Marginal fit of 3-unit implant-supported fixed partial dentures: Influence of pattern fabrication method and repeated porcelain firings

Abstract

Background Marginal fit significantly impacts the long-term success of dental restorations. Different pattern fabrication methods, including hand-waxing, milling, or 3D printing, may affect restorations accuracy. The effect of porcelain firing cycles on the marginal fit of metal-ceramic restorations remains controversial, with conflicting findings across studies. Purpose The aim was to evaluate the potential effects of multiple porcelain firings (3, 5, 7 cycles) as well as pattern fabrication method (conventional hand-waxing, milling, and 3D printing) on the marginal adaptation of 3-unit implant-supported metal-ceramic fixed partial dentures. It was hypothesized that neither the wax pattern fabrication method nor repeated ceramic firings would significantly affect the marginal adaptation of metal-ceramic crowns. Methods In this in-vitro study, 30 Cobalt-Chromium alloy frameworks were fabricated based on pattern made through three techniques: conventional hand-waxing, CAD-CAM milling, and CAD-CAM 3D printing (n = 10 per group). Sixteen locations were marked on each abutment to measure the vertical marginal gap at four stages: before porcelain veneering and after 3, 5, and 7 firing cycles. The vertical marginal gap was measured using direct microscopic technique at ×80 magnification. Mean vertical marginal gap values were calculated and two-way ANOVA and Tukey’s post hoc tests were used for inter-group comparisons (α = 0.05). Results The 3D printing group showed significantly lower (P<0.001) mean vertical marginal gaps (60–76 μm) compared to the milling (77–115 μm) and conventional hand-waxing (102–110 μm) groups. The milling group exhibited a significant vertical gap increase after 3 firing cycles (P<0.001); while the conventional (P = 0.429) and 3D printing groups (P = 0.501) showed no significant changes after 7 firing cycles. Notably, the vertical marginal gap in all groups remained below the clinically acceptable threshold of 120 μm. Conclusion CAD-CAM 3D printing provided superior marginal fit compared to CAD-CAM milling and conventional hand-wax pattern fabrication methods. The impact of porcelain firing on the mean marginal gap was significant only in the milling group. All three fabrication techniques yielded clinically acceptable vertical marginal adaptation after repeated firings. Additive manufacturing holds promise to produce precise implant-supported prostheses.