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Mostafa A, Sadek HMA, Hamdy A, Emam M. Comparison of marginal and internal fit of custom-made post and core restorations milled with 4-axis and 5-axis milling machines in Polyetheretherketone and composite. J Dent 2025; 156:105706. [PMID: 40122367 DOI: 10.1016/j.jdent.2025.105706] [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: 12/13/2024] [Revised: 03/18/2025] [Accepted: 03/20/2025] [Indexed: 03/25/2025] Open
Abstract
OBJECTIVES This study aimed to compare the effects of two milling systems (4-axis and 5-axis) and two materials - polyetheretherketone (PEEK) and computer-aided-design/computer-assisted-manufacturing (CAD/CAM) Composite- on the marginal and internal fit of custom-made post and core restorations. MATERIALS AND METHODS Eighteen single-rooted premolars were endodontically treated and prepared with a standardized post space of 10 mm. The teeth were scanned to receive post and core restorations, fabricated using the SHERAEco-mill 40 (4-axis) and SHERAEco-mill 50 (5-axis) milling machines (Shera Werkstoff-Technologie, Germany) and two materials-PEEK and Composite. Marginal and internal fit were measured using Geomagic Control X (3D Systems, Rock Hill, SC, USA), based on root mean square (RMS) values obtained from comparing the STL files of the design with the scanned, milled restorations. Data was analyzed with a two-way ANOVA and pairwise t-tests, with Bonferroni correction (p < 0.05). RESULTS Pairwise comparisons revealed significant differences in RMS values between milling machines, with 4-axis milled posts showing higher marginal (139.45±24.59 µm) and internal RMS values (135.04±8.68 µm) than 5-axis milled posts (104.14±10.51 µm and 116.22±9.89 µm, respectively). Higher significant RMS values in marginal surfaces were detected (118.60±16.7023.64 µm) for PEEK posts compared to (89.68±4.32 µm) for Composite posts milled with 5-axis. No significant differences were observed between materials for marginal or internal fit in 4-axis and internal fit in 5-axis. CONCLUSIONS This in vitro study findings demonstrated a superiority of 5-axis milling machines over 4-axis machines in achieving superior marginal and internal fit for post and core restorations, irrespective of the material utilized. While material selection did not significantly influence fit when employing 4-axis milling, a notable discrepancy emerged with 5-axis milling, where PEEK restorations exhibited poorer marginal fit compared to composite restorations. CLINICAL SIGNIFICANCE 5-axis milling machines demonstrated superior performance in producing custom-made post and core restorations with enhanced marginal and internal fit compared to 4-axis machines. This improved fit can potentially enhance seating accuracy, minimize cement thickness and micro-gaps, and ultimately contribute to improved long-term clinical outcomes. Furthermore, the lack of significant differences in fit observed between PEEK and CAD/CAM composite materials with 4-axis milling provides clinicians with greater flexibility in material selection based on other clinically relevant factors, such as esthetics, mechanical properties, adhesive properties, and patient preferences.
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Affiliation(s)
- Asmaa Mostafa
- Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Organization of african unity St., Abbasia, Cairo, 11566, Egypt
| | - Hoda M Abdel Sadek
- Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Organization of african unity St., Abbasia, Cairo, 11566, Egypt
| | - Amina Hamdy
- Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Organization of african unity St., Abbasia, Cairo, 11566, Egypt
| | - Marwa Emam
- Fixed Prosthodontics Department, Faculty of Dentistry, Ain Shams University, Organization of african unity St., Abbasia, Cairo, 11566, Egypt; Fixed Prosthodontics Department, Faculty of Dentistry, Galala University, Galala Plateau, Attaka, Suez, Egypt.
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Şiriner Gümüş H, Gül Aygün EB, Tuzlalı M, Totik Doğan N. Evaluation of the marginal and internal gaps of partially crystallized versus fully crystallized lithium disilicate CAD-CAM crowns. Odontology 2025:10.1007/s10266-025-01104-6. [PMID: 40220251 DOI: 10.1007/s10266-025-01104-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 03/30/2025] [Indexed: 04/14/2025]
Abstract
This in vitro study aimed to evaluate the internal and marginal adaptation of crowns produced from partially crystallized and fully crystallized lithium disilicate CAD-CAM blocks using direct view and the silicone replica method. The mandibular first molar was used as an abutment. A total of twenty crowns (n = 10) were produced using milling CAD-CAM. The direct viewing technique was used to measure the marginal gap. The measurement of internal adaptation was conducted using the silicone replica technique. Following the subsequent glazing procedure, all crowns underwent another round of measurements. The paired samples t-test was used to compare two related continuous variables. The study revealed that the mean value of the marginal gap of the partially crystallized block is significantly higher than the fully crystallized block both before and after the glazing process. A statistically significant difference was found before and after glazing of the partially crystallized block in the marginal gap values. The fully crystallized crowns showed better marginal gap values than the partially crystallized ones. No change was observed before and after the glaze in the fully crystallized block. The recommended limit of 120 µm for the marginal gap of lithium disilicate CAD-CAM crowns was never exceeded.
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Affiliation(s)
| | - Esma Başak Gül Aygün
- Department of Prosthodontics, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Mesut Tuzlalı
- Department of Prosthodontics, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Nazlı Totik Doğan
- Department of Biostatistics, Faculty of Medicine, Cukurova University, Adana, Turkey
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Khwanpuang N, Suphachartwong C, Klaisiri A, Leelaponglit S, Angkananuwat C, Krajangta N. Accuracy, Reproducibility, and Gaps in Different Angulations of 3D-Printed versus Milled Hybrid Ceramic Crown. Eur J Dent 2024. [PMID: 39750518 DOI: 10.1055/s-0044-1795116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2025] Open
Abstract
OBJECTIVES This article compared the accuracy, reproducibility, and gap of crowns resulting from variations in print angulation of three-dimensional (3D)-printed VarseoSmile Crownplus (VS) and milled resin-ceramic hybrid materials (Cerasmart 270, CS, and Enamic, E). MATERIALS AND METHODS A total of 60 specimens, consisting of VS printed at four different angulations (30, 45, 60, and 90 degrees), along with CS and E were investigated. External and internal accuracy and reproducibility were measured with the 3D deviation analysis. External and internal gaps were measured with the silicone replica technique. The results were analyzed using Welch's one-way analysis of variance with Dunnett T3 post hoc comparison at p ≤ 0.05. RESULTS Across all groups, external and internal accuracy were 0.55 to 20.02 μm and external and internal reproducibility were 0.05 to 0.69 μm. Overall external accuracy was not significant (p = 0.063), whereas significance was noted in overall internal accuracy and reproducibility among groups (p < 0.001). External and internal gaps were 33.76 to 93.11 μm. Statistically significant differences were found in internal and external gaps among groups (p < 0.001), with milled crowns demonstrating larger internal and smaller external gaps than 3D-printed crowns. Within the 3D-printed group, statistically, 90-degree angles exhibited the smallest external and internal gaps. CONCLUSION Both milled and 3D-printed methods achieved clinically acceptable accuracy, reproducibility, and gap dimensions, offering viable options for hybrid ceramic crown restoration. Among 3D-printed crowns, the 90-degree printing angle group exhibited satisfactory accuracy and reproducibility, alongside the best internal and external fit.
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Affiliation(s)
- Nadaprapai Khwanpuang
- Division of Restorative Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Chayaporn Suphachartwong
- Division of Restorative Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Awiruth Klaisiri
- Division of Restorative Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
- Thammasat University Research Unit in Restorative and Esthetic Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Seelassaya Leelaponglit
- Division of Restorative Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
- Thammasat University Research Unit in Restorative and Esthetic Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Chayanit Angkananuwat
- Division of Prosthodontic Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Nantawan Krajangta
- Division of Restorative Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
- Thammasat University Research Unit in Restorative and Esthetic Dentistry, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
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Ayres AP, Cuschieri LA, Bianchi DM, Pradíes G, Côrtes ARG. Advantages and drawbacks of different methods to measure marginal gaps in fixed dental prostheses: A scoping review. J Dent 2024; 151:105400. [PMID: 39393607 DOI: 10.1016/j.jdent.2024.105400] [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: 05/03/2024] [Revised: 08/22/2024] [Accepted: 10/06/2024] [Indexed: 10/13/2024] Open
Abstract
OBJECTIVES This review aimed to compare traditional and digital methods to assess marginal gaps in fixed dental prostheses. Each method's characteristics, advantages, and limitations were identified and discussed, also addressing the knowledge gaps in the current scientific literature. DATA Studies comparing currently available techniques for marginal gap examination were investigated. The main techniques analyzed were the Cross-Sectional Method (CSM), Direct View (DV), Silicone Replica Technique (SRT), Dual-Scan Method (DSM), Triple-Scan Method (TSM), Optical Coherence Tomography (OCT), and Micro-Computed Tomography (MCT). SOURCES Two experienced independent reviewers screened online databases (MEDLINE via PubMed and Scopus) to identify studies published in English up to March 2024. References from primary studies and the main peer-reviewed scientific journals were manually searched. STUDY SELECTION From an initial pool of 8126 articles, the reviewers meticulously selected 25 in vitro studies on objective comparisons between two or more methods for assessing marginal gaps in fixed dental prostheses on natural teeth. Publications that assessed marginal gaps in implant-supported fixed dental prostheses were excluded. CONCLUSIONS This study highlights that while traditional methods like CSM and SRT are widely used and validated, they have limitations in comprehensive gap assessment, often neglecting recommended measurement points. The DV technique, focusing solely on external gaps, may be less relevant for modern assessments. Conversely, three-dimensional techniques like TSM, DSM, OCT, and MCT offer a more thorough evaluation of dental restoration fit. Moreover, digital methods such as TSM and DSM have a significant potential for future clinical application. CLINICAL SIGNIFICANCE This review examined methods for evaluating marginal gaps in fixed dental prostheses. The review aids dental professionals and researchers in choosing the most suitable technique for clinical in vivo or laboratory assessment of the marginal adaptation of dental restorations. This study also indicates the need for an established and standardized assessment protocol for the marginal fit.
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Affiliation(s)
- A P Ayres
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - L A Cuschieri
- Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Msida, Malta
| | - D M Bianchi
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - G Pradíes
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - A R G Côrtes
- Department of Dental Surgery, Faculty of Dental Surgery, University of Malta, Msida, Malta
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Zandinejad A, Zadeh RS, Khanlar LN, Barmak AB, Revilla-León M. Fracture resistance, marginal and internal adaptation of innovative 3D-printed graded structure crown using a 3D jet printing technology. J Prosthodont 2024; 33:684-690. [PMID: 39118597 DOI: 10.1111/jopr.13895] [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: 10/21/2023] [Accepted: 05/27/2024] [Indexed: 08/10/2024] Open
Abstract
PURPOSE This in vitro study aimed to create a graded structured dental crown using 3D printing technology and investigate the fracture resistance and the adaptation of this new design. MATERIALS AND METHODS A dental crown with a uniform thickness of 1.5 mm was designed, and the exported stereolithography file (STL) was used to manufacture 30 crowns in three groups (n = 10), solid (SC), bilayer (BL), and multilayer (ML) crowns using 3D jet printing technology. Marginal and internal gaps were measured using the silicone replica technique. Crowns were then luted to a resin die using a temporary luting agent and the fracture resistance was measured using a universal testing machine. One-way ANOVA and Tukey post hoc tests were used to compare the fracture resistance and the adaptation of crowns at a significance level of 0.05. RESULTS Mean marginal and internal gap of the ML group were 80 and 82 mm, respectively; which were significantly (p < 0.05) smaller than BL (203 and 183 mm) and SC (318 and 221 mm) groups. The SC group showed the highest mean load at fracture (2330 N) which was significantly (p < 0.05) higher than the BL (1716 N) and ML (1516 N) groups. CONCLUSION 3D jet printing technology provides an opportunity to manufacture crowns in a graded structure with various mechanical properties. This study provided an example of graded structured crowns and presented their fracture resistance. SC group had the highest fracture resistance; however, ML had the best marginal and internal adaptation.
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Affiliation(s)
- Amirali Zandinejad
- Implant Dentistry Associates of Arlington, ClearChoice, Arlington, Texas, USA
- School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Ramtin Sadid Zadeh
- Department of Restorative Dentistry, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Leila Nasiry Khanlar
- A.T. Still University-Missouri School of Dentistry & Oral Health, Kirksville, Missouri, USA
| | - Abdul Basir Barmak
- Clinical Research and Biostatistics, School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
| | - Marta Revilla-León
- Director of Research and Digital Dentistry, Kois Center, Seattle, Washington, USA
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Daou EE, Salameh P. Does the choice of the measuring technique affect the comparison of fit between zirconia and cobalt-chromium prostheses? J Indian Prosthodont Soc 2024; 24:201-207. [PMID: 38650346 PMCID: PMC11129817 DOI: 10.4103/jips.jips_429_23] [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: 08/28/2023] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
AIMS The objectives of the study were to compare the adaptation of presintered zirconia and cobalt- chromium prostheses using microcomputed tomography (μCT), scanning electron microscopy (SEM), and stereomicroscope (SM). MATERIALS AND METHODS Twenty-four fixed dental prostheses (FDPs) were fabricated on metal abutments, duplicated from maxillary first premolar and first molar prepared on a typodont model. Teeth were reduced to obtain chamfer of 1.2 mm and reduction occlusaly of 2 mm occlusal. Scanning of the abutments was done with random assignment to two groups receiving the FDPs made from soft-milled Co-Cr (n = 12) and zirconia (n = 12). Marginal and internal gaps were assessed using three evaluation techniques (X-ray microcomputer tomography, SEM, and stereomicroscopy). STATISTICAL ANALYSIS USED Comparison of the results was made using Levene and analysis of variance tests (α =0.05). RESULTS Irrespective of the material tested, statistical differences were found between the measuring techniques (P = 0.001 overall); the obtained mean gaps were for CT scan (92.60 ± 13.31), for SEM (101.92 ± 23.03), and for SM (113.44 ± 14.68): the multiple comparisons between techniques found a significant difference between CT and SM (P < 0.001), and SEM and SM (P = 0.025). When materials were compared within each measuring technique, Co-Cr showed lower values compared to zirconia in SEM (P < 0.001) and Stereo (P = 0.049); similar results were found in CT. CONCLUSIONS Results values differed with the chosen measuring technique. Co-Cr prostheses had a better fit than zirconia prostheses in SEM and Stereo. µCT showed comparable results to SEM, smaller than SM results.
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Affiliation(s)
- Elie E. Daou
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
- Department of Fixed Prosthodontics, Faculty of Dentistry, Saint Joseph University, Beirut, Lebanon
| | - Pascale Salameh
- Department of Public Health, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Son YT, Son K, Eo GO, Lee KB. Feasibility of images acquired using smartphone camera for marginal and internal fit of fixed dental prosthesis: comparison and correlation study. Sci Rep 2024; 14:5291. [PMID: 38438467 PMCID: PMC10912410 DOI: 10.1038/s41598-024-55711-4] [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: 07/18/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
This study aimed to measure marginal and internal fit using images captured with both an optical microscope and a smartphone camera, comparing the fit measurement performance of these devices and analyzing their correlation. Working casts (with 10 posterior and 10 anterior teeth) created to fabricate fixed dental prostheses were used. These working casts were scanned using a desktop scanner (E1) to design an interim crown, and the designed interim crown was fabricated using a three-dimensional (3D) printer. Utilizing the silicone replica technique, the fabricated interim crown replicated the fit, which was then captured using both an optical microscope and a smartphone camera. The captured images were used to measure the marginal and internal fit according to the imaging device. Intraclass correlation coefficients (ICC) were used for reliability analysis according to the imaging device. Furthermore, the Wilcoxon signed-rank test was adopted for the comparative evaluation of the marginal and internal fit between the imaging devices (α = 0.05). The measurement results of the marginal and internal fit according to the optical microscope and smartphone camera did exhibit a significant difference (P < 0.05). The ICC between the two devices showed an "excellent" agreement of over 0.9 at all measurement points (P < 0.001). A smartphone camera could be used to obtain images for evaluating the marginal and internal fit.
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Affiliation(s)
- Young-Tak Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu, Republic of Korea
- Advanced Dental Device Development Institute, Kyungpook National University, 2177 Dalgubuldaero, Jung-Gu, Daegu, 41940, Republic of Korea
| | - KeunBaDa Son
- Advanced Dental Device Development Institute, Kyungpook National University, 2177 Dalgubuldaero, Jung-Gu, Daegu, 41940, Republic of Korea
| | - Gyeong-O Eo
- Department of Smart Software, Yonam Institute of Technology, Jinju-Si, Gyeongsangnam-Do, Republic of Korea
| | - Kyu-Bok Lee
- Advanced Dental Device Development Institute, Kyungpook National University, 2177 Dalgubuldaero, Jung-Gu, Daegu, 41940, Republic of Korea.
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea.
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Khanlar LN, Francis C, Basir Barmak A, Rios ALS, Ashtiani RE, Zandinejad A. Effect of a new support design on the marginal and internal gap of additively manufactured interim crowns using direct light deposition technology. J Prosthodont 2024; 33:188-194. [PMID: 36810925 DOI: 10.1111/jopr.13668] [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: 09/16/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
PURPOSE To investigate the design and location of supporting structures on the marginal and internal gap of interim restorations. MATERIALS AND METHODS A mandibular right first molar resin tooth was prepared for a full coverage crown and scanned using a laboratory scanner (3Shape D900). The scanned data were converted into standard tessellation language (STL) format and an indirect prosthesis was designed using computer-aided design (CAD) software (exocad DentalCAD). The STL file was used to fabricate a total of 60 crowns with a 3D printer (EnvisionTEC Vida HD). The crowns were printed using E-Dent C&B MH resin and divided into 4 groups based on four different support structure designs, including supports on the occlusal (0° group), buccal and occlusal (45° group), buccal (90° group), and a new design consisting of horizontal bars placed on all surfaces and line angles (Bar) (n = 15). The silicone replica technique was used to determine the gap discrepancy. Fifty measurements were obtained for each specimen to examine the marginal and internal gaps by using a digital microscope (Olympus SZX16) at ×70 magnification. Additionally, the marginal discrepancy at different locations of the tested crowns, including buccal (B), lingual (L), mesial (M), and distal (D), as well as the maximum and minimum marginal gap intervals among groups, were analyzed. The collected data were analyzed using factorial ANOVA, followed by the Tukey HSD test for multiple comparisons (a = 0.05). RESULTS There was a significant difference in marginal and internal gaps among the groups (p < 0.001). The buccal placement supports (90° group) had the least marginal and internal discrepancies (p < 0.001). The new design group showed the highest marginal and internal gap. The marginal discrepancy in different locations of the tested crowns (B, L, M, D) was found to be significantly different among the groups (p < 0.001). The mesial margin of the Bar group had the largest marginal gap, whereas the buccal margin of the 90° group had the lowest marginal gap. The new design had a significantly smaller difference between the maximum and minimum marginal gap intervals than other groups (p < 0.001). CONCLUSION The location and design of the supporting structures affected the marginal and internal gaps of an interim crown. The buccal placement of supporting bars (90° printing orientation) showed the smallest mean internal and marginal discrepancies.
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Affiliation(s)
- Leila Nasiry Khanlar
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Claire Francis
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Abdul Basir Barmak
- Department of Comprehensive Dentistry, EIOH Medical Center, University of Rochester, Rochester, New York, USA
| | - Alma L Salazar Rios
- Department of Prosthodontics, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Reza Eftekhar Ashtiani
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirali Zandinejad
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
- Private Practice, Arlington, Texas, USA
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Farghal A, Dewedar K, AbdElaziz MH, Saker S, Hassona M, Algabri R, Alqutaibi AY. Effect of ceramic materials and tooth preparation design on computer-aided design and computer-aided manufacturing endocrown adaptation and retentive strength: An in vitro study. Clin Exp Dent Res 2024; 10:e843. [PMID: 38345492 PMCID: PMC10828905 DOI: 10.1002/cre2.843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 11/23/2023] [Accepted: 01/04/2024] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVES To evaluate how various tooth preparation designs impact the adaptation-both at the margins and internally-and the retentive strength of computer-aided design and computer-aided manufacturing (CAD/CAM) produced endocrowns. MATERIALS AND METHODS 60 extracted human mandibular first molars were endodontically treated and assigned into three groups (n = 20) according to the tooth preparation design: Group N: butt joint design, Group F and F1 received 1- and 2-mm circumferential ferrule preparation, respectively. Endocrowns were milled using either lithium disilicate glass-ceramic (IPS emax ceramic) or monolithic zirconia. The internal and marginal adaptation of the endocrowns were evaluated using the replica technique. After cementation, the endocrowns of all test groups were dislodged axially at 0.5 mm/min using a universal testing machine. A 2-way ANOVA and the independent samples t-test (α = .05) were performed to statistically analyze the data. RESULTS The effect of changing the design of the tooth preparation (butt joint, ferrule) on the marginal and internal gap was shown to be statistically significant (p < .05); the lower gap values were recorded at the axial followed by cervical, marginal, and pulpal floor walls in both ceramic groups regardless of the teeth preparation design. The ANOVA test revealed similar average removal forces and stresses for the two types of tested ceramic materials. CONCLUSION IPS emax ceramic adapted better than monolithic zirconia ceramic, regardless of the preparation design. Ferrule preparation design is more retentive than butt joint preparation, regardless of the type of ceramic material used.
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Affiliation(s)
- Ahmed Farghal
- Substitutive Dental Science, College of DentistryTaibah UniversityMadinahSaudi Arabia
| | - Karim Dewedar
- Crown and Bridge Department, Faculty of Dental MedicineAl‐Azhar UniversityCairoEgypt
| | - Mohammed H. AbdElaziz
- Substitutive Dental Science, College of DentistryTaibah UniversityMadinahSaudi Arabia
- Crown and Bridge Department, Faculty of Dental MedicineAl‐Azhar UniversityCairoEgypt
| | - Samah Saker
- Fixed Prosthodontics, Faculty of DentistryMansoura UniversityMansouraEgypt
| | - Mahy Hassona
- Fixed Prosthodontics, Faculty of DentistryMansoura UniversityMansouraEgypt
| | - Radwan Algabri
- Prosthodontic Department, Faculty of DentistryIbb UniversityIbbYemen
- Prosthodontic Department, Faculty of DentistryNational University, Ibb branchIbbYemen
| | - Ahmed Yaseen Alqutaibi
- Substitutive Dental Science, College of DentistryTaibah UniversityMadinahSaudi Arabia
- Prosthodontic Department, Faculty of DentistryIbb UniversityIbbYemen
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Cantó-Navés O, Michels K, Figueras-Alvarez O, Fernández-Villar S, Cabratosa-Termes J, Roig M. In Vitro Comparison of Internal and Marginal Adaptation between Printed and Milled Onlays. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6962. [PMID: 37959559 PMCID: PMC10650727 DOI: 10.3390/ma16216962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/16/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023]
Abstract
STATEMENT OF PROBLEM Nowadays, milling is still the gold standard for fabricating indirect restorations, but to overcome its disadvantages, there are alternatives, such as 3D printing. PURPOSE This study aimed to compare the gaps between the prepared tooth and milled and printed onlays fabricated with the same CAD design. It also aimed to determine the gap reproducibility across onlays fabricated by 3D printing and milling. METHODS A resin tooth was prepared for an onlay. After scanning the preparation, an onlay was designed with proprietary dental software. Next, 22 onlays were milled in a graphene-reinforced PMMA disc (Group 1), and 22 onlays were 3D-printed with a hybrid composite material (Group 2). After that, all fabricated restorations were scanned and superimposed on the scanned prepared resin tooth. Subsequently, a specific software was used to measure the margin, central, and intaglio-located gap between the milled or printed restoration and the preparation. Finally, measurements were compared with a multifactor analysis of variance. RESULTS The results demonstrated that printed onlays (Group 2) adapted better to the prepared tooth than the milled ones (Group 1) (p < 0.05). The comparison of standard deviations showed the better gap reproducibility of printed onlays (p < 0.05). CONCLUSION This study concluded that the printed onlays adapted significantly better to the prepared tooth than the milled onlays. Printed onlays also showed significantly better gap reproducibility.
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Affiliation(s)
- Oriol Cantó-Navés
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Barcelona, Spain; (O.C.-N.); (S.F.-V.); (J.C.-T.); (M.R.)
| | - Kyra Michels
- Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Barcelona, Spain;
| | - Oscar Figueras-Alvarez
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Barcelona, Spain; (O.C.-N.); (S.F.-V.); (J.C.-T.); (M.R.)
| | - Sandra Fernández-Villar
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Barcelona, Spain; (O.C.-N.); (S.F.-V.); (J.C.-T.); (M.R.)
| | - Josep Cabratosa-Termes
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Barcelona, Spain; (O.C.-N.); (S.F.-V.); (J.C.-T.); (M.R.)
| | - Miguel Roig
- Department of Restorative Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Barcelona, Spain; (O.C.-N.); (S.F.-V.); (J.C.-T.); (M.R.)
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Hasanzade M, Yaghoobi N, Nematollahi P, Ghazanfari R. Comparison of the marginal and internal fit of PMMA interim crowns printed with different layer thicknesses in 3D-printing technique. Clin Exp Dent Res 2023; 9:832-839. [PMID: 37386767 PMCID: PMC10582242 DOI: 10.1002/cre2.758] [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: 03/04/2023] [Revised: 06/02/2023] [Accepted: 06/17/2023] [Indexed: 07/01/2023] Open
Abstract
OBJECTIVE The aim of this in vitro study was to compare the effect of printing layer thickness on the marginal and internal fit of interim crowns. MATERIAL AND METHODS A maxillary first molar model was prepared for ceramic restoration. Thirty-six crowns were printed with three different layer thicknesses using a digital light processing-based three-dimensional printer (25, 50, and 100 µm [LT 25, LT 50, and LT 100]). The marginal and internal gaps of the crowns were measured with replica technique. An analysis of variance was conducted to determine if there were significant differences between the groups (ɑ = .05). RESULTS The marginal gap of LT 100 group was significantly higher than that LT 25 (p = .002) and LT 50 groups (p ≤ .001). The LT 25 group has significantly larger axial gaps than LT 50 group (p = .013); however, there were no statistically significant differences between other groups. The LT 50 group showed the smallest axio-occlusal gap. The mean occlusal gap differed significantly by printing layer thickness (p ≤ .001), with the largest gap occurring for LT 100. CONCLUSIONS Provisional crowns printed with 50 µm layer thickness provided the best marginal and internal fit. CLINICAL SIGNIFICANCE It is recommended that provisional crowns be printed with a 50 µm layer thickness to ensure optimal marginal and internal fit.
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Affiliation(s)
- Mahya Hasanzade
- Department of Prosthodontics, School of Dentistry, International CampusTehran University of Medical SciencesTehranIran
| | - Negin Yaghoobi
- Department of Prosthodontics, School of DentistryTehran University of Medical SciencesTehranIran
| | - Parsa Nematollahi
- School of Dentistry, International CampusTehran University of Medical SciencesTehranIran
| | - Rezvaneh Ghazanfari
- Department of Prosthodontics, School of Dentistry, International CampusTehran University of Medical SciencesTehranIran
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Fasih P, Tavakolizadeh S, Sedaghat Monfared M, Sofi-Mahmudi A, Yari A. Marginal fit of monolithic versus layered zirconia crowns assessed with 2 marginal gap methods. J Prosthet Dent 2023; 130:250.e1-250.e7. [PMID: 37451899 DOI: 10.1016/j.prosdent.2023.06.005] [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: 01/25/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/18/2023]
Abstract
STATEMENT OF PROBLEM Zirconia can be used either monolithically or veneered with porcelain. However, whether veneering zirconia affects marginal fit is unclear. PURPOSE The purpose of this in vitro study was to evaluate the marginal fit of the monolithic and layered zirconia prostheses using 2 different assessment methods. MATERIAL AND METHODS An ideal complete crown with a chamfer finish line was prepared on an extracted maxillary central incisor. Two prosthesis designs, a framework and a monolithic design, and 2 marginal fit evaluation methods, the silicone replica and the triple scanning techniques, were used. In the first group, 10 crowns were fabricated with the framework design followed by porcelain veneering, and 10 crowns were fabricated monolithically in the second group. The marginal gap in each group was evaluated with both the silicone replica and triple scan methods. Data were statistically analyzed with a 2-way repeated measures ANOVA (α=.05). RESULTS A significant difference was found in the mean marginal gap by design type (P=.003), with the monolithic prostheses having lower mean marginal gaps (31.0 and 84.0 µm). However, both groups showed clinically acceptable marginal fit. No significant difference was found between the assessment methods (P=.092). CONCLUSIONS Monolithic zirconia crowns had a better marginal fit than veneered zirconia frameworks. Both the replica and triple scan techniques for marginal gap assessment yielded similar results.
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Affiliation(s)
- Paniz Fasih
- Post-graduate student, Department of Prosthodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sara Tavakolizadeh
- Associate Professor, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Sedaghat Monfared
- Assistant Professor, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Sofi-Mahmudi
- Researcher, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Amir Yari
- Post-graduate student, Dental Research Center, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Farah RI, Alresheedi B. Evaluation of the marginal and internal fit of CAD/CAM crowns designed using three different dental CAD programs: a 3-dimensional digital analysis study. Clin Oral Investig 2023; 27:263-271. [PMID: 36100722 DOI: 10.1007/s00784-022-04720-6] [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: 02/25/2022] [Accepted: 09/07/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVES The purpose of this in vitro study was to assess and compare the marginal and internal fit of machine-milled crowns designed using three different CAD software programs. MATERIALS AND METHODS Digital impressions of the master zirconia casts containing the prepared molar were obtained using an intraoral scanner. The obtained standard tessellation language (STL) files were imported into three CAD software programs (Multi-CAD, Blue-Sky CAD, and InLab), and crown designs were generated. Crown design digital STL files were used to mill crowns with a five-axis dental milling machine. The internal and marginal fits of the fabricated crowns over the master-prepared tooth were assessed using the triple-scan protocol and digital analysis techniques. The 3D marginal and internal fit values of the fabricated crowns from the designs generated by the three CAD programs were evaluated and statistically compared using one-way analysis of variance (ANOVA) and post hoc Tukey's tests (α = 0.05). RESULTS There were no significant differences in the internal fit of the crowns designed by the three CAD programs (p > 0.05). However, there were significant differences in the mean marginal fit (p = 0.009) of the crowns. The marginal fit values for the InLab-designed crowns were significantly better than those for Multi-CAD (p = 0.03) and Blue-Sky CAD (p = 0.012) groups. CONCLUSIONS All three CAD programs can design clinically acceptable crowns in terms of internal and marginal fit. InLab crowns outperformed the Multi-CAD and Blue-Sky CAD programs in terms of marginal fit. CLINICAL RELEVANCE It is critical to test the ability of newly released CAD programs to design acceptable virtual crowns that can be transformed into actual crowns with optimal marginal and internal fit to existing clinical tooth preparations/conditions to ensure the high technical quality and long-term success of fabricated crowns.
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Affiliation(s)
- Ra'fat I Farah
- Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, P.O. Box: 6700, Al-Mulaydah, 51452, Qassim, Saudi Arabia.
| | - Bandar Alresheedi
- Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, P.O. Box: 6700, Al-Mulaydah, 51452, Qassim, Saudi Arabia
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Kassis C, Mehanna C, Khoury P, Tohme H, Cuevas-Suárez CE, Bourgi R, Lukomska-Szymanska M, Hardan L. Triple scan evaluation of internal and marginal adaptation of overlays using different restorative materials. J ESTHET RESTOR DENT 2022; 35:493-500. [PMID: 36260931 DOI: 10.1111/jerd.12977] [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: 05/05/2022] [Revised: 09/26/2022] [Accepted: 10/06/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Problems in the confection of indirect restorations may increase the marginal and internal gap. This study aimed to quantify the marginal and the internal fit of overlays fabricated with three different materials. MATERIALS AND METHODS Standardized cavities were prepared on endodontically treated human third molars and digital impressions were done using an intraoral camera (Trios 3). Restorations were designed (n = 15) and fabricated with three materials: Hybrid ceramic (Cerasmart; GC Corp, EUROPE), high-strength lithium disilicate (GC Initial® LiSi Press; GC Corp, Tokyo, Japan), and zirconia reinforced Lithium Silicate Glass Ceramic (Vita Suprinity; Vita, Germany). Axial, marginal, pulpal, and gingival gaps were calculated by measuring the distance between the restoration and the tooth at several reference points. Two-Way analysis of variance was used for statistical analysis. The significance level was set at α = 0.05. RESULTS Mean gap was significantly influenced by the material (p < 0.001), gap localization (p < 0.001), and interaction between the factors (p = 0.002). For all materials, the highest gap was observed at gingival and pulpal surfaces (p ≤ 0.015). LiSi Press achieved the overall lowest values at axial values measurements (p ≤ 0.003). CONCLUSIONS The performance of a CAD/CAM system relative to marginal adaptation is influenced by the restorative material used. High-strength lithium disilicate seems to be showed the best marginal adaptation. CLINICAL SIGNIFICANCE Marginal and internal adaptation of CAD/CAM restorations could be influenced by the type of material chosen.
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Affiliation(s)
- Cynthia Kassis
- Department of Esthetic and Restorative Dentistry, School of Dentistry, St Joseph University, Beirut, Lebanon
| | - Carina Mehanna
- Department of Esthetic and Restorative Dentistry, School of Dentistry, St Joseph University, Beirut, Lebanon
| | - Pierre Khoury
- Department of Prosthodontics, School of Dentistry, Lebanese University, Beirut, Lebanon
| | - Hani Tohme
- Digital Unit, School of Dentistry, St Joseph University, Beirut, Lebanon
| | - Carlos Enrique Cuevas-Suárez
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca, Hidalgo, Mexico
| | - Rim Bourgi
- Department of Esthetic and Restorative Dentistry, School of Dentistry, St Joseph University, Beirut, Lebanon
| | | | - Louis Hardan
- Department of Esthetic and Restorative Dentistry, School of Dentistry, St Joseph University, Beirut, Lebanon
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Su S, Dudley J. The marginal gaps of lithium disilicate crowns constructed by different scanner and milling unit combinations. Aust Dent J 2021; 67:125-131. [PMID: 34855210 DOI: 10.1111/adj.12891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The purpose of this study was to compare the marginal gaps of CAD/CAM lithium disilicate (LDS) crowns constructed using three different scanner and milling unit combinations. METHODS Twenty-four Columbia model lower left molars were prepared for LDS crowns by undergraduate students in a simulated environment. One LDS crown was constructed for each crown preparation using each of the following intraoral scanner/milling unit combinations: TRIOS 3 scanner/E4D milling unit (TRIO/E4DM); TRIOS 3 scanner/Sirona inLab MC X5 milling unit (TRIO/MCX5); E4D scanner/E4D milling unit (E4DS/E4DM). The crowns were seated onto the original crown preparations and three vertical marginal gap measurements taken at four locations (mid-buccal, mid-lingual, mid-mesial and mid-distal) using a stereomicroscope. The mean marginal gap (MMG) was calculated for each crown and each individual tooth surface. RESULTS The TRIO/MCX5 scanner/milling unit combination produced the smallest MMG of 63.73 ± 47.38 μm followed by E4DS/E4DM (88.64 ± 106.51 μm) and TRIO/E4DM (107.41 ± 76.47 μm). There was a significant effect of milling unit (p < 0.0001) on MMG but no significant effect of scanner (p = 0.070) or location (p = 0.182). CONCLUSIONS The newer scanner/milling unit combination produced LDS crowns with the smallest MMG. All scanner/milling unit combinations produced LDS crowns within a clinically acceptable MMG.
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Affiliation(s)
- Sinclair Su
- Adelaide Dental School, Adelaide Health & Medical Sciences, The University of Adelaide, South Australia, Australia
| | - James Dudley
- Adelaide Dental School, The University of Adelaide, South Australia, Australia
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Yang J, Li H, Xu L, Wang Y. Selective laser sintering versus conventional lost-wax casting for single metal copings: A systematic review and meta-analysis. J Prosthet Dent 2021; 128:897-904. [PMID: 33789799 DOI: 10.1016/j.prosdent.2021.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/12/2021] [Accepted: 02/16/2021] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM Evidence comparing the marginal and internal fit of single metal copings fabricated via selective laser sintering and conventional lost-wax casting is inadequate. PURPOSE The purpose of this systematic review was to compare the fit of single metal copings fabricated via selective laser sintering and lost-wax casting. Moreover, the effects of different variables on fit accuracy were determined. MATERIAL AND METHODS Google Scholar, ScienceDirect, SpringerLink, and Wiley databases were searched electronically as well as manually. The mean absolute marginal gap, marginal gap, internal gap, axial gap, and occlusal gap values of single metal copings fabricated via selective laser sintering and lost-wax casting were statistically analyzed to determine and evaluate the factors affecting the fit accuracy (α=.05). RESULTS Single metal copings fabricated via selective laser sintering had mean absolute marginal gaps and occlusal gaps similar to those of copings fabricated via lost-wax casting, based on a subgroup meta-analysis of gaps evaluated using stereomicroscopy (P>.05). The fit of single metal copings was not affected by the type of tooth (P>.05). The conventional impression, the indirect digital scan, and the direct digital scan led to similar values of mean axial gap, internal gap, and marginal gap for the copings fabricated via lost-wax casting (P>.05). The indirect and direct digital scans led to similar values of mean axial gap, internal gap, and marginal gap for the copings fabricated via selective laser sintering (P>.05). Printed wax patterns provided significantly smaller mean axial gap values than milled plastic or milled wax patterns for the copings fabricated via lost-wax casting (P<.05). Printed, milled, and conventional wax patterns had similar mean marginal gaps and internal gaps for the copings fabricated via lost-wax casting (P>.05). For single copings fabricated via lost-wax casting, Ni-Cr and Co-Cr had similar mean internal gaps (P>.05). CONCLUSIONS No statistically significant differences were found between single metal copings fabricated via selective laser sintering and lost-wax casting. Selective laser sintering can satisfy the clinical requirement for single metal copings.
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Affiliation(s)
- Jun Yang
- Lecturer, Department of Restorative Dentistry, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, PR China.
| | - Hainan Li
- Professor, School of Management Science and Engineering, Chongqing Technology and Business University, Chongqing, PR China
| | - Ling Xu
- Professor, Department of Restorative Dentistry, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, PR China
| | - Yuan Wang
- Assistant, Department of Restorative Dentistry, Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, PR China
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