The Influence of Different Fabrication and Impression Techniques on the Marginal Adaptation of Lithium Disilicate Crowns : A Comparative in Vitro Study

Background: The marginal adaptation has a key role in the success and longevity of the fixed dental restoration, which is affected by the impression and the fabrication techniques .The objective of this in vitro study was to evaluate and compare the marginal fitness of lithium disilicate crowns using two different digital impression techniques (direct and indirect techniques) and two different fabrication techniques (CAD/CAM and Press techniques). Materials and Methods: Thirty two sound upper first premolar teeth of comparable size extracted for orthodontic reason were selected in this study .Standardized preparation of all teeth samples were carried out with modified dental surveyor to receive all ceramic crown restoration with 1 mm deep chamfer finishing line, 4 mm axial length and 6 degree convergence angle. Half of the teeth were duplicated and poured in type IV dental stone to have sixteen dies and then these dies and the remaining teeth divided in to two groups according to the type of digital impression techniques (n=16) as follow: Group A: Indirect digital impression technique scanned by inEos X5 camera; Group B: Direct digital impression technique scanned by CEREC AC Omnicam camera. Each group was subdivided according to the technique of fabrication into two subgroups (n=8): Press technique using IPS e-max press (A1, B1); CAD/CAM technique using IPS e-max CAD (A2, B2).Marginal gaps were evaluated on the prepared teeth at four defined points on each aspect using digital microscope at a magnification of (280X). One way ANOVA and LSD tests were used to identify and localize the source of difference among the groups. Results: The results showed that indirect digital impression with IPS e-max CAD/CAM group A2 revealed the poorest marginal integrity with (55.93 μm ± 3.300). Group B2 and group A1 were next in line with(44.49 μm ± 6.840 and 37.74 μm± 5.433) respectively, while in the first group of restorations, the result of 29.9 μm ± 5.534 obtained with direct digital impression with pressable ceramic was clearly better. Conclusions: All the tested digital impression techniques showed clinically acceptable accuracy and intraoral scanning with pressable ceramic significantly enhanced the marginal fit