ORIGINAL RESEARCH

Comparative Evaluation of Retention and Vertical Marginal

Accuracy of Co–Cr Copings Fabricated Using Three Different
Techniques: An In Vitro Study
Bhagyashree G Kalsekar1, Paresh V Gandhi2, Rupali Patil3, Ajay V Sabane4, Pankaj P Kadam5, Nishita S Bhosale6

A b s t r ac t
Aim: This study was conducted to comparatively assess the retention and vertical marginal fit of cobalt–chromium copings fabricated by the
conventional casting technique, 3D-printed resin pattern, and with direct metal laser sintering (DMLS) technique.
Materials and methods: Out of the total 60 test samples, 20 copings were obtained from inlay-casting wax and 20 from casting of 3D-printed
resin patterns. In total, 20 copings were obtained from the laser sintering technique.
All 60 test samples were then cemented serially on the prepared maxillary-extracted premolars and were evaluated for vertical marginal gap
in 8 pre-established reference areas. Retention was evaluated using a universal testing machine.
Results: Results obtained for both marginal gap and retention were statistically analyzed, and the values fall within the clinically acceptable
range. The DMLS technique proved precedence over the other two techniques used, as it exhibited maximum retention and marginal accuracy,
which is an area of prime concern.
Conclusion: The results from this study encourage further research with different pattern-forming materials and techniques and the need to
identify the factors that facilitate better marginal fit and retention of cast restorations.
Clinical significance: This study has myriad of applications in clinical dentistry mainly in decision-making for casting procedure to provide better
retention and marginal accuracy for fabrication of Co–Cr crowns. It also aims to aid the clinician to minimize errors by using different techniques
for fabrication of wax pattern as well as the coping, keeping abreast with the recent technology to evaluate the accuracy of 3D-printed resin
pattern over conventional wax pattern.
Keywords: Co–Cr copings, Direct metal laser sintering, Marginal fit, Retention, 3D-printed resin pattern.
The Journal of Contemporary Dental Practice (2022): 10.5005/jp-journals-10024-3399

Introduction
The fundamental goal of fixed prosthodontic treatment involves
replacement and restoration of teeth by artificial substitutes
ranging from the restoration of a single tooth to the rehabilitation
of the entire occlusion.1
Based on literature review, the largest prevalent cause of
failure in crown and fixed partial dentures is the lack of retention,
amounting to 45% of the total failures, which can be attributed
to various causes like improper preparation of tooth and lack of
resistance form. Another most common cause of failure is poor
marginal adaptation leading to microleakage.2,3
The survival of fixed prosthodontics particularly depends on
the marginal integrity and retention.4 This is principally balanced
by manual and laboratory factors, the latter playing an enormous
role. Manual errors being inaccuracy in impression-making,
inappropriate oral environment for impression-making, whereas
laboratory factors comprising of incompatibility of dental materials
such as wax, die stone and casting investments, die spacer, and the
casting techniques.
To overcome the manual and laboratory challenges, the
advent of recent technologies like digitizing and automation
has gained an important place in fixed prosthodontic treatment
plan. 5 Several techniques of using Co–Cr for fixed prosthesis are
available today after the lost-wax technique that was introduced
by William Taggart in 1907. 6 In recent times, introduction of
computer-aided design and computer-aided manufacturing
1–5
Department of Prosthodontics and Crown and Bridge, Bharati
Vidyapeeth Deemed University Dental College and Hospital, Pune,
Maharashtra, India
6
Department of Periodontology, Bharati Vidyapeeth Deemed
University Dental College and Hospital, Pune, Maharashtra, India
Corresponding Author: Bhagyashree G Kalsekar, Department
of Prosthodontics and Crown and Bridge, Bharati Vidyapeeth
Deemed University Dental College and Hospital, Pune, Maharashtra,
India, Phone: +91 9890876681, e-mail: bhagyashree.kalsekar@
bharatividyapeeth.edu
How to cite this article: Kalsekar BG, Gandhi PV, Patil R, et al.
Comparative Evaluation of Retention and Vertical Marginal Accuracy
of Co–Cr Copings Fabricated using Three Different Techniques: An In
Vitro Study. J Contemp Dent Pract 2022;23(10):991–997.
Source of support: Nil
Conflict of interest: None
(CAD–CAM) technology has given an opportunity for fabricating
metal prosthesis using alternate methods like milling, 3D printing,
and DMLS.7,8 The intraoral scanner helps in reducing the manual
errors associated with impression-making, while the CAD–CAM
and rapid prototyping techniques help reduce the laboratory
errors affecting the fit of the restorations.
The proponents of these newer methodologies claim
superiority over the conventional casting technique, but additional

© The Author(s). 2022 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.
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 Comparative Evaluation of Retention and Vertical Marginal Accuracy of Co–Cr Copings

studies to check the fit of these restorations prepared by these new Flowchart 1: Flowchart of the methodology of the study
techniques are required.
Literature states studies conducted on fabrication of Co–Cr
crowns and bridges using different techniques that have been
performed using metal and stone dies.
This study was planned to focus on the effect of conventional
and rapid prototyping techniques (3D printing and direct metal
laser sintering) on the vertical marginal fit and retention of
Co–Cr copings fabricated on extracted teeth which gains utmost
importance for application in clinical dentistry.

M at e r ia l s and Methods
An in vitro study was undertaken at the Department of
Prosthodontics, Bharati Vidyapeeth Deemed University Dental
College and Hospital, Pune, Maharashtra. The measurements were
done at Praj Metallurgical Laboratory, Kothrud, Pune, Maharashtra.

Materials Used in the Study

Sixty sound extracted human maxillary premolars for orthodontic
treatment:
a) Acrylic block for mounting teeth
b) Pattern wax
c) Resin pattern for 3D printing
d) Investment materials
e) Luting agent
f) Testing equipment (Praj Metallurgical Laboratory, Kothrud, Pune,
Maharashtra)
• Universal testing machine (computerized, software-based)
Company: ACME, India, Model no. UNITEST 10.
• Stereomicroscope: Make: Wuzhou New Found Instrument
Co. Ltd., China, Model: XTL 3400E, magnification: 20×
Methodology
For the evaluation of vertical marginal fit and retention, preparation
of 60 extracted human maxillary premolars was carried out to
receive an all-metal crown. The preparation was standardized
by using an airotor attachment to the surveyor. The teeth were
mounted in an acrylic block using a metal mold and were randomly
divided into three groups of 20 samples each to receive Co–Cr
copings fabricated by three techniques (Flowchart 1).
Group A (samples A1–A20) – Conventional wax pattern
fabricated through lost wax technique.
Group B (samples B1–B20) – 3D-printed resin pattern using the
(FORM LABS) 3D printer, and cast conventionally.
Group C (samples C1–C20) – Direct metal laser sintering using
the LAVA 3M EOSINT M270.
The methodology is divided into four steps:
Tooth Preparation
A stainless-steel rod was inserted through the roots of each tooth
and 60 resin blocks of dimension 20(L) × 20(W) × 20(H) were made
using a metal mold. All the tooth preparations had the following
features:
• Occluso-cervical dimension was maintained between 6 and
7 mm as customized with the plaster base on the surveyor to
engage the acrylic block with 1-mm-wide chamfer finish line
and a convergence angle of 6 degrees.
• The tooth preparations were standardized by using an attached
instrument with clamp that was able to maintain a constant
relationship of high-speed airotor to a surveyor (Fig. 1A).
A protractor was affixed perpendicular to the horizontal long
axis of the airotor on the horizontal bar, which was attached to
the vertical spindle of the surveyor (Fig. 1B).
• Each tooth preparation had an inbuilt taper due to the round-
end-tapered diamond point, which is 3 degrees on each axial
surface, therefore, total occlusal convergence of 6 degrees.
• Standardization was maintained in proximal (Fig. 1C) and
occlusal preparations (Fig. 1D).
Wax Pattern, Casting (Group A)
The conventional wax patterns were directly fabricated on the
prepared teeth (Fig. 2A). Investment of these wax patterns was
done in phosphate-bonded investment material (Bellasum, Bego).
The castings were then inspected for any irregularities, which, if
present, were removed using a sintered diamond bur. A total of
40 castings were fabricated, respectively, for group A and group B.
Three-dimensional Printing of Resin Patterns Followed by
Conventional Casting (Group B)
Scanning using EXO-CAD software and designing of copings for
3D printing: Group B was scanned using 3M/LAVA scanner and
scans were processed to dental CAD software (EXOCAD). A digital
model selection option was selected to export the data into STL
format. The print option of the model was selected along with
selection of the layer thickness of the resin which was 0.05 mm of
thickness to achieve clinically relevant accuracy. The resin tank,
resin cartridge, and build platform were inserted into the printer
and the copings were printed onto the build platform. Printing of
the 20 copings (group B) in pattern resin was completed (Fig. 2B)
and the copings were then conventionally casted in Co–Cr using
similar steps as used for casting the copings of group A.
Fabrication of Laser-sintered Co–Cr Copings (Group C)
Twenty prepared maxillary premolars were scanned using LAVA
scanner and were processed to dental CAD software (EXOCAD). The
designing involved die spacer thickness set at 30 μm. The designs
were uploaded into the sintering unit. High-powered (200 W)
laser beam was focused onto a powdered metal bed that started
production of the copings by fusion of these particles into a thin
solid layer. Parts were built up additively layer by layer, of about 0.02

992 The Journal of Contemporary Dental Practice, Volume 23 Issue 10 (October 2022)
 Comparative Evaluation of Retention and Vertical Marginal Accuracy of Co–Cr Copings

Figs 1A to D: (A) Surveyor with airotor attachment; (B) Protractor attached to the vertical spindle of the surveyor; (C) Completed tooth preparation
with 6-degree occlusal convergence (proximal view); (D) Occlusal view of completed tooth preparation

Figs 2A to C: (A) Conventional wax patterns for group A; (B) Group B 3D-printed resin patterns; (C) Copings of all the groups ready for cementation
and testing

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 Comparative Evaluation of Retention and Vertical Marginal Accuracy of Co–Cr Copings

mm of thickness. When all the layers had been built up, the solid to the circular ring attached to the cast coping in a universal testing
copings were retrieved from the machine, sandblasted, polished, machine at a cross-head speed of 0.5 mm/minute. The machine’s
inspected, and ultrasonically cleaned. Copings of all the groups software recorded the tensile force values required to separate
(groups A, B, and C) were ready for cementation and testing (Fig. 2C). the copings (N).

Cementation Statistical Analysis

Glass ionomer cement was used for the cementation of each
coping. Each coping was then seated on the tooth and held under
compression load test under 5000 gm (50 N) for 5 minutes in order
to simulate the maximum biting force generated by the masticatory
muscles that vary from 42 N to 1245 N.
Testing
Testing for vertical marginal fit of the Co–Cr copings: Measurements
were made using a digital optical stereomicroscope (Fig. 3A) (Make:
Wuzhou New Found Instrument Co. Ltd., China Model: XTL 3400E,
magnification: 20×), with an accuracy of 0.1 μm. The casting was
seated onto the tooth and was clamped horizontally in position,
using the metallic jig fixture of the digital microscope, at two-and-a
half turns of the thumb-screw (Fig. 3B).
Measurements were made between the margins of the casting
(Figs 3C and D).
The reference marks were scribed on the acrylic block at four
points, i.e., 0°, 90°, 180°, and 270°. All measurements were performed
by the same operator without knowledge of the identity of the
testing groups.
Testing for retention of the Co–Cr copings: Universal testing
machine was used for the evaluation of retention of all the samples
(Fig. 4). Coping retention was measured by applying a tensile force
The results were tabulated and subjected to unpaired t-test
and one-way analysis of variance (ANOVA) to detect statistically
significant differences. Between- and within-group differences in
tensile bond strength were analyzed using one-way ANOVA test of
significance with Tukey’s post hoc analysis. Statistical analysis was
done using the IBM Corporation SPSS version 20 (Chicago, USA)
program at a significant level of p ≤ 0.05.
R e s u lts
The mean values of marginal fit were tabulated and a highly
significant difference was observed with the p>0.001* (Table 1). The
Co–Cr copings obtained by conventional casting technique (group
A) (216.54 ± 36.682) showed the highest marginal discrepancy
followed by Co–Cr copings fabricated from 3D-printed resin pattern
(group B) (100.82 ± 12.516) and the Co–Cr copings fabricated from
direct metal laser sintering (group C) (100.82 ± 12.516) showed the
least marginal discrepancy (Fig. 5). Therefore, the present study has
rejected the null hypothesis as there is a significant difference in the
marginal discrepancy of Co–Cr copings fabricated by group A and
Co–Cr copings fabricated from group B and group C.
Comparison of the retention force among all the groups
showed significant difference present in the retention of the three

Figs 3A to D: (A) Digital stereomicroscope used for testing vertical marginal fit; (B) Testing of vertical marginal gap of each sample using a metallic
jig; (C) Marginal gap measurement for group A Co–Cr copings; (D) Marginal gap measurement for group C Co–Cr copings

994 The Journal of Contemporary Dental Practice, Volume 23 Issue 10 (October 2022)
 Comparative Evaluation of Retention and Vertical Marginal Accuracy of Co–Cr Copings

Table 2: Comparison of the retention force in terms of {mean (SD)}

among all the groups using ANOVA test
Group N Mean Std. deviation F-value p-value
Group A 20 120.53 74.613 3.936 0.025*
Group B 20 169.62 81.653
Group C 20 186.08 74.121
Total 60 158.74 80.608
*p < 0.05 – significant

Fig. 4: Testing for retention of copings under the universal testing

machine

Table 1: Comparison of the marginal gap in terms of {mean (SD)} among

all the groups using the ANOVA test
Group N Mean Std. deviation F-value p-value
Group A 20 216.54 36.682 265.500 <0.001**
Group B 20 100.82 12.516
Group C 20 49.21 12.535
Total 60 122.19 74.246
**p < 0.001 – highly significant
Fig. 6: Comparison of the retention force in terms of {mean (SD)} among
all the groups

aesthetically sound tooth preparations.9 The principal objective

Fig. 5: Comparison of the marginal gap in terms of {mean (SD)} among
all the groups using ANOVA test
groups, with the p < 0.05* (Table 2). Laser sintering technique
(group C) (186.08 ± 74.121) of coping fabrication showed the highest
retention of the Co–Cr copings followed by 3D-printed resin printed
technique (group B) (169.62 ± 81.653) (Fig. 6).
Discussion
Successful clinical outcome of fixed prosthodontic treatment
depends on the creation of mechanically, biologically, and
of this study was to evaluate whether there is any influence of
the fabrication technique on marginal integrity and retention
factors on the longevity of the final prosthesis in the oral cavity.10
In this study, Co–Cr copings fabricated from three different
techniques – conventional casting, 3D-printed pattern resin, and
direct metal laser sintering – were evaluated for vertical marginal
accuracy and retention. Group A Co–Cr copings were fabricated
using conventional casting of manually fabricated wax patterns.
Group  B Co–Cr copings were fabricated using conventional
casting of 3D-printed resin patterns. Group C Co–Cr copings were
fabricated using direct metal laser sintering. There are various
studies discussing the effect of different fabrication techniques on
retention and marginal fit of Co–Cr copings conducted on metal
and stone dies. This study has been performed on extracted human
maxillary premolars to add to the clinical relevance of the study.
While evaluating vertical marginal fit parameter, null
hypothesis of the present study was rejected as group C showed
highly significant marginal accuracy as compared to group A and
group B. Diverse values for clinically acceptable range of marginal
discrepancy have been stated in literature. The frontiers like
Fransson et al. and McLean and von Fraunhofer have given the
clinically acceptable marginal gap after cementation as <150 and
120 μm, respectively.11,12
Akova et al. reported a marginal gap in the range of less than
or upto 76–93 μm and 62.6 μm, respectively, for laser-sintered
copings.8 Thus, in accordance to the different marginal gap values
quoted by different authors, the present study is in congruence with

The Journal of Contemporary Dental Practice, Volume 23 Issue 10 (October 2022) 995
 Comparative Evaluation of Retention and Vertical Marginal Accuracy of Co–Cr Copings
the clinically acceptable marginal gap value as stated by McLean
et al. and von Fraunher for groups B and C and Moldovan et al. for
group A, respectively.13
In the present study, group A demonstrated the highest
mean marginal discrepancy among all the groups. The precision
of the scanner used to digitize the working models, precision of
designing via computer software, and precision of the machine
used to fabricate the 3D design attributed to this difference in the
marginal discrepancy.
The findings of the present study are in consensus with the work
conducted by Vojdani et al.,14 who observed the lowest marginal
discrepancy for DMLS copings (group C) and highest discrepancy
for conventional lost-wax technique.15 The reason for the highest
marginal discrepancy for group A attributes to multiple steps in
the production of copings, which maximizes discrepancies in the
definitive product. Wax has a tendency to distort or warp when
allowed to stand unrestrained. The use of 3D printing software
in group B compensated for the polymerization shrinkage and
increased the precision without any chance of manual errors during
fabrication process, which led to a better marginal fit of group B
when compared with group A.
The results of retention parameter in the present study state
that the technique of fabrication does have an effect on the
retentive properties of the copings, irrespective of the cement
used. Our findings are in accordance with Suleiman and Vult von
Steyern,16 who concluded there was no significant difference in
strength between Co and Cr crowns produced using production
technologies: casting, milling, or laser-sintering. In a study
conducted by Krug et al., there were no statistically significant
differences in the retentive forces between conventionally cast,
metal-sintered and milled FDPs.17
In the present study, GIC was used to cement milled metal
and all ceramic copings. Although resin cements have maximum
retention, previous studies assessed that GIC has also got
adequate retention.18 Recently, the study conducted by Choi et al.
evaluated the mechanical properties for Co–Cr alloy fabricated by
conventional casting, 3D printing laser-sintered, and CAD-/CAM-
milled techniques. The results were in congruence with the present
study showing that the Co–Cr alloy fabricated by laser sintering had
the highest retention.19
The significant difference in the retention values between
the Co–Cr copings fabricated from lost-wax technique and direct
metal laser-sintered technique is because of the errors involved
in technique-sensitive conventional casting procedure, precision
involved in the addition technique for designing of the DMLS
copings, and manual errors involved in wax pattern fabrication.
However, there are very few studies to evaluate the retention for
Co–Cr copings fabricated with different fabrication techniques.
Further studies are required for better evaluation and verification
of the values of retention obtained in the present study.
Limitations of the Study
• Marginal fit of copings was not determined before cementation.
• Cemented copings were not subjected to thermal cycling.
Thermal cycling is one of the important factors that affect the
long-term marginal fit of crown.
• All the copings were produced and tested under ideal conditions,
which may not reflect conditions in daily clinical practice.
• Polishing and finishing of the casting were done manually, which
may also create some discrepancy in the casting.
996 The Journal of Contemporary Dental Practice, Volume 23 Issue 10 (October 2022)
Future Directions of the Study
• Help the clinician decide which casting procedure provides
better retention and marginal accuracy for fabrication of Co–Cr
crowns.
• Help the clinician get an idea about the errors that can be
minimized by using different techniques for fabrication of wax
pattern as well as the coping.
• Help the clinician evaluate the effect of laser sintering on the
retention and marginal fit of direct metal laser-sintered Co–Cr
crowns.
• Help the clinician evaluate the accuracy of 3D-printed resin
patterns over conventional wax pattern.
C o n c lu s i o n
In this in vitro study, the Co–Cr copings obtained from DMLS
technique show the highest marginal accuracy when compared
with conventionally cast copings obtained from inlay casting wax
and 3D-printed resin pattern. The retention was least for copings
obtained from the lost-wax technique followed by copings
fabricated from 3D-printed resin pattern and copings from DMLS
technique.
Within the limitations of the study, we can conclude that
the results encourage further research with different pattern-
forming materials and techniques and the need to identify the
factors that facilitate better marginal fit and retention of cast
restorations. Further studies that better simulate oral conditions
are recommended for optimized clinical success.
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