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Marouki C, Shamon A, Svanborg P. Evaluation of fit and accuracy of single crowns fabricated from self-glazed zirconia compared with milled zirconia. J Prosthet Dent 2024; 131:1105-1110. [PMID: 36959004 DOI: 10.1016/j.prosdent.2023.02.016] [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: 12/02/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 03/25/2023]
Abstract
STATEMENT OF PROBLEM Self-glazed zirconia is a novel dental material fabricated with a combination of subtractive and additive manufacturing techniques. However, how the marginal and internal fit of these restorations compare with conventionally fabricated zirconia is unclear. PURPOSE The purpose of this in vitro study was to evaluate the marginal and internal fit and internal accuracy of single crowns made from self-glazed zirconia compared with those made from milled zirconia. MATERIAL AND METHODS A metal die was scanned, and a crown was designed using a computer-aided-design program. The computer-aided-manufacturing milling method (conventional technique) was used to produce 10 zirconia crowns, and additive manufacturing was used to produce 10 self-glazed zirconia crowns. Internal and marginal fit measurements were made by using the silicone replica method; marginal fit was also measured by using the direct-view technique. An independent t test was performed to compare both types of crowns and test the null hypothesis (α=.05). RESULTS For the occlusal, internal, and total mean distances, significant differences were found between self-glazed and milled zirconia crowns (P<.001). With the direct-view technique, a significant difference (P=.004) between the 2 techniques was found in the marginal area. The accuracy for the axial and occlusal areas combined for self-glazed and milled zirconia was 27 μm and 49 μm, respectively. CONCLUSIONS Both techniques produced crowns with clinically acceptable marginal and internal fit. The self-glazed zirconia crowns had higher accuracy of internal fit than milled zirconia crowns.
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Affiliation(s)
| | - Assal Shamon
- Public Health Service, Region Stockholm, Stockholm, Sweden
| | - Per Svanborg
- Senior Lecturer, Department of Prosthodontics/Dental materials Science, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
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Hosseini M, Worsaae N, Gotfredsen K. SURVIVAL RATE OF IMPLANT-SUPPORTED, SINGLE-TOOTH RESTORATIONS BASED ON ZIRCONIA OR METAL ABUTMENT IN PATIENTS WITH TOOTH AGENESIS: A 5-YEARS PROSPECTIVE CLINICAL STUDY. J Evid Based Dent Pract 2024; 24:101970. [PMID: 38821661 DOI: 10.1016/j.jebdp.2024.101970] [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: 10/13/2023] [Revised: 12/22/2023] [Accepted: 01/13/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES The primary aim was to investigate survival rate of zirconia versus metal abutments, and the secondary aim was clinical outcomes of all-ceramic versus metal-ceramic crowns on single-tooth implants. METHODS Patients with tooth-agenesis participated to previously published prospective clinical study with 3-year follow-up were recalled after 5 years. Biological variables included survival and success rate of implants, marginal bone level, modified Plaque and Sulcus Bleeding Index and biological complications. Technical variables included restoration survival rate, marginal adaptation and technical complications. The aesthetic outcome of crowns and peri-implant mucosa in addition to patient-reported outcome were recorded. Descriptive analysis, linear mixed model for quantitative data, or generalized linear mixed model for ordinal categorical data were applied; significance was set to 0.05. RESULTS Fifty-three patients (mean age: 32.4 years), with 89 implants participated to the 5-years examination. The implants supported 50 zirconia abutments with 50 all-ceramic (AC) crown and 39 metal abutments with 29 metal-ceramic (MC) and 10 AC crowns. The Implant and restoration survival rate was 100% and 96%, respectively. No clinically relevant biological difference between implants supporting metal or zirconia abutments was registered. The technical complications were veneering fracture of AC-crowns (n = 3), crown loosening of MC-crowns (n = 4) and one abutment screw loosening (MC-crown on metal abutment). MC-crowns had significantly better marginal adaptation than AC-crowns (p = .01). AC-crowns had significantly better color and morphology than MC-crowns (p = .01). CONCLUSIONS Zirconia-based single-tooth restorations are reliable alternative materials to metal-based restorations with favorable biological and aesthetic outcome, and few technical complications.
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Affiliation(s)
- Mandana Hosseini
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen N-2200, Denmark.
| | - Nils Worsaae
- Department of Oral and Maxillofacial Surgery, University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen N-2200, Denmark
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Lim YA, Kim JM, Choi Y, Park S. Evaluation of Fitness and Accuracy of Milled and Three-Dimensionally Printed Inlays. Eur J Dent 2023; 17:1029-1036. [PMID: 36599450 PMCID: PMC10756847 DOI: 10.1055/s-0042-1758796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE This article compares and evaluates the marginal and internal fitness and three-dimensional (3D) accuracy of class II inlays fabricated using Tescera (TS) resin, milling of hybrid and zirconia blocks, and 3D printing with NextDent C&B. MATERIALS AND METHODS Fifty-two mesio-occlusal inlays were fabricated using conventional method with TS, milling of Lava Ultimate (LU), milling of Zolid Fx multilayer (ZR), and 3D printing (n = 13 each). The marginal and internal fitness were evaluated at six points in the mesio-distal section of a replica under a digital microscope (160× magnification), and the accuracy was evaluated using 3D software. Analyses were conducted using t-test, one-way analysis of variance (ANOVA) and two-way ANOVA, while Duncan's multiple range test was used for post hoc analyses (α = 0.05). RESULTS The marginal and internal fitness of the 3D and ZR were significantly superior to that of the TS and LU. For LU, ZR, and 3D, a significant discrepancy between the marginal gap and internal gap was observed (p < 0.05). On evaluating accuracy, trueness was significantly higher in ZR than in TS and LU; precision was significantly higher in 3D and ZR than in TS and LU (p < 0.05). CONCLUSION The marginal and internal fitness and the accuracy of TS, ZR, and 3D were within the clinically acceptable range. The marginal and internal fitness and accuracy of 3D were better than those of TS and LU, which are commonly used in dentistry. There is immense potential for using 3D-printed inlays in routine clinical practice.
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Affiliation(s)
- Yoen Ah Lim
- Department of Conservative Dentistry, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - Jeong Mi Kim
- Wonkwang University Dental Hospital, Central Dental Laboratory, Iksan, Republic of Korea
| | - Yoorina Choi
- Department of Conservative Dentistry, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - Sujung Park
- Department of Conservative Dentistry, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
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The Effect of a Digital Manufacturing Technique, Preparation Taper, and Finish Line Design on the Marginal Fit of Temporary Molar Crowns: An In-Vitro Study. Biomedicines 2023; 11:biomedicines11020570. [PMID: 36831106 PMCID: PMC9953521 DOI: 10.3390/biomedicines11020570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
The aim of this study is to investigate the combined effect of a digital manufacturing technique (subtractive vs. additive), preparation taper (10° vs. 20° TOC), and finish line (chamfer vs. shoulder) on the marginal adaptation of temporary crowns following cementation with a compatible temporary cement. Four mandibular first molar typodont teeth were prepared for full coverage crowns with standard 4 mm preparation height as follows: 10° TOC with the chamfer finish line, 10° TOC with the shoulder finish line, 20° TOC with the chamfer finish line and 20° TOC with the shoulder finish line. Each of the four preparation designs were subdivided into two subgroups to receive CAD/CAM milled and 3D-printed crowns (n = 10). A total of 80 temporary crowns (40 CAD/CAM milled and 40 3D-printed) were cemented to their respective die using clear temporary recement in the standard cementation technique. The samples were examined under a stereomicroscope at ×100 magnification following calibration. Linear measurements were performed at seven equidistant points on each axial surface and five equidistant points on each proximal surface. One-way ANOVA analysis and Tukey HSD (Honestly Significance Difference) were performed. The best marginal fit was seen in group 8, while the poorest fit was noted in group 2. Shoulder finish lines and 10° TOC resulted in higher marginal gaps, especially in CAD/CAM milled group. The selection of 3D-printed crowns may provide a better marginal fit within the range of clinical acceptability. Marginal gaps were within clinical acceptability (50 and 120 µm) in all groups except group 2.
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Marginal and Internal Fit of Monolithic Zirconia Crowns Fabricated by Using Two Different CAD-CAM Workflows: An In Vitro Study. PROSTHESIS 2023. [DOI: 10.3390/prosthesis5010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives: Few studies have evaluated the marginal fit of computer-aided design—computer-aided manufacturing (CAD-CAM) monolithic zirconia crowns fabricated through completely digital workflow; however, the internal fit of these restorations is not well known. The purpose of this in vitro study was to evaluate the marginal and internal fit of monolithic zirconia crowns fabricated by using digital workflow, including intraoral scanner (IOS) scans, and compare the results to those of a semi-digital workflow, which combined conventional impressions, poured casts, and extraoral scanner (EOS) scanning. Materials and methods: A typodont right mandibular first molar was prepared for a complete-coverage ceramic crown and scanned using an IOS. The conventional impressions of the preparation were also made, and stone casts were poured and scanned by using an EOS. Virtual models were generated for both workflows, and identical virtual anatomic contour crowns were designed using CAD software. Monolithic zirconia crowns were fabricated for both IOS (ZI; n = 10) and EOS (ZE; n = 10) groups. The silicon replica technique was used to evaluate the marginal and internal fit of the crowns. Measurements were made at 13 points on buccolingual and mesiodistal cross-sections per specimen with a ×6.5 to ×50 zoom stereo microscope. The results from both groups were statistically compared using the Independent Samples t-tests and the Mann–Whitney U test (α = 0.05). Results: Mean gap values at all measurement locations for ZE were significantly higher than those for ZI (p ≤ 0.002). Overall mean values ranged between 29 and 43 µm (median: 28–42 µm) for ZI and 42 and 75 µm (median: 43–77 µm) for ZE. Conclusion: Completely digital workflow through intraoral scans provided significantly better marginal and internal fit for CAD-CAM monolithic zirconia crowns compared with the semi-digital workflow, where stone casts obtained from conventional impressions were scanned with an EOS. Yet, both workflows provided an acceptable marginal and internal fit for CAD-CAM monolithic zirconia molar crowns (<120 µm). Clinical Relevance: Completely digital workflow using IOS scans may be advantageous for the fabrication of CAD-CAM monolithic zirconia crowns as favorable results can be obtained with less material waste and potentially shortened overall treatment time as the impression files can be transferred to the production facility electronically. The results need to be corroborated with clinical studies.
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Ryniewicz W, Bojko Ł, Ryniewicz AM. The Impact of Sintering Technology and Milling Technology on Fitting Titanium Crowns to Abutment Teeth-In Vitro Studies. MATERIALS (BASEL, SWITZERLAND) 2022; 15:5835. [PMID: 36079217 PMCID: PMC9457018 DOI: 10.3390/ma15175835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/14/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The aim of the study is to evaluate the marginal and internal fit of titanium alloy (Ti6Al4V) crowns using the Selective Laser Melting (SLM) method and CAD/CAM milling. MATERIALS AND METHODS The research materials are abutment teeth and prosthetic crowns. The method is based on scanning the abutments and the interior of the substructures, creating their 3D models, using the program for comparison, and determining error maps of fitting crowns to the reference models, in the form of positive and negative deviations. Adding the deviations gives information about the tightness of the crowns. The Shapiro-Wilk test and the one-way ANOVA analysis were performed. The level of significance was p = 0.05. RESULTS The crowns made in SLM, a slightly better internal fit was found than for milled crowns, as well as a comparable marginal fit. The mean deviations for the sintering were the values [mm]: -0.039 and +0.107 for tooth 15 and -0.033 and +0.091 for tooth 36, and for the milling -0.048 and +0.110 for tooth 15 and -0.038 and +0.096 and for tooth 36. CONCLUSION Based on the research conducted and the experience in therapeutic procedures, it can be indicated that the fitting of titanium alloy crowns in SLM and milling meets the clinical requirements. To evaluate the technology, a method was developed that determines the accuracy of mapping the shape of the tooth abutments in the crown substructures for the individual conditions of the patient.
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Affiliation(s)
- Wojciech Ryniewicz
- Department of Dental Prosthodontics and Orthodontics, Dental Institute, Faculty of Medicine, Jagiellonian University Medical College, 4 Montelupich Street, 31-155 Krakow, Poland
| | - Łukasz Bojko
- Faculty of Mechanical Engineering and Robotics, AGH University of Science and Technology, 30 Mickiewicza Ave., 30-059 Krakow, Poland
| | - Anna M. Ryniewicz
- Faculty of Mechanical Engineering and Robotics, AGH University of Science and Technology, 30 Mickiewicza Ave., 30-059 Krakow, Poland
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In Vitro Evaluation of the Shading Effect of Various Zirconia Surface Stains on Porcelain Crowns. COATINGS 2022. [DOI: 10.3390/coatings12060734] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Human teeth display various colors under natural light. Dental restorations, such as zirconia crowns, are generally used to rehabilitate the oral function of patients with tooth loss due to trauma or natural tooth falls. However, significant improvements in the color and translucency of zirconia are required to meet the clinical needs for dental restoration. In the past, a large amount of ceramic powder has been used to improve the appearance of zirconia. However, the interface between the ceramic powder and zirconia makes them prone to falling off. Therefore, the aesthetics of zirconia crowns remains a major challenge. Recently, substantial advances have been made in the field of dental materials, as special staining agents for zirconia have been introduced as alternatives to ceramic powders. Therefore, this study tested zirconia-specific staining agents that were used to produce zirconia samples with A1 and A3 colors. A dental colorimetric plate was used as the control group to assess the staining effects of the different brands of staining agents. Meanwhile, two hypotheses were proposed: that the staining effects of these special staining agents for zirconia met the criteria for clinical application and that there was no significant difference between the different staining agents for zirconia. The results showed that the coatings of different brands of staining agents were ultrathin, with a thickness of approximately 27–78 µm. In addition, the coloring effects of the zirconia staining agents were not significantly different from those of the colorimetric plates. After staining, the zirconia samples had decreased surface roughness and contact angle values, which improved surface smoothness and cleanliness. In summary, the results support the hypothesis of this study that zirconia stains can be used as an alternative to the current fabrication methods for clinical dental restorations. We sought to identify the clinical techniques that are easier to perform and to overcome the current problem of dental technicians requiring considerable dentin space for staining. It is expected that the results of this study will be useful in clinical dental restorations.
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Prospective Clinical Evaluation of Posterior Third-Generation Monolithic Zirconia Crowns Fabricated with Complete Digital Workflow: Two-Year Follow-Up. MATERIALS 2022; 15:ma15020672. [PMID: 35057389 PMCID: PMC8780337 DOI: 10.3390/ma15020672] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
Clinical studies on the behavior of posterior translucent monolithic zirconia restorations are lacking. We assessed the clinical outcome and survival rate of posterior third-generation monolithic zirconia crowns over a 2-year period. A total of 24 patients, requiring 30 posterior full-contour restorations were selected. All abutments were scanned, and crowns were milled and cemented with a self-adhesive dual cure cement. Crowns were assessed using the California Dental Association’s criteria. Gingival status was assessed by evaluating the gingival index, plaque index, periodontal probing depth of the abutments and control teeth, and the margin index of the abutment teeth. Statistical analyses were performed using the Friedman and the Wilcoxon signed-rank tests. During the 2-year follow-up, no biological or mechanical complications were observed, and the survival and success rate was 100%. All restorations ranked as satisfactory throughout the follow-up period. The gingival index and plaque index were worse at the end of the 2-year follow-up. The margin index was stable during the 2 years of clinical service. No significant differences were recorded in periodontal parameters between crowns and control teeth. Third-generation monolithic zirconia could be a reliable alternative to posterior metal–ceramic and second-generation monolithic zirconia posterior crowns.
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The occlusal precision of milled versus printed provisional crowns. J Dent 2021; 117:103924. [PMID: 34910962 DOI: 10.1016/j.jdent.2021.103924] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/12/2021] [Accepted: 12/10/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to compare the occlusal precision of computer-aided-design/ computer-assisted-manufacturing (CAD/CAM) milled versus 3D printed polymethylmethacrylate (PMMA) temporary prosthetic crowns , starting from the same digital CAD design. MATERIALS AND METHODS The study sample included 34 patients presenting 34 premolars in need of prosthetic rehabilitation: a total of 68 temporary crowns were manufactured, 34 of which milled and 34 printed. Immediately after manufacturing, the milled and printed provisionals were scanned with a desktop scanner (E1, 3Shape) to obtain STL files, that were superimposed to the original CAD design in order to identify the occlusal trueness (Analysis A). A second occlusal comparison was performed by scanning both kind of provisional after being placed intraorally with Trios scanner (3 Shape); intraoral scans were obtained in order to compare STL files of provisionals before and after occlusal adjustments (Analysis B). The occlusal trueness was identified at three reference points, P1 (vestibular cusp), P2 (palatal / lingual cusp), P3 (central fossa). The statistical analysis was performed using the R 3.4.3 statistical software (The R Foundation for Statistical Computing), with a significance level of p <0.05. RESULTS Overall, the printed crowns showed lower occlusal differences than the milled crowns, when compared to the CAD design file, with a statistically significant difference in P1 (difference of 0.025 ± 0.046 mm), P2 (difference of 0.027 ± 0 0.044 mm) and P3 ( difference of 0.018 ± 0.050) for Analysis A (p <0.05). In the Analysis B the direct comparison between the degree of average difference between the pre-adjustment and the post-occlusal adjustment of the milled and printed crowns shows that the printed crowns have lower occlusal mean difference values in all three points compared to the milled ones (difference of 0.146 ± 0.273 mm in P1, 0.285 ± 0.360 mm in P2 and 0.257 ± 0.277 mm in P3). CONCLUSIONS Within the limitation of this study, the data obtained showed a better occlusal surface dimensional accuracy of the 3D printed provisional crowns, when compared to the milled ones. Comparing the results obtained, it is possible to assume that the intraoral scans also had a contribution to occlusion, beside the manufacturing method. 3D printing can be successfully applied for manufacturing temporary PMMA crowns.
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Sadeqi HA, Baig MR, Al-Shammari M. Evaluation of Marginal/Internal Fit and Fracture Load of Monolithic Zirconia and Zirconia Lithium Silicate (ZLS) CAD/CAM Crown Systems. MATERIALS 2021; 14:ma14216346. [PMID: 34771872 PMCID: PMC8585271 DOI: 10.3390/ma14216346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/15/2021] [Accepted: 10/20/2021] [Indexed: 11/24/2022]
Abstract
Fit accuracy and fracture strength of milled monolithic zirconia (Zi) and zirconia-reinforced lithium silicate (ZLS) crowns are important parameters determining the success of these restorations. This study aimed to evaluate and compare the marginal and internal fit of monolithic Zi and ZLS crowns, along with the fracture load, with and without mechanical aging. Thirty-two stone dies acquired from a customized master metal molar die were scanned, and ceramic crowns (16 Zi Ceramill Zolid HT+ and 16 ZLS Vita Suprinity) were designed and milled. Absolute marginal discrepancies (AMD), marginal gaps (MG), and internal gaps (IG) of the crowns, in relation to the master metal die, were evaluated using x-ray nanotomography (n = 16). Next, thirty-two metal dies were fabricated based on the master metal die, and crowns (16 Zi; 16 ZLS) cemented and divided into four groups of eight each; eight Zi with mechanical aging (MA), eight Zi without mechanical aging (WMA), eight ZLS (MA), and eight ZLS (WMA). Two groups of crowns (Zi-MA; ZLS-MA) were subjected to 500,000 mechanical cycles (200 ± 50 N, 10 Hz) followed by axial compressive strength testing of all crowns, until failure, and the values were recorded. Independent sample t tests (α = 0.05) revealed no significant differences between Zi and ZLS crowns (p > 0.05); for both internal and marginal gaps, however, there were significant differences in AMD (p < 0.005). Independent samples Mann–Whitney U and Kruskal–Wallis tests revealed significant differences between the two materials, Zi and ZLS, regardless of fatigue loading, and for the individual material groups based on aging (α = 0.05). Multiple comparisons using Bonferroni post-hoc analysis showed significant differences between Zi and ZLS material groups, with or without aging. Within the limitations of this study, the ZLS crown fit was found to be on par with Zi, except for the AMD parameter. As regards fracture resistance, both materials survived the normal range of masticatory forces, but the Zi crowns demonstrated greater resistance to fracture. The monolithic Zi and ZLS crowns seem suitable for clinical application, based on the fit and fracture strength values obtained.
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Affiliation(s)
- Haneen A. Sadeqi
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, P.O. Box 24923,
Safat 13110, Kuwait; (H.A.S.); (M.A.-S.)
| | - Mirza Rustum Baig
- Department of Restorative Sciences (Prosthodontics), Faculty of Dentistry, Kuwait University, P.O. Box 24923,
Safat 13110, Kuwait
- Correspondence:
| | - Mohammad Al-Shammari
- Department of Bioclinical Sciences, Faculty of Dentistry, Kuwait University, P.O. Box 24923,
Safat 13110, Kuwait; (H.A.S.); (M.A.-S.)
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Nagata K, Fuchigami K, Okuhama Y, Wakamori K, Tsuruoka H, Nakashizu T, Hoshi N, Atsumi M, Kimoto K, Kawana H. Comparison of digital and silicone impressions for single-tooth implants and two- and three-unit implants for a free-end edentulous saddle. BMC Oral Health 2021; 21:464. [PMID: 34556111 PMCID: PMC8458793 DOI: 10.1186/s12903-021-01836-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022] Open
Abstract
Background The use of intraoral scanners (IOS) has facilitated the use of digital workflows for the fabrication of implant-supported prostheses not only for single missing teeth, but also for multiple missing teeth. However, the clinical application of IOS and computer-aided design/manufacturing (CAD/CAM) in implant-supported prosthodontics remains unclear. This study aimed to compare the accuracy of digital and silicone impressions for single-tooth implants for bounded edentulous spaces and two-unit and three-unit implant-supported fixed dental prostheses for free-end edentulous spaces. Methods This study enrolled 30 patients (n = 10 for each of the three groups) with an average age of 61.9 years. Conventional silicone-based and digital IOS-based impressions were made for all patients, and the implant superstructures were fabricated. We measured the scan-body misfit and compared the accuracy of the impressions for single-unit, two-unit, and three-unit implant prostheses with a bounded edentulous space by superimposing the standard triangulated language (STL) data obtained from IOS over the STL data of the plaster model used for final prosthesis fabrication. The scan bodies of the superimposed single-molar implant, two-unit implant prosthesis without teeth on the mesial side, two-unit implant prosthesis without teeth on the distal side, three-unit implant prosthesis without teeth on the mesial side, and three-unit implant prosthesis without teeth on the distal side were designated as A, B1, B2, C1, and C2, respectively. The misfit for each scan body was calculated and the accuracies were compared using the Tukey–Kramer method. Results The average scan-body misfit for conditions A, B1, B2, C1, and C2 was 40.5 ± 18.9, 45.4 ± 13.4, 56.5 ± 9.6, 50.7 ± 14.9, and 80.3 ± 12.4 μm, respectively. Significant differences were observed between the accuracies of A and B2, A and C2, and C1 and C2 (P < 0.001). Conclusions IOS and CAD/CAM can find clinical applications for implant-supported prostheses of up to three units for a bounded edentulous saddle. The use of IOS could render implant treatment easier, benefiting both the surgeons and patients. Prosthesis maladjustment may lead to peri-implantitis and prosthetic fracture. Therefore, further validation of the accuracy of IOS impressions is required in patients with multiple missing teeth in long-span implant prostheses.
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Affiliation(s)
- Koudai Nagata
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kei Fuchigami
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Yurie Okuhama
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Kana Wakamori
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Hayato Tsuruoka
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan
| | - Toshifumi Nakashizu
- Department of Dental Laboratory, Kanagawa Dental University Hospital, Yokosuka, Japan
| | - Noriyuki Hoshi
- Division of Prosthodontics and Oral Implantology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Mihoko Atsumi
- Division of Prosthodontics and Oral Implantology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Katsuhiko Kimoto
- Division of Prosthodontics and Oral Implantology, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan
| | - Hiromasa Kawana
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka, 238-8580, Japan.
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Vasiliu RD, Porojan SD, Porojan L. In Vitro Study of Comparative Evaluation of Marginal and Internal Fit between Heat-Pressed and CAD-CAM Monolithic Glass-Ceramic Restorations after Thermal Aging. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E4239. [PMID: 32977603 PMCID: PMC7579449 DOI: 10.3390/ma13194239] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 11/17/2022]
Abstract
The accuracy of newly developed ceramic materials is still being studied. Marginal and internal adaptation are known factors that have an essential impact on the long term success of dental restorations. The aim of this in vitro study was to evaluate the marginal and internal fit of heat-pressed and milled monolithic glass-ceramic restorations based on their ceramic type, processing technique, and in vitro thermocycling. Thirty-two crowns were studied and divided into four groups (n = 8), according to the ceramic material (feldspathic glass-ceramic (F) and zirconia reinforced lithium silicate glass-ceramic (ZLS)) and to their technological obtaining processes (milling (M) and heat-pressing (P)). A typodont preparation was scanned with a D2000 3D scanner to obtain identical 32 resin 3D-printed abutment teeth. Marginal and internal gaps were measured using the silicone replica technique under 40× magnification. The crowns were further cemented and thermally aged for 10,000 cycles After cementation and thermocycling of the samples, marginal and internal gaps were assessed using micro-CT (micro-computed tomography)) analysis. Data were statistically analyzed using statistical tests. Significant differences were found before and after cementation and thermocycling among the tested materials (p < 0.05). Related to technological processing, significant differences were seen in the marginal area between FP and FM (p < 0.05) Significant differences were also found in the axial and occlusal areas between the ZLSP and ZLSM. Thermocycling and cementation did not have a significant effect on the tested materials (p < 0.05). The technological processes influenced the marginal and internal fit of the crowns in favor of the CAD/CAM (computer aided design/computer aided manufacturing)technologies. Thermal aging had little effect on marginal adaptability; it increased the values for all the tested samples in a small way, but the values remained in their clinically acceptable range for all of the crowns.
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Affiliation(s)
- Roxana-Diana Vasiliu
- Department of Dental Prostheses Technology (Dental Technology), University of Medicine and Pharmacy “Victor Babes”, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania;
| | - Sorin Daniel Porojan
- Department of Oral Rehabilitation (Dental Technology), University of Medicine and Pharmacy “Victor Babes”, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania;
| | - Liliana Porojan
- Department of Dental Prostheses Technology (Dental Technology), University of Medicine and Pharmacy “Victor Babes”, Eftimie Murgu Sq. no. 2, 300041 Timisoara, Romania;
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