Purpose: To compare the trueness and precision of 3D-printed versus milled monolithic
zirconia crowns (MZCs). Methods: A model of a maxilla with a prepared premolar was
scanned with an industrial scanner (ATOSQ (R), Gom) and an MZC was designed in computer-assisted-design
(CAD) software (DentalCad (R), Exocad). From that standard tessellation language (STL)
file, 10 MZCs (test) were 3D-printed with a Lithography-based Ceramic Manufacturing
(LCM) printer (CerafabS65 (R), Lithoz) and 10 MZCs (control) were milled using a 5-axis
machine (DWX-52D (R), DGShape). All MZCs were sintered and scanned with the aforementioned
scanner. The surface data of each sample (overall crown, marginal area, occlusal surface)
were superimposed to the original CAD file (ControlX (R), Geomagic) to evaluate trueness:
(90-10)/2, absolute average (ABS AVG) and root mean square (RMS) values were obtained
for test and control groups (MathLab (R), Mathworks) and used for analysis. Finally,
the clinical precision (marginal adaptation, interproximal contacts) of test and control
MZCs was investigated on a split-cast model printed (Solflex350 (R), Voco) from the
CAD project, and compared. Results: The milled MZCs had a significantly higher trueness
than the 3D-printed ones, overall [(90-10)/2 printed 37.8 pm vs milled 21.2 pm; ABS
AVG printed 27.2 pm vs milled 15.1 pm; RMS printed 33.2 pm vs milled 20.5 pm; p =
0.0000051, at the margins [(90-10)/2 printed 25.6 pm vs milled 12.4 pm; ABS AVG printed
17.8 pm vs milled 9.4 pm; RMS printed 22.8 pm vs milled 15.6 pm; p= 0.0000111 and
at the occlusal level [(90-10)/2 printed 50.4 pm vs milled 21.9 pm; ABS AVG printed
29.6 pm vs milled 14.7 pm; RMS printed 38.9 pm vs milled 22.5 pm; p = 0.0000051. However,
with regard to precision, both test and control groups scored highly, with no significant
difference either in the quality of interproximal contact points (p = 0.355) or marginal
closure (p = 0.355). Conclusions: Milled MZCs had a statistically higher trueness
than 3D-printed ones; all crowns, however, showed high precision, compatible with
the clinical use. Clinical significance: Although milled MZCs remain more accurate
than 3D-printed ones, the LCM technique seems able to guarantee the production of
clinically precise zirconia crowns.
