1
|
Lee HB, Noh MJ, Bae EJ, Lee WS, Kim JH. Accuracy of zirconia crown manufactured using stereolithography and digital light processing. J Dent 2024; 141:104834. [PMID: 38217958 DOI: 10.1016/j.jdent.2024.104834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 12/30/2023] [Accepted: 01/07/2024] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVES The aim of this study is to evaluate the accuracy of zirconia crowns fabricated using stereolithography (SLA) and digital light processing (DLP) and to compare their accuracy with those fabricated using the subtractive manufacturing (SM) method. METHODS A typodont model with a prepared maxillary first molar was scanned, and the anatomical contour crown was designed using dental computer-aided-design (CAD) software. The designed file in standard tessellation language (STL) format was used to fabricate 10 crowns per group. The crowns were manufactured using a dental milling machine (Datron D5; MLC group), SLA (CERAMAKER 900; SLAC group), and DLP (ZIPRO; DLPC group) printers. The fabricated crowns were scanned using a dental laboratory scanner and saved in three parts: the external, intaglio, and marginal surfaces. For accuracy assessment, these parts were superimposed to the reference file. Root mean square (RMS) values were evaluated using three-dimensional analysis software (Geomagic Control X). Statistical significance was evaluated using a nonparametric Kruskal-Wallis test (α = 0.05) and a post-hoc Mann-Whitney U test with Bonferroni correction (α = 0.016). RESULTS Trueness evaluation revealed the lowest RMS value in all areas in the MLC group, followed by that in the DLPC group. The precision evaluation revealed the lowest RMS value in all areas in the MLC group. Statistically significant differences were observed among the groups in the external, intaglio, and marginal surface (P < 0.05). CONCLUSIONS Although the restorations fabricated using SM revealed higher accuracy, the crowns manufactured using SLA and DLP methods were considered clinically acceptable. CLINICAL SIGNIFICANCE In the production of zirconia crowns, subtractive manufacturing continues to demonstrate significantly higher accuracy compared to additive manufacturing. However, crowns fabricated using the additive manufacturing method also demonstrated high accuracy.
Collapse
Affiliation(s)
- Ha-Bin Lee
- Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Hana Sciences Hall B #374, 145, Anam-ro, Seongbuk-gu, Seoul, Korea
| | - Mi-Jun Noh
- Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Hana Sciences Hall B #374, 145, Anam-ro, Seongbuk-gu, Seoul, Korea
| | - Eun-Jeong Bae
- Department Of Dental Technology, Bucheon University, 56, Sosa-ro, Bucheon, Gyeonggi-do, Korea
| | - Wan-Sun Lee
- Department Of Dental Technology, Bucheon University, 56, Sosa-ro, Bucheon, Gyeonggi-do, Korea
| | - Ji-Hwan Kim
- Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Hana Sciences Hall B #374, 145, Anam-ro, Seongbuk-gu, Seoul, Korea.
| |
Collapse
|
2
|
Lupi SM, De Martis D, Todaro C, Isola G, Beretta M, Rodriguez y Baena R. Conometric Connection for Implant-Supported Crowns: A Prospective Clinical Cohort Study. J Clin Med 2023; 12:7647. [PMID: 38137716 PMCID: PMC10743547 DOI: 10.3390/jcm12247647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND Traditional screw or cemented connections in dental implants present limitations, prompting the exploration of alternative methods. This study assesses the clinical outcomes of single crowns and fixed partial prostheses supported by conometric connections after one year of follow-up. METHODS Twenty-two patients received 70 implants, supporting 33 rehabilitations. Biological responses and prosthodontic complications were evaluated at baseline, 6 months, and 12 months. RESULTS All implants exhibited successful osseointegration, with no losses or peri-implant inflammation. Marginal bone levels showed minimal changes, well below pathological thresholds. The difference in marginal bone loss (MBL) was -0.27 ± 0.79 mm between T0 and T1, and -0.51 ± 0.93 mm between T0 and T2. No abutment screw loosening or crown chipping occurred. However, coupling stability loss was observed in nine cases. CONCLUSIONS The conometric connection demonstrated successful integration and minimal complications after one year. This alternative shows promise, particularly in simplifying handling and improving marginal adaptation. Further research with larger sample sizes and longer follow-up is warranted for comprehensive validation.
Collapse
Affiliation(s)
- Saturnino Marco Lupi
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy; (S.M.L.); (D.D.M.); (R.R.y.B.)
| | - Dario De Martis
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy; (S.M.L.); (D.D.M.); (R.R.y.B.)
| | - Claudia Todaro
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy; (S.M.L.); (D.D.M.); (R.R.y.B.)
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, 95124 Catania, Italy;
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy;
| | - Ruggero Rodriguez y Baena
- Department of Clinical Surgical, Diagnostic and Pediatric Sciences, School of Dentistry, University of Pavia, 27100 Pavia, Italy; (S.M.L.); (D.D.M.); (R.R.y.B.)
| |
Collapse
|
3
|
Al-Chalabi ZS, Tuna SH. The effect of thermomechanical aging on the retention of a conometric system in a chewing simulator. J Prosthodont 2023; 32:838-845. [PMID: 36600594 DOI: 10.1111/jopr.13638] [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: 04/08/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To evaluate the retention force of a novel conometric system after thermomechanical aging. In addition, the conometric system's retention force was compared with that of the cemented implant-retained crowns. MATERIALS AND METHODS Two systems to retain implant crowns were tested in this study: a conometric system and a cement-retained system. Forty-eight zirconia crowns were fabricated using computer-aided design and computer-aided manufacturing technology. Twenty-four zirconia crowns were cemented onto conometric caps with resin-modified glass ionomer cement, which were then connected with abutments. These specimens were divided into three groups, and each group was subjected to the pull-out test. A-control group: 12 specimens directly subjected to pull-out test; A-aged group: 12 specimens subjected to thermomechanical aging followed by pull-out test; A-repeat group: After the pull-out, the specimens in the aging group (A-aged) were reconnected, and the pull-out test was repeated once more. The remaining 24 zirconia crowns were cemented on standard abutments with zinc phosphate cement, and two groups were formed. C-control group: 12 specimens directly subjected to the pull-out test; C-aged group: 12 specimens subjected to thermomechanical aging followed by pull-out. Scanning electron microscope (SEM) was used to evaluate the surfaces of caps and abutments. To analyze the data, repeated measures, one-way ANOVA, and Bonferroni tests were used (p < 0.05). RESULTS The mean retention force value of the A-control group was 148.22 ± 16.37 N. The highest mean retention force value was measured in the A-aged group (204.93 ± 51.67 N), and the lowest mean retention force value was seen in the A-repeated group (77.02 ± 21.48 N). Thermomechanical aging had a significant influence (p < 0.05) on both systems. No significant differences in retention force were found between the thermomechanical aged groups of both systems (p > 0.05). SEM analysis revealed that aging had an impact on the surface of the conometric system's caps and abutments. CONCLUSIONS The retention force of the conometric system increased significantly following thermomechanical aging. No crown separation occurred during the thermomechanical aging of the conometric system. There was no significant difference in the retention of the conometric and cemented systems after thermomechanical aging.
Collapse
Affiliation(s)
- Zainab S Al-Chalabi
- Department of Prosthodontics, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Süleyman H Tuna
- Department of Prosthodontics, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| |
Collapse
|
4
|
The Conometric Connection for the Implant-Supported Fixed Prosthesis: A Narrative Review. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4030037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: The conometric concept was proposed as a possible connection between the abutment and the prosthetic coping. This research aimed to review the features and possible clinical uses of this connection in an implant-supported fixed prosthesis. Methods: An electronic search was conducted on an online database for the topic in object; articles published in international literature were considered and the research gave 17 results, and 6 parameters were analyzed. Results: This connection eliminated the possibility of cement residues in the subgingival region, reducing the risk of inflammation of peri-implant soft and hard tissues; not having to remove the cement residues, it is possible to place the margins in more apical portions, improving the aesthetics outcomes of the rehabilitations. It is also known that the retention by means of a screw causes a weakening of the restoration. The retentive force is adequate for fixed rehabilitation even after a high number of insertion–disengagement cycles; in vitro studies have also shown a high bacterial sealing. Implant rehabilitation using preformed components, such as conometric hoods, is helpful for CAD/CAM, so a digital workflow is possible. Several types of prosthesis were presented, all of which demonstrated adequate clinical performance in the follow-up observation. Conclusions: This type of connection seems to be suitable to support fixed implant rehabilitations, but long-term clinical studies are needed to validate this system.
Collapse
|
5
|
Schäfer S, Smeets R, Köpf M, Drinic A, Kopp A, Kröger N, Hartjen P, Assaf AT, Aavani F, Beikler T, Peters U, Fiedler I, Busse B, Stürmer EK, Vollkommer T, Gosau M, Fuest S. Antibacterial properties of functionalized silk fibroin and sericin membranes for wound healing applications in oral and maxillofacial surgery. BIOMATERIALS ADVANCES 2022; 135:212740. [PMID: 35929202 DOI: 10.1016/j.bioadv.2022.212740] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 02/13/2022] [Accepted: 02/25/2022] [Indexed: 06/15/2023]
Abstract
Oral wounds are among the most troublesome injuries which easily affect the patients' quality of life. To date, the development of functional antibacterial dressings for oral wound healing remains a challenge. In this regard, we investigated antibacterial silk protein-based membranes for the application as wound dressings in oral and maxillofacial surgery. The present study includes five variants of casted membranes, i.e., i) membranes-silver nanoparticles (CM-Ag), ii) membranes-gentamicin (CM-G), iii) membranes-control (without functionalization) (CM-C), iv) membranes-silk sericin control (CM-SSC), and v) membranes-silk fibroin/silk sericin (CM-SF/SS), and three variants of nonwovens, i.e., i) silver nanoparticles (NW-Ag), ii) gentamicin (NW-G), iii) control (without functionalization) (NW-C). The surface structure of the samples was visualized with scanning electron microscopy. In addition, antibacterial testing was accomplished using agar diffusion assay, colony forming unit (CFU) analysis, and qrt-PCR. Following antibacterial assays, biocompatibility was evaluated by cell proliferation assay (XTT), cytotoxicity assay (LDH), and live-dead assay on L929 mouse fibroblasts. Findings indicated significantly lower bacterial colony growth and DNA counts for CM-Ag with a reduction of bacterial counts by 3log levels (99.9% reduction) in CFU and qrt-PCR assay compared to untreated control membranes (CM-C and CM-SSC) and membranes functionalized with gentamicin (CM-G and NW-G) (p < 0.001). Similarly, NW-G yielded significantly lower DNA and colony growth counts compared to NW-Ag and NW-C (p < 0.001). In conclusion, CM-Ag represented 1log level better antibacterial activity compared to NW-G, whereas NW-G showed better cytocompatibility for L929 cells. As data suggest, these two membranes have the potential of application in the field of bacteria-free oral wound healing. However, provided that loading strategy and cytocompatibility are adjusted according to the antibacterial agents' characteristic and fabrication technique of the membranes.
Collapse
Affiliation(s)
- Sogand Schäfer
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany; Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | | | | | | | - Nadja Kröger
- Department of Plastic, Reconstructive and Aesthetic Surgery, University Hospital of Cologne, 50937 Cologne, Germany
| | - Philip Hartjen
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Alexandre Thomas Assaf
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Farzaneh Aavani
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Imke Fiedler
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Ewa K Stürmer
- Department of Vascular Medicine, University Heart Center, Translational Wound Research, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Tobias Vollkommer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany.
| | - Sandra Fuest
- Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251 Hamburg, Germany.
| |
Collapse
|
6
|
Gehrke P, Burg S, Peters U, Beikler T, Fischer C, Rupp F, Schweizer E, Weigl P, Sader R, Smeets R, Schäfer S. Bacterial translocation and microgap formation at a novel conical indexed implant abutment system for single crowns. Clin Oral Investig 2021; 26:1375-1389. [PMID: 34401947 PMCID: PMC8816325 DOI: 10.1007/s00784-021-04112-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 07/27/2021] [Indexed: 10/26/2022]
Abstract
OBJECTIVES A conometric concept was recently introduced in which conical implant abutments hold the matching crown copings by friction alone, eliminating the need for cement or screws. The aim of this in vitro study was to assess the presence of microgap formation and bacterial leakage at the Acuris conometric restorative interface of three different implant abutment systems. MATERIAL AND METHODS A total of 75 Acuris samples of three implant-abutment systems (Ankylos, Astra Tech EV, Xive) were subjected to microbiological (n = 60) and scanning electron microscopic (SEM) investigation (n = 15). Bacterial migration into and out of the conical coupling system were analyzed in an anaerobic workstation for 48, 96, 144, and 192 h. Bacterial DNA quantification using qrt-PCR was performed at each time point. The precision of the conometric coupling and internal fit of cemented CAD/CAM crowns on corresponding Acuris TiN copings were determined by means of SEM. RESULTS qrt-PCR results failed to demonstrate microbial leakage from or into the Acuris system. SEM analysis revealed minute punctate microgaps at the apical aspect of the conometric junction (2.04 to 2.64 µm), while mean cement gaps of 12 to 145 µm were observed at the crown-coping interface. CONCLUSIONS The prosthetic morse taper connection of all systems examined does not allow bacterial passage. Marginal integrity and internal luting gap between the ceramic crown and the coping remained within the clinically acceptable limits. CLINICAL RELEVANCE Conometrically seated single crowns provide sufficient sealing efficiency, relocating potential misfits from the crown-abutment interface to the crown-coping interface.
Collapse
Affiliation(s)
- Peter Gehrke
- Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany. .,Private Practice for Oral Surgery and Implant Dentistry, Bismarckstraße 27, 67059, Ludwigshafen, Germany.
| | - Simon Burg
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany
| | - Ulrike Peters
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Carsten Fischer
- Dental Laboratory, Sirius Ceramics, 60528, Frankfurt am Main, Germany
| | - Frank Rupp
- Section Medical Materials Science and Technology, University Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Ernst Schweizer
- Section Medical Materials Science and Technology, University Hospital Tuebingen, 72076, Tuebingen, Germany
| | - Paul Weigl
- Department of Postgraduate Education, Center for Dentistry and Oral Medicine (Carolinum), University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center, University Hospital, Goethe University Frankfurt, 60528, Frankfurt am Main, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany.,Department of Oral and Maxillofacial Surgery, Division of Regenerative Orofacial Medicine, University Hospital Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Sogand Schäfer
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, 20251Hamburg, Germany
| |
Collapse
|