Laser digitization of casts to determine the effect of tray selection and cast formation technique on accuracy

Evaluating the accuracy of CAD/CAM optimized stones compared to conventional type IV stones

This study compared the accuracy (trueness and precision) of stone models fabricated using two brands of CAD/CAM optimized stones Cerec Stone (BC) and Elite Master (EM), and a conventional type IV stone Elite Rock Fast (ERF). 30 conventional Type IV and scannable stone complete-arch models were scanned with a blue LED extraoral scanner, and root mean square values were obtained. 6 abutments were used in complete-arch models. The digital models were compared with the master model to evaluate their trueness using model superimposition with Geomagic software. Precision was determined for each case by superimposing combinations of the 10 datasets in each group. The point cloud density of each model was calculated with MeshLab software. Kruskal-Wallis and Mann-Whitney non-parametric tests were used for the statistical analysis. The trueness of the stone models was 96 μm for the BC, 88.2 μm for the EM, and 87.6 μm for the ERF. There were no significant differences between the tested dental stones (p = .768). However, the EM models (35.6 μm) were more precise than the BC (46.9 μm) and ERF (56.4 μm) models (p = .001, p < .001). EM models also showed the highest point cloud density. There were significant differences in point cloud density (p = .003). The EM models showed significant differences in precision but no significant differences in terms of trueness. Although EM was more precise and had the highest point cloud density, all models were within the clinically acceptable limit.

Accuracy of Conventional and Digital Methods of Obtaining Full-Arch Dental Impression (In Vitro Study)

Introduction

The current gold standard is a conventional impression made with various impression materials and trays and results in a gypsum cast. With the development of milling and printing materials in dentistry, especially zirconia, a digital model has become increasingly important.

Objectives

To compare the accuracy of the conventional impression scan (CIS), gypsum cast scan (GCS), and digital impression scan (DIS) to obtain a full-arch digital model.

Materials and methods

A resin reference cast was fabricated. It was scanned by an extra-oral scanner to measure its accuracy as a reference scanner. Eight conventional impressions of the reference cast were taken by polyvinyl siloxane and scanned. After that, they were poured with type IV dental stones and scanned too. The reference cast was scanned by an intraoral scanner eight separate times. Digital models within each group were superimposed individually to measure precision. In addition, each model from each group was superimposed on one model from the reference scanner precision group to measure trueness.

Results

The reference scanner showed the highest accuracy among groups with a precision of 1.5±0.8 µm and a trueness of 5.5±1.9 µm (P<0.006), while precision values of gypsum cast were 8.1±1.7 µm and trueness values were 9.3±2.6 µm (P<0.012). Conventional impressions showed a precision of 14.06±2.01 µm and a trueness of 16.15±2.07 µm (P<0.012). Digital impressions were the least accurate among the groups, as precision values were 38.22±15.23 μm and trueness values were 35.19±8.7 μm (P<0.006).

Conclusion

The gypsum cast scans showed the highest accuracy, followed by the conventional impression scans, and finally the digital impression scans, with no clinical significance.

Comparative analysis of different impression techniques in relation to single tooth impression

It is of interest to compare the accuracy of three different impression techniques for a single tooth impression. We used 3 groups with 15 samples each in this study. Group 1: Putty and light body in a sectional stock tray; Group 2: Monophase and extra light body in a sectional stock tray; Group 3: Matrix impression technique. 15 impressions were taken of a prepared tooth on a typodont with each technique. The dimensions of the casts poured from these impression techniques were compared with the control typodont tooth. Data analysis shows that the matrix impression technique gave the best results in terms of dimensional study followed by monophase and extra light body impression technique and putty and light body impression technique gave the least accurate results. The results show that there is a statistically significant difference between the three impression techniques in terms of dimensional stability. Data analysis shows that the matrix impression technique gave the best results in terms of dimensional study followed by monophase and extra light body impression technique and putty and light body impression technique gave the least accurate results. The variations between the groups are within acceptable limits. Hence, it can be concluded that all the impression techniques will result in adequate dimensional stability and can be used in clinical scenarios.

Comparison of cooling methods on denture base adaptation of rapid heat-cured acrylic using a three-dimensional superimposition technique

Aim

To investigate the effect of different cooling methods on denture base adaptation of rapid heat-cured acrylic resin using 3D superimposition technique.

Setting and Design

In vitro - Comparative study.

Materials and Methods

Denture base adaptation of two different rapid heat-cured polymethyl methacrylate acrylic resins using five different cooling methods were compared. Forty maxillary edentulous stone cast were prepared to produce the denture bases with standardized thickness. The specimens were divided into five groups (n = 8) according to type of materials and cooling methods. The master stone cast and all forty denture bases were scanned with 3Shape E1 laboratory scanner. The scanned images of each of the denture bases were superimposed over the scanned image of the master cast using Materialize 3-matic software. Three dimensional differences between the two surfaces were calculated and color surface maps were generated for visual qualitative assessment.

Statistical Analysis Used

Generalized Linear Model Test, Bonferroni Post Hoc Analysis.

Results

All bench-cooled specimens showed wide green-colored area in the overall palatal surface, while the rapid cooled specimens presented with increased red color areas especially at the palate and post dam area. Generalized Linear Model test followed by Bonferroni post hoc analysis showed significant difference in the root mean square values among the specimen groups.

Conclusion

Samples that were bench cooled, demonstrated better overall accuracy compared to the rapid cooling groups. Regardless of need for shorter denture processing time, bench cooling of rapid heat-cured PMMA is essential for acceptable denture base adaptation.

Fit of monolithic multilayer zirconia fixed partial dentures fabricated by conventional versus digital impression: a clinical and laboratory investigations

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.

Effect of multiple pouring on the accuracy of casts made using 3D-printed custom trays with different spacer thicknesses: A research study

Background. This study aimed to evaluate the effect of different pouring times and spacer thicknesses on the three-dimensional accuracy of casts made of 3D-printed custom trays. Methods. A partial edentulous maxillary model was scanned for fabricating custom acrylic trays. Twenty custom trays were created using a CAD/CAM system and divided into two groups in terms of their spacer thicknesses (2 mm and 4 mm). All the trays were designed with 2-mm thickness, multiple retentive holes measuring 2 mm in diameter, and three interior seating stops (two on the edentulous ridge and one on the incisal edge of the central incisors). Impressions were made using monophasic polyvinyl siloxane and poured in two different times (one hour and 24 hours after removal) with type IV dental stone. All the casts were scanned to measure three distances (inter-buccal cusps, inter-palatal cusps, and inter-fossa distances) between the two first premolars. The data were analyzed with two-way ANOVA and Bonferroni test at a significance level of 0.05. Results. There was no significant difference between the 3D accuracy of casts made using two different spacer thicknesses poured at 1-hour and 24-hour intervals. However, there was a difference between casts made after 1 hour and 24 hours when using custom trays with 2 mm of spacer thickness in terms of inter-buccal distance. Conclusion. There was no significant difference between the accuracy of casts made using custom trays with either 2 or 4 mm of spacer thickness, which were poured 1 hour or 24 hours after tray removal.

The effect of scanning distance on the accuracy of intra-oral scanners used in dentistry

The aim of this study was to evaluate the factors affecting intra-oral scanner accuracy by analyzing variation in measurements of a dental model according to scanning distance. A dental cast, including a prepared left mandibular first molar, was used. Rectangular frames measuring 20 × 30 mm with heights of 2.5, 5.0, and 7.5 mm were made. The model was scanned 10 times with a reference scanner to obtain the true value. Scanning was performed 10 times at four distances of 0, 2.5, 5.0, and 7.5 mm with the frame of each height using the following intra-oral scanners: TRIOS; CS 3500; and PlanScan. In the linear distance measurement method (2D), measurements were taken at five parameters using the Rapidform software. In the best-fit alignment method (3D), using the Geomagic Control X, the root mean square values of the two scan images were calculated. In the 2D comparison, the different from the reference value was the smallest at 2.5 and 5.0 mm. In the 3D comparison, 2.5 and 5.0 mm were the most accurate, and 0 mm was the least accurate among the four distances. To the best of our knowledge, this study was the first to evaluate the accuracy of scanning distances, and found a difference between the accuracy of the scanning distance and the accuracy of the scanner. Moreover, the results of this study indicated that the scanning distance was a variable affecting accuracy. Clin. Anat. 32:430-438, 2019. © 2019 Wiley Periodicals, Inc.

Effect of techniques, trays and materials on accuracy of impressions clinically made

Abstract Introduction Making accurate and dimensionally stable impressions to duplicate oral conditions and tooth morphology is an essential step of prosthetic dentistry for fabricating well-fitted indirect restorations and, consequently, ensure the longevity and success of the treatment. Several authors describe pros and cons of different impression techniques, although there is no unanimity among them about the best one. Objective This study evaluated casts’ accuracy made by different impression techniques, trays and materials. Material and method 10 patients were selected and 20 impressions from teeth #13 to #16 were performed using single-step (SS) and two-step techniques, made with metal stock and customized acrylic resin partial trays, vinyl polysiloxane and condensation silicone rubbers. Type IV gypsum was used to pour the casts. Three photographs of each patient (baseline), as their respective gypsum casts, were taken, measured in their interested buccal surface area. Comparisons of area values among experimental groups and baseline were performed. Data showed adherence to normal curve, being submitted to 3-way ANOVA/Bonferroni test (α=.05). Result Technique produced significant differences (P=0.02). SS technique was more accurate than BUR one (P=0.003; 95=1.22 to 5.98), but both resulted in similar casts to PVC, MOV and NR techniques, which were similar to each other (P>0.05). Conclusion SS technique showed the closest absolute values to baseline.

Three-Dimensional Accuracy of Digital Impression versus Conventional Method: Effect of Implant Angulation and Connection Type

Purpose

The aim of this in vitro study was to compare the accuracy of different implant impression techniques of the maxillary full arch with tilted implants of two connection types.

Materials and Methods

Two maxillary edentulous acrylic resin models with two different implant connections (internal or external) served as a reference model. Each model had two anterior straight and two posterior angulated implants. Ninety impressions were made using an intraoral scanner (Trios 3Shape) with scan bodies for digital impression (groups DII and DIE), a custom open tray with additional silicone for the conventional direct group (groups CDI and CDE), and a custom closed tray with additional silicone for the conventional indirect group (groups CII and CIE) from both internal and external models, respectively. A coordinate-measuring machine (CMM) was used to measure linear and angular displacement for conventional specimens. For digital groups, an optical CMM was used to scan the reference model. STL data sets from the digital specimen were superimposed on STL reference data sets to assess angular and linear deviations. Data were analyzed with three-way ANOVA and t-test at α=0.05.

Results

There were significant angular and linear distortion differences among three impression groups (P < 0.001), angular distortion differences between internal and external connections (P < 0.001), and between straight and tilted implants for either linear (P < 0.001) or angular (P=0.002) distortion. The type of the connection and implant angle did not have any effect on linear and angular distortion of the digital technique (p > 0.05). Minimum angular and linear distortion was seen for tilted implants in DII and DIE groups (0.36° ± 0.37 and 0.16 ± 0.1 mm).

Conclusion

Impression techniques (digital versus conventional) affected the transfer accuracy. Digital techniques demonstrated superior outcome in comparison with conventional methods, and the direct technique was better than the indirect conventional technique. Connection type and implant angulation were other factors that influenced accuracy. However, when digital impression was applied, accuracy was not affected by the type of connection and angulation.

Clinical marginal fit of zirconia crowns and patients' preferences for impression techniques using intraoral digital scanner versus polyvinyl siloxane material

STATEMENT OF PROBLEM

The use of digital intraoral scanners is increasing; however, evidence of its precision in making crown impressions clinically remains scarce. Patients should also feel more comfortable with digital impressions, but only a few studies evaluating this subject have been performed.

PURPOSE

The purpose of this clinical study was to evaluate the marginal fit of monolithic zirconia crowns and patients' preferences for digital impressions versus polyvinyl siloxane (PVS) impressions.

MATERIAL AND METHODS

Sixteen participants with indications for single molar crowns were included. After crown preparation, digital impressions by intraoral scanner and PVS impressions were made. The participants were asked to complete a 6-item questionnaire with a visual analog scale related to perceptions of each of the following topics: time involved, taste/smell, occlusal registration, size of impression tray/scanner, gag reflex, and overall preference. Computer-aided design and computer-aided manufacturing monolithic zirconia crowns were fabricated from both impressions. The crowns were evaluated intraorally, and a blinded examiner measured the marginal discrepancy of silicone replicas under a stereomicroscope. Intraexaminer reliability was evaluated by calculating the intraclass correlation coefficient. Data for patients' preferences and marginal discrepancies were analyzed using the paired t test (α=.05).

RESULTS

Visual analog scale scores for digital impressions were statistically significantly higher than those for PVS impressions in every topic (P<.05), except for occlusal registration. The results showed excellent reliability of the examiner with an intraclass correlation coefficient of .996. No significant difference was found in marginal discrepancies between the PVS group and the digital group on all sides (P>.05).

CONCLUSIONS

No differences were found in the clinical marginal fit of zirconia crowns fabricated from either digital impressions compared with PVS impressions. Furthermore, patients' satisfaction with digital impressions was significantly higher than with conventional impressions.

Accuracy of Gypsum Casts after Different Impression Techniques and Double Pouring

This study evaluated the accuracy of gypsum casts after different impression techniques and double pouring. Ten patients were selected and for each one it was obtained 5 partial putty/wash impressions with vinyl polysiloxane (VPS) material from teeth #13 to #16 with partial metal stock trays. The following techniques were performed: (1) one-step; two-step relief with: (2) PVC film; (3) slow-speed tungsten carbide bur and scalpel blade, (4) small movements of the tray and (5) without relief—negative control. The impressions were disinfected with 0.5% sodium hypochlorite for 10 minutes and stored during 110 and 230 minutes for the first and second pouring, respectively, with type IV gypsum. Three intra-oral lateral photographs of each patient were taken using a tripod and a customized radiographic positioner. The images were imported into ImageJ software and the total area of the buccal surface from teeth #13 to #16 was measured. A 4.0% coefficient of variance was criterion for using these measurements as Baseline values. The casts were photographed and analyzed using the same standardization for the clinical images. The area (mm²) obtained from the difference between the measurements of each gypsum cast and the Baseline value of the respective patient were calculated and analyzed by repeated-measures two way-ANOVA and Mauchly’s Sphericity test (α = 0.05). No significant effect was observed for Impression technique (P = 0.23), Second pouring (P = 0.99) and their interaction (P = 0.25). The impression techniques and double pouring did not influence the accuracy of the gypsum casts.

Effect of dental technician disparities on the 3-dimensional accuracy of definitive casts

STATEMENT OF PROBLEM

Studies that evaluated the effect of dental technician disparities on the accuracy of presectioned and postsectioned definitive casts are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the accuracy of presectioned and postsectioned definitive casts fabricated by different dental technicians by using a 3-dimensional computer-aided measurement method.

MATERIAL AND METHODS

An arch-shaped metal master model consisting of 5 abutments resembling prepared mandibular incisors, canines, and first molars and with a 6-degree total angle of convergence was designed and fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) technology. Complete arch impressions were made (N=110) from the master model, using polyvinyl siloxane (PVS) and delivered to 11 dental technicians. Each technician fabricated 10 definitive casts with dental stone, and the obtained casts were numbered. All casts were sectioned, and removable dies were obtained. The master model and the presectioned and postsectioned definitive casts were digitized with an extraoral scanner, and the virtual master model and virtual presectioned and postsectioned definitive casts were obtained. All definitive casts were compared with the master model by using computer-aided measurements, and the 3-dimensional accuracy of the definitive casts was determined with best fit alignment and represented in color-coded maps. Differences were analyzed using univariate analyses of variance, and the Tukey honest significant differences post hoc tests were used for multiple comparisons (α=.05).

RESULTS

The accuracy of presectioned and postsectioned definitive casts was significantly affected by dental technician disparities (P<.001). The largest dimensional changes were detected in the anterior abutments of both of the definitive casts. The changes mostly occurred in the mesiodistal dimension (P<.001).

CONCLUSIONS

Within the limitations of this in vitro study, the accuracy of presectioned and postsectioned definitive casts is susceptible to dental technician differences.

Changes in views on digital intraoral scanners among dental hygienists after training in digital impression taking

BACKGROUNDS

Despite the rapid development of digital dentistry, the use of digital intraoral scanners remains limited. The aim of this study was to evaluate the changes in views on intraoral scanners among dental hygienists after training.

METHODS

Thirty-four dental hygienists with >3 years of clinical experience participated and were divided into 2 groups : iTero and Trios groups. Participants of each group practiced the usage of both intraoral scanners, for total 12 times over 4 sessions, Questionnaires were given to participants at two different times; prior to and after the completion of the training sessions. The parameters of questionnaires included on difficulty of use, patient discomfort, awareness, preference, and clinical usefulness of intraoral scanners and comparison of two types of scanners.

RESULTS

Upon the completion of the training, both iTero and Trios groups gave positive feedback on anticipated accuracy, efficiency, and clinical usefulness. More participants of the iTero group responded that the level of difficulty of use and patient discomfort was greater than Trios. Both groups preferred Trios for its clinical usefulness.

CONCLUSIONS

The perceptions of dental hygienists on usage of intraoral scanner and digital impression improved positively with the training. The participants favored Trios over iTero in terms of difficulty of use , patient comfort, and clinical usefulness. This study showed that appropriate training could change the views on the efficiency of intraoral scanners positively among dental hygienists.

In vivo precision of conventional and digital methods of obtaining complete-arch dental impressions

STATEMENT OF PROBLEM

Digital impression systems have undergone significant development in recent years, but few studies have investigated the accuracy of the technique in vivo, particularly compared with conventional impression techniques.

PURPOSE

The purpose of this in vivo study was to investigate the precision of conventional and digital methods for complete-arch impressions.

MATERIAL AND METHODS

Complete-arch impressions were obtained using 5 conventional (polyether, POE; vinylsiloxanether, VSE; direct scannable vinylsiloxanether, VSES; digitized scannable vinylsiloxanether, VSES-D; and irreversible hydrocolloid, ALG) and 7 digital (CEREC Bluecam, CER; CEREC Omnicam, OC; Cadent iTero, ITE; Lava COS, LAV; Lava True Definition Scanner, T-Def; 3Shape Trios, TRI; and 3Shape Trios Color, TRC) techniques. Impressions were made 3 times each in 5 participants (N=15). The impressions were then compared within and between the test groups. The cast surfaces were measured point-to-point using the signed nearest neighbor method. Precision was calculated from the (90%-10%)/2 percentile value.

RESULTS

The precision ranged from 12.3 μm (VSE) to 167.2 μm (ALG), with the highest precision in the VSE and VSES groups. The deviation pattern varied distinctly according to the impression method. Conventional impressions showed the highest accuracy across the complete dental arch in all groups, except for the ALG group.

CONCLUSIONS

Conventional and digital impression methods differ significantly in the complete-arch accuracy. Digital impression systems had higher local deviations within the complete arch cast; however, they achieve equal and higher precision than some conventional impression materials.

Dimensional accuracy of stone casts made from silicone-based impression materials and three impression techniques

The aim of this study was to measure and compare the dimensional accuracy of stone casts of a partially edentulous mandibular arch made by two condensation silicones, two addition silicones and three impression techniques (1-step putty/light-body, 2-step putty/light-body and monophase technique). A partially edentulous standard stainless steel mandibular arch cast was obtained with reference points on the permanent mandibular right and left canines, and permanent mandibular right and left second molars. The anteroposterior distances (between the mandibular left canine and second molar and between the mandibular right canine and second molar) and transverse distances (between the mandibular left and right canines and between the mandibular left and right second molars) of stainless steel cast were measured by a microscope at 30× magnification and 0.5 µm accuracy. All impressions were made with condensation or addition silicones. The 1- and 2-step putty/light-body impressions were accomplished with putty and light-body materials and the monophase impressions with light-body material only. After the impression procedures, accuracy of each material and technique was assessed measuring the stone casts poured (n=5) from the impressions, by the same microscope. The differences between the values of stone cast and stainless steel cast were calculated, presented as percentages and analyzed statistically by two-way ANOVA and the means compared by Tukey's test (α=0.05). All distances measured on stone casts showed altered dimensions with significantly negative linear changes (shrinkage) as compared to those of the stainless steel cast. The stone casts made from the addition silicones were dimensionally more accurate. No differences were found among the impression techniques.

Accuracy of 3D white light scanning of abutment teeth impressions: evaluation of trueness and precision

PURPOSE

This study aimed to evaluate the accuracy of digitizing dental impressions of abutment teeth using a white light scanner and to compare the findings among teeth types.

MATERIALS AND METHODS

To assess precision, impressions of the canine, premolar, and molar prepared to receive all-ceramic crowns were repeatedly scanned to obtain five sets of 3-D data (STL files). Point clouds were compared and error sizes were measured (n=10 per type). Next, to evaluate trueness, impressions of teeth were rotated by 10°-20° and scanned. The obtained data were compared with the first set of data for precision assessment, and the error sizes were measured (n=5 per type). The Kruskal-Wallis test was performed to evaluate precision and trueness among three teeth types, and post-hoc comparisons were performed using the Mann-Whitney U test with Bonferroni correction (α=.05).

RESULTS

Precision discrepancies for the canine, premolar, and molar were 3.7 µm, 3.2 µm, and 7.3 µm, respectively, indicating the poorest precision for the molar (P<.001). Trueness discrepancies for teeth types were 6.2 µm, 11.2 µm, and 21.8 µm, respectively, indicating the poorest trueness for the molar (P=.007).

CONCLUSION

In respect to accuracy the molar showed the largest discrepancies compared with the canine and premolar. Digitizing of dental impressions of abutment teeth using a white light scanner was assessed to be a highly accurate method and provided discrepancy values in a clinically acceptable range. Further study is needed to improve digitizing performance of white light scanning in axial wall.

Comparison of digital and conventional impression techniques: evaluation of patients' perception, treatment comfort, effectiveness and clinical outcomes

BACKGROUND

The purpose of this study was to compare two impression techniques from the perspective of patient preferences and treatment comfort.

METHODS

Twenty-four (12 male, 12 female) subjects who had no previous experience with either conventional or digital impression participated in this study. Conventional impressions of maxillary and mandibular dental arches were taken with a polyether impression material (Impregum, 3 M ESPE), and bite registrations were made with polysiloxane bite registration material (Futar D, Kettenbach). Two weeks later, digital impressions and bite scans were performed using an intra-oral scanner (CEREC Omnicam, Sirona). Immediately after the impressions were made, the subjects' attitudes, preferences and perceptions towards impression techniques were evaluated using a standardized questionnaire. The perceived source of stress was evaluated using the State-Trait Anxiety Scale. Processing steps of the impression techniques (tray selection, working time etc.) were recorded in seconds. Statistical analyses were performed with the Wilcoxon Rank test, and p < 0.05 was considered significant.

RESULTS

There were significant differences among the groups (p < 0.05) in terms of total working time and processing steps. Patients stated that digital impressions were more comfortable than conventional techniques.

CONCLUSIONS

Digital impressions resulted in a more time-efficient technique than conventional impressions. Patients preferred the digital impression technique rather than conventional techniques.

A comparative evaluation of wear of enamel caused by ceramics with different fusion temperatures

Dental ceramics are the most used esthetic fixed Prosthodontic restorative material today. However, dentists remain suspicious about their potential abrasivity. Lower-fusing ceramic materials developed, are claimed to be wear friendly. This study was conducted to compare the wear of enamel of extracted teeth against one conventionally used ceramic VMK-95 (fusing temperature 930 °C) and two new lower-fusing ceramics-Omega 900 and Finesse with fusing temperatures 900 and 760 °C respectively, used for metal-ceramic restorations. Metal disks were prepared from ceramic alloy and divided into three groups of 10 disks each on which VMK-95, Omega 900 and Finesse ceramics were applied respectively. Ceramic disks and tooth specimen were mounted on custom-made wear simulator and subjected to predefined masticatory test. Each tooth specimen was profiled by laser triangulation sensor before and after masticatory test. Difference in height was calculated. The results showed that mean loss of height of tooth was least against Finesse (0.3431 + 0.0177 mm) followed by Omega 900 (0.4076 + 0.0135 mm) and VMK-95 (0.6177 + 0.014 mm). Statistical analysis revealed statistically significant difference between VMK-95 & Omega 900 and VMK-95 & Finesse. The difference in loss of height of tooth against Finesse & Omega 900 is statistically insignificant (P < 0.001). The results of this study indicate that lower-fusing dental ceramics cause less wear of opposing enamel.

The influence of tray space and repeat pours on the accuracy of monophasic polyvinylsiloxane impression

AIM

While literature demonstrates that the optimum accuracy is obtained with the custom trays, the use of stock trays for elastomeric impressions appears to be popular in general practice. The aim of the study was to evaluate the effect of thickness of impression material on the dimensional accuracy of impressions made from monophasic polyvinylsiloxane impression material. This study also studies the dimensional stability of the impressions poured at different time intervals.

MATERIALS AND METHODS

A metal model simulating two abutment teeth was fabricated along with reference lines inscribed on them. Custom impression trays were fabricated with spacer thickness of 2, 4 and 6 mm. impressions were made using monophasic polyvinyl siloxane impression material. The impressions were poured and stone models were obtained. The dimensional accuracy of the impressions were determined indirectly by measuring the dimensional changes of the recovered stone models. The dimensional stability was also evaluated by pouring the impressions at time intervals of 1 hour, 24 hours and 7 days. The obtained data was statistically analyzed.

RESULTS

The results of the study indicated that the impressions made from 2 and 4 mm tray space produced more accurate stone models when compared to 6 mm tray space. There was no significant deviation in the mesiodistal and buccolingual dimensions when impressions were made using impression trays with 2, 4 and 6 mm tray spacers. There was a significant decrease in interabutment distance (p = 0.001) and height of the abutment (p = 0.024) when impressions were made using impression trays with a tray space of 6 mm. There were no significant differences found among the stone models obtained from 1 hour, 24 hours and 1 week pour times.

CONCLUSION

The mesiodistal and buccolingual dimensions of the abutments were not affected by the variations in thickness of impression material. There was a decrease in the height of the abutment which was clinically not significant. As the thickness of the impression material increased, the interabutment space decreased, which is a factor of concern when impressions are made for fixed partial dentures.

CLINICAL SIGNIFICANCE

When monophasic polyvinylsiloxane is used as the impression material, stock trays can be used for making impressions for individual castings.

Digitization and its futuristic approach in prosthodontics

Digitization has become part and parcel of the contemporary prosthodontics with the probability of most of the procedures being based on the digital techniques in near future. Let us think of X-rays or photographs, making impressions, recording jaw movements or fabricating prosthesis, educating and training new dentists or patient motivation for practice build up, all has become digital. CAD-CAM has revolutionized not just the ceramic technology but has also been used for the CAD-CAM implant surgeries, maxillofacial prosthesis and diagnostic splints. Today a practicing dentist needs to be abreast with the latest but with the technology changing so fast, this poses a great challenge. There is endless scope of digitisation and technology in prosthodontics- let it be in the clinical and lab procedures like use of CAD-CAM technology, stereolithography, rapid prototyping, use of virtual articulators and digital face bows, digital radiographs, or in the field of training, education and research by the use of virtual patient programs, dental softwares, optoelectronic recording of jaw motion, digital instron machine, retention testing device, audiovisual aids,… the list will remain endless. The article reviews those various aspects of prosthodontics where digitization has modified the conventional procedures. For discussion they have been considered under the educational aspect, diagnostics, treatment procedures, prosthesis fabrication and lastly the research and futuristic development. The day is not far when remote sensing robotic devices would be performing the restorations under the command and surveillance of the master-the dentist without his immediate presence.

Evaluation of effect of tray space on the accuracy of condensation silicone, addition silicone and polyether impression materials: an in vitro study

Optimal thickness of impression materials in the custom tray in order to get the most accurate impression. To investigate the effect of different tray spacer thickness on the accuracy and the dimensional stability of impressions made from monophasic condensation silicone, addition silicone and polyether impression materials. Three different types of elastomeric monophasic impression materials were used for making the impression of a master die with tray having tray spacer thickness of 2, 4 and 6 mm. Each type of impression was poured in die stone after 1 h. Each cast was analyzed by a travelling microscope and compared with the master die. The data was tabulated and subjected to statistical evaluation. The results of the study indicated that the impressions made from 2 to 4 mm spaced trays produced more accurate stone casts when compared to 6 mm spaced tray. No statistical significant differences were observed between the accuracy and dimensional stability of the three materials tested. Minimum changes were observed when the cast was poured after 1 h and the tray space was 2 mm for all the materials tested. It is therefore advisable not to exceed tray space of 2 mm.

Computer aided analysis of digitized dental stone replicas by dental CAD/CAM technology

OBJECTIVES

To determine the reproducibility of digitized dental stone replicas compared to the master model and the reliability of the computer aided analysis.

METHODS

Four master dies, prepared for complete crowns were fabricated in presintered yttria-stabilized tetragonal zirconia (Y-TZP). Eight vinyl polysiloxane impressions (PROVIL novo; Heraeus Kulzer) were taken of each die and stone replicas were poured in type IV stone (Vel-Mix Stone; Kerr). The master dies and the stone replicas were digitized in a touch-probe scanner (Procera Forte; Nobel Biocare AB), to create triangulated surface-models. The point-cloud from the first of the repeated digitizations of each master die was used as CAD-reference-models (CRM). Discrepancies between the points in the triangulated surface-models and the corresponding CRM were measured by a matching-software (CopyCAD 6.504 SP2; Delcam Plc). The distribution of the discrepancies was analyzed and presented in color-difference-maps.

RESULTS

The precision of the measuring method, presented as the repeatability coefficient, ranged between 7 and 16 microm (entire surface), whereas the analysis of the stone replicas revealed a precision (repeatability coefficient) ranging from 19 to 26 microm. The accuracy of the replica to master (the mean discrepancy) ranged from 0.5 to 2.0 microm (95% confidence interval 1.5-2.9 microm).

SIGNIFICANCE

The greatest precision of the measurement was seen in the jacket surface of the die. The size of the stone replicas varied and the repeatability coefficient was on average 15 microm (2-25 microm) greater for the replica-to-master alignment than the repeated digitizations of the master.

A three-dimensional evaluation of a laser scanner and a touch-probe scanner

STATEMENT OF PROBLEM

The fit of a dental restoration depends on quality throughout the entire manufacturing process. There is difficulty in assessing the surface topography of an object with a complex form, such as teeth, since there is no exact reference form.

PURPOSE

The purpose of this study was to determine the repeatability and relative accuracy of 2 dental surface digitization devices. A computer-aided design (CAD) technique was used for evaluation to calculate and present the deviations 3-dimensionally.

MATERIAL AND METHODS

Ten dies of teeth prepared for complete crowns were fabricated in presintered yttria-stabilized tetragonal zirconia (Y-TZP). The surfaces were digitized 3 times each with an optical or mechanical digitizer. The number of points in the point clouds from each reading were calculated and used as the CAD reference model (CRM). Alignments were performed by registration software that works by minimizing a distance criterion. In color-difference maps, the distribution of the discrepancies between the surfaces in the CRM and the 3-dimensional surface models was identified and located.

RESULTS

The repeatability of both scanners was within 10 microm, based on SD and absolute mean values. The qualitative evaluation resulted in an even distribution of the deviations in the optical digitizer, whereas the dominating part of the surfaces in the mechanical digitizer showed no deviations. The relative accuracy of the 2 surface digitization devices was within +/- 6 microm, based on median values.

CONCLUSION

The repeatability of the optical digitizer was comparable with the mechanical digitization device, and the relative accuracy was similar.

The use of a 3D laser scanner using superimpositional software to assess the accuracy of impression techniques

OBJECTIVE

Several studies have made comparisons in the dimensional accuracy of different elastomeric impression materials. Most have used two-dimensional measuring devices, which neglect to account for the dimensional changes that exist along a three-dimensional surface.

PURPOSE

The aim of this study was to compare the dimensional accuracy of an impression technique using a polyether material (Impregum) and a vinyl poly siloxane material (President) using a laser scanner with three-dimensional superimpositional software.

MATERIALS AND METHODS

Twenty impressions, 10 with a polyether and 10 with addition silicone, of a stone master model that resembled a dental arch containing three acrylic posterior teeth were cast in orthodontic stone. One plastic tooth was prepared for a metal crown. The master model and the casts were digitised with the non-contacting laser scanner to produce a 3D image. 3D surface viewer software superimposed the master model to the stone replica and the difference between the images analysed.

RESULTS

The mean difference between the model and the stone replica made from Impregum was 0.072mm (SD 0.006) and that for the silicone 0.097mm (SD 0.005) and this difference was statistically significantly, p=0.001.

CONCLUSIONS

Both impression materials provided an accurate replica of the prepared teeth supporting the view that these materials are highly accurate.

A technique for fabricating patterns for removable partial denture frameworks using digitized casts and electronic surveying

Although computer-aided design and manufacture techniques have shown some promising applications in the fabrication of crowns, inlays, and maxillofacial and oral surgery, the field of removable prosthodontics has not embraced these technologies so far. This article describes the development and investigation of computer-aided techniques that may eventually enable prosthodontic procedures such as surveying and the production of sacrificial patterns to be performed digitally. A 3-dimensional computer model of a conventional cast from a patient was obtained using an optical surface capture device (a scanner). The shape of a number of components of a removable partial denture framework was modeled on the 3-dimensional scan electronically, using computer-aided design software. A physical plastic shape of the components was produced using a Rapid Prototyping machine and used as a sacrificial pattern. Techniques to allow digital cast surveying before the production of sacrificial patterns were also developed. The results show that digital dental surveying and machine-produced sacrificial patterns can be accomplished. This article forms a basis for further developments leading to a fully integrated approach to the computer-aided design and fabrication of removable partial denture frameworks.

Evaluation of dental arch reproduction using three-dimensional optical digitization

STATEMENT OF PROBLEM

Numerous investigations have been done to determine the most accurate method to reproduce a dental arch. Investigations have used different definitive cast configurations, materials, and measuring techniques to evaluate dimensional change, leaving clinicians undecided as to the most accurate method to reproduce a dental arch.

PURPOSE OF STUDY

The purpose of this investigation was to evaluate the effect of impression tray selection on accuracy of reproductions of a dental arch using a 3-dimensional optical digitizer.

MATERIALS AND METHODS

Impressions were made of a stone cast of a dental arch using vinyl polysiloxane impression material in custom and stock impression trays (n=12). Custom trays, designed with full palatal coverage, were fabricated on a separate standard stone cast using 2 layers of pink baseplate wax as the spacer and tissue stops on 1 anterior tooth and both first molar teeth. Impressions were poured with type IV gypsum and allowed to set with the tray inverted (n=5) or not inverted (n=5). The standard cast and resulting casts were digitized using an optical digitizer. Custom software was used to align and process the 3-dimensional images created by the digitizer. Each image was superimposed onto the standard cast image, curves were created of the percent of points less than a defined distance between the 2 superimposed images, and the area under the curve was calculated. A weighted average area was calculated for each cast, and these values were analyzed using a 2-way ANOVA (alpha=.05).

RESULTS

The main effect of tray type, laboratory setting technique, and the interaction between these 2 characteristics was analyzed. None of these effects was significant.

CONCLUSION

The differences in accuracy of reproductions of a dental arch, regardless of the impression and laboratory techniques, were not significant when evaluated using a 3-dimensional optical digitizer.