Influence of Surface Roughness on Mechanical Properties of Two Computer-aided Design/Computer-aided Manufacturing (CAD/CAM) Ceramic Materials

SUMMARY The aim of this study was to evaluate the influence of surface roughness on surface hardness (Vickers; VHN), elastic modulus (EM), and flexural strength (FLS) of two computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic materials. One hundred sixty-two samples of VITABLOCS Mark II (VMII) and 162 samples of IPS Empress CAD (IPS) were ground according to six standardized protocols producing decreasing surface roughnesses (n=27/group): grinding with 1) silicon carbide (SiC) paper #80, 2) SiC paper #120, 3) SiC paper #220, 4) SiC paper #320, 5) SiC paper #500, and 6) SiC paper #1000. Surface roughness (Ra/Rz) was measured with a surface roughness meter, VHN and EM with a hardness indentation device, and FLS with a three-point bending test. To test for a correlation between surface roughness (Ra/Rz) and VHN, EM, or FLS, Spearman rank correlation coefficients were calculated. The decrease in surface roughness led to an increase in VHN from (VMII/IPS; medians) 263.7/256.5 VHN to 646.8/601.5 VHN, an increase in EM from 45.4/41.0 GPa to 66.8/58.4 GPa, and an increase in FLS from 49.5/44.3 MPa to 73.0/97.2 MPa. For both ceramic materials, Spearman rank correlation coefficients showed a strong negative correlation between surface roughness (Ra/Rz) and VHN or EM and a moderate negative correlation between Ra/Rz and FLS. In conclusion, a decrease in surface roughness generally improved the mechanical properties of the CAD/CAM ceramic materials tested. However, FLS was less influenced by surface roughness than expected.

Surface Roughness and Microhardness of Two Recent CAD/CAM-Materials After Storage

Objectives: To investigate surface roughness and microhardness of two recent resin-ceramic materials for computer-aided design/computer-aided manufacturing (CAD/CAM) after polishing with three polishing systems. Surface roughness and microhardness were measured immediately after polishing and after six months storage including monthly artificial toothbrushing. Methods: Sixty specimens of Lava Ultimate (3M ESPE) and 60 specimens of VITA ENAMIC (VITA Zahnfabrik) were roughened in a standardized manner and polished with one of three polishing systems (n=20/group): Sof-Lex XT discs (SOFLEX; three-step (medium-superfine); 3M ESPE), VITA Polishing Set Clinical (VITA; two-step; VITA Zahnfabrik), or KENDA Unicus (KENDA; one-step; KENDA Dental). Surface roughness (Ra; μm) was measured with a profilometer and microhardness (Vickers; VHN) with a surface hardness indentation device. Ra and VHN were measured immediately after polishing and after six months storage (tap water, 37°C) including monthly artificial toothbrushing (500 cycles/month, toothpaste RDA ~70). Ra- and VHN-values were analysed with nonparametric ANOVA followed by Wilcoxon rank sum tests (α=0.05). Results: For Lava Ultimate, Ra (mean [standard deviation] before/after storage) remained the same when polished with SOFLEX (0.18 [0.09]/0.19 [0.10]; p=0.18), increased significantly with VITA (1.10 [0.44]/1.27 [0.39]; p=0.0001), and decreased significantly with KENDA (0.35 [0.07]/0.33 [0.08]; p=0.03). VHN (mean [standard deviation] before/after storage) decreased significantly regardless of polishing system (SOFLEX: 134.1 [5.6]/116.4 [3.6], VITA: 138.2 [10.5]/115.4 [5.9], KENDA: 135.1 [6.2]/116.7 [6.3]; all p<0.0001). For VITA ENAMIC, Ra (mean [standard deviation] before/after storage) increased significantly when polished with SOFLEX (0.37 [0.18]/0.41 [0.14]; p=0.01) and remained the same with VITA (1.32 [0.37]/1.31 [0.40]; p=0.58) and with KENDA (0.81 [0.35]/0.78 [0.32]; p=0.21). VHN (mean [standard deviation] before/after storage) remained the same regardless of polishing system (SOFLEX: 284.9 [24.6]/282.4 [31.8], VITA: 284.6 [28.5]/276.4 [25.8], KENDA: 292.6 [26.9]/282.9 [24.3]; p=0.42-1.00). Conclusion: Surface roughness and microhardness of Lava Ultimate was more affected by storage and artificial toothbrushing than was VITA ENAMIC.

Dentin Bond Strength of Two Recent CAD/CAM-Materials after Storage

Purpose: To investigate the bond strength to dentin of two recent resin-ceramic materials for computer-aided design/computer-aided manufacturing (CAD/CAM) after 24 hours and after six months storage. Methods and Materials: Ninety cylinders were milled out of Lava Ultimate (3M ESPE) and 90 cylinders out of VITA ENAMIC (VITA Zahnfabrik) (dimension of cylinders: ∅=3.6 mm, h=2 mm). All Lava Ultimate cylinders were sandblasted (aluminium oxide, grain size: 27 μm) and cleaned with ethanol, whereas all VITA ENAMIC cylinders were acid-etched (5% hydrofluoric acid) and cleaned with water-spray. According to the three groups of cements used, the cylinders (n=30/resin-ceramic material) were further pretreated with 1) Scotchbond Universal for RelyX Ultimate (3M ESPE), 2) CLEARFIL Ceramic Primer for PANAVIA F2.0 (Kuraray), or 3) no further pretreatment for Ketac Cem Plus (3M ESPE). The cylinders were then bonded to ground human dentin specimens with 1) Scotchbond Universal and RelyX Ultimate (light-cured), 2) ED PRIMER II and PANAVIA F2.0 (light-cured), or 3) no adhesive system; Ketac Cem Plus (self-cured). Shear bond strength (SBS) was measured after 24 hours for 15 specimens/group and after six months (37°C, 100% humidity) for the other 15 specimens/group. SBS-values were statistically analysed with nonparametric ANOVA followed by exact Wilcoxon rank sum tests (α=0.05). Results: SBS of the two resin-ceramic materials and the three cements after 24 hours and after six months storage are shown in Figure 1. The statistical analysis showed that the duration of storage had a significant effect on SBS of Lava Ultimate for all three cements but had no significant effect on SBS of VITA ENAMIC. For Lava Ultimate SBS-values were (MPa; medians after 24 hours/six months): 13.5/22.5 (p=0.04) for RelyX Ultimate, 11.4/5.8 (p=0.0006) for PANAVIA F2.0, and 0.34/0.09 (p=0.04) for Ketac Cem Plus (Fig. 1). For VITA ENAMIC SBS-values were (MPa; medians after 24 hours/six months): 16.0/21.2 (p=0.10) for RelyX Ultimate, 11.4/14.4 (p=0.06) for PANAVIA F2.0, and 0.43/0.41 (p=0.32) for Ketac Cem Plus (Fig. 1). After 24 hours, there was no significant difference in SBS between Lava Ultimate and VITA ENAMIC for all three cements (p≥0.37). After six months, there was no significant difference in SBS between Lava Ultimate and VITA ENAMIC for RelyX Ultimate and Ketac Cem Plus (p≥0.07) whereas for PANAVIA F2.0, SBS was significantly lower for Lava Ultimate than for VITA ENAMIC (p<0.0001). Conclusion: SBS of Lava Ultimate was more affected by six months storage and by the cement used than was VITA ENAMIC.

[Zirconia and removable partial dentures]

The present paper deals with the double crown technique in removable prosthodontics. New ceramic materials like zirconia are increasingly used in combination with CAD/CAM technologies for framework fabrication of fixed prosthesis, tooth- or implant-supported. However, zirconia is also a newly accepted material in removable prosthodontics. It replaces gold alloys for the fabrication of primary telescopic crowns. The Galvanoforming technology is preferably used to fabricate the secondary crowns. The combination of both techniques and materials results in a prosthetic reconstruction of high quality, optimum fit and good biocompatibility.

Light curing through glass ceramics: effect of curing mode on micromechanical properties of dual-curing resin cements

OBJECTIVES The aim of this study was to investigate micromechanical properties of five dual-curing resin cements after different curing modes including light curing through glass ceramic materials. MATERIALS AND METHODS Vickers hardness (VH) and indentation modulus (Y HU) of Panavia F2.0, RelyX Unicem 2 Automix, SpeedCEM, BisCem, and BeautiCem SA were measured after 1 week of storage (37 °C, 100 % humidity). The resin cements were tested following self-curing or light curing with the second-generation light-emitting diode (LED) curing unit Elipar FreeLight 2 in Standard Mode (1,545 mW/cm(2)) or with the third-generation LED curing unit VALO in High Power Mode (1,869 mW/cm(2)) or in XtraPower Mode (3,505 mW/cm(2)). Light curing was performed directly or through glass ceramic discs of 1.5 or 3 mm thickness of IPS Empress CAD or IPS e.max CAD. VH and Y HU were analysed with Kruskal-Wallis tests followed by pairwise Wilcoxon rank sum tests (α = 0.05). RESULTS RelyX Unicem 2 Automix resulted in the highest VH and Y HU followed by BeautiCem SA, BisCem, SpeedCEM, and finally Panavia F2.0. Self-curing of RelyX Unicem 2 Automix and SpeedCEM lowered VH and Y HU compared to light curing whereas self-curing of Panavia F2.0, BisCem, and BeautiCem SA led to similar or significantly higher VH and Y HU compared to light curing. Generally, direct light curing resulted in similar or lower VH and Y HU compared to light curing through 1.5-mm-thick ceramic discs. Light curing through 3-mm-thick discs of IPS e.max CAD generally reduced VH and Y HU for all resin cements except SpeedCEM, which was the least affected by light curing through ceramic discs. CONCLUSIONS The resin cements responded heterogeneously to changes in curing mode. The applied irradiances and light curing times adequately cured the resin cements even through 1.5-mm-thick ceramic discs. CLINICAL RELEVANCE When light curing resin cements through thick glass ceramic restorations, clinicians should consider to prolong the light curing times even with LED curing units providing high irradiances.

Push-out bond strength of CAD/CAM-ceramic luted to dentin with self-adhesive resin cements

OBJECTIVES: This study evaluated the initial and the artificially aged push-out bond strength between ceramic and dentin produced by one of five resin cements. METHODS: Two-hundred direct ceramic restorations (IPS Empress CAD) were luted to standardized Class I cavities in extracted human molars using one of four self-adhesive cements (SpeedCEM, RelyX Unicem Aplicap, SmartCem2 and iCEM) or a reference etch-and-rinse resin cement (Syntac/Variolink II) (n=40/cement). Push-out bond strength (PBS) was measured (1) after 24h water storage (non-aged group; n=20/cement) or (2) after artificial ageing with 5000 thermal cycles followed by 6 months humid storage (aged group; n=20/cement). Nonparametrical ANOVA and pairwise Wilcoxon rank-sum tests with Bonferroni-Holm adjustment were applied for statistical analysis. The significance level was set at alpha=0.05. In addition, failure mode and fracture pattern were analyzed by stereomicroscope and scanning electron microscopy. RESULTS: Whereas no statistically significant effect of storage condition was found (p=0.441), there was a significant effect of resin cement (p<0.0001): RelyX Unicem showed significantly higher PBS than the other cements. Syntac/Variolink II showed significantly higher PBS than SmartCEM2 (p<0.001). No significant differences were found between SpeedCEM, SmartCem2, and iCEM. The predominant failure mode was adhesive failure of cements at the dentin interface except for RelyX Unicem which in most cases showed cohesive failure in ceramic. SIGNIFICANCE: The resin cements showed marked differences in push-out bond strength when used for luting ceramic restorations to dentin. Variolink II with the etch-and-rinse adhesive Syntac did not perform better than three of the four self-adhesive resin cements tested.

Bonding of restorative materials to dentin with various luting agents

The aim was to compare eight types of luting agents when used to bond six indirect, laboratory restorative materials to dentin. Cylinders of the six restorative materials (Esteticor Avenir [gold alloy], Tritan [titanium], NobelRondo [feldspathic porcelain], Finesse All-Ceramic [leucite-glass ceramic], Lava [zirconia], and Sinfony [resin composite]) were ground and air-abraded. Cylinders of feldspathic porcelain and glass ceramic were additionally etched with hydrofluoric acid and were silane-treated. The cylinders were luted to ground human dentin with eight luting agents (DeTrey Zinc [zinc phosphate cement], Fuji I [conventional glass ionomer cement], Fuji Plus [resin-modified glass ionomer cement], Variolink II [conventional etch-and-rinse resin cement], Panavia F2.0 and Multilink [self-etch resin cements], and RelyX Unicem Aplicap and Maxcem [self-adhesive resin cements]). After water storage at 37°C for one week, the shear bond strength of the specimens (n=8/group) was measured, and the fracture mode was stereomicroscopically examined. Bond strength data were analyzed with two-factorial analysis of variance (ANOVA) followed by Newman-Keuls' Multiple Range Test (?=0.05). Both the restorative material and the luting agent had a significant effect on bond strength, and significant interaction was noted between the two variables. Zinc phosphate cement and glass ionomer cements produced the lowest bond strengths, whereas the highest bond strengths were found with the two self-etch and one of the self-adhesive resin cements. Generally, the fracture mode varied markedly with the restorative material. The luting agents had a bigger influence on bond strength between restorative materials and dentin than was seen with the restorative material.

In vitro fracture strength and thermal shock resistance of metal-ceramic crowns with cast and machined AuTi frameworks

STATEMENT OF PROBLEM: AuTi alloys with 1.6% to 1.7% (wt%) Ti provide sufficient bond strength to veneering ceramics, but the strength of entire metal-ceramic restorations fabricated from these alloys is not known. However, this information is important to assess the clinical performance of such materials. PURPOSE: This in vitro study evaluated the fracture strength and thermal shock resistance of metal-ceramic crowns with AuTi frameworks produced by milling or casting. MATERIAL AND METHODS: Frameworks of the alloy Au-1.7Ti-0.1Ir (wt%) (Esteticor Vision) were produced by milling or casting (test groups). A high-gold alloy (Esteticor Special) was used as the control. The frameworks were veneered with ceramic (VMK 95). Specimens (n=7) were loaded until fracture. Loads at failure (N) were recorded and the mean values statistically evaluated using 1-way analysis of variance and a post hoc Dunnett test (alpha=.05). To assess the crazing resistance of the veneering ceramic, 6 additional crowns of each group were subjected to a thermal shock test. Fractured surfaces were documented by scanning electron microscopy. Coefficients of thermal expansion of the materials used were measured (n=2) to assess the thermal compatibility between alloys and ceramic. RESULTS: The mean fracture strength of the crowns with machined AuTi frameworks (1294 +/- 236 N) was significantly lower (P=.012) than that of the cast AuTi frameworks (1680 +/- 150 N), but statistically not different than the high-gold alloy (1449 +/- 159 N). Bonding failure to the AuTi alloy predominantly occurred at the alloy-oxide interface. For the high-gold alloy, more ceramic residues were observed. In the thermal shock test, crowns with milled AuTi frameworks showed significantly higher thermal shock resistance compared to the other groups. The coefficients of thermal expansion (Esteticor Vision cast: 14.5 microm/m.K; Esteticor Vision milled: 14.3 microm/m.K; Esteticor Special cast: 13.7 microm/m.K) did not correlate with the results of the thermal shock test. CONCLUSION: The in vitro fracture strength of crowns with milled AuTi frameworks is lower than that obtained with cast AuTi frameworks, but comparable to those crowns produced with a high-gold alloy.

Ceramic bonding to a machined Au-Ti alloy

Objective: To assess in vitro the bond strength of a machined surface of a Au-Ti alloy to a veneering ceramic. Method and Materials: Metal strips of the alloy Au 1.7-Ti 0.1-Ir were milled from a semiproduct fabricated by continuous casting and cold forming. For comparison, the same alloy as well as a traditional Au-Pt-Pd-In alloy were used in the as-cast state. Six samples of each group were fabricated for the crack initiation test, according to ISO 9693:1999, by preparing appropriate metal strips that were veneered with ceramic using a standard firing procedure. The crack initiation test was performed in a universal testing machine. Load at fracture was recorded. Means of bond strength were calculated for each group and the results compared by use of a 1-sided Student t test (P < .05). Fracture sites were documented by means of SEM. Results: Bond strength in the 3 groups was in the same order of magnitude. Failure mode was different for both alloys. Failure of the bonding to the Au-Ti alloy predominantly occurred at the alloy-oxide interface, no matter which fabrication process was used. On the Au-Pt-Pd-In alloy, more ceramic residues were observed. Conclusion: The machined alloy Au 1.7-Ti 0.1-Ir provides sufficient bond strength to veneering ceramics, but this has to be proven by a clinical study. (Quintessence Int 2007;38:867-872).

Impact of pore size on the vascularization and osseointegration of ceramic bone substitutes in vivo

The repair of bone defects with biomaterials depends on a sufficient vascularization of the implantation site. We analyzed the effect of pore size on the vascularization and osseointegration of biphasic calcium phosphate particles, which were implanted into critical-sized cranial defects in Balb/c mice. Dense particles and particles with pore sizes in the ranges 40-70, 70-140, 140-210, and 210-280 mum were tested (n = 6 animals per group). Angiogenesis, vascularization, and leukocyte-endothelium interactions were monitored for 28 days by intravital microscopy. The formation of new bone and the bone-interface contact (BIC) were determined histomorphometrically. Twenty-eight days after implantation, the functional capillary density was significantly higher with ceramic particles whose pore sizes exceeded 140 mum [140-210 mum: 6.6 (+/-0.8) mm/mm(2); 210-280 mum: 7.3 (+/-0.6) mm/mm(2)] than with those whose pore sizes were lesser than 140 mum [40-70 mum: 5.3 (+/-0.4) mm/mm(2); 70-140 mum: 5.6 (+/-0.3) mm/mm(2)] or with dense particles [5.7 (+/-0.8) mm/mm(2)]. The volume of newly-formed bone deposited within the implants increased as the pore size increased [40-70 mum: 0.07 (+/-0.02) mm(3); 70-140 mum: 0.10 (+/-0.06) mm(3); 140-210 mum: 0.13 (+/-0.05) mm(3); 210-280 mum: 0.15 (+/-0.06) mm(3)]. Similar results were observed for the BIC. The data demonstrates pore size to be a critical parameter governing the dynamic processes of vascularization and osseointegration of bone substitutes. (c) 2007 Wiley Periodicals, Inc. J Biomed Mater Res, 2007.

Maxillary sinus grafting with Bio-Oss or Straumann Bone Ceramic: histomorphometric results from a randomized controlled multicenter clinical trial

INTRODUCTION: This investigation was designed to compare the histomorphometric results from sinus floor augmentation with anorganic bovine bone (ABB) and a new biphasic calcium phosphate, Straumann Bone Ceramic (BCP). MATERIALS AND METHODS: Forty-eight maxillary sinuses were treated in 37 patients. Residual bone width was > or =6 mm and height was > or =3 mm and <8 mm. Lateral sinus augmentation was used, with grafting using either ABB (control group; 23 sinuses) or BCP (test group; 25 sinuses); sites were randomly assigned to the control or test groups. After 180-240 days of healing, implant sites were created and biopsies taken for histological and histomorphometric analyses. The parameters assessed were (1) area fraction of new bone, soft tissue, and graft substitute material in the grafted region; (2) area fraction of bone and soft tissue components in the residual alveolar ridge compartment; and (3) the percentage of surface contact between the graft substitute material and new bone. RESULTS: Measurable biopsies were available from 56% of the test and 81.8% of the control sites. Histology showed close contact between new bone and graft particles for both groups, with no significant differences in the amount of mineralized bone (21.6+/-10.0% for BCP vs. 19.8+/-7.9% for ABB; P=0.53) in the biopsy treatment compartment of test and control site. The bone-to-graft contact was found to be significantly greater for ABB (48.2+/-12.9% vs. 34.0+/-14.0% for BCP). Significantly less remaining percentage of graft substitute material was found in the BCP group (26.6+/-5.2% vs. 37.7+/-8.5% for ABB; P=0.001), with more soft tissue components (46.4+/-7.7% vs. 40.4+/-7.3% for ABB; P=0.07). However, the amount of soft tissue components for both groups was found not to be greater than in the residual alveolar ridge. DISCUSSION: Both ABB and BCP produced similar amounts of newly formed bone, with similar histologic appearance, indicating that both materials are suitable for sinus augmentation for the placement of dental implants. The potential clinical relevance of more soft tissue components and different resorption characteristics of BCP requires further investigation.

Effect of zirconia surface treatments on the shear strength of zirconia/veneering ceramic composites

Aim of the investigation was to assess the effect of different surface treatments on the bond strength of veneering ceramics to zirconia. In a shear test, the influences of polishing, sandblasting, and silica-coating of the zirconia surface on bonding were assessed with five different veneering ceramics. In addition the effect of liner application was examined. With one veneering ceramic, the impact of regeneration firing of zirconia was also evaluated. Statistical analysis was performed with one-way ANOVA and post hoc Scheffé's test. Failure in every case occurred in the veneering ceramic adjacent to the interface with a thin layer of ceramic remaining on the zirconia surface, indicating that bond strength was higher than the cohesive strength of the veneering ceramic. Shear strength ranged from 23.5 +/- 3.4 MPa to 33.0 +/- 6.8 MPa without explicit correlation to the respective surface treatment. Regeneration firing significantly decreased the shear strength of both polished and sandblasted surfaces. Findings of this study revealed that bonding between veneering ceramics and zirconia might be based on chemical bonds. On this note, sandblasting was not a necessary surface pretreatment to enhance bond strength and that regeneration firing was not recommended.

Ultra-high-resolution dual-source CT for forensic dental visualization-discrimination of ceramic and composite fillings

Dental identification is the most valuable method to identify human remains in single cases with major postmortem alterations as well as in mass casualties because of its practicability and demanding reliability. Computed tomography (CT) has been investigated as a supportive tool for forensic identification and has proven to be valuable. It can also scan the dentition of a deceased within minutes. In the present study, we investigated currently used restorative materials using ultra-high-resolution dual-source CT and the extended CT scale for the purpose of a color-encoded, in scale, and artifact-free visualization in 3D volume rendering. In 122 human molars, 220 cavities with 2-, 3-, 4- and 5-mm diameter were prepared. With presently used filling materials (different composites, temporary filling materials, ceramic, and liner), these cavities were restored in six teeth for each material and cavity size (exception amalgam n = 1). The teeth were CT scanned and images reconstructed using an extended CT scale. Filling materials were analyzed in terms of resulting Hounsfield units (HU) and filling size representation within the images. Varying restorative materials showed distinctively differing radiopacities allowing for CT-data-based discrimination. Particularly, ceramic and composite fillings could be differentiated. The HU values were used to generate an updated volume-rendering preset for postmortem extended CT scale data of the dentition to easily visualize the position of restorations, the shape (in scale), and the material used which is color encoded in 3D. The results provide the scientific background for the application of 3D volume rendering to visualize the human dentition for forensic identification purposes.

In vitro precision of fit of computer-aided designed and computer-aided manufactured titanium screw-retained fixed dental prostheses before and after ceramic veneering

OBJECTIVE To compare the precision of fit of full-arch implant-supported screw-retained computer-aided designed and computer-aided manufactured (CAD/CAM) titanium-fixed dental prostheses (FDP) before and after veneering. The null-hypothesis was that there is no difference in vertical microgap values between pure titanium frameworks and FDPs after porcelain firing. MATERIALS AND METHODS Five CAD/CAM titanium grade IV frameworks for a screw-retained 10-unit implant-supported reconstruction on six implants (FDI tooth positions 15, 13, 11, 21, 23, 25) were fabricated after digitizing the implant platforms and the cuspid-supporting framework resin pattern with a laser scanner (CARES(®) Scan CS2; Institut Straumann AG, Basel, Switzerland). A bonder, an opaquer, three layers of porcelain, and one layer of glaze were applied (Vita Titankeramik) and fired according to the manufacturer's preheating and fire cycle instructions at 400-800°C. The one-screw test (implant 25 screw-retained) was applied before and after veneering of the FDPs to assess the vertical microgap between implant and framework platform with a scanning electron microscope. The mean microgap was calculated from interproximal and buccal values. Statistical comparison was performed with non-parametric tests. RESULTS All vertical microgaps were clinically acceptable with values <90 μm. No statistically significant pairwise difference (P = 0.98) was observed between the relative effects of vertical microgap of unveneered (median 19 μm; 95% CI 13-35 μm) and veneered FDPs (20 μm; 13-31 μm), providing support for the null-hypothesis. Analysis within the groups showed significantly different values between the five implants of the FDPs before (P = 0.044) and after veneering (P = 0.020), while a monotonous trend of increasing values from implant 23 (closest position to screw-retained implant 25) to 15 (most distant implant) could not be observed (P = 0.169, P = 0.270). CONCLUSIONS Full-arch CAD/CAM titanium screw-retained frameworks have a high accuracy. Porcelain firing procedure had no impact on the precision of fit of the final FDPs. All implant microgap measurements of each FDP showed clinically acceptable vertical misfit values before and after veneering. Thus, the results do not only show accurate performance of the milling and firing but show also a reproducible scanning and designing process.