Fit of cobalt–chromium implant frameworks before and after ceramic veneering in comparison with CNC‐milled titanium frameworks

Computer‐aided design/computer‐aided manufacturing fabrication of implant‐supported frameworks is a standard procedure, and the use of ceramic‐veneered cobalt–chromium alloys is increasing. However, no data are available concerning the precision of fit of these frameworks and the impact on the fit of the veneering procedure. The aim of this study was to evaluate the fit of computer numeric‐controlled‐milled cobalt–chromium and titanium implant frameworks for edentulous maxillas, provided with six implants. An additional aim was to evaluate the effect of ceramic veneering on the fit of the cobalt–chromium frameworks. Ten stone casts simulating an edentulous maxilla provided with six dental implants and abutments were produced. One computer numeric‐controlled‐milled cobalt–chromium framework and one titanium framework were fabricated for each stone cast. Each stone cast and corresponding titanium and cobalt–chromium framework was measured with a coordinate measuring machine in the three‐dimensional (X axis, Y axis, and Z axis) directions. Both milled titanium and cobalt–chromium frameworks presented a good fit in the vertical plane (Z axis), 5.3 µm for titanium frameworks and 4.6 µm for the cobalt–chromium frameworks. The titanium frameworks showed a statistically significant smaller mean degree of misfit in the horizontal plane, X (5.0 µm) and Y (2.8 µm) axes as compared with the cobalt–chromium frameworks presenting a mean deviation of 13.5 µm in X axis and 6.3 µm in Y axis (P < 0.001). After ceramic veneering of the cobalt–chromium frameworks, the horizontal distortion significantly decreased from 13.5 to 9.7 µm in X axis (P = 0.007) and from 6.3 to 4.4 µm in Y axis (P = 0.017). The fit of both titanium and cobalt–chromium frameworks was very good. There were small but significant differences in fit between the titanium and cobalt–chromium frameworks, but the difference is of no clinical significance. The ceramic veneering resulted in a minor but significant improvement of the fit for the cobalt–chromium frameworks.