Received: 3 July 2020 Accepted: 21 August 2020

DOI: 10.1111/jerd.12651

RESEARCH ARTICLE

Microcomputed tomography evaluation of cement film

thickness of veneers and crowns made with conventional and
3D printed provisional materials

Camila S. Sampaio DDS, MS, PhD1 | Katherin D. Niemann DDS1 |

2 3
Daniel D. Schweitzer DDS | Ronaldo Hirata DDS, MS, PhD |
Pablo J. Atria DDS, MS1,4
1
Department of Biomaterials, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
2
Key Opinion Leader Imaging and CAD/CAM System, Dentsply Sirona, Santiago, Chile
3
Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, New York
4
New York University, Sackler Institute of Graduate Biomedical Sciences, New York, New York

Correspondence
Camila S. Sampaio, Department of
Biomaterials, Faculty of Dentistry, Univerdidad
de los Andes, Santiago, Av Monseñor Alvaro
del Portillo, 12455, Santiago, Chile.
Email: csampaio@miuandes.cl
Funding information
Fondo Nacional de Desarrollo Científico y
Tecnológico, Grant/Award Number: 11170920
Abstract
Objective: To evaluate, through microcomputed tomography (μCT), the cement film
thickness of veneers and crowns made with different provisional materials.
Material and Methods: A veneer and a crown preparation were performed on a cen-
tral incisor and a second molar of a dental model, respectively, scanned with an
intraoral scanner, and the
stl files were exported to an LCD-based SLA three-
dimensional (3D)-Printer. Twenty-four preparations were 3D-printed for each veneer
and crown and divided into four groups (n = 6/group): (a) Acrylic resin (Acrílico
Marche); (b) Bisacrylic resin (Protemp 4); (c) PMMA computer-aided design and
computer-aided manufacturing (CAD-CAM) (Vipiblock); and (d) 3D-printed resin for
provisional restorations (Raydent C&B for temporary crown and bridge). Veneers and
crowns restorations were performed and cemented with a flowable composite. Each
specimen was scanned with a μCT apparatus, files were imported for data analysis,
and cement film thickness was quantitatively measured. Data were analyzed by
2-way ANOVA and Tukey post-hoc tests (α = .05).
Results: Crowns presented a thicker cementation film than veneers (P < .05).The
bisacrylic resin showed the smallest veneer film thickness, similar to the acrylic resin
(P = .151), which was not significantly different than the PMMA CAD/CAM material
(P = .153). The 3D printed provisional material showed the thicker film, different than
all other materials (P < .05). The bisacrylic resin showed a cement film thickness with
a high number of voids in its surface. For crowns cementation, the 3D printed provi-
sional material showed the thicker cementation film, different than all other mate-
rials (P < .05).
Conclusions: Different provisional materials present different film thicknesses. The
3D printed provisional material showed the highest veneer and crown film

J Esthet Restor Dent. 2020;1–9. wileyonlinelibrary.com/journal/jerd © 2020 Wiley Periodicals LLC 1

2 SAMPAIO ET AL.

thicknesses. Veneers film thicknesses were smaller than crowns for all provisional
materials.
Clinical Significance: The 3D printed provisional material studied can be satisfactorily
used, presenting appropriate adaptation with the tooth preparation, however, it
shows the highest cement film thickness for both veneers and crowns cementations
when compared with other provisional materials. A better internal fit, or smaller
cement film thickness is obtained by CAD/CAM materials, acrylic and bisacrylic
resins. Veneer cementation showed a smaller cement film thickness compared with
crown cementation for all provisional materials.

KEYWORDS

3D printing, CAD/CAM, film thickness, intraoral scanner, microcomputed tomography, oral

rehabilitation, veneers

1 | I N T RO DU CT I O N AM manufacturing builds objects layer-by-layer and thus pro-

Provisional restorations are used as a transitional phase of fixed dental
prosthesis and must fulfill biologic, mechanical, and esthetic require-
ments.1,2 Depending on the treatment and if additional therapy is
needed, they might need to be in function for extended periods of
time, and thus, should offer improved characteristics such as adequate
fit to ensure mechanical stability, durability, and health of the sur-
rounding soft tissues.1 Moreover, their use offers a template for defin-
ing tooth contour, esthetics, proximal contacts, and occlusion for the
future prosthesis.3 Different characteristics are important when
choosing a provisional material, such as: working time, ease of fabrica-
tion and repair, biocompatibility, dimensional stability during and after
4
fabrication, shade selection, color stability, among others.
Different materials are used for provisional purposes, acrylic
resins being the most commonly used since a long time ago. In gen-
eral, their popularity is due to their low cost, acceptable esthetics, and
2
versatility. However, they present tissue toxicity and thermal irrita-
tion; bisacrylic resins were later introduced to reduce such problems.2
Recently, there has been a trend to the implementation of three-
dimension (3D) digital tools in prosthetic dentistry, producing reliable
restorations with accurate dimensions and reduced manufacturing
time.5,6
The 3D manufacturing process can be categorized into two types:
subtractive manufacturing (SM) and additive manufacturing (AM). SM,
such as computer-aided design and computer-aided manufacturing
(CAD-CAM), is based on milling the dental restoration from a block of
7
material with a computer controlled machine. AM, such as 3D print-
ing, is based on adding the material and fabricating objects from 3D
7
models layer by layer until the object is completed.
The emergence of the CAD/CAM technology allowed for high
precision materials, since restoration is milled from prepolymerized
blocks, thus, any degree of polymerization shrinkage occurs during the
8
processing of the block, not in the mouth. Moreover, this indirect
material presents higher fracture strength than direct techniques such
as bisacryl resins.8
duces almost no waste of material, there is no restriction in the geo-
metric shape of the products, and tolerance of milled parts is no
longer an issue.9 Recently, cheaper and faster AM techniques have
been developed, as well as polymer materials for 3D printing.10 The
accessibility growth of 3D printers is due to the fact that the early
patents related to the additive manufacturing devices have expired,
which opened the door for many start-up companies to develop new
3D printer devices, driving down the cost.11
The 3D printing process starts by drawing a 3D CAD model using
computer software, which is saved as an stereolithography language (.
STL) file format.12 After that, usually, the 3D printer manufacturer
provides its own software and a preparatory phase in which the build
orientation is selected, the .STL file is sliced, and the support structure
is generated; the designed object is built and afterward, it is pos-
tcured. The final object is obtained after removal of the support struc-
ture, finishing, and polishing.10-13 Such process is been increasingly
used in dentistry for different purposes, such as fabrication of surgical
guides,14 diagnostic models,15 orthodontic aligners,16 provisional
restorations,17 digital wax-ups,18 among others. However, these
examples generally use polymers that have little potential for intraoral
clinical application due to the incompatibility of their properties with
medium to long-term dental applications,19 thus, more studies regard-
ing the subject are needed.
For instance, different factors seem to affect the accuracy of 3D
printed restorations. The selection of a build angle is critical and deter-
mines the necessary number of support structures.13 Different studies
observed the effect of build angles on the support of 3D printed sam-
ples, observing more accuracy for certain building angles, information
that is not conclusive within studies.13,17,19 Different degrees of poly-
merization also have been observed according to the location of the
layers, near or farther away from the printing platform.19 Resin color
also affected the accuracy of 3D impressions.19 Controversial results
were also described for the fit of milled vs 3D printed restorations,
with authors mentioning that printed restorations exhibit lower mar-
ginal gap than milled restorations,20 while other authors mentioned
SAMPAIO ET AL. 3

that the fit of crowns fabricated based on the 3D printed models was
inferior to that of crowns prepared with stone models.21
The use of microcomputed tomography (μCT) is a technology that
has allowed the study of polymerization shrinkage,22-24 gaps and
voids observation,25 vectors tracing in resin composites,26 and cement
film thickness quantification in veneers cementation.20,27 This
approach offers several advantages of being nondestructive, and
allows for quantitative measurements in three dimensions. Researches
evaluating the cement film thickness of the different materials used
for provisional restorations are extremely important and studies are
lacking.
Therefore, the aim of this study was to evaluate, through μCT
technology, the cement film thickness of veneers and crowns made
with different provisional materials: acrylic resin, bisacrylic resin,
CAD/CAM PMMA material, and 3D printed resin made using a SLA
3D printer (Photon; Anycubic). The null hypotheses tested were that
(a) different provisional materials would present comparable cement
film thickness when a veneer or a crown was cemented to a standard
preparation; and (b) veneers and crowns would present similar film
thicknesses.
2 | M A T E R I A L S A N D M ET H O D S
A veneer preparation was performed on a maxillary central incisor,
and a crown preparation was performed on a second molar, from a
dental model manufacturer (Ref 08MN002; P-Oclusal). Both prepara-
tions were scanned with an intraoral scanner (CEREC Omnicam;
Denstply Sirona) and the .STL files were exported to an LCD-based
SLA 3D Printer machine (Photon; Anycubic), in order to print all the
preparations in a standardized manner, serving as tested models. All
preparations were printed in a 3D printed resin (Anycubic 3D printing
UV sensitive system, green shade; Anycubic). Parameters for printing
the preparations were: layer thickness: 0.08 mm, layer exposure:
14 seconds, bottom exposure: 70 seconds, off: 3, total layers: 89 and
116 (second molars and incisors, respectively), and bottom layer:

F I G U R E 1 Schematic of the step-by-step of the specimen preparation. First and second rows, steps used for the PMMA CAD/CAM
provisional material, for veneers and crowns respectively. In order: copy of the original tooth for incisor (upper image) and molar (lower image);
copy of the preparation of the incisor (upper image) and molar (lower image); superimposition of the original teeth and the preparations, as a
biogeneric copy; positioning of the veneer (upper image) and crown (lower image) in the CAD/CAM block for milling. Third and fourth rows, steps
used in the 3D printing software. In order: positioning of the preparations from incisors (upper left image) and molars (lower left image) in the 3D
printer software; positioning of the veneers from incisors (upper middle image) and crowns from molars (lower middle image) in the 3D printer
software; 3D printed preparation before and after cementation of the incisor's veneer (upper right image) and 3D printed preparation before and
after cementation of the molar's crown (lower right image)
4 SAMPAIO ET AL.

4. After printing, preparations were washed in ethanol according to
manufacturer's instructions and postpolymerized ultraviolet light for
15 minutes.
Twenty-four preparations were 3D-printed for each veneer and
crown and divided into four groups (n = 6/group) according to the
provisional materials used for performing the restorations: (a) Acrylic
resin (Acrílico Marche 46 shade; Marche); (b) Bisacrylic resin (Protemp
A2 shade; 3M Espe); (c) PMMA CAD-CAM material (Vipiblock A2
shade; Trilux); and (d) 3D-printed resin for provisional restorations
(Raydent C&B for temporary crown and bridge; 3D materials).
Restorations were performed as following: Groups a—Acrylic
resin and b—Bisacrylic resin: a polyvinyl siloxane impression was per-
formed on the maxillary central incisor and the second molar before
performing their preparations, serving as a mold for posterior building
of the restorations. After that, the impression was used to perform
the provisional veneer and crown restorations with the acrylic or
bisacrylic resin, following the manufacturer's instructions for material
preparation. Each restoration was fabricated in its own 3D printed
preparation; Group c—PMMA CAD-CAM: a scan was done with an
intra-oral scanner (CEREC Omnicam) for the maxillary central incisor
or second molar, before preparation, and for each preparation
individually, after that, the restoration was designed according to the
“biogeneric copy” of the tooth in the software (CEREC Software
4.5.1; Dentsply Sirona) and afterward, they were milled (CEREC
MCXL; Dentsply Sirona); Group d—3D-printed resin: the .STL file from
the restoration was obtained from the scanned restorations and they
were exported for the 3d printing software according to the manufac-
turer's instructions, followed by water washing, according to manufac-
turer's instructions, and postpolymerizing in ultraviolet light for
30 minutes. Parameters for printing the restorations were: layer thick-
ness: 0.1 mm, layer exposure: 9 seconds, bottom exposure:
60 seconds, off: 6.5, total layers: 133 and 51 (second molars and inci-
sors, respectively), and bottom layer: 5.
All restorations and preparations were cleaned with phosphoric
acid (Ultra-Etch 35%; Ultradent Products Inc.), rinsed and dried, and
cemented with a flowable resin composite (SDR Plus Bulk fill
flowable; Dentsply Sirona). The same flowable composite was used in
order to standardize the procedure, as it presents different radio-
pacities and attenuation levels than all the provisional materials stud-
ied, therefore it is easily differentiated in the μCT images. Moreover,
flowable materials can be clinically used for provisional cementation,
and they were also chosen since they present a thinner cement film

F I G U R E 2 Step by step of the measurements acquisition for the veneers' cementation. Upper row, selection of the threshold used; middle
row, different views of the selection of the cut made for performing the measurement of the cement film thickness, the cut was performed in the
midline of the cementation; lower row, five equidistant points defined and averaged, from the most incisal to the most cervical area of the veneer
preparation
SAMPAIO ET AL. 5

F I G U R E 3 Step by step of the measurements acquisition for the crowns' cementation. Upper row, selection of the threshold used; middle
row, different views of the selection of the cut made for performing the measurement of the cement film thickness, the cut was performed in the
midline of the cementation; lower row, five equidistant points defined and averaged, from the most incisal to the most cervical area of the crown
preparation

T A B L E 1 Mean ± SE of cement film thickness (n = 6) determined

the excess cement was removed with a disposable applicator
for each material, measured in millimeters
(Microbrush; Microbrush Intl) and the specimens were light polymer-
Material Veneer Crown ized. Each specimen was scanned with a μCT apparatus (μCT 40;
Acrylic resin—Marche 0.14 (0.03) BCb 0.34 (0.06) Ba Scanco Medical AG). The μCT was calibrated using a phantom stan-
Bisacrylic resin—Protemp 4 0.09 (0.04) Cb 0.28 (0.08) Ba dard at 70 kVp/Beam Hardening 200 mgHA/cm, and the operating
PMMA CAD/CAM—Vipiblock 0.18 (0.03) Bb 0.24 (0.04) Ba condition for the μCT device was as follows: energy of 70 kVp,
3D provisional—Raydent C&B 0.32 (0.03) Ab 0.62 (0.08) Aa 114 μA with a voxel size of 30 μm per slice and an integration time of
30 minutes per specimen, as previously described. All specimens from
Notes: Different uppercase letters represent means that differ from each
other in same column; different lowercase letters represent means that
the same group were scanned simultaneously.
differ from each other in same row (P < .05). The μCT scanning files were imported into a workstation for 3D
data analysis and visualization (Amira v5.5.2; VSG). Figures 2 and 3
show the step by step of the samples measurements for veneers and
thickness than other cementation materials.27 After that, light poly- crowns, respectively. Thresholds were visually determined and used
merization was performed (Bluephase; Ivoclar Vivadent) at a standard- for all the specimens, as all the specimens were cemented with the
ized distance of 1 mm. The total light polymerization time was same material (and thus the same radiopacities and attenuation levels),
80 seconds (20 seconds from labial, distal, mesial, and palatal by a single calibrated operator. For each specimen, the preparation
surfaces). midline was used as a reference. In the analysis software (Amira
A schematic showing the steps for specimen preparation is pres- v5.5.2; VSG), a cross-sectional layer image was obtained with the tool
ented in Figure 1. The cementation agent was applied to the entire “surface cut,” and five equidistant points defined from the most incisal
surface of the veneer or the crown, which was immediately positioned to the most cervical area (for the veneer preparation), and from mesial
over the tooth preparation, and after the seating of the restorations, to distal (for the crown preparation), were used for the measurements,
6 SAMPAIO ET AL.
FIGURE 4 The 3D reconstructions from veneers' cement film thickness views from all groups
which were calculated with the Measurement-3D Length tool; values
were given in millimeters, as previously described. The average value
of the five cement film thickness measurements was calculated and
used for comparison among groups. The obtained data were analyzed
by 2-way ANOVA and the Tukey HSD post-hoc test (a = .05).
3 | RESULTS
Table 1 summarizes the mean and SE of cement film thickness for the
different provisional materials for veneers and crowns. A significant
statistical difference was found among groups (P < .05). Cement film
thickness means varied from 0.09 to 0.32 mm for veneers cementa-
tion, while it varied from 0.24 to 0.62 mm for crowns. When veneers
and crowns film thicknesses were compared, for all materials, crowns
presented a thicker cementation film than veneers (P < .05).
When comparing the film thicknesses of veneers (Figure 4), the
bisacrylic resin showed the smaller film thickness, not statistically dif-
ferent than the acrylic resin (P = .151). The PMMA CAD/CAM provi-
sional material was also not significantly different than the acrylic
resin (P = .153). The 3D printed provisional material showed the
thicker film, significantly different than all other materials (P < .05).
The PMMA CAD/CAM materials and the 3D printed provisional
materials showed an homogeneous film thickness, while the acrylic
and bisacrylic resin showed a cement film thickness with a high num-
ber of voids in its surface.
When comparing the film thicknesses of crowns (Figure 5), again
the 3D printed provisional material showed the worst adaptation, or
the thicker film, significantly different than all other materials
(P < .05), while the other materials were not significantly different
within each other (P > .05).
4 | DI SCU SSION
The present study evaluated the cement film thickness of veneers and
crowns made with different provisional materials and cemented to a
standard preparation. Tooth preparation design was chosen to simu-
late the clinical situation, controlling the experiment's variables.
Results showed that different provisional materials promote different
cement film thickness of cement used when veneers and crowns are
performed, and crowns presented thicker film thicknesses than
veneers, rejecting both null hypotheses.
The smallest veneer cement film thickness results were observed
for the bisacrylic resin, not significantly different than the acrylic resin.
Both materials are used by performing the provisional fixed prosthesis
directly on the tooth preparation (which can be translated in a die
spacer thickness of 0 mm), explaining the present results. Although
SAMPAIO ET AL.
FIGURE 5 The 3D reconstructions from crowns' cement film thickness views from all groups
both acrylic and bisacrylic materials suffer from polymerization
28
shrinkage, the later showing less than the first, it did not affect the
adaptation of the veneers made with these materials, possibly
because of the preparation design. Veneers preparation showed a ten-
dency for a flatter design, while crown preparations present a curved
design. Although the provisionals made with bisacrylic resin presented
lower cement film thickness (meaning better adaptation), the cement
film thickness of such cementations showed a significant amount of
voids (or spaces lacking cementation material), as observed in
Figure 4, which can be a problem on the long-term use of such pros-
thesis. Clinically, nonuniform internal gaps negatively affect the frac-
ture strength of prosthesis.29
The PMMA CAD/CAM material presented statistically similar
marginal adaptation results to the acrylic and bisacrylic resins, and,
visually, it was observed a more homogeneous cement film thickness
than the bisacrylic resin, although thicker. The CAD/CAM provisional
is performed by scanning the preparation, designing the restoration in
a software, choosing a die spacer thickness, and afterward, milling
it. In the present study, the die spacer chosen was 0.12 mm, which is
within the acceptable range of fit of fixed prosthesis.30 However, it
was observed an increase in about 50% of this value, in accordance to
previous studies, which showed increased film thicknesses compared
with the programmed die spacer thickness value.20,29 Such results
bring to a conclusion that the die spacer chosen for CAD/CAM
7
PMMA restorations need to be decreased compared with what is
actually desired. A previous study showed that when no die spacer
(0 mm) is selected, still 65 mm internal gap can be expected.29 Even
so, there is no absolute consensus on the maximum marginal discrep-
ancies that could be considered as clinically acceptable.31
When cement film thickness was evaluated for crown cementa-
tion, it was observed that acrylic, bisacrylic, and the PMMA
CAD/CAM materials presented similar values, ranging from 0.24
(PMMA CAM/CAM material) to 0.34 mm (acrylic resin). For the
CAD/CAM material, such values presented an increased value of
about 2× the pre-determined die spacer thickness value (0.12 mm as
pre-determined, against 0.24 as observed), agreeing with previous
studies.20,29 Regarding acrylic and bisacrylic resins, such values can be
explained by the volumetric shrinkage observed for these materials.
Shrinkage can cause distortion that may jeopardize the fit accuracy of
the provisional prosthesis.28,32 It is interesting to mention that, for all
materials, despite of the total film thickness, acquired by measure-
ment of different points of the cementation and averaging them, it
was observed that a thicker film was observed in the occlusal part of
the cementation, agreeing with a previous study,33 while in the mar-
gins, the thickness was clearly reduced, as observed in Figure 5. This
fact is important since a thicker film in the margins could undergo
more solubility than thinner ones.34
8 SAMPAIO ET AL.
Results obtained from both veneer and crown preparations
showed the highest film thickness, for the 3D printed material, statis-
tically different than all other materials. Our results disagree with a
recent publication,20 that observed that 3D-printed restorations
exhibited significantly lower marginal and internal gap values than
their milled counterparts; the authors attributed such results to errors
20
resulting from the tolerance of milling burs. However, a recent study
showed that the fit of crowns produced on 3D printed models was infe-
rior to those produced in die stones,31 thus, controversies still exist
when dealing with 3D printed materials, as it is a novel technology and
lacks studies. Different post processing times and units could also affect
the final dimensions of the obtained restoration and the film thicknesses
of the cementation, as observed by the present research group,
although the results are not yet published and is thus a limitation of the
present study. Furthermore, as the amount of 3D printing materials are
increasing, further studies should be performed to compare those mate-
rials in their different aspects, specifically regarding their accuracy. Dif-
ferent 3D printers have different wavelengths, the most common ones
are 385 and 405 nm, if a 3D printer of 385 nm is used and the resin is
supposed to be used with 405 nm, the final result would not be ideal
and different results could be obtained as well.
The 3D printed materials accuracy is influenced by the build
13,17,19 13,19 19
angle, support structures and even resin color. Studies
have demonstrated different deviations for different build angles. A
recent study showed that a build angle of 135 offers the lowest devi-
ation for 3D-printed casts,17 while other study showed that bar sam-
 19
ples printed in a 90 orientation were the most accurate.
Contradictory, a recent study showed that a build angle of 120 pro-
motes crowns with the highest dimensional accuracy.13 Another prob-
lem related to 3D printing is the layer polymerization, as it was
previously observed that samples printed with this technology
appears to be slightly more polymerized at the “top” (near the printing
platform) then at the “base,”19 which in the case of this study could
possibly influence on the mechanical property of the provisional res-
torations, a topic that can be further investigated in the future. A
recent study observed that a percent error variation greater than
41.5% was observed in the sample thickness depending upon which
resin color setting was selected for the printing process19; the authors
stated that these error values could be considered high for clinical res-
torations, especially if accurate margins are desired. This observation
goes in accordance with the results of the present study, as the higher
cement film thickness was observed for provisionals made with this
material. Even though the veneers and crowns fitted in the prepara-
tion, the fit of the veneers (0.32 mm) was more than twice the accept-
able range of fit of a fixed prosthesis (0.12 mm), while the fit of the
crowns was more than five times (0.62 mm) the acceptable range of
0.12 mm. This can be explained by the contraction of the materials
while constructing layers of minimum thickness, as well as further
contraction and residual stress accumulation during the postcuring
process.12,21 Polymerization shrinkage plays a major role in the mar-
ginal adaptation of provisional restorations.2 Degree of conversion of
3D printed resins can be affected by the choice of the postcuring
method,35 which can affect directly the shrinkage of the material, and
indirectly the cement film thickness of the veneer or crown.
Apart from the problems related to the 3D printing technology,
observed in the present study, regarding its increased film thickness, it
is a technology constantly growing and improving, which presents a
good potential to be used intraorally, as observed in this study. A
recent study pointed out that a commercially available 3D printable
restorative dental material allowed for sufficient mechanical proper-
ties for intraoral use of provisional restorations, despite the limited
3D printing accuracy.19 The great potential of the use of 3D printing
in the context of restorative dentistry is not debatable, as, in a clinical
relevant situation a patient could have his/her tooth prepared,
scanned, printed, and cemented, all in a single session and decreased
time and cost. Nevertheless, future studies are needed in order to fur-
ther investigate the mechanical properties of the different 3D printed
restorative materials, since different resins could produce also differ-
ent accuracies due to the monomer and photoinitatior composition, as
well as promoting an increased fitting accuracy according to the print-
ing parameters of such materials. Moreover, manufacturers must pro-
vide more information regarding their materials, such as the exact
postcuring times for each resin, and more researches need to be per-
formed in the field, so clinicians could follow scientific based evidence
instead of social media recommendations.
5 | CONC LU SIONS
Within the limitations of this in vitro study, the following conclusions
were drawn:
1. The 3D printed provisional material showed the highest cement
film thickness for both veneers and crowns cementations.
2. For veneers cementation, the materials performed with the direct
technique, acrylic and bisacrylic resins, showed the smallest film
thickness, which can be translated in better internal fit, although
several number of voids and lack of cementation material were
observed for the bisacrylic resin cementation. The PMMA
CAD/CAM material showed a more homogeneous film thickness,
although thicker than the bisacrylic resin.
3. For crowns cementation, the PMMA CAD/CAM material, the
acrylic and bisacrylic resins showed similar film thicknesses.
4. Veneer cementation showed a smaller cement film thickness com-
pared with crown cementation for all provisional materials, with a
thicker cement film thickness in the occlusal area of the crowns
than in the margins.
ACKNOWLEDG MENTS
This study was partially financed by Fondo Nacional de Desarrollo
Científico y Tecnológico (Fondecyt Project 11170920).
CONFLIC T OF INT ER E ST
The authors declare no conflicts of interest.
SAMPAIO ET AL.
ORCID
Camila S. Sampaio https://orcid.org/0000-0002-2517-7684
Pablo J. Atria https://orcid.org/0000-0001-6298-9756
RE FE R ENC E S
1. Burns DR, Beck DA, Nelson SK. A review of selected dental literature
on contemporary provisional fixed prosthodontic treatment: report of
the committee on research in fixed prosthodontics of the academy of
fixed prosthodontics. J Prosthet Dent. 2003;90:474-497.
2. Saisadan D, Manimaran P, Meenapriya PK. In vitro comparative evalu-
ation of mechanical properties of temporary restorative materials
used in fixed partial denture. J Pharm Bioallied Sci. 2016;8:S105-S109.
3. Digholkar S, Madhav VN, Palaskar J. Evaluation of the flexural
strength and microhardness of provisional crown and bridge materials
fabricated by different methods. J Indian Prosthodont Soc. 2016;16:
328-334.
4. Diaz-Arnold AM, Dunne JT, Jones AH. Microhardness of provisional
fixed prosthodontic materials. J Prosthet Dent. 1999;82:525-528.
5. Dehurtevent M, Robberecht L, Hornez JC, Thuault A, Deveaux E,
Béhin P. Stereolithography: a new method for processing dental
ceramics by additive computer-aided manufacturing. Dent Mater.
2017;33:477-485.
6. Van Noort R. The future of dental devices is digital. Dent Mater. 2012;
28:3-12.
7. Park ME, Shin SY. Three-dimensional comparative study on the accu-
racy and reproducibility of dental casts fabricated by 3D printers.
J Prosthet Dent. 2018;119:e1-e7.
8. Abdullah AO, Tsitrou EA, Pollington S. Comparative in vitro evaluation
of CAD/CAM vs conventional provisional crowns. J Appl Oral Sci.
2016;24:258-263.
9. Berman B. 3-D printing: the new industrial revolution. Bus Horiz.
2012;55:155-162.
10. Dizon JRC, Espera AH Jr, Chen Q, Advincula RC. Mechanical charac-
terization of 3D-printed polymers. Addit Manuf. 2018;20:44-67.
11. Stansbury JW, Idacavage MJ. 3D printing with polymers: challenges
among expanding options and opportunities. Dent Mater. 2016;32:
54-64.
12. Alharbi N, Osman R, Wismeijer D. Effects of build direction on the
mechanical properties of 3D-printed complete coverage interim den-
tal restorations. J Prosthet Dent. 2016;115:760-767.
13. Alharbi N, Osman RB, Wismeijer D. Factors influencing the dimen-
sional accuracy of 3D-printed full-coverage dental restorations using
stereolithography technology. Int J Prosthodont. 2016;29:503-510.
14. Di Giacomo GA, Cury PR, da Silva AM, et al. A selective laser sintering
prototype guide used to fabricate immediate interim fixed complete
arch prostheses in flapless dental implant surgery: technique descrip-
tion and clinical results. J Prosthet Dent. 2016;116:874-879.
15. Atria PJ, Sampaio CS, Hirata R, Jorquera G. Preliminary evidence for
the complete digital esthetic rehabilitation treatment: case report and
1-year follow-up. J Evid Based Dent Pract. 2017;17:76-82.
16. Caminiti M, Lou T. Clear aligner orthognathic splints. J Oral Maxillofac
Surg. 2019;77:e1071-e1078.
17. Osman RB, Alharbi N, Wismeijer D. Build angle: does it influence the
accuracy of 3D-printed dental restorations using digital light-
processing technology? Int J Prosthodont. 2017;30:182-188.
18. Sampaio CS, Atria PJ. Restaurações diretas e impressões 3D: do com-
putador ao dente. J Clin Dent Res. 2018;15:16-25.
19. Tahayeri A, Morgan M, Fugolin AP, et al. 3D printed versus conven-
tionally cured provisional crown and bridge dental materials. Dent
Mater. 2018;34:192-200.
20. Alharbi N, Alharbi S, Cuijpers VMJI, Osman RB, Wismeijer D. Three-
dimensional evaluation of marginal and internal fit of 3D-printed
9
interim restorations fabricated on different finish line designs.
J Prosthodont Res. 2018;62:218-226.
21. Sim JY, Jang Y, Kim WC, Kim HY, Lee DH, Kim JH. Comparing the
accuracy (trueness and precision) of models of fixed dental prosthe-
ses fabricated by digital and conventional workflows. J Prosthodont
Res. 2019;63:25-30.
22. Algamaiah H, Sampaio CS, Rigo LC, et al. Microcomputed tomography
evaluation of volumetric shrinkage of bulk-fill composites in class II
cavities. J Esthet Restor Dent. 2017;29:118-127.
23. Sampaio CS, Chiu KJ, Farrokhmanesh E, et al. Microcomputed tomog-
raphy evaluation of polymerization shrinkage of class I flowable resin
composite restorations. Oper Dent. 2017;42:E16-E23.
24. Atria PJ, Sampaio CS, Cáceres E, et al. Micro-computed tomography
evaluation of volumetric polymerization shrinkage and degree of con-
version of composites cured by various light power outputs. Dent
Mater J. 2018;37:33-39.
25. Caceres EA, Sampaio CS, Atria PJ, et al. Void and gap evaluation using
microcomputed tomography of different fiber post cementation tech-
niques. J Prosthet Dent. 2018;119:103-107.
26. Sampaio CS, Atria PJ, Rueggeberg FA, et al. Effect of blue and violet
light on polymerization shrinkage vectors of a CQ/TPO-containing
composite. Dent Mater. 2017;33:796-804.
27. Sampaio CS, Barbosa JM, Cáceres E, et al. Volumetric shrinkage and
film thickness of cementation materials for veneers: an in vitro 3D
microcomputed tomography analysis. J Prosthet Dent. 2017;117:
784-791.
28. Nejatidanesh F, Lotfi HR, Savabi O. Marginal accuracy of interim res-
torations fabricated from four interim autopolymerizing resins.
J Prosthet Dent. 2006;95:364-367.
29. Hoang LN, Thompson GA, Cho S-H, Berzins DW, Ahn KW. Die spacer
thickness reproduction for central incisor crown fabrication with
combined computer-aided design and 3D printing technology: an
in vitro study. J Prosthet Dent. 2015;113:398-404.
30. McLean J, von Fraunhofer JA. The estimation of cement film thick-
ness by an in vivo technique. Br Dent J. 1971;131:107-111.
31. Jang Y, Sim JY, Park JK, Kim WC, Kim HY, Kim JH. Evaluation of the
marginal and internal fit of a single crown fabricated based on a
three-dimensional printed model. J Adv Prosthodont. 2018;10:
367-373.
32. Kim SH, Watts DC. Polymerization shrinkage-strain kinetics of tem-
porary crown and bridge materials. Dent Mater. 2004;20:88-95.
33. Boitelle P, Mawussi B, Tapie L, Fromentin O. A systematic review of
CAD/CAM fit restoration evaluations. J Oral Rehabil. 2014;41:
853-874.
34. Sulaiman TA, Abdulmajeed AA, Altitinchi A, Ahmed SN, Donovan TE.
Physical properties, film thickness, and bond strengths of resin-
modified glass ionomer cements according to their delivery method.
J Prosthodont. 2019;28:85-90.
35. Reymuns M, Lümkemann N, Stawarczyk B. 3D-printed material for
temporary restorations: impact of print layer thickness and post-
curing method on degree of conversion. Int J Comput Dent. 2019;22:
231-237.
How to cite this article: Sampaio CS, Niemann KD,
Schweitzer DD, Hirata R, Atria PJ. Microcomputed
tomography evaluation of cement film thickness of veneers
and crowns made with conventional and 3D printed
provisional materials. J Esthet Restor Dent. 2020;1–9. https://
doi.org/10.1111/jerd.12651