Vergleichende materialabhängige Evaluation der marginalen und internen Passgenauigkeit bei der Chairside- und Labside-CAD/CAM-Fertigung von vollkeramischen Einzelkronen mittels zweier Analyseverfahren

A Comparative, Material-Dependent Evaluation of Marginal and Internal Fit of Chairside and Labside CAD/CAM-Fabricated All-Ceramic Single Crowns Using Two Analysis Methods

by Carl Jacob Grübel
Doctoral thesis
Date of Examination:2024-11-26
Date of issue:2024-11-22
Advisor:Prof. Dr. Matthias Rödiger
Referee:Prof. Dr. Matthias Rödiger
Referee:Prof. Dr. Michael Hülsmann
Persistent Address: http://dx.doi.org/10.53846/goediss-10891

 

 

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Abstract

English

Purpose: The aim of this study was to evaluate the material-dependent fit of CAD/CAM-fabricated all-ceramic restorations, focusing on the marginal and internal fit of monolithic single-tooth crowns produced using chairside and labside manufacturing techniques with materials Vita Enamic® and Vita Suprinity® PC. Material and Methods: 56 CAD/CAM-fabricated all-ceramic crowns were analyzed, produced from Vita Enamic® and Vita Suprinity® PC materials using both chairside and labside methods. The crowns were fabricated based on the direct and indirect digitization of 14 model teeth. Marginal fit was evaluated using light microscopy at 24 defined measurement points per crown. Internal fit was assessed with the replica technique, where crowns were temporarily fixed with silicone on the model teeth, simulating cementation. The replicas were segmented to evaluate internal fit at 64 points. Statistical analysis was conducted using non-parametric rank-based methods with repeated measurements and correlation analysis. Results: A significant influence of the manufacturing process on marginal fit was found using light microscopy (p = 0.0064). However, the replica technique only confirmed this effect for internal fit (p = 0.0288), not for marginal fit (p = 0.1496). Material choice significantly affected marginal fit (p < 0.0001), with no significant material effect on internal fit (p = 0.4376). A significant correlation between the results from the light microscopy and replica techniques was established, confirming the validity of the findings. Discussion: The results indicate that both manufacturing technique (chairside vs. labside) and material type (Vita Enamic® vs. Vita Suprinity® PC) play significant roles in the fit of CAD/CAM-fabricated all-ceramic crowns. While the marginal fit was significantly influenced by both factors, the internal fit was more closely linked to the manufacturing process than the material used. The findings underscore the importance of precise control over both the material and manufacturing technique in achieving optimal fit in clinical practice. Conclusion: CAD/CAM-fabricated all-ceramic restorations, specifically monolithic single-tooth crowns, show promising results for clinical application. However, the study emphasizes the necessity of standardized methods for evaluating the marginal and internal fit of these restorations. Further studies, particularly clinical long-term trials, should focus on refining manufacturing processes and exploring new materials to optimize restoration quality and fit.
Keywords: CAD/CAM; all-ceramic restorations; marginal fit; internal fit; Vita Enamic; Vita Suprinity; replica technique; light microscopy; prothetics; dental materials; chairside; labside; material science; intraoral scanner; crown