CLINICAL RESEARCH

Accuracy of trial restorations from virtual planning: A

comparison of two fabrication techniques
Luca Ortensi, DDS,a Erica Lo Castro, DDS,b Ernesto Rapisarda, DMD, PhD,c and
Eugenio Pedullà, DDS, MScD, PhDd

ABSTRACT
Statement of problem. Different technologies have been used to fabricate trial restorations. However, studies investigating the accuracy of
trial restorations fabricated with different techniques in comparison with the initial 3-dimensional virtual design are lacking.
Purpose. The purpose of this clinical study was to evaluate completely digital workflows for managing the esthetic outcome through the
production of trial restorations with 2 different technologies: stereolithography apparatus (SLA 3D) and computer-aided design and
computer-aided manufacturing (CAD-CAM). The aim was to determine which of them provided trial restorations more similar to those of the
3D virtual design.
Material and methods. Thirty participants who did not meet ideal esthetic proportions for the anterior maxillary teeth were enrolled. For
each, 2 intraoral and extraoral frontal photographs and intraoral digital scans were made. The digital images were processed by using the
Digital Smile System (DSS) software program to have a smile preview after the treatment. Virtual designs were matched with the surface
tessellation language (STL) files from the intraoral scans and edited by exocad DentalCAD to create custom trial restorations using SLA 3D
and CAD-CAM technologies. Two independent examiners measured the virtual restorations by using virtual calipers in the software
program and then the trial restorations by using digital calipers. The measurements were carried out from the incisal edge to the gingival
margin, mesial-distal widths of the central incisors, and the distance from the distal margins of maxillary right and left canines. The trial
restorations were evaluated intraorally for fit. The participants approved the definitive treatment outcome after the evaluation. The
normality of data was verified with the Shapiro-Wilk test, and the Friedman test for matched groups with the Bonferroni and Dunn tests
for multiple comparisons were used (a=.05).
Results. Comparing the 3D designs with the printed trial restorations, a significant increase was only found in the mesial-distal width of
central incisors (P<.05), while the milled trial restorations showed a significant increase (P<.05) of all measurements except for the
maxillary right and left canines. Comparing printed trial restorations with the milled ones, the only significant difference was found in
height measures of maxillary right central incisor, with the milled trial restorations exhibiting higher values than the printed ones (P<.05).
The printed trial restorations showed good clinical fit, and the milled restorations had poor clinical adaptation.
Conclusions. The accuracy of printed trial restorations was higher than that of milled trial restorations, except for the canine to canine width
of maxillary anterior teeth. However, this difference did not compromise the fit of the printed trial restorations. The milled trial restorations
had increased dimensions in comparison with the measurements made in 3D designs, and consequently, their clinical fit was compromised.
SLA 3D- printing technology provided the best fit. (J Prosthet Dent 2020;-:---)

Patient demand for esthetic dental treatments has and function of teeth and soft tissues.4,5 A diagnostic
increased,1 with porcelain laminate veneers representing waxing and the related trial restorations are tools that
a clinically acceptable and minimally invasive treatment improve the patient’s understanding of the expected
option to improve the smile2,3 and maintain the health result.6,7 However, patient satisfaction with the treatment

a
Assistant Professor, Department of General Surgery and Medical-Surgical Specialties, University of Catania School of Dentistry, Catania, Italy.
b
Graduate student, Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, Catania, Italy.
c
Professor, Department of General Surgery and Medical-Surgical Specialties, University of Catania School of Dentistry, Catania, Italy.
d
Research Associate Professor, Department of General Surgery and Medical-Surgical Specialties, University of Catania School of Dentistry, Catania, Italy.

THE JOURNAL OF PROSTHETIC DENTISTRY 1

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The Journal of Prosthetic Dentistry, Corrected proof. doi:10.1016/j.prosdent.2020.08.040

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The Journal of Prosthetic Dentistry, Corrected proof. doi:10.1016/j.prosdent.2020.08.040

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laoreet, massa sit amet condimentum volutpat, odio lorem tempus dui, sit amet aliquet felis sem id lectus.

Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut vulputate augue eget odio placerat, in consectetur orci
tincidunt. In hac habitasse platea dictumst. Aliquam efficitur metus ligula, sit amet vehicula ligula rutrum ut. Duis
mollis nibh fringilla lacus maximus, vitae lobortis metus volutpat. Suspendisse ut sapien erat. Pellentesque commodo
nulla vitae facilisis dignissim. Vivamus at orci mi. Donec tristique rhoncus elit ac dapibus.

The Journal of Prosthetic Dentistry, Corrected proof. doi:10.1016/j.prosdent.2020.08.040

Cras metus lectus, pellentesque ullamcorper bibendum a, interdum non ligula. In ultrices sodales iaculis. Ut ipsum felis,
eleifend non nunc ut, pharetra molestie ex. In volutpat ante ex. Suspendisse bibendum tortor a lectus consectetur
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faucibus consectetur.

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Sed dignissim placerat enim et aliquet. Aenean consectetur interdum massa at cursus. Maecenas aliquam, tortor a
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porta leo, ut aliquet mi enim non turpis. Vestibulum ante ipsum primis in faucibus orci luctus

Sed dignissim placerat enim et aliquet. Aenean consectetur interdum massa at cursus. Maecenas aliquam, tortor a
eleifend aliquam, tellus orci fringilla arcu, id dictum lacus risus id nunc. Curabitur quis dolor a ex cursus iaculis. Nulla
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porta leo, ut aliquet mi enim non turpis. Vestibulum ante ipsum primis in faucibus orci luctus

The Journal of Prosthetic Dentistry, Corrected proof. doi:10.1016/j.prosdent.2020.08.040