Influence of repetitive diamond bur use on the trueness and surface roughness of subtractively manufactured PICN restorations
DOI:
https://doi.org/10.2340/biid.v13.46232Keywords:
CAD/CAM, subtractive manufacturing, PICN, hybrid ceramic, bur degradation, fabrication trueness, surface roughnessAbstract
Objectives: Progressive diamond bur degradation during the subtractive manufacturing (SM) of polymer-infiltrated ceramic networks (PICNs) compromises restorative clinical quality. To evaluate the degradation extent across two SM systems and investigate its effects on the trueness and surface roughness of PICN crowns.
Materials and Methods: A total of 121 premolar crowns were fabricated from PICN blocks (Vita Enamic) using two SM machines (PrograMill PM7 and inLab MC X5). Crown trueness was quantified by superimposing crown scans onto the original digital design using three-dimensional inspection software (Geomagic Control X) and reported as the root-mean-square (RMS) ± standard deviation (µm). Surface roughness (Ra, Sa, Sq) was measured using confocal microscopy. Bur degradation was assessed after every five crown fabrications using machine-reported lifespan, surface roughness, and color deviation maps. Diamond bur tips, before and after use, were examined using scanning electron microscopy to characterize wear patterns. Statistical comparisons were performed both between and within machines using Welch’s Analysis of Variance (ANOVA) (p < 0.05).
Results: Significant differences were observed in regional trueness (p < 0.0001): the PM7 yielded more accurate intaglio (inner) surfaces (22.21 ± 4.31 µm), while the MC X5 achieved higher external surface trueness (17.89 ± 2.76 µm). Bur degradation led to distinct error modes – whereas the PM7 exhibited a significant increase in negative deviations (overmilling), the MC X5 predominantly resulted in under-milled surfaces but with less impact from bur degradation. Crown surface roughness also differed between the two SM systems. While a consistent decreasing trend in surface roughness was observed in the MC X5 with repetitive milling cycles, the PM7 showed an initial decline followed by an accelerated increase after the 55th crown.
Conclusions: The rate and extent of bur degradation varied by systems, causing distinct impacts on crown quality. Degradation in the PM7 predominantly resulted in adverse over-milling errors, whereas the MC X5 was more likely to cause inadequate material removal. System-specific degradation mechanisms substantially affect the ultimate quality of restorations. Surface roughness initially decreased in both SM systems; however, the systems followed divergent late-stage trajectories – one maintained a downward trend while the other exhibited a U-shaped recovery.
Downloads
References
Singer L, Fouda A, Bourauel C. Biomimetic approaches and materials in restorative and regenerative dentistry: review article. BMC Oral Health. 2023;23:105. DOI: https://doi.org/10.1186/s12903-023-02808-3
Coldea A, Swain MV, Thiel N. Mechanical properties of polymer-infiltrated-ceramic-network materials. Dent Mater. 2013;29:419–26. DOI: https://doi.org/10.1016/j.dental.2013.01.002
Ling L, Lai T, Malyala R. Fracture toughness and brittleness of novel CAD/CAM resin composite block. Dent Mater. 2022;38:e308–17. DOI: https://doi.org/10.1016/j.dental.2022.11.012
Duarte S, Jr, Phark JH. Advances in dental restorations: a comprehensive review of machinable and 3D-printed ceramic-reinforced composites. J Esthet Restor Dent. 2025;37:257–76. DOI: https://doi.org/10.1111/jerd.13371
Kawajiri Y, Ikeda H, Nagamatsu Y, Masaki C, Hosokawa R, Shimizu H. PICN nanocomposite as dental CAD/CAM block comparable to human tooth in terms of hardness and flexural modulus. Materials. 2021;14:1182. DOI: https://doi.org/10.3390/ma14051182
Facenda JC, Borba M, Corazza PH. A literature review on the new polymer-infiltrated ceramic-network material (PICN). J Esthet Restor Dent. 2018;30:281–6. DOI: https://doi.org/10.1111/jerd.12370
Zhang J, Pou P, Hodásová L, Yarahmadi M, Elizalde S, Cabrera J-M, et al. Polymer-infiltrated ceramic network produced by direct ink writing: the effects of manufacturing design on mechanical properties. Ceramics. 2024;7:436–51. DOI: https://doi.org/10.3390/ceramics7020028
Leung BT, Tsoi JK, Matinlinna JP, Pow EH. Comparison of mechanical properties of three machinable ceramics with an experimental fluorophlogopite glass ceramic. J Prosthet Dent. 2015;114:440–6. DOI: https://doi.org/10.1016/j.prosdent.2015.02.024
Ali MH, Majeed MA. Milling versus printing: the effect of fabrication technique on the trueness and fitness of fabricated crowns (a comparative in vitro study). Prosthesis. 2025;7:107. DOI: https://doi.org/10.3390/prosthesis7050107
Abduo J, Lyons K, Bennamoun M. Trends in computer-aided manufacturing in prosthodontics: a review of the available streams. Int J Dent. 2014;2014:783948. DOI: https://doi.org/10.1155/2014/783948
Rekow D, Thompson VP. Near-surface damage – a persistent problem in crowns obtained by computer-aided design and manufacturing. Proc Inst Mech Eng H. 2005;219:233–43. DOI: https://doi.org/10.1243/095441105X9363
Ellakany P, Fouda SM, Mahrous AA, AlGhamdi MA, Aly NM. Influence of CAD/CAM milling and 3D-printing fabrication methods on the mechanical properties of 3-unit interim fixed dental prosthesis after thermo-mechanical aging process. Polymers. 2022;14:4103. DOI: https://doi.org/10.3390/polym14194103
Pajaziti A, Tafilaj O, Gjelaj A, Berisha B. Optimization of toolpath planning and CNC machine performance in time-efficient machining. Machines. 2025;13:65. DOI: https://doi.org/10.3390/machines13010065
Kumar R, Sharma S, Kumar R, Verma S, Rafighi M. Review of lubrication and cooling in computer numerical control (CNC) machine tools: a content and visualization analysis, research hotspots and gaps. Sustainability. 2023;15:4970. DOI: https://doi.org/10.3390/su15064970
Pilecco RO, Machry RV, Baldi A, Tribst JPM, Sarkis-Onofre R, Valandro LF, et al. Influence of CAD-CAM milling strategies on the outcome of indirect restorations: a scoping review. J Prosthet Dent. 2024;131:811.e1–.e10. DOI: https://doi.org/10.1016/j.prosdent.2024.02.021
International Organization for Standardization. Accuracy (trueness and precision) of measurement methods and results – part 1: general principles and definitions. (ISO Standard No 5725-1:2023). 2023.
Pacquet W, Tapie L, Mawussi B, Boitelle P. Volumetric and dimensional accuracy assessment of CAD-CAM-manufactured dental prostheses from different materials. J Prosthet Dent. 2023;129:150–9. DOI: https://doi.org/10.1016/j.prosdent.2021.05.024
Orgev A, Li R, Yilmaz B, Cakmak G. Trueness, precision, and internal fit of additively and subtractively manufactured definitive resin-based crowns. J Prosthodont. 2025;2025:1–8. DOI: https://doi.org/10.1111/jopr.14065
Denry I. How and when does fabrication damage adversely affect the clinical performance of ceramic restorations? Dent Mater. 2013;29:85–96. DOI: https://doi.org/10.1016/j.dental.2012.07.001
Aliyu AAA, Puncreobutr C, Shinjo J, Kuimalee S, Phetrattanarangsi T, Boonchuduang T, et al. Lack of fusion-induced cracking effect on tensile and fatigue behaviours of laser powder-bed fusion-processed Ti-6Al-4V implant. Eng Failure Anal. 2025;168:109095. DOI: https://doi.org/10.1016/j.engfailanal.2024.109095
Brandeburski SBN, Vidal ML, Collares K, Zhang Y, Della Bona A. Edge chipping test in dentistry: a comprehensive review. Dent Mater. 2020;36:e74–84. DOI: https://doi.org/10.1016/j.dental.2020.01.019
Fischer H, Schäfer M, Marx R. Effect of surface roughness on flexural strength of veneer ceramics. J Dent Res. 2003;82:972–5. DOI: https://doi.org/10.1177/154405910308201207
Quirynen M, Bollen CM. The influence of surface roughness and surface-free energy on supra- and subgingival plaque formation in man. A review of the literature. J Clin Periodontol. 1995;22:1–14. DOI: https://doi.org/10.1111/j.1600-051X.1995.tb01765.x
Rashid H. The effect of surface roughness on ceramics used in dentistry: a review of literature. Eur J Dent. 2014;8:571–9. DOI: https://doi.org/10.4103/1305-7456.143646
Kalia P, Nair KC, Jaiswal D, Tikmani C, Banerjee D, Bera R. A comparative study on the effect of polishing systems on the color and surface texture of different porcelain systems – feldspathic, pressable, and computer-aided design/computer-aided manufacturing. J Indian Prosthodont Soc. 2021;21:173–9. DOI: https://doi.org/10.4103/jips.jips_425_20
Liu X, Cameron AB, Haugli KH, Mougios AA, Heng NCK, Choi JJE. Influence of CAD/CAM diamond bur wear on the accuracy and surface roughness of dental ceramic restorations: a systematic review. J Mech Behav Biomed Mater. 2025;161:106813. DOI: https://doi.org/10.1016/j.jmbbm.2024.106813
Franke J, Koutecký T, Koutný D. Comparison of sublimation 3D scanning sprays in terms of their effect on the resulting 3D scan, thickness, and sublimation time. Materials. 2023;16:6165. DOI: https://doi.org/10.3390/ma16186165
Schaefer O, Watts DC, Sigusch BW, Kuepper H, Guentsch A. Marginal and internal fit of pressed lithium disilicate partial crowns in vitro: a three-dimensional analysis of accuracy and reproducibility. Dent Mater. 2012;28:320–6. DOI: https://doi.org/10.1016/j.dental.2011.12.008
Liu X, Cameron AB, Haugli KH, Mougios AA, Heng NCK, Choi JJE. Accuracy of lithium disilicate and polymer-infiltrated ceramic-network (PICN) ceramic restorations fabricated from subtractive manufacturing: a systematic review of in vitro studies. J Dent. 2025;161:105872. DOI: https://doi.org/10.1016/j.jdent.2025.105872
Cameron AB, Choi JJE, Ip A, Lyons N, Yaparathna N, Dehaghani AE, et al. Assessment of the trueness of additively manufactured mol3% zirconia crowns at different printing orientations with an industrial and desktop 3D printer compared to subtractive manufacturing. J Dent. 2024;144:104942. DOI: https://doi.org/10.1016/j.jdent.2024.104942
Nawafleh NA, Mack F, Evans J, Mackay J, Hatamleh MM. Accuracy and reliability of methods to measure marginal adaptation of crowns and FDPs: a literature review. J Prosthodont. 2013;22:419–28. DOI: https://doi.org/10.1111/jopr.12006
Feldhausen T, Heinrich L, Saleeby K, Burl A, Post B, MacDonald E, et al. Review of computer-aided manufacturing (CAM) strategies for hybrid directed energy deposition. Addit Manuf. 2022;56:102900. DOI: https://doi.org/10.1016/j.addma.2022.102900
Alsoufi MS, Bawazeer SA. Predictive modeling of surface integrity and material removal rate in computer numerical control machining: effects of thermal conductivity and hardness. Materials. 2025;18:1557. DOI: https://doi.org/10.3390/ma18071557
Shajari S, Sadeghi MH, Hassanpour H. The influence of tool path strategies on cutting force and surface texture during ball end milling of low curvature convex surfaces. ScientificWorldJournal. 2014;2014:374526. DOI: https://doi.org/10.1155/2014/374526
Kim T, Sarma SE. Toolpath generation along directions of maximum kinematic performance; a first cut at machine-optimal paths. Comput Aided Des. 2002;34:453–68. DOI: https://doi.org/10.1016/S0010-4485(01)00116-6
Sadílek M, Poruba Z, Čepová L, Šajgalík M. Increasing the accuracy of free-form surface multiaxis milling. Materials. 2020;14:25. DOI: https://doi.org/10.3390/ma14010025
Zhang X, Zhang J, Zheng X, Pang B, Zhao W. Tool orientation optimization of 5-axis ball-end milling based on an accurate cutter/workpiece engagement model. CIRP J Manuf Sci Technol. 2017;19:106–16. DOI: https://doi.org/10.1016/j.cirpj.2017.06.003
O’Toole L, Kang CW, Fang FZ. Precision micro-milling process: state of the art. Adv Manuf. 2021;9:173–205. DOI: https://doi.org/10.1007/s40436-020-00323-0
Kundu A, Nogueira Campos MG, Santra S, Rajaraman S. Precision vascular delivery of agrochemicals with micromilled microneedles (µMMNs). Sci Rep. 2019;9:14008. DOI: https://doi.org/10.1038/s41598-019-50386-8
Chan T-C, Chang C-C, Ullah A, Lin H-H. Study on kinematic structure performance and machining characteristics of 3-axis machining center. Appl Sci. 2023;13:4742. DOI: https://doi.org/10.3390/app13084742
Wang Y, Ji L, Dong J, Liu M, Liu J. Research on continuous machining strategy for five-axis machine tool: five-axis linkage to four-axis linkage. Appl Sci. 2023;13:7038. DOI: https://doi.org/10.3390/app13127038
Makulavičius M, Petkevičius S, Rožėnė J, Dzedzickis A, Bučinskas V. Industrial robots in mechanical machining: perspectives and limitations. Robotics. 2023;12:160. DOI: https://doi.org/10.3390/robotics12060160
Ji Y, Wang L, Song Y, Wang H, Liu Z. Investigation of robotic milling chatter stability prediction under different cutter orientations by an updated full-discretization method. J Sound Vib. 2022;536:117150. DOI: https://doi.org/10.1016/j.jsv.2022.117150
Zhu Y, Chen Z-T, Ning T, Xu R-F. Tool orientation optimization for 3+2-axis CNC machining of sculptured surface. Comput Aided Des. 2016;77:60–72. DOI: https://doi.org/10.1016/j.cad.2016.02.007
Salem B, Mkaddem A, Ghazali S, Habak M, Felemban BF, Jarraya A. Towards an advanced modeling of hybrid composite cutting: heat discontinuity at interface region. Polymers. 2023;15:1955. DOI: https://doi.org/10.3390/polym15081955
Müller M, Hrabě P. Overlay materials used for increasing lifetime of machine parts working under conditions of intensive abrasion. Rec Agric Eng. 2013;59:16–22. DOI: https://doi.org/10.17221/64/2011-RAE
Tutunea-Fatan OR, Feng H-Y. Configuration analysis of five-axis machine tools using a generic kinematic model. Int J Mach Tools Manuf. 2004;44:1235–43. DOI: https://doi.org/10.1016/j.ijmachtools.2004.03.009
Varga J, Tóth T, Kaščák Ľ, Spišák E. The effect of the machining strategy on the surface accuracy when milling with a ball end cutting tool of the aluminum alloy AlCu4Mg. Appl Sci. 2022;12:10638. DOI: https://doi.org/10.3390/app122010638
Olejnik P, Desta YD. Friction-induced interactions: acoustic emissions, vibrations, and wear – a multiscale review. Nonlinear Dyn. 2025;113:24101–40. DOI: https://doi.org/10.1007/s11071-025-11397-5
Colling C, Schumacher A, Mecking K. Level-set-based topology optimization of threedimensional structures considering the manufacturing process with realistic milling tools. Struct Multidiscipl Optim. 2024;67:204. DOI: https://doi.org/10.1007/s00158-024-03928-2
Ram SM, Ranadive NN, Nadgere JB. Microcomputed tomography a noninvasive method to evaluate the fit of a restoration as compared to conventional replica technique. J Indian Prosthodont Soc. 2019;19:233–9. DOI: https://doi.org/10.4103/jips.jips_71_19
Feng K, Long J, Zhang F, Li C, Wu Z, Zhang M, et al. Research on the construction method of mechanical model for micro-hole drilling based on compression characteristics of contact area. J Manuf Process. 2024;131:1404–22. DOI: https://doi.org/10.1016/j.jmapro.2024.09.102
Zhang X, Yu T, Wang W. Modeling, simulation, and optimization of five-axis milling processes. Int J Adv Manuf Technol. 2014;74:1611–24. DOI: https://doi.org/10.1007/s00170-014-6075-1
Azarbal A, Azarbal M, Engelmeier RL, Kunkel TC. Marginal fit comparison of CAD/CAM crowns milled from two different materials. J Prosthodont. 2018;27:421–8. DOI: https://doi.org/10.1111/jopr.12683
Turkyilmaz I, Wilkins GN, Yun S. Moving from analogue to digital workflows in dentistry: understanding undermilling and overmilling as detrimental factors in fabricating CAD/CAM crowns. Prim Dent J. 2022;11:59–61. DOI: https://doi.org/10.1177/20501684221100938
Elsherbini A, Fathy SM, Al-Zordk W, Özcan M, Sakrana AA. Mechanical performance and surface roughness of lithium disilicate and zirconia-reinforced lithium silicate ceramics before and after exposure to acidic challenge. Dent J. 2025;13:117. DOI: https://doi.org/10.3390/dj13030117
Nascimento VA, Bento VAA, Cruz KH, Silva LS, Pesqueira AA, Pellizzer EP. Color stability and surface roughness of resin-ceramics with different surface treatments: a systematic review and meta-analysis of in vitro studies. J Prosthet Dent. 2025;134:72–84. DOI: https://doi.org/10.1016/j.prosdent.2023.08.023
El Zhawi H, Kaizer MR, Chughtai A, Moraes RR, Zhang Y. Polymer infiltrated ceramic network structures for resistance to fatigue fracture and wear. Dent Mater. 2016;32:1352–61. DOI: https://doi.org/10.1016/j.dental.2016.08.216
Saleh Ismail H, Ibrahim Ali A. The effect of finishing and polishing systems on surface roughness and microbial adhesion of bulk fill composites: a systematic review and meta-analysis. Front Dent. 2023;20:26. DOI: https://doi.org/10.18502/fid.v20i26.13344
Abellán-Nebot JV, Vila Pastor C, Siller HR. A review of the ractors influencing surface roughness in machining and their impact on sustainability. Sustainability. 2024;16:1917. DOI: https://doi.org/10.3390/su16051917
Wan B, Shahmoradi M, Zhang Z, Shibata Y, Sarrafpour B, Swain M, et al. Modelling of stress distribution and fracture in dental occlusal fissures. Sci Rep. 2019;9:4682. DOI: https://doi.org/10.1038/s41598-019-41304-z
Mehl C, Harder S, Steiner M, Vollrath O, Kern M. Influence of cement film thickness on the retention of implant-retained crowns. J Prosthodont. 2013;22:618–25. DOI: https://doi.org/10.1111/jopr.12058
Abdalla MM, Ali IAA, Khan K, Mattheos N, Murbay S, Matinlinna JP, et al. The influence of surface roughening and polishing on microbial biofilm development on different ceramic materials. J Prosthodont. 2021;30:447–53. DOI: https://doi.org/10.1111/jopr.13260
Denkena B, Krödel-Worbes A, Müller-Cramm D. Wear-adaptive optimization of in-process conditioning parameters during face plunge grinding of PcBN. Sci Rep. 2022;12:1012. DOI: https://doi.org/10.1038/s41598-022-05066-5
Song X-F, Kang N, Yin L. Effect of bur selection on machining damage mechanisms of polymer-infiltrated ceramic network material for CAD/CAM dental restorations. Ceram Int. 2020;46:23116–26. DOI: https://doi.org/10.1016/j.ceramint.2020.06.089
Ahmed AA, Owen CP. A base-line study of the wear of burs used for chairside milling of ceramic crowns of different hardness: effect on internal fit and surface roughness. S Afr Dent J. 2020;75:534–40. DOI: https://doi.org/10.17159/2519-0105/2020/v75no10a1
Simba BG, Alves MFRP, Villela TF, Ribeiro MV, Strecker K, dos Santos C. Impact of diamond tool wear on the surface finish of lithium silicate glass ceramics machined with the assistance of CAD/CAM systems. J Braz Soc Mech Sci Eng. 2023;45:42. DOI: https://doi.org/10.1007/s40430-022-03952-7
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Xiaoyun Liu, Andrew B. Cameron, Ketil Hegerstrøm Haugli, Adriane Andersen Mougios, Nicholas C. K. Heng, Joanne Jung Eun Choi

This work is licensed under a Creative Commons Attribution 4.0 International License.
Biomaterial Investigations in Dentistry is a Diamond Open Access peer-reviewed journal, publishing research in oral biomaterials science. The publishing of articles is free for authors, thanks to the support of Acta Odontologica Scandinavica Society (AOSS), a not-for-profit society. 
