Marginal adaptation of three-unit interim restorations fabricated by the CAD-CA systems and the direct method before and after thermocycling

BACKGROUND: Limited information is available regarding the marginal adaptation of three-unit interim restorations fabricated by different techniques from different materials. Also, the efficacy of computer-aided design/computer-aided manufacturing (CAD-CAM) systems for their fabrication is still questionable. This study aimed to assess the marginal adaptation of three-unit interim restorations fabricated by the CAD-CAM systems and the direct method from different materials before and after thermocycling. MATERIAL AND METHODS: A sound mandibular second premolar and a second molar were prepared for a three-unit all-ceramic restoration. Metal dies were fabricated to simulate a case of mandibular first molar missing, and were mounted in an acrylic block. Seventy-two three-unit interim restorations were fabricated by different techniques from different materials in six groups (n=12). In the first four groups, restorations were fabricated from Tempron, Visalys Temp, Unifast III, and Acropars by the direct technique, while the Amann Girrbach and Arum CAD-CAM systems and Ceramill Temp blocks were used in the last two groups. Marginal gap in each group was measured under a stereomicroscope at ×100 magnification. The specimens then underwent 5000 thermal cycles (5-55°C), and the marginal gap was measured again afterwards. ANCOVA and Bonferroni test (for pairwise comparisons) were applied for statistical analyses (α=0.05). RESULTS: Amann Girrbach and Arum CAD-CAM systems were not significantly different regarding the marginal gap of restorations (P=0.999). Among the traditional interim materials, Acropars showed significantly higher marginal gap than others (P<0.001). No significant difference was noted between other traditional materials. CAD-CAM interim materials showed significantly smaller marginal gap than traditional materials (P<0.001). CONCLUSIONS: The CAD-CAM interim materials yielded superior marginal adaptation in three-unit interim restorations compared with traditional interim materials. The type of CAD-CAM system had no significant effect on the final marginal adaptation of restorations. Key words:Dental marginal adaptation, interim dental prosthesis, CAD-CAM.