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Vag J, Romanszky L, Sersli G, DeFee M, Renne W, Mangano F, Borbola D. Application of the virtual-fit method for fixed complete denture cases designed on intraoral scans: Effect of cement spacing. J Dent 2024; 141:104780. [PMID: 37981046 DOI: 10.1016/j.jdent.2023.104780] [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: 06/17/2023] [Revised: 11/04/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVES To validate the virtual-fit alignment, analyze the impact of cement spacing on internal/marginal gaps, and correlate results with conventional trueness measures. METHODS Four dental abutment models were scanned using an industrial reference scanner (one time each), Emerald S (three times each), and Medit i700 (three times each) intraoral scanners (IOS). On each IOS scan (n = 24), three complete-arch fixed frameworks were designed with 70 or 140 µm cement space with no marginal space (groups 70 and 140) and 70 µm with an additional 20 µm space, including the margin (group 70+20). Two types of alignment were performed by GOM Inspect software. The reference and IOS scans were aligned through a conventional iterative closest point algorithm (ICP) where the penetration of the two scans was permitted into each other (conventional trueness method). Second, the computer-aided designs were superimposed with the reference scan also using an ICP, but preventing the design from virtual penetration into the model (virtual-fit method). The virtual-fit algorithm was validated by non-penetration alignment of the designs with the IOS scans. Internal and marginal gap was measured between the design and the abutments. The difference between spacing groups was compared by Friedman's test. A statistical correlation (Spearman's Rho Test) was computed between the measured gaps and the conventional trueness method. A significant difference was accepted at p<0.05 after the Bonferroni correction. RESULTS The gaps deviated from the set cement space by 3-13 µm on IOS scans (validation of virtual-fit algorithm). The internal gap of the design on the reference scan was not affected by cement spacing (Emerald S, p = 0.779; Medit i700, p = 0.205). The marginal gap in groups 70 and 70+20 was significantly lower than in group 140 in Emerald S (p<0.05). In Medit i700, it was lower in the 70+20 group than in the group 70 (p<0.01) and in the group 140 (p<0.05). Some Medit i700 scans exhibited high marginal gaps within group 70 but not in groups 70 and 140. The measured gaps correlated significantly (r = 0.51-0.81, p<0.05-0.001) with the conventional trueness but were 2.6-4.6 times higher (p<0.001). CONCLUSION Virtual-fit alignment can simulate restoration seating. A 20 µm marginal and 90 µm internal spacing could compensate for scan errors up to several hundred micrometers. However, 140 µm internal spacing is counterproductive. The conventional trueness method could only partially predict framework misfit. CLINICAL SIGNIFICANCE The virtual-fit method can provide clinically interpretable data for intraoral scanners. Emerald S and Medit i700 intraoral scanners are suitable for fabricating complete-arch fixed tooth-supported prostheses. In addition, a slight elevation of spacing at the margin could compensate for moderate inaccuracies in a scan.
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Affiliation(s)
- Janos Vag
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest H-1088, Hungary.
| | - Laszlo Romanszky
- Dental Technicians, Artifex Dentis Kft., Révay utca 12, Budapest H-1065, Hungary
| | - Gyorgy Sersli
- Dental Technicians, Artifex Dentis Kft., Révay utca 12, Budapest H-1065, Hungary
| | - Michael DeFee
- Modern Optimized Dentistry Institute, 320 Broad St. #210 Charleston, SC 29401, United States
| | - Walter Renne
- Modern Optimized Dentistry Institute, 320 Broad St. #210 Charleston, SC 29401, United States
| | - Francesco Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, 8-2 Trubetskaya Street, Moscow 119991, Russian Federation
| | - Daniel Borbola
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest H-1088, Hungary
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Bandiaky ON, Clouet R, Le Bars P, Soueidan A, Le Guehennec L. Marginal and internal fit of five-unit zirconia-based fixed dental prostheses fabricated with digital scans and conventional impressions: A comparative in vitro study. J Prosthodont 2023; 32:846-853. [PMID: 36627825 DOI: 10.1111/jopr.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study aimed to compare the marginal and internal fit of five-unit zirconia-based fixed dental prostheses (FDPs) fabricated using digital scans and conventional impressions. MATERIALS AND METHODS Nine master models with three zirconia abutments were scanned with an intraoral scanner (test group), and nine conventional impressions (control group) of these same models were also made. The stone casts from these impressions were scanned with a laboratory extraoral scanner (D700, 3Shape, Copenhagen, Denmark). A total of 18 five-unit zirconia-based FDP frameworks (test group, n = 9; control group, n = 9) were manufactured. Marginal and internal fit (in μm) were evaluated using the replica method under micro-computed tomography. Analysis of variance (one-way ANOVA) and Kruskal-Wallis tests were used to compare continuous variables across two groups. A level of p < 0.05 was accepted as statistically significant. RESULTS The mean ± standard deviation of the marginal fit was 95.03 ± 12.74 μm in the test group and 106.02 ± 14.51 μm in the control group. The lowest marginal mean value was observed in the test group, with a statistically significant difference compared to the control group (F = 14.56, p < 0.05). The mean ± standard deviation of the internal fit was 103.61 ± 9.32 and 106.38 ± 7.64 μm, respectively, in the test and control groups, with no statistically significant difference (F = 1.56, p > 0.05). The mean values of both groups were clinically acceptable. CONCLUSIONS The five-unit zirconia-based FDPs fabricated with digital scans showed better fit than those in the conventional impression group. Within the limitations of this study, these results are encouraging, and continued progress in the digital field should allow for more accurate long-span restorations.
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Affiliation(s)
- Octave Nadile Bandiaky
- Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
| | - Roselyne Clouet
- Department of Prosthetic Dentistry, Nantes University, CHU Nantes, Nantes, France
| | - Pierre Le Bars
- Department of Prosthetic Dentistry, Nantes University, CHU Nantes, Nantes, France
| | - Assem Soueidan
- Department of Periodontology, Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
| | - Laurent Le Guehennec
- Department of Prosthodontics, Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
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Klein M, Tuminelli FJ, Sallustio A, Giglio GD, Lerner H, Berg RW, Waltuch A. Full-arch restoration with the NEXUS IOS® system: A retrospective clinical evaluation of 37 restorations after a one year of follow-up. J Dent 2023; 139:104741. [PMID: 37832627 DOI: 10.1016/j.jdent.2023.104741] [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: 09/07/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVES Report the results with a novel workflow of digital restoration for completely edentulous patients with implant supported full arch fixed dental prostheses (ISFDP). METHODS This multicenter retrospective clinical study was based on the evaluation from a cohort of 29 patients restored with 37 ISFDP designed and manufactured from the data captured by a direct intraoral scan, using a novel full digital system (NEXUS IOS®, Osteon Medical, a Keystone Dental Group company, Melbourne, Australia). Data was collected over a 3-year period, in six different dental centers. This study reported on the clinical parameters including: precision of marginal fit, functional and aesthetic integration of Nexus ISFDP. All patients were followed for a period of one year post delivery. Implant survival, biologic and prosthetic complications were assessed, at one year. A statistical analysis was conducted. RESULTS All 37 ISFDP were deemed clinically acceptable on insertion. Implant survival at one year was 100 %. The biologic and prosthetic complications were minimal during the follow-up period. CONCLUSIONS ISFDP, designed and manufactured using the NEXUS IOS® system, are clinically acceptable, with a low incidence of complications at one year. Long-term clinical studies are needed. STATEMENT OF CLINICAL RELEVANCE Within the limitations of this study (retrospective design, small patient sample, limited follow-up) the NEXUS IOS® system seems to represent a viable solution for the restoration of completely edentulous patients with ISFDP, in a full digital workflow.
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Affiliation(s)
| | - Frank J Tuminelli
- Diplomate & Director, American Board of Prosthodontics, Director, Graduate Prosthodontics VA NY Harbor Healthcare System, Adjunct Clinical Instructor, NYU Dental School, Clinical Assistant Professor, Hofstra Northwell School of Medicine, New York, NJ, USA
| | - Anthony Sallustio
- Chief of Maxillofacial Prosthetics, The Regional Craniofacial Center, St. Joseph's Hospital, Paterson, NJ, USA
| | | | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe-University, Frankfurt am Main, Private Practice, Baden, Germany
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Mahat NS, Shetty NY, Kohli S, Jamayet NB, Patil P. Clinical outcomes of implant-supported and tooth-supported fixed prostheses fabricated from digital versus analogue impression: a systematic review and meta-analysis. Evid Based Dent 2023; 24:142. [PMID: 37369705 DOI: 10.1038/s41432-023-00904-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/15/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE To analyze the clinical outcomes of implant-supported prostheses and tooth-supported fixed prostheses, fabricated from digital and conventional impression. MATERIALS AND METHODS The literature search was carried out on two electronic databases (PubMed and Cochrane Library). Randomized controlled trials (RCT) published from January 2011 to September 2022 were included. The bias risk was evaluated using Cochrane Risk of Bias Tool 2.0. Further screening was done for meta-analysis according to modified Newcastle-Ottawa scoring criteria. Forest plot was generated using a statistical method of inverse variance of random effect with 95% confidence interval. RESULTS A total of 8 randomized controlled trials were included for systematic review out of which four studies were based on tooth-supported fixed prosthesis and remaining four were based on implant-supported prosthesis. Further screening was conducted and three studies were eligible for meta-analysis. Tooth-supported fixed prosthesis fabricated from digital impression showed no significant difference in the marginal fit in any region measured, except for occlusal region where conventional impression showed more favorable marginal fit. Implant-supported prosthesis fabricated from digital impression showed survival rates ranging from 97.3 to 100% and there was no statistically significant difference in marginal bone loss (p = 0.14). CONCLUSION Implant-supported prostheses fabricated from digital and conventional impressions show no significant differences in their clinical outcomes. Tooth-supported fixed prostheses fabricated from digital impression have shown favorable findings in terms of marginal fit. Despite that, there is still lack of clinical trials with larger sample size and longer follow-up periods. Future studies that fulfill these two criteria are deemed necessary.
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Affiliation(s)
- Nur Safiani Mahat
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Naresh Yedthare Shetty
- Associate Professor, Department of Clinical Sciences, Ajman University, Ajman, UAE
- Centre of Medical and Biomedical Allied Health Sciences Research, Deanship of Graduate Studies and Research, Ajman, UAE
| | - Shivani Kohli
- Senior Lecturer, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Nafij Bin Jamayet
- Senior Lecturer, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Pravinkumar Patil
- Associate Professor, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Gagnon-Audet A, An H, Jensen UF, Bratos M, Sorensen JA. Trueness of 3-dimensionally printed complete arch implant analog casts. J Prosthet Dent 2023:S0022-3913(23)00421-3. [PMID: 37558526 DOI: 10.1016/j.prosdent.2023.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 08/11/2023]
Abstract
STATEMENT OF PROBLEM Although a completely digital workflow has numerous advantages, a physical definitive cast may be especially helpful for the accurate assembly of components of complex complete arch-fixed prostheses, the evaluation of esthetic and occlusion features, or prosthesis fabrication. Research on the accuracy of additive complete arch casts with implants positioned with a large anterior-posterior (A-P) spread is sparse. PURPOSE The purpose of this in vitro study was to evaluate the trueness of complete arch 4-implant analog casts with a large A-P distribution fabricated with different 3-dimensional (3D) printers. MATERIAL AND METHODS Ten systems were evaluated representing currently available printing technologies and materials for the additive fabrication of complete arch 4-implant analog casts and compared for deviations in the X-, Y-, and Z-axes from the master model scan (MMS), recorded in standard tessellation language (STL). The MMS was provided to the laboratory selected by the manufacturer, permitting them to create their specific cast with computer-aided design and computer-aided manufacture specific to a particular system, including analog receptacle offset settings. Laboratories fabricated N=10 casts and affixed analogs. A conventional splinted impression and stone cast (CON) was fabricated as a control. The casts were scanned with a precision laboratory scanner (D2000; 3Shape A/S), and files were imported into the Convince metrology software program (3Shape A/S) for comparison with the MMS for mean deviations in the X-, Y-, and Z- axes. A 2-way ANOVA and the Tukey HSD comparison tests were performed between system groups and the 4 implant locations (α=.05). Comparative color maps were used to determine dimensional changes of the edentulous ridges. RESULTS For 2-dimensional deviations from the MMS in each of the 3 axes, the printer type, implant location, and interaction between those 2 variables were found to be statistically significant (P<.05). Comparisons among printers showed the smallest deviations for Asiga Pro 4K (ASG) and Stratasys Origin One (ORI) printers in both the X- and Y-axes and for CON in the Z-axis. For 3D deviations, comparison among printers indicated that ORI, SprintRay Pro55 S (SPR), and Ackuretta SOL (ACK) had the largest deviations, whereas CON and ASG showed the smallest deviations. Comparison color mapping demonstrates a disparity between printed model dimensional changes and implant analog positioning since the color maps of the casts' ridge crests were not in concordance with the results of the implant analog deviations. CONCLUSIONS ASG, 3D Systems ProJet MJP 2500 Plus (MJP), 3D Systems NextDent 5100 (NEX), Stratasys J5 DentaJet (PJ5), Ivoclar PrograPrint PR5 (PR5), and Prodways ProMaker LD20 (PWY) were similar in terms of 3D deviations to the conventional stone cast control. Comparative color mapping showed the direction and quantity of the dimensional changes of the ridge crest frequently did not correlate with the 3D deviations of implant analog positioning. Implant analog insertion errors were predominantly responsible for analog position 3D deviations rather than the polymerization shrinkage of additive photopolymers.
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Affiliation(s)
- Andréa Gagnon-Audet
- Graduate student, Graduate Prosthodontics Program, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
| | - Hongseok An
- Assistant Professor, Department of Restorative Dentistry, School of Dentistry, Oregon Health and Science University, Portland, Ore
| | - Unnur Flemming Jensen
- Adjunct Professor, Department of Restorative Dentistry, School of Dentistry, University of Iceland, Reykjavik, Iceland; and Private practice, Reykjavik, Iceland
| | - Manuel Bratos
- Affiliate Lecturer, Department of Restorative Dentistry, and Associate, Biomimetics Biophotonics Biomechanics & Technology Laboratory, School of Dentistry, University of Washington, Seattle, Wash; and Private practice, Madrid, Spain
| | - John A Sorensen
- Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; and Director, Biomimetics Biophotonics Biomechanics & Technology Laboratory, School of Dentistry, University of Washington, Seattle, Wash.
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Pilecco RO, Dapieve KS, Baldi A, Valandro LF, Scotti N, Pereira GKR. Comparing the accuracy of distinct scanning systems and their impact on marginal/internal adaptation of tooth-supported indirect restorations. A scoping review. J Mech Behav Biomed Mater 2023; 144:105975. [PMID: 37379673 DOI: 10.1016/j.jmbbm.2023.105975] [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: 04/27/2023] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE To summarize the existing scientific evidence on the effect of distinct intraoral (IOS) and extraoral (EOS) scanners in terms of their accuracy for image acquisition and the marginal/internal adaptation of indirect restorations. METHODS The protocol of this scoping review is available online (https://osf.io/cwua7/). A structured search, with no date restriction, was performed in LILACS, MEDLINE via Pubmed, EMBASE, Web of Science, and Scopus, for articles written in English. The inclusion criteria were studies that considered at least two scanners, regardless of method (intra or extraoral), for the production of tooth-supported restorations. Two independent and blinded researchers screened the studies, collected and analyzed the data descriptively. RESULTS 103 studies were included (55 on marginal/internal adaptation, 33 on accuracy, 5 on both outcomes, and 10 reviews). Most of them, shown clinically acceptable adaptation (<120 μm). Factors commonly related to the performance of scanners are: use of anti-reflection powders, method of image acquisition, and restoration/tooth characteristics. The need of anti-reflection powders was controversial. Different scanning principles seems to result on similar performance; IOS that combine them could be promising. The most explored systems were Omnicam - IOS, and inEos X5 - EOS, which showed similar performance on marginal/internal adaptation. Scarce studies explored the performance of EOS systems, especially in terms of accuracy. Different restoration designs as single-unit seemed not to modify the performance of scanners. Limited information is available regarding the planned cement space, restorative material and design (multi-unit restorations), as also techniques to measure adaptation. CONCLUSIONS Digital scanners are valid approaches to obtain accurate impressions resulting in clinically acceptable restorations. Systems that uses combined principles of image acquisition seems promising for optimal performance. Based on high discrepancy, the quality of evaluated evidence is low, and well-designed studies are still encouraged, especially considering validated IOS/EOS as a control comparison condition.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences, Division of Prosthodontics, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Kiara Serafini Dapieve
- Post-Graduate Program in Oral Sciences, Division of Prosthodontics, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Andrea Baldi
- Department of Surgical Sciences, Endodontics and Operative Dentistry. Dental School, University of Turin (UNITO), Piemonte State, Italy.
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences, Division of Prosthodontics, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Nicola Scotti
- Department of Surgical Sciences, Endodontics and Operative Dentistry. Dental School, University of Turin (UNITO), Piemonte State, Italy.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Division of Prosthodontics, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
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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; 129:150-159. [PMID: 34330531 DOI: 10.1016/j.prosdent.2021.05.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 01/18/2023]
Abstract
STATEMENT OF PROBLEM In computer-aided design and computer-aided manufacturing (CAD-CAM) dentistry, the CAD of the prosthesis represents the clinical prerequisite design to restore the treated tooth. However, how closely the CAM prosthesis shape matches the CAD, particularly in relation to different materials, is unclear. PURPOSE The purpose of this in vitro study was to evaluate onlays designed and manufactured with the same CAD-CAM system but manufactured with different materials. MATERIAL AND METHODS A single standard tessellation language (STL) model was used to produce 6 composite resin onlays, 6 leucite glass-ceramic onlays, and 6 lithium disilicate glass-ceramic onlays. The onlays were digitized by using an X-ray microtomographic protocol with a metrological calibration. The CAD model was then compared with the scans of the different onlays. An analysis by region of interest was then carried out to assess the accuracy and reliability of the dimensional accuracy. RESULTS The composite resin and the lithium disilicate glass-ceramic had the best dimensional accuracy. The leucite glass-ceramic exhibited a lack of trueness linked to consistent overmilling. The composite resin had less peripheral chipping than the glass-ceramics. CONCLUSIONS The composite resin and the lithium disilicate glass-ceramic material exhibited satisfactory dimensional accuracy. Milling the glass-ceramic before crystallization considerably improved dimensional accuracy.
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Affiliation(s)
- William Pacquet
- Assistant Professor, Oral rehabilitation Department, Faculty of Dentistry, University Lille Nord de France, Paris, France.
| | - Laurent Tapie
- Senior Lecturer, Mechanical engineering Department, University Sorbonne Paris Nord, Paris, France
| | - Bernardin Mawussi
- Professor and Senior Lecturer, Mechanical engineering Department, University Sorbonne Paris Nord, Paris, France
| | - Philippe Boitelle
- Senior Lecturer, Oral rehabilitation Department, Faculty of Dentistry, University Lille Nord de France, Paris, France
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Bonfante EA, Calamita M, Bergamo ETP. Indirect restorative systems-A narrative review. J ESTHET RESTOR DENT 2023; 35:84-104. [PMID: 36688803 DOI: 10.1111/jerd.13016] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The background and clinical understanding of the properties of currently available indirect restorative systems and fabrication methods is, along with manufacturer and evidence-based literature, an important starting point to guide the clinical selection of materials for tooth and/or implant supported reconstructions. Therefore, this review explores most indirect restorative systems available in the market, especially all-ceramic, along with aspects of manufacturing process, clinical survival rates, and esthetic outcomes. OVERVIEW Progressive incorporation of new technologies in the dental field and advancements in materials science have enabled the development/improvement of indirect restorative systems and treatment concepts in oral rehabilitation, resulting in reliable and predictable workflows and successful esthetic and functional outcomes. Indirect restorative systems have evolved from metal ceramics and polymers to glass ceramics, polycrystalline ceramics, and resin-matrix ceramics, aiming to improve not only biological and mechanical properties, but especially the optical properties and esthetic quality of the reconstructions, in attempt to mimic natural teeth. CONCLUSIONS Based on several clinical research, materials, and patient-related parameters, a decision tree for the selection of indirect restorative materials was suggested to guide clinicians in the rehabilitation process. CLINICAL SIGNIFICANCE The pace of materials development is faster than that of clinical research aimed to support their use. Since no single material provides an ideal solution to every case, professionals must continuously seek information from well designed, long-term clinical trials in order to incorporate or not new materials and technological advancements.
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Affiliation(s)
- Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Marcelo Calamita
- Department of Restorative Dental Sciences at the University of Florida, Gainesville, Florida, USA
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
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Sarafidou K, Chatziparaskeva M, Chatzikamagiannis D, Mpotskaris V, Tortopidis D, Bakopoulou A, Kokoti M. Evaluation of marginal/internal fit of fixed dental prostheses after digital, conventional, and combination impression techniques: A systematic review. Eur J Oral Sci 2022; 130:e12902. [PMID: 36346664 DOI: 10.1111/eos.12902] [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: 08/13/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022]
Abstract
Advances of digital technology are rapidly adopted in dental practice. This systematic review aimed to collect evidence on the accuracy of fit of different types of fixed dental prostheses (FDPs) fabricated through digital, conventional, or combination impression techniques. Data collection was based on the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Two databases (PubMed, Scopus) were searched for articles in English published between 2010 and 2021 resulting in 480 articles. Of those, 35 studies fulfilled the inclusion criteria. These articles referred to three groups of materials/techniques including all-ceramic (zirconia; lithium disilicate) and porcelain-fused-to-metal (PFM) restorations. Results showed clinically acceptable marginal fit (< 120 μm) for all materials and impression techniques. Α fully digital workflow appears more promising for the construction of short-span zirconia FDPs. Nevertheless, most articles evaluated marginal/internal fit of single crowns or short-span FDPs in vitro, while clinical data are limited for long-span FDPs. The necessity for gingival retraction remains a major drawback of all impression techniques, increasing procedural time and patient discomfort. Besides, factors related to the fabrication process, including milling and 3D printing of working models significantly influence the outcome. Overall, there still some way to go before digital technology can be incorporated in complex treatment plans in prosthodontics.
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Affiliation(s)
- Katia Sarafidou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Chatziparaskeva
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Chatzikamagiannis
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Mpotskaris
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Tortopidis
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athina Bakopoulou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Kokoti
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Chandran S, Sers L, Picciocchi G, Luongo F, Lerner H, Engelschalk M, Omar S. Guided implant surgery with R2Gate®: A multicenter retrospective clinical study with 1 year of follow-up. J Dent 2022; 127:104349. [PMID: 36283626 DOI: 10.1016/j.jdent.2022.104349] [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: 09/23/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To present the results obtained with a novel sleeveless and keyless guided implant surgery system. METHODS Inclusion criteria for this multicenter clinical retrospective study were fully or partially edentulous patients who had been treated with a sleeveless and keyless guided implant surgery system (R2Gate®, Megagen), and who had been rehabilitated with fixed restorations, with a minimum follow-up of 1 year. All surgeries and prosthetic procedures were conducted following the same protocol, and data were obtained from the patients' medical records. The outcomes were the fit and stability of the surgical guide, any intra-operative and immediate post-operative complications, any biologic and prosthetic complications that occurred during the 1-year follow-up period, implant survival, and prosthetic success. RESULTS Sixty patients were selected for the installation of 124 implants, through a guided procedure: 66 sleeveless, keyless surgical guides were manufactured. The incidence of immediate intra-operative (lack of space: 12.1%; lack of implant stability 2.6%) and immediate post-operative (pain and discomfort: 6.6%; mild swelling 3.3%) complications was low. In total, 112/124 implants (90.3%) were successfully placed with a guided procedure, in 52 patients; among them, 82 (73.2%) were placed with a flapless procedure. Thirty fixtures supported single crowns (SCs), 42 fixed partial dentures (FPDs) and 52 full-arch (FA) restorations. Sixty-two fixed prosthetic restorations (30 SCs, 22 FPDs and 10 FAs) were delivered; among these restorations, 15 (24.1%) were subjected to immediate functional loading. All implants (100%) survived. Two implants had peri‑implant mucositis (1.6%), two SCs had abutment screw loosenings (1.6%), two FAs and one FPD had ceramic chipping/fracture (2.4%), for an overall prosthetic success amounting to 88.7%. CONCLUSIONS Within the limits of this study, this novel guided surgery system appeared to be clinically reliable; further studies are needed to confirm these results. STATEMENT OF CLINICAL RELEVANCE The use of sleveless and keyless surgical guides can be clinically reliable and may be represent a valid option for the surgeon.
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Affiliation(s)
- Segin Chandran
- Research Fellow, Santosh University, No.1 Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India
| | - Laurent Sers
- Private Practitioner, 54 Rue d'Antibes, Cannes 06400, France
| | - Guido Picciocchi
- Private Practitioner, via Brigata Liguria 3, Genova 16121, Italy
| | | | - Henriette Lerner
- Department of Oral, Maxillofacial and Plastic Surgery, Goethe University, Frankfurt, Germany
| | | | - Sam Omar
- Private Practitioner, OneDay Clinic, Shalz Mall, G2C4 2nd floor, El Sheikh Zayed City 7th District, Mogawra 2, Giza, Governorate 12593, Egypt; OneDay Digital Academy, Shalz Mall, G2C13 2nd Floor, El Sheikh Zayed City 7th District, Mogawra 2, Giza, Governorate 12593, Egypt.
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11
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Yang CH, Cheng CW, Ye SY, Chien CH. A double blinded trial to compare the patient satisfaction and crown accuracy of two different intraoral scanners for the fabrication of monolithic lithium disilicate single crowns. J Dent Sci 2022. [DOI: 10.1016/j.jds.2022.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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12
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Limones A, Celemín-Viñuela A, Romeo-Rubio M, Castillo-Oyagüe R, Gómez-Polo M, Martínez Vázquez de Parga JA. Outcome measurements and quality of randomized controlled clinical trials of tooth-supported fixed dental prostheses: A systematic review and qualitative analysis. J Prosthet Dent 2022:S0022-3913(22)00282-7. [PMID: 36109260 DOI: 10.1016/j.prosdent.2022.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM The lack of consensus regarding a standardized set of outcome measurements and noncompliance with current reporting guidelines in clinical trials of tooth-supported fixed dental prostheses (FDPs) hamper interstudy comparability, compromise scientific evidence, and waste research effort and resources in prosthetic dentistry. PURPOSE The primary objective of this systematic review was to identify all primary and secondary outcome measurements assessed in randomized controlled trials (RCTs) of tooth-supported FDPs. Secondary objectives were to assess their methodological quality by using the Cochrane Collaboration's risk of bias tool (RoB, v2.0) and their reporting quality by means of a standardized 16-item CONSORT assessment tool through published reports. MATERIAL AND METHODS An electronic search was conducted in MEDLINE, EMBASE, and Cochrane library to identify all RCT-related articles published in the past 10 years. Differences in RoB were tested with the Pearson chi-square test, and those in CONSORT score with the Student t test. RESULTS A total of 64 RCTs from 79 publications were deemed eligible. The diversity of outcome measures used in the field is apparent. Twenty percent of the included studies had a low RoB, 79% showed some concerns, and 1% had a high RoB. The mean ±standard deviation CONSORT compliance score was 22.56 ±3.17. Trials adhered to the CONSORT statement reported lower RoB than those that did not adhere (P<.001). RCTs with a low RoB reported more comprehensive adherence to CONSORT guidelines than those with some concerns (MD 4 [95% CI 1.52-6.48]; P=.004). CONCLUSIONS A standardized core outcome reporting set in clinical research on tooth-supported FDPs remains evident. Adherence to the CONSORT statement continues to be low, with some RoB concerns that can be improved.
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Affiliation(s)
- Alvaro Limones
- Student, Assistant Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain.
| | - Alicia Celemín-Viñuela
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Marta Romeo-Rubio
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Raquel Castillo-Oyagüe
- Cathedratic Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
| | - Miguel Gómez-Polo
- Professor, Department of Conservative & Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid (UCM), Madrid, Spain
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13
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Uluc IG, Guncu MB, Aktas G, Turkyilmaz I. Comparison of marginal and internal fit of 5-unit zirconia fixed dental prostheses fabricated with CAD/CAM technology using direct and indirect digital scans. J Dent Sci 2022; 17:63-69. [PMID: 35028021 PMCID: PMC8739750 DOI: 10.1016/j.jds.2021.07.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/09/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/PURPOSE Advancements in digital dentistry and the development of intraoral scanners (IOS) have provided clinicians with an accurate and efficient alternative to analog impressions. The aim of this study was to assess the accuracy of the marginal and internal fit of 5-unit monolithic zirconia fixed dental prostheses (FDPs) fabricated with CAD/CAM technology using direct and indirect digitalization methods. MATERIAL AND METHODS Three teeth in a maxillary typodont model were prepared to receive a 5-unit zirconia FDP. Six different groups were created according to the type of scanner (intraoral and extraoral) and the type of workflow. For direct workflow, the typodont was scanned with two different IOS (3Shape Trios 3 [3S-IOS] and Cerec Omnicam [C-IOS]). For indirect workflow, after conventional impressions were obtained, the impressions (IMP) were scanned with two different laboratory scanners (3S-IMP and C-IMP). After the impressions were poured, the stone (STN) casts were scanned with the same laboratory scanners (3S-STN and C-STN). Sixty 5-unit monolithic zirconia FDPs (10 in each group) were designed and milled. The marginal and internal fit was assessed. RESULTS The mean marginal gap values were 78.2±9 μm in the IOS group, 82.6± 9 μm in the IMP group, and 82.6±9 μm in the STN group, indicating no statistically significant differences among groups (p > 0.05). The mean axial gap values were 77.7 ± 10 μm in IOS group, 83.61 ± 15 μm in the IMP group, and 84.5±9 μm in the STN group, indicating no statistically significant differences among groups (p > 0.05). CONCLUSION The marginal and internal fit of 5-unit monolithic zirconia FDPs fabricated with direct and indirect digital scans were similar. The smallest gap values were observed at the marginal region while the greatest gap values were detected at the occlusal region.
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Affiliation(s)
- Irem Gokce Uluc
- Department of Prosthodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Mustafa Baris Guncu
- Department of Prosthodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Guliz Aktas
- Department of Prosthodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ilser Turkyilmaz
- New York University College of Dentistry, Department of Prosthodontics, New York, NY, USA
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Özal Ç, Ulusoy M. In-vitro evaluation of marginal and internal fit of 3-unit monolithic zirconia restorations fabricated using digital scanning technologies. J Adv Prosthodont 2022; 13:373-384. [PMID: 35003553 PMCID: PMC8712113 DOI: 10.4047/jap.2021.13.6.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/30/2021] [Accepted: 11/15/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study aimed to compare the marginal and internal fit of 3-unit monolithic zirconia restorations that were designed by using the data obtained with the aid of intraoral and laboratory scanners. MATERIALS AND METHODS For the fabrication of 3-unit monolithic zirconia restorations using impressions taken from the maxillary master cast, plaster cast was created and scanned in laboratory scanners (InEos X5 and D900L). The main cast was also scanned with different intraoral scanners (Omnicam [OMNI], Primescan [PS], Trios 3 [T3], Trios 4 [T4]) (n = 12 per group). Zirconia fixed partial dentures were virtually designed, produced from presintered block, and subsequently sintered. Marginal and internal discrepancy values (in µm) were measured by using silicone replica method under stereomicroscope. Data were statistically analyzed by using 1-way ANOVA and Kruskal Wallis tests (P<.05). RESULTS In terms of marginal adaptation, the measurements on the canine tooth indicated better performance with intraoral scanners than those in laboratory scanners, but there was no difference among intraoral scanners (P<.05). In the premolar tooth, PS had the lowest marginal (86.9 ± 19.2 µm) and axial (92.4 ± 14.8 µm), and T4 had the lowest axio-occlusal (89.4 ± 15.6 µm) and occlusal (89.1 ± 13.9 µm) discrepancy value. In both canine and premolar teeth, the D900L was found to be the most marginally and internally inconsistent scanner. CONCLUSION Within the limits of the study, marginal and internal discrepancy values were generally lower in intraoral scanners than in laboratory scanners. Marginal discrepancy values of scanners were clinically acceptable (< 120 µm), except D900L.
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Affiliation(s)
- Çise Özal
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Nicosia, Turkey
| | - Mutahhar Ulusoy
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Nicosia, Turkey
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15
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Bandiaky ON, Le Bars P, Gaudin A, Hardouin JB, Cheraud-Carpentier M, Mbodj EB, Soueidan A. Comparative assessment of complete-coverage, fixed tooth-supported prostheses fabricated from digital scans or conventional impressions: A systematic review and meta-analysis. J Prosthet Dent 2022; 127:71-79. [PMID: 33143901 DOI: 10.1016/j.prosdent.2020.09.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM Intraoral scanners have significantly improved over the last decade. Nevertheless, data comparing intraoral digital scans with conventional impressions are sparse. PURPOSE The purpose of this systematic review and meta-analysis was to determine the impact of impression technique (digital scans versus conventional impressions) on the clinical time, patient comfort, and marginal fit of tooth-supported prostheses. MATERIAL AND METHODS The authors conducted a literature search based on the Population, Intervention, Comparison, and Outcome (PICO) framework in 3 databases to identify clinical trials with no language or date restrictions. The mean clinical time, patient comfort, and marginal fit values of each study were independently extracted by 2 review authors and categorized according to the scanning or impression method. The authors assessed the study-level risk of bias. RESULTS A total of 16 clinical studies met the inclusion criteria. The mean clinical time was statistically similar for digital scan procedures (784 ±252 seconds) and for conventional impression methods (1125 ±159 seconds) (P>.05). The digital scan techniques were more comfortable for patients than conventional impressions; the mean visual analog scale score was 67.8 ±21.7 for digital scans and 39.6 ±9.3 for conventional impressions (P<.05). The mean marginal fit was 80.9 ±31.9 μm and 92.1 ±35.4 μm for digital scan and conventional impressions, respectively, with no statistically significant difference (P>.05). CONCLUSIONS Digital scan techniques are comparable with conventional impressions in terms of clinical time and marginal fit but are more comfortable for patients than conventional impression techniques.
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Affiliation(s)
- Octave Nadile Bandiaky
- Graduate student, Graduate Prosthodontics, Department of Odontology, University of Dakar, Dakar, Senegal
| | - Pierre Le Bars
- Associate Professor, Division of Fixed Prosthodontics, CHU Nantes, Nantes, France
| | - Alexis Gaudin
- Associate Professor Biostatistics, UMR 1246 INSERM SPHERE "MethodS in Patients-Centered Outcomes and HEalth ResEarch", Universities of Nantes and Tours, Nantes, France
| | - Jean Benoit Hardouin
- Associate Professor of Endodontics and Restorative Dentistry, Department of Endodontics and Restorative Dentistry, University of Nantes, Nantes, France
| | | | - Elhadj Babacar Mbodj
- Professor, Clinic of Fixed and Removable Prosthodontics, Department of Odontology, University of Dakar, Dakar, Senegal
| | - Assem Soueidan
- Professor of Periodontology, Department of Periodontology, Rmes U1229, University of Nantes, Nantes, France.
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Tribst JPM, dos Santos AFC, da Cruz Santos G, da Silva Leite LS, Lozada JC, Silva-Concílio LR, Baroudi K, Amaral M. Effect of Cement Layer Thickness on the Immediate and Long-Term Bond Strength and Residual Stress between Lithium Disilicate Glass-Ceramic and Human Dentin. MATERIALS 2021; 14:ma14185153. [PMID: 34576376 PMCID: PMC8465145 DOI: 10.3390/ma14185153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 02/07/2023]
Abstract
This study tested whether three different cement layer thicknesses (60, 120 and 180 μm) would provide the same bonding capacity between adhesively luted lithium disilicate and human dentin. Ceramic blocks were cut to 20 blocks with a low-speed diamond saw under cooling water and were then cemented to human flat dentin with an adhesive protocol. The assembly was sectioned into 1 mm2 cross-section beams composed of ceramic/cement/dentin. Cement layer thickness was measured, and three groups were formed. Half of the samples were immediately tested to evaluate the short-term bond strength and the other half were submitted to an aging simulation. The microtensile test was performed in a universal testing machine, and the bond strength (MPa) was calculated. The fractured specimens were examined under stereomicroscopy. Applying the finite element method, the residual stress of polymerization shrinkage according to cement layer thickness was also calculated using first principal stress as analysis criteria. Kruskal–Wallis tests showed that the ‘‘cement layer thickness’’ factor significantly influenced the bond strength results for the aged samples (p = 0.028); however, no statistically significant difference was found between the immediately tested groups (p = 0.569). The higher the cement layer thickness, the higher the residual stress generated at the adhesive interface due to cement polymerization shrinkage. In conclusion, the cement layer thickness does not affect the immediate bond strength in lithium disilicate restorations; however, thinner cement layers are most stable in the short term, showing constant bond strength and lower residual stress.
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Affiliation(s)
- João Paulo Mendes Tribst
- Department of Dentistry, University of Taubaté (UNITAU), Taubaté 12020-340, Brazil; (A.F.C.d.S.); (G.d.C.S.); (L.S.d.S.L.); (L.R.S.-C.); (K.B.); (M.A.)
- Correspondence:
| | - Alison Flavio Campos dos Santos
- Department of Dentistry, University of Taubaté (UNITAU), Taubaté 12020-340, Brazil; (A.F.C.d.S.); (G.d.C.S.); (L.S.d.S.L.); (L.R.S.-C.); (K.B.); (M.A.)
| | - Giuliane da Cruz Santos
- Department of Dentistry, University of Taubaté (UNITAU), Taubaté 12020-340, Brazil; (A.F.C.d.S.); (G.d.C.S.); (L.S.d.S.L.); (L.R.S.-C.); (K.B.); (M.A.)
| | - Larissa Sandy da Silva Leite
- Department of Dentistry, University of Taubaté (UNITAU), Taubaté 12020-340, Brazil; (A.F.C.d.S.); (G.d.C.S.); (L.S.d.S.L.); (L.R.S.-C.); (K.B.); (M.A.)
| | - Julio Chávez Lozada
- Department of Operative Dentistry, FO-National University of Córdoba, Córdoba 5016, Argentina;
| | - Laís Regiane Silva-Concílio
- Department of Dentistry, University of Taubaté (UNITAU), Taubaté 12020-340, Brazil; (A.F.C.d.S.); (G.d.C.S.); (L.S.d.S.L.); (L.R.S.-C.); (K.B.); (M.A.)
| | - Kusai Baroudi
- Department of Dentistry, University of Taubaté (UNITAU), Taubaté 12020-340, Brazil; (A.F.C.d.S.); (G.d.C.S.); (L.S.d.S.L.); (L.R.S.-C.); (K.B.); (M.A.)
| | - Marina Amaral
- Department of Dentistry, University of Taubaté (UNITAU), Taubaté 12020-340, Brazil; (A.F.C.d.S.); (G.d.C.S.); (L.S.d.S.L.); (L.R.S.-C.); (K.B.); (M.A.)
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Fit of monolithic multilayer zirconia fixed partial dentures fabricated by conventional versus digital impression: a clinical and laboratory investigations. Clin Oral Investig 2021; 25:5363-5373. [PMID: 33619632 DOI: 10.1007/s00784-021-03845-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 02/16/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study aimed to compare the accuracy of conventional and digital impressions based on the fit of produced three-unit fixed partial dentures (FPDs) in vivo and the trueness and precision of both impression techniques. MATERIALS AND METHODS Twelve patients received a conventional polyether impression (group C, control, n=12) and a digital impression with CS3500 (group D, test, n=12) for each participant. Monolithic multilayer zirconia FPDs were fabricated, and the internal and marginal fit were assessed using the replica technique. Trueness and precision of both impression methods were assessed in vitro. A master model was used to create a reference scan. The master model received conventional impressions (group C, control, n=5) and digital impressions (group D, test, n=5). The virtual models of both groups were superimposed over the reference scan (5 superimpositions) using a three-dimensional (3D) processing software, and the 3D deviations were measured and averaged to obtain trueness value. For precision, the virtual models of each group were superimposed over each other (10 superimpositions) and the average deviation value was calculated. The data were analyzed using one-tailed Mann-Whitney U test at P ≤ 0.05. RESULTS Group D resulted in a significantly better marginal and internal fit (30.91±15.15 and 30.86±13.57 μm for group D and 40.02±19.50 and 41.86±18.94 μm for group C). The mean values of trueness and precision for conventional and digital techniques were comparable (trueness: 62.8±5.45 and 62.72±12.01 μm and precision: 56.47±27 and 60.9±14.5 μm, respectively). CONCLUSIONS No significant difference was found between conventional and digital impressions in 3D datasets accuracy. In addition, both techniques resulted in FPDs with an acceptable clinical fit. However, the FPDs fabricated using the digital technique displayed better internal and marginal fit. CLINICAL RELEVANCE The applied impression technique as well as the computer-aided processing of the produced virtual models can significantly affect the fit of the final restoration. Direct digital impression is recommended over conventional impression for fabricating accurate monolithic zirconia 3-unit FPDs. TRIAL REGISTRATION This clinical trial was retrospectively registered on August 11, 2020, in the Pan African Clinical Trial Registry database, and the number for the registry is PACTR202008685699453.
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Licurci CAA, Lins L, Garbossa M, Canabarro A. A comparative study between replica and cementation techniques in the evaluation of internal and marginal misfits of single crowns. J Prosthet Dent 2020; 127:609-616. [PMID: 33342611 DOI: 10.1016/j.prosdent.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Systematic reviews about the internal and marginal misfits of fixed prostheses have identified a limited number of clinical studies, suggesting the need for further research on the subject. Although the replica technique has been described as suitable for this purpose, few studies have validated it. PURPOSE The purpose of this in vitro study was to compare the ability of a nondestructive replica technique and a destructive cementation technique to assess internal and marginal misfits of zirconia copings, considering current materials and designs. MATERIAL AND METHODS Twelve anatomic prefabricated abutments (Neodent) were used to manufacture zirconia copings following the Ceramill (Amann Girrbach AG) (n=6) and Lava (3M ESPE) (n=6) systems. Replications of the cementation line were obtained with polyvinyl siloxane for the replica technique, and the copings were then cemented and sectioned to obtain 5 surfaces (buccal, palatal, mesial, distal, and incisal) and the linear and angle regions (internal axiogingival and axioincisal angles). The thickness of the cement line and silicone film was measured at 45 reference points on each abutment. A total of 540 measurements were made with an optical microscope with a digital camera at magnifications of ×100 and ×200. Data were analyzed by repeated-measures ANOVA and the Bonferroni multiple comparison tests (α=.05). RESULTS In the internal misfit evaluation, the mean values observed for the cementation technique and replica technique were as follows: angle regions, 70.6 μm and 72.2 μm; linear regions, 59.1 μm and 59.6 μm; incisal surface, 139.0 μm and 139.8 μm; buccal surface, 72.4 μm and 73.8 μm; palatal surface, 73.1 μm and 75.2 μm; mesial surface, 74.1 μm and 73.8 μm; distal surface, 75.0 μm and 76.3 μm; and overall mean, 73.6 μm and 74.8 μm, respectively. In the evaluation of the marginal misfit, the mean values found were: buccal surface, 36.7 μm and 37.8 μm; palatal surface, 37.5 μm and 36.8 μm; mesial surface, 44.0 μm and 43.7 μm; and distal surface, 44.6 μm and 45.2 μm, respectively. No significant differences were found between the 2 techniques for all locations and systems (P>.05). CONCLUSIONS Within the limitations of this in vitro study, both techniques presented the same ability to assess the internal and marginal misfits when the location and overall mean averages were evaluated (P>.05).
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Affiliation(s)
- Cristiana A A Licurci
- Postgraduate student, Department of Oral Rehabilitation, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Leonardo Lins
- PhD student, Department of Oral Rehabilitation, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Marcelo Garbossa
- Professor, Department of Prosthodontics, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Antonio Canabarro
- Full Professor, Department of Oral Rehabilitation, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil; Associate Professor, Department of Periodontology, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
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Mangano FG, Admakin O, Bonacina M, Lerner H, Rutkunas V, Mangano C. Trueness of 12 intraoral scanners in the full-arch implant impression: a comparative in vitro study. BMC Oral Health 2020; 20:263. [PMID: 32962680 PMCID: PMC7509929 DOI: 10.1186/s12903-020-01254-9] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The literature has not yet validated the use of intraoral scanners (IOSs) for full-arch (FA) implant impression. Hence, the aim of this in vitro study was to assess and compare the trueness of 12 different IOSs in FA implant impression. METHODS A stone-cast model of a totally edentulous maxilla with 6 implant analogues and scanbodies (SBs) was scanned with a desktop scanner (Freedom UHD®) to capture a reference model (RM), and with 12 IOSs (ITERO ELEMENTS 5D®; PRIMESCAN® and OMNICAM®; CS 3700® and CS 3600®; TRIOS3®; i-500®; EMERALD S® and EMERALD®; VIRTUO VIVO® and DWIO®; RUNEYES QUICKSCAN®). Ten scans were taken using each IOS, and each was compared to the RM, to evaluate trueness. A mesh/mesh method and a nurbs/nurbs method were used to evaluate the overall trueness of the scans; linear and cross distances between the SBs were used to evaluate the local trueness of the scans. The analysis was performed using reverse engineering software (Studio®, Geomagics; Magics®, Materialise). A statistical evaluation was performed. RESULTS With the mesh/mesh method, the best results were obtained by CS 3700® (mean error 30.4 μm) followed by ITERO ELEMENTS 5D® (31.4 μm), i-500® (32.2 μm), TRIOS 3® (36.4 μm), CS 3600® (36.5 μm), PRIMESCAN® (38.4 μm), VIRTUO VIVO® (43.8 μm), RUNEYES® (44.4 μm), EMERALD S® (52.9 μm), EMERALD® (76.1 μm), OMNICAM® (79.6 μm) and DWIO® (98.4 μm). With the nurbs/nurbs method, the best results were obtained by ITERO ELEMENTS 5D® (mean error 16.1 μm), followed by PRIMESCAN® (19.3 μm), TRIOS 3® (20.2 μm), i-500® (20.8 μm), CS 3700® (21.9 μm), CS 3600® (24.4 μm), VIRTUO VIVO® (32.0 μm), RUNEYES® (33.9 μm), EMERALD S® (36.8 μm), OMNICAM® (47.0 μm), EMERALD® (51.9 μm) and DWIO® (69.9 μm). Statistically significant differences were found between the IOSs. Linear and cross distances between the SBs (local trueness analysis) confirmed the data that emerged from the overall trueness evaluation. CONCLUSIONS Different levels of trueness were found among the IOSs evaluated in this study. Further studies are needed to confirm these results.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, 119992 Moscow, Russia
| | - Oleg Admakin
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, 119992 Moscow, Russia
| | - Matteo Bonacina
- Ars and Technology, Sotto il Monte Giovanni XXIII, 24039 Bergamo, Italy
| | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, 60323 Frankfurt am Main, Germany
| | - Vygandas Rutkunas
- Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, LT-01513 Vilnius, Lithuania
| | - Carlo Mangano
- Department of Dental Sciences, Vita and Salute University San Raffaele, 20132 Milan, Italy
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2020; 124:274-349. [PMID: 32811666 DOI: 10.1016/j.prosdent.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/20/2023]
Abstract
This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.
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Adaptability Evaluation of Metal-Ceramic Crowns Obtained by Additive and Subtractive Technologies. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10165563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
(1) Background: Traditional metal-ceramic restorations are considered as a standard in the evaluation of new technologies. A critical factor in their longevity is represented by their adaptability; The purpose of this study was to evaluate the marginal and internal gap of ceramic-fused to metal crowns with frameworks obtained by additive manufacturing (AM) technologies and the influence of veneering process on their fit; (2) Methods: Metal-ceramic crowns have been produced by conventional lost-wax technology (T), digital milling (F), selective laser sintering (SLS) and selective laser melting (SLM). The adaptability was assessed using silicone replicas before and after ceramic veneering; (3) Results: The best values were obtained for the milled group followed closely by SLM and SLS, and a significantly higher gap for casted copings. The veneering process did not significantly influence the adaptability of the crowns, regardless of the manufacturing process used for frameworks. The present study promotes additive technologies (AT) as a fast, efficient, and cost-effective alternative to traditional technology. There are fewer steps in which errors can occur when digital technologies are used and the risk of distortion is diminished. (4) Conclusions: CAD/CAM technologies, both additive and subtractive, represent an excellent option to produce time-effective, precise metal-ceramic crowns with excellent adaptation.
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A within-subject comparison of the conventional clasp-retained with attachment-retained removable partial dentures. J Taibah Univ Med Sci 2020; 15:305-311. [PMID: 32982634 PMCID: PMC7479171 DOI: 10.1016/j.jtumed.2020.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/25/2020] [Accepted: 05/29/2020] [Indexed: 11/23/2022] Open
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Congruence between Meshes and Library Files of Implant Scanbodies: An In Vitro Study Comparing Five Intraoral Scanners. J Clin Med 2020; 9:jcm9072174. [PMID: 32660070 PMCID: PMC7408706 DOI: 10.3390/jcm9072174] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose. To compare the reliability of five different intraoral scanners (IOSs) in the capture of implant scanbodies (SBs) and to verify the dimensional congruence between the meshes (MEs) of the SBs and the corresponding library file (LF). Methods. A gypsum cast of a fully edentulous maxilla with six implant analogues and SBs screwed on was scanned with five different IOSs (PRIMESCAN®, CS 3700®, MEDIT i-500®, ITERO ELEMENTS 5D®, and Emerald S®). Ten scans were taken for each IOS. The resulting MEs were imported to reverse engineering software for 3D analysis, consisting of the superimposition of the SB LF onto each SB ME. Then, a quantitative and qualitative evaluation of the deviations between MEs and LF was performed. A careful statistical analysis was performed. Results. PRIMESCAN® showed the highest congruence between SB MEs and LF, with the lowest mean absolute deviation (25.5 ± 5.0 μm), immediately followed by CS 3700® (27.0 ± 4.3 μm); the difference between them was not significant (p = 0.1235). PRIMESCAN® showed a significantly higher congruence than MEDIT i-500® (29.8 ± 4.8 μm, p < 0.0001), ITERO ELEMENTS 5D® (34.2 ± 9.3 μm, p < 0.0001), and Emerald S® (38.3 ± 7.8 μm, p < 0.0001). CS 3700® had a significantly higher congruence than MEDIT i-500® (p = 0.0004), ITERO ELEMENTS 5D® (p < 0.0001), and Emerald S® (p < 0.0001). Significant differences were also found between MEDIT i-500® and ITERO ELEMENTS 5D® (p < 0.0001), MEDIT i-500® and Emerald S® (p < 0.0001), and ITERO ELEMENTS 5D® and Emerald S® (p < 0.0001). Significant differences were found among different SBs when scanned with the same IOS. The deviations of the IOSs showed different directions and patterns. With PRIMESCAN®, ITERO ELEMENTS 5D®, and Emerald S®, the MEs were included inside the LF; with CS 3700®, the LF was included in the MEs. MEDIT i-500® showed interpolation between the MEs and LF, with no clear direction for the deviation. Conclusions. Statistically different levels of congruence were found between the SB MEs and the corresponding LF when using different IOSs. Significant differences were also found between different SBs when scanned with the same IOS. Finally, the qualitative evaluation revealed different directions and patterns for the five IOSs.
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Venturini AB, Wandscher VF, Marchionatti AME, Evangelisti E, Ramos GF, Melo RM, May LG, Baldissara P, Valandro LF. Effect of resin cement space on the fatigue behavior of bonded CAD/CAM leucite ceramic crowns. J Mech Behav Biomed Mater 2020; 110:103893. [PMID: 32957199 DOI: 10.1016/j.jmbbm.2020.103893] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/23/2020] [Accepted: 05/26/2020] [Indexed: 10/24/2022]
Abstract
This study evaluated the influence of occlusal resin cement space on the fatigue performance of bonded-leucite crowns to a dentin-analogue material. Leucite anatomical crowns were adhesively cemented to dentin-like preparations having distinct occlusal cement space (50, 100 and 300 μm) (n = 18), and subjected to step-stress fatigue testing (150 N - 350 N; step-size: 25 N; 20,000 cycles/step; 20 Hz). Fatigue data (load and number of cycles for failure) were analyzed using Kaplan-Meier and Mantel-Cox (log-rank) tests (p <0.05). Fractographic analysis and occlusal internal space measurements were also performed. There was no significant difference for the distinct occlusal cement layer (50 μm: 289 N, 136,111 cycles; 100 μm: 285 N, 132,778 cycles; 300 μm: 246 N, 101,667 cycles). Occlusal internal space analysis showed a mean thickness of 120.4 (50 μm), 174.9 (100 μm) and 337.2 (300 μm). All failures were radial cracks originating at the ceramic-cement interface. Distinct occlusal cement spaces had no effect on the fatigue behavior of anatomical leucite crowns.
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Affiliation(s)
- Andressa Borin Venturini
- Division of Prosthodontics, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Vinícius Felipe Wandscher
- Division of Prosthodontics, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | | | - Edoardo Evangelisti
- Department of Biomedical Sciences and Neuromotor, Division of Prosthodontics, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Gabriela Freitas Ramos
- Division of Prosthodontics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil.
| | - Renata Marques Melo
- Division of Prosthodontics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil.
| | - Liliana Gressler May
- Division of Prosthodontics, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
| | - Paolo Baldissara
- Department of Biomedical Sciences and Neuromotor, Division of Prosthodontics, Alma Mater Studiorum University of Bologna, Bologna, Italy.
| | - Luiz Felipe Valandro
- Division of Prosthodontics, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
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Kumar HC, Kumar TP, Hemchand S, Suneelkumar C, Subha A. Accuracy of marginal adaptation of posterior fixed dental prosthesis made from digital impression technique: A systematic review. J Indian Prosthodont Soc 2020; 20:123-130. [PMID: 32655216 PMCID: PMC7335028 DOI: 10.4103/jips.jips_382_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/12/2019] [Accepted: 02/24/2020] [Indexed: 11/04/2022] Open
Abstract
Aim The aim of this systematic review was to investigate the marginal adaptation of three or four unit fixed dental prosthesis (FDP) fabricated with digital impression techniques to those fabricated using any other impression technique. Settings and Design Database/electronic searches were conducted till August 2019 in PUBMED-MEDLINE, SCOPUS, and Cochrane library. To identify published articles, multiple keywords were used to develop a search strategy in various combinations. Manual searching of articles was also done. Clinicaltrials.gov.in WHOICTRP and CTRI websites were also searched. Two independent reviewers (TP and VK) assessed eligibility for inclusion, extracted data, and assessed quality using the Cochrane risk of bias tool. Results Database search identified 497 citations and four citations through manual search. After removing duplicates and going through abstracts, 23 articles were perused for full-text screening. Two articles met the inclusion criteria; characteristics were described qualitatively, with two studies having overall low risk of bias. Conclusions Marginal adaptation of FDPs fabricated using the digital and conventional impressions method was within the clinically acceptable limits. However, more robust clinical trials need to be conducted with large sample size to validate the conclusions.
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Affiliation(s)
- Hanuman Chalapathi Kumar
- Department of Prosthodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Tannamala Pavan Kumar
- Department of Prosthodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Surapaneni Hemchand
- Department of Prosthodontics, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram, Andhra Pradesh, India
| | - Chinni Suneelkumar
- Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Anirudhan Subha
- Department of Conservative Dentistry and Endodontics, Sri Ramakrishna Dental College and Hospital, Coimbatore, Tamil Nadu, India
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Svanborg P. A systematic review on the accuracy of zirconia crowns and fixed dental prostheses. Biomater Investig Dent 2020; 7:9-15. [PMID: 32010901 PMCID: PMC6968690 DOI: 10.1080/26415275.2019.1708202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 12/17/2019] [Indexed: 11/20/2022] Open
Abstract
Purpose The aim of this study was to review the fit and assess the accuracy of tooth-supported single and multi-unit zirconia fixed dental prostheses. Background The fit of zirconia restorations has been reported in several studies, but the accuracy of the manufacturing process is seldom discussed or used when drawing conclusions on the fit. Materials and methods A literature search of articles published in PubMed between 2 March 2013 and 1 February 2018 was performed using clearly defined inclusion and exclusion criteria. 841 articles were found and 767 were excluded after screening the title and abstract. After full-text analysis another 60 articles were excluded which left 14 articles to be included for data extraction. Fit was the mean of distances reported in the studies and accuracy was the fit minus the pre-set spacer Results For marginal gap of single crowns and multi-unit FDPs combined, the fit was 83 μm and the accuracy was 59 μm. The internal gap fit was 111 μm and the accuracy 61 μm. For the total gap, the fit was 101 μm, and the accuracy of the zirconia restorations was 53 μm. Conclusions Within the limitations of the present systematic review the fit of zirconia single crowns and multi-unit FDPs may be regarded as clinically acceptable, and the accuracy of the manufacturing of zirconia is ∼60 μm for marginal, internal, and total gap. Also, digital impressions seem to be associated with a smaller gap value.
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Affiliation(s)
- Per Svanborg
- Department of Prosthodontics/Dental Materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Yilmaz H, Aydin MN. Digital versus conventional impression method in children: Comfort, preference and time. Int J Paediatr Dent 2019; 29:728-735. [PMID: 31348834 DOI: 10.1111/ipd.12566] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND The comfortness and effectiveness of digital and conventional impression methods in children have not yet been compared. AIM To assess the digital and conventional impression methods in children in terms of comfort, preference, and the time required to take impressions. DESIGN Digital impressions were taken by using an intraoral scanner, and conventional impressions were taken by using alginate from 28 patients by the same operator. In each impression-taking-process, comfort was assessed by both the children and the clinician, and the chairside times were written. Student's t tests and Mann-Whitney U tests were used for statistical analyses, and P < .05 was considered to be significant. RESULTS The digital impression was considered to be more comfortable in the assessments by both the children and the clinician (P < .001). The total time the digital impression took was 465.89 ± 76.71 second(s) while that of the conventional impression was 450.25 ± 64.08 s when the chairside times of the two impression methods were compared. There was no statistically significant difference (P = .41). CONCLUSION The digital impression method compared with the conventional impression method was found to be both more comfortable and preferable by the children, but there was no difference in terms of the time required to take impressions.
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Affiliation(s)
- Hakan Yilmaz
- Department of Orthodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
| | - Merve Nur Aydin
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey
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Digital dentistry: The new state of the art - Is it disruptive or destructive? Dent Mater 2019; 36:9-24. [PMID: 31526522 DOI: 10.1016/j.dental.2019.08.103] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 08/22/2019] [Accepted: 08/23/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Summarizing the new state of the art of digital dentistry, opens exploration of the type and extent of innovations and technological advances that have impacted - and improved - dentistry. The objective is to describe advances and innovations, the breadth of their impact, disruptions and advantages they produce, and opportunities created for material scientists. METHODS On-line data bases, web searches, and discussions with industry experts, clinicians, and dental researchers informed the content. Emphasis for inclusion was on most recent publications along with innovations presented at trade shows, in press releases, and discovered through discussions leading to web searches for new products. RESULTS Digital dentistry has caused disruption on many fronts, bringing new techniques, systems, and interactions that have improved dentistry. Innovation has spurred opportunities for material scientists' future research. SIGNIFICANCE With disruptions intrinsic in digital dentistry's new state of the art, patient experience has improved. More restoration options are available delivering longer lifetimes, and better esthetics. Fresh approaches are bringing greater efficiency and accuracy, capitalizing on the interest, capabilities, and skills of those involved. New ways for effective and efficient inter-professional and clinician-patient interactions have evolved. Data can be more efficiently mined for forensic and epidemiological uses. Students have fresh ways of learning. New, often unexpected, partnerships have formed bringing further disruption - and novel advantages. Yes, digital dentistry has been disruptive, but the abundance of positive outcomes argues strongly that it has not been destructive.
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Zens MA, Icochea AL, Costa BC, Lisboa-Filho PN, Bastos NA, Francisconi PAS, Furuse AY, Foschini C, Gerlin Neto V, Borges AFS. A new approach for Y-TZP surface treatment: evaluations of roughness and bond strength to resin cemen. J Appl Oral Sci 2019; 27:e20180449. [PMID: 30994777 PMCID: PMC6459228 DOI: 10.1590/1678-7757-2018-0449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/28/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE This study aims to evaluate the effect of sonochemical treatment on the surface of yttria-stabilized tetragonal zirconia (Y-TZP) before and after the final sintering. MATERIAL AND METHODS Twenty-eight Y-TZP discs were divided into four groups (n=7), according to surface treatment: PRE: pre-sintering sonication with 30% nominal power for 15 min; POS: post-sintering sonication with 30% nominal power for 15 min; JAT: air abrasion with 50-μm alumina particles; and CON: control group with no treatment. The POS and JAT groups were sintered before sonication and the PRE group after sonication. Surface roughness was analyzed using confocal microscopy, after which resin cement cylinders were placed on the surface of the Y-TZP discs and subjected to mechanical microshear bond strength test until fracture. Surface roughness and microshear bond strength values underwent ANOVA and the Tukey tests. RESULTS The surface roughness values for the PRE group (299.91 nm) and the POS group (291.23 nm) were not significantly different (p≥0.05), statistically, and the surface roughness value of the JAT group (925.21 nm) was higher than those of PRE and POS (p=0.007) groups. The mechanical microshear bond strength test showed that there was no statistically significant difference between the groups (p=0.08). CONCLUSIONS Therefore, the results showed that sonochemical treatment modifies the Y-TZP surface and is similar to the well-established sandblasting surface treatment regarding the strength of the bond with the resin cement.
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Affiliation(s)
- Marlyni Aparecida Zens
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Dentários, Bauru, São Paulo, Brasil
| | - Alfredo Llerena Icochea
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Dentários, Bauru, São Paulo, Brasil
| | - Bruna Carolina Costa
- Universidade Estadual Paulista (UNESP), Departamento de Física, Bauru, São Paulo, Brasil
| | | | - Natália Almeida Bastos
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Dentários, Bauru, São Paulo, Brasil
| | - Paulo Afonso Silveira Francisconi
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Dentários, Bauru, São Paulo, Brasil
| | - Adilson Yoshio Furuse
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Dentários, Bauru, São Paulo, Brasil
| | - Cesar Foschini
- Universidade Estadual Paulista (UNESP), Departamento de Engenharia Mecânica, Bauru, São Paulo, Brasil
| | - Vicente Gerlin Neto
- Universidade Estadual Paulista (UNESP), Departamento de Engenharia Mecânica, Bauru, São Paulo, Brasil
| | - Ana Flávia Sanches Borges
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Dentários, Bauru, São Paulo, Brasil
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Mangano F, Mangano C, Margiani B, Admakin O. Combining Intraoral and Face Scans for the Design and Fabrication of Computer-Assisted Design/Computer-Assisted Manufacturing (CAD/CAM) Polyether-Ether-Ketone (PEEK) Implant-Supported Bars for Maxillary Overdentures. SCANNING 2019; 2019:4274715. [PMID: 31531155 PMCID: PMC6724437 DOI: 10.1155/2019/4274715] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 07/01/2019] [Indexed: 05/12/2023]
Abstract
PURPOSE To present a digital method that combines intraoral and face scanning for the computer-assisted design/computer-assisted manufacturing (CAD/CAM) fabrication of implant-supported bars for maxillary overdentures. METHODS Over a 2-year period, all patients presenting to a private dental clinic with a removable complete denture in the maxilla, seeking rehabilitation with implants, were considered for inclusion in this study. Inclusion criteria were fully edentulous maxilla, functional problems with the preexisting denture, opposing dentition, and sufficient bone volume to insert four implants. Exclusion criteria were age < 55 years, need for bone augmentation, uncompensated diabetes mellitus, immunocompromised status, radio- and/or chemotherapy, and previous treatment with oral and/or intravenous aminobisphosphonates. All patients were rehabilitated with a maxillary overdenture supported by a CAD/CAM polyether-ether-ketone (PEEK) implant-supported bar. The outcomes of the study were the passive fit/adaptation of the bar, the 1-year implant survival, and the success rates of the implant-supported overdentures. RESULTS 15 patients (6 males, 9 females; mean age 68.8 ± 4.7 years) received 60 implants and were rehabilitated with a maxillary overdenture supported by a PEEK bar, designed and milled from an intraoral digital impression. The intraoral scans were integrated with face scans, in order to design each bar with all available patient data (soft tissues, prosthesis, implants, and face) in the correct spatial position. When testing the 3D-printed resin bar, 12 bars out of 15 (80%) had a perfect passive adaptation and fit; in contrast, 3 out of 15 (20%) did not have a sufficient passive fit or adaptation. No implants were lost, for a 1-year survival of 100% (60/60 surviving implants). However, some complications (two fixtures with peri-implantitis in the same patient and two repaired overdentures in two different patients) occurred. This determined a 1-year success rate of 80% for the implant-supported overdenture. CONCLUSIONS In this study, the combination of intraoral and face scans allowed to successfully restore fully edentulous patients with maxillary overdentures supported by 4 implants and a CAD/CAM PEEK bar. Further studies are needed to confirm these outcomes.
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Affiliation(s)
- Francesco Mangano
- Lecturer, Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119992 Moscow, Russia
| | - Carlo Mangano
- Professor and Lecturer, Department of Dental Sciences, Vita and Salute University San Raffaele, 20132 Milan, Italy
| | - Bidzina Margiani
- Lecturer, Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119992 Moscow, Russia
| | - Oleg Admakin
- Professor and Head, Department of Prevention and Communal Dentistry, Sechenov First Moscow State Medical University, 119992 Moscow, Russia
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Randomized controlled clinical trial of digital and conventional workflows for the fabrication of zirconia-ceramic fixed partial dentures. Part I: Time efficiency of complete-arch digital scans versus conventional impressions. J Prosthet Dent 2019; 121:69-75. [DOI: 10.1016/j.prosdent.2018.04.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 11/15/2022]
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Mühlemann S, Benic GI, Fehmer V, Hämmerle CHF, Sailer I. Randomized controlled clinical trial of digital and conventional workflows for the fabrication of zirconia-ceramic posterior fixed partial dentures. Part II: Time efficiency of CAD-CAM versus conventional laboratory procedures. J Prosthet Dent 2018; 121:252-257. [PMID: 30037692 DOI: 10.1016/j.prosdent.2018.04.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 04/19/2018] [Accepted: 04/19/2018] [Indexed: 10/28/2022]
Abstract
STATEMENT OF PROBLEM Clinical trials are needed to evaluate the digital and conventional fabrication technology for providing fixed partial dentures (FPDs). PURPOSE The purpose of the second part of this clinical study was to compare the laboratory production time for tooth-supported, 3-unit FPDs by means of computer-aided design and computer-aided manufacturing (CAD-CAM) systems and a conventional workflow. In addition, the quality of the 3-unit framework of each treatment group was evaluated clinically. MATERIAL AND METHODS For each of 10 participants, a 3-unit FPD was fabricated. Zirconia was used as the framework material in the CAD-CAM systems and included Lava C.O.S. CAD software (3M) and centralized CAM (group L); CARES CAD software (Institut Straumann AG) and centralized CAM (group iT); and CEREC Connect CAD software (Dentsply Sirona) and centralized CAM (group C). The noble metal framework in the conventional workflow (group K) was fabricated by means of the traditional lost-wax technique. All frameworks were evaluated clinically before veneering. The time for the fabrication of the cast, the 3-unit framework, and the veneering process was recorded. In addition, chairside time during the clinical appointment for the evaluation of the framework was recorded. The paired Wilcoxon test together with appropriate Bonferroni correction was applied to detect differences among treatment groups (α=.05). RESULTS The total effective working time (mean ±standard deviation) for the dental technician was 220 ±29 minutes in group L, 217 ±23 minutes in group iT, 262 ±22 minutes in group C, and 370 ±34 minutes in group K. The dental technician spent significantly more time in the conventional workflow than in the digital workflow, independent of the CAD-CAM systems used (P<.001). CONCLUSIONS Irrespective of the CAD-CAM system, the overall laboratory time for the dental technician was significantly less for a digital workflow than for the conventional workflow.
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Affiliation(s)
- Sven Mühlemann
- Senior Teaching and Research Assistant, Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - Goran I Benic
- Senior Teaching and Research Assistant, Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Vincent Fehmer
- Master Dental Technician, Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Christoph H F Hämmerle
- Professor, Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Irena Sailer
- Professor, Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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