Esthetic appearances of anatomic contour zirconia crowns made by additive wet deposition and subtractive dry milling: A self-controlled clinical trial

• Published in: The Journal of prosthetic dentistry Vol. 123; no. 3; pp. 442 - 448
• Main Authors: Cui, Xinyue, Shen, Zhijian, Wang, Xinzhi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2020
• Subjects: Crowns; Dental Porcelain; Dental Prosthesis Design; Esthetics, Dental; Humans; Reproducibility of Results; Zirconium
• ISSN: 0022-3913; 1097-6841; 1097-6841
• DOI: 10.1016/j.prosdent.2019.02.016

Anatomic contour zirconia crowns are widely used in clinical dental practice because of their mechanical reliability and improved appearance. However, few studies have performed clinical evaluations of the esthetics of these crowns in terms of color and translucency gradient. The purpose of this clinical trial was to compare the esthetic effect and color-matching behaviors of anatomic contour zirconia crowns manufactured with 3-dimensional (3D) gel deposition and dry milling methods. Twenty-seven premolar teeth of 27 participants received 2 identical anatomic contour zirconia crowns fabricated by additive 3D gel deposition or dry milling. Color differences (ΔE) between the crown and natural control teeth were measured by a dental shade-matching device. Subjective color matching was rated by professionals using an extended visual rating scale for appearance match (EVRSAM) and by participants using a visual analog scale (VAS). Data were analyzed by using repeated measures ANOVA, the Bonferroni test, paired Student t test, Pearson chi-square test, and Wilcoxon test (α=.05). Significant differences were found in ΔE between zirconia crown and core types (P<.05); however, there was no significant interaction between these factors (P>.05). The average ΔE of crowns made by wet deposition and dry milling were 2.45 ±1.60 and 4.55 ±1.54 (P<.05). The mean crown ΔE was significantly higher if a gold cast post-and-core was placed rather than a prefabricated fiber post and composite core (P<.05). Consistent with these findings, subjective color matching was significantly higher in the wet deposition group than in the dry milling group as rated by EVRSAM and VAS (P<.05). Anatomic contour zirconia crowns fabricated by additive wet deposition were better matched to adjacent teeth and had excellent esthetics in terms of color and translucency gradient.