Trueness, precision, time-efficiency and cost analysis of chairside additive and subtractive versus lab-based workflows for manufacturing single crowns: An in vitro study

Francesco Guido Mangano; Dario Cianci; Nicola Pranno; Henriette Lerner; Fernando Zarone; Oleg Admakin

doi:10.1016/j.jdent.2023.104792

Trueness, precision, time-efficiency and cost analysis of chairside additive and subtractive versus lab-based workflows for manufacturing single crowns: An in vitro study

J Dent. 2024 Feb:141:104792. doi: 10.1016/j.jdent.2023.104792. Epub 2023 Nov 25.

Authors

Francesco Guido Mangano¹, Dario Cianci², Nicola Pranno³, Henriette Lerner⁴, Fernando Zarone⁵, Oleg Admakin⁶

Affiliations

¹ Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia. Electronic address: francescoguidomangano@gmail.com.
² Private Practice, Zelo Buon Persico (LO), Italy.
³ Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy.
⁴ Department of Oral, Maxillofacial and Plastic Surgery, Goethe University, Frankfurt, Germany.
⁵ Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy.
⁶ Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.

PMID: 38013004
DOI: 10.1016/j.jdent.2023.104792

Abstract

Purpose: To evaluate the trueness, precision, time efficiency, and cost of three different workflows for manufacturing single crowns (SCs).

Methods: A plaster model with a prepared tooth (#15) was scanned with an industrial scanner, and an SC was designed in computer-assisted-design (CAD) software. Ten SCs were printed with a hybrid composite (additive chairside) and a stereolithographic (SLA) printer (Dfab®), 10 SCs were milled in lithium disilicate (subtractive chairside) using a chairside milling unit (inLab MC XL®), and 10 SCs were milled in zirconia (lab-based) using a five-axis laboratory machine (DWX-52D®). All SCs were scanned with the same scanner after polymerization/sinterization. Each scan was superimposed to the marginal area of the original CAD file to evaluate trueness: absolute average (ABS AVG), root mean square (RMS), and (90˚-10˚)/2 percentile were calculated for each group. Marginal adaptation and quality of the occlusal and interproximal contact points were also investigated by two prosthodontists on 3D printed and plaster models. Finally, the three workflows' time efficiency and costs were evaluated.

Results: Additive chairside and subtractive lab-based SCs had significantly better marginal trueness than subtractive chairside SCs in all three parameters (ABS AVG, p < 0.01; RMS, p < 0.01; [90˚-10˚]/2, p < 0.01). However, the two prosthodontists found no significant differences between the three manufacturing procedures in the quality of the marginal closure (p = 0.186), interproximal (p = 0.319), and occlusal contacts (p = 0.218). Both time efficiency and cost show a trend favoring the chairside additive workflow.

Conclusions: Chairside additive technology seems to represent a valid alternative for manufacturing definitive SCs, given the high marginal trueness, precision, workflow efficiency and low costs.

Statement of clinical relevance: Additive chairside manufacturing of definitive hybrid composite SCs is now possible and shows high accuracy, time efficiency, and competitive cost.

Keywords: Additive technology; Chairside; Cost-analysis; Dental laboratory; Precision; Single crowns; Subtractive technology; Time-efficiency; Trueness.

MeSH terms

Computer-Aided Design
Costs and Cost Analysis
Crowns*
Dental Marginal Adaptation
Dental Materials
Dental Prosthesis Design* / methods
Workflow

Substances

Dental Materials