Three-dimensional misfit between Ti-Base abutments and implants evaluated by replica technique

Abstract An important factor affecting the biomechanical behavior of implant-supported reconstructions is the implant-abutment misfit. Objective: This study evaluated the misfit between Ti-Base abutments and implants by means of polyvinyl siloxane replica technique using microcomputed tomography (μCT). Methodology: Volumetric and linear (central and marginal) gaps of four Ti-base abutments (n=10/group): (i) Odontofix LTDA (OD), (ii) Singular Implants (SING), (iii) EFF Dental Components (EFF), and (iv) Control Group (S.I.N implants) compatible with an implant system (Strong SW, S.I.N Implants) were measured using μCT reconstructed polyvinyl siloxane replicas. Results: The results showed significantly lower volume gap for Control S.I.N (0.67±0.29 mm3) and SING (0.69±0.28 mm3) Ti-base abutments relative to OD (1.42±0.28 mm3) and EFF groups (1.04±0.28 mm3) (p<0.033), without significant difference between them (p=0.936). While gap values were homogenous in the central region, EFF presented a significantly higher marginal gap. Accordingly, the Control S.I.N and Singular Ti-base abutments showed improved volumetric and marginal fit relative to Odontofix and EFF. Conclusion: The method of manufacturing abutments influenced the misfit at the implant-abutment interface.

Comparison of marginal and internal discrepancies of zirconia crowns fabricated by various digital scan methods / 대한치과재료학회지

In this study, marginal and internal discrepancies of zirconia crowns fabricated with the CAD/CAM (computer aided design

Comparative evaluation of marginal and internal fit of metal copings fabricated by various CAD/CAM methods / 대한치과보철학회지

PURPOSE: The purpose of the present study was to compare the accuracy of four different metal copings fabricated by CAD/CAM technology and to evaluate clinical effectiveness. MATERIALS AND METHODS: Composite resin tooth of the maxillary central incisor was prepared for a metal ceramic crown and duplicated metal die was fabricated. Then scan the metal die for 12 times to obtain STL files using a confocal microscopy type oral scanner. Metal copings with a thickness of 0.5 mm and a cement space of 50 µm were designed on a CAD program. The Co-Cr metal copings were fabricated by the following four methods: Wax pattern milling & Casting (WM), Resin pattern 3D Printing & casting (RP), Milling & Sintering (MS), Selective laser melting (SLM). Silicone replica technique was used to measure marginal and internal discrepancies. The data was statistically analyzed with One-way analysis of variance and appropriate post hoc test (Scheffe test) (α=.05). RESULTS: Mean marginal discrepancy was significantly smaller in the Group WM (27.66 ± 9.85 µm) and Group MS (28.88 ± 10.13 µm) than in the Group RP (38.09 ± 11.14 µm). Mean cervical discrepancy was significantly smaller in the Group MS than in the Group RP. Mean axial discrepancy was significantly smaller in the Group WM and Group MS then in the Group RP and Group SLM. Mean incisal discrepancies was significantly smaller in the Group RP than in all other groups. CONCLUSION: The marginal and axial discrepancies of the Co-Cr coping fabricated by the Wax pattern milling and Milling/Sintering method were better than those of the other groups. The marginal, cervical and axial fit of Co-Cr copings in all groups are within a clinically acceptable range.

Evaluation of adaptation of ceramic inlays using optical coherence tomography and replica technique

Abstract Optical coherence tomography (OCT) has generally been used as a nondestructive technique to evaluate integrities of composite restorations. We investigated marginal and internal adaptations of ceramic inlay restorations with OCT and compared them to results with the silicone replica technique. Round-shaped class I cavities were prepared on 16 human maxillary first premolar teeth. Ceramic inlays were fabricated. Silicone replicas from inlays were obtained and sectioned to measure marginal and internal adaptations with a stereomicroscope (Leica Dfc 295, Bensheim, Germany). Inlays were cemented on respective teeth. Marginal and internal adaptations were then measured with the OCT system (Thorlabs, New Jersey, USA) in 200- μm intervals. Replica and OCT measurements were compared with independent samples t-tests. A paired t-test was used to evaluate the marginal and internal adaptations of each group (p < 0.05). Marginal and internal adaptations were 100.97 ± 31.36 and 113.94 ± 39.75 μm, respectively, using the replica technique and 28.97 ± 17.86 and 97.87 ± 21.83 μm, respectively, using OCT. The differences between the techniques were significant (p = 0.00 and p = 0.01, respectively). On evaluation within the groups, internal adaptation values were found to be significantly higher than the marginal adaptation values for the replica technique (p = 0.00) and OCT (p = 0.00). Therefore, the replica and OCT techniques showed different results, with higher values of marginal and internal adaptation found with the replica technique. Marginal and internal adaptation values of ceramic inlays, whether measured by replica or OCT techniques, were within clinically acceptable limits.

Reliability of light microscopy and a computer-assisted replica measurement technique for evaluating the fit of dental copings

Abstract The aim of this in vitro study was to assess the reliability of two measurement systems for evaluating the marginal and internal fit of dental copings. Material and Methods: Sixteen CAD/CAM titanium copings were produced for a prepared maxillary canine. To modify the CAD surface model using different parameters (data density; enlargement in different directions), varying fit was created. Five light-body silicone replicas representing the gap between the canine and the coping were made for each coping and for each measurement method: (1) light microscopy measurements (LMMs); and (2) computer-assisted measurements (CASMs) using an optical digitizing system. Two investigators independently measured the marginal and internal fit using both methods. The inter-rater reliability [intraclass correlation coefficient (ICC)] and agreement [Bland-Altman (bias) analyses]: mean of the differences (bias) between two measurements [the closer to zero the mean (bias) is, the higher the agreement between the two measurements] were calculated for several measurement points (marginal-distal, marginal-buccal, axial-buccal, incisal). For the LMM technique, one investigator repeated the measurements to determine repeatability (intra-rater reliability and agreement). Results: For inter-rater reliability, the ICC was 0.848-0.998 for LMMs and 0.945-0.999 for CASMs, depending on the measurement point. Bland-Altman bias was −15.7 to 3.5 μm for LMMs and −3.0 to 1.9 μm for CASMs. For LMMs, the marginal-distal and marginal-buccal measurement points showed the lowest ICC (0.848/0.978) and the highest bias (-15.7 μm/-7.6 μm). With the intra-rater reliability and agreement (repeatability) for LMMs, the ICC was 0.970-0.998 and bias was −1.3 to 2.3 μm. Conclusion: LMMs showed lower interrater reliability and agreement at the marginal measurement points than CASMs, which indicates a more subjective influence with LMMs at these measurement points. The values, however, were still clinically acceptable. LMMs showed very high intra-rater reliability and agreement for all measurement points, indicating high repeatability.

Evaluation of marginal and internal gaps of Ni-Cr and Co-Cr alloy copings manufactured by microstereolithography

PURPOSE: The purpose of this study was to evaluate the marginal and internal gaps of Ni-Cr and Co-Cr copings, fabricated using the dental µ-SLA system. MATERIALS AND METHODS: Ten study dies were made using a two-step silicone impression with a dental stone (type IV) from the master die of a tooth. Ni-Cr (NC group) and Co-Cr (CC group) alloy copings were designed using a dental scanner, CAD software, resin coping, and casting process. In addition, 10 Ni-Cr alloy copings were manufactured using the lost-wax technique (LW group). The marginal and internal gaps in the 3 groups were measured using a digital microscope (160 ×) with the silicone replica technique, and the obtained data were analyzed using the non-parametric Kruskal-Wallis H test. Post-hoc comparisons were performed using Bonferroni-corrected Mann-Whitney U tests (α=.05). RESULTS: The mean (±standard deviation) values of the marginal, chamfer, axial wall, and occlusal gaps in the 3 groups were as follows: 81.5±73.8, 98.1±76.1, 87.1±44.8, and 146.8±78.7 µm in the LW group; 76.8±48.0, 141.7±57.1, 80.7±47.5, and 194.69±63.8 µm in the NC group; and 124.2±52.0, 199.5±71.0, 67.1±37.6, and 244.5±58.9 µm in the CC group. CONCLUSION: The marginal gap in the LW and NC groups were clinically acceptable. Further improvement is needed for CC group to be used clinical practice.

Evaluation of the marginal and internal gaps of three different dental prostheses: comparison of the silicone replica technique and three-dimensional superimposition analysis

PURPOSE: The purposes of this study were to evaluate the marginal and internal gaps, and the potential clinical applications of three different methods of dental prostheses fabrication, and to compare the prostheses prepared using the silicone replica technique (SRT) and those prepared using the three-dimensional superimposition analysis (3DSA). MATERIALS AND METHODS: Five Pekkton, lithium disilicate, and zirconia crowns were each manufactured and tested using both the SRT and the two-dimensional section of the 3DSA. The data were analyzed with the nonparametric version of a two-way analysis of variance using rank-transformed values and the Tukey's post-hoc test (α = .05). RESULTS: Significant differences were observed between the fabrication methods in the marginal gap (P .350), deep chamfer (P > .719), and axial wall (P > .150). As the 3DSA method is three-dimensional, it allows for the measurement of arbitrary points. CONCLUSION: All of the three fabrication methods are valid for measuring clinical objectives because they produced prostheses within the clinically acceptable range. Furthermore, a three-dimensional superimposition analysis verification method such as the silicone replica technique is also applicable in clinical settings.

Verification of a computer-aided replica technique for evaluating prosthesis adaptation using statistical agreement analysis

PURPOSE: The purpose of this study was to evaluate the reliability of computer-aided replica technique (CART) by calculating its agreement with the replica technique (RT), using statistical agreement analysis. MATERIALS AND METHODS: A prepared metal die and a metal crown were fabricated. The gap between the restoration and abutment was replicated using silicone indicator paste (n = 25). Gap measurements differed in the control (RT) and experimental (CART) groups. In the RT group, the silicone replica was manually sectioned, and the marginal and occlusal gaps were measured using a microscope. In the CART group, the gap was digitized using optical scanning and image superimposition, and the gaps were measured using a software program. The agreement between the measurement techniques was evaluated by using the 95% Bland-Altman limits of agreement and concordance correlation coefficients (CCC). The least acceptable CCC was 0.90. RESULTS: The RT and CART groups showed linear association, with a strong positive correlation in gap measurements, but without significant differences. The 95% limits of agreement between the paired gap measurements were 3.84% and 7.08% of the mean. The lower 95% confidence limits of CCC were 0.9676 and 0.9188 for the marginal and occlusal gap measurements, respectively, and the values were greater than the allowed limit. CONCLUSION: The CART is a reliable digital approach for evaluating the fit accuracy of fixed dental prostheses.

In vitro evaluation methods on adaptation of fixed dental prosthesis

Clinically, the fit of fixed prosthesis is an essential element for successful restoration. The fit of prosthesis is largely classified into marginal fit and internal fit, and various methods to assess these have been introduced including microscopic margin measurement, cross-sectional measurement, silicone replica technique, 3-dimensional scanning data superposition, weight technique and micro CT scanning. Thus, this study is aimed at proposing a more convenient and accurate measurement method of fits in a digital environment by comparatively analyzing the advantages and disadvantages of each known method based on existing literature.

Evaluation of marginal and internal gaps in single and three-unit metal frameworks made by micro-stereolithography

PURPOSE: The purpose of this study is to compare single and three-unit metal frameworks that are produced by micro-stereolithography. MATERIALS AND METHODS: Silicone impressions of a selected molar and a premolar were used to make master abutments that were scanned into a stereolithography file. The file was processed with computer aided design software to create single and three-unit designs from which resin frameworks were created using micro-stereolithography. These resin frameworks were subjected to investment, burnout, and casting to fabricate single and three-unit metal ones that were measured under a digital microscope by using the silicone replica technique. The measurements were verified by means of the Mann-Whitney U test (α=.05). RESULTS: The marginal gap was 101.9 ± 53.4 µm for SM group and 104.3 ± 62.9 µm for TUM group. The measurement of non-pontics in a single metal framework was 93.6 ± 43.9 µm, and that of non-pontics in a three-unit metal framework was 64.9 ± 46.5 µm. The dimension of pontics in a single metal framework was 110.2 ± 61.4 µm, and that of pontics in a three-unit metal framework was 143.7 ± 51.8 µm. CONCLUSION: The marginal gap was smaller for the single metal framework than for the three-unit one, which requires further improvement before it can be used for clinical purposes.

Evaluation of marginal and internal gap of three-unit metal framework according to subtractive manufacturing and additive manufacturing of CAD/CAM systems

PURPOSE: To evaluate the fit of a three-unit metal framework of fixed dental prostheses made by subtractive and additive manufacturing. MATERIALS AND METHODS: One master model of metal was fabricated. Twenty silicone impressions were made on the master die, working die of 10 poured with Type 4 stone, and working die of 10 made of scannable stone. Ten three-unit wax frameworks were fabricated by wax-up from Type IV working die. Stereolithography files of 10 three-unit frameworks were obtained using a model scanner and three-dimensional design software on a scannable working die. The three-unit wax framework was fabricated using subtractive manufacturing (SM) by applying the prepared stereolithography file, and the resin framework was fabricated by additive manufacturing (AM); both used metal alloy castings for metal frameworks. Marginal and internal gap were measured using silicone replica technique and digital microscope. Measurement data were analyzed by Kruskal-Wallis H test and Mann-Whitney U-test (α=.05). RESULTS: The lowest and highest gaps between premolar and molar margins were in the SM group and the AM group, respectively. There was a statistically significant difference in the marginal gap among the 3 groups (P < .001). In the marginal area where pontic was present, the largest gap was 149.39 ± 42.30 µm in the AM group, and the lowest gap was 24.40 ± 11.92 µm in the SM group. CONCLUSION: Three-unit metal frameworks made by subtractive manufacturing are clinically applicable. However, additive manufacturing requires more research to be applied clinically.

Marginal and internal fit of all ceramic crown using the replica technique and the triple-scan protocol / 대한치과보철학회지

PURPOSE: This study was conducted to compare the marginal and internal fit of all ceramic crown using the replica technique and the triple-scan protocol. MATERIALS AND METHODS: Twenty zirconia ceramic crowns were fabricated using titanium abutment model. All crowns were divided into two groups of 10 each, depending on the replica technique and the triple-scan protocol. The internal and marginal fit of 10 zirconia ceramic crowns were measured at 17 points for each specimen using the replica technique. The other 10 ceramic crowns were measured using the triple-scan protocol. Statistical analysis was performed by t-test (α= .05). RESULTS: The mean and standard deviation of marginal and internal fit were significantly different between the replica technique (49.86 ± 29.69 µm) and triple-scan protocol (75.35 ± 64.73 µm, P.343). CONCLUSION: There was a statistically significant difference in the marginal fit measured by the two methods. However, there was no statistically significant difference in the internal fit between the two methods.

Assessment of the fit of zirconia-based prostheses fabricated with two different scan methods / 대한치과보철학회지

PURPOSE: This research was conducted to compare the marginal and internal fit of zirconia prostheses fabricated with the model scan method and the intraoral scan method. MATERIALS AND METHODS: In this study, 20 extracted human mandibular first molar was used in the preparation of abutment tooth for the fabrication of zirconia prostheses. In the first group, the model scan method was applied on 10 prepared teeth. In the other group, the intraoral scan method was used on other 10 prepared teeth. Datum of both groups were transmitted to the software system. Afterwards, 20 zirconia prostheses were fabricated using the Ceramill system. Weight technique was used to evaluate the internal gap of the zirconia prostheses. In the Replica technique, marginal gap of the zirconia prostheses were analyzed by optical microscopy. Statistical analysis was based on one-way ANOVA. RESULTS: Model scan group showed lower average weight than intraoral scan group when weight technique was applied, which has significance (P < .05). Also, model scan group showed significantly lower figures in all 5 measurements of replica technique than intraoral scan group (P < .05). CONCLUSION: Zirconia prostheses of both groups demonstrated clinically acceptable margin and internal fit. However, model scanned zirconia prostheses showed higher marginal and internal fit than intraoral scanned crowns.

Evaluation of marginal and internal gap under model-free monolithic zirconia restoration fabricated by digital intraoral scanner / 대한치과보철학회지

PURPOSE: The aim of this study was to evaluate the marginal and internal adaptation of monolithic zirconia restoration made without physical model by digital intraoral scanner. MATERIALS AND METHODS: A prospective clinical trial was performed on 11 restorations as a pilot study. The monolithic zirconia restorations were fabricated after digital intraoral impression taking by intraoral scanner (TRIOS, 3shape, Copenhagen, Denmark), computer-aided designing, and milling manufacturing process. Completed zirconia crowns were tried in the patients' mouth and a replica technique was used to acquire the crown-abutment replica. The absolute marginal discrepancy, marginal gap, and internal gap of axial, line angle, and occlusal part were measured after sectioning the replica in the mesiodistal and buccolingual direction. Statistical analysis was performed using Kruskal-Wallis and Mann-Whitney U test (α=.05). RESULTS: From the adaptation analysis by replica, the statistically significant difference was not found between mesiodistal and buccolingual sections (P>.05), but there was significant difference among the measurement location (P<.01). The amount of absolute marginal discrepancy was larger than those of marginal gap and internal gap (P<.01). CONCLUSION: Within the limitations of this study, the adaptation accuracy of model-free monolithic zirconia restoration fabricated by intraoral scanner exhibited clinically acceptable result. However, the margin of zirconia crown showed tendency of overcontour and cautious clinical application and follow up is necessary.

Study on methodology for the assessment of internal and marginal adaptation on fixed dental prosthesis

This article is to review various methods used to investigate internal and marginal adaptation of fixed dental prostheses, and to summarize a merit, worth, and limitation of each method, using some results of previous studies. The methods of measuring internal and marginal gap are divided into two categories in this study; in vivo and in vitro. In vivo methods are clinical evaluations, including exploration, radiography, and impression technique. In vitro methods are laboratory evaluations such as direct view, cross-sectioning, and silicone replica technique using microscope. Measuring by micro computed tomography (CT) or profilometer is also in vitro methods. In recent years, the development of scanning systems is able to analyze 3-dimensional internal and marginal space in detail. As measuring and analyzing technology become more advanced, the ability to thoroughly examine crown adaptation is becoming both simpler and more efficient.

Comparison of the fit accuracy of zirconia-based prostheses generated by two CAD/CAM systems

PURPOSE: The purposes of this study are to evaluate the internal and marginal adaptation of two widely used CAD/CAM systems and to study the effect of porcelain press veneering process on the prosthesis adaptation. MATERIALS AND METHODS: Molar of a lower jaw typodont resin model was prepared by adjusting a 1.0 mm circumferential chamfer, an occlusal reduction of 2.0 mm, and a 5° convergence angle and was duplicated as an abrasion-resistant master die. The monolithic crowns and copings were fabricated with two different CAD/CAM system-Ceramil and Zirkonzahn systems. Two kinds of non-destructive analysis methods are used in this study. First, weight technique was used to determine the overall fitting accuracy. And, to evaluate internal and marginal fit of specific part, replica technique procedures were performed. RESULTS: The silicone weight for the cement space of monolithic crowns and copings manufactured with Ceramil system was significantly higher than that from Zirkonzahn system. This gap might cause the differences in the silicone weight because the prostheses were manufactured according to the recommendation of each system. Marginal discrepancies of copings made with Ceramil system were between 106 and 117 µm and those from Zirkonzahn system were between 111 and 115 µm. Marginal discrepancies of copings made with Ceramil system were between 101 and 131 µm and those from Zirkonzahn system were between 116 and 131 µm. CONCLUSION: Marginal discrepancy was relatively lower in Ceramil system and internal gap was smaller in Zirkonzahn system. There were significant differences in the internal gap of monolithic crown and coping among the 2 CAD/CAM systems. Marginal discrepancy produced from the 2 CAD/CAM systems were within a reported clinically acceptable range of marginal discrepancy.

Impact of surface roughness of gypsum materials on adaptation of zirconia cores

PURPOSE: The present study investigated the influences of various gypsum materials on the precision of fit of CAD/CAM-fabricated prostheses and analyzed their correlation with surface roughness. MATERIALS AND METHODS: The master model of the mandibular right first molar was replicated, and four experimental groups based on two types of Type IV stone (GC Fujirock EP, Die keen) and two types of scannable stone (Aesthetic-Basegold, Everest Rock) were created to include a total of 40 specimens, 10 in each group. The surface roughness of the working models for the respective experimental groups was measured. Once the zirconia cores had been fabricated, the marginal and internal fits were measured with a digital microscope using the silicone replica technique. The mean and standard deviation of the respective points of measurement were computed and analyzed through the one-way ANOVA and Tukey's HSD test. The correlation between surface roughness and the precision of fit of the zirconia core was analyzed using the Pearson correlation analysis (alpha=.05). RESULTS: The zirconia cores fabricated from the scannable stone working models exhibited a superior precision of fit as compared to those fabricated from the Type IV stone working models. The correlation analysis results showed a clear positive correlation between surface roughness and the precision of fit of zirconia cores in all of the experimental groups (P<.05). CONCLUSION: The results confirmed that the surface roughness of dental working models has a decisive influence on the precision of fit of zirconia cores.

Accuracy evaluation of metal copings fabricated by computer-aided milling and direct metal laser sintering systems

PURPOSE: To assess the marginal and internal gaps of the copings fabricated by computer-aided milling and direct metal laser sintering (DMLS) systems in comparison to casting method. MATERIALS AND METHODS: Ten metal copings were fabricated by casting, computer-aided milling, and DMLS. Seven mesiodistal and labiolingual positions were then measured, and each of these were divided into the categories; marginal gap (MG), cervical gap (CG), axial wall at internal gap (AG), and incisal edge at internal gap (IG). Evaluation was performed by a silicone replica technique. A digital microscope was used for measurement of silicone layer. Statistical analyses included one-way and repeated measure ANOVA to test the difference between the fabrication methods and categories of measured points (alpha=.05), respectively. RESULTS: The mean gap differed significantly with fabrication methods (P<.001). Casting produced the narrowest gap in each of the four measured positions, whereas CG, AG, and IG proved narrower in computer-aided milling than in DMLS. Thus, with the exception of MG, all positions exhibited a significant difference between computer-aided milling and DMLS (P<.05). CONCLUSION: Although the gap was found to vary with fabrication methods, the marginal and internal gaps of the copings fabricated by computer-aided milling and DMLS fell within the range of clinical acceptance (<120 microm). However, the statistically significant difference to conventional casting indicates that the gaps in computer-aided milling and DMLS fabricated restorations still need to be further reduced.

Accuracy evaluation of metal copings fabricated by computer-aided milling and direct metal laser sintering systems

PURPOSE: To assess the marginal and internal gaps of the copings fabricated by computer-aided milling and direct metal laser sintering (DMLS) systems in comparison to casting method. MATERIALS AND METHODS: Ten metal copings were fabricated by casting, computer-aided milling, and DMLS. Seven mesiodistal and labiolingual positions were then measured, and each of these were divided into the categories; marginal gap (MG), cervical gap (CG), axial wall at internal gap (AG), and incisal edge at internal gap (IG). Evaluation was performed by a silicone replica technique. A digital microscope was used for measurement of silicone layer. Statistical analyses included one-way and repeated measure ANOVA to test the difference between the fabrication methods and categories of measured points (alpha=.05), respectively. RESULTS: The mean gap differed significantly with fabrication methods (P<.001). Casting produced the narrowest gap in each of the four measured positions, whereas CG, AG, and IG proved narrower in computer-aided milling than in DMLS. Thus, with the exception of MG, all positions exhibited a significant difference between computer-aided milling and DMLS (P<.05). CONCLUSION: Although the gap was found to vary with fabrication methods, the marginal and internal gaps of the copings fabricated by computer-aided milling and DMLS fell within the range of clinical acceptance (<120 microm). However, the statistically significant difference to conventional casting indicates that the gaps in computer-aided milling and DMLS fabricated restorations still need to be further reduced.

Gap comparison between single crown and three-unit bridge zirconia substructures

PURPOSE: To compare marginal and internal gaps of zirconia substructure of single crowns with those of three-unit fixed dental prostheses. MATERIALS AND METHODS: Standardized Co-Cr alloy simulated second premolar and second molar abutments were fabricated and subsequently duplicated into type-III dental stone for working casts. After that, all zirconia substructures were made using Lava(TM) system. Marginal and internal gaps were measured in 2 planes (mesial-distal plane and buccal-palatal plane) at 5 locations: marginal opening (MO), chamfer area (CA), axial wall (AW), cusp tip (CT) and mid-occlusal (OA) using Replica technique. RESULTS: There were significant differences between gaps at all locations. The mean +/- SD of marginal gap in premolar was 43.6 +/- 0.4 microm and 46.5 +/- 0.5 microm for single crown and 3-unit bridge substructure respectively. For molar substructure the mean +/- SD of marginal gap was 48.5 +/- 0.4 microm and 52.6 +/- 0.4 microm for single crown and 3-unit bridge respectively. The largest gaps were found at the occlusal area, which was 150.5 +/- 0.5 microm and 154.5 +/- 0.4 microm for single and 3-unit bridge premolar substructures respectively and 146.5 +/- 0.4 microm and 211.5 +/- 0.4 microm for single and 3-unit bridge molar substructure respectively. CONCLUSION: Independent-samples t-test showed significant differences of gap in zirconia substructure between single crowns and three-unit bridge (P<.001). Therefore, the span length has the effect on the fit of zirconia substructure that is fabricated using CAD/CAM technique especially at the occlusal area.