A comparison of the accuracy of fit of 2 methods for fabricating implant-prosthodontic frameworks.
OBJECTIVE
To compare the in vitro 3-dimensional (3D) accuracy of fit of laser-scanned Computer Numeric Controlled (CNC)-milled implant titanium frameworks to that of conventional cast frameworks.


METHODS
Nine cast frameworks were fabricated on the mandibular master casts of 9 patients with 5 implants each following the well-established conventional fabrication technique. The frameworks were then laser scanned, and 9 CNC-milled titanium frameworks matching the outline of the conventional frameworks were fabricated. The accuracy of fit of both framework types was measured using a contact-type coordinate measuring machine and a computer program developed specifically for this purpose. Statistical analysis was done by a series of paired ttests.


RESULTS
The laser-scanned CNC-milled frameworks showed significantly less distortion along the x-axis (transversal, d(x)) compared with the conventional frameworks (means: 33.7 microm and 49.2 microm, respectively) (P = .011). The titanium frameworks also demonstrated significantly less distortion on the horizontal plane compared with the conventional frameworks (means: 56 microm and 85 microm, respectively) (P = .012). The d(y) (sagittal) and d(z) (vertical) axes and total 3D distortion (square root of dx(2) + dy(2) + dz(2)) showed less distortion overall in the laser-scanned CNC-milled frameworks, but this was not statistically significant (mean: 22.3 vs 35.6 microm, 13.3 vs 59.2 microm, 51 vs 114.1 microm, respectively, for y, z, and 3D distortion).


CONCLUSIONS
Within the limitations of this study, fabrication of an implant-prosthodontic framework using the CNC milling technique yields a more accurate fit than the currently used cast technique. In vivo studies are needed to investigate the clinical significance of this recorded difference.
Al-Fadda
Sara A
SA
Department of Prosthodontics, Faculty of Dentistry, University of Toronto, Ontario, Canada. s.alfadda@utoronto.ca
Zarb
George A
GA
Finer
Yoav
Y
D017076:Computer-Aided Design; D003300:Copper / Q000737:chemistry; D000044:Dental Abutments; D003722:Dental Alloys / Q000737:chemistry; D003734:Dental Casting Investment / Q000737:chemistry; D003735:Dental Casting Technique; D015921:Dental Implants; D003764:Dental Materials / Q000737:chemistry; D019094:Dental Prosthesis, Implant-Supported; D003779:Denture Design; D006047:Gold Alloys / Q000737:chemistry; D006801:Humans; D021621:Imaging, Three-Dimensional; D007575:Jaw, Edentulous / Q000534:rehabilitation; D007834:Lasers; D010165:Palladium / Q000737:chemistry; D012834:Silver / Q000737:chemistry; D013499:Surface Properties; D014025:Titanium / Q000737:chemistry
D003722:Dental Alloys; D003734:Dental Casting Investment; D015921:Dental Implants; D003764:Dental Materials; D006047:Gold Alloys; D012834:Silver; D010165:Palladium; D003300:Copper; D014025:Titanium