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Microfractures in metal-ceramic and all-ceramic implant-supported fixed dental prostheses caused by superstructure fixation.

The effect of ceramic veneering on the passivity of fit of cast metal and CAD/CAM-fabricated zirconia ceramic implant-supported three-unit cement-retained restorations was investigated, as well as the effect of misfit stress on the marginal integrity of ceramic veneers. Superstructures were fabricated using cast metal or by CAD/CAM milling of presintered or HIP zirconia ceramic (n=10). Before and after veneering, strain gages were used to measure in vitro the strain developed in all the restorations as a result of superstructure fixation. Fluorescent penetrant method was used to detect microcracks developed in ceramic veneers. Cast frameworks showed significantly higher strain values than CAD/CAM frameworks (p=0.000). Veneering significantly increased strain development in all CAD/CAM frameworks (p=0.000). Compared to zirconia ceramic restorations, significantly more microcracks were observed in cast restorations (p=0.000) both before and after superstructure fixation.