Conventional cast vs. CAD/CAM post and core in a fully digital chairside workflow - An in vivo comparative study of accuracy of fit and feasibility of impression taking

Jonas Adrian Helmut Vogler; Louise Billen; Kay-Arne Walther; Bernd Wöstmann

doi:10.1016/j.jdent.2023.104638

Conventional cast vs. CAD/CAM post and core in a fully digital chairside workflow - An in vivo comparative study of accuracy of fit and feasibility of impression taking

J Dent. 2023 Sep:136:104638. doi: 10.1016/j.jdent.2023.104638. Epub 2023 Jul 26.

Authors

Jonas Adrian Helmut Vogler¹, Louise Billen², Kay-Arne Walther², Bernd Wöstmann²

Affiliations

¹ Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany. Electronic address: Jonas.A.Vogler@dentist.med.uni-giessen.de.
² Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany.

PMID: 37506812
DOI: 10.1016/j.jdent.2023.104638

Abstract

Objectives: Clinical data for CAD/CAM post and cores (PC) is still scarce, even though developments in digital dentistry have improved dental treatment in many aspects. Therefore, the purpose of this in vivo study was to compare CAD/CAM PC fabricated in a fully digital chairside workflow to conventional cast PC (CPC) according to the accuracy of fit and the impression taking. The null hypothesis was that there is no significant difference between CAD/CAM PC and CPC.

Methods: The study was conducted on 30 teeth in 25 patients receiving a CPC during their prosthetic treatment plan. On each tooth a conventional and a digital post impression were taken. Subsequently, one CPC following a conventional and one CAD/CAM PC following a digital workflow were fabricated. Both PC were tried-in intraorally and assessed according to a standardised evaluation sheet. The deviation between the two impression methods was evaluated by superimposing the datasets in a 3D analysis software. Statistical analysis for pairwise comparison was conducted according to Wilcoxon and median test with a significance level of p = 0.05.

Results: CAD/CAM PC performed significantly better compared to CPC according to accuracy of fit (p = 0.022) and feasibility of impression taking (p < 0.001). The deviation between post impression methods increased from "coronal" to "apical". Between "coronal"/"middle" no significant difference (p = 0.158) was detected, whereas the pairwise comparison between the other measurement categories showed significant differences (p = 0.002, p < 0.001).

Conclusions: The null hypothesis was rejected since CAD/CAM PC performed significantly better and the deviation between the post impression methods showed significant differences.

Clinical significance: By using intraoral scanners (IOS) teeth can be restored with customised CAD/CAM PC in a single session. Within the limitations of this study the fully digital chairside workflow led to superior accuracy of fit of PC and higher feasibility of impression taking than the conventional workflow for CPC.

Keywords: CAD/CAM; Chairside; Intraoral scanner; Post and core.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Ceramics*
Computer-Aided Design
Crowns
Dental Impression Technique*
Dental Prosthesis Design / methods
Feasibility Studies
Humans
Workflow