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Auškalnis L, Akulauskas M, Osnes C, Revilla-León M, Kernen-Gintautė A, Rutkūnas V. Trueness of maxillomandibular relationship in 3D-printed and conventional casts. J Dent 2024:105044. [PMID: 38710316 DOI: 10.1016/j.jdent.2024.105044] [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: 11/07/2023] [Revised: 04/10/2024] [Accepted: 05/03/2024] [Indexed: 05/08/2024] Open
Abstract
OBJECTIVES To compare the trueness of maxillomandibular relationship between articulated 3D-printed and conventional diagnostic casts in maximum intercuspation (MIP). METHODS Reference casts were articulated in MIP, and scanned using a Coordinate Measurement Machine (CMM, n = 1). Digital scans were made from the reference casts by using an intraoral scanner (IOS, n = 10) (Trios 4; 3Shape A/S). IOS scans were processed to create 3D-printed casts by using MAX UV385 (Asiga) and NextDent 5100 (3DSystems) 3D-printers. The conventional workflow implemented vinylpolysiloxane (VPS) impressions and Type IV stone. Stone and 3D-printed casts were articulated and digitized with a laboratory scanner (E4; 3Shape A/S). The 3D-printed casts were scanned on two occasions: with and without positioning pins. Inter-arch distances and 3D-contact area were measured and compared. Statistical tests used were Shapiro-Wilk, Levene's, Welch's t-test, and 2-way ANOVA (α=0.05). RESULTS IOS group showed similar or better maxillomandibular relationship trueness than stone casts and 3D-printed casts (p < 0.05). 3D-contact area analysis showed similar deviations between 3D-printed and stone casts (p > 0.05). The choice of 3D-printer and presence of positioning pins on the casts significantly influenced maxillomandibular relationship trueness (p < 0.05). CONCLUSIONS Articulated 3D-printed and stone casts exhibited similar maxillomandibular relationship trueness. CLINICAL SIGNIFICANCE Although 3D-printing methods can introduce a considerable amount of deviations, the maxillomandibular relationship trueness of articulated 3D-printed and stone casts in MIP can be considered similar.
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Affiliation(s)
- Liudas Auškalnis
- PhD student, Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
| | - Mykolas Akulauskas
- PhD student, Biomedical Engineering Institute, Kaunas University of Technology, Kaunas, Lithuania
| | - Cecilie Osnes
- Research Assistant, School of Dentistry, University of Leeds, Leeds, UK
| | - Marta Revilla-León
- DDS, MSD, PhD, Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash and Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass, USA
| | - Aistė Kernen-Gintautė
- Dr. med. dent., University Hospital Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Germany
| | - Vygandas Rutkūnas
- Professor, PhD, Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Schubert O, Goob J, Schweiger J, Güth JF, Edelhoff D, Graf T. Clinical performance of monolithic lithium disilicate hybrid abutment crowns over at least 3.5 years. J Prosthodont 2024; 33:34-40. [PMID: 37243453 DOI: 10.1111/jopr.13719] [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: 01/03/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023] Open
Abstract
PURPOSE Hybrid abutment crowns (HACs) made from monolithic ceramics represent an efficient option for single restorations on implants. However, long-term data are scarce. The purpose of this clinical trial was to evaluate the survival and complication rates of CAD-CAM fabricated HACs over a time period of at least 3.5 years. MATERIALS AND METHODS Twenty-five patients with a total of 40 HACs made of monolithic lithium disilicate ceramic bonded to a titanium base CAD-CAM abutment were retrospectively evaluated. All implants and screw-retained restorations were placed and manufactured in the same department of a university hospital. Only crowns that had been in service for more than 3.5 years were included in the study. HACs were evaluated regarding technical and biological complications. Functional Implant Prosthodontic Scores (FIPS) were obtained. RESULTS The mean observation time was 5.9 ± 1.4 years. Implant survival was 100%, and HAC survival was 97.5%. Over the observation period, one crown fracture was observed, necessitating refabricating of the restoration. Three minor biological complications were found. The overall mean FIPS score was 8.69 ± 1.12 points. CONCLUSIONS Within the limitations of this study, monolithic screw-retained HACs milled from lithium disilicate ceramics and bonded to titanium bases appeared to be a reliable treatment option over more than 3.5 years due to their low biological and technical complication rates.
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Affiliation(s)
- Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Janosch Goob
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Jan-Frederik Güth
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Graf
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University Frankfurt am Main, Frankfurt am Main, Germany
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Edinger D, Henningsen A, Bibiza E, Smeets R, Joda T. Comparison of functional and esthetic outcomes in digital versus analog rehabilitation of one-piece screw-retained implant crowns placed at second stage surgery. J Prosthodont 2023; 32:793-800. [PMID: 37194739 DOI: 10.1111/jopr.13699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/20/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023] Open
Abstract
PURPOSE Analog and digital impressions are established procedures for restoration of single-tooth implants. In this study, single-tooth implants were restored with definitive restorations during second-stage surgery. Analog and digital workflows were compared. MATERIAL AND METHODS Eighty single-tooth implants were examined in total. In 40 implants, an index was taken immediately after implant placement using composite resin to fabricate the final crowns (analog workflow). For the other 40 single-tooth implants, intraoral intraoperative scans were performed (digital workflow) during primary surgery. The custom-fabricated screw-retained crowns were placed during second-stage surgery. Photographs and examinations for the scores were taken at the time of the follow-up visit, 1-4 years after placement of the crowns. The number of treatment appointments required was recorded and the modified pink esthetic score (PES) was determined. Additionally, the functional implant prosthetic score (FIPS) was measured. RESULTS The mean PES was 12.15/14 for the digital workflow and 11.95/14 for the analog workflow. The most common deficit was incomplete papillae for both workflows. Three treatment appointments were required for both workflows: (1) Scan and/or impressions making and patient consent, (2) implant placement, and (3) second-stage surgery with crown insertion. The FIPS was 9.1/10 for the digital workflow group and 9.2/10 for the analog workflow group. Common deficits presented as missing papillae as well as open approximal contacts. The FIPS was not significantly different between workflows (p = 0.679). The PES also did not show a statistically significant difference for both workflows (p = 0.654), however, the analog workflow showed better values for the papillae (p < 0.05). A significant difference was also found in the other PES values, with the digital workflow showing better results here (p < 0.05). A chronological analysis of the results of the digital technique showed that the cases treated last had significantly better values than the cases treated first. CONCLUSIONS According to the results of this study, both workflows allowed placement of the definitive crowns on single-tooth implants during second-stage surgery. Both workflows were found to be equivalent in terms of esthetic results in this study, although the digital workflow demonstrated a learning curve.
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Affiliation(s)
| | - Anders Henningsen
- University Medical Center Hamburg-Eppendorf, Division, Regenerative Orofacial Medicine, Hamburg, Germany
| | - Eric Bibiza
- University Medical Center Hamburg-Eppendorf, Division, Regenerative Orofacial Medicine, Hamburg, Germany
| | - Ralf Smeets
- University Medical Center Hamburg-Eppendorf, Division, Regenerative Orofacial Medicine, Hamburg, Germany
| | - Tim Joda
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Reconstructive Dentistry, University Center of Dental Medicine Basel, University of Basel, Basel, Switzerland
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Ioannidis A, Pala K, Strauss FJ, Hjerppe J, Jung RE, Joda T. Additively and subtractively manufactured implant-supported fixed dental prostheses: A systematic review. Clin Oral Implants Res 2023; 34 Suppl 26:50-63. [PMID: 37750533 DOI: 10.1111/clr.14085] [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: 02/06/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 09/27/2023]
Abstract
AIM To compare and report on the performance of implant-supported fixed dental prostheses (iFDPs) fabricated using additive (AM) or subtractive (SM) manufacturing. METHODS An electronic search was conducted (Medline, Embase, Cochrane Central, Epistemonikos, clinical trials registries) with a focused PICO question: In partially edentulous patients with missing single (or multiple) teeth undergoing dental implant therapy (P), do AM iFDPs (I) compared to SM iFDPs (C) result in improved clinical performance (O)? Included were studies comparing AM to SM iFDPs (randomized clinical trials, prospective/retrospective clinical studies, case series, in vitro studies). RESULTS Of 2'184 citations, no clinical study met the inclusion criteria, whereas six in vitro studies proved to be eligible. Due to the lack of clinical studies and considerable heterogeneity across the studies, no meta-analysis could be performed. AM iFDPs were made of zirconia and polymers. For SM iFDPs, zirconia, lithium disilicate, resin-modified ceramics and different types of polymer-based materials were used. Performance was evaluated by assessing marginal and internal discrepancies and mechanical properties (fracture loads, bending moments). Three of the included studies examined the marginal and internal discrepancies of interim or definitive iFDPs, while four examined mechanical properties. Based on marginal and internal discrepancies as well as the mechanical properties of AM and SM iFDPs, the studies revealed inconclusive results. CONCLUSION Despite the development of AM and the comprehensive search, there is very limited data available on the performance of AM iFDPs and their comparison to SM techniques. Therefore, the clinical performance of iFDPs by AM remains to be elucidated.
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Affiliation(s)
- Alexis Ioannidis
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Kevser Pala
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jenni Hjerppe
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Tim Joda
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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Graf T, Schweiger J, Stimmelmayr M, Erdelt K, Schubert O, Güth JF. Influence of monolithic restorative materials on the implant-abutment interface of hybrid abutment crowns: An in vitro investigation. J Prosthodont Res 2023; 67:450-459. [PMID: 36517017 DOI: 10.2186/jpr.jpr_d_22_00115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Purpose This in vitro study aimed to investigate the long-term performance, stability, and fracture mode of monolithic hybrid abutment crowns, and the effect of different materials on the implant-abutment interface (IAI).Methods Eighty monolithic hybrid abutment crowns luted on titanium bases were manufactured from 3Y-TZP zirconia (ZY3), "Gradient Technology" zirconia (ZY35), 5Y-TZP zirconia (ZY5), lithium disilicate ceramic (LDS), zirconia-reinforced lithium silicate ceramic (ZLS), polymer-infiltrated ceramic network (MHY), polymethylmethacrylate (PMA), and 3D-printed hybrid composite (PHC) (n = 10 for each material). Eighty implants (Camlog Progressive-Line, diameter: 3.8 mm) were embedded in accordance with ISO standard 14801, and crowns were mounted. After artificial aging (1.2 × 106 cycles, 50 N, thermocycling), intact specimens were loaded 30° off-axis in a universal testing machine until failure.Results Seven specimens in the PHC group failed during artificial aging, and all the others survived. There were two subgroups based on the one-way analysis of variance and Dunnett's test (P < 0.05) of the mean fracture load values. The first comprised Z3Y, ZY35, Z5Y, and LDS, with mean fracture loads between 499.4 and 529.7 N, while the second included ZLS, MHY, and PMA, with values in the 346.2-416.0 N range. ZY3, ZY35, ZY5, and LDS exhibited irreversible, visible deformations of the implant shoulders with varying dimensions after load-to-fracture tests.Conclusions Crowns made of LDS, ZLS, MHY, and PMA may act as potential stress breakers, and prevent possible deformation at IAIs. Further clinical studies need to assess if these materials also withstand relevant loads in-vivo.
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Affiliation(s)
- Tobias Graf
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Kurt Erdelt
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Jan-Frederik Güth
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Germany
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Valenti M, Valenti A, Schmitz JH, Cortellini D, Canale A. Survival analysis up to 7 years of 621 zirconia monolithic single crowns with feather-edge margins fabricated with a cast-free workflow starting from intraoral scans: A multicentric retrospective study. J Prosthet Dent 2023; 129:76-82. [PMID: 35850872 DOI: 10.1016/j.prosdent.2022.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 01/18/2023]
Abstract
STATEMENT OF PROBLEM Clinical studies on the fabrication of monolithic zirconia restorations with a feather-edge tooth preparation from digital scans and a cast-free fully digital workflow are lacking. PURPOSE The purpose of this retrospective multicentric study in private practices was to evaluate the outcomes of monolithic zirconia crowns fabricated with feather-edge margins and a cast-free approach. MATERIAL AND METHODS A total of 621 teeth were prepared with feather-edge margins and restored with monolithic zirconia crowns fabricated with a fully digital cast-free workflow. Data were analyzed by using the Kaplan-Meier test and descriptive statistics. The clinical evaluation adopted the California Dental Association-modified criteria after recalling all patients between April and July 2021. RESULTS The clinical survival of 619 of 621 crowns, including recemented crowns placed in 427 patients (217 men, 220 women) over 5 years (2014 to 2019 with crowns in service between 12 and 85 months), was analyzed. The 2 excluded crowns were delivered to patients who dropped out of the study. Of the 619 crowns, 5 failed during the follow-up period: 4 teeth were extracted because of fracture and 1 restoration fractured. No other technical or biological failures were observed. The mean overall survival time was 84.4 months (standard error, 0.255; 95% confidence interval for the mean, 83.92 to 84.92). The overall survival probability was 99.1% up to 85 months. CONCLUSIONS The clinical outcomes of the monolithic zirconia crowns with feather-edge margins evaluated were comparable with outcomes reported using other margin designs and materials.
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Mata-Mata SJ, Donmez MB, Meirelles L, Johnston WM, Yilmaz B. Influence of digital implant analog design on the positional trueness of an analog in additively manufactured models: An in-vitro study. Clin Implant Dent Relat Res 2022; 24:821-830. [PMID: 36196856 DOI: 10.1111/cid.13137] [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: 06/23/2022] [Revised: 08/19/2022] [Accepted: 09/14/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Limited evidence exists regarding the accuracy of implant analog position in printed models, particularly when implant analogs with varying designs are used. PURPOSE To evaluate the effect of digital implant analog (DIA) design on the trueness of their position in additively manufactured digital implant models (DIMs) and to compare with that of a conventional implant analog in a stone cast. MATERIALS AND METHODS A dentate maxillary model with a conventional implant analog (Nobel Biocare Implant Replica 4.3 mm CC RP) at left second premolar site was digitized by using a laboratory scanner (3Shape D2000) and a (SB) scan body to generate the master standard tessellation language (STL) file (M0). 12 custom trays were fabricated on M0 file and conventional polyvinylsiloxane impressions of the model were made. All impressions were poured after inserting conventional implant analogs (Nobel RP Implant Replica) (Group A). Model was then digitized with an intraoral scanner (TRIOS 3) and the same SB, and DIMs with three different DIA designs (Nobel Biocare [Group B], Elos [Group C], and NT-trading [Group D]) were generated (Dental System-Model Builder). 12 DIMs of each design were additively manufactured and corresponding DIAs were inserted. All models were digitized by using the same laboratory scanner and SB, and these STLs were transferred to a 3D analysis software (Geomagic Control X), where the STL files of the models were superimposed over M0. Linear and 3D deviations at three selected points on SB (implant-abutment connection, most cervical point on SB, and most coronal point on SB) as well as angular deviations on two planes (buccolingual and mesiodistal) were calculated. Analysis of variance (ANOVA) and Bonferroni corrected t-tests were used to analyze the trueness of implant analog positions (α = 0.05). RESULTS The interaction of main effects significantly affected linear (p < 0.001) and angular deviations (p = 0.020). At point 1, group D had higher deviations than groups A and B (p ≤ 0.015). In addition, groups A and D had higher deviations than group B at point 4 (p < 0.001). While group C had similar linear deviations to those of other groups at point 1 and point 4 (p ≥ 0.192), the differences among test groups at point 2 were nonsignificant (p ≥ 0.276). Group B had lower angular deviations than groups C (p = 0.039) and D (p = 0.006) on buccolingual plane. CONCLUSIONS Analog design affected the trueness of analog position as proprietary, pressure/friction fit DIA (group B) had higher linear trueness than screw-retained DIA (Group D) and conventional implant analog (group A). In addition, pressure/friction fit DIA had the highest angular trueness among tested DIAs.
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Affiliation(s)
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey
| | - Luiz Meirelles
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - William Michael Johnston
- Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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