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Metin DS, Schmidt F, Beuer F, Prause E, Ashurko I, Sarmadi BS, Unkovskiy A. Accuracy of the intaglio surface of 3D-printed hybrid resin-ceramic crowns, veneers and table-tops: An in vitro study. J Dent 2024; 144:104960. [PMID: 38513937 DOI: 10.1016/j.jdent.2024.104960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/13/2024] [Accepted: 03/19/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES The present study aims to examine the influence of the build angle on the accuracy (trueness and precision) of 3D printed crowns, table-tops and veneers with a hybrid resin-ceramic material. METHODS One crown, on table-top and one veneer were printed in five different build angles (0°, 30°, 45°, 60°, 90°) (n = 50) with the digital light processing (DLP) system (Varseo XS, Bego) using hybrid resin (Varseo Smile Crownplus A3, Bego). All printed restorations were scanned using the laboratory scanner (D2000, 3Shape) and matched onto the initial reference design in metrology software (Geomagic Control X, 3D Systems). The root mean square error (RMSE) was calculated between the scanned and reference data. The data was statistically analyzed using the Tukey multiple comparison test and Wilcoxon multiple comparison test. RESULTS The crown group showed higher trueness at 30° (0.021 ± 0.002) and 45° (0.020 ± 0.002), and table-tops at 0° (0.015 ± 0.001) and 30° (0.014 ± 0.001) (p < 0.0001). Veneers demonstrated higher trueness at 30° (0.016 ± 0.002) (p < 0.0001). All three restoration types demonstrated the lowest trueness at a 90° build angle and portrayed deviations along the z axis. The veneer and table-top groups showed the lowest precision at 90° (veneers: 0.021 ± 0.008; table-tops: 0.013 ± 0.003). The crown group portrayed the lowest precision at 45° (0.017 ± 0.005) (p < 0.0001). CONCLUSION The build angle of DLP-printed hybrid resin-ceramic restorations influences their accuracy. CLINICAL SIGNIFICANCE Considering the build angle is important to achieve a better accuracy of 3D-printed resin-ceramic hybrid restorations. This may help predict or avoid the interference points between a restoration and a die and minimize the clinical adjustments.
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Affiliation(s)
- Dilan Seda Metin
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str., 4-6, 14197, Berlin, Germany
| | - Franziska Schmidt
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str., 4-6, 14197, Berlin, Germany
| | - Florian Beuer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str., 4-6, 14197, Berlin, Germany
| | - Elisabeth Prause
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str., 4-6, 14197, Berlin, Germany
| | - Igor Ashurko
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, Moscow, 119146, Russia
| | - Bardia Saadat Sarmadi
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str., 4-6, 14197, Berlin, Germany
| | - Alexey Unkovskiy
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str., 4-6, 14197, Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, Moscow, 119146, Russia.
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Simeon P, Unkovskiy A, Saadat Sarmadi B, Nicic R, Koch PJ, Beuer F, Schmidt F. Wear resistance and flexural properties of low force SLA- and DLP-printed splint materials in different printing orientations: An in vitro study. J Mech Behav Biomed Mater 2024; 152:106458. [PMID: 38364445 DOI: 10.1016/j.jmbbm.2024.106458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To investigate the influence of material and printing orientation on wear resistance and flexural properties of one low force SLA- and two DLP-printed splint materials and to compare these 3D-printed splints to a subtractively manufactured splint material. METHODS Two DLP-printed (V-Print splint, LuxaPrint Ortho Plus) and one low force SLA-printed (Dental LT Clear) material, where specimens were printed in three printing orientations (0°, 45°, 90°), were investigated. In addition, one milled splint material (Zirlux Splint Transparent) was examined. A total of 160 specimens were produced for both test series. The two-body wear test was performed in a chewing simulator (80'000 cycles at 50 N with 5-55 °C thermocycling). Steatite balls were used as antagonists. The wear pattern was analyzed with a 3D digital microscope in terms of maximum vertical intrusion depth (mm) and total volume loss (mm³). The flexural properties were investigated by three-point bending in accordance with ISO 20795-1: 2013 (denture base polymers). The flexural strength (MPa) and the flexural modulus (MPa) were measured. Two-way ANOVA was performed to investigate the effects of the two independent variables material and printing orientation for the three 3D-printed materials. The comparison of the printing orientations within one material was carried out with one-way ANOVA with post-hoc Tukey tests. RESULTS Two-way ANOVA revealed that wear and flexural properties are highly dependent on the 3D-printed material (p < 0.001). Across groups, a significant effect was observed for wear depth (p = 0.031) and wear volume (p = 0.044) with regard to printing orientation but this was not found for flexural strength (p = 0.080) and flexural modulus (p = 0.136). One-way ANOVA showed that both DLP-printed groups showed no significant differences within the printing orientations in terms of wear and flexural properties. Dental LT Clear showed that 90° oriented specimens had higher flexural strength than 0° oriented ones (p < 0.001) and 45° oriented specimens also showed higher values than 0° ones (p = 0.038). No significant differences were observed within the printing orientations for flexural modulus and wear behaviour within this group. T-tests showed that the milled splints exhibited statistically higher wear resistance and flexural properties compared to all three 3D-printed splint materials (p < 0.001) and that highly significant differences were found between the 3D-printed splint materials for both test series. CONCLUSION Within the limitations of this in vitro study, it can be stated that wear behaviour and flexural properties are highly dependent on the 3D-printed material itself. Currently, milled splints exhibit higher wear resistance and flexural properties compared to 3D-printed splint materials. The printing orientation has a minor influence on the properties investigated. Nevertheless, two-way ANOVA also showed a significant influence of printing orientation in the wear test across groups and one-way ANOVA detected significant effects for SLA material in terms of flexural strength, with printing in 90° showing the highest flexural strength. Therefore, anisotropy was found in SLA material, but it can be limited with the employed printing parameters. Both DLP-printed materials showed no significant difference within the printing orientation.
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Affiliation(s)
- Philipp Simeon
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Alexey Unkovskiy
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, Moscow, 119146, Russia
| | - Bardia Saadat Sarmadi
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Robert Nicic
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Petra Julia Koch
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Orthodontics and Orthofacial Orthopedics, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Florian Beuer
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Franziska Schmidt
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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Li P, Fernandez PK, Spintzyk S, Schmidt F, Yassine J, Beuer F, Unkovskiy A. Effects of layer thickness and build angle on the microbial adhesion of denture base polymers manufactured by digital light processing. J Prosthodont Res 2023; 67:562-567. [PMID: 36804247 DOI: 10.2186/jpr.jpr_d_22_00126] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
PURPOSE To investigate the effects of printing-layer thickness and build angle on the surface characteristics and microbial adhesion of denture base polymers manufactured by digital light processing (DLP). METHODS Specimens were additively manufactured using DLP. The specimens were printed with different printing-layer thicknesses (25, 50, and 100 μm) and build angles (0°, 45°, and 90°). Scanning electron microscopy was used to observe the surface topography, and the arithmetical mean heights (Sa) were measured. Moreover, the initial Candida albicans (C. albicans) adhesion to the specimens was evaluated using an adhesion test. Finally, two-way ANOVA and Tukey's multiple comparison tests were conducted. RESULTS The results regarding the Sa values exhibited a statistically significant interaction (F (4, 45) = 90.77, P < 0.0001). The build angle has a significant impact on the surface topography. Furthermore, quantitative results revealed that the printing-layer thickness significantly affected C. albicans adhesion (F (2, 99) = 6.96, P = 0.0015). CONCLUSIONS The surface roughness was significantly affected by the printing-layer thickness and the build angle. Additionally, the surface topography was mainly determined by the build angle. Furthermore, the adhesion of C. albicans to the DLP-printed denture surfaces was significantly affected by the printing-layer thickness but not by the build angle. Consequently, it is critical to decrease the thickness of the printing layer to produce digital dentures with optimal material properties.
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Affiliation(s)
- Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
- Section Medical Materials Science and Technology, Tübingen University Hospital, Tübingen, Germany
| | - Pablo Kraemer Fernandez
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tübingen University Hospital, Tübingen, Germany
- ADMiRE Lab - Additive Manufacturing, intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Villach, Austria
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jamila Yassine
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
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Prause E, Schmidt F, Unkovskiy A, Beuer F, Hey J. Survival and complications of 3D-printed, non-invasive restorations for prosthetic rehabilitations: A 12-month preliminary observational study. Int J Comput Dent 2023; 0:0. [PMID: 37823541 DOI: 10.3290/j.ijcd.b4451424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
AIM The adjustment and transfer of a stable occlusion can be a major challenge in prosthetic rehabilitations. The aim of this study was to assess a non-invasive treatment option for complex prosthetic rehabilitations and occlusal analyses using 3D-printed restorations clinically. MATERIALS AND METHODS Eleven patients received a partial or complete rehabilitation with the aid of 3D-printed restorations (n=171). After 12 months of clinical service, all restorations were analyzed using the United States Public Health Service (USPHS) criteria. RESULTS The 12-month clinical data revealed that 3D-printed restorations showed a survival rate of 84.4%. Complications occurred mostly regarding the anatomical form (7%) or marginal integrity (6AC%) and were consequently rated "Charlie" or "Delta." Color stability and color match of 3D-printed restorations were rated "Alpha" in 83% and 73%, respectively, of all restorations. Marginal inflammation was rated "Alpha" in 89% of all restorations. An excellent surface texture and no secondary caries or postoperative sensitivities (100%) were observed. CONCLUSIONS 3D-printed restorations might be an alternative treatment option for initiating complex prosthetic rehabilitations. Technical complications rarely occurred. Biological complications did not occur at all. The color stability showed promising results after 12 months of clinical service. However, the results should be interpreted with caution. Long-term results with a high number of restorations should be awaited.
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Kluge J, Bruggink R, Pandis N, Unkovskiy A, Jost-Brinkmann PG, Kuijpers-Jagtman AM, Bartzela T. Longitudinal Three-Dimensional Stereophotogrammetric Growth Analysis in Infants with Unilateral Cleft Lip and Palate from 3 to 12 Months of Age. J Clin Med 2023; 12:6432. [PMID: 37892569 PMCID: PMC10607132 DOI: 10.3390/jcm12206432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
This longitudinal study aimed to evaluate facial growth and soft tissue changes in infants with complete unilateral cleft lip, alveolus, and palate (CUCLAP) at ages 3, 9, and 12 months. Using 3D images of 22 CUCLAP infants, average faces and distance maps for the entire face and specific regions were created. Color-coded maps highlighted more significant soft tissue changes from 3 to 9 months than from 9 to 12 months. The first interval showed substantial growth in the entire face, particularly in the forehead, eyes, lower lip, chin, and cheeks (p < 0.001), while the second interval exhibited no significant growth. This study provides insights into facial soft tissue growth in CUCLAP infants during critical developmental stages, emphasizing substantial improvements between 3 and 9 months, mainly in the chin, lower lip, and forehead. However, uneven growth occurred in the upper lip, philtrum, and nostrils throughout both intervals, with an overall decline in growth from 9 to 12 months. These findings underscore the dynamic nature of soft tissue growth in CUCLAP patients, highlighting the need to consider these patterns in treatment planning. Future research should explore the underlying factors and develop customized treatment interventions for enhanced facial aesthetics and function in this population.
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Affiliation(s)
- Jennifer Kluge
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
| | - Robin Bruggink
- Radboudumc 3D Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands;
| | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, Freiburgstraße 7, 3010 Bern, Switzerland (A.M.K.-J.)
| | - Alexey Unkovskiy
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow 119146, Russia
| | - Paul-Georg Jost-Brinkmann
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, Medical Faculty, University of Bern, Freiburgstraße 7, 3010 Bern, Switzerland (A.M.K.-J.)
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
- Faculty of Dentistry, Universitas Indonesia, Campus Salemba, Jalan Salemba Raya No. 4, Jakarta 10430, Indonesia
| | - Theodosia Bartzela
- Department of Orthodontics and Dentofacial Orthopedics, Center for Oral Health Sciences CC3, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Straße 4-6, 14197 Berlin, Germany; (A.U.); (P.-G.J.-B.)
- Department of Orthodontics, Technische Universität Dresden, Fetscherstraße 74, 01307 Dresden, Germany
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Ashurko I, Tarasenko S, Magdalyanova M, Bokareva S, Balyasin M, Galyas A, Khamidova M, Zhornik M, Unkovskiy A. Comparative analysis of xenogeneic collagen matrix and autogenous subepithelial connective tissue graft to increase soft tissue volume around dental implants: a systematic review and meta-analysis. BMC Oral Health 2023; 23:741. [PMID: 37817128 PMCID: PMC10566022 DOI: 10.1186/s12903-023-03475-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 09/29/2023] [Indexed: 10/12/2023] Open
Abstract
OBJECTIVE The gold standard for a soft tissue augmentation around implants is a subepithelial connective tissue graft (CTG), but the xenogeneic collagen matrices (XCM) started to be used as an alternative. This systematic review aimed to assess the effectiveness XCM in comparison to CTG for the increasing the thickness of the soft tissue around implants. DATA All studies included at least two parallel groups comparing the use of CTG and XCM with a minimum follow-up of 3 months. As the primary outcome, the amount of soft tissue thickness gain after soft tissue augmentation with XCM or CTG was assessed. Secondary outcomes were clinical and patient-related outcomes; evaluation of aesthetic outcomes, patient-reported outcomes measures (PROMs) and complications. Eligible studies were selected based on the inclusion criteria. Meta-analysis was applied whenever possible. The quality of the evidence of studies including in meta-analysis was assessed using the GRADE approach. SOURCE A systematic literature search up to January 2022 was conducted using the following electronic databases: PubMed (MEDLINE), Scopus, Cochrane Library, LILACS, eLIBRARY.RU. Unpublished researches, the gray literature, nonprofit reports, government studies and other materials were reviewed electronically using an EASY search. An additional manual search was carried out in November 2022. STUDY SELECTION Of the 1376 articles from the initial search, 8 randomized controlled trials (RCTs) (306 patients and 325 implants) were included in this systematic review, and 7 studies were part of the meta-analysis. Meta-analysis revealed that XCM is less effective than the CTG in increasing soft tissue thickness around dental implants. However, XCM also provides soft tissue thickness gain and can be recommended for use in various clinical situations. CLINICAL SIGNIFICANCE Previous systematic reviews and meta-analyses have shown that autologous grafts are more effective than collagen matrices in increasing soft tissue thickness, however, the latter can be used as an alternative. Studies included in previous systematic reviews varied in design, which could lead to limitations. The present systematic review and meta-analysis includes for the first time only randomized controlled clinical trials with collagen matrix of xenogeneic origin in the test group. Tight eligibility criteria were established, and the main parameter studied was soft tissue thickness. It was found that xenogeneic collagen matrix is effective for increasing soft tissue thickness around dental implants, however, the results obtained using an autogenous connective tissue graft are superior.
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Affiliation(s)
- Igor Ashurko
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Svetlana Tarasenko
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Mary Magdalyanova
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Svetlana Bokareva
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | | | - Anna Galyas
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Marina Khamidova
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Mariia Zhornik
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia
| | - Alexey Unkovskiy
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow, 119146, Russia.
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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Unkovskiy A, Spintzyk S, Kiemle T, Roehler A, Huettig F. Trueness and precision of skin surface reproduction in digital workflows for facial prosthesis fabrication. J Prosthet Dent 2023; 130:402-413. [PMID: 35256182 DOI: 10.1016/j.prosdent.2021.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM How much skin surface details of facial prostheses can be transferred throughout the digital production chain has not been quantified. PURPOSE The purpose of this in vitro study was to quantify the amount of skin surface details transferred from the prosthesis virtual design through the prototype printing with various additive manufacturing (AM) methods to the definitive silicone prosthesis with an indirect mold-making approach. MATERIAL AND METHODS Twelve test blocks with embossed wrinkles of 0.05 to 0.8 mm and 12 test blocks with applied earlobe skin structures were printed with stereolithography (SLA), direct light processing (DLP), and PolyJet methods (n=4). DLP and SLA prototype specimens were duplicated in wax. All specimens were then transferred into medical-grade silicone. Rz values of the wrinkle test blocks and the root mean square error (RMSE) of the earlobe test blocks were evaluated by laser topography to determine the trueness and precision of each stage. RESULTS For the earlobe test blocks, the PolyJet method had superior trueness and precision of the final skin surface reproduction. The SLA method showed the poorest trueness, and the DLP method, the lowest precision. For the wrinkle test blocks, the PolyJet method had the best wrinkle profile reproduction level, followed by DLP and SLA. CONCLUSIONS The indirect mold-making approach of facial prostheses manufacturing may be associated with 7% of skin surface profile loss with SLA, up to 20% with DLP, and no detail loss with PolyJet.
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Affiliation(s)
- Alexey Unkovskiy
- Research Associate, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Sebastian Spintzyk
- Research Associate, Section "Medical Materials and Science", Tuebingen University Hospital, Tuebingen, Germany
| | - Tobias Kiemle
- Research Associate, Department of Geosciences, University of Tuebingen, Tuebingen, Germany
| | - Ariadne Roehler
- Research Associate, Section "Medical Materials and Science", Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Acting Deputy Head, Priv.-Doz, Department of Prosthodontics, Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
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Prause E, Hey J, Schmidt F, Nicic R, Beuer F, Unkovskiy A. The Assessability of Approximal Secondary Caries of Non-Invasive 3D-Printed Veneers Depending on the Restoration Thickness-An In Vitro Study. Bioengineering (Basel) 2023; 10:992. [PMID: 37760094 PMCID: PMC10525397 DOI: 10.3390/bioengineering10090992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/12/2023] [Accepted: 08/20/2023] [Indexed: 09/29/2023] Open
Abstract
To date, no scientific data is available regarding the development and radiographic assessment of approximal caries development after the insertion of 3D-printed, non-invasive veneers of different restoration thicknesses. For the present study, non-invasive veneers were fabricated from two different materials for printing and milling (Vita Enamic and VarseoSmile Crown plus). Three different restoration thicknesses (0.5, 0.7, and 0.9 mm) were selected. After digital design, leaving the approximal space free, and manufacturing of the restorations, adhesive insertion followed. All specimens were placed in a demineralizing solution for 28 days. Subsequently, a radiological and fluorescent examination was performed. The present study showed statistically significant interactions for the day (p < 0.0001) and manufacturing method (p < 0.0001) but not for restoration thickness. Additive manufactured restorations showed less radiological caries progression compared to subtractive manufactured restorations after 21 and 28 days (0.7 and 0.9 mm restoration thickness) (p < 0.0001). DIAGNOdent proved that the restoration thickness affected the caries progression within the subtractive group (p < 0.0001). Radiographic and fluorescence examination showed equivalent results regarding approximal caries assessment. For additive manufacturing, less caries progression was shown without consideration of the restoration thickness.
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Affiliation(s)
- Elisabeth Prause
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.H.); (F.S.); (R.N.); (F.B.); (A.U.)
| | - Jeremias Hey
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.H.); (F.S.); (R.N.); (F.B.); (A.U.)
- Department of Prosthodontics, School of Dental Medicine, Martin-Luther-University, 06112 Halle, Germany
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.H.); (F.S.); (R.N.); (F.B.); (A.U.)
| | - Robert Nicic
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.H.); (F.S.); (R.N.); (F.B.); (A.U.)
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.H.); (F.S.); (R.N.); (F.B.); (A.U.)
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; (J.H.); (F.S.); (R.N.); (F.B.); (A.U.)
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, 119146 Moscow, Russia
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Unkovskiy A, Beuer F, Metin DS, Bomze D, Hey J, Schmidt F. Additive Manufacturing of Lithium Disilicate with the LCM Process for Classic and Non-Prep Veneers: Preliminary Technical and Clinical Case Experience. Materials (Basel) 2022; 15:ma15176034. [PMID: 36079415 PMCID: PMC9457325 DOI: 10.3390/ma15176034] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/23/2022] [Accepted: 08/30/2022] [Indexed: 05/02/2023]
Abstract
BACKGROUND ceramic veneers, crowns, and other types of restorations are often made using either the press heating technique or the subtractive method. The advent of lithography-based ceramic manufacturing (LCM) allows for the manufacturing of such restorations in an additive way. METHODS this concept paper describes the first clinical experience in the application of LCM lithium disilicate restorations in vivo for the manufacturing of classic veneers for a patient with severe tooth wear. The applied restorations were analyzed in terms of their marginal fit in metrology software (Geomagic Control X, 3D Systems). Furthermore, the feasibility of 3D printing of non-prep veneers with a 0.1 mm thickness was tested. RESULTS the classic LCM lithium disilicate veneers were tried in the mouth cavity and demonstrated adequate esthetics and a sufficient marginal fit of 100 µm. Furthermore, the non-prep veneers with a 0.1 mm thickness could be successfully printed using LCM technology and also demonstrated an adequate fit on the model in vitro. CONCLUSIONS the described technical approach of lithium disilicate 3D printing with LCM technology may pose a valid alternative to subtractive and analog manufacturing and be a game-changing option with the use of additive chairside ceramic fabrication.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany
- Department of Prosthodontics, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- Correspondence:
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany
| | - Dilan Seda Metin
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany
| | - Daniel Bomze
- Lithoz GmbH, Mollardgasse 85a/2/64-69, 1060 Vienna, Austria
| | - Jeremias Hey
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4–6, 14197 Berlin, Germany
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Unkovskiy A, Unkovskiy N, Spintzyk S. A virtual patient concept for esthetic and functional rehabilitation in a fully digital workflow. Int J Comput Dent 2021; 24:405-417. [PMID: 34931776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND A combination of facial and intraoral scans produces a fully digitalized virtual patient. This concept allows for a 3D smile design and individualized virtual articulator application, which makes the rehabilitation outcome more predictable in terms of esthetics and function. CASE PRESENTATION In the present clinical case, the patient was 'digitalized' with the use of facial and intraoral scans. The full-mouth rehabilitation by means of implant- and tooth-supported single ceramic restorations was performed through both digital and analog workflows. The 3D printing of the restoration patterns was achieved through the rapid prototyping (RP) approach, and the ceramic milling through the rapid manufacturing approach. The clinical and technical performance of both additive and subtractive manufacturing methods were assessed for this type of rehabilitation. CONCLUSION Both additive and subtractive manufacturing of ceramic restorations yielded a clinically acceptable marginal fit, which was inspected on the conventionally fabricated stone cast. As the milling of small ceramic restorations has met with failure in the past, the 3D printing of restoration patterns in the context of an RP approach may be regarded as a viable technical option.
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Unkovskiy A, Spintzyk S, Beuer F, Huettig F, Röhler A, Kraemer-Fernandez P. Accuracy of capturing nasal, orbital, and auricular defects with extra- and intraoral optical scanners and smartphone: An in vitro study. J Dent 2021; 117:103916. [PMID: 34875273 DOI: 10.1016/j.jdent.2021.103916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES This in vitro study compares the scanning accuracy of various stationary and portable as well as extra- and intraoral devices for capturing oncological defects. METHODS A 3D-printed model of a nasal, orbital, and auricular defect, as well as one of an intact auricle, were digitalized (n = 7 per device) with a stationary optical scanner (Pritiface), a portable extraoral optical scanner (Artec Space Spider), two intraoral scanners (Trios 4 and Primescan), and a smartphone (iPhone 11 Pro). For the reference data, the defect models were digitalized using a laboratory scanner (D2000). For quantitative analysis, the root mean square error value for trueness and precision and mean deviations in millimeters were obtained for each defect type. The data were statistically analyzed using two-way ANOVA and Tukey multiple comparison test. For qualitative analysis, a colorimetric map was generated to display the deviation within the defect area and adjacent tissue. RESULTS Statistically significant interactions were found in the trueness and precision for defect and scanner type. CONCLUSION The Primescan and Artec Space Spider scanners showed the highest accuracy for most defect types. Primescan and Trios 4 failed to capture the orbital defect. The iPhone 11 Pro showed clinically acceptable trueness but inferior precision. CLINICAL SIGNIFICANCE The scanning devices may demonstrate varying accuracy, depending on the defect type. A portable extraoral optical scanner is an universal tool for the digitization of oncological defects. Alternatively, an intraoral scanner may be employed in maxillofacial prosthetics with some restrictions. Utilizing a smartphone in maxillofacial rehabilitation should be considered with caution, because it provides inconsistent accuracy.
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Affiliation(s)
- Alexey Unkovskiy
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, 119146 Moscow, Russian Federation.
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany; ADMiRE Lab-Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, 9524 Villach
| | - Florian Beuer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, Tbingen 72076, Germany
| | - Ariadne Röhler
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Pablo Kraemer-Fernandez
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, Tbingen 72076, Germany
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Unkovskiy A, Huettig F, Kraemer-Fernandez P, Spintzyk S. Multi-Material 3D Printing of a Customized Sports Mouth Guard: Proof-of-Concept Clinical Case. Int J Environ Res Public Health 2021; 18:ijerph182312762. [PMID: 34886486 PMCID: PMC8657614 DOI: 10.3390/ijerph182312762] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 01/05/2023]
Abstract
A multilayer mouth guard is known to have the best protective performance. However, its manufacturing in a digital workflow may be challenging with regards to virtual design and materialization. The present case demonstrates a pathway to fabricate a multilayer individualized mouth guard in a fully digital workflow, which starts with intraoral scanning. A free-form CAD software was used for the virtual design. Two various CAM techniques were used, including Polyjet 3D printing of rubber-like soft material and silicone printing using Drop-on-Demand technique. For both methods the outer layer was manufactured from more rigid materials to facilitate its protective function; the inner layer was printed from a softer material to aid a better adaptation to mucosa and teeth. Both 3D printed multilayer mouth guards showed a clinically acceptable fit and were met with patient appraisal. Their protective capacities must be evaluated in further clinical studies.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, 14197 Berlin, Germany
- Department of Prosthodontics, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- Correspondence:
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, 72076 Tuebingen, Germany; (F.H.); (P.K.-F.)
| | - Pablo Kraemer-Fernandez
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, 72076 Tuebingen, Germany; (F.H.); (P.K.-F.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, 72076 Tuebingen, Germany;
- ADMiRE Lab—Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, 9800 Villach, Austria
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Li P, Fernandez PK, Spintzyk S, Schmidt F, Beuer F, Unkovskiy A. Effect of additive manufacturing method and build angle on surface characteristics and Candida albicans adhesion to 3D printed denture base polymers. J Dent 2021; 116:103889. [PMID: 34800586 DOI: 10.1016/j.jdent.2021.103889] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/23/2021] [Accepted: 11/09/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To investigate the influence of additive manufacturing method and build angle on surface characteristics and Candida albicans (C. albicans) adhesion to 3D printed denture base polymers. METHODS Specimens of 3D printing denture base polymers were prepared by two printers, namely, stereolithography (SLA, Form 3B) and digital light processing technology (DLP, Solflex 350 plus). Three build angles were used: 0°, 45°, and 90°. Surface topography was examined by scanning electron microscopy. Also, arithmetical mean height (Sa) values were calculated. An adhesion test was performed to observe initial C. albicans adhesion to the specimens. The data were statistically analyzed using the two-way analysis of variance and Tukey's multiple comparison test. RESULTS The data of Sa values had statistically significant differences, which were mainly determined by the main factor of build angle (p < 0.05). Moreover, the quantitative results of C. albicans adhesion exhibited no significant differences: printing techniques (p = 0.7794) and build angle (p = 0.0589), respectively. CONCLUSIONS Surface roughness was significantly influenced by the build angle rather than by the AM method. Whereas, AM method (SLA and DLP) and build angle (0°, 45°, and 90º) had no impacts on the C. albicans adhesion to the 3D printed denture bases. CLINICAL SIGNIFICANCE Build angle dominates the surface roughness and topography of the 3D printed denture polymers. Our results indicate that C. albicans' adhesion might not be influenced by AM method and build angle.
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Affiliation(s)
- Ping Li
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China; Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, Tübingen 72076, Germany.
| | - Pablo Kraemer Fernandez
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Osianderstr. 2-8, Tübingen 72076, Germany
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, Tübingen 72076, Germany; ADMiRE Lab - Additive Manufacturing, intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Villach, Austria
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, Moscow 119146, Russia
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Spintzyk S, Brinkmeier S, Huettig F, Unkovskiy A. Bonding strength of 3D printed silicone and titanium retention magnets for maxillofacial prosthetics application. J Prosthodont Res 2021; 66:422-430. [PMID: 34545007 DOI: 10.2186/jpr.jpr_d_21_00019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To assess the bonding between conventional and additively manufactured silicone elastomers and cylindrical retention titanium magnets for anchorage of facial prostheses. METHODS The customized titanium retention magnets were embedded in conventional and additively produced silicone blocks without primer application (n = 20) and with two commercially available primers G611 (n = 20) and A304 (n = 20) applied onto the magnet surface. The pull out test was performed in the universal testing machine using 45° and 90° angulation and the pull out strength was measured for each group. Additionally the SEM images of the pulled out magnets' surface were obtained and the amount of residual silicone onto the magnet surface was quantified. RESULTS Significantly higher pull out strength values (p < 0.05) were revealed for 90° specimens (0.11 - 0.17 ± 0.01 N/mm2) compared to the 45° group (0.03 ± 0.02 N/mm2). The pull out test with primer revealed no significant differences between the G 611 and A 304 primers in the additive group. However, significantly (p < 0,05) higher values were observed for conventional specimens in the A304 group (1.10 ± 0.21 N/mm2) compared to the G611 group (0.59 ± 0.27 N/mm2). CONCLUSION The application of both used primers may be an acceptable technical option for the anchorage of retention titanium magnets in silicone facial prostheses, produced additively in a fully digital workflow.
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Affiliation(s)
- Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
| | - Sophia Brinkmeier
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriartric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin, Germany.,Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
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Aretxabaleta M, Unkovskiy A, Koos B, Spintzyk S, Xepapadeas AB. Accuracy Evaluation of Additively and Subtractively Fabricated Palatal Plate Orthodontic Appliances for Newborns and Infants-An In Vitro Study. Materials (Basel) 2021; 14:4103. [PMID: 34361299 PMCID: PMC8347028 DOI: 10.3390/ma14154103] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/02/2022]
Abstract
Different approaches for digital workflows have already been presented for their use in palatal plates for newborns and infants. However, there is no evidence on the accuracy of CAD/CAM manufactured orthodontic appliances for this kind of application. This study evaluates trueness and precision provided by different CAM technologies and materials for these appliances. Samples of a standard palatal stimulation plate were manufactured using stereolithography (SLA), direct light processing (DLP) and subtractive manufacturing (SM). The effect of material (for SM) and layer thickness (for DLP) were also investigated. Specimens were digitized with a laboratory scanner (D2000, 3Shape) and analyzed with a 3D inspection software (Geomagic Control X, 3D systems). For quantitative analysis, differences between 3D datasets were measured using root mean square (RMS) error values for trueness and precision. For qualitative analysis, color maps were generated to detect locations of deviations within each sample. SM showed higher trueness and precision than AM technologies. Reducing layer thickness in DLP did not significantly increase accuracy, but prolonged manufacturing time. All materials and technologies met the clinically acceptable range and are appropriate for their use. DLP with 100 µm layer thickness showed the highest efficiency, obtaining high trueness and precision within the lowest manufacturing time.
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Affiliation(s)
- Maite Aretxabaleta
- Department of Orthodontics in the University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery within the University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany; (B.K.); (A.B.X.)
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany;
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, 119146 Moscow, Russia
| | - Bernd Koos
- Department of Orthodontics in the University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery within the University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany; (B.K.); (A.B.X.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany;
| | - Alexander B. Xepapadeas
- Department of Orthodontics in the University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery within the University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany; (B.K.); (A.B.X.)
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Kraemer Fernandez P, Unkovskiy A, Benkendorff V, Klink A, Spintzyk S. Surface Characteristics of Milled and 3D Printed Denture Base Materials Following Polishing and Coating: An In-Vitro Study. Materials (Basel) 2020; 13:ma13153305. [PMID: 32722240 PMCID: PMC7435723 DOI: 10.3390/ma13153305] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 07/21/2020] [Accepted: 07/22/2020] [Indexed: 12/23/2022]
Abstract
(1) Background: To date, no information on the polishability of milled and 3D-printed complete denture bases has been provided, which is relevant in terms of plaque accumulation. (2) Methods: three groups (n = 30) were manufactured using the cold-polymerization polymethilmethacrilate, milling (SM) and 3D printing (AM). 10 specimens of each group were left untreated (reference). 10 more specimens were pre-polished (intermediate polishing) and 10 final specimens were highgloss polished. An additional 20 specimens were 3D printed and coated with the liquid resin (coated), 10 of which were additionally polished (coated + polished). For each group Ra and Rz values, gloss value and REM images were obtained. (3). The “highgloss-polished” specimens showed statistically lower Ra and Rz values in the SM, followed by AM and conventional groups. In the AM group statistically lower surfaces roughness was revealed for highgloss-polished, “coated + polished”, and “coated” specimens, respectively. (4) Conclusions: The milled specimens demonstrated superiors surface characteristics than 3D printed and conventionally produced after polishing. The polished specimens demonstrated superior surface characteristics over coated specimens. However, the surface roughness by both polished and coated specimens was within the clinically relevant threshold of 0.2 µm.
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Affiliation(s)
- Pablo Kraemer Fernandez
- Department of Prosthodontics, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tübingen, Germany; (P.K.F.); (V.B.); (A.K.)
| | - Alexey Unkovskiy
- Department of Prothodontics, Geriartric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Trubetskaya Str. 8-2, 119991 Moscow, Russia
- Correspondence: or ; Tel.: +49-30-450-662798
| | - Viola Benkendorff
- Department of Prosthodontics, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tübingen, Germany; (P.K.F.); (V.B.); (A.K.)
| | - Andrea Klink
- Department of Prosthodontics, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tübingen, Germany; (P.K.F.); (V.B.); (A.K.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany;
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Unkovskiy A, Wahl E, Huettig F, Keutel C, Spintzyk S. Multimaterial 3D printing of a definitive silicone auricular prosthesis: An improved technique. J Prosthet Dent 2020; 125:946-950. [PMID: 32680736 DOI: 10.1016/j.prosdent.2020.02.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 12/01/2022]
Abstract
Direct silicone printing has been reported for the manufacture of interim facial prostheses. The recent advancements in printing hardware have allowed for multimaterial simultaneous silicone printing with 4 nozzles. With this technology, an auricular prosthesis was printed with various grades of Shore hardness. A few analog steps, including polishing, sealing, coloring, and relining, resulted in an individualized prosthesis with a thin frontal margin and smooth transition into the adjacent tissue. It was considered a definitive treatment option.
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Affiliation(s)
- Alexey Unkovskiy
- Research Associate, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Eugen Wahl
- Dental Technician, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Acting Deputy Head, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Constanze Keutel
- Assistant Medical Director and Head of Radiology Department at the Centre of Dentistry, Department of Oral and Maxillofacial Surgery, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tübingen, Germany
| | - Sebastian Spintzyk
- Material Science Engineer, Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
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Younis M, Unkovskiy A, ElAyouti A, Geis-Gerstorfer J, Spintzyk S. The Effect of Various Plasma Gases on the Shear Bond Strength between Unfilled Polyetheretherketone (PEEK) and Veneering Composite Following Artificial Aging. Materials (Basel) 2019; 12:ma12091447. [PMID: 31060213 PMCID: PMC6540062 DOI: 10.3390/ma12091447] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 04/28/2019] [Accepted: 04/30/2019] [Indexed: 11/16/2022]
Abstract
This study investigated the effect of different gaseous plasma surface treatments on the shear bond strength between unfilled polyetheretherketone (PEEK) and veneering composite resin. The study followed ISO 10477 guidelines in preparing, bonding, and testing the samples. Specimens of unfilled PEEK were distributed to one of the following six surface treatment groups: reference, adhesive, argon, nitrogen, oxygen, and air plasmas. After milling, the specimens were wet polished using (P320) polishing discs. Bonding procedures were done according to the manufacturer's instructions using (Opaquer + Dentine), except in the adhesive group (Visio.link + Opaquer + Dentine). Afterwards, thermal cycling for 5000 cycles between 5 and 55 °C in distilled water was conducted. Finally, the shear bond strengths of all groups were calculated, and mode of fracture was determined. Nitrogen surface treatment had the highest mean shear bond strength of 10.04 (±1.84) MPa, while the reference group showed the lowest value of 5.38 (±2.90) MPa. Regarding mode of fracture, all the specimens showed a 100% adhesive failure mode. Plasma surface treatment can be a reliable alternative method to the traditional protocol of bonding veneering composite resin to unfilled PEEK material.
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Affiliation(s)
- Mohamed Younis
- Section Medical Materials Science & Technology, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany.
| | - Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery Dental School, Tuebingen University Hospital, Osianderstrasse 2-8, 72076 Tuebingen, Germany.
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Trubetskaya str. 8-2, 119991 Moscow, Russia.
| | - Ashraf ElAyouti
- Department of Conservative Dentistry, at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery Dental School, Tuebingen University Hospital, Osianderstrasse 2-8, 72076 Tuebingen, Germany.
| | - Jürgen Geis-Gerstorfer
- Section Medical Materials Science & Technology, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany.
| | - Sebastian Spintzyk
- Section Medical Materials Science & Technology, University Hospital Tuebingen, Osianderstrasse 2-8, 72076 Tuebingen, Germany.
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Unkovskiy A, Wahl E, Zander AT, Huettig F, Spintzyk S. Intraoral scanning to fabricate complete dentures with functional borders: a proof-of-concept case report. BMC Oral Health 2019; 19:46. [PMID: 30866892 PMCID: PMC6417141 DOI: 10.1186/s12903-019-0733-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 02/25/2019] [Indexed: 11/24/2022] Open
Abstract
Background The utilization of intraoral scanning for manufacturing of complete dentures (CD) has been reported recently. However, functional border molding still cannot be supported digitally. A proof-of-concept trial shows two possible pathways to overcome this limitation by integrating a relining procedure into the digital workflow for CD manufacturing. Case presentation Intraoral scans and additional facial scans were performed with two various scanning systems for the rehabilitation of an edentulous male patient. The obtained raw data was aligned and used for the computer aided design (CAD) of the CD. The virtually constructed dentures were materialized in two various ways, considering rapid manufacturing and digital relining approaches in order to apply functionally molded borders. Conclusion The use of intraoral edentulous jaws scans in combination with the digital relining procedure may allow for fabrication of CD with functional borders within a fully digital workflow.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany. .,Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, 119146, Moscow, Russia.
| | - Eugen Wahl
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - Anne Teresa Zander
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany
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Unkovskiy A, Roehler A, Huettig F, Geis-Gerstorfer J, Brom J, Keutel C, Spintzyk S. Simplifying the digital workflow of facial prostheses manufacturing using a three-dimensional (3D) database: setup, development, and aspects of virtual data validation for reproduction. J Prosthodont Res 2019; 63:313-320. [PMID: 30792148 DOI: 10.1016/j.jpor.2019.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/08/2019] [Accepted: 01/17/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To set up the digital database (DDB) of various anatomical parts, skin details and retention elements in order to simplify the digital workflow of facial prostheses manufacturing; and to quantify the reproduction of skin wrinkles on the prostheses prototypes with stereolithography (SLA) and direct light processing (DLP) methods. METHODS Two structured light scanners were used to obtain the nasal and auricle forms of 50 probands. Furthermore, the ala nasi and scapha areas were captured with the digital single lens reflex camera and saved in jpeg format. The four magnetic retention elements were remodeled in computer aided design (CAD) software. The 14 test blocks with embossed wrinkles of 0.05-0.8mm were printed with SLA and DLP methods and afterwards analyzed by means of profilometry and confocal microscopy. RESULTS The introduced DDB allows for production of customized facial prosthesis and makes it possible to consider the integration of concrete retention elements on the CAD stage, which makes the prosthesis modelling more predictable and efficient. The obtained skin structures can be applied onto the prosthesis surface for customization. The reproduction of wrinkles from 0.1 to 0.8mm in depth may be associated with the loss of 4.5%-11% of its profile with SLA or DLP respectively. Besides, the reproduction of 0.05mm wrinkles may be met with up to 40% profile increasement. CONCLUSIONS The utilization of DDB may simplify the digital workflow of facial prostheses manufacturing. The transfer of digitally applied skin wrinkles till the prostheses' prototypes may be associated with deviations from 11 to 40%.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Ariadne Roehler
- Section Medical Materials and Science, Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | | | | | - Constanze Keutel
- Department of Oral and Maxillofacial Surgery, and Head of Radiology Department at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tübingen, Germany
| | - Sebastian Spintzyk
- Section Medical Materials and Science, Tuebingen University Hospital, Tuebingen, Germany
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Xu Y, Unkovskiy A, Klaue F, Rupp F, Geis-Gerstorfer J, Spintzyk S. Compatibility of a Silicone Impression/Adhesive System to FDM-Printed Tray Materials-A Laboratory Peel-off Study. Materials (Basel) 2018; 11:ma11101905. [PMID: 30301282 PMCID: PMC6213137 DOI: 10.3390/ma11101905] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 09/21/2018] [Accepted: 10/04/2018] [Indexed: 01/15/2023]
Abstract
Computer-aided design (CAD) and additive manufacturing (AM) have shown promise in facilitating the fabrication of custom trays. Due to the clinical requirements, custom tray materials should achieve good bonding to the impression/adhesive systems. This study evaluated the retention of three fused deposition modeling (FDM) custom tray materials to a silicone impression/adhesive system before and after gritblasting (GB) by peel-off test. CAD-designed experimental test blocks were printed by FDM using acrylonitrile butadiene styrene (ABS), polyethylene terephthalate glycol copolyester (PETG), and high impact polystyrene (HIPS), and the reference test blocks were made of a conventional light-curing resin (n = 11). Before and after GB, the surface topography of all tray materials was analysed, and the maximum strength of the test block peeled off from a silicone impression/adhesive system was measured. After GB, the arithmetic mean height (Sa) and the valley fluid retention index (Svi) of the four material groups declined (p < 0.05). The peel-off strength of each of the four material groups significantly decreased by GB (p < 0.05), but no statistical difference could be found among them before or after GB. In all peel-off tests, adhesive failure occurred at the adhesive-impression material interface. The results indicated ABS, HIPS, and PETG could provide sufficient adhesion to the adhesive as the conventional light-curing resin, and GB could reduce the roughness generated by FDM and weaken the bonding between the adhesive and the silicone impression.
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Affiliation(s)
- Yichen Xu
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
| | - Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, University Hospital Tuebingen, 72076 Tuebingen, Germany.
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, Moscow 119146, Russia.
| | - Felix Klaue
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
| | - Frank Rupp
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
| | - Juergen Geis-Gerstorfer
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
| | - Sebastian Spintzyk
- Section Medical Materials Science & Technology, University Hospital Tuebingen, 72076 Tuebingen, Germany.
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Unkovskiy A, Bui PHB, Schille C, Geis-Gerstorfer J, Huettig F, Spintzyk S. Objects build orientation, positioning, and curing influence dimensional accuracy and flexural properties of stereolithographically printed resin. Dent Mater 2018; 34:e324-e333. [PMID: 30293688 DOI: 10.1016/j.dental.2018.09.011] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the influence of printing parameters on flexural properties and accuracy of SLA-printed standard objects. METHODS Thirty specimens were printed in 0°, 45° and 90° orientation. Fourth nine more specimens were printed evenly on the build platform. forty more specimens were printed and polymerized with three curing unit. Length, height and width was measured three times for each specimen and compared to the original dimensions. Afterwards all specimens underwent a three-point-bending test to assess their flexural properties. One way ANOVA and the Post-Hoc all pairs Tukey-Kramer HSD test were used for data evaluation. RESULTS The print orientation influences the printing accuracy. The parameters printed along the Z-axis are particularly prone to inaccuracies. Specimens with 45° orientation were found to be the most accurate. Object printed on the borders of build platform a rather prone to inaccuracies than those in the center. The 90° specimens with layer orientation parallel to the axial load showed the superior flexural strength and flexural modulus. The use of different curing unit is unlikely to affect the objects printing accuracy and flexural properties. SIGNIFICANCE The anisotropical behavior of printed specimens with regards to build orientation and positioning was revealed. The understanding of how the adjustable printing parameter influence the printing outcome is important for a precise fabrication of surgical guides. Inaccuracies up to 10% along the Z-axis, as revealed in the present study,may restrict an accurate implant placement.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tubingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, 8-2 Trubetskaya st., 119991 Moscow, Russia.
| | - Phan Hai-Binh Bui
- Section "Medical Materials, Science and Technology" Tuebingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Christine Schille
- Section "Medical Materials, Science and Technology" Tuebingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Juergen Geis-Gerstorfer
- Section "Medical Materials, Science and Technology" Tuebingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tubingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Sebastian Spintzyk
- Section "Medical Materials, Science and Technology" Tuebingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
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Unkovskiy A, Spintzyk S, Brom J, Huettig F, Keutel C. Direct 3D printing of silicone facial prostheses: A preliminary experience in digital workflow. J Prosthet Dent 2018; 120:303-308. [PMID: 29429837 DOI: 10.1016/j.prosdent.2017.11.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/06/2017] [Accepted: 11/06/2017] [Indexed: 11/29/2022]
Abstract
Direct silicone printing may be applied to the fabrication of maxillofacial prostheses, although its clinical feasibility is unknown. The present clinical report shows an early application of a directly printed silicone prosthesis for the rehabilitation of a nasal defect. Two extraoral scanning systems were used to capture the face and the defect. The virtual construction of the nasal prosthesis was performed with free-form software. Two prostheses were printed in silicone and post-processed by manual sealing and coloring. The clinical outcome was acceptable for an interim prosthesis; however, the marginal adaptation and color match were not satisfactory without further individualization.
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Affiliation(s)
- Alexey Unkovskiy
- Dentist, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany.
| | - Sebastian Spintzyk
- Material Science Engineer, Section of Medical Materials and Science, Tübingen University Hospital, Tübingen, Germany
| | - Joern Brom
- Anaplastologist, Brom Epithetik, Heidelberg, Germany
| | - Fabian Huettig
- Assistant Medical Director, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany
| | - Constanze Keutel
- Senior Associate, Department of Oral and Maxillofacial Surgery, and Head of Radiology Department at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany
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Unkovskiy A, Brom J, Huettig F, Keutel C. Auricular Prostheses Produced by Means of Conventional and Digital Workflows: A Clinical Report on Esthetic Outcomes. INT J PROSTHODONT 2017; 31:63–66. [PMID: 29145528 DOI: 10.11607/ijp.5446] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The utilization of additive manufacturing (AM) technology for the production of auricular prostheses has been widely acknowledged. However, few studies and case history reports have evaluated the esthetic outcomes of AM prostheses compared to those of conventionally manufactured prostheses. In this case history report, three manufacturing approaches-conventional, indirect, and direct mold preparation-were assessed for their esthetic outcomes in the same patient.
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Unkovskiy A, Spintzyk S, Axmann D, Engel EM, Weber H, Huettig F. Additive Manufacturing: A Comparative Analysis of Dimensional Accuracy and Skin Texture Reproduction of Auricular Prostheses Replicas. J Prosthodont 2017; 28:e460-e468. [PMID: 29125215 DOI: 10.1111/jopr.12681] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The use of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing in maxillofacial prosthetics has been widely acknowledged. Rapid prototyping can be considered for manufacturing of auricular prostheses. Therefore, so-called prostheses replicas can be fabricated by digital means. The objective of this study was to identify a superior additive manufacturing method to fabricate auricular prosthesis replicas (APRs) within a digital workflow. MATERIALS AND METHODS Auricles of 23 healthy subjects (mean age of 37.8 years) were measured in vivo with respect to an anthropometrical protocol. Landmarks were volumized with fiducial balls for 3D scanning using a handheld structured light scanner. The 3D CAD dataset was postprocessed, and the same anthropometrical measurements were made in the CAD software with the digital lineal. Each CAD dataset was materialized using fused deposition modeling (FDM), selective laser sintering (SLS), and stereolithography (SL), constituting 53 APR samples. All distances between the landmarks were measured on the APRs. After the determination of the measurement error within the five data groups (in vivo, CAD, FDM, SLS, and SL), the mean values were compared using matched pairs method. To this, the in vivo and CAD dataset were set as references. Finally, the surface structure of the APRs was qualitatively evaluated with stereomicroscopy and profilometry to ascertain the level of skin detail reproduction. RESULTS The anthropometrical approach showed drawbacks in measuring the protrusion of the ear's helix. The measurement error within all groups of measurements was calculated between 0.20 and 0.28 mm, implying a high reproducibility. The lowest mean differences of 53 produced APRs were found in FDM (0.43%) followed by SLS (0.54%) and SL (0.59%)--compared to in vivo, and again in FDM (0.20%) followed by SL (0.36%) and SLS (0.39%)--compared to CAD. None of these values exceed the threshold of clinical relevance (1.5%); however, the qualitative evaluation revealed slight shortcomings in skin reproduction for all methods: reproduction of skin details exceeding 0.192 mm in depth was feasible. CONCLUSION FDM showed the superior dimensional accuracy and best skin surface reproduction. Moreover, digital acquisition and CAD postprocessing seem to play a more important role in the outcome than the additive manufacturing method used.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Sebastian Spintzyk
- Medical Material Science and Technology, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Detlef Axmann
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Eva-Maria Engel
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Heiner Weber
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Fabian Huettig
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
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