Assessment of internal fit and micro leakage of conventionally fabricated ceramometallic restoration versus CAD wax and press veneering (in-vitro study)

STATEMENT OF PROBLEM: Accuracy of internal fit and microleakage for CAD-CAM systems used in metal coping fabrication and veneered with layering or pressing porcelain in ceramometallic restoration is unclear. MATERIAL AND METHODS: A master metal die was milled to resemble the right mandibular first molar preparation for coverage with ceramometallic restoration. Master die was duplicated to twenty-four resin specimen dies.They were divided into two groups according to metal coping construction technique using either conventional (C) or CAD (D) wax. Each group was subdivided into two subgroups (n = 6) according to the technique of porcelain veneering (layered or pressed) to fabricate ceramometallic restorations, where subgroup (CL, DL) were conventionally layered by porcelain and (CP, DP) were press veneered. A standardized thickness of metal and porcelain was performed in all specimens as per manufacturer’s instructions for techniques ceramometallic restoration construction. Evaluation of internal fit was done with silicone replica technique using stereomicroscope at ×24 magnification where the thickness of silicon layer was measured at 20 reference points on each specimen. Then specimens were subjected to thermocycling. Sectioned specimens were assessed for microleakage using a stereomicroscope at ×12 magnification along die-cement interface with a five scale score. RESULTS: Mean internal gap values of veneering showed a statistically nonsignificant difference between specimens made with layering(L) and pressing(P). Different techniques of wax construction showed a non-significant difference in internal gap values between specimens made with conventional(C) and CAD(D) waxing. However, a significant difference was found in the internal gap at different sites. The highest internal gap was found at the occlusal surface, while the lowest gap was found at the finish line. The highest mean microleakage score was found with CAD wax and press veneering, while the lowest mean microleakage score was found with conventional wax and press veneering. CONCLUSION: Both construction techniques of ceramometallic restoration were considered reliable in restoration production within a clinically acceptable range regarding internal fit and microleakage. There is a strong positive correlation between internal fit and microleakage of ceramometallic restoration constructed.