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Odontology (2010) 98:170–172 © The Society of The Nippon Dental University 2010

DOI 10.1007/s10266-010-0122-7

SHORT COMMUNICATION

Raquel C. Oyagüe · M. Isabel Sánchez-Jorge


Andrés Sánchez Turrión

Evaluation of fit of zirconia posterior bridge structures constructed with


different scanning methods and preparation angles

Received: September 4, 2009 / Accepted: January 25, 2010

Abstrac This study evaluated the influence of scanning design10–12 may play an important role in the clinical success
method, abutment position, and preparation angle on the of the denture, different preparation angles can be evalu-
vertical seal of three-unit posterior zirconia structures. Sixty ated to test the accuracy of different CAD/CAM systems.
differently angled metallic models were machined to receive The purpose of this research was to investigate the influ-
30 bridge frameworks. For each preparation type, half of the ence of scanning method (wax-up vs abutment digitization),
structures were waxed-up and digitized, whereas the other bridge retainer (mesial vs distal), and preparation conver-
half were computer-designed after the abutments were gence angle (10°, 15°, or 20°) on the marginal adaptation of
scanned. Once milled, the samples were cemented in stan- three-unit posterior zirconia structures fabricated with
dard fashion. Misfit was assessed by scanning electron Cercon Smart Ceramics (Dentsply International, York, PA,
microscopy. Three-way analysis of variance showed signifi- USA). The null hypothesis was that scanning method, abut-
cant differences. Computer-designed structures achieved ment position, and preparation angle had no effect on the
the highest accuracy (P < 0.0001). No significant differences vertical fit of zirconia bridge frameworks.
were recorded concerning the abutment position and con-
vergence angle. All discrepancy values were within the clini-
cally acceptable range.
Materials and methods
Key words CAD/CAM scanning method · Vertical discrep-
ancy · Occlusal convergence angle Sixty stainless-steel master dies were machined to simulate
tooth preparations for full crowns (cervical diameter, 6 mm;
height, 7 mm; finish line, chamfer of 1 mm). The abutments
Introduction were fitted in pairs into aluminum bases.
The pairs of dies were randomly assigned to three experi-
The physical, biocompatible, and aesthetic properties of zir- mental groups (n = 10), according to their preparation angle
conium oxide cores for all-ceramic fixed partial dentures (10°, 15°, or 20°). Half of the structures from each group
have been widely recognized.1–3 However, even though mar- were waxed-up and digitized (Cercon Brain unit), and the
ginal discrepancies may lead to secondary caries, periodon- remaining frameworks were computer-designed after the
tal diseases, debonding, or mechanical failure of cemented abutments were scanned (Cercon Eye optical laser). Once
restorations,4–6 few studies of posterior zirconia bridges milled and sintered, the structures were fixed with zinc
have been conducted.3,4,6–8 phosphate cement (Fortex, Faciden S.L., Girona, Spain)
Vertical gaps may be introduced during either fabrica- under a constant axial load (15 N/cm2 for 4 min) using a
tion step, including during computer-aided design (CAD)/ customized jig that fitted a dynamometric key (Defcon,
computer-aided manufacturing (CAM) digitization.9 Hence, Impladent, Holliswood, NY, USA) (Fig. 1).
since both the scanning technique7,9 and the preparation Vertical misfit was assessed by measuring the distance
parallel to the abutment axis from the structure margin to
the finish line using a JSM-6400 scanning electron micro-
scope (JEOL, Tokyo, Japan) at 500× magnification. The
R.C. Oyagüe (*) · M.I. Sánchez-Jorge · A. Sánchez Turrión abutment supports ensured repeatable projection angles.
Department of Prosthodontics, Faculty of Dentistry, Complutense Thus, the vertical gap was always perpendicular to the
University of Madrid, U.C.M. Pza. Ramón y Cajal s/n, 28040 Madrid,
optical axis of the microscope. Twenty measurements were
Spain
Tel. +34-607367903; Fax +34-947506610 taken along the axial planes of every die (200 measurements
e-mail: raquel.castillo@odon.ucm.es per experimental subgroup of bridge structures). Discrep-
171

Fig. 1. Three-unit zirconia sample luted onto two master dies fitted in
their platform

A
Table 1. Mean misfit values of wax-up digitized and direct-scanned
zirconia structures in relation to the bridge retainer and the prepara-
tion convergence angle
Vertical misfit recorded in the experimental groups (μm)

Digitizing method W D

Convergence angle Bridge abutment Mean misfit (SD)

10° M 108 (7) a1 74 (8) b1


D 112 (12) a1 78 (7) b1
15° M 98 (11) a1 75 (6) b1
D 99 (10) a1 73 (7) b1
20° M 110 (9) a1 80 (7) b1
D 105 (11) a1 72 (8) b1
Different letters in the rows indicate statistically significant differences
(P < 0.05) Equal numbers in columns indicate no significant differences
(P > 0.05)
W, wax-up digitized; D, direct-scanned; M, mesial; D, distal
B

ancies were calculated with image-analysis software (INCA-


4.04, Oxford Instruments, Abingdon, UK) at marginal points Fig. 2A, B. Scanning electron microscope photomicrographs showing
equally distributed to standardize the procedure and mini- the vertical misfit values of structures cemented onto 15°-tapered dies
mize the operator bias. (500× magnification, 20 kV; bar, 100 μm). A Direct-scanned and com-
Misfit data were initially analyzed by two-way analysis puter-designed framework. B Structure obtained from wax-up digitiza-
tion, showing a higher misfit
of variance (ANOVA) with repeated measurements for the
abutment factor. Since no interaction involving scanning
method or preparation angle resulted in a significant intra-
group difference between paired abutments, three-way Interaction among scanning method, abutment, and prepa-
ANOVA was performed, using the bridge retainer as an ration angle was not significant (P = 0.950).
additional independent variable.

Discussion
Results
The development of new CAD/CAM technologies has
The vertical discrepancy of waxed-up digitized structures accelerated in recent years,1,7 but there are few scientific
was significantly higher than that of the computer-designed data concerning their reliability for the fabrication of well-
frameworks (P < 0.0001) (Table 1, Fig. 2). The abutment fitted ceramic cores.7,9
position did not influence the vertical misfit (P = 0.717). The In this study, the null hypothesis was partly rejected,
preparation convergence angle did not significantly affect because computer-designed structures showed better mar-
the marginal seal (P = 0.086). No significant interactions ginal adaptation than wax-up digitized structures (Table 1,
were recorded between scanning method and abutment Fig. 2). This result agrees with another result obtained under
(P = 0.709), scanning method and preparation angle (P = similar experimental conditions,7 and is probably due to the
0.225), or abutment and convergence angle (P = 0.215). reduced number of steps when the abutments are scanned.7
172

However, consistent with previous research on zirconia


bridges,8 no differences in misfit between mesial and distal
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Acknowledgments We are grateful to the technicians of the U.C.M.


Central Labs and to D. Rafael Briones of Prótesis S.A. Dental Labora-
tory (Madrid, Spain) for their support in this project.

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