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Rokhshad R, Tehrani AM, Nahidi R, Zarbakhsh A. Fit of removable partial denture frameworks fabricated from 3D printed patterns versus the conventional method: An in vitro comparison. J Prosthet Dent 2024; 131:1144-1149. [PMID: 35597606 DOI: 10.1016/j.prosdent.2022.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM The conventional method of fabricating removable partial denture (RPD) patterns is a time-consuming, expensive, and complex process, and the success of the treatment depends on the fit of the framework. Questions still remain as to whether the 3D-printing method is an acceptable procedure compared with the conventional method. PURPOSE The purpose of this in vitro study was to compare the fit of RPDs cast from 3D printed frameworks and conventionally fabricated RPDs according to the gaps between the framework and the reference model. MATERIAL AND METHODS A metal reference model was made from a Kennedy class III modification 1 maxillary typodont. For the conventional group (n=9), impressions were made from the metal cast. Cobalt chromium frameworks were cast with the conventional method. For the digital group (n=9), the metal cast was scanned with a laboratory scanner, and the RPD was designed in the 3Shape platform. The standard tessellation language (STL) file of the design was downloaded to a 3D printer (Hunter DLP), and 9 resin frameworks were printed. These frameworks were invested and cast in the same dental laboratory as the first group. Gap measurement was assessed vertically with a superimposition software program (Geomagic Control X), and additional measurements were assessed under rests, reciprocal arms, and a 2.2-mm box under the major connector. The independent t test was used for determining the results and statistical analysis between groups. The paired t test was used for statistical analysis within groups (α=.05 for all tests). RESULTS No significant differences (P>.05) were observed in the mean ±standard deviation in overall fit according to the gaps in the conventional group (103 ±18 μm) and those in the digital group (109 ±21 μm). The biggest gap (poorest fit) was observed in the 2.2-mm box under the major connector (115 ±6 μm). CONCLUSIONS Both conventional and 3D-printing methods showed clinically acceptable fits. Further clinical studies with a larger sample size and long-term follow-up are needed.
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Affiliation(s)
- Rata Rokhshad
- Dentist, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran; and Topic Group Dental Diagnostics and Digital Dentistry, ITU/WHO Focus Group AI on Health, Berlin, Germany
| | - Azita Mazaheri Tehrani
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Reza Nahidi
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Arash Zarbakhsh
- Assistant Professor, Prosthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Ribeiro AKC, de Freitas RFCP, Costa RTF, de Moraes SLD, Srinivasan M, Carreiro ADFP. Maxillomandibular relationship record methods for computer-engineered complete dentures: a scoping review. Clin Oral Investig 2024; 28:320. [PMID: 38750145 DOI: 10.1007/s00784-024-05706-2] [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: 12/16/2023] [Accepted: 05/06/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES The purpose of this scoping review was to identify different methods employed for recording the maxillomandibular relationship (MMR) for computer-aided designed and manufactured (CAD-CAM) complete dentures (CDs). MATERIALS AND METHODS This scoping review followed the PRISMA-ScR guidelines and was developed according to Arksey and O'Malley and The Joanna Briggs Institute protocol. The methods were registered on the Open Science Framework (< osf.io/rf4xm> ). The focus question was: "What are the different techniques for recording the maxillomandibular relationship in the digital workflow used in CECDs?" Two investigators searched 3 online databases [MEDLINE (PubMed), Scopus, and Science Direct] independently. The inclusion criteria were clinical studies and reviews that assessed techniques for recording MMR using digital workflow for manufacturing of CECDs. A descriptive analysis was performed considering the study design, manufacturing system, clinical steps, and tools for the determination of MMR, and the difficulty level of procedures. RESULTS 4779 articles were identified in the electronic search and 10 studies were included for data analysis. The review identified 4 commercially available CAD-CAM denture systems and 3 innovative methods suitable for abbreviating the number of appointments (2 to 4 visits). The trial denture is inherent to the procedure for the Baltic System and 3 innovative techniques. Three techniques (2 innovative and WholeYouNexteeth) demonstrated lower difficulty levels for performing the clinical procedures, regardless of the professional skills. CONCLUSIONS The commercially available and innovative techniques for the recording of MMR may provide predictability of the treatment. The techniques are effective, however, rely on the learning curve and the patient's clinical condition. CLINICAL RELEVANCE Recording of the maxillomandibular relationship is paramount for the manufacturing and functionality of complete dentures. Clinicians should be aware of the different tools and techniques described for registering the jaw relationship.
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Affiliation(s)
- Anne Kaline Claudino Ribeiro
- Post-graduate student, Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | | | | | | | - Murali Srinivasan
- Clinic of General-, Special care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Adriana da Fonte Porto Carreiro
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal (UFRN), 1787 Salgado Filho Senator Avenue Lagoa Nova, 59056000, Natal, RN, Brazil.
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Liao P, Budsabong O. A method of fabricating a stackable CAD-CAM custom record tray for complete dentures. J Prosthet Dent 2024:S0022-3913(24)00290-7. [PMID: 38704323 DOI: 10.1016/j.prosdent.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/06/2024]
Abstract
Digital complete denture fabrication has advanced with the integration of computer-aided design and computer-aided manufacturing (CAD-CAM), intraoral scanning, and 3-dimensional printing. A method of fabricating a stackable CAD-CAM custom record tray for complete dentures is introduced. The method combines a custom tray, record base, and occlusion rim in a single piece.
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Affiliation(s)
- Peixi Liao
- Clinical Associate Professor, Department of Restorative Sciences and Biomaterials, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass.
| | - Onkamon Budsabong
- Clinical Assistant Professor, Department of General Dentistry, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass
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Li H, Bai H, Ma K, Sun F, Chen H. Fabricating a digital custom tray and interim complete denture base: A dental technique. J Prosthet Dent 2024:S0022-3913(24)00203-8. [PMID: 38565439 DOI: 10.1016/j.prosdent.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 03/03/2024] [Accepted: 03/05/2024] [Indexed: 04/04/2024]
Abstract
High-quality impressions and accurate occlusal relationship records are essential for the success of complete dentures. A custom impression tray and interim complete denture base fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) are introduced, enhancing the ability to obtain precise definitive impressions and accurate jaw relation records and improving complete denture treatment.
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Affiliation(s)
- Hong Li
- Researcher, First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology (Key Laboratory of Digital Stomatology, Chinese Academy of Medical Sciences), Beijing, PR China
| | - Hefei Bai
- Graduate student, Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Kenan Ma
- Graduate student, Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Feng Sun
- Researcher, First Clinical Division, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Hu Chen
- Associate Clinical Professor, Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology (Key Laboratory of Digital Stomatology, Chinese Academy of Medical Sciences), Beijing, PR China.
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Park K, Kang NG, Lee JH, Srinivasan M. Removable complete denture with a metal base: Integration of digital design and conventional fabrication techniques. J ESTHET RESTOR DENT 2024; 36:255-262. [PMID: 37578750 DOI: 10.1111/jerd.13121] [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: 05/26/2023] [Revised: 07/13/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE Digitally-designed removable complete dentures are typically composed of a resin denture base without a metal framework. However, metal denture bases are preferable as resin bases are more susceptible to fracture. Therefore, this article introduces a unique technique that integrates computer-aided design (CAD) and conventional resin processing for the fabrication of removable complete dentures with a metal framework. CLINICAL CONSIDERATIONS A maxillary complete denture with a metal base and a mandibular implant-retained overdenture reinforced with a metal framework were fabricated. The dentures were designed using CAD software and a tooth library. The denture bases were milled from wax disks, and artificial teeth were placed to complete the wax dentures. The metal frameworks were also designed using CAD software and produced via casting of printed resin patterns. Finally, conventional denture processing techniques were applied to obtain dentures with metal frameworks. CONCLUSIONS A digitally designed, removable complete denture with a metal base can be successfully fabricated using the described technique, which merges digital design and conventional methods. This article demonstrates the feasibility and potential advantages of this innovative approach in denture fabrication. CLINICAL SIGNIFICANCE The presented technique provides the following advantages: digital design features, precise space above implant overdenture attachments for a metal framework, convenience of esthetic evaluation with printed trial dentures, long-term data storage and duplication, reliable bond between the artificial teeth and denture base, and enhanced strength of the removable complete denture due to the metal reinforcement.
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Affiliation(s)
- Koungjin Park
- Department of Prosthodontics, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Nam-Gil Kang
- Central Dental Laboratory, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Jae-Hyun Lee
- Department of Prosthodontics and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Murali Srinivasan
- Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
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Al-Kaff FT, Al Hamad KQ. Additively manufactured CAD-CAM complete dentures with intraoral scanning and cast digitization: A controlled clinical trial. J Prosthodont 2024; 33:27-33. [PMID: 37200587 DOI: 10.1111/jopr.13704] [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: 01/08/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/20/2023] Open
Abstract
PURPOSE To assess, clinically, patient satisfaction of additively manufactured complete dentures with intraoral scanning and hybrid cast digitization in comparison with conventional complete dentures. MATERIALS AND METHODS Participants who were edentulous in both arches were recruited and received three types of complete dentures (CDs): conventionally manufactured with conventional impression (CC), additively manufactured with intraoral scanning (AMI), and additively manufactured with cast digitization (AMH). Definitive impressions of the edentulous arches were made with medium viscosity polyvinyl siloxane (Hydrorise Monophase; Zhermack, Italy) for the CC group, intraoral scanning (TRIOS 4; 3Shape, Copenhagen, Denmark) for the AMI group, and laboratory scanning of the definitive casts (Ceramill Map400 AMANNGIRRBACH, Pforzheim, Deutschland) for the AMH group. The trial dentures of the CC group were scanned for occlusion registrations of the AMI and AMH groups and were used to guide the designing process (Exocad 3.0 Galway; Exocad GmbH). The AMI and AMH dentures were additively manufactured with a vat-polymerization 3D printer (Sonic XL 4K; phrozen, Taiwan). Patient satisfaction and clinical outcome were assessed with OHIP EDENT, and 14-factor criteria, respectively. Statistical analyses were performed with paired sample t-test and one-way repeated measure ANOVA for satisfaction, Wilcoxon signed rank test for clinical outcome, and Pearson's r (r) for effect size, with α = 0.05. RESULTS A total of 20 participants were included. Satisfaction had no statistically significant difference within or among the groups (p < 0.105). Within-group comparison between the two arches showed no statistical significance for the clinical outcome except for a significantly higher maxillary AMI score (p = 0.01, r = -0.40 with medium effect size). For among group's comparison; AMI had a significantly lower score than CC for the maxillary and mandibular arches (p = 0.01, r = -0.40, medium effect size, and p = 0.003, r = -0.47, medium effect size), and significantly lower score than the mandibular AMH (p = 0.03, r = -0.47, medium effect size), with significantly lower quality in teeth arrangement and retention domains for the AMI, and teeth arrangement for the AMH, in comparison with CC. CONCLUSIONS Patient satisfaction with both types of additively manufactured dentures is comparable to conventional dentures. The comparable overall clinical outcomes between hybrid and conventional dentures indicate that additive manufacturing is an acceptable clinical substitute for the conventional methods. However, additively manufactured dentures made with intraoral scanning have lower clinical quality and retention than hybrid and conventional dentures, particularly for the mandibular arch. Teeth arrangement of both additively manufactured dentures is clinically inferior to the conventional denture.
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Affiliation(s)
- Fatma T Al-Kaff
- Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
| | - Khaled Q Al Hamad
- Department of Prosthodontics, Jordan University of Science & Technology, Irbid, Jordan
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Dib Zakkour S, Dib Zakkour J, Guadilla Y, Montero J, Dib A. Comparative Evaluation of the Digital Workflow and Conventional Method in Manufacturing Complete Removal Prostheses. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6955. [PMID: 37959552 PMCID: PMC10650844 DOI: 10.3390/ma16216955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/10/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023]
Abstract
The aging population in developed countries has increased the number of edentulous patients and, therefore, the need for prosthetic rehabilitation to improve their quality of life. Complete dentures are the main treatment option in these cases. The use of CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) in dentistry has improved clinical protocols and outcomes, achieving a reduction in work time and economic costs for the patients. The main objective of this review was to compare the characteristics of conventional and digital dentures, attempting to determine whether the use of new technologies represents an improvement in the properties of removable complete dentures. A bibliographic review was carried out in the PubMed/MEDLINE, Cochrane Library, Scielo, and Embase databases. With the initial search, 157 articles were obtained. After applying the inclusion and exclusion criteria, 64 publications were selected for this bibliographic review. The different conclusions of the studies consulted were compared regarding fit and retention, fracture resistance, surface roughness, biocompatibility, and aesthetics, taking into account the different methods of prostheses fabrication. In general, digital prostheses have shown better mechanical properties and, consequently, better biocompatibility and aesthetics than conventional prostheses. However, the obtained results were very heterogeneous, preventing a supported conclusion.
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Affiliation(s)
| | | | - Yasmina Guadilla
- Dental Clinic of the Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain; (Y.G.); (J.M.); (A.D.)
| | - Javier Montero
- Dental Clinic of the Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain; (Y.G.); (J.M.); (A.D.)
| | - Abraham Dib
- Dental Clinic of the Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain; (Y.G.); (J.M.); (A.D.)
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Erbulak Z, Ergun G. The effects of different surface treatments applied to milled PMMA denture base material on repair bond strength. Odontology 2023; 111:953-970. [PMID: 37016128 DOI: 10.1007/s10266-023-00806-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 03/14/2023] [Indexed: 04/06/2023]
Abstract
The high cost of CAD/CAM systems and materials is a severe economic burden. Therefore, repair of CAD/CAM PMMA, selecting appropriate repair materials, and surface modifications are clinically important. This study aims to evaluate the shear bond strength of PMMA repair materials after various surface treatments on CAD/CAM PMMA denture base material. For this purpose, a total of 480 CAD/CAM PMMA denture base test specimens were manufactured. Then all test specimens were divided into 6 groups, and different surface treatments were applied. Group A: sandblasting, Group B: 4% hydro fluoric acid, Group C: tungsten carbide bur, Group D: dichloromethane + methyl methacrylate mixture, Group E: dichloromethane and methyl methacrylate, Group F: no surface treatment. Each group is then divided into 4 different subcategories; repair processes were performed using; heat-cured acrylic resin (n:20), auto-polymerized acrylic resin (n:20), gingiva composite (n:20), and CAD/CAM PMMA tooth material (n:20). After repairs, thermal aging was applied to half of the test specimens in each subcategory. The shear bond strength value was measured with a universal test device. Sandblasting group showed the highest surface roughness value in all test specimens (p < 0.001). Heat-cured acrylic resin with sandblasting exhibited the highest bond strength, while the untreated gingiva composite resin exhibited the lowest value. Thermal aging decreased bond strength in all repair materials (p < 0.001). Among the surface treatment groups, sandblasting with Al2O3 particles exhibited the highest surface roughness value and repair bond strength. The application of organic solvents to the surface increased the surface roughness and repair bond strength. Applying dichloromethane and methyl methacrylate monomer separately is more effective than applying it as a mixture. The ideal bonding among repair materials was obtained with heat-cured acrylic resin.
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Affiliation(s)
- Zahıde Erbulak
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Bişkek Cad. 1.Sk. No:4 06490 Emek, Ankara, Turkey.
| | - Gulfem Ergun
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Bişkek Cad. 1.Sk. No:4 06490 Emek, Ankara, Turkey
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Schiller S, Rustemeier E, Kraus D, Stark H, Müller F, Utz KH. Misfit of Complete Maxillary Dentures' Posterior Palatal Seal following Polymerisation with Four Different Autopolymerising Resins: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5285. [PMID: 35955220 PMCID: PMC9369520 DOI: 10.3390/ma15155285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND The majority of complete dentures are still conventionally manufactured using a flask-and-pack technique. However, the polymerization process may introduce a distortion of the denture body. The aim of this study was to evaluate the three-dimensional fit of the posterior palatal seal of maxillary complete dentures with the original impression, and to give recommendations for scraping. METHODS Four autopolymerising resins were used to manufacture 40 palatal plates each for high, medium and flat palates (total n = 120). The misfit was captured by taking a reline impression with a highly fluid silicone, the dimensions of which were measured with a flat-bed scanner. RESULTS The shape of the palate had a significant impact (median p = 0.0435), but not the resin type (median p = 0.2575). It was largest for the flat palate and smallest for the high palate. The largest misfit was observed in the palatal midline area (flat-palate average median: 685 µm; high and medium palates: 620 µm) decreasing towards the lateral and anterior regions. CONCLUSIONS The results suggest compensating for the palatal misfit that occurs with autopolymerising resins by scraping a postdam of an approximately 0.7 mm depth to the master cast, decreasing towards the anterior and lateral areas. In high and medium palates, the scraping could be less pronounced.
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Affiliation(s)
- Simone Schiller
- Independent Researcher, Kastanienstraße 10, 53340 Meckenheim, Germany;
| | - Elke Rustemeier
- Global Precipitation Climatology Centre, Deutscher Wetterdienst, Frankfurter Straße 135, 63067 Offenbach am Main, Germany;
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; (D.K.); (H.S.)
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; (D.K.); (H.S.)
| | - Frauke Müller
- Division de Gérodontologie et Prothèse Adjointe, Clinique Universitaire de Médecine Dentaire (CUMD), 1 rue Michel-Servet, 1211 Geneva, Switzerland;
| | - Karl-Heinz Utz
- Department of Prosthodontics, Preclinical Education and Dental Material Science, University of Bonn, Welschnonnenstr. 17, 53111 Bonn, Germany; (D.K.); (H.S.)
- Independent Researcher, Käferweg 1, 53639 Königswinter, Germany
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Khan AA, Fareed MA, Alshehri AH, Aldegheishem A, Alharthi R, Saadaldin SA, Zafar MS. Mechanical Properties of the Modified Denture Base Materials and Polymerization Methods: A Systematic Review. Int J Mol Sci 2022; 23:5737. [PMID: 35628546 PMCID: PMC9143457 DOI: 10.3390/ijms23105737] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/15/2022] [Accepted: 05/19/2022] [Indexed: 12/22/2022] Open
Abstract
Amidst growing technological advancements, newer denture base materials and polymerization methods have been introduced. During fabrication, certain mechanical properties are vital for the clinical longevity of the denture base. This systematic review aimed to explore the effect of newer denture base materials and/or polymerization methods on the mechanical properties of the denture base. An electronic database search of English peer-reviewed published papers was conducted using related keywords from 1 January 2011, up until 31 December 2021. This systematic review was based on guidelines proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search identified 579 papers. However, the inclusion criteria recognized 22 papers for eligibility. The risk of bias was moderate in all studies except in two where it was observed as low. Heat cure polymethyl methacrylate (PMMA) and compression moulding using a water bath is still a widely used base material and polymerization technique, respectively. However, chemically modified PMMA using monomers, oligomers, copolymers and cross-linking agents may have a promising result. Although chemically modified PMMA resin might enhance the mechanical properties of denture base material, no clear inferences can be drawn about the superiority of any polymerization method other than the conventional compression moulding technique.
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Affiliation(s)
- Aftab Ahmed Khan
- Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Muhammad Amber Fareed
- Department of Restorative Dentistry, College of Dentistry, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates;
| | - Abdulkarim Hussain Alshehri
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Alhanoof Aldegheishem
- Department of Clinical Dental Science, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (A.A.); (R.A.)
| | - Rasha Alharthi
- Department of Clinical Dental Science, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (A.A.); (R.A.)
| | - Selma A. Saadaldin
- Prosthodontics Division, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B9, Canada;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawarah, Medina 42353, Saudi Arabia;
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 46000, Pakistan
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Romalee W, Kettratad M, Trang TTN, Wang DH, Chen JE, Hsu ML. Evaluation of the potential denture covering area in buccal shelf with intraoral scanner. J Dent Sci 2022; 17:1335-1341. [PMID: 35784113 PMCID: PMC9236950 DOI: 10.1016/j.jds.2022.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/15/2022] [Indexed: 11/27/2022] Open
Abstract
Background/purpose The characteristic of soft tissue changes in buccal shelf area during function is unclear. This study aimed for evaluating the potential denture covering area in buccal shelf area in different ranges of mouth opening by a digital approach. Materials and methods Nineteen qualified dentate participants were enrolled. An intraoral scanner was used to record soft tissue in buccal shelf area in different ranges of mandibular opening, which were maximum intercuspation, 10 mm, 20 mm, and 30 mm of interincisal distance. The experiment was performed by two examiners. The common area of each range was generated within the clinically acceptable denture adaptation range, which was represented as the potential denture covering area. Data were statistically analyzed using descriptive statistic, one-way repeated measure ANOVA, intraclass correlation coefficient (ICC), and the Pearson correlation test. Results Trends of the mean distance of the potential denture covering area increased from the frenum area to the second premolar and the first molar area then decreased in the second molar area, along with the ranges of mouth opening increased. The distance in the second molar area had drastic percentage changes during the mouth opening. The mean distances changed significantly when the mouth opening increased (P < 0.001). All ICC values of intra-, inter-rater reliability indicated good to excellent reliability. The correlation between the results from two examiners was strong (P < 0.001). Conclusion The characteristic of the denture covering area posteriorly to the first molar area is inversely proportional in length to ranges of mouth opening.
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Affiliation(s)
- Worachate Romalee
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Community Dentistry & Gerodontology, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Matana Kettratad
- Department of Community Dentistry & Gerodontology, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Tran Thi Ngoc Trang
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ding-Han Wang
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jia-En Chen
- Medical 3D Printing Center, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Lun Hsu
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Corresponding author. College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong St. Taipei 112, Taiwan. Fax: +886 2 28201074.
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Abd El Galil EG, Mohamed SL, Rizk FN, Sabet ME. Evaluation of two computer-aided design software on the adaptation of digitally constructed maxillary complete denture. J Indian Prosthodont Soc 2021; 21:383-390. [PMID: 34810366 PMCID: PMC8617444 DOI: 10.4103/jips.jips_137_21] [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] [Indexed: 11/25/2022] Open
Abstract
Aims: This study was conducted to evaluate the adaptation of maxillary complete denture designed by two different open computer-aided design software programs (3Shape and Exocad) using Geomagic surface matching software. Settings and Design: This was a nonrandomized crossover clinical trial. Materials and Methods: Twenty completely edentulous patients were selected in this study. Forty complete dentures were designed using two different software programs: twenty dentures were designed by 3Shape software and the other twenty dentures were designed by Exocad software. Maxillary dentures were evaluated regarding their adaptation by measuring the deviations that occurred between the fitting surface of the three-dimensional printed dentures, and the scanned master casts using Geomagic surface matching software. Statistical Analysis Used: An unpaired t-test was used for statistical analysis. Results: According to the positive average deviation value that represented pressure areas, 3Shape-designed maxillary dentures showed significantly lower mean deviation values (0.041115 ± 0.018165 mm) than Exocad-designed maxillary dentures (0.500665 ± 0.032619 mm). Regarding the negative average deviation values that represented the gap areas, Exocad-designed maxillary dentures showed significantly lower mean deviation values (0.161555 ± 0.007842 mm) than 3Shape-designed maxillary dentures (0.231350 ± 0.009146 mm). The results of the total average deviation values showed significantly lower mean deviation values (0.096950 ± 0.008868 mm) of 3Shape-designed maxillary dentures than Exocad-designed maxillary dentures (0.250755 ± 0.021154 mm). Conclusion: 3Shape and Exocad software programs produced acceptable maxillary dentures regarding denture adaptation. However, maxillary dentures designed by 3 Shape software showed better adaptation than maxillary dentures designed by Exocad software.
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Affiliation(s)
- Eman G Abd El Galil
- Department of Removable Prosthodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Shaimaa L Mohamed
- Department of Removable Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Fardos N Rizk
- Department of Removable Prosthodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
| | - Marwa E Sabet
- Department of Removable Prosthodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt
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Srinivasan M, Kalberer N, Fankhauser N, Naharro M, Maniewicz S, Müller F. CAD-CAM complete removable dental prostheses: A double-blind, randomized, crossover clinical trial evaluating milled and 3D-printed dentures. J Dent 2021; 115:103842. [PMID: 34637889 DOI: 10.1016/j.jdent.2021.103842] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/28/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This double-blind, randomized, crossover, clinical trial aimed to evaluate and compare the differences between milled and 3D-printed complete removable dental prostheses (CRDPs). METHODS Fifteen edentulous patients (men: n = 10, women: n = 5; age: 66.7 ± 8.0 years) rehabilitated with conventional CRDPs were recruited for this trial. Participants were randomized to first receiving either the milled or 3D-printed CAD-CAM manufactured CRDPs and then after 6-weeks cross over to the other set. Both, clinicians and participants were blinded to the group allocation. Outcomes included patient's denture satisfaction (PDS), oral-health related quality of life (OHIP-EDENT), willingness-to-pay analysis, final choice (FC) of CRDPs, clinician's denture quality evaluation (CDQE), chewing efficiency (CE), maximum-voluntary-bite-force (MBF), and prosthodontic maintenance needs. The outcomes were measured at baseline (with old CRDPs), at 1 and 6 weeks after new CRDP insertion; following crossover with the second set of CRDPs, an identical protocol was followed. Generalized linear regression for repeated measures was used for statistical analysis with α=0.05. RESULTS All participants completed the trial. 3D-printed CRDPs required more maintenance visits, adjustment time (p = 0.0003), and adjustment costs (p = 0.021). Patients were willing-to-pay an average of 606.67 Swiss Francs more than the actual cost for the milled CRDPs. There were no differences in the PDS, OHIP, FC, CDQE, CE, and MBF between the two CRDPs groups. CONCLUSIONS The findings of this double-blind randomized crossover clinical trial confirm that both milled and 3D-printed CRDPs are valid treatment modalities for edentulous patients, with the latter performing inferiorly with regard to the time and costs involved with the prosthodontic aftercare, as well as the patients' willingness-to-pay. CLINICAL RELEVANCE The findings of this trial provide evidence to help the clinician in choosing the appropriate CAD-CAM manufacturing process for fabricating the CRDPs.
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Affiliation(s)
- Murali Srinivasan
- Clinic of General, Special care, and Geriatric dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva - 4, Switzerland.
| | - Nicole Kalberer
- Clinic of General, Special care, and Geriatric dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Nicolas Fankhauser
- Clinic of General, Special care, and Geriatric dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Manuel Naharro
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva - 4, Switzerland
| | - Sabrina Maniewicz
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva - 4, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva - 4, Switzerland; Department of Rehabilitation and Geriatrics, University Hospitals of Geneva, Chemin du Pont-Bochet 3, 1226 Thônex, Switzerland
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An In-Vitro Study to Evaluate the Effect of Denture Cleansing Agents on Color Stability of Denture Bases Fabricated Using CAD/CAM Milling, 3D-Printing and Conventional Techniques. COATINGS 2021. [DOI: 10.3390/coatings11080962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current literature lacks substantial information about the effect of denture cleansers on the color stability of denture bases formed using Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) additive and CAD/CAM subtractive manufacturing techniques. This study aimed to assess the effect of two commercially available denture cleansers on the color stability of denture base resins fabricated using four different techniques. Forty-five disc-shaped specimens were fabricated using each technique. Initial color readings were recorded. Specimens were randomly divided into three subgroups (n = 15): a control group (distilled water) and two denture cleanser groups. They were immersed in these solutions, simulating 180 days of use. Final color readings were recorded. The color difference was calculated, and the data were statistically analyzed. For all the specimens, significant color changes were observed after immersion in denture cleanser solutions. The extent of color change varied according to the type of denture cleanser used. When placed in the denture cleanser solutions, the CAD/CAM subtractive group showed the maximum color change (−1.10 and −0.72), while the CAD/CAM additive (3D printing) groups showed the least color change (−0.48 and −0.54). Clinicians should choose appropriate denture cleansers for newly introduced denture base resins to minimize the changes in the color of the dentures.
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Swamidass R, Goodacre CJ. Conversion of Digital Dentures for Immediate Loading of Complete Arch Implant Prostheses. J Prosthodont 2021; 30:143-149. [PMID: 33988279 DOI: 10.1111/jopr.13323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2020] [Indexed: 12/01/2022] Open
Abstract
The development and expanded use of digital dentures has led to their use in the immediate loading of complete arch implant prostheses. This paper reviews the prosthetic complications that can occur with immediately loaded conversion prostheses along with the advantages afforded by digital dentures in minimizing or eliminating these complications. The process of using digital dentures in the fabrication of conversion dentures for immediate loading of complete arch implant prostheses is presented as well as the use of digital dentures for definitive prostheses. The described procedures include methods of obtaining clinical records, the fabrication of conversion dentures, the immediate loading procedure using a conversion prosthesis, and use of a conversion denture in the fabrication of a definitive prosthesis.
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Affiliation(s)
- Rajesh Swamidass
- Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA
| | - Charles J Goodacre
- Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, CA
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A completely digital workflow for the transition from a failed dentition to interim complete-arch fixed implant-supported prostheses: A clinical report. J Prosthet Dent 2020; 127:527-532. [DOI: 10.1016/j.prosdent.2020.09.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/14/2022]
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Accuracy of intraoral scanning in completely and partially edentulous maxillary and mandibular jaws: an in vitro analysis. Clin Oral Investig 2020; 25:1839-1847. [PMID: 32812098 PMCID: PMC7966190 DOI: 10.1007/s00784-020-03486-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 07/30/2020] [Indexed: 10/28/2022]
Abstract
OBJECTIVES New generation intraoral scanners are promoted to be suitable for digital scans of long-span edentulous spaces and completely edentulous arches; however, the evidence is lacking. The current study evaluated the accuracy of intraoral scanning (IOS) in partially and completely edentulous arch models and analyzed the influence of operator experience on accuracy. MATERIALS AND METHODS Four different resin models (completely and partially edentulous maxilla and mandible) were scanned, using a new generation IOS device (n = 20 each). Ten scans of each model were performed by an IOS-experienced and an inexperienced operator. An industrial high-precision scanner was employed to obtain reference scans. IOS files of each model-operator combination, their respective reference scan files (n = 10 each; total = 80), as well as the IOS files from each model generated by the same operator, were superimposed (n = 45; total = 360) to calculate trueness and precision. An ANOVA for mixed models and post hoc t tests for mixed models were used to assess group-wise differences (α = 0.05). RESULTS The median overall trueness and precision were 24.2 μm (IQR 20.7-27.4 μm) and 18.3 μm (IQR 14.4-22.1 μm), respectively. The scans of the inexperienced operator had significantly higher trueness in the edentulous mandibular model (p = 0.0001) and higher precision in the edentulous maxillary model (p = 0.0004). CONCLUSION The accuracy of IOS for partially and completely edentulous arches in in vitro settings was high. Experience with IOS had small influence on the accuracy of the scans. CLINICAL RELEVANCE IOS with the tested new generation intraoral scanner may be suitable for the fabrication of removable dentures regardless of clinician's experience in IOS.
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Kraemer Fernandez P, Unkovskiy A, Benkendorff V, Klink A, Spintzyk S. Surface Characteristics of Milled and 3D Printed Denture Base Materials Following Polishing and Coating: An In-Vitro Study. MATERIALS 2020; 13:ma13153305. [PMID: 32722240 PMCID: PMC7435723 DOI: 10.3390/ma13153305] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/23/2022]
Abstract
(1) Background: To date, no information on the polishability of milled and 3D-printed complete denture bases has been provided, which is relevant in terms of plaque accumulation. (2) Methods: three groups (n = 30) were manufactured using the cold-polymerization polymethilmethacrilate, milling (SM) and 3D printing (AM). 10 specimens of each group were left untreated (reference). 10 more specimens were pre-polished (intermediate polishing) and 10 final specimens were highgloss polished. An additional 20 specimens were 3D printed and coated with the liquid resin (coated), 10 of which were additionally polished (coated + polished). For each group Ra and Rz values, gloss value and REM images were obtained. (3). The “highgloss-polished” specimens showed statistically lower Ra and Rz values in the SM, followed by AM and conventional groups. In the AM group statistically lower surfaces roughness was revealed for highgloss-polished, “coated + polished”, and “coated” specimens, respectively. (4) Conclusions: The milled specimens demonstrated superiors surface characteristics than 3D printed and conventionally produced after polishing. The polished specimens demonstrated superior surface characteristics over coated specimens. However, the surface roughness by both polished and coated specimens was within the clinically relevant threshold of 0.2 µm.
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Affiliation(s)
- Pablo Kraemer Fernandez
- Department of Prosthodontics, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tübingen, Germany; (P.K.F.); (V.B.); (A.K.)
| | - Alexey Unkovskiy
- Department of Prothodontics, Geriartric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Trubetskaya Str. 8-2, 119991 Moscow, Russia
- Correspondence: or ; Tel.: +49-30-450-662798
| | - Viola Benkendorff
- Department of Prosthodontics, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tübingen, Germany; (P.K.F.); (V.B.); (A.K.)
| | - Andrea Klink
- Department of Prosthodontics, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tübingen, Germany; (P.K.F.); (V.B.); (A.K.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany;
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In silico evaluation of the peripheral and inner seals in complete denture master impressions using a custom-developed 3D software. Clin Oral Investig 2020; 25:125-132. [PMID: 32488486 DOI: 10.1007/s00784-020-03343-z] [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: 01/08/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Despite the complexity of the edentulous anatomy, little evidence exists as to what impression techniques and materials should be employed for an optimal result. The aim of this in silico study was to evaluate the trueness of peripheral and inner seals of different edentulous jaw impressions. MATERIALS AND METHODS Twelve maxillary edentulous participants (male = 8, female = 4; age 68.5 ± 11.7 years) participated in this study. Four different impression materials and techniques, irreversible hydrocolloid (Alginate; Blueprint X-Crème, Dentsply Sirona, PA, USA), polyvinyl siloxane impression (PVS; Aquasil Ultra+ Medium, Dentsply Sirona, PA, USA), and subsequently modified with ZnOE (PVSM) and an optical impression (Optical; 3Shape A/S, Copenhagen, Denmark), were tested against a control impression: low-fusing impression compound border molding (Kerr Corp., CA, USA) followed by a ZnOE impression (ZnOE; SS White impression paste, S.S. White Group, Gloucester, England). All impressions were scanned and analyzed using a custom-built 3D comparison software analyzing the vertical and horizontal trueness. RESULTS The vertical discrepancy (peripheral seal) of the impression surface was significantly more true for PVSM than Alginate (p = 0.001), PVS (p = 0.019), and Optical groups (p < 0.001). Where the horizontal discrepancy (inner seal) was compared, the impression surface was more true for PVSM than Alginate (p < 0.001) and Optical (p < 0.001). PVS group was also significantly more true than Optical (p = 0.015). CONCLUSION Impression techniques and materials may significantly influence the peripheral and inner seal of an edentulous jaw impression. CLINICAL RELEVANCE When using a polyvinylsiloxane impression material for master edentulous impressions, a selective inner seal reline with a conventional zinc oxide eugenol impression paste can improve the inner seal.
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