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  • Title: Trueness of four different milling procedures used in dental CAD/CAM systems.
    Author: Kirsch C, Ender A, Attin T, Mehl A.
    Journal: Clin Oral Investig; 2017 Mar; 21(2):551-558. PubMed ID: 27469100.
    Abstract:
    OBJECTIVES: Milling is a crucial step in producing restorations using computer-aided design and computer-aided manufacturing (CAD/CAM) systems. In this study the trueness of currently available milling devices was evaluated. MATERIALS AND METHODS: Thirty clinical cases (ten inlays, ten crowns, ten onlays) were milled from ceramic blocks using four different milling approaches: five axis with IMES CORiTEC 450i, four axis with CEREC MCXL, four axis with CEREC MCXL-EF and five axis with inLab MCX5. The milled restorations were scanned and the occlusal and inner surfaces compared to the originally calculated 3D surface using difference analysis software. The (90-10 %) / 2 percentile of the distances were calculated and analysed using one-way ANOVA with the post hoc Scheffé test (α = 0.05). Chipping of marginal areas were visually examined and analysed using one-way ANOVA with a post hoc Tamhane test (α = 0.05). RESULTS: At inner surfaces, the milling trueness of IMES (33.9 ± 16.3 μm), X5 (32.3 ± 9.7 μm) and MCXL-EF (34.4 ± 7.5 μm) was significantly better (p < 0.001) than that of MCXL (62.1 ± 17.1 μm). At occlusal surfaces, MCXL-EF (25.7 ± 9.3 μm) showed significant higher accuracy (p < 0.001) than MCXL (48.7 ± 23.3 μm) and X5 (40.9 ± 20.4 μm). IMES produced the most chipping (p < 0.001). CONCLUSIONS: Five-axis milling devices yield high trueness. MCXL-EF is competitive and may allow chairside fabrication with good milling results. CLINICAL RELEVANCE: Accurate milling is required for well-fitting restorations and thereby requires fewer manual finishing steps, yields smaller marginal gaps, resistance to secondary caries and longevity of restorations.
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