To compare the trueness and precision of 3D-printed versus milled monolithic zirconia crowns (MZCs). A model of a maxilla with a prepared premolar was scanned with an industrial scanner (ATOSQ®, Gom) and an MZC was designed in computer-assisted-design (CAD) software (DentalCad®, Exocad). From that standard tessellation language (STL) file, 10 MZCs (test) were 3D-printed with a Lithography-based Ceramic Manufacturing (LCM) printer (CerafabS65®, Lithoz) and 10 MZCs (control) were milled using a 5-axis machine (DWX-52D®, DGShape). All MZCs were sintered and scanned with the aforementioned scanner. The surface data of each sample (overall crown, marginal area, occlusal surface) were superimposed to the original CAD file (ControlX®, Geomagic) to evaluate trueness: (90-10)/2, absolute average (ABS AVG) and root mean square (RMS) values were obtained for test and control groups (MathLab®, Mathworks) and used for analysis. Finally, the clinical precision (marginal adaptation, interproximal contacts) of test and control MZCs was investigated on a split-cast model printed (Solflex350®, Voco) from the CAD project, and compared. The milled MZCs had a significantly higher trueness than the 3D-printed ones, overall [(90-10)/2 printed 37.8 µm vs milled 21.2 µm; ABS AVG printed 27.2 µm vs milled 15.1 µm; RMS printed 33.2 µm vs milled 20.5 µm; p = 0.000005], at the margins [(90-10)/2 printed 25.6 µm vs milled 12.4 µm; ABS AVG printed 17.8 µm vs milled 9.4 µm; RMS printed 22.8 µm vs milled 15.6 µm; p= 0.000011] and at the occlusal level [(90-10)/2 printed 50.4 µm vs milled 21.9 µm; ABS AVG printed 29.6 µm vs milled 14.7 µm; RMS printed 38.9 µm vs milled 22.5 µm; p = 0.000005]. However, with regard to precision, both test and control groups scored highly, with no significant difference either in the quality of interproximal contact points (p = 0.355) or marginal closure (p = 0.355). Milled MZCs had a statistically higher trueness than 3D-printed ones; all crowns, however, showed high precision, compatible with the clinical use. Although milled MZCs remain more accurate than 3D-printed ones, the LCM technique seems able to guarantee the production of clinically precise zirconia crowns.

Background: The aim of this randomized controlled trial was to evaluate the capability of an IOS (Intra Oral Scanner) device, used in standardized conditions, to detect margins of abutments prepared with knife-edge finishing line located at three different levels in relation to the gingival sulcus. Methods: sixty abutment teeth for treatment with full crowns were selected and randomly divided in three groups accordingly to the depth of the finishing line: Group A: supragingival margin; Group B: 0.5–1.0 mm into the sulcus; Group C: 1.5–2.0 mm into the sulcus. Temporary crowns were placed for two weeks and then digital impressions (Aadva IOS 100, GC, Japan) were made of each abutment. As controls, analog impressions were taken, poured, and scanned using a laboratory scanner (Aadva lab scanner, GC, Japan). Two standard tessellation language (STL) files were generated for each abutment, subsequently processed, and superimposed by Exocad software (Exocad GmbH, Darmstadt, Germany), applying the “best-fit“ algorithm in order to align the scan of the conventional with the digital impressions. The distances between each preparation margin and the adjacent gingival tissue were measured. Four measures were taken, two interproximally and buccally, for a total of six measures of each abutment considering three modes of impressions. The data were statistically evaluated using two-way analysis of variance (ANOVA) for each site and the Bonferroni test. Results: there was no difference between the two kinds of impression in Group A in both sites, in Group B a difference of 0.483 mm and 0.682 mm at interproximal and buccal sites, respectively, and in Group C 0.750 mm and 0.964 mm at interproximal and buccal sites, respectively. The analysis performed on a site level (mesial/distal/vestibular) for the depth of both vertical preparations revealed significant differences (p < 0.0001). After a post hoc analysis (Bonferroni), vestibular sites of the shallow vertical preparations resulted in significantly lower values compared to the other sites prepared deeply. Conclusions: the results showed that the location of the margin is an important factor in making a precise and complete impression when IOS (Intra Oral Scanner) is used. Moreover, deep preparation into the sulcus is not recommended for IOS (Intra Oral Scanner) impressions.

Background: This study was aimed at comparing the accuracy of impressions of a reference typodont (RT) reproducing a totally edentulous maxilla made with three impression materials: polysulfide, polyether, and polyvinyl-siloxane. Methods: The RT was scanned using a desktop scanner, obtaining a reference scan. Ten impressions for each of the three tested materials were made using a mechanical device with a standardized and consistent modality. A laboratory scanner performed the digitization of each impression. We produced digital models by processing “in reverse” the scans of the physical impressions using a dedicated software, obtaining three groups (n = 10), respectively. The groups were titled: “polysulfide,” “polyvinyl-siloxane,” and “polyether”. The scans in .stl format were imported into Geomagic Control X and then compared to RT to evaluate the accuracy of each scan by calculating trueness and precision in µm. Recorded data were subjected to descriptive statistics. Results: Trueness (arithmetic proximity) values (95%CI) were: polysulfide = 249.9 (121.3–378.5), polyvinyl-siloxane = 216.8 (123.1–310.6), polyether = 291.1 (219.9–362.3). Precision values (95% CI) were: polysulfide = 261.9 (108.8–415), polyvinyl-siloxane = 209.4 (111.9–306.8), polyether = 283 (227.9–338.1). Statistically significant differences were not detected between the means of the experimental groups, both for trueness and precision. Conclusions: The accuracy of the scans obtained from polyvinyl-siloxane, polysulfide, and polyether impressions can be considered comparable in a fully edentulous maxilla.