Journal of Prosthetic Dentistry

Volumetric and dimensional accuracy assessment of CAD-CAM–manufactured dental prostheses from different materials


      Statement of problem

      In computer-aided design and computer-aided manufacturing (CAD-CAM) dentistry, the CAD of the prosthesis represents the clinical prerequisite design to restore the treated tooth. However, how closely the CAM prosthesis shape matches the CAD, particularly in relation to different materials, is unclear.


      The purpose of this in vitro study was to evaluate onlays designed and manufactured with the same CAD-CAM system but manufactured with different materials.

      Material and methods

      A single standard tessellation language (STL) model was used to produce 6 composite resin onlays, 6 leucite glass-ceramic onlays, and 6 lithium disilicate glass-ceramic onlays. The onlays were digitized by using an X-ray microtomographic protocol with a metrological calibration. The CAD model was then compared with the scans of the different onlays. An analysis by region of interest was then carried out to assess the accuracy and reliability of the dimensional accuracy.


      The composite resin and the lithium disilicate glass-ceramic had the best dimensional accuracy. The leucite glass-ceramic exhibited a lack of trueness linked to consistent overmilling. The composite resin had less peripheral chipping than the glass-ceramics.


      The composite resin and the lithium disilicate glass-ceramic material exhibited satisfactory dimensional accuracy. Milling the glass-ceramic before crystallization considerably improved dimensional accuracy.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Prosthetic Dentistry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Benic G.I.
        • Sailer I.
        • Zeltner M.
        • Gütermann J.N.
        • Özcan M.
        • Mühlemann S.
        Randomized controlled clinical trial of digital and conventional workflows for the fabrication of zirconia-ceramic fixed partial dentures. Part III: Marginal and internal fit.
        J Prosthet Dent. 2019; 121: 426-431
        • Miyazaki T.
        • Hotta Y.
        • Kunii J.
        • Kuriyama S.
        • Tamaki Y.
        A review of dental CAD/CAM: current status and future perspectives from 20 years of experience.
        Dent Mater J. 2009; 28: 44-56
        • Li R.W.K.
        • Chow T.W.
        • Matinlinna J.P.
        Ceramic dental biomaterials and CAD/CAM technology: State of the art.
        J Prosthodont Res. 2014; 58: 208-216
        • Zimmermann M.
        • Valcanaia A.
        • Neiva G.
        • Mehl A.
        • Fasbinder D.
        Influence of different CAM strategies on the fit of partial crown restorations: A digital three-dimensional evaluation.
        Oper Dent. 2018; 43: 530-538
        • Ruse N.D.
        • Sadoun M.J.
        Resin-composite blocks for dental CAD/CAM applications.
        J Dent Res. 2014; 93: 1232-1234
        • Lambert H.
        • Durand J.-C.
        • Jacquot B.
        • Fages M.
        Dental biomaterials for chairside CAD/CAM: State of the art.
        J Adv Prosthodont. 2017; 9: 486-495
        • Gonzaga C.C.
        • Cesar P.F.
        • Miranda W.G.
        • Yoshimura H.N.
        Slow crack growth and reliability of dental ceramics.
        Dent Mater Off Publ Acad Dent Mater. 2011; 27: 394-406
        • Benaqqa C.
        • Chevalier J.
        • Saädaoui M.
        • Fantozzi G.
        Slow crack growth behaviour of hydroxyapatite ceramics.
        Biomaterials. 2005; 26: 6106-6112
        • Rossetti P.H.O.
        • do Valle A.L.
        • de Carvalho R.M.
        • De Goes M.F.
        • Pegoraro L.F.
        Correlation between margin fit and microleakage in complete crowns cemented with three luting agents.
        J Appl Oral Sci Rev FOB. 2008; 16: 64-69
        • Trajtenberg C.P.
        • Caram S.J.
        • Kiat-amnuay S.
        Microleakage of all-ceramic crowns using self-etching resin luting agents.
        Oper Dent. 2008; 33: 392-399
        • Schaefer O.
        • Kuepper H.
        • Thompson G.A.
        • Cachovan G.
        • Hefti A.F.
        • Guentsch A.
        Effect of CNC-milling on the marginal and internal fit of dental ceramics: A pilot study.
        Dent Mater Off Publ Acad Dent Mater. 2013; 29: 851-858
        • Dong X.D.
        • Ruse N.D.
        Fatigue crack propagation path across the dentinoenamel junction complex in human teeth.
        J Biomed Mater Res A. 2003; 66: 103-109
        • Boitelle P.
        • Mawussi B.
        • Tapie L.
        • Fromentin O.
        A systematic review of CAD/CAM fit restoration evaluations.
        J Oral Rehabil. 2014; 41: 853-874
        • Lebon N.
        • Tapie L.
        • Vennat E.
        • Mawussi B.
        Influence of CAD/CAM tool and material on tool wear and roughness of dental prostheses after milling.
        J Prosthet Dent. 2015; 114: 236-247
        • Chavali R.
        • Nejat A.H.
        • Lawson N.C.
        Machinability of CAD-CAM materials.
        J Prosthet Dent. 2017; 118: 194-199
        • Palin W.M.
        • Fleming G.J.
        • Burke F.J.
        • Marquis P.M.
        • Pintado M.R.
        • Randall R.C.
        • et al.
        The frictional coefficients and associated wear resistance of novel low-shrink resin-based composites.
        Dent Mater. 2005; 21: 1111-1118
        • Jeong Y.-G.
        • Lee W.-S.
        • Lee K.-B.
        Accuracy evaluation of dental models manufactured by CAD/CAM milling method and 3D printing method.
        J Adv Prosthodont. 2018; 10: 245-251
        • Pacquet W.
        • Tapie L.
        • Mawussi B.
        • Boitelle P.
        Evaluation of the dimensional accuracy of manufactured dental prosthesis in relation to its computer-aided model.
        Int J Comput Dent. 2020; 23: 1-8
        • Ahlers M.O.
        • Mörig G.
        • Blunck U.
        • Hajtó J.
        • Pröbster L.
        • Frankenberger R.
        Guidelines for the preparation of CAD/CAM ceramic inlays and partial crowns.
        Int J Comput Dent. 2009; 12: 309-325
        • Guess P.C.
        • Schultheis S.
        • Wolkewitz M.
        • Zhang Y.
        • Strub J.R.
        Influence of preparation design and ceramic thicknesses on fracture resistance and failure modes of premolar partial coverage restorations.
        J Prosthet Dent. 2013; 110: 264-273
        • Holberg C.
        • Rudzki-Janson I.
        • Wichelhaus A.
        • Winterhalder P.
        Ceramic inlays: Is the inlay thickness an important factor influencing the fracture risk?.
        J Dent. 2013; 41: 628-635
        • Ferraris F.
        Posterior indirect adhesive restorations (PIAR): preparation designs and adhesthetics clinical protocol.
        Int J Esthet Dent. 2017; 12: 482-502
        • Chang Y.-H.
        • Lin W.-H.
        • Kuo W.-C.
        • Chang C.-Y.
        • Lin C.-L.
        Mechanical interactions of cuspal-coverage designs and cement thickness in a cusp-replacing ceramic premolar restoration: A finite element study.
        Med Biol Eng Comput. 2009; 47: 367-374
        • Krifka S.
        • Stangl M.
        • Wiesbauer S.
        • Hiller K.-A.
        • Schmalz G.
        • Federlin M.
        Influence of different cusp coverage methods for the extension of ceramic inlays on marginal integrity and enamel crack formation in vitro.
        Clin Oral Investig. 2009; 13: 333-341
        • Veneziani M.
        Posterior indirect adhesive restorations: updated indications and the morphology driven preparation technique.
        Int J Esthet Dent. 2017; 12: 204-230
        • Rocca G.T.
        • Rizcalla N.
        • Krejci I.
        • Dietschi D.
        Evidence-based concepts and procedures for bonded inlays and onlays. Part II. Guidelines for cavity preparation and restoration fabrication.
        Int J Esthet Dent. 2015; 10: 392-413
        • Jahanmir S.
        Ultrahigh speed microgrinding of dental ceramics.
        Mach Sci Technol. 2010; 14: 411-422
        • Gaspar M.
        • Weichert F.
        Integrated construction and simulation of tool paths for milling dental crowns and bridges.
        Comput-Aided Des. 2013; 45: 1170-1181
        • Dong X.
        • Yin L.
        • Jahanmir S.
        • Ives L.K.
        • Rekow E.D.
        Abrasive machining of glass-ceramics with a dental handpiece.
        Mach Sci Technol. 2000; 4: 209-233
        • Song X.-F.
        • Yin L.
        • Han Y.-G.
        • Li J.
        Finite element analysis of subsurface damage of ceramic prostheses in simulated intraoral dental resurfacing.
        J Biomed Mater Res. 2008; 85: 50-59
        • Song X.-F.
        • Yin L.
        Subsurface damage induced in dental resurfacing of a feldspar porcelain with coarse diamond burs.
        J Biomech. 2009; 42: 355-360
        • Tapie L.
        • Chiche N.
        • Boitelle P.
        Adaptation Measurement of CAD/CAM dental crowns with x-ray micro-CT: Metrological chain standardization and 3D gap size distribution.
        Adv Mater Sci Eng. 2016; 2016: 1-13
        • Du L.Y.
        • Umoh J.
        • Nikolov H.N.
        • Pollmann S.I.
        • Lee T.-Y.
        • Holdsworth D.W.
        A quality assurance phantom for the performance evaluation of volumetric micro-CT systems.
        Phys Med Biol. 2007; 52: 7087
        • Johnston S.M.
        • Johnson G.A.
        • Badea C.T.
        Geometric calibration for a dual tube/detector micro-CT system.
        Med Phys. 2008; 35: 1820-1829
        • International Organization for Standardization
        Accuracy (trueness and precision) of measurement methods and results — Part 1 : General principles and definitions.
        ISO, 1994
        • International Organization for Standardization
        Accuracy (trueness and precision) of measurement methods and results — Part 2 : Basic method for the determination of repeatability and reproducibility of a standard measurement method.
        ISO, 2019
        • Tapie L.
        • Lebon N.
        • Mawussi B.
        • Fron Chabouis H.
        • Duret F.
        • Attal J.-P.
        Understanding dental CAD/CAM for restorations--the digital workflow from a mechanical engineering viewpoint.
        Int J Comput Dent. 2015; 18: 21-44
        • Yin L.
        • Jahanmir S.
        • Ives L.K.
        Abrasive machining of porcelain and zirconia with a dental handpiece.
        Wear. 2003; 255: 975-989
        • Newman M.G.
        Newman and Carranza’s clinical periodontology.
        13th edition. Elsevier, Inc, Philadelphia, PA2018: 944