Background: At a time when esthetics is becoming increasingly important in society, the metal-ceramic system, although clinically reliable in the long term, no longer grants satisfaction in terms of mimicry and biocompatibility. Over the last two decades, the growth of computer-aided design and computer-aided manufacturing (CAD/CAM) systems has promoted the development of new all-ceramic materials. However, the abundance and diversity of the suggested materials involved in fixed prosthetic rehabilitation place the practitioner in a situation of conflict regarding the choice of selecting the type of restoration appropriate to the clinical situation presented to him/her. Aim: The aim of this article is to classify the different types of milled ceramics according to their microstructure, to review the clinical indications of each, and to indicate whether they should be cemented or bonded. Results: The diverse sorts of milled ceramics using the CAD/CAM procedures are classified into four categories according to their chemical nature. Therefore, the large constitutional and structural variety of the all-ceramic materials will define the esthetic and mechanical properties of each group. Conclusion:The all-ceramic CAD/CAM restorations are witnessing a well-deserved rise, knowing that none of those milled ceramics has a universal clinical application. Clinical significance: Given the abundance and diversity of the new machined ceramics materials, it is necessary to familiarize with their properties as well as with their mode of assembling to the dental structures to ensure the success and durability of the restoration.
Aim: This in vitro study's objective is to assess the Three-Dimensional (3D) internal and marginal fit of all-ceramic CAD/CAD crowns produced by various digital impression systems. Materials and Methods: Three different intraoral scanners: CEREC Primescan (Dentsply Sirona), Trios 4 (3Shape), and CS 3700 (Carestream Dental) were used to digitally scan an experimental model based on ISO 12836:2015. The CAD/CAM processes suggested by each system (CEREC Primescan, Trios 4 and CS 3700; N = 15) were used to create ceramic crowns. A 3D inspection program (Geomagic control X) was used to measure The Three-Dimensional (3D) marginal and internal fit of each ceramic crown. By using the Kruskal-Wallis test, differences between the systems and various measurements were assessed. Pairwise comparisons were used to validate statistically significant differences (= 0.05). Results: Occlusal gaps in the CEREC Primescan, Trios 4 and CS 3700 groups were 113.0, 161.3, and 438.2 µm, respectively (p<0.001). The axial gaps were 83.4, 78.0, and 107.9 µm, respectively. While the marginal gaps were 77.8, 99.3, and 60.6 µm, respectively, finally the whole gaps were 85.9, 107.3, and 214.0 µm, respectively. The marginal gap sizes with the Trios 4 system were considerably different from those with the other two systems. The CEREC Primescan system proved no distinctive variations between the four measured regions. However, the Trios 4 and CS 3700 systems did show a statistically significant difference (p<0.05). Conclusion: The marginal gap, which is the most essential aspect in the marginal and internal fit of fixed prostheses, was recorded to be below 100 µm in all three systems, leading to the conclusion that all three systems are capable of producing clinically acceptable prostheses.
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