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Lemaire S, Bouby C, Thiebaud F, Berry-Kromer V. Prosthetic framework improvement using lattice structure: A comparative finite element study of a mandibular implant-supported prosthesis. J Mech Behav Biomed Mater 2024; 155:106538. [PMID: 38608345 DOI: 10.1016/j.jmbbm.2024.106538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVES An alternative option was proposed regarding the prosthetic rehabilitation of a fully edentulous mandible using only four implants. The aim was to reduce the stiffness of the prosthetic framework. To that end, the alternative option consists of a prosthetic framework optimized with a porous structure. Mechanical differences were analyzed between non-prosthetic mandible and restored mandible either with a conventional bulk titanium framework or with this alternative option. The non-prosthetic mandible corresponds to the mandible in its natural state, without prosthesis. This will be considered as the reference for comparison with restored models (mandible with prosthesis). METHODS Three models are used: the first one is the non-prosthetic mandible, the second one is the restored mandible with conventional bulk titanium prosthetic framework, and the third one is the alternative option. Prosthetic framework was optimized with the use of a lattice structure. A numerical analysis was performed (with Abaqus Standard software®) to obtain the effective parameters corresponding to equivalent homogeneous behavior. In the 3 models, physiological boundary conditions were used, considering the activity of several muscles of the masticatory system during three main tasks of mastication (incisive clenching, maximum intercuspation and unilateral molar clenching). RESULTS Numerical simulations allowed to obtain mandibular global kinematics, local displacement at the bone-implant interface and the state of strain at the bone-implant interface, for each masticatory tasks. For this comparative study, the non-prosthetic mandible model was used as a reference to observe the benefits of using a lattice prosthetic framework compared to a conventional bulk titanium framework. CONCLUSION Compared to conventional titanium framework, the lattice prosthetic one appeared to be more respectful of the natural mandible kinematics, given by the reference model. It also resulted in strain values within the physiological loading range.
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Affiliation(s)
- Samuel Lemaire
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3, Nancy, F-54500, France.
| | - Céline Bouby
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3, Nancy, F-54500, France
| | - Frédéric Thiebaud
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3, Nancy, F-54500, France
| | - Valérie Berry-Kromer
- Université de Lorraine, CNRS, Arts et Métiers ParisTech, LEM3, Nancy, F-54500, France
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Dönmez MB, Çakmak G, Güven ME, Dede DÖ, Abou-Ayash S, Yilmaz B. Fatigue behavior of implant-supported cantilevered prostheses in recently introduced CAD-CAM polymers: An in vitro study. J Prosthet Dent 2024:S0022-3913(24)00306-8. [PMID: 38760311 DOI: 10.1016/j.prosdent.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/29/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024]
Abstract
STATEMENT OF PROBLEM Cantilevered complete arch implant-supported prostheses are commonly fabricated from zirconia and more recently from strength gradient zirconia. Different polymer-based materials indicated for definitive fixed prostheses that could be used with additive or subtractive manufacturing have also been marketed recently. However, knowledge on the long-term fatigue behavior of cantilevered implant-supported prostheses made from these polymer-based materials and strength gradient zirconia is lacking. PURPOSE The purpose of this in vitro study was to evaluate the fatigue behavior of implant-supported cantilevered prostheses of recently introduced computer-aided design and computer-aided manufacturing polymers and zirconia. MATERIAL AND METHODS A master standard tessellation language file of a 9×11×20-mm specimen with a titanium base (Ti-base) space that represented an implant-supported cantilevered prosthesis was used to fabricate specimens from additively manufactured interim resin (AM), polymethyl methacrylate (SM-PM), nanographene-reinforced polymethyl methacrylate (SM-GR), high-impact polymer composite resin (SM-CR), and strength gradient zirconia (SM-ZR) (n=10). Each specimen was prepared by following the respective manufacturer's recommendations, and Ti-base abutments were cemented with an autopolymerizing luting composite resin. After cementation, the specimens were mounted in a mastication simulator and subjected to 1.2 million loading cycles under 100 N at 1.5 Hz; surviving specimens were subjected to another 1.2 million loading cycles under 200 N at 1.5 Hz. The load was applied to the cantilever extension, 12-mm from the clamp of the mastication simulator. The Kaplan-Meier survival analysis and Cox proportional hazards model were used to evaluate the data (α=.05). RESULTS Significant differences in survival rate and hazard ratio were observed among materials (P<.001). Among tested materials, SM-ZR had the highest and AM had the lowest survival rate (P≤.031). All materials had a significantly higher hazard ratio than SM-ZR (P≤.011) in the increasing order of SM-GR, SM-PM, SM-CR, and AM. CONCLUSIONS SM-ZR had the highest survival rate with no failed specimens. Even though most of the tested polymer-based materials failed during cyclic loading, these failures were commonly observed during the second 1.2 million loading cycles with 200 N. All materials had a higher hazard ratio than SM-ZR.
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Affiliation(s)
- Mustafa Borga Dönmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey; and ITI Scholar, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Gülce Çakmak
- Senior Resarch Associate, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mehmet Esad Güven
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Doğu Ömür Dede
- Professor, Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Samir Abou-Ayash
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
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Barbin T, Borges GA, Jardini AL, Mesquita MF. Hot isostatic pressing as an alternative thermo-mechanical treatment for metallic full-arch implant-supported frameworks obtained by additive and subtractive manufacturing technology: Vertical and horizontal fit, screw removal torque, and stress analysis. J Prosthodont 2024. [PMID: 38513224 DOI: 10.1111/jopr.13842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 02/05/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE To assess vertical and horizontal fit, screw removal torque, and stress analysis (considered biomechanical aspects) of full-arch implant frameworks manufactured in Ti-6Al-4V through milling, and additive manufacturing Direct Metal Laser Sintering (DMLS) and Electron Beam Melting (EBM), and the effect of the thermo-mechanical treatment Hot Isostatic Pressing (HIP) as a post-treatment after manufacturing. MATERIAL AND METHODS Maxillary full-arch implant frameworks were made by milling, DMLS, and EBM. The biomechanical assessments were screw removal torque, strain-gauge analyses, and vertical and horizontal marginal fits. The vertical fit was assessed by the single-screw test and with all screws tightened. All frameworks were submitted to a standardized HIP cycle (920°C, 1000 bar pressure, 2 h), and the tests were repeated (α = 0.05). RESULTS At the initial time, milled frameworks presented higher screw removal torque values, and DMLS and EBM frameworks presented lower levels of strain. Using the single-screw test, milled and DMLS frameworks presented higher vertical fit values, and with all screws tightened and horizontally, higher fit values were found for milled frameworks, followed by DMLS and EBM. After HIP, milling and EBM frameworks presented higher screw removal torque values; the lowest strain values were found for EBM. Using the single-screw test, milled and DMLS frameworks presented higher vertical fit values, and with all screws tightened and horizontally no differences were found. CONCLUSIONS DMLS and EBM full-arch frameworks presented adequate values of screw removal torque, strain, and marginal fit, although the worst values of marginal fit were found for EBM frameworks. The HIP cycle enhanced the screw removal torque of milled and EBM frameworks and reduced the strain values of milled frameworks. The HIP represents a reliable post-treatment for Ti-6Al-4V dental prostheses produced by milling and EBM technologies.
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Affiliation(s)
- Thaís Barbin
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Guilherme Almeida Borges
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - André Luiz Jardini
- National Institute of Biofabrication, School of Chemical Engineering, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Marcelo Ferraz Mesquita
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
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Atsu S, Erol U. Marginal fit and fracture resistance of polyetheretherketone, zirconia, and titanium implant-supported prosthesis frameworks for a partially edentulous arch after thermomechanical aging. J Prosthet Dent 2024; 131:273-280. [PMID: 37620182 DOI: 10.1016/j.prosdent.2023.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/26/2023]
Abstract
STATEMENT OF PROBLEM Although polyetheretherketone (PEEK) and zirconia (Zir) have been used as implant-supported prosthesis (ISP) frameworks, the long-term effects of thermomechanical aging on the marginal fit and fracture resistance of PEEK and Zir ISP frameworks with titanium (Ti) bases for patients with a partially edentulous arch are not clear. PURPOSE The purpose of this in vitro study was to determine the marginal fit and fracture resistance of PEEK and Zir ISP frameworks with Ti bases and Ti ISP frameworks for partially edentulous arches after aging. MATERIAL AND METHODS A total of 30 ISP epoxy resin casts were obtained from a typodont with 1 straight implant (Nobel Biocare) in the mandibular right canine region and 1 implant with a 30-degree distal tilt in the mandibular right first molar region. All frameworks (n=10) were fabricated on their own epoxy resin cast with multiunit abutment replicas by using a computer-aided design and computer-aided manufacturing system (exocad-Yenadent). The PEEK and Zir frameworks were fabricated with Ti-bases. Primer (MKZ) and resin cement (DTK adhesive) were used to cement the frameworks to the Ti-bases under a static load of 10 N. After thermomechanical aging (1.2×106 cycles, 120 N, 5 °C-55 °C), marginal gaps between the Ti-bases and cemented frameworks and vertical and passive fits between the Ti-bases and framework and multi-unit abutments were measured by using a stereomicroscope (Euromex) at ×100 magnification. Fracture resistances and types were then determined by using a universal test machine and a stereomicroscope at ×40 magnification. Data were analyzed by using 1-way analysis of variance (ANOVA) and the Tukey HSD and Fisher-Freeman-Halton tests (α=.05). RESULTS The marginal gaps of the PEEK and Zir frameworks were respectively 83.5 ±27.1 and 81.8 ±17.8 µm. PEEK (23.7 ±4.6) and Zir (32.9 ±8.7) had a better vertical fit (µm) than Ti (52.5 ±10.6) (P<.001). Zir (49.3 ±16.2) (P<.001) and PEEK (70.9 ±19.6) (P>.05) frameworks had better passive fit (µm) than Ti (91.3 ±24.2). Ti had the highest mean fracture resistance (N) (14800.2 ±3442.3) followed by Zir (7318.7 ±1385.1) and PEEK (3448.9 ±486.6) (P<.001). Fracture types were different in different groups (P<.001). CONCLUSIONS The PEEK and Zir frameworks with Ti bases had better vertical and passive fit than the Ti frameworks. All ISP frameworks represented mean marginal fit below 92 µm and withstood physiologic occlusal forces after thermomechanical aging.
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Affiliation(s)
- Saadet Atsu
- Professor, Research Assistant, Department of Prosthodontics, Faculty of Dentistry, University of Kırıkkale, Kırıkkale, Turkey; Visiting Professor, Materials Engineering, McGill University, Montreal, Canada..
| | - Ulas Erol
- Professor, Research Assistant, Department of Prosthodontics, Faculty of Dentistry, University of Kırıkkale, Kırıkkale, Turkey
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Borga Donmez M, Çakmak G, Schimmel M, Yilmaz B. Implementation of triple-scan protocol to evaluate the fit of complete-arch implant-supported fixed prostheses. J Prosthodont 2024. [PMID: 38291720 DOI: 10.1111/jopr.13830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024] Open
Abstract
Passive fit is essential for multiple-unit implant-supported prostheses. Conventional methods to assess the passivity of complete-arch implant-supported prostheses do not allow 3-dimensional (3D) visualization and quantification of misfit. This report describes the marginal and internal fit evaluation of a complete-arch implant-supported prosthesis by using the triple-scan protocol involving a scanner and a 3D analysis freeware. This technique allows researchers, clinicians, or dental technicians to detect and quantify 3D prosthetic misfit, which may facilitate the preparation for dental appointments and objective measurement of misfit for research studies.
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Affiliation(s)
- Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Ohio, USA
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Donmez MB, Çakmak G, Dede DÖ, Küçükekenci AS, Lu WE, Schumacher FL, Revilla-León M, Yilmaz B. Effect of scan powder and scanning technology on measured deviations of complete-arch implant supported frameworks digitized with industrial and intraoral scanners. J Dent 2023; 138:104736. [PMID: 37802291 DOI: 10.1016/j.jdent.2023.104736] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/08/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023] Open
Abstract
OBJECTIVES To evaluate the suitability of intraoral scanners (IOSs) to analyze the fabrication trueness of titanium complete-arch implant-supported frameworks by comparing with an industrial-grade scanner and investigate how anti-reflective scan powder affects measured deviations. METHODS Ten titanium complete-arch implant-supported frameworks were milled from a reference standard tessellation language (STL) file. An industrial-grade blue light scanner (ATOS Core 80 (AT)) and three IOSs (Primescan (PS), TRIOS T3 (T3), and TRIOS T4 (T4)) with (PS-P, T3-P, and T4-P) or without (PS, T3, and T4) anti-reflective scan powder application were used to generate test STL (TSTL) files of the frameworks. Reference STL and TSTLs were imported into a metrology-grade analysis software (Geomagic Control X) and whole surface root mean square (RMS) values were calculated. Another software (Medit Link v 2.4.4) was used to virtually isolate marginal surfaces of all STL files and marginal RMS values were calculated by using the same metrology-grade analysis software. A linear mixed effects model was used to compare the transformed deviations of the scans performed by using each IOS (with or without powder) with the deviations of those performed by using the reference AT scanner within each surface, where a Box-Cox type transformation was used for variance stability. Bonferroni corrected post-hoc tests were used to compare conditions within each IOS (α=0.05). RESULTS All IOSs had significantly higher whole surface and marginal RMS values than AT, regardless of the condition (P≤.002). However, scan powder application did not affect the whole surface and marginal RMS values in scans of tested IOSs (P≥.054). CONCLUSION Measured whole surface and marginal deviations in all IOS scans performed with or without the use of scan powder were higher than those in AT scans. The application of anti-reflective scan powder did not affect the deviations in scans of tested IOSs. CLINICAL SIGNIFICANCE Even though deviations measured in the scans of tested scanners were significantly different than those in the reference scanner, the maximum raw mean difference was 37.33 µm and the maximum raw confidence interval value of estimated differences was 47.88 µm, which can be considered clinically small taking into account the size of the frameworks tested. Therefore, tested intraoral scanners may be feasible to scan prostheses similar to or smaller than tested frameworks for fabrication trueness analysis, which may facilitate potential clinical adjustments.
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Affiliation(s)
- Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Doğu Ömür Dede
- Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | | | - Wei-En Lu
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Fernanda Lang Schumacher
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Washington, USA; Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Yilmaz B, Dede DÖ, Donmez MB, Küçükekenci AS, Lu WE, Schumacher FL, Çakmak G. Comparison of intraoral and laboratory scanners to an industrial-grade scanner while analyzing the fabrication trueness of polymer and titanium complete-arch implant-supported frameworks. J Dent 2023; 138:104697. [PMID: 37696469 DOI: 10.1016/j.jdent.2023.104697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES To compare the scans of different intraoral scanners (IOSs) and laboratory scanners (LBSs) to those of an industrial-grade optical scanner by measuring deviations of complete-arch implant-supported frameworks from their virtual design file. MATERIAL AND METHODS Ten polyetheretherketone (PEEK) and 10 titanium (Ti) complete-arch implant-supported frameworks were milled from a master standard tessellation language (STL) file. An industrial-grade blue light scanner (AT), 2 LBSs (MT and E4), and 3 IOSs (PS, T3, and T4) were used to generate STL files of these frameworks. All STLs were imported into an analysis software (Geomagic Control X) and overall root mean square (RMS) values were calculated. Marginal surfaces of all STL files were then virtually isolated (Medit Link v 2.4.4) and marginal RMS values were calculated. Deviations in scans of tested scanners were compared with those in scans of AT by using a linear mixed effects model (α = 0.05). RESULTS When the scans of PEEK frameworks were considered, PS and T3 had similar overall RMS to those of AT (p ≥ .076). However, E4 and T4 had higher and MT had lower overall RMS than AT (p ≤ .002) with a maximum estimated mean difference of 13.41 µm. When the scans of Ti frameworks were considered, AT had significantly lower overall RMS than tested scanners (p ≤ .010) with a maximum estimated mean difference of 31.35 µm. Scans of tested scanners led to significantly higher marginal RMS than scans of AT (p ≤ .006) with a maximum estimated mean difference of 53.90 µm for PEEK and 40.50 µm for Ti frameworks. CONCLUSION Only the PEEK framework scans of PS and T3 led to similar overall deviations to those of AT. However, scans of all tested scanners resulted in higher marginal deviations than those of AT scans. CLINICAL SIGNIFICANCE Scans performed by using PS and T3 may be alternatives to those of tested reference industrial scanner AT, for the overall fabrication trueness analysis of complete-arch implant-supported PEEK frameworks.
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Affiliation(s)
- Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, OH, USA
| | - Doğu Ömür Dede
- Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey.
| | | | - Wei-En Lu
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Fernanda Lang Schumacher
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Dede DÖ, Çakmak G, Donmez MB, Küçükekenci AS, Lu WE, Ni AA, Yilmaz B. Effect of analysis software program on measured deviations in complete arch, implant-supported framework scans. J Prosthet Dent 2023:S0022-3913(23)00436-5. [PMID: 37596157 DOI: 10.1016/j.prosdent.2023.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 08/20/2023]
Abstract
STATEMENT OF PROBLEM Implementation of fabrication trueness analysis by using a recently introduced nonmetrology-grade freeware program may help clinicians and dental laboratory technicians in their routine practice. However, knowledge of the performance of this freeware program when compared with the International Organization for Standardization recommended metrology-grade analysis software program is limited. PURPOSE The purpose of this in vitro study was to evaluate the effect of an analysis software program on measured deviations in the complete arch, implant-supported framework scans. MATERIAL AND METHODS A total of 20 complete arch, implant-supported frameworks were fabricated from a master standard tessellation language (STL) file from either polyetheretherketone (PEEK) or titanium (Ti) (n=10). All frameworks were then digitized by using different scanners to generate test STLs. All STL files were imported into a nonmetrology-grade freeware program (Medit Link) and a metrology-grade software program (Geomagic Control X) to measure the overall and marginal deviations of frameworks from the master STL file by using the root mean square (RMS) method. Data were analyzed by using the two 1-sided paired t test procedure, in which 50 µm was considered as the minimal clinically meaningful difference (α=.05). RESULTS When overall RMS values were considered, the nonmetrology-grade freeware program was not inferior to the metrology-grade software program (P<.05). When marginal RMS values were considered, the nonmetrology-grade freeware program was inferior to the metrology-grade software program only when PEEK frameworks were scanned with an E4 laboratory scanner (P>.05). CONCLUSIONS The use of the tested nonmetrology-grade freeware program resulted in overall deviation measurements similar to those when a metrology-grade software program was used. The freeware program was inferior when marginal deviations were analyzed on E4 scans of a PEEK framework, which was the only scanner-material pair that led to a significant difference, among the 15 pairs tested.
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Affiliation(s)
- Doğu Ömür Dede
- Department of Prosthodontics, Ordu University, Ordu, Turkey
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey.
| | | | - Wei-En Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Andy Ai Ni
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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Çakmak G, Jutzi D, Donmez MB, Kahveci Ç, de Paula MS, Schimmel M, Yilmaz B. Effect of number of supports and build angle on the fabrication and internal fit accuracy of additively manufactured definitive resin-ceramic hybrid crowns. J Dent 2023; 134:104548. [PMID: 37192693 DOI: 10.1016/j.jdent.2023.104548] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/03/2023] [Accepted: 05/12/2023] [Indexed: 05/18/2023] Open
Abstract
OBJECTIVES To evaluate the effect of number of supports and build angle on the fabrication and internal fit accuracy (trueness and precision) of additively manufactured resin-ceramic hybrid crowns. METHODS A mandibular first molar crown was designed and nested on the build platform of a printer either with a 30° angle between the occlusal surface and the build platform (BLS (less support) and BMS (more support)) or its occlusal surface parallel to the build platform (VLS (less support) and VMS (more support)) to fabricate additively manufactured resin-ceramic hybrid crowns (n=14). After fabrication, supports were removed by a blinded operator and all crowns were digitized with an intraoral scanner. Fabrication accuracy (overall, external, intaglio occlusal, occlusal, and marginal) was evaluated by using root mean square (RMS) method, while internal fit was evaluated with triple scan method. RMS, average gap, and precision of these data were analyzed (α= .05). RESULTS VLS had higher overall deviations than BLS and VMS (P≤.039). VMS had higher occlusal deviations than BLS (P=.033). While BMS and BLS had higher marginal deviations than VLS (P≤.006), BMS also had higher values than VMS (P=.012). BLS led to higher precision than VMS (intaglio occlusal and occlusal surfaces) and VLS (occlusal surface) (P≤.008). VLS led to higher precision than BMS (marginal surface) (P=.027). Average gap values were similar (P=.723); however, BLS resulted in higher precision than VLS (P=.018). CONCLUSIONS Considering their high marginal and occlusal surface trueness, and similar internal occlusal deviations and average gaps (trueness), clinical fit of resin-ceramic hybrid crowns fabricated with tested parameters may be similar. Reduced number of supports and angled orientation may lead to higher precision of fit. CLINICAL SIGNIFICANCE Tested resin-ceramic hybrid-printer pair may be used to fabricate crowns with reduced number of supports to maintain occlusal surface integrity without compromising the fabrication accuracy and fit.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Dino Jutzi
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Donmez
- Department of Prosthodontics, Istinye University, Faculty of Dentistry, Istanbul, Turkey; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Çiğdem Kahveci
- Department of Prosthodontics, Giresun University Faculty of Dentistry, Giresun, Turkey
| | - Marcella Silve de Paula
- Universidade Federal de Goiás (UFG), Department of Prevention and Oral Rehabilitation, Goiânia, Brazil
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Ohio, USA
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Igarashi K, Katagiri H, Abou-Ayash S, Schimmel M, Afrashtehfar KI. Double-Crown Prosthesis Retention Using Polyetherketoneketone (PEKK): An In Vitro Study. J Prosthodont 2023; 32:154-161. [PMID: 35343624 DOI: 10.1111/jopr.13512] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/23/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To assess the retentive force of telescopic crowns using polyetherketoneketone (PEKK) high-performance polymer in relation to conventional materials over a long period of time in an in vitro setting. MATERIALS AND METHODS Thirty-six sets of primary and secondary crowns were fabricated as per the double crown-retained prostheses approach. Six samples were included in each of the five test groups (1: zirconia/PEKK [Zr/PEKK]; 2: titanium/PEKK [Ti/PEKK]; 3: cobalt-chrome/PEKK [CoCr/PEKK]; 4: PEKK/PEKK; and 5: gold/PEKK [Au/PEKK]) and the single control group (gold/galvano-gold [Au/GA]). The insertion-removal test was performed for 20,000 cycles, and the surface condition was observed. Retentive forces were analyzed using two-way ANOVA (α<0.05). RESULTS The retention forces in groups Zr/PEKK and Ti/PEKK significantly decreased over time (group 1: p = 0.035 and group 2: p = 0.001), whereas retentive force increased significantly in groups PEKK/PEKK, Au/PEKK, and control (group 4: p = 0.001, group 5: p = 0.008, and control: p = 0.042). Similar wear was observed on the primary crown in groups PEKK/PEKK, gold/PEKK, and control. CONCLUSIONS Groups PEKK/PEKK and Au/PEKK showed a transition of retentive force similar to the control group. Groups PEKK/PEKK and Au/PEKK had similar wear on the surface compared to control. Therefore, PEKK has a promising clinical potential.
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Affiliation(s)
- Kensuke Igarashi
- Department of Dental Materials Science, The Nippon Dental University, School of Life Dentistry at Niigata, Niigata, Japan
| | - Hiroki Katagiri
- Advanced Research Center, The Nippon Dental University, School of Life Dentistry at Niigata, Niigata, Japan.,Department of Histology, The Nippon Dental University, School of Life Dentistry at Niigata, Niigata, Japan
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Gerodontology and Removable Prosthodontics, University of Geneva, Geneva, Switzerland
| | - Kelvin I Afrashtehfar
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Clinical Sciences Department, Ajman University College of Dentistry, Ajman Emirate, UAE.,School of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain
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