Influence of different convergence angles and tooth preparation heights on the internal adaptation of Cerec crowns☆☆☆★★★♢♢♢

Abstract 

Statement of Problem. Because of an imagining principle called active triangulation in the Cerec system, a shadow is cast distal to the illuminated objects. This distal shadow may be enlarged when the occlusal-cervical height of the prepared tooth is increased. Depth data of the shadow are unreliable, so the internal fit of Cerec crowns has been questioned. Purpose. This study evaluated the influence of different convergence angles and tooth preparation heights on the internal adaptation of Cerec crowns. Material and Methods. Tooth preparations were made on typodont teeth with different combinations of convergence angles and occlusal-cervical heights: Group I = 20° angle, 6 mm height; Group II = 20° angle, 4 mm height; Group III = 12° angle, 6 mm height; and Group IV = 12° angle, 4 mm height. Ten Cerec crowns were fabricated for each type of tooth preparation. Measurements of the internal fit were performed with the cement space replica technique and an image analysis system. Three-way analysis of variance was used to analyze the differences in cement space with different tooth preparations and the number of times that milling tools were used to prepare the Cerec crowns (P<.05). Multiple comparisons were made to evaluate differences between groups (P<.0083). Results. Cerec crowns with a 12° convergence angle demonstrated the best internal fit (cement space in Groups III and IV = 121 ± 41 μm and 115 ± 42 μm, respectively). The difference between the 2 convergence types was within the range of the scanning error (25 μm) produced by the Cerec camera. The number of times that milling tools were used had no significant effect on internal fit (P=.78). Tooth preparation height equal to or shorter than 6 mm occlusal-cervically with both 12° and 20° convergence angles also had no significant effect on internal fit (P>.0083). Cement space at distal walls (185 ± 28 μm) was the thickest among all axial walls (P=.0001) and was twice as thick as that at the facial (90 ± 14 μm) and palatal walls (92 ± 15 μm). Conclusion. Within the limitations of this study, there was little difference in the internal fit of Cerec crowns prepared with convergence angles of 12° and 20°. Distal shadows influenced the thickness of the cement spaces, particularly at the distal walls. However, tooth preparations with an occlusal-cervical height not greater than 6 mm did not exaggerate the effect of the distal shadows. (J Prosthet Dent 2002;87:248-55.)