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Bennett GW, Jarecke L, Wordekemper L, Sundine M. Analysis of occlusal clearance of crown preparations in a predoctoral clinical setting. J Dent Educ 2025; 89:370-374. [PMID: 39390693 PMCID: PMC11903929 DOI: 10.1002/jdd.13737] [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: 04/12/2024] [Revised: 08/28/2024] [Accepted: 09/20/2024] [Indexed: 10/12/2024]
Abstract
PURPOSE This study sought to assess the presence and location of inadequate tooth preparation performed by predoctoral dental students by scanning mounted casts submitted for monolithic zirconia crown fabrication METHODS: An intraoral scanner capable of volumetric measurements of crown preparations was used to analyze 56 crown preparations on mounted stone casts before submission to a lab for crown fabrication. The mounted casts were scanned individually and then a buccal bite was scanned to stitch the models together into virtual occlusion. The distance between the crown preparations and opposing dentition was displayed volumetrically, and the minimum clearance of each preparation was recorded for both the functional and non-functional cusps. Preparations were evaluated for adequate interocclusal clearance and comparisons were made using a Chi-square test with α = 0.05 with respect to tooth location, functional versus nonfunctional cusp, and or single versus multi-unit preparation. RESULTS Over 47% of mounted casts with crown preparations analyzed for the study exhibited a lack of occlusal clearance in at least one area. Functional cusps were more often under-reduced than non-functional (p < 0.001). No other comparisons were statistically significant. CONCLUSIONS The present study demonstrates a high percentage of under-reduced crown preparations in a predoctoral clinic and emphasizes the utility of quality control and analysis via digital scanning of crown preparations prior to crown fabrication.
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Affiliation(s)
- Gregory W. Bennett
- Department of Adult Restorative DentistryUniversity of Nebraska Medical Center College of DentistryLincolnNebraskaUSA
| | - Lucas Jarecke
- University of Nebraska Medical Center College of DentistryLincolnNebraskaUSA
| | - Luke Wordekemper
- University of Nebraska Medical Center College of DentistryLincolnNebraskaUSA
| | - Makena Sundine
- Department of Adult Restorative DentistryUniversity of Nebraska Medical Center College of DentistryLincolnNebraskaUSA
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Jánosi KM, Cerghizan D, Rétyi Z, Kovács A, Szász A, Mureșan I, Albu AI, Hănțoiu LG. Influence of the Operator`s Experience, Working Time, and Working Position on the Quality of the Margin Width: In Vitro Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020244. [PMID: 36837447 PMCID: PMC9966406 DOI: 10.3390/medicina59020244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/24/2023] [Accepted: 01/24/2023] [Indexed: 01/31/2023]
Abstract
Background and Objectives: Appropriate tooth preparation is mandatory to obtain a perfect marginal fit of fixed restorations. The heavy chamfer is the most commonly used finish line, especially for minimally invasive tooth preparation. The aim of the study was to compare the width of the finish line obtained during tooth preparation performed by experienced (university lecturers) and inexperienced persons (dental students) in different working times and positions. Materials and Methods: Forty left upper-second molars were prepared on the simulator by each participant, totalizing 160 prepared teeth. A new round-end tapered diamond was used to obtain the 0.5 mm width of the heavy chamfer. The prepared teeth were photographed using a Canon D5300 camera with a macro lens attached to a tripod. The measurements were made with the Image-Pro Insight software selecting the same eight reference points. From these points, perpendicular lines were drawn above the finish line to the axial walls and the distance between the chamfer's outer edge and the axial wall's inner edge was measured. GraphPad Instat and NCSS Dowson Edition software were used. The statistical significance was set at p < 0.05. The mean (M) and standard deviation (SD) were calculated. The used tests: one sample t-test, ANOVA test, and Tukey-Kramer Multiple Comparisons Test. Results: Statistically significant differences were obtained according to the experience of the participant, preparation time, patient's position, and the chamfer width on the prepared tooth different surfaces. Conclusions: Daytime or weeklong tiredness and patient position do not affect the width of the heavy chamfer prepared by experienced and inexperienced persons. The experience and the operator's working position influence the width of the prepared finish line.
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Affiliation(s)
- Kinga Mária Jánosi
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540142 Targu Mures, Romania
| | - Diana Cerghizan
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540142 Targu Mures, Romania
- Correspondence: ; Tel.: +4-07-400-768-76
| | - Zsigmond Rétyi
- Independent Researcher, SC Fusion Dental Clinic SRL, 520089 Sfantu Gheorghe, Romania
| | - Alpár Kovács
- Independent Researcher, SC Maxdent Office SRL, 540501 Targu Mures, Romania
| | - Andrea Szász
- Independent Researcher, SC Maxdent Office SRL, 540501 Targu Mures, Romania
| | - Izabella Mureșan
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540142 Targu Mures, Romania
| | - Aurița Ioana Albu
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540142 Targu Mures, Romania
| | - Liana Georgiana Hănțoiu
- Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gh. Marinescu Str., 540142 Targu Mures, Romania
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Alahmari NM, Adawi HA, Al, Moaleem MM, Alqahtani MMA, Alkahtani LAA, Alqahtani GAS, Aldhelai TA. Bonding Strength of Lithium Disilicate Adhesive Crowns with Different Occluso-Cervical Preparation Heights and Cement Types. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.2821] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this study was to evaluate if adhesion technology with CAD/CAM can compensate for the reduction of occluso cervical preparation heights using different types of dental cement. The de-bonding failure types were then assessed. Here, 72 caries-free extracted human premolar teeth
were prepared to have a remaining occlusal height of two, three, and four mm. IPS e.max lithium disilicate CAD/CAM crowns were cemented with adhesive resin cement Panavia SA, self-adhesive resin cement, RelyX Unicem Aplicap, and zinc phosphate cement. The cementation techniques were based
on the manufacturer’s instructions. After thermocycling, all samples were tested for tensile bond strength via an Instron machine. One-way analysis of variance (ANOVA) with post hoc testing (P < 0.05) was performed. The means TBS for the two, three, and four-mm OCHP groups
were 2.72±0.69, 3.06±0.82, and 3.25±0.79.0 MPa; ARC, SARC, and ZPC were 3.41±0.51, 3.45±0.41, 2.08±0.35 MPa, respectively with significant differences in both. The mixed cement had failures in the resin cement groups. Failure was predominantly cohesive
in the zinc phosphate group. Resin cement had the highest SBS values versus ZPC values when both bonded to lithium disilicate crowns with different occlusal heights. The failure of the adhesive to the crown and/or to the tooth were the highest for the four types of resin cement. Around 25%
were cohesive failures with resin cement, but this was predominately adhesive in crowns in zinc phosphate regardless of the preparation heights.
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Affiliation(s)
- Nasser M. Alahmari
- Prosthetic Department, College of Dentistry, King Khalid University, Abha, 62562, SA
| | - Hafiz A. Adawi
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | - Mohammed M. Al, Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| | | | | | | | - Thiyezen A. Aldhelai
- Department of Orthodontic and Pediatric Dentistry, College of Dentistry, Qassim University, Buraydah, 51473, SA; Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, Ibb University, IBB, 00967, Yemen
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Influence of intraoral scanning on the quality of preparations for all-ceramic single crowns. Clin Oral Investig 2020; 24:4511-4518. [PMID: 32436159 PMCID: PMC7666666 DOI: 10.1007/s00784-020-03316-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 04/30/2020] [Indexed: 11/25/2022]
Abstract
Objectives To evaluate the influence of intraoral scanning on the quality of preparations for all-ceramic single crowns. Material and methods A total of 690 randomly selected and anonymized in vivo single crown preparations were examined. Three hundred twenty-three preparations were directly recorded with an intraoral scanner (group IS). Data from plaster casts digitized by a laboratory scanner (group ID; N = 367) served as control. Comparisons included convergence angle, marginal design, marginal substance reduction, homogeneity of the finish line, and undercuts. Evaluation was performed using fully automated specialized software. Data were analyzed applying Kolmogorov-Smirnov, Mann-Whitney U test, and Fisher’s exact test. Level of significance was set at p < 0.05. Results Convergence angle was above optimum in both groups, but significantly larger for group IS (p < 0.001). Marginal design was more ideal in group IS concerning the absence of featheredge design (p < 0.001) and reverse bevel (p = 0.211). Marginal substance reduction was closer to prerequisites for all-ceramic restorations in group IS (p < 0.001). Finish lines were more homogeneous in group IS regarding the uniformity of their course (p < 0.001). Undercuts were more frequently found in group ID than in group IS (p < 0.001). Conclusions Intraoral scanning of prepared teeth has positive impact on the quality of preparations for all-ceramic single crowns regarding marginal substance reduction, marginal design, homogeneity of the finish line, and undercuts. Clinical relevance Accurate preparation design represents a fundamental condition for success of ceramic crowns. Since there is potential for optimization, intraoral scanning might enhance preparation quality providing instant visual feedback.
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Lee SJ, Kim SW, Lee JJ, Cheong CW. Comparison of Intraoral and Extraoral Digital Scanners: Evaluation of Surface Topography and Precision. Dent J (Basel) 2020; 8:dj8020052. [PMID: 32443865 PMCID: PMC7344681 DOI: 10.3390/dj8020052] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the surface topography and the precision measurements of different intraoral and extraoral digital scanners. A reference model of a maxillary arch with four implant analogs was prepared and scanned by three intraoral and two extraoral scanners. The reference model was scanned fifteen times with each digital scanning system, investigating the surface topography and precision measurements for the same-arch and cross-arch measurements. The data was exported to 3D inspection and mesh-processing software (GOM Inspect, Braunschweig, Germany). Statistical analysis was performed using a one-way Analysis of Variance (ANOVA) with the Tukey method for pairwise comparisons. The effect of parameters on generating the surface topography was analyzed by Univariate Linear Regression Analysis. Of the scanner systems evaluated, iTero (IT) exhibited the most number of triangulation points, followed by Trios 3 Shape (TR) and Straumann Cares (SC). There were no significant differences observed in the surface topography when comparing flat and contoured surfaces, the anterior and posterior position, and interproximal areas. For the precision measurement in the same quadrant, no statistical difference was noted between intra- and extraoral scanners. However, the extraoral scanners showed substantially higher precision measurements for the cross-arch measurement. Surface topography did not correlate to precision. Rather, precision correlated with the scanning mechanism. For a quadrant scanning, both intraoral and extraoral scanners are recommended, but extraoral scanners are recommended for a full-arch scanning.
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Affiliation(s)
- Sang J. Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (J.J.L.); (C.W.C.)
- Correspondence: ; Tel.: +1-617-432-3064
| | - Soo-Woo Kim
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA 02115, USA;
| | - Joshua J. Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (J.J.L.); (C.W.C.)
| | - Chan W. Cheong
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA 02115, USA; (J.J.L.); (C.W.C.)
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Yee S, Richert R, Viguie G, Couraud S, Dehurtevent M, Fages M, Corne P, Ducret M. Evaluation of the use of a guided bur during preclinical teaching of tooth preparation: A pilot study. Clin Exp Dent Res 2019; 5:588-593. [PMID: 31890295 PMCID: PMC6934350 DOI: 10.1002/cre2.184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 11/23/2022] Open
Abstract
Objectives An innovative calibrated bur, aiming to improve precision during reduction of the incisal edge, was recently proposed to guide practitioners during tooth preparation. However, limited information is available concerning its usefulness in dental preclinical education. The aim of this study was to evaluate whether using this innovative guided bur improves learning experience quality and the performance of students during tooth preparation. Material and methods After having provided written consent, 60 second-year students were divided into two groups. One group used a 1-mm rounded bur to perform depth grooves, whereas the second group used the innovative guided bur, consisting in a 2-mm-depth marker with a stopping surface. Once the grooves were obtained, they were then connected using the same wheel bur in both groups. The aim was to obtain a final 2-mm reduction of the incisal edge. Quality of the learning experience (stress level, motivation to restart, self-evaluation of the preparation, and difficulty) was quantified using a visual analog scale. Duration of the procedure was also measured in both groups. 3D measurements for each tooth were performed using an STL comparison software. Results There were no significant differences between groups in terms of stress and self-evaluation of the preparation. Students in the guided bur group reported significantly lower perception of exercise difficulty (p < .001) and significantly higher motivation to restart the procedure (p < .001). The guided bur group performed the procedure in 16.4% less time than the rounded bur group. The use of the guided bur led to a 23% over-reduction, whereas the use of the rounded bur led to a 10% under-reduction. Conclusions Overall, the present study shows that the guided bur provides significant improvement in the student's learning experience with increased motivation and decreased perception of difficulty. It shortens the duration of procedure performance, but it also induces a reduction in preparation accuracy.
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Affiliation(s)
- Soho Yee
- Faculté d'OdontologieUniversité de Lyon, Université Lyon 1LyonFrance
- Hospices Civils de LyonService de Consultations et Traitements DentairesLyonFrance
| | - Raphaël Richert
- Faculté d'OdontologieUniversité de Lyon, Université Lyon 1LyonFrance
- Hospices Civils de LyonService de Consultations et Traitements DentairesLyonFrance
| | - Gilbert Viguie
- Faculté d'OdontologieUniversité de Lyon, Université Lyon 1LyonFrance
- Hospices Civils de LyonService de Consultations et Traitements DentairesLyonFrance
| | - Sébastien Couraud
- Faculté de médecine et de maïeutique Lyon‐SudUniversité de Lyon, Université Lyon 1LyonFrance
- Service de Pneumologie Aiguë Spécialisée et Cancérologie ThoraciqueCentre Hospitalier Lyon SudPierre BéniteFrance
| | | | - Michel Fages
- Prosthetic DepartmentFaculté d'Odontologie de MontpellierMontpellierFrance
- Laboratoire de Bioingéniérie et Nanosciences (LBN)Montpellier UniversitéMontpellierFrance
| | - Pascale Corne
- Nancy School of DentistryUniversity of LorraineNancy CedexFrance
| | - Maxime Ducret
- Faculté d'OdontologieUniversité de Lyon, Université Lyon 1LyonFrance
- Hospices Civils de LyonService de Consultations et Traitements DentairesLyonFrance
- Laboratoire de Biologie Tissulaire et Ingénierie thérapeutiqueUMR5305 CNRS/Université Lyon 1, UMS3444 BioSciences Gerland‐Lyon SudLyonFrance
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Abdulla F, Khamis H, Milosevic A, Abuzayda M. Convergence angles of all-ceramic full crown preparations performed in Dubai private practice. J Clin Exp Dent 2019; 10:e1192-e1197. [PMID: 30697378 PMCID: PMC6343971 DOI: 10.4317/jced.55269] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 10/25/2018] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed to determine the degree of taper and total occlusal convergence angles (TOC) for all-ceramic bonded crown preparations carried out by private practitioners in Dubai, UAE. Material and Methods A convenience sample of all-ceramic crown preparations carried out by private dental practitioners were scanned (Carestream CS 3500) from casts and the digital images assessed. The degree of taper was measured on the axial walls of each crown preparation and the bucco-lingual and mesio-distal convergence angles subsequently calculated. Results A total of 154 dentists prepared a total of 206 crown preparations (72 anterior, 134 posterior). The mean convergence angles mesio-distally for all preparations was 24.6° (sd 11.8º), and for the bucco-lingual it was 32.6° (sd 15.3°). The mean TOC was 28.6°. In anterior preparations, the mean bucco-lingual convergence angle was 38.8° (sd 12.2°) compared to 29.3° (sd 15.5°) for posterior preparations (p<0.001). Mean mesio-distal convergence anteriorly was 20.6° (sd 10.18°) compared to 26.7° (sd 12.16°) posteriorly (p<0.001). Distal and buccal taper were significantly greater on posterior teeth (<0.001) compared to anteriors whereas lingual taper was greater on anterior teeth (p<0.001). Mesial taper was not different. Premolars had significantly lower convergence values compared to other teeth. Conclusions Bucco-lingual and mesio-distal convergence angles significantly exceeded the clinically acceptable convergence angle of between 10° and 22°. Greater axial taper is recommended for resin bonded all-ceramic crowns but reliance on adhesion in such preparations rather than parallelism may reduce retention and have increased biologic cost to pulp health. Key words:All-ceramic crown preparations, convergence angles, axial taper.
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Affiliation(s)
- Fahad Abdulla
- BDS MSc Former resident, Department of Prosthodontics, Hamdan Bin Mohamed College of Dental Medicine, Mohamed Bin Rashid University (MBRU) of Medicine and Health Sciences, Dubai, UAE
| | - Hassan Khamis
- BSc MSc DEA PhD, Department of Biostatistics, Hamdan Bin Mohamed College of Dental Medicine, Mohamed Bin Rashid University (MBRU) of Medicine and Health Sciences, Dubai, UAE
| | - Alexander Milosevic
- BDS PhD FDSRCS DRDRCS FDTF Ed, Chair and Program Director, Department of Prosthodontics, Hamdan Bin Mohamed College of Dental Medicine, Mohamed Bin Rashid University (MBRU) of Medicine and Health Sciences, Dubai, UAE
| | - Moosa Abuzayda
- DDS Dr Med Dent, Department of Prosthodontics, Hamdan Bin Mohamed College of Dental Medicine, Mohamed Bin Rashid University (MBRU) of Medicine and Health Sciences, Dubai, UAE
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Schweyen R, Beuer F, Bochskanl M, Hey J. Implementing a new curriculum for computer-assisted restorations in prosthetic dentistry. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2018; 22:e237-e247. [PMID: 28653464 DOI: 10.1111/eje.12278] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/28/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Computer-aided design/computer-aided manufacturing (CAD/CAM) of fixed prosthetic restorations has gained popularity in the last decade. However, this field of dentistry has not been integrated in the dental curriculum at most universities. MATERIAL AND METHODS According to the method of Kern, a curriculum was designed and established on a voluntary basis in the prosthetic education of a German dental school. The success of the implementation was measured by evaluation carried out by the participants on a visual analogue scale. Furthermore, the clinical performance of the fabricated restorations was evaluated. RESULTS Ninety-four percent of all students participated in the CAD/CAM curriculum indicating considerable interest. Nearly half of all students used the acquired knowledge to design crowns for their patients. All restorations fabricated by participants of the new CAD/CAM programme showed good clinical performance. DISCUSSION By phasing-in the CAD/CAM training programme, independent CAD/CAM-based fabrication of all-ceramic crowns increased student's self-confidence in tooth preparation. A tendency was found that students using CAD/CAM technology prepared more teeth than their fellow students who did not use CAD/CAM technology. Further studies are required to investigate the influence of independent CAD/CAM-based single-crown fabrication on the quality of the preparation.
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Affiliation(s)
- R Schweyen
- Department of Prosthodontics, University of Halle, Halle, Germany
| | - F Beuer
- Department of Prosthodontics, Charité - University of Berlin, Berlin, Germany
| | - M Bochskanl
- Department of Prosthodontics, University of Halle, Halle, Germany
| | - J Hey
- Department of Prosthodontics, University of Halle, Halle, Germany
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Hoopes W, Cushen S, DuVall N, Wajdowicz M, Brewster J, Roberts H. Failure load effect of molar axial wall height with CAD/CAM ceramic crowns with moderate occlusal convergence. J ESTHET RESTOR DENT 2018; 30:249-253. [PMID: 29383829 DOI: 10.1111/jerd.12366] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To evaluate the significance of axial wall height (AWH) in molar fracture resistance involving CAD/CAM adhesively bonded, all-ceramic full coverage restorations on preparations with moderate total occlusal convergence (TOC) (16°). MATERIALS AND METHODS 60 newly extracted maxillary third molars were divided into 5 groups (n = 12). Specimens were prepared for full-coverage, all ceramic restorations with occlusal cervical AWHs of 4, 3, 2, 1 as well as a flat preparation (0 mm AWH) with all preparations with AWH containing a moderate 16° TOC. Scanned preparations were fitted with a lithium disilicate restoration with a self-adhesive resin luting agent after intaglio surface preparation with hydrofluoric acid and silanation. Specimens were stored at 37°C/98% humidity for 24 hours and tested to failure at a 45° angle applied to the palatal cusp on a universal testing machine. Mean results were analyzed using ANOVA/Tukey's (P = .05). RESULTS Preparations containing 2, 3, and 4 millimeters of AWH demonstrated similar and higher resistance to fracture than the 1 and zero millimeter AWH groups. CONCLUSIONS Under the conditions of this study, results suggest that adhesive CAD/CAM technology may compensate for reduced axial wall height. However, more definitive results depend on fatigue testing. CLINICAL SIGNIFICANCE These in vitro results suggest that adhesive CAD/CAM technology may compensate for less than optimal AWH.
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Affiliation(s)
- Wyeth Hoopes
- AEGD-1, 60th Dental Squadron, Davis Grant Medical Center, Travis AFB, California
| | - Sara Cushen
- Commander, 75th Dental Flight, Hill AFB, Utah
| | | | - Michael Wajdowicz
- USAF Postgraduate Dental School, Keesler Air Force Base, 606 Fisher Street, Mississippi
| | - John Brewster
- USAF Postgraduate Dental School, Keesler Air Force Base, 606 Fisher Street, Mississippi
| | - Howard Roberts
- Restorative Dentistry Division Chief, University of Kentucky College of Dentistry, Lexington, Kentucky
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Muruppel AM, Thomas J, Saratchandran S, Nair D, Gladstone S, Rajeev MM. Assessment of Retention and Resistance Form of Tooth Preparations for All Ceramic Restorations using Digital Imaging Technique. J Contemp Dent Pract 2018; 19:143-149. [PMID: 29422462 DOI: 10.5005/jp-journals-10024-2228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM This in vitro study evaluated the resistance form of die preparations for all ceramic restorations and, thereby, explored the concept of effective taper and its correlation between the ideal in theory and actual in the clinical situation by analyzing the digital images of the die preparations. MATERIALS AND METHODS Scanned digital images of 114 die preparations for all ceramic restorations (n = 114) were collected from a dental laboratory. All the images were also analyzed digitally using Adobe Photoshop® software to analyze the degree of taper (angle of convergence) of each preparation and then applied the Zuckerman's circle, and the Lewis perpendicular methods were used to measure the resistance form. RESULTS For the current study, the overall average degree of taper was found to be 20.9° (range, 2-80°), which is more than what is recommended by most previous studies and also sharply greater than the textbook ideal of 3 to 6°. Mean degree of taper for maxillary was 17.56° (anterior-10.50°, posterior-23.7°), and for mandibular teeth, it was 25.22° (anterior-15°, posterior- 28.45°). Out of the 64 analyzed images of maxillary teeth, 61 presented resistance form, while 3 were without it. Out of the 50 mandibular teeth analyzed, 38 possessed resistance form, whereas 12 were without. All the anterior teeth showed resistance form irrespective of the arch. CONCLUSION The degree of taper showed a significant relationship with resistance and retention form, which was inversely proportional to each other. The recommended "degree of taper" is not always the clinically achievable as advocated in textbooks, as it is modified by various factors in the actual clinical situation. CLINICAL SIGNIFICANCE The study provides scientific background regarding the relationship between the degree of taper with resistance and retention form, and the relationship was found to be inversely proportional to each other. The recommended "degree of taper" is not always the clinically achievable as advocated in textbooks, and it is modified by various modifying or limiting factors in the actual clinical situation.
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Affiliation(s)
- Alex M Muruppel
- Department of Prosthodontics and Implantology, PMS College of Dental Science & Research, Thiruvananthapuram Kerala, India
| | - Joyce Thomas
- Department of Prosthodontics, Al Azhar Dental College Thodupuzha, Kerala, India, e-mail:
| | - Sudeep Saratchandran
- Department of Prosthodontics and Implantology, PMS College of Dental Science & Research, Thiruvananthapuram Kerala, India
| | - Dinesh Nair
- Department of Prosthodontics and Implantology, PMS College of Dental Science & Research, Thiruvananthapuram Kerala, India
| | - Sheeba Gladstone
- Department of Prosthodontics and Implantology, PMS College of Dental Science & Research, Thiruvananthapuram Kerala, India
| | - Milen M Rajeev
- Department of Prosthodontics, Mar Baselios Dental College Ernakulam, Kerala, India
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Carbajal Mejía JB, Yatani H, Wakabayashi K, Nakamura T. Marginal and Internal Fit of CAD/CAM Crowns Fabricated Over Reverse Tapered Preparations. J Prosthodont 2017; 28:e477-e484. [PMID: 29194841 DOI: 10.1111/jopr.12715] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Intraoral digital scanning can accurately record single abutment tooth preparations despite their geometry, and the algorithms of the CAD software can be set to manage different abutment forms. The purpose of this in vitro study was to evaluate the marginal and internal fit of CAD/CAM zirconia crowns fabricated over conventional and reverse-tapered preparations. MATERIALS AND METHODS Crown preparations with known total occlusal convergence (TOC) angles (-8°, -4°, 0°, 8°, 12°, 16°, and 22°) were digitally created from a maxillary left central incisor and printed in acrylic resin. Next, casts were scanned with a TRIOS intraoral scanner, and crowns were designed with KaVo multiCAD software using default parameters (50 μm cement space) on abutments with positive TOC angles, whereas reverse-tapered abutments (negative TOC angles) were digitally blocked out at 0° and had an extra mesiodistal gap set to 50 μm. Then, zirconia crowns were fabricated, and their marginal and internal discrepancies were recorded with the silicone replica technique. All replicas were examined under a stereomicroscope at 50× magnification. Collected data were analyzed with one-way ANOVA and post hoc Tukey test for marginal fit. For the axial and incisal fit, measured values did not follow a normal distribution; therefore, the Kruskal-Wallis and the Dunn/Bonferroni multiple comparison tests were applied (p = 0.05). RESULTS The mean marginal fit of -8° crowns (58.2 ± 6.0 μm) was statistically different (p < 0.0001) from all the remaining crowns (range 42.1-47.3 μm). Also, the internal fit was statistically significant when comparing crowns fabricated over abutments with positive and negative TOC angles (p < 0.0001). The largest median axial discrepancies were found in the -8° (165.5 μm) and -4° (130.8 μm) groups; however, when evaluating the incisal fit, they showed the smallest discrepancies (67.3 and 81.8 μm, respectively). CONCLUSIONS Under the conditions of this study, the marginal and internal fit of zirconia crowns fabricated over inverse-tapered preparations is within clinically accepted values.
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Affiliation(s)
- Jeison B Carbajal Mejía
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kazumichi Wakabayashi
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Takashi Nakamura
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
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Evaluation of tooth root surface area using a three-dimensional scanning technique and cone beam computed tomographic reconstruction in vitro. Arch Oral Biol 2017; 84:13-18. [PMID: 28934648 DOI: 10.1016/j.archoralbio.2017.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 07/19/2017] [Accepted: 07/20/2017] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To study the feasibility of measuring root surface area (RSA) by 3D scanning technique and cone beam computed tomography (CBCT) reconstruction in vitro. DESIGN Twenty extracted teeth (10 single-rooted teeth and 10 multi-rooted teeth) were collected in this study. The RSA of the extracted teeth was measured by the membrane technique, 3D scanning technique, and CBCT reconstruction. A standard part was also designed to check the accuracy of each method. All statistical analyses were performed using the SPSS software. RESULTS According to the results of one-way ANOVA, there was no significant difference among the values of RSA measured by the three techniques (p>0.05). The results of Wilcoxon matched-pairs signed-rank test further demonstrated that there was no significant difference among the values of RSA in both single- and multi-rooted teeth measured by the three techniques (p>0.05). CONCLUSIONS The membrane technique, the 3D scanning technique, and CBCT reconstruction are novel reliable techniques for measuring the RSA in both single- and multi-rooted teeth, which will provide wide clinical applications in the future.
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Influence of preparation design on the quality of tooth preparation in preclinical dental education. J Dent Sci 2017; 12:27-32. [PMID: 30895020 PMCID: PMC6395288 DOI: 10.1016/j.jds.2016.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Revised: 05/11/2016] [Indexed: 11/22/2022] Open
Abstract
Background/purpose One of the major educational goals in preclinical dental education is to learn tooth preparation techniques. The purpose of this study was to evaluate the influence of different preparation designs on the development of the manual dexterity of students, in order to perform a state-of-the-art tooth preparation. Material and methods Seventy-two 1st semester students were divided into two groups and educated in tooth preparation for a ceramic anterior single crown. One group received cylindrical burs with a rounded edge to prepare a typodont model with a shoulder finishing line, while the other group had cylindrical burs with round noses to prepare a chamfer finishing line. All preparations were digitized and evaluated using special software focusing on the parameters of preparation depth and preparation angle. In addition, violation of the adjacent teeth was estimated. Data was statistically evaluated at a level of significance of 5%. Results The preparation design used did not show a statistically significant influence on the preparation depth or on the preparation angle. A trend to a higher tooth structure removal as required was detected. Furthermore, no influence of the type of preparation design on the number of violated adjacent teeth was found. Conclusion In preclinical dental education, the type of preparation design was found to have no influence on the measured parameters representing the quality of the preparation.
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Analysis of tooth preparations for zirconia-based crowns and fixed dental prostheses using stereolithography data sets. J Prosthet Dent 2016; 116:783-789. [PMID: 27236595 DOI: 10.1016/j.prosdent.2016.03.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 03/24/2016] [Accepted: 03/24/2016] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM Under clinical circumstances, it can be challenging for a dentist to achieve an adequate tooth preparation, which is essential for the long-term success of fixed dental restorations. This is particularly true for zirconia restorations fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) because of the difficulties involved in the scanning and milling process. PURPOSE The purpose of this retrospective study was to use a digital approach to evaluate dental tooth preparations for zirconia-based crowns and fixed dental prostheses (FDP) performed by general dental practitioners in Germany and to find out whether the type of prepared tooth or the type of restoration influenced the outcome. MATERIAL AND METHODS Stereolithography data sets of 182 zirconia frameworks with a total of 305 abutment teeth obtained by the CAD-CAM process were analyzed regarding total occlusal convergence, abutment height, and finish line design using a 3-dimensional (3D) inspection and mesh processing software. The criteria for adequate preparations were defined based on current literature and compared with the measurement results. The Kruskal-Wallis 1-way analysis of variance and the Mann-Whitney U test were applied to detect significant differences (α=.05). RESULTS Only 13 teeth (4.3%) met the clinical requirements for adequate zirconia-based tooth preparations. The mean total occlusal convergence was 17.9 ±9.7 degrees. Molars (23.2 ±10.1 degrees) showed statistically significant difference (P<.001) when compared with premolars (14.2 ±8.2 degrees) and anterior teeth (16.4 ±8.1 degrees). No significant difference was observed between the crown and FDP preparations. The mean abutment height was 5.6 ±1.3 mm. Again, significant differences occurred when tooth types (4.8 ±1.0 mm for molars, 5.2 ±0.9 mm for premolars and 6.9 ±1.2 mm for anterior teeth; P≤.01) were compared. In 92.5% of teeth, the finish line design was not ideal for zirconia-based restorations. CONCLUSION The tooth preparations of general dental practitioners differ from the ideal clinical preparation recommended for zirconia-based restorations. Difficulties are primarily related to the total occlusal convergence and finish line design. Although the outcome is strongly influenced by the type of tooth, the type of restoration seems to have only a minor effect on the tooth preparation quality.
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An audit of cavity and crown preparations and two direct restorations carried out by foundation dentists in the Oxford and Wessex Deaneries. Br Dent J 2016; 216:421-5. [PMID: 24722101 DOI: 10.1038/sj.bdj.2014.249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2013] [Indexed: 11/09/2022]
Abstract
It is likely that many foundation dentists (FDs) will have completed only minimal amounts of restorative dentistry for a number of months immediately prior to commencing work as FDs. Thus this audit aimed to assess the performance of the FDs when they carried out a number of simulated clinical exercises: amalgam cavities and restoration; Class IV resin composite restorations; and full crown preparations for metal-ceramic restorations. A total of 67 FDs completed the assessments and some results did indicate a high level of concern and need for further evaluation of restorative practice.
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Reporting numeric values of complete crowns. Part 1: Clinical preparation parameters. J Prosthet Dent 2015; 114:67-74. [PMID: 25858212 DOI: 10.1016/j.prosdent.2015.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 01/28/2015] [Accepted: 01/28/2015] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM An implemented objective measuring system for measuring clinical tooth preparations does not exist. PURPOSE The purpose of this study was to compare clinically achieved tooth preparations for ceramic crowns by general dentists with the recommended values in the literature with an objective measuring method. MATERIAL AND METHODS Two hundred thirty-six stone dies prepared for anterior and posterior complete ceramic crown restorations (IPS e.max Press; Ivoclar Vivadent) were collected from dental laboratories. The dies were scanned and analyzed using the coordinate geometry method. Cross-sectioned images were captured, and the average total occlusal convergence angle, margin width, and abutment height for each preparation was measured and presented with associated 95% confidence intervals. RESULTS The average total occlusal convergence angles for each tooth type was above the recommended values reported in the literature. The average margin widths (0.40 to 0.83 mm) were below the minimum recommended values (1 to 1.5 mm). The tallest preparations were maxillary canines (5.25 mm), while the shortest preparations were mandibular molars (1.87 mm). CONCLUSIONS Complete crown preparations produced in general practice do not achieve the recommended values found in the literature. However, these recommended values are not based on clinical trials, and the effects of observed shortfalls on the clinical longevity of these restorations are not predictable.
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Tooth preparation for full-coverage restorations—a literature review. Clin Oral Investig 2015; 19:959-68. [DOI: 10.1007/s00784-015-1439-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 02/23/2015] [Indexed: 10/23/2022]
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18
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Tiu J, Al-Amleh B, Waddell JN, Duncan WJ. Clinical tooth preparations and associated measuring methods: A systematic review. J Prosthet Dent 2015; 113:175-84. [DOI: 10.1016/j.prosdent.2014.09.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 09/23/2014] [Accepted: 09/23/2014] [Indexed: 11/17/2022]
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Marghalani TY. Convergence angles of metal ceramic crowns prepared by dental students. J Prosthet Dent 2014; 112:1250-6. [DOI: 10.1016/j.prosdent.2014.03.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 03/19/2014] [Accepted: 03/20/2014] [Indexed: 11/26/2022]
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20
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Seven-year prospective clinical study on zirconia-based single crowns and fixed dental prostheses. Clin Oral Investig 2014; 19:1137-45. [DOI: 10.1007/s00784-014-1330-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 10/03/2014] [Indexed: 11/26/2022]
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Lee SJ, Betensky RA, Gianneschi GE, Gallucci GO. Accuracy of digital versus conventional implant impressions. Clin Oral Implants Res 2014; 26:715-9. [PMID: 24720423 DOI: 10.1111/clr.12375] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The accuracy of digital impressions greatly influences their clinical viability in implant restorations. The aim of this study was to compare the accuracy of gypsum models acquired from the conventional implant impression to digitally milled models created from direct digitalization by three-dimensional analysis. MATERIALS AND METHODS Thirty gypsum and 30 digitally milled models, impressed directly from a reference model, were prepared. The models and reference model were scanned by a laboratory scanner, and 30 surface tessellation language datasets from each group were imported to an inspection software program. The datasets were aligned to the reference dataset by a repeated best-fit algorithm, and 10 specified contact locations of interest were measured in mean volumetric deviations. The areas were pooled by cusps, fossae, interproximal contacts, horizontal and vertical axes of implant position and angulation. The pooled areas were statistically analysed by comparing each group to the reference model to investigate the mean volumetric deviations accounting for accuracy and standard deviations for precision. RESULTS Milled models from digital impressions had comparable accuracy to gypsum models from conventional impressions. However, differences in fossae and vertical displacement of the implant position from the gypsum and digitally milled models compared to the reference model exhibited statistical significance (P < 0.001, P = 0.020, respectively). CONCLUSION Milled models from digital impression are comparable to gypsum models from conventional impression.
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Affiliation(s)
- Sang J Lee
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
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Tiu J, Waddell JN, Al-Amleh B, Jansen van Vuuren WA, Swain MV. Coordinate geometry method for capturing and evaluating crown preparation geometry. J Prosthet Dent 2014; 112:481-7. [PMID: 24674808 DOI: 10.1016/j.prosdent.2013.11.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 11/05/2013] [Accepted: 11/27/2013] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM A validated universal method requiring no human input is needed to capture and evaluate preparation geometries in a manner that can be used to see the correlation of different parameters. PURPOSE The purpose of this study was to present a method of capturing and evaluating crown preparation geometry. MATERIAL AND METHODS One manually machined acrylic resin block and 9 randomly selected preparations for ceramic complete crowns prepared by general dentists were selected and prepared. The specimens were scanned (3D scanner; Nobel Biocare), and buccolingual and mesiodistal cross section images were collected. The images were imported into digitizing software (Engauge Digitizer 4.1) to convert the outlines into x and y coordinates. Six points were chosen by using a set of algorithms, and the resulting parameters were calculated. RESULTS The acrylic resin block was milled with a 12 degree total occlusal convergence (TOC) instrument producing a 12.83 degree TOC. For the other specimens, average TOC values ranged from 18 degrees to 52 degrees. The mean average margin width was 0.70 mm, and the mean average base dimension was 6.23 mm. The surface area/volume ratio, resistance length, and limiting taper were also calculated. CONCLUSIONS The method described provides a basis for accurately evaluating preparation geometry without human input.
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Affiliation(s)
- Janine Tiu
- Postgraduate student, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
| | - J Neil Waddell
- Senior Lecturer, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Basil Al-Amleh
- Senior Lecturer, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Wendy-Ann Jansen van Vuuren
- Lecturer, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Michael V Swain
- Professor, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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