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Effect of Milling Protocols on Trueness and Precision of Ceramic Crowns

Article  in  Journal of Prosthodontics · August 2020

DOI: 10.1111/jopr.13245

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Effect of Milling Protocols on Trueness and Precision of
Ceramic Crowns
Khaled Q. Al Hamad, BDS, MSc, MRD RCSEd, FDS RCSEd ,1 Rama B. Al-Rashdan, BDS ,2
Bashar A. Al-Rashdan, BDS, MS, FACP. ,2 & Nadim Z. Baba, DMD, MSD, FACP. 3
1
Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
2
Private practice, Amman, Jordan
3
Advanced Specialty Education Program in Prosthodontics, Loma Linda University, School of Dentistry, Loma Linda, CA

Keywords
Trueness; milling protocol; ceramics;
precision; accuracy.
Correspondence
Khaled Q. Al Hamad, Department of
Prosthodontics, Faculty of Dentistry, Jordan.
PO Box 3030, Irbid 22110. E-mail:
kqalhamad@just.edu.jo,
kqalhamad@gmail.com
This study was supported by a grant
(20190394) from the Jordan University of
Science and Technology, Irbid, Jordan.
Authors declare no conflict of interest.
Accepted August 21, 2020
doi: 10.1111/jopr.13245
Abstract
Purpose: To investigate the effect of different milling protocols for different ceramic
materials on the trueness and precision of milled ceramic crowns.
Materials and Methods: A definitive impression from a patient requiring a ceramic
crown was used to fabricate forty glass ceramic crowns (VITABLOCS mark II, Vita
Zahnfabrik) milled with wet, hard milling protocol, and 40 zirconia crowns (inCoris
TZI, Dentsply, Sirona) milled with dry, soft milling protocol, using a 5-axis milling
machine (inLab MC X5; Dentsply Sirona). Trueness and precision for different crown
areas were evaluated with a 3D evaluation software (Geomagic Control X, 3D sys-
tems). Statistical analysis was performed between the 2 crown types with independent
t-test, and analysis of variances followed by Bonferroni tests among crown areas for
each crown.
Results: All areas of the glass ceramic crowns had higher trueness than the zirconia
crown areas (p < 0.05). Crown areas of each crown type had significantly different
trueness values (p < 0.001, F = 175.17 for glass crowns, p < 0.001, F = 35.04 for
zirconia crowns). Glass crowns had 3.78 µm precision, while zirconia crowns had
4.12 µm precision, with a precision difference range between the 2 types of crowns
from 0.32 µm for the inner surface to 6.5 µm for the marginal surface.
Conclusions: Type of ceramic material and milling protocol affected trueness of
the milled crown, with higher trueness for the hardmilled glass crowns than the soft
milled zirconia crowns. Soft milled zirconia crowns were generally overmilled in
comparison with the reference design and glass crowns. However, glass crowns ex-
hibited more undermilling in thin and deep areas. The crown area affected trueness,
with external areas having better trueness than internal areas. The 5-axis milling ma-
chine had high precision, which was minimally affected by the ceramic type, milling
protocol, or crown area.

The fabrication of ceramic restorations with computer-
aided design and computer-aided manufacturing (CAD/CAM)
technology comprises 3 steps; scanning, designing, and
machining.1,2 All steps of fabrication must provide the nec-
essary accuracy to provide restorations of adequate quality.3,4
Ceramic CAD/CAM restorations are machined out of material
blocks using form-grinding, which consists of removal of the
ceramic surface with hard particles impregnated on the surface
of the grinding tool at 1:1 ratio (hard grinding).5,6 However,
yttrium-stabilized tetragonal zirconia polycrystals (Y-TZP) are
commonly milled out of partially sintered blocks that are ap-
proximately 25% larger to compensate for sintering shrinkage
(soft milling).7–9
Accuracy can be defined in terms of both trueness and
precision.10 Trueness is the amount a measured object or data
set deviates from the reference object or reference data set,
while precision represents the repeatability of measurements.11
Superimposition analysis of measured data and reference data
with a 3D inspection software is recommended for the eval-
uation of trueness.12 This method is nondestructive and pro-
vides results both numerically and visually.11,13 The root mean
square (RMS) value between the measured data and the ref-
erence data is often used to express trueness, with a low
RMS value representing a high trueness.14 One study reported
a trueness of 61 ± 22 µm for inner surfaces and 55 ± 18
µm for occlusal surfaces of restorations for the 3- or 4-axis

Journal of Prosthodontics 00 (2020) 1–6 © 2020 by the American College of Prosthodontists 1

Milling Protocols Effect on Trueness and Precision of Crowns
machine, while higher trueness of 41 ± 15 µm for inner sur-
faces and 42 ± 10 µm for occlusal surfaces were reported for
the 5-axis machines.1 Other studies reported trueness of 37 to
43 µm for the internal surface of partially sintered 3Y-TZP and
37 to 38 µm for the internal surfaces of glass ceramics with
5-axis milling machines.5,15 Differences in the constructions
of milling machines, and differences in machining strategies
among different types of ceramic materials may influence the
trueness values.16–21
The effects of the differences between soft and hard machin-
ing strategies among different ceramic materials on the accu-
racy of milled restorations are not well documented. Therefore,
the purpose of this study was to investigate the effect of differ-
ent milling protocols on the trueness and precision of differ-
ent milled ceramic crowns. The null hypothesis was that there
would be no effect of the type of ceramic material, the milling
protocol, or the area of the crown on the trueness and precision
of milled ceramic crowns.
Materials and methods
Two ceramic materials were used in this study to represent
2 milling protocols; Feldspathic glass ceramics (G) with a hard
grinding protocol (VITABLOCS mark II; Vita Zahnfabrik, Bad
Säckingen, Germany), and partially sintered Y-TZP (Z) with
a soft milling protocol (inCoris TZI; Dentsply Sirona, York,
PA). A patient requiring a ceramic crown for the maxillary
left first premolar was selected for this study. The patient pro-
vided informed consent, and the study protocol was approved
by the regional research committees (IRB 82-124-2019). The
patient received a tooth preparation for a ceramic crown with
approximately 1-mm shoulder finish, 1-mm axial reduction,
and 2-mm occlusal reduction. Proper soft tissue management
was performed, and intraoral quadrant maxillary, mandibular,
and buccal scans were made with an intraoral scanner (Con-
nect SW 4.6; CEREC Omnicam; Dentsply Sirona). A design
was created for a monolithic crown by using a dental design
software(inLab CAD SW 18.0; Dentsply Sirona) with the fol-
lowing design parameters; radial and occlusal spacer: 80 µm,
proximal, occlusal and dynamic contacts: 25 µm, minimal ra-
dial thickness: 500 µm, minimal occlusal thickness: 700 µm,
marginal thickness: 50 µm, width of ramp: 150 µm, angle
of ramp: 60 µm, undercuts removal and instrument geome-
try were considered. A total of 40 G crowns were fabricated
with a set of 4 diamond grinding burs (Diamond bur, Dentsply
Sirona), and wet, hard grinding, extra fine, and normal speed
milling protocol. The same reference design was also used for
the sequential fabrication of 40 Z crowns with a set of 3 tung-
sten carbide milling burs (Bur ZrO2, Dentsply Sirona), and dry,
soft milling, extra fine, and normal speed milling protocol. All
crowns were fabricated by using a 5-axis milling machine (in-
Lab MC X5, Dentsply Sirona) and were retrieved from the G
blocks and Z discs. The remains of the sprues were not ad-
justed and no finishing or glazing procedures were performed.
All crowns were freed from dust with a ceramic brush and
compressed air and then dried in a drying cabinet at 80°C
for 25 min. The Z crowns were sintered in a sintering fur-
nace (inFire HTC speed, Dentsply Sirona) by using the inCoris
TZI program in a sintering tray with beads intended for high-
2 Journal of Prosthodontics 00 (2020) 1–6 © 2020 by the American College of Prosthodontists
Hamad et al
temperature furnace, as recommended by the manufacturer’s
instructions.
All crowns were scanned with the intraoral scanner, and were
exported, along with the reference designs as high-resolution
Standard Tessellation Language files to a 3D evaluation soft-
ware (Geomagic Control X, 3D systems). The software aligns
the reference file and test file with iterative closest point al-
gorithm. The algorithm uses 3D correspondence between 2
clouds of points and determines the minimum distance be-
tween objects. The reference design was divided by using the
split command function in the software into 7 areas of inter-
est; occlusal area representing the occlusal surface, mesial area
representing the mesial contact area, distal area representing
the distal contact area, external area representing the rest of the
external surface, marginal area representing the marginal sur-
face with around 1mm of the internal surface, internal area rep-
resenting the rest of the intaglio surface of the crown, and inner
area representing both the internal and marginal areas. Each
area was evaluated for trueness by superimposing the mea-
sured data on the reference CAD design data. Best fit alignment
between the reference and the measured data was performed
with 20 maximum iteration count and 0.5 mm maximum av-
erage deviation. A 3D comparison was performed with 100%
specimen ratio, shortest projection direction, +0.5 mm and
−0.5 mm for maximum and minimum deviations, and 0 spe-
cific tolerance.
The results of the trueness evaluation were presented as a
color-difference map and numerical values of minimum, max-
imum, average, positive average, negative average, variation,
and RMS for each crown area. The RMS represents the aver-
age of the positive and negative value coexistence according to
the following formula:

n
i=1 (X 1, i − X 2, i)
2
RMS = √
n
where n is the total number of measuring points, X1,i is the
measuring point of the reference scan data, and X2,i is the mea-
suring point of the milled crown prosthesis scan data.11 The
standard deviation of the RMS mean represented precision.
Descriptive statistics are presented as means for RMS, posi-
tive average, and negative average for each crown area. Homo-
geneity of variance was checked with the Levene test. Statisti-
cal differences were calculated with independent t-test between
the 2 crown types for each crown area, and analysis of vari-
ances (ANOVA) and Bonferroni post hoc tests among crown
areas for each crown. All statistical analyses were performed
with a statistical software program (IBM Statistics for Win-
dows, v22.0; IBM Corp) with α = 0.05.
Results
Means for RMS, positive averages, and negative averages are
shown in Table 1. All areas of the G crowns had signifi-
cantly higher trueness (lower RMS) than the Z crown areas
(p < 0.05). There were also significant differences among the
crown areas for each type of crown (p < 0.001, F = 175.17
for the G crowns, p < 0.001, F = 35.04 for the Z crowns).
There were significant differences among the G crown areas
Hamad et al Milling Protocols Effect on Trueness and Precision of Crowns

Table 1 Means for root mean square (RMS), positive average (+AVG), negative average (–AVG), and P value and confidence intervals (CI) for glass
crowns (G) and zirconia crowns (Z) for each crown area

Crown area RMS (G) ± SD∗ +AVG (G) -AVG (G) RMS (Z) ±SD∗ +AVG (Z) -AVG (Z) p∗∗ 95% CI

External 37.5 ± 2.93 26.4 −29.7 44.23 ± 7.28 80.57 −58.05 p = 0.003 −6.93 to -1.54
Occlusal 35.9 ± 4.89 14.7 −33.5 61.45 ± 7.51 16.10 −64.45 p < 0.001 −25.21 to −18.53
Mesial 25.3 ± 3.26 17.4 −24 50.75 ± 6.80 6.59 −75.39 p < 0.001 −25.77 to −19.95
Distal 17.1 ± 2.44 15.0 −10.64 64.28 ± 1.88 6.47 −61.24 p < 0.001 −52.81 to −40.64
Marginal 48.9 ± 6.6 4.50 −45.78 71.14 ± 1.1 13.87 −58.13 p < 0.001 −22.27 to −13.48
Inner 43.9 ± 2.88 36.0 −35.3 78.95 ± 2.56 23.77 −47.62 p < 0.001 −40.27 to −23.56
Internal 41.4 ± 3.49 36.8 −24.31 83.89 ± 1.74 24.56 −41.43 p < 0.001 −46.32 to −35.01
*
SD: standard deviation representing the precision value.
**
Independent t-test.

except between the occlusal and external areas (p = 0.99), in-
ternal and inner areas (p = 0.077), occlusal and internal areas
(p = 0.103), and external and internal areas (p = 0.262). There
were also statistically significant differences among the crown
areas of the Z crowns (p < 0.001) except between the ex-
ternal and mesial areas (p = 0.99), distal and occlusal areas
(p = 0.614), distal and marginal areas (p = 0.99), occlusal and
marginal areas (p = 0.092), mesial and occlusal areas (p =
0.670), and inner and internal areas (p = 0.99).
Precision analysis (based on the standard deviation of RMS)
showed a total precision of 3.78 µm for the G crowns and 4.12
µm for the Z crowns, with a precision difference range between
the 2 types of crowns from 0.32 µm for the inner surface to
6.5 µm for the marginal surface (Table 1).
The color-difference maps between the reference design data
and the measured data for a G and a Z crowns are presented
in Figures 1 and 2. Light to dark blue areas represent a nega-
tive deviation, which means that the measured data are lower
than the reference data. Yellow to red areas represent a posi-
tive deviation, which is the opposite of the negative deviation.
Z crowns were generally over-milled (negative deviations) in
comparison with the reference design and also in comparison
with the G crowns.
Discussion
This study investigated the effect of hard machining of glass
ceramics and soft machining of partially sintered Y-TZP on
the trueness and precision of different areas of the milled
crowns. Trueness was significantly different between the 2
crown types for each crown area. It also was significantly
different among the crown areas for each crown type, so
the null hypothesis was rejected for the trueness analysis.
The precision analysis showed minimal differences between
the 2 crown types for each area, and also minimal differ-
ences among the areas for each type of crowns, and therefore,
the null hypothesis was partially accepted for the precision
analysis.
All Z crowns were sintered by using a sintering tray with
beads, which are intended for high-temperature furnace. Beads
are used as rollers to allow the crowns to shrink and move dur-
ing the sintering process. Crowns were positioned occlusally in
the sintering layer without touching each other or the edge of
the sintering tray. In order to prevent the sintering beads from
sticking, the crowns were not pressed or embedded into the
sintering beads layer, according to the manufacturer’s recom-
mendations.
All crowns were milled with a 5-axis milling machine, which
uses instruments with different geometry with one motor spin-
dle sweeping the restoration in the z direction. Two spindles
that grind the restoration from both sides in a U-shaped move-
ment are used in the 3- or 4-axis milling machines.5 Higher
trueness and a more effective milling of surfaces close to the
insertion axis were reported for the 5-axis milling machines.1,12
However, the milling time is slower in comparison with 3- or
4-axis milling machines.12
The hard grinding of glass ceramics showed significantly
higher trueness than the soft milling of partially sintered
Y-TZP in all crown areas. This could be attributed to the dif-
ferences in the machinability between the 2 ceramic materials.
The milling protocols are controlled by the numeric control
program that contains a set of instructions for the machine
tool to execute specific axis motions (tool path) at a given feed
rate, and to rotate the milling tool at a specific spindle speed.18
The G and Z crowns had different material hardness, types of
burs, and milling protocols. The soft milling of the Z crowns
is widely used because it is cost-effective and easy to perform,
but it takes longer and requires milling to approximately
25% larger size to compensate for the sintering shrinkage.
The sintering process was reported to induce self-healing of
surface flaws caused during the milling process.8,9 The G
crowns were milled out of ceramic blocks in their final size
and required no sintering process.
The Z crowns were generally over-milled in comparison with
the reference design and also in comparison with the G crowns,
as shown by the negative average in Table 1 and the color-
difference map in Figures 1 and 2. This could be attributed to
insufficient shrinkage compensation. One study reported less
variation in the internal fit of hard machined restorations in
comparison with soft machined restorations.19 This was a re-
flection of the complex production where sintering shrinkage
must be counter weighed during the process of soft machining.
Zirconia could be milled from fully sintered blocks, and this
is advantageous due to the lack of post sintering process, how-
ever, it requires a robust milling system with high accuracy,
especially in thin areas, and could be disadvantageous in terms

Journal of Prosthodontics 00 (2020) 1–6 © 2020 by the American College of Prosthodontists 3

Milling Protocols Effect on Trueness and Precision of Crowns Hamad et al

Figure 1 Color difference map trueness analysis for glass ceramic crown areas. A, Reference design. B, Glass ceramic crown specimen. C, Best-fitting
alignment between reference design and ceramic crown specimen. D, External area, positive deviation in 1st yellow color level. E and F, Mesial and
distal areas, mixed negative and positive deviations in 1st levels of yellow and blue colors. G, Occlusal area, deviation is mostly negative in 1st and
2nd blue color levels, with positive deviation in central fissure and marginal ridge area. H, Marginal area, negative deviation mostly in 1st blue color
level. I, Internal area, mixed deviations. Positive deviation in areas related to buccal and palatal cusps and also distal marginal ridge. Mild orange and
higher orange color levels are related to deeper cavities provided by software design. Rest of internal area showed negative deviation mostly in 1st
blue color level.

of surface flaws, surface roughness, and phase transformation.7
The G and Z crowns had also different milling angles to the z
axis of the milling spindle because the G glass was milled by
using ceramic blocks in a constant position in the milling ring,
while the Z crowns were nested sequentially in variable posi-
tions in the disc. The effect of this on trueness is not clear and
requires further investigation.
In agreement with another study, trueness analysis re-
vealed significant differences among the different areas of the
crown.12 External, occlusal, and proximal areas had generally
higher trueness than the marginal, inner, and internal areas. In-
ternal area were reported to be more difficult to mill in com-
parison with external areas.12
Previous studies reported trueness values between 37 and
43 µm for the internal, occlusal, or external areas.1,5,15 These
were similar to the trueness values of the G crowns areas, how-
ever, the inner-internal areas of the Z crowns had higher RMS
of around 79 to 84 µm. These differences could be attributed to
the differences in the type of milling machine, ceramic material
hardness, and the methodology of the 3D comparison analysis
between this study and the previous studies. To the authors’
knowledge, there were no available studies with similar crown
areas for comparison with the results of this study.
The color-difference map analysis of both types of crowns
exhibited more positive deviations in thin areas, in the areas
around the sprue, and occlusally in the central fissure area and
the distal marginal ridge area. However, G crowns exhibited
more positive deviations in these areas, and in the external sur-
face. This is in agreement with other studies that reported the
presence of undermilling of deep areas due to the limitations
of the tools for milling harder materials.5,12,13,20 Analysis of
the tooth preparation showed sharp distal-occlusal and palatal-
occlusal line angles. The internal areas that corresponded to
the sharp line angles of the preparation showed increased pos-
itive deviation. Instrument geometry was considered in the de-
sign of the crown, and this meant that when the instrument di-
ameter exceeded the dimension of curves in the preparation,
unwanted cavities were produced.5 It can be recommended to

4 Journal of Prosthodontics 00 (2020) 1–6 © 2020 by the American College of Prosthodontists

Hamad et al Milling Protocols Effect on Trueness and Precision of Crowns

Figure 2 Color difference map of trueness analysis for zirconia ceramic crown areas. A, Reference design. B, Zirconia ceramic crown specimen. C,
Best fit alignment between reference design and Zirconia ceramic crown specimen. D, External area, negative deviation in 1st and 2nd blue color levels
and positive deviation in area related to sprue and beneath marginal ridge. E and F. Mesial and distal areas, Mostly negative deviations in 1st and 2nd
blue color levels with minor areas of 1st yellow color level. G, Occlusal area, negative deviations in 1st three blue color levels with positive deviations
in disto-buccal and central fissure areas. H, Marginal area, negative deviations in 1st and 2nd blue color levels. I, Internal area, mixed deviations with
negative deviations in 1st and 2nd blue color levels in most area and positive deviation of 1st yellow color level in areas related to distal marginal ridge
and palatal cusp.

remove sharp line angles in the prepared tooth, and to avoid
deep grooves and acute bends in crown designs. Furthermore,
extra attention is recommended to avoid sprue placement in
critical crown areas, such as the occlusal and proximal areas,
and also in adjustments of not only the remains of sprues but
also to the area in close proximity around the sprue.
Despite using the default crown milling parameters, the
milling machine performed differently between the soft milling
of the Z crowns and the hard grinding of the G crowns. The G
crowns were closer to the reference design in comparison with
over-milled Z crowns. However, G crowns were less forgiving
than the Z crowns in the thin and sharp line angles, and in the
areas around the sprue. Similar results of 30% to 200% devi-
ation from the default parameter setting were reported by one
study.21 The complex manufacturing process, inherent material
properties, and abutment geometry were reported as possible
reasons. The design parameters recommended by the manufac-
turer should be considered a requirement for optimal results.
However, changes to the default setting to suit the type and
material of the restoration could be recommended for better
milling quality.
The clinical relevance of the results in this study should
be interpreted with caution. Two-dimensional techniques were
used in most previous studies that investigated the fit of milled
restorations.22–24 Trueness, however, is a 3D measuring tech-
nique with a large number of randomly distributed measur-
ing points, and it is not a measure of fit, nor is it a measure
of clinical quality. It is a measure of the difference between
the crown and its reference design. Unfortunately, a reference
RMS value that indicates a clinically acceptable trueness is
lacking. One study recommended an RMS value of less than
10 µm for an excellent trueness.14 Others used 50 µm as a ref-
erence tolerance.11,13 These recommendations, however, were
not based on objective criteria.
The 5-axis milling machine had an overall slightly higher
precision for the G crowns in comparison with the Z crowns,
which could be due to the lack of the sintering process.
The precision analysis showed small differences in precision

Journal of Prosthodontics 00 (2020) 1–6 © 2020 by the American College of Prosthodontists 5

Milling Protocols Effect on Trueness and Precision of Crowns
values between the 2 crowns and also among crowns areas. The
occlusal and external areas for the Z crowns and the occlusal
and marginal areas for the G crowns had the largest precision
values (Table 1). The lower precision in these areas in com-
parison with other areas could be attributed to the presence of
deep and thin areas in the occlusal and marginal area, and the
presence of sprues in the external areas. This is in agreement
with other studies,12,13 however, these differences are likely of
no clinical relevance.
Only 2 types of ceramics for a single crown restoration
were investigated in this study. The results could vary with
other types of materials and milling machines.1,5,12,15–18 The
use of other types of restorations such as inlays, onlays, or
partial fixed dental prosthesis, and other ceramic materials,
such as fully sintered zirconia, lithium disilicate, or polymer-
containing ceramic materials, which would require different
milling protocols, are recommended in future studies.
Conclusions
The type of ceramic material and the milling protocol affected
the trueness of the milled crown; the hard-grinded glass ce-
ramic crowns had better trueness than the soft milled zirconia
crowns. The soft milled zirconia crowns were generally over-
milled in comparison with the reference design and also in
comparison with the hard-grinded glass ceramic crowns. How-
ever, glass ceramic crowns exhibited more undermilling in thin
and deep areas. The area of the crown affected trueness, with
the external areas having better trueness than the internal areas.
The 5-axis milling machine had high precision, which was
minimally affected by the type of ceramics, milling protocol,
and the area of the crown.
References
1. Tapie L, Lebon N, Mawussi B, et al: Understanding dental
CAD/CAM for restorations—accuracy from a mechanical
engineering viewpoint. Int J Comput Dent 2015;18:343-367
2. Tinschert J, Natt G, Hassenpflug S, et al: Status of current
CAD/CAM technology in dental medicine. Int J Comput Dent
2004;7:25-45
3. Lee KB, Park CW, Kim KH, et al: Marginal and internal fit of
all-ceramic crowns fabricated with two different CAD/CAM
systems. Dent Mater J 2008;27:422-426
4. Kosyfaki P, del Pilar Pinilla Martin M, Strub JR: Relationship
between crowns and the periodontium: a literature update.
Quintessence Int 2019;41:109-126
5. Kirsch C, Ender A, Attin T, et al: Trueness of four different
milling procedures used in dental CAD/CAM systems. Clin Oral
Invest 2017;21:551-558
6. Andrade GS, Diniz V, Datte CE, et al: Newer vs. older
CAD/CAM burs: influence of bur experience on the fatigue
behavior of adhesively cemented simplified lithium-disilicate
glass-ceramic restorations. J Mech Behav Biomed Mater
2019;95:172-179
7. Abduo J, Lyons K, Swain M: Fit of zirconia fixed partial
denture: a systematic review. J Oral Rehabil 2010;37:866-876
6 Journal of Prosthodontics 00 (2020) 1–6 © 2020 by the American College of Prosthodontists
View publication stats
Hamad et al
8. Edwards Rezende CE, Sanches Borges AF, Macedo RM, et al:
Dimensional changes from the sintering process and fit of
Y–TZP copings: micro-CT analysis. Dent Mater 2017;33:
e405-e413
9. Hatanaka GR, Polli GS, Fais LM, et al: Zirconia changes
after grinding and regeneration firing. J Prosthet Dent 2017;118:
61-68
10. International Organization for Standardization: Accuracy
(trueness and precision) of measurement methods and results
part 1: general principles and definitions. ISO 5725-1:1994(en).
Berlin, Beuth Verlag GmbH; 1997
11. Kim CM, Kim SR, Kim JH, et al: Trueness of milled prostheses
according to number of ball-end mill burs. J Prosthet Dent
2016;115:624-629
12. Bosch G, Ender A, Mehl A. A 3-dimensional accuracy analysis
of chairside CAD/CAM milling processes. J Prosthet Dent
2014;112:1425-1431
13. Cho JH, Yoon HI, Han JS, et al: Trueness of the inner surface of
monolithic crowns fabricated by milling of a fully sintered (Y,
Nb)-TZP block in chairside CAD-CAM system for single-visit
dentistry. Materials 2019;12:e3252
14. Peters MCRB, Delong R, Pintado MR, et al: Comparison of two
measurement techniques for clinical wear. J Dent
1999;27:479-485
15. Kaizer MR, Gierthmuehlen PC, Dos Santos MB, et al: Speed
sintering translucent zirconia for chairside one–visit dental
restorations: optical, mechanical, and wear characteristics.
Ceram Int 2017;43:10999-11005
16. Brawek PK, Wolfart S, Endres L, et al: The clinical accuracy of
single crowns exclusively fabricated by digital workflow—the
comparison of two systems. Clin Oral Investig
2013;17:2119-2125
17. Chuangwen XU, Jianming D, Yuzhen C, et al: The relationships
between cutting parameters, tool wear, cutting force and
vibration. Adv Mech Eng 2018;10:1-14
18. Chavali R, Nejat AH, Lawson NC. Machinability of CAD-CAM
materials. J Prosthet Dent 2017;118:194-199
19. Schriwer C, Skjold A, Gjerdet NR, et al: Monolithic
zirconia dental crowns. Internal fit, margin quality,
fracture mode and load at fracture. Dent Mater 2017;33:
1012-1020
20. Li R, Chen H, Wang Y, et al: Three-dimensional trueness and
margin quality of monolithic zirconia restorations fabricated by
additive 3D gel deposition. J Prosthodont Res 2020;64:478-
484
21. Dahl BE, Rønold HJ, Dahl JE: Internal fit of single crowns
produced by CAD-CAM and lost-Wax metal casting technique
assessed by the triple-scan protocol. J Prosthet Dent
2017;117:400-404
22. Dahl BE, Dahl JE, Rønold HJ: Digital evaluation of marginal
and internal fit of single-crown fixed dental prostheses. Eur J
Oral Sci 2018;126:512-517
23. Pradíes G, Zarauz C, Valverde A, et al: Clinical evaluation
comparing the fit of all-ceramic crowns obtained from silicone
and digital intraoral impressions based on wavefront sampling
technology. J Dent 2015;43:201-208
24. Al Hamad KQ, Al Rashdan BA, Al Omari WA, et al:
Comparison of the fit of lithium disilicate crowns made from
conventional, digital, or conventional/digital techniques.
J Prosthodont 2019;28:e580-e586