoral impression. However, the
accuracy of data acquisition varied
according to the systems’ various opti-
cal impression technologies. Software
technology and milling accuracy also
differed.53,77,103-105 In addition, even
for the same system, substantial varia-
tions among the measured values were
noted, which was mainly due to the
Contrepois et al
different experimental protocols used in
each study.
Measurement method
Different measurement methods
were used among the various studies,
and this could have impacted results
significantly. The first and most widely
used method involved direct micro-
scopic examination of the marginal
area. Unfortunately, this method has 2
important disadvantages. First, identi-
fying reference points to measure may
prove difficult. Second, it may lead to
projection errors.33,106 In the second
method, cemented specimens were
cross-sectioned, and the marginal area
was then examined under a micro-
scope. However, only a limited number
of sections could be cut on any one
specimen. These 2 techniques were
sometimes used to measure an epoxy
resin replica of the marginal area
instead of the area itself. This practice
does not provide accurate results and,
therefore, is discouraged. A third
method involved creating a light-
bodied silicone replica of the gap be-
tween the crown and the tooth. This
replica was then sectioned, and the
zone that corresponded to the marginal
area was observed by microscopy.
This provided only a limited number
of marginal gap measurements. A
fourth method, laser videography, also
involved a light-bodied silicone replica,
which was digitized along with the die.
This method has often been used to
measure internal gap107-109 but did
not appear to provide reliable identifi-
cation of the essential reference points
necessary to measure marginal fit. A
fifth technique, profilometry, measured
marginal fit by using a profilometer, a
device initially designed to evaluate
the roughness of a surface. It only
allowed for indirect measurements of
the absolute marginal discrepancy, and
its results were subject to false inter-
pretation.23 The last technique used
was x-ray microtomography. This
innovative and nondestructive tech-
nique, which delivers 2-dimensional
and 3-dimensional imaging of the
451
space between the reconstitution and
the die,23,110,111 can provide very close
sections of the marginal area, which
allows for a great number of measure-
ment sites and for easy recognition of
the critical distances.
In vitro and in vivo studies
For technical reasons, silicone
replication was the only marginal fit
measurement method used in vivo; its
results were not as accurate as those
yielded by other methods available
in vitro such as x-ray microtomography.
In addition, in vivo, tooth preparation
could be more complex because
accessibility and vision could be
impaired.37 Likewise, the quality of an
impression could be affected by various
factors, such as the location of the
finish line, periodontal health, sulcus
bleeding during impression making,
saliva flow rate, and patient compli-
ance.64 To minimize the impact of
environmental factors, the accuracy
of a system should be tested in optimal
clinical conditions. These can be suit-
ably replicated in a well-designed
in vitro experiment, in which a
near-perfect preparation with regular
shoulder and chamfer lines can be
achieved.112
Number of measure sites
There is no agreement in the litera-
ture concerning the number of measure
sites necessary to evaluate marginal fit.
Yet, this parameter seems critical
because, within a distance of 300 mm,
the marginal opening can fluctuate by
100 mm on the same specimen.113
Groten et al106 suggested taking 50
measurements of the marginal fit to
limit the numerical variance to 5 mm.
In 2004, Gassino et al112 argued that
the results of Groten et al106 were
erroneous and concluded that 18
observation points were necessary to
evaluate experimental crowns made for
laboratory-prepared abutments and 90
for crowns manufactured from intrao-
ral impression to produce a sample
mean value within 5 mm of the true
452
mean, with a standard error 4 mm. Of
the 54 selected studies, only 18 can be
said to fulfill these criteria.
Preparation design
In vitro, a tooth or model should be
prepared in accordance with clinical
conditions. Thus, the use of metallic
models with overly simplified shapes and
a flat occlusal surface25,41,49,53,65,70,75
that bear no relation to actual tooth
anatomy should be discontinued. In
addition, finish lines that exhibit some
degree of curve should perhaps be
preferred because they better simulate the
presence of a gingival margin.
Measurements at coping stage or
crown stage
A better approximation of clinical
conditions may be reached by con-
ducting measurements upon completion
of the crown. In addition, measuring fit
at the crown stage is necessary to
compare single-layer crowns with multi-
layer crowns.
Adjustments on the internal surface
of the coping
Some of the selected studies
included adjustments made on the in-
ternal surface of the copings or crowns
before measuring marginal fit. Such
grinding procedures were an important
source of result distortion and should
not be used in studies of marginal fit.37
Measurements made on a die or an
abutment tooth
Six studies29,40,42,54,59,60 attempted
to determine whether measurements
made on the die differed from those
made on the abutment tooth. Half
the studies noted a significant
discrepancy among the values of
marginal fit measured on the die and
on the tooth.40,58,59 In the absence
of consensus, it may be preferable
to conduct measurements on the
tooth to better approximate clinical
conditions.
The Journal of Prosthetic Dentistry
Measurements made before or after
cementation
Measurements made solely after
cementation did not allow for the deter-
mination of the relative impact on mar-
ginal fit of cementation and of a system’s
intrinsic precision.33 Besides, it is more
convenient to conduct measurements
without cementing the crown, and this is
what most investigators did. This does
not exclude further evaluation of the
marginal fit after cementation if the
chosen evaluation method permits it.
CONCLUSION
Generally, the marginal adaptation
of ceramic crowns issuing from the
various manufacturing systems was
clinically acceptable. Therefore, the se-
lection of a manufacturing system
should not be based primarily on mar-
ginal accuracy but rather on each sys-
tem’s ability to provide the ceramic
material best adapted to clinical and
esthetic requirements. Four factors with
a likely influence on marginal fit were
identified: finish line configuration,
value of the cementing space, veneering
process, and cementation. Because of
significant protocol heterogeneity, it
was impossible to establish a ranking of
the different systems or to conduct a
proper comparison among them. X-ray
microtomography was the only method
that allowed both for a precise identi-
fication of the critical distances and for
a sufficient number of gap measure-
ments. For this reason, future in-
vestigators are encouraged to use
this method for the measurement of
marginal accuracy.
REFERENCES
1. Conrad HJ, Seong WJ, Pesun IJ. Current
ceramic materials and systems with clinical
recommendations: a systematic review.
J Prosthet Dent 2007;98:389-404.
2. Bjorn AL, Bjorn H, Grkovic B. Marginal fit
of restorations and its relation to peri-
odontal bone level. II. Crowns. Odontol
Revy 1970;21:337-46.
3. Gardner FM. Margins of complete
crownsdliterature review. J Prosthet Dent
1982;48:396-400.
Volume 110 Issue 6
4. Hunter AJ, Hunter AR. Gingival margins for
crowns: a review and discussion. Part II:
discrepancies and configurations. J Prosthet
Dent 1990;64:636-42.
5. Felton DA, Kanoy BE, Bayne SC,
Wirthman GP. Effect of in vivo crown
margin discrepancies on periodontal health.
J Prosthet Dent 1991;65:357-64.
6. Richter WA, Ueno H. Relationship of
crown margin placement to gingival
inflammation. J Prosthet Dent 1973;30:
156-61.
7. Behrend DA. Crown margins and gingival
health. Ann R Australas Coll Dent Surg
1984;8:138-45.
8. Saltzberg DS, Ceravolo FJ, Holstein F,
Groom G, Gottsegen R. Scanning electron
microscope study of the junction between
restorations and gingival cavosurface
margins. J Prosthet Dent 1976;36:517-22.
9. Schwartz NL, Whitsett LD, Berry TG,
Stewart JL. Unserviceable crowns and fixed
partial dentures: life-span and causes for
loss of serviceability. J Am Dent Assoc
1970;81:1395-401.
10. Karlsson S. A clinical evaluation of fixed
bridges, 10 years following insertion. J Oral
Rehabil 1986;13:423-32.
11. Bergenholtz G, Cox CF, Loesche WJ,
Syed SA. Bacterial leakage around dental
restorations: its effect on the dental pulp.
J Oral Pathol 1982;11:439-50.
12. Janenko C, Smales RJ. Anterior crowns
and gingival health. Aust Dent J 1979;24:
225-30.
13. Sorensen SE, Larsen IB, Jorgensen KD.
Gingival and alveolar bone reaction to
marginal fit of subgingival crown margins.
Scand J Dent Res 1986;94:109-14.
14. Cooper TM, Christensen GJ, Laswell HR,
Baxter R. Effect of venting on cast gold full
crowns. J Prosthet Dent 1971;26:621-6.
15. Jacobs MS, Windeler AS. An investigation of
dental luting cement solubility as a function
of the marginal gap. J Prosthet Dent
1991;65:436-42.
16. Piwowarczyk A, Lauer HC, Sorensen JA.
Microleakage of various cementing agents
for full cast crowns. Dent Mater 2005;21:
445-53.
17. White SN, Ingles S, Kipnis V. Influence of
marginal opening on microleakage of
cemented artificial crowns. J Prosthet Dent
1994;71:257-64.
18. Gu XH, Kern M. Marginal discrepancies and
leakage of all-ceramic crowns: influence of
luting agents and aging conditions. Int J
Prosthodont 2003;16:109-16.
19. Rossetti PH, do Valle AL, de Carvalho RM,
De Goes MF, Pegoraro LF. Correlation
between margin fit and microleakage in
complete crowns cemented with three luting
agents. J Appl Oral Sci 2008;16:64-9.
20. Albert FE, El-Mowafy OM. Marginal adap-
tation and microleakage of Procera
AllCeram crowns with four cements. Int J
Prosthodont 2004;17:529-35.
21. Holmes JR, Bayne SC, Holland GA,
Sulik WD. Considerations in measurement
of marginal fit. J Prosthet Dent 1989;62:
405-8.
Contrepois et al
December 2013
22. Suarez MJ, Gonzalez de Villaumbrosia P,
Pradies G, Lozano JF. Comparison of the
marginal fit of Procera AllCeram crowns
with two finish lines. Int J Prosthodont
2003;16:229-32.
23. Pelekanos S, Koumanou M, Koutayas SO,
Zinelis S, Eliades G. Micro-CT evaluation of
the marginal fit of different In-Ceram
alumina copings. Eur J Esthet Dent 2009;4:
278-92.
24. American Dental Association. ANSI/ADA
Specification n 8 for zinc phosphate
cement. In: Guide to dental materials and
devices. 5th ed. Chicago: American Dental
Association; 1970-71.
25. Bhowmik H, Parkhedkar R. A comparison of
marginal fit of glass infiltrated alumina
copings fabricated using two different tech-
niques and the effect of firing cycles over
them. J Adv Prosthodont 2011;3:196-203.
26. McLean JW, von Fraunhofer JA. The estima-
tion of cement film thickness by an in vivo
technique. Br Dent J 1971;131:107-11.
27. Griggs JA. Recent advances in materials for
all-ceramic restorations. Dent Clin North
Am 2007;51:713-27, viii.
28. Guess PC, Schultheis S, Bonfante EA,
Coelho PG, Ferencz JL, Silva NR. All-ceramic
systems: laboratory and clinical performance.
Dent Clin North Am 2011;55:333-52, ix.
29. Pera P, Gilodi S, Bassi F, Carossa S. In vitro
marginal adaptation of alumina porcelain
ceramic crowns. J Prosthet Dent 1994;72:
585-90.
30. Rinke S, Huls A, Jahn L. Marginal accuracy
and fracture strength of conventional and
copy-milled all-ceramic crowns. Int J
Prosthodont 1995;8:303-10.
31. Shearer B, Gough MB, Setchell DJ. Influence
of marginal configuration and porcelain
addition on the fit of In-Ceram crowns.
Biomaterials 1996;17:1891-5.
32. Sulaiman F, Chai J, Jameson LM,
Wozniak WT. A comparison of the
marginal fit of In-Ceram, IPS Empress, and
Procera crowns. Int J Prosthodont 1997;10:
478-84.
33. Groten M, Girthofer S, Probster L. Marginal
fit consistency of copy-milled all-ceramic
crowns during fabrication by light and
scanning electron microscopic analysis
in vitro. J Oral Rehabil 1997;24:871-81.
34. May KB, Russell MM, Razzoog ME, Lang BR.
Precision of fit: the Procera AllCeram crown.
J Prosthet Dent 1998;80:394-404.
35. Beschnidt SM, Strub JR. Evaluation of the
marginal accuracy of different all-ceramic
crown systems after simulation in the artifi-
cial mouth. J Oral Rehabil 1999;26:582-93.
36. Nakamura T, Nonaka M, Maruyama T.
In vitro fitting accuracy of copy-milled
alumina cores and all-ceramic crowns. Int J
Prosthodont 2000;13:189-93.
37. Boening KW, Wolf BH, Schmidt AE,
Kastner K, Walter MH. Clinical fit of Pro-
cera AllCeram crowns. J Prosthet Dent
2000;84:419-24.
38. Nakamura T, Dei N, Kojima T,
Wakabayashi K. Marginal and internal fit of
Cerec 3 CAD/CAM all-ceramic crowns. Int J
Prosthodont 2003;16:244-8.
Contrepois et al
39. Yeo IS, Yang JH, Lee JB. In vitro marginal fit
of three all-ceramic crown systems.
J Prosthet Dent 2003;90:459-64.
40. Coli P, Karlsson S. Fit of a new pressure-
sintered zirconium dioxide coping. Int J
Prosthodont 2004;17:59-64.
41. Quintas AF, Oliveira F, Bottino MA. Vertical
marginal discrepancy of ceramic copings
with different ceramic materials, finish lines,
and luting agents: an in vitro evaluation.
J Prosthet Dent 2004;92:250-7.
42. Naert I, Van der Donck A, Beckers L. Precision
of fit and clinical evaluation of all-ceramic full
restorations followed between 0.5 and 5
years. J Oral Rehabil 2005;32:51-7.
43. Bindl A, Mormann WH. Marginal and
internal fit of all-ceramic CAD/CAM
crown-copings on chamfer preparations.
J Oral Rehabil 2005;32:441-7.
44. Kokubo Y, Ohkubo C, Tsumita M,
Miyashita A, Vult von Steyern P,
Fukushima S. Clinical marginal and internal
gaps of Procera AllCeram crowns. J Oral
Rehabil 2005;32:526-30.
45. Nakamura T, Tanaka H, Kinuta S, Akao T,
Okamoto K, Wakabayashi K, et al. In vitro
study on marginal and internal fit of CAD/
CAM all-ceramic crowns. Dent Mater J
2005;24:456-9.
46. Kokubo Y, Nagayama Y, Tsumita M,
Ohkubo C, Fukushima S, Vult von Steyern P.
Clinical marginal and internal gaps of In-
Ceram crowns fabricated using the GN-I
system. J Oral Rehabil 2005;32:753-8.
47. Okutan M, Heydecke G, Butz F, Strub JR.
Fracture load and marginal fit of shrinkage-
free ZrSiO4 all-ceramic crowns after chewing
simulation. J Oral Rehabil 2006;33:827-32.
48. Komine F, Iwai T, Kobayashi K,
Matsumura H. Marginal and internal
adaptation of zirconium dioxide ceramic
copings and crowns with different finish line
designs. Dent Mater J 2007;26:659-64.
49. Kunii J, Hotta Y, Tamaki Y, Ozawa A,
Kobayashi Y, Fujishima A, et al. Effect of
sintering on the marginal and internal fit of
CAD/CAM-fabricated zirconia frameworks.
Dent Mater J 2007;26:820-6.
50. Pilathadka S, Slezak R, Srinivasan V,
Ivancakova R. Precision of marginal
adaptation of the incisor and molar Procera
allceram crown copings. Prague Med Rep
2008;109:71-82.
51. Pilathadka S, Slezak R, Vahaloa D,
Kudiyirickal MG, Sukumar S. Influence of
different luting agents on the marginal
discrepancy of Procera Allceram alumina
crown copings: an experimental study. Acta
Medica (Hradec Kralove) 2008;51:13-8.
52. Lee KB, Park CW, Kim KH, Kwon TY. Mar-
ginal and internal fit of all-ceramic crowns
fabricated with two different CAD/CAM
systems. Dent Mater J 2008;27:422-6.
53. Iwai T, Komine F, Kobayashi K, Saito A,
Matsumura H. Influence of convergence
angle and cement space on adaptation of
zirconium dioxide ceramic copings. Acta
Odontol Scand 2008;66:214-8.
54. Al-Rabab’ah MA, Macfarlane TV,
McCord JF. Vertical marginal and internal
adaptation of all-ceramic copings made by
453
CAD/CAM technology. Eur J Prosthodont
Restor Dent 2008;16:109-15.
55. Beuer F, Edelhoff D, Gernet W,
Naumann M. Effect of preparation angles
on the precision of zirconia crown copings
fabricated by CAD/CAM system. Dent
Mater J 2008;27:814-20.
56. Limkangwalmongkol P, Kee E, Chiche GJ,
Blatz MB. Comparison of marginal fit
between all-porcelain margin versus
alumina-supported margin on Procera
Alumina crowns. J Prosthodont 2009;18:
162-6.
57. Beuer F, Aggstaller H, Richter J, Edelhoff D,
Gernet W. Influence of preparation angle on
marginal and internal fit of CAD/CAM-
fabricated zirconia crown copings. Quin-
tessence Int 2009;40:243-50.
58. Romeo E, Iorio M, Storelli S,
Camandona M, Abati S. Marginal
adaptation of full-coverage CAD/CAM
restorations: in vitro study using a
non-destructive method. Minerva Stomatol
2009;58:61-72.
59. D’Arcy BL, Omer OE, Byrne DA, Quinn F.
The reproducibility and accuracy of internal
fit of Cerec 3D CAD/CAM all ceramic
crowns. Eur J Prosthodont Restor Dent
2009;17:73-7.
60. Comlekoglu M, Dundar M, Ozcan M,
Gungor M, Gokce B, Artunc C. Influence
of cervical finish line type on the marginal
adaptation of zirconia ceramic crowns.
Oper Dent 2009;34:586-92.
61. Tao J, Han D. The effect of finish line
curvature on marginal fit of all-ceramic
CAD/CAM crowns and metal-ceramic
crowns. Quintessence Int 2009;40:745-52.
62. Reich S, Uhlen S, Gozdowski S, Lohbauer U.
Measurement of cement thickness under
lithium disilicate crowns using an impres-
sion material technique. Clin Oral Investig
2011;15:521-6.
63. Pak HS, Han JS, Lee JB, Kim SH, Yang JH.
Influence of porcelain veneering on the
marginal fit of Digident and Lava CAD/
CAM zirconia ceramic crowns. J Adv Pros-
thodont 2010;2:33-8.
64. Syrek A, Reich G, Ranftl D, Klein C, Cerny B,
Brodesser J. Clinical evaluation of all-
ceramic crowns fabricated from intraoral
digital impressions based on the principle of
active wavefront sampling. J Dent 2010;38:
553-9.
65. Ural C, Burgaz Y, Sarac D. In vitro evalua-
tion of marginal adaptation in five ceramic
restoration fabricating techniques.
Quintessence Int 2010;41:585-90.
66. Fahmy NZ. Influence of veneering materials
on the marginal fit and fracture resistance
of an alumina core system. J Prosthodont
2011;20:45-51.
67. Castillo Oyague R, Sanchez-Jorge MI,
Sanchez Turrion A. Influence of CAD/CAM
scanning method and tooth-preparation
design on the vertical misfit of zirconia
crown copings. Am J Dent 2010;23:341-6.
68. Kokubo Y, Tsumita M, Kano T, Sakurai S,
Fukushima S. Clinical marginal and internal
gaps of zirconia all-ceramic crowns.
J Prosthodont Res 2011;55:40-3.
454
69. Martinez-Rus F, Suarez MJ, Rivera B,
Pradies G. Evaluation of the absolute mar-
ginal discrepancy of zirconia-based ceramic
copings. J Prosthet Dent 2011;105:108-14.
70. Korkut L, Cotert HS, Kurtulmus H. Mar-
ginal, internal fit and microleakage of zir-
conia infrastructures: an in-vitro study.
Oper Dent 2011;36:72-9.
71. Grenade C, Mainjot A, Vanheusden A. Fit of
single tooth zirconia copings: comparison
between various manufacturing processes.
J Prosthet Dent 2011;105:249-55.
72. Yuksel E, Zaimoglu A. Influence of marginal
fit and cement types on microleakage of
all-ceramic crown systems. Braz Oral Res
2011;25:261-6.
73. Al-Makramani BM, Razak AA, Abu-
Hassan MI, Sulaiman E, Loon LJ, Yahya NA.
Marginal integrity of turkom-cera compared
to other all-ceramic materials: effect of fin-
ish line. Int J Prosthodont 2011;24:379-81.
74. Hmaidouch R, Neumann P, Mueller WD.
Influence of preparation form, luting space
setting and cement type on the marginal
and internal fit of CAD/CAM crown cop-
ings. Int J Comput Dent 2011;14:219-26.
75. Assuncao Souza RO, Ozcan M, Augusto
Pavanelli C, Buso L, Leao Lombardo GH,
Araujo Michida SM, et al. Marginal and in-
ternal discrepancies related to margin design
of ceramic crowns fabricated by a CAD/CAM
System. J Prosthodont 2012;21:94-100.
76. Cho SH, Nagy WW, Goodman JT, Solomon E,
Koike M. The effect of multiple firings on the
marginal integrity of pressable ceramic single
crowns. J Prosthet Dent 2012;107:17-23.
77. Alghazzawi TF, Liu PR, Essig ME. The effect
of different fabrication steps on the mar-
ginal adaptation of two types of glass-
infiltrated ceramic crown copings fabricated
by CAD/CAM technology. J Prosthodont
2012;21:167-72.
78. Euan R, Figueras-Alvarez O, Cabratosa-
Termes J, Brufau-de Barbera M, Gomes-
Azevedo S. Comparison of the marginal
adaptation of zirconium dioxide crowns in
preparations with two different finish lines.
J Prosthodont 2012;21:291-5.
79. Davis DR. Comparison of fit of two types of all-
ceramic crowns. J Prosthet Dent 1988;59:12-6.
80. Schaerer P, Sato T, Wohlwend A.
A comparison of the marginal fit of three
cast ceramic crown systems. J Prosthet Dent
1988;59:534-42.
81. Abbate MF, Tjan AH, Fox WM. Comparison
of the marginal fit of various ceramic crown
systems. J Prosthet Dent 1989;61:527-31.
82. Hung SH, Hung KS, Eick JD, Chappell RP.
Marginal fit of porcelain-fused-to-metal
and two types of ceramic crown. J Prosthet
Dent 1990;63:26-31.
83. Ferrari M. Cement thickness and microleakage
under Dicor crowns: an in vivo investigation. Int
J Prosthodont 1991;4:126-31.
84. Vahidi F, Egloff ET, Panno FV. Evaluation of
marginal adaptation of all-ceramic crowns
and metal ceramic crowns. J Prosthet Dent
1991;66:426-31.
The Journal of Prosthetic Dentistry
85. Weaver JD, Johnson GH, Bales DJ. Marginal
adaptation of castable ceramic crowns.
J Prosthet Dent 1991;66:747-53.
86. Holmes JR, Sulik WD, Holland GA,
Bayne SC. Marginal fit of castable ceramic
crowns. J Prosthet Dent 1992;67:594-9.
87. Alkumru HN, Wilson HJ, Bor S. The fit of
all-ceramic crowns cemented with different
luting agents. J Marmara Univ Dent Fac
1992;1:198-202.
88. Hoard RJ, Chiang PC, Hewlett ER,
Caputo AA. Marginal discrepancy as related
to margin design in porcelain-fused-to-Dicor
restorations. Oral Health 1993;83:15-6, 18.
89. Clark MT, Richards MW, Meiers JC. Seating
accuracy and fracture strength of vented and
nonvented ceramic crowns luted with three
cements. J Prosthet Dent 1995;74:18-24.
90. Bindl A, Windisch S, Mormann WH. Full-
ceramic CAD/CIM anterior crowns and
copings. Int J Comput Dent 1999;2:97-111.
91. Mitchell CA, Pintado MR, Douglas WH.
Nondestructive, in vitro quantification of
crown margins. J Prosthet Dent 2001;85:
575-84.
92. Goldin EB, Boyd NW III, Goldstein GR,
Hittelman EL, Thompson VP. Marginal fit
of leucite-glass pressable ceramic restora-
tions and ceramic-pressed-to-metal resto-
rations. J Prosthet Dent 2005;93:143-7.
93. Holden JE, Goldstein GR, Hittelman EL,
Clark EA. Comparison of the marginal fit of
pressable ceramic to metal ceramic resto-
rations. J Prosthodont 2009;18:645-8.
94. Hollenback GM. Precision gold inlays made
by a simple technique. J Am Dent Assoc
1943;30:99-109.
95. Eames WB, O’Neal SJ, Monteiro J, Miller C,
Roan JD Jr, Cohen KS. Techniques to
improve the seating of castings. J Am Dent
Assoc 1978;96:432-7.
96. Shillingburg HT, Hobo S, Whitsett LD,
Jacobi R, Brackett SE. Fundamentals of
fixed prosthodontics. 3rd ed. Chicago:
Quintessence Publishing; 1997. p. 120.
97. Goodacre CJ, Campagni WV, Aquilino SA.
Tooth preparations for complete crowns:
an art form based on scientific principles.
J Prosthet Dent 2001;85:363-76.
98. Gemalmaz D, Alkumru HN. Marginal fit
changes during porcelain firing cycles.
J Prosthet Dent 1995;73:49-54.
99. Balkaya MC, Cinar A, Pamuk S. Influence of
firing cycles on the margin distortion of 3
all-ceramic crown systems. J Prosthet Dent
2005;93:346-55.
100. DeHoff PH, Barrett AA, Lee RB, Anusavice KJ.
Thermal compatibility of dental ceramic
systems using cylindrical and spherical
geometries. Dent Mater 2008;24:744-52.
101. Isgro G, Wang H, Kleverlaan CJ, Feilzer AJ.
The effects of thermal mismatch and fabri-
cation procedures on the deflection of
layered all-ceramic discs. Dent Mater
2005;21:649-55.
102. Jorgensen KD, Petersen GF. The grain size of
zinc phosphate cements. Acta Odontol
Scand 1963;21:255-70.
Volume 110 Issue 6
103. Luthardt R, Weber A, Rudolph H, Schone C,
Quaas S, Walter M. Design and production
of dental prosthetic restorations: basic
research on dental CAD/CAM technology.
Int J Comput Dent 2002;5:165-76.
104. Beuer F, Naumann M, Gernet W,
Sorensen JA. Precision of fit: zirconia three-
unit fixed dental prostheses. Clin Oral
Investig 2009;13:343-9.
105. Bornemann G, Lemelson S, Luthardt R.
Innovative method for the analysis of the
internal 3D fitting uracy of Cerec-3 crowns.
Int J Comput Dent 2002;5:177-82.
106. Groten M, Axmann D, Probster L, Weber H.
Determination of the minimum number of
marginal gap measurements required for
practical in-vitro testing. J Prosthet Dent
2000;83:40-9.
107. Luthardt RG, Bornemann G, Lemelson S,
Walter MH, Huls A. An innovative method
for evaluation of the 3-D internal fit of
CAD/CAM crowns fabricated after direct
optical versus indirect laser scan digitizing.
Int J Prosthodont 2004;17:680-5.
108. Laurent M, Scheer P, Dejou J, Laborde G.
Clinical evaluation of the marginal fit of
cast crowns: validation of the silicone
replica method. J Oral Rehabil 2008;35:
116-22.
109. Moldovan O, Luthardt RG, Corcodel N,
Rudolph H. Three-dimensional fit of CAD/
CAM-made zirconia copings. Dent Mater
2011;27:1273-8.
110. Borba M, Cesar PF, Griggs JA, Della
Bona A. Adaptation of all-ceramic fixed
partial dentures. Dent Mater 2011;27:
1119-26.
111. Seo D, Yi Y, Roh B. The effect of preparation
designs on the marginal and internal gaps in
Cerec3 partial ceramic crowns. J Dent
2009;37:374-82.
112. Gassino G, Barone Monfrin S, Scanu M,
Spina G, Preti G. Marginal adaptation
of fixed prosthodontics: a new in vitro
360-degree external examination
procedure. Int J Prosthodont 2004;17:
218-23.
113. Chan C, Haraszthy G, Geis-Gerstorfer J,
Weber H, Huettemann H. Scanning elec-
tron microscopic studies of the marginal fit
of three esthetic crowns. Quintessence Int
1989;20:189-93.
Corresponding author:
Dr Mathieu Contrepois
Université Bordeaux Segalen
Faculté d’Odontologie
16-20 Cours de la Marne
33002 Bordeaux Cedex
FRANCE
E-mail: mathieu.contrepois@gmail.com
Acknowledgments
The authors thank Dr Elise Arrivé and Julia
Menard for their valuable help.
Copyright ª 2013 by the Editorial Council for
The Journal of Prosthetic Dentistry.
Contrepois et al
 December 2013
Contrepois et al

Supplemental Table I. Summary of included studies

Protocol Fit
Absolute
No. Marginal
System Sample Finish Measure Discrepancy Marginal
Reference Manufacturer Size State Line Cemented Examination Method Sites (mm) Gap (mm)

1994
Pera et al29 In-Ceram Alumina 9 Coping C No In vitro 4 (D) 8.61
(slip-casting) Crown Direct examination with 9.31
9 Coping S optical microscope 12.78
Crown 13.61
9 Coping C 4 (T) 9.44
Crown Yes 21.67
9 Coping S No 13.61
Crown Yes 27.50

1995
Rinke et al30 In-Ceram Alumina 10 Pm Crown S No In vitro 54 (T) 45
(slip-casting) 10 Inc Direct examination with 33.5
Celay (block 10 Pm optical microscope 45
In-Ceram Alumina)
10 Inc 38

1996
Shearer et al31 In-Ceram Alumina 10 Coping C Yes In vitro 2 (D) 13.4
(slip-casting) 10 S Optical microscopic 25.9
10 Crown C examination of cross-sectioned 18.2
silicone replica
10 S 28.6

1997
Sulaiman et al32 Procera AllCeram 30 NA NA No In vitro 4 (D) 82
IPS Empress I 30 NA Direct examination with 62
(veneering optical microscope
technique)
In-Ceram Alumina 30 NA 160.66
(slip-casting)

454.e1
 454.e2
The Journal of Prosthetic Dentistry

Supplemental Table I. (Continued) Summary of included studies

Protocol Fit
Absolute
No. Marginal
System Sample Finish Measure Discrepancy Marginal
Reference Manufacturer Size State Line Cemented Examination Method Sites (mm) Gap (mm)
33
Groten et al Celay (block 10 Coping S Yes In vitro 124-138 (T) 20.6
In-Ceram Alumina) Crown Direct examination with 18.3
optical microscope
Direct examination with SEM 100 (T) 23

1998
May et al34 Procera AllCeram 25 Mol Crown C No In vitro 36 (D) 63
25 Pm Laser videography 56

1999
Beschnidt In-Ceram Alumina 10 Crown S No In vitro 2500-3000 60
and Strub35 (slip-casting) (D)
Yes Direct examination on an epoxy 82
IPS Empress I 10 No resin replica of the marginal 47
(staining technique) area with optical microscope
Yes 63
IPS Empress I 10 No 62
(veneering Yes 76
technique)
Celay (block 10 No 99
Vita Celay) Yes 117
Celay (block 10 No 78
In-Ceram Alumina)
Yes 91

2000

Volume 110 Issue 6

Contrepois et al

Nakamura et al36 Celay (block 10 Coping S Yes In vitro 2 (D) 40 (v)

In-Ceram Alumina) Optical microscopic examination 30 (l)
10 Crown after cross-sectioning 44 (v)
44 (l)
 December 2013
Contrepois et al

Boening et al37 Procera AllCeram 40 Inc + Can Crown C No In vivo 6 (T) 95 (v)
Optical microscopic examination 80 (l)
of cross-sectioned silicone 85 (m)
replica
80 (d)
40 Pm + Mol 8 (T) 120 (v)
145 (l)
90 (m)
100 (d)

2003
Suarez et al22 Procera AllCeram 10 Coping C Yes In vitro 2 (D) 143 26
10 S Optical microscopic 71 40
examination after
cross-sectioning
Nakamura et al38 Cerec 3 (block 5 (TOC: 4 ) Crown S No In vitro 4 (T) 66
Vita Mark II) 5 (TOC: 8 ) 
Direct examination with 66
5 (TOC: 12 ) optical microscope 53
39
Yeo et al In-Ceram Alumina 30 Crown S No In vitro 50(T) 112
(slip-casting)
Celay (block 29 Direct examination with 83
In-Ceram Alumina) optical microscope
IPS Empress II 29 46
(veneering
technique)

2004
Coli and Karlsson40 Decim 10 Inc Coping C No In vitro 4 (D) 34
Optical microscopic examination 4 (T) 22
of cross-sectioned silicone
10 Pm 4 (D) 42
replica
4 (T) 41
41 ia
Quintas et al IPS Empress II 60 Coping No In vitro 1 (D) 68
Yes* Direct examination with 110
In-Ceram Alumina 60 No optical microscope 57
(slip-casting)
Yes* 117
Procera AllCeram 60 No 25
Yes* 44

454.e3
 454.e4
The Journal of Prosthetic Dentistry

Supplemental Table I. (Continued) Summary of included studies

Protocol Fit
Absolute
No. Marginal
System Sample Finish Measure Discrepancy Marginal
Reference Manufacturer Size State Line Cemented Examination Method Sites (mm) Gap (mm)
Albert and Procera AllCeram 10 Crown C Yes* In vitro 8 (T) 47
El-Mowafy 20 10 Direct examination with 57
10 optical microscope 53
10 58

2005
Naert et al42 Procera AllCeram 4 Coping C No In vitro 4 (D) 14
Yes* Direct examination with 4 (T) 30
No optical microscope 4 (T) 24
4 4 (D) 14
4 (T) 30
Yes* 4 (T) 29
Bindl and In-Ceram Zirconia 12 Coping C Yes In vitro 8 (D) 25
Mormann43 (slip-casting) [ia]
IPS Empress II 12 Direct examination 44
Cerec inlab (block 12 with SEM 43
In-Ceram Zirconia)
DCS Précident 12 33
Decim 12 23
Procera AllCeram 12 17
44
Kokubo et al Procera AllCeram 24 Inc + Can Crown C No In vivo 4 (T) 36
43 Pm Optical microscopic examination 32
19 Mol of cross-sectioned silicone 35

Volume 110 Issue 6

replica
Contrepois et al

Nakamura et al45 Decsy (block ProCAD) 7 (TOC: 4 ) Crown S No In vitro 4 (D) 42


7 (TOC: 12 ) Direct examination with 45
optical microscope
 Kokubo et al46 GN-I (block 49 Inc + Can Crown [ia] C No In vivo 4 (T) 66.1

December 2013
Contrepois et al

In-Ceram Alumina)
24 Pm Optical microscopic examination 65.3
of cross-sectioned silicone
replica
9 Mol 72.9

2006
Okutan et al47 Everest HPC 16 Crown S No In vitro 64 (T) 32.7
Yes* Direct examination on an epoxy 33.0
16 No resin replica of the marginal 44.6
area with optical microscope
Yes* 46.6

2007
Komine et al48 Cercon 8 Coping C No In vitro 60 (T) 64
Crown Direct examination with 55
8 Coping S optical microscope 61
Crown 60
Kunii et al49 Katana 3 Coping S Yes In vitro 2 (T) 3.6
Optical microscopic examination
after cross-sectioning

2008
Pilathadka et al50,51 Procera AllCeram 12 Coping C Yes* In vitro 16 (D) 53.37
12 Direct examination with SEM 29.30
12 44.72
52
Lee et al Procera AllCeram 10 Coping S No In vitro 50 (T) 72.7
Crown Direct examination with 89.6
Cerec 3 (block 10 optical microscope 94.4
Vita Mark II)
Iwai et al53 Cercon 8 (TOC: 6 ) Coping S No In vitro 60 (T) 37.1

8 (TOC: 12 ) Direct examination with 30.4
optical microscope
8 (TOC: 20 ) 27.4
54
Al-Rabab’ah et al Procera AllCeram 15 Coping S No In vitro 50 (D) 26.1
[ia]
Direct examination with 50 (T) 43
Cerec inLab (block 15 optical microscope 50 (D) 44.6
Vita Mark II)
50 (T) 64.6
IPS Empress II 15 50 (D) 56.5

454.e5
50 (T) 85.3
 454.e6
The Journal of Prosthetic Dentistry

Supplemental Table I. (Continued) Summary of included studies

Protocol Fit
Absolute
No. Marginal
System Sample Finish Measure Discrepancy Marginal
Reference Manufacturer Size State Line Cemented Examination Method Sites (mm) Gap (mm)
Beuer et al 55
Cercon 10 (TOC: 8 ) Coping C Yes In vitro 4 (D) 37.6
[ia]
10 (TOC: 8 ) Optical microscopic examination 45.5

10 (TOC: 16 ) after cross-sectioning 42.3
10 (TOC: 16 ) 36.6

10 (TOC: 24 ) 36.8

10 (TOC: 24 ) 40.3

2009
Limkangwalmongkol Procera AllCeram 8 Crown S No In vitro 6 (T) 68.07
et al56 8 Crown Profilometry 101.29
Beuer et al57 Cercon 10 (TOC: 8 ) Coping C Yes In vitro 4 (D) 91

10 (TOC: 8 ) Coping Optical microscopic examination 67
[ia] after cross-sectioning
10 (TOC: 16 ) Coping 82
10 (TOC: 16 ) Coping 67
[ia]
10 (TOC: 24 ) Coping 50
10 (TOC: 24 ) Coping 46
[ia]
Romeo et al58 DCS Précident 5 Coping C No In vitro 4 (T) 23.270
[ia]
Crown [ia] Direct examination with 47.448
optical microscope

Volume 110 Issue 6

5 Coping 4 (D) 18.188
Contrepois et al

[ia]
Crown [ia] 47.192
59
D’Arcy et al Cerec 3 (block 24 Crown S No In vitro 1 (D) 174
Vita Mark II) 24 Optical microscopic 1 (T) 149
examination of cross-sectioned
silicone replica
 December 2013
Contrepois et al

Comlekoglu et al60 Zirkonzahn 7 Crown [ia] C Yes In vitro 16 (D) 144

7 S Optical microscopic examination 114
after cross-sectioning
Tao and Han61 Cercon 5 Coping c1 S No In vitro 4 (D) 48 (v)
Direct examination with 52 (l)
optical microscope 43 (m)
47 (d)
Crown c1 54 (v)
51 (l)
47 (m)
49 (d)
5 Coping c2 51 (v)
49 (l)
48 (m)
53 (d)
Crown c2 49 (v)
53 (l)
54 (m)
55 (d)
5 Coping c3 50 (v)
48 (l)
53 (m)
54 (d)
Crown c3 57 (v)
54 (l)
53 (m)
52 (d)
23
Pelekanos et al WolCeram 4 Coping C No In vitro 20 (T) 49.86 34.86
(In-Ceram Alumina)
In-Ceram Alumina 4 Micro-XCT 60.09 21.08
(slip-casting)
Cerec inLab (block 4 187.64 55.09
In-Ceram Alumina)
Celay (block 4 179.36 139.27
In-Ceram Alumina)

454.e7
 454.e8
The Journal of Prosthetic Dentistry

Supplemental Table I. (Continued) Summary of included studies

Protocol Fit
Absolute
No. Marginal
System Sample Finish Measure Discrepancy Marginal
Reference Manufacturer Size State Line Cemented Examination Method Sites (mm) Gap (mm)
2010
Reich et al62 Cerec 3 (block 20 Crown S No In vivo 4 à 8 (T) 100
e.max Cad) Optical microscopic examination
of cross-sectioned silicone
replica
Pak et al63 Digident 20 Coping S No In vitro 50 (T) 61.52
Crown Direct examination with 83.15
Lava 20 Coping optical microscope 62.22
Crown 82.03
64
Syrek et al Lava 18 Coping S No In vivo 12 (T) 71
Lava + Lava C.O.S 18 Optical microscopic examination 49
of cross-sectioned silicone
replica
Ural et al65 Cerec3 (block NA) 10 Crown S No In vitro 30 (T) 29.26
Yes Direct examination with SEM 49.80
IPS Empress II 10 No 61.94
(technique NA) Yes 83.00
Cerconl 10 No 77.10
Yes 93.56
In-Ceram Alumina 10 No 109.11
(slip-casting) Yes 125.40
Fahmy66 In-Ceram Alumina 10 Coping S No In vitro 4 (T) 129.8
(slip-casting)

Volume 110 Issue 6

Crown c1 Direct examination with 157.8
Contrepois et al

10 Coping optical microscope 132.7

Crown c2 106.3
10 Coping 131.5
Crown c3 111.4
 December 2013
Contrepois et al

Castillo Cerconl 5 (TOC: 15 ) Coping C No In vitro 5 (D) 102

Oyagüe et al67 S Direct examination with SEM 120
5 (TOC: 20 ) C 105
S 111

Cercon 5 (TOC: 15 ) C 61
S 84

5 (TOC: 20 ) C 65
S 65

2011
Kokubo et al68 Procera zirconia 44 Inc + Can Crown S No In vivo 4 (T) 42.5
35 Pm Optical microscopic examination 41.9
12 Mol of cross-sectioned silicone 57.4
replica
Martínez-Rus et al69 Cerec inlab (block 10 Coping C No In vitro 40 (D) 28.98
In-Ceram Zirconia)
Cerec inlab (block 10 Direct examination with 12.24
In-ceram Yz) optical microscope
Cerconl 10 13.15
Procera Zirconia 10 8.67
70 l
Korkut et al Cercon 10 Coping C Yes In vitro 2 (T) 43.02
IPS Empress II 10 Optical microscopic examination 47.51
Procera Zirconia 10 after cross-sectioning 50.29
Grenade et al71 Procera Zirconia 20 Coping C Yes In vitro 2 (D) 86 51
Optical microscopic examination
after cross-sectioning
Yuksel and Lava 12 Coping C Yes* In vitro 4 (T) 82.7
Zaimoglu72
IPS e.max Press 12 Optical microscopic examination 92.6
after cross-sectioning
Al-Makramani Procera 10 Coping C No In vitro 50 (T) 34.4
et al73 AllCeram 10 Direct examination with 71.5
In-Ceram Alumina optical microscope
(slip-casting)

454.e9
 454.e10
The Journal of Prosthetic Dentistry

Supplemental Table I. (Continued) Summary of included studies

Protocol Fit
Absolute
No. Marginal
System Sample Finish Measure Discrepancy Marginal
Reference Manufacturer Size State Line Cemented Examination Method Sites (mm) Gap (mm)
74
Hmaidouch et al Cerec 3 (block 5 Coping NA Yes In vitro 4 (D) 81.69
In-ceram Yz) 5 Optical microscopic examination 73.23
after cross-sectioning
Bhowmik and In-Ceram Alumina 15 Coping S No In vitro 6 (D) 81.446
Parkhedkar25 (slip-casting)
Crown Direct examination with 60.129
optical microscope

2012
Assuncao Cerec inlab (block 10 Crown [ia] C No In vitro 50 (T) 64.71
Souza et al75 IPS Empress CAD) 10 S Direct examination with 28.24
optical microscope
Cho et al76 IPS Empress I 10 Coping S No In vitro 4 (D) 35.1
10 C Direct examination with 27.2
IPS e.max Press 10 S optical microscope 27.5
10 C 30.2
Alghazzawi et al77 Cerec inlab (block 30 Coping S No In vitro 8 (D) 54
In-Ceram Alumina)
Cerec inlab (block 30 Optical microscopic examination 53
In-Ceram Zirconia) after cross-sectioning an epoxy
resin replica of the marginal area
Euan et al78 Lava 10 Coping S No In vitro 20 (T) 50.13
Crown Direct examination with 55.12
Yes optical microscope 59.83

Volume 110 Issue 6

Contrepois et al

10 Coping C No 63.56
Crown 74.12
Yes 76.97

Inc, incisor; Can, canine; Pm, premolar; Mol, molar; buc, buccal; ling, lingual; Mes, mesial; Dist, distal; C, chamfer; S, shoulder; [ia], internal adjustments made on restorations; (T), measurements made on abutment
tooth; (D), measurements made on die; p1/p2/p3, type of veneering porcelain; c1/c2/c3, type of finish line curvature; TOC, total occlusal convergence; SEM, scanning electron microscope; l, CAM; NA, not available.
*various cements tested.