1
|
Handermann R, Rammelsberg P, Bömicke W. Metal-Ceramic Resin-Bonded Fixed Partial Dentures After a Mean Observation Time of 7.5 Years. INT J PROSTHODONT 2024; 37:157-165. [PMID: 38648164 DOI: 10.11607/ijp.8296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE To generate data on the long-term survival of metal-ceramic resin-bonded fixed partial dentures (RBFPDs). MATERIALS AND METHODS A total of 89 patients received 94 RBFPDs, 5 of whom (women n = 1; men n = 4) received 2 RBFPDs each. All RBFPDs were fabricated as two-retainer end-abutment metal-ceramic restorations. Clinical follow-ups were performed 6 months after cementation and then annually thereafter. The mean observation time was 7.5 years. Cox regression was performed to test the effects of the variables: gender, location, arch, design, use of rubber dam, and adhesive luting system. Survival and success were calculated using Kaplan-Meier curves. As a secondary objective, patient and dentist satisfaction with the esthetics and function of the RBFPDs was evaluated. The significance level was set at α = .05 for all calculations. RESULTS Estimated Kaplan-Meier failure-free survival was 97.5% (standard error [SE] 1.7) after 5 years and 83.3% (SE 5.3) after 10 years. Calculated intervention-free survival (success) was 90.1% (SE 3.4) after 5 years and 65.5% (SE 6.7) after 10 years. Debonding-free survival was 92.6% (SE 2.9) after 5 years and 80.6% (SE 5.4) after 10 years. Cox regression revealed that none of the four tested variables had a significant effect on the incidence of complications in RBFPDs. Patient and dentist satisfaction with RBFPD esthetics and function was consistently high throughout the observation period. CONCLUSIONS Within the limitations of an observational study, RBFPDs achieved clinically successful outcomes over a mean observational period of 7.5 years.
Collapse
|
2
|
Bömicke W, Boisserée P, Rammelsberg P, Rues S. Initial damage and failure load of zirconia-ceramic and metal-ceramic posterior cantilever fixed partial dentures. Clin Oral Investig 2024; 28:94. [PMID: 38221600 PMCID: PMC10788321 DOI: 10.1007/s00784-024-05501-z] [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: 10/16/2023] [Accepted: 01/07/2024] [Indexed: 01/16/2024]
Abstract
OBJECTIVES The aim of this study was to compare failure load and initial damage in monolithic, partially veneered, and completely veneered (translucent) zirconia cantilevered fixed partial dentures (CFPDs), as well as completely veneered metal-ceramic CFPDs under different support and loading configurations. MATERIALS AND METHODS Eight test groups with anatomically congruent CFPDs (n = 8/group) were fabricated, differing in CFPD material/support structure/loading direction (load applied via steel ball (Ø 6 mm) 3 mm from the distal end of the pontic for axial loading with a 2-point contact on the inner cusp ridges of the buccal and oral cusps and 1.3 mm below the oral cusp tip for 30° oblique loading): (1) monolithic zirconia/CoCr abutment teeth/axial, (2) monolithic zirconia/CoCr abutment teeth/oblique, (3) partially veneered zirconia/CoCr abutment teeth/axial, (4) partially veneered zirconia/CoCr abutment teeth/oblique, (5) completely veneered zirconia/CoCr abutment teeth/axial, (6) completely veneered CoCr/CoCr abutment teeth/axial (control group), (7) partially veneered zirconia/implants/axial, and (8) partially veneered zirconia/natural teeth/axial. Restorations were artificially aged before failure testing. Statistical analysis was conducted using one-way ANOVA and Tukey post hoc tests. RESULTS Mean failure loads ranged from 392 N (group 8) to 1181 N (group 1). Axially loaded monolithic zirconia CFPDs (group 1) and controls (group 6) showed significantly higher failure loads. Oblique loading significantly reduced failure loads for monolithic zirconia CFPDs (group 2). Initial damage was observed in all groups except monolithic zirconia groups, and fractography revealed design flaws (sharp edges at the occlusal boundary of the veneering window) in partially veneered zirconia CFPDs. CONCLUSIONS Monolithic zirconia CFPDs might be a viable alternative to completely veneered CoCr CFPDs in terms of fracture load. However, oblique loading of monolithic zirconia CFPDs should be avoided in clinical scenarios. Design improvements are required for partially veneered zirconia CFPDs to enhance their load-bearing capacity. CLINICAL RELEVANCE Monolithic zirconia may represent a viable all-ceramic alternative to the established metal-ceramic option for CFPD fabrication. However, in daily clinical practice, careful occlusal adjustment and regular monitoring should ensure that oblique loading of the cantilever is avoided.
Collapse
Affiliation(s)
- Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | | | - Peter Rammelsberg
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
3
|
Klotz AL, Halfmann J, Rues S, Bömicke W, Rammelsberg P, Zenthöfer A. Fracture Resistance of Posterior Tooth-Supported Cantilever Fixed Dental Prostheses of Different Zirconia Generations and Framework Thicknesses: An In Vitro Study. Materials (Basel) 2024; 17:263. [PMID: 38204115 PMCID: PMC10779861 DOI: 10.3390/ma17010263] [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] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
The rehabilitation of free-end situations is a frequent indication in prosthetic dentistry. Cantilever fixed dental prostheses (cFDPs) made of 1st and 2nd generation zirconia are one treatment option. Due to a unique gradient technology, combinations of different zirconium dioxide generations are thus feasible in one restoration. However, data about these materials are rare. The purpose of this study was therefore to investigate the fracture resistance and fracture modes of tooth-supported cFDPs fabricated from different zirconia materials (gradient technology) and different framework thicknesses. A total of 40 cFDPs were fabricated using the CAD/CAM approach and belonged to five test groups. The different groups differed in the yttria content, the proportion of the tetragonal/cubic phases, or in wall thickness (0.7 mm or 1 mm). After completion, the cFDPs were subjected to thermal cycling and chewing simulation (1.2 × 106 load cycles, 108 N load). Afterwards, cFDPs were statically loaded until fracture in a universal testing machine. A non-parametric ANOVA was compiled to determine the possible effects of group membership on fracture resistance. In addition, post-hoc Tukey tests were used for bivariate comparisons. The mean fracture loads under axial load application ranged from 288 to 577 N. ANOVA detected a significant impact of the used material on the fracture resistances (p < 0.001). Therefore, the use of cFDPs fabricated by gradient technology zirconia may not be unreservedly recommended for clinical use, whereas cFPDs made from 3Y-TZP exhibit fracture resistance above possible masticatory loads in the posterior region.
Collapse
Affiliation(s)
- Anna-Luisa Klotz
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; (J.H.); (S.R.); (W.B.); (P.R.); (A.Z.)
| | | | | | | | | | | |
Collapse
|
4
|
Waldecker M, Rues S, Behnisch R, Rammelsberg P, Bömicke W. Effect of scan-path length on the scanning accuracy of completely dentate and partially edentulous maxillae. J Prosthet Dent 2024; 131:146-154. [PMID: 35367080 DOI: 10.1016/j.prosdent.2022.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/16/2021] [Revised: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM The accuracy of fit of fixed partial dentures is directly dependent on the accuracy of a digital scan. However, the influence of scan-path length on scanning accuracy is unclear. PURPOSE The purpose of this in vitro study was to evaluate how scan-path length influenced the scanning accuracy of a completely dentate or partially edentulous maxilla captured by 3 intraoral scanners: Omnicam AC (OC), TRIOS 4 (TR), and Primescan (PS). MATERIAL AND METHODS Each intraoral scanner was used to make 30 scans each of the 2 clinical scenarios (completely dentate and partially edentulous) simulated with a reference model. The partially edentulous model simulated a maxilla with 6 prepared teeth to support a complete arch fixed partial denture. The missing teeth were then added to create a completely dentate model. The prepared teeth were later used to determine distance, angular, and tooth-axis deviations between the reference model (digitized with high precision before the tests) and the intraoral scans. Data were statistically analyzed by using a linear model or, if not applicable, a type II ANOVA (α=.05). RESULTS Distance deviations increased linearly as the scan-path length increased. In contrast, angular and tooth-axis deviations did not increase linearly. All types of deviation differed depending on the scanning system used. Regarding the 90% quantile values, total distance deviations related to scan-path length amounted to 1.31 μm/mm (OC), 1.00 μm/mm (PS), and 1.45 μm/mm (TR) for the completely dentate maxilla and 1.10 μm/mm (OC), 1.46 μm/mm (PS), and 1.40 μm/mm (TR) for the partially edentulous maxilla. CONCLUSIONS Distance deviations became larger as the scan-path length increased.
Collapse
Affiliation(s)
- Moritz Waldecker
- Assistant Professor, Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany.
| | - Stefan Rues
- Assistant Professor, Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Rouven Behnisch
- Assistant Professor, Institute of Medical Biometry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Director, Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Bömicke
- Associate Professor, Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
5
|
Bömicke W, Rammelsberg P, Spatola G, Rues S. The Effect of Titanium Anodization on the Bond Strength of 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) Resin Cement. INT J PROSTHODONT 2023; 36:133-142. [PMID: 38112736 DOI: 10.11607/ijp.7821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE To examine the effects of anodization and different surface modifications of titanium on bond strength to 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) resin cement. MATERIALS AND METHODS Grade 5 titanium alloy disks (n = 160) were assigned to one of five prebonding surface treatment study groups (polished; polished and anodized; polished, etched, and anodized; sandblasted; sandblasted and anodized). Disks were adhesively bonded with 10-MDP resin cement (Panavia 21; bonding area: 3.3 mm in diameter) to composite resin cylinders. In each study group, tensile bond strength tests were conducted after 24 ± 1 hours and after 6 months (180 ± 2 days) of water storage (n = 16 specimens per water storage subgroup). Debonded specimens were stereomicroscopically analyzed to determine their fracture mode. Statistics included one-way and multifactorial ANOVA and Tukey post hoc tests (α = .05). RESULTS Anodization and water storage did not significantly (P ≥ .389) affect tensile bond strength. Although subgroups of polished samples had significantly (P ≤ .031) lower bond strengths (subgroup mean values: 20 to 26 MPa) than etched or sandblasted samples (subgroup mean values: 29 to 33 MPa), they nonetheless exceeded the empirical threshold of 10 MPa used as a criterion for clinical recommendation. The fracture mode of all test specimens was predominantly cohesive. CONCLUSIONS Anodization of titanium surfaces can be performed without weakening the adhesion of 10-MDP-based resin cement to titanium.
Collapse
|
6
|
Hinz S, Bömicke W, Bensel T. Cumulative 10-year performance of endodontically treated teeth with prosthetic restorations of base metal alloy double crowns with friction pins-a retrospective study. Clin Oral Investig 2023; 27:4411-4423. [PMID: 37212841 PMCID: PMC10415510 DOI: 10.1007/s00784-023-05060-9] [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: 03/12/2023] [Accepted: 05/02/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES This 120-month follow-up study aimed to investigate the complication rate of abutment teeth after endodontic pretreatment with base metal alloy double crowns with friction pins. MATERIALS AND METHODS A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth (n = 459, 88.3% vital) were retrospectively analyzed between 2006 and 2022. Of the endodontically treated abutment teeth, 6.9% (n = 36) were additionally treated with post and core reconstructions. Cumulative complication rates were calculated using the Kaplan-Meier estimator and log-rank test. In addition, Cox regression analysis was performed. RESULTS The cumulative complication rate at 120 months for the entire set of abutment teeth was 39.6% (confidence interval [CI]: 33.0-46.2). Endodontically treated abutment teeth (33.8%; CI: 19.6-48.0) were found to have a significantly higher cumulative fracture rate than vital teeth (19.9%; CI: 13.9-25.9, p < 0.001). Endodontically treated teeth restored with post and core reconstructions (30.4%; CI: 13.2-47.6) showed a nonsignificant lower cumulative fracture rate than that of teeth with root fillings only (41.6%; CI: 16.4-66.8, p = 0.463). CONCLUSIONS Higher 120-month cumulative fracture rates were observed in endodontically treated teeth. Comparable performance was observed in teeth with post and core reconstructions compared to teeth with root fillings only. CLINICAL RELEVANCE If endodontically treated teeth are used as abutments for double crowns, the risk of complications from these teeth should be considered when planning treatment and communicating with the patient.
Collapse
Affiliation(s)
- Sebastian Hinz
- Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 16, 06112, Halle, Germany.
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Tobias Bensel
- Institute for Research in International Assistance, Akkon University for Human Sciences, Colditzstraße 34-36, 12099, Berlin, Germany
| |
Collapse
|
7
|
Rues S, Zehender N, Zenthöfer A, Bömicke W, Herpel C, Ilani A, Erber R, Roser C, Lux CJ, Rammelsberg P, Schwindling FS. Fit of anterior restorations made of 3D-printed and milled zirconia: An in-vitro study. J Dent 2023; 130:104415. [PMID: 36640843 DOI: 10.1016/j.jdent.2023.104415] [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: 07/19/2022] [Revised: 12/23/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To evaluate the fit of zirconia veneers made by either 3D printing or milling. METHODS A typodont maxillary central incisor was prepared for a 0.5-mm-thick veneer and was reproduced 36 times from resin. Restorations were designed with a 20-µm-wide marginal and a 60-µm-wide internal cement gap, and were made from 3D-printed zirconia (LithaCon 3Y 210, Lithoz, n = 24) and milled zirconia (Cercon ht, DentsplySirona, n = 12). For milled zirconia, a drill compensation was needed to give the milling bur access to the intaglio surface. The restorations were cemented, cross-sectioned, and the cement gap size was analyzed by two raters. Inter-rater reliability was studied at 12 3D-printed veneers (intraclass correlation coefficient, ICC, mixed model, absolute agreement). Twelve remaining 3D-printed restorations were compared with 12 milled restorations regarding fit at three locations: marginally, labially, and at the incisal edge (Mann-Whitney U-tests, α<0.05). RESULTS Inter-rater reliability was excellent, with an ICC single-measure coefficient of 0.944 (95%-confidence interval: [0.907; 0.966]). Gap sizes (mean ± SD / maximum) were 55 ± 9 / 143 µm at the margins, 68 ± 14 / 130 µm labially, and 78 ± 19 / 176 µm at the incisor edge for 3D-printed veneers. For milled veneers, gap sizes were 44 ± 11 / 141 µm at the margins, 85 ± 19 / 171 µm labially, and 391 ± 26 / 477 µm at the incisor edge. At the margins, the milled veneers outperformed the 3D-printed restorations (p = 0.011). The cement gap at the incisor edge was significantly smaller after 3D printing (p < 0.001). CONCLUSIONS 3D-printed zirconia restorations showed clinically acceptable mean marginal gaps below 100 µm. Because drill compensation could be omitted with 3D printing, the fit at the sharp incisal edge was significantly tighter than with milling. CLINICAL SIGNIFICANCE The fit of 3D-printed ceramic anterior restorations meets clinical standards. In addition, 3D printing is associated with a greater geometrical freedom than milling. With regard to fit this feature allows tighter adaptation even after minimally invasive preparation.
Collapse
Affiliation(s)
- Stefan Rues
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Nathalie Zehender
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Zenthöfer
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Wolfgang Bömicke
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher Herpel
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Ali Ilani
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Ralf Erber
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christoph Roser
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, Heidelberg University Hospital, Heidelberg, Germany
| | | |
Collapse
|
8
|
Schmitter M, Bömicke W, Behnisch R, Lorenzo Bermejo J, Waldecker M, Rammelsberg P, Ohlmann B. Ceramic Crowns and Sleep Bruxism: First Results from a Randomized Trial. J Clin Med 2022; 12:jcm12010273. [PMID: 36615073 PMCID: PMC9821737 DOI: 10.3390/jcm12010273] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022] Open
Abstract
Background: This randomized clinical trial was conducted to assess whether sleep bruxism (SB) is associated with an increased rate of technical complications (ceramic defects) in lithium disilicate (LiDi) or zirconia (Z) molar single crowns (SCs). Methods: Adult patients were classified as affected or unaffected by SB based on structured questionnaires, clinical signs, and overnight portable electromyography (BruxOff) and block randomized into four groups according to SB status and crown material (LiDi or Z): LiDi-SB (n = 29), LiDi-no SB (n = 24), Z-SB (n = 23), and Z-no SB (n = 27). Differences in technical complications (main outcome) and survival and success rates (secondary outcomes) one year after crown cementation were assessed using Fisher’s exact test with significance level α = 0.05. Results: No technical complications occurred. Restoration survival rates were 100% in the LiDi-SB and LiDi-no SB groups, 95.7% in the Z-SB group, and 96.3% in the Z-no SB group (p > 0.999). Success rates were 96.6% in the LiDi-SB group, 95.8% in the LiDi-no SB group (p > 0.999), 91.3% in the Z-SB group, and 96.3% in the Z-no SB group (p ≥ 0.588). Conclusions: With a limited observation time and sample size, no effect of SB on technical complication, survival, and success rates of molar LiDi and Z SCs was detected.
Collapse
Affiliation(s)
- Marc Schmitter
- Department of Prosthodontics, University of Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
| | - Wolfgang Bömicke
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-622-156-6052
| | - Rouven Behnisch
- Institute of Medical Biometry, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Justo Lorenzo Bermejo
- Institute of Medical Biometry, University of Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Moritz Waldecker
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - Brigitte Ohlmann
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| |
Collapse
|
9
|
Rathmann F, Pohl M, Rammelsberg P, Bömicke W. Up to 10 years clinical performance of zirconia ceramic and metal-ceramic fixed partial dentures: A retrospective study. J Prosthet Dent 2022:S0022-3913(22)00692-8. [PMID: 36464507 DOI: 10.1016/j.prosdent.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 12/02/2022]
Abstract
STATEMENT OF PROBLEM Completely veneered zirconia ceramic (ZC) fixed partial dentures (FPDs) have been reported to have a higher incidence of ceramic chipping than the standard metal-ceramic FPDs. However, data from comparative long-term studies are sparse. PURPOSE The purpose of this retrospective study was to compare the long-term survival, chipping-free survival, and success of ceramic-veneered high noble metal alloy (HN), base metal alloy (cobalt-chromium alloy) (CC), and ZC FPDs and to isolate risk factors for the incidence of failure, veneer chipping, and overall complications. MATERIAL AND METHODS Data from 289 study participants (58.7% women; mean age, 57.97 ±11.51 years) provided with a total of 400 FPDs comprising 197 (49.3%) HN FPDs, 121 (30.3%) CC FPDs, and 82 (20.5%) ZC FPDs fabricated from presintered 3 mol% yttria-stabilized zirconia (mean time of service, 6.85 ±3.25 years) were evaluated. Of these, 278 (69.5%) FPDs were provided by dentists and 122 (30.5%) by dental students. Five- and 10-year survival, chipping-free survival, and success rates were calculated using the Kaplan-Meier method and compared with the log-rank test. Risk factors were assessed using Cox regression analysis. The study was exploratory, so all P values were considered exploratory and descriptive. RESULTS The 5- and 10-year survival rates were 94.7% and 77.8% for HN, 93.7% and 81.2% for CC, and 92.9% and 53.3% for ZC FPDs, respectively, indicating no clear difference in survival among the framework materials. The 5- and 10-year chipping-free rates were 94.1% and 82.8% for HN, 96.1% and 78.9% for CC, and 82.6% and 62.2% for ZC FPDs, respectively, indicating a difference between HN and ZC, and CC and ZC restorations. The 5- and 10-year success rates were 83.7% and 55.3% for HN, 86.5% and 51.4% for CC, and 68.9% and 30.2% for ZC FPDs, respectively, indicating a difference between HN and ZC, and CC and ZC restorations. The Cox regression model indicated framework material as an influencing risk factor for success, and this influence persisted when chipping was investigated. Compared with zirconia, the use of a metal alloy reduced the risk of chipping or the occurrence of complications by up to one-third. CONCLUSIONS All FPDs showed high 5-year survival rates and acceptable 10-year survival rates with no strong differences among the materials. Higher success and chipping-free rates were observed for both HN and CC restorations compared with ZC restorations. Metal frameworks had a lower risk for complications or veneer chipping than zirconia frameworks.
Collapse
Affiliation(s)
- Friederike Rathmann
- Assistant Professor, Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Moritz Pohl
- Assistant Professor, Institute of Medical Biometry, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Director, Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Bömicke
- Associate Professor, Department of Prosthodontics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.
| |
Collapse
|
10
|
Waldecker M, Bömicke W, Awounvo Awounvo S, Rammelsberg P, Rues S. Influence of artificial landmarks on the accuracy of complete arch scans in the partially edentulous maxilla: An in vitro study. J Prosthet Dent 2022:S0022-3913(22)00507-8. [PMID: 36437136 DOI: 10.1016/j.prosdent.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/16/2022] [Accepted: 08/16/2022] [Indexed: 11/27/2022]
Abstract
STATEMENT OF PROBLEM Scan path length and the presence of edentulous alveolar ridge sections have a negative influence on scanning accuracy. How different artificial landmarks combined with an adapted scanning method affect accuracy is unclear. PURPOSE The purpose of this in vitro study was to determine the influence of 2 different artificial landmarks combined with an adapted scanning method on the scanning accuracy of a partially edentulous maxillary model. MATERIAL AND METHODS The model simulated a maxilla with 6 prepared teeth to accommodate a complete arch fixed partial denture. Five ceramic precision balls (ball center P1-P5), distributed buccally to the dental arch, were used to detect the dimensional and angular changes between the reference model and the intraoral scans. One intraoral scanner (Primescan) was used to make 30 scans each with either the scanning strategy recommended by the manufacturer (M) or with an adapted scanning strategy and the use of a bar (B) or 4 plates (P) as artificial landmarks in the dorsal palate. Data were statistically analyzed using a generalized least squares regression model (α=.05). RESULTS Scanning with artificial landmarks reduced the maximum absolute distance deviations (M: 249 μm, B: 190 μm, P: 238 μm) and the maximum angle deviations (M: 0.31 degrees, B: 0.28 degrees, P: 0.26 degrees). Vertical distance deviations were improved by 10 to 50% with the use of artificial landmarks. Absolute mean distance deviations were significantly lower for group M (P<.001). In contrast, with artificial landmarks, mean angle (P<.001) and mean vertical distance deviations (P<.014) improved significantly. CONCLUSIONS Scanning with artificial landmarks in the dorsal palate combined with an adapted scanning method improved the scanning accuracy and reliability of vertical distance deviations.
Collapse
Affiliation(s)
- Moritz Waldecker
- Assistant Professor, Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany.
| | - Wolfgang Bömicke
- Associated Professor, Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Sinclair Awounvo Awounvo
- Assistant Professor, Institute of Medical Biometry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Director of Department, Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Stefan Rues
- Assistant Professor, Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
11
|
Hinz S, Bömicke W, Schweyen R, Bensel T. Ten-year clinical performance of non-precious metal double crowns with friction pins in severely reduced dentitions—a retrospective study. Clin Oral Investig 2022; 27:1623-1635. [PMID: 36414766 PMCID: PMC10102142 DOI: 10.1007/s00784-022-04788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
Abstract
Objectives
This follow-up study aimed at collecting long-term data for removable partial dentures (RPDs) retained by double crowns with spark-eroded friction pins (DCP) and comparing them in the presence of severely reduced dentition (SRD) and non-SRD (NSRD, i.e. residual dentition with more than three abutment teeth) after a 10-year wearing period.
Materials and methods
A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth were followed up between 2006 and 2022. The SRD group included 144 RPDs supported by 314 abutment teeth. The data collection was performed retrospectively. 10-year survival rates of RPDs and abutment teeth were determined using the Kaplan–Meier method and compared using the log-rank test for SRD and NSRD, among others. Cox regression analyses were conducted to isolate risk factors for the survival of both RPDs and abutment teeth.
Results
The 10-year cumulative survival rate of all abutment teeth was 65.6% with significantly lower values in the SRD group (53.5%) (p < 0.001). The survival rate for all RPDs was 65.5%. The SRD group showed lower survival rates (57.9%) (p = 0.004). The number and location of the abutment teeth had a significant influence on the survival rates of the RPDs and the abutment teeth. Age, sex, jaw, relining, and vitality had a significant influence on the abutment teeth survival rates.
Conclusions
RPDs showed an acceptable clinical survival rate after 10 years. The number, location, and vitality of abutment teeth were factors that influenced the survival of both RPDs and abutment teeth.
Clinical relevance
Consideration of the influencing factors found can help improve the prognostic assessment of double crown-retained dentures in the context of prosthetic therapy planning.
Collapse
|
12
|
Zenthöfer A, Rues S, Rammelsberg P, Ohlmann B, Bömicke W. Influence of geometric dimensions on early failures of adhesively retained composite resin core build-ups. J ESTHET RESTOR DENT 2022; 35:435-441. [PMID: 36786653 DOI: 10.1111/jerd.12953] [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: 03/08/2022] [Revised: 06/23/2022] [Accepted: 07/20/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the influence of the geometric dimensions of core build-ups on early core build-up failure, that is, loss before definitive prosthesis cementation. MATERIALS AND METHODS Adhesive core build-ups of exclusively vital teeth in 114 participants were evaluated (n materials: 40 Rebilda DC, 38 Multicore Flow, 36 Clearfil DC Core; n teeth: 8 incisors, 54 premolars, 52 molars). Impressions of the abutment teeth were made (1) after removal of insufficient restorations/caries and (2) after core build-up and preparation for a fixed prosthesis. Digitized model surfaces of both situations were aligned (Geomagic Design X) and core build-up volume (VCBU ), remaining hard tissue volume (VAbut ), and size of the adhesive surface (Aadh ) were assessed. The derived measure dCBU = VCBU /Aadh can be interpreted as mean arithmetic core build-up thickness. Associations between participant or core build-up design characteristics and the occurrence of early failures were statistically evaluated (SPSS v27, α = 0.05). RESULTS A total of six (5.3%) core build-up failures were registered. Higher participant age, greater core build-up volume VCBU and greater arithmetic uniform thickness dCBU were associated with a greater incidence of failure in bivariate and univariate, however, not in multivariate statistics. CONCLUSIONS Core build-up volume and thickness were associated with early success or failure. CLINICAL SIGNIFICANCE In the case of voluminous/thick core build-ups in relation to the adhesive surface, additional measures, such as the preparation of retentive elements to increase the bonding area, might be considered to reduce the risk of early core build-up failure.
Collapse
Affiliation(s)
- Andreas Zenthöfer
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Brigitte Ohlmann
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
13
|
Waldecker M, Rues S, Awounvo Awounvo JS, Rammelsberg P, Bömicke W. In vitro accuracy of digital and conventional impressions in the partially edentulous maxilla. Clin Oral Investig 2022; 26:6491-6502. [PMID: 35778534 DOI: 10.1007/s00784-022-04598-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/03/2022] [Accepted: 06/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This in vitro study compared the dimensional accuracy of conventional impressions (CI) with that of digital impressions (DI) in a partially edentulous maxilla. DIs were made by two intraoral scanners, Omnicam (OC) and Primescan (PS). MATERIALS AND METHODS CI and both intraoral scanners were used to take 30 impressions of two identical reference models. CIs were poured with type 4 gypsum and the saw-cut models were digitized. The reference models simulated a maxilla with six prepared teeth that accommodated a cross-arch fixed partial denture. Center points of five precision balls and center points at the margin level of each prepared tooth were used to detect changes in dimensions and tooth axis between the reference model and the scans. RESULTS For DI, the largest deviations (176 µm for OC and 122 µm for PS) occurred over the cross-arch. For CI, the largest deviation (118 µm) occurred over the anterior segment. For shorter distances up to a quadrant, DI was superior to CI. For longer scan distances, DI was comparable (2 sextant and anterior segment) or inferior (cross-arch) to CI. Vertical and tooth axis deviations were significantly smaller for CI than for DI (p < 0.001). CONCLUSIONS The impression method affected the impression accuracy of a partially edentulous maxilla with prepared teeth. DI is recommended for scans up to a quadrant. Larger scan volumes are not yet suitable for fabricating a fixed partial denture because of the high scatter of accuracy values. CLINICAL RELEVANCE In contrast to conventional impressions, digital impressions lead to comparable or better results concerning scans up to a quadrant. Consequently, for larger scan volumes, several smaller scans should be performed or, if restoration-related not possible, it is recommended to take conventional impressions.
Collapse
Affiliation(s)
- Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Stefan Rues
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | | | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
14
|
Bensel T, Erhart I, Megiroo S, Kronenberg W, Bömicke W, Hinz S. Oral health status of nursing staff in Ilembula, Wanging'ombe District, Njombe region, Tanzania: a cross-sectional study. BMC Oral Health 2022; 22:169. [PMID: 35534856 PMCID: PMC9081662 DOI: 10.1186/s12903-022-02064-x] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Owing to the reduced dental treatment infrastructure in the Tanzanian highlands, maintaining good oral health is a challenge for not only the general population but also individual professional groups. In this study, the caries prevalence and, subsequently, the prosthetic treatment needs of the nurses of the Ilembula Lutheran Hospital (ILH) and Ilembula Institute of Health and Allied Sciences (IIHAS), Tanzania, were investigated. MATERIALS AND METHODS One hundred and sixty-eight ILH and IIHAS nurses and nursing students (87 women, 81 men; age 23.1 ± 6.1 years, range 18-58 years) participated in this cross-sectional study conducted in February 2020. The participants were examined at the dental office of ILH. The Decayed, Missing, and Filled Teeth (DMF/T) Index, Simplified Oral Hygiene Index, and details regarding edentulism, nutrition habits, and socioeconomic factors were collected. Linear regression and binary logistic regression were used for statistical analysis. RESULTS The mean DMF/T-Index was 6.30 ± 4.52. In 7.14% of the investigated nurses, no dental plaque was detected. An enhanced prosthodontic treatment (Kennedy Class III) demand was identified in 31.50% of the participants, and 4.80% of the participants required treatment for acute malocclusion. Oral hygiene products were used by 99.4% of the patients. CONCLUSIONS The current oral health situation of the study participants showed a moderate restorative and prosthetic treatment demand in the rural area of Tanzania. The development of an interdisciplinary oral health prophylaxis system could be a means to remedy this situation.
Collapse
Affiliation(s)
- Tobias Bensel
- Department of Prosthodontics, University of Halle, Magdeburger Straße 16, 06112, Halle (Saale), Germany
| | - Imke Erhart
- Department of Prosthodontics, University of Halle, Magdeburger Straße 16, 06112, Halle (Saale), Germany
| | - Simon Megiroo
- Health Department, ELCT/NORTH CENTRAL DIOCESE, P. O. Box 16173, Arusha, United Republic of Tanzania
| | - Werner Kronenberg
- Ilembula Lutheran Hospital, P.O. Box 14, Ilembula, United Republic of Tanzania
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sebastian Hinz
- Department of Prosthodontics, University of Halle, Magdeburger Straße 16, 06112, Halle (Saale), Germany.
| |
Collapse
|
15
|
Ohlmann B, Rathmann F, Bömicke W, Behnisch R, Rammelsberg P, Schmitter M. Validity of patient self‐reports and clinical signs in the assessment of sleep bruxism based on home‐recorded electromyographic/electrocardiographic data. J Oral Rehabil 2022; 49:720-728. [DOI: 10.1111/joor.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/21/2022] [Accepted: 03/24/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Brigitte Ohlmann
- Department of Prosthodontics University of Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Friederike Rathmann
- Department of Prosthodontics University of Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Wolfgang Bömicke
- Department of Prosthodontics University of Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics (IMBI) University of Heidelberg Im Neuenheimer Feld 130.3 69120 Heidelberg Germany
| | - Peter Rammelsberg
- Department of Prosthodontics University of Heidelberg Im Neuenheimer Feld 400 69120 Heidelberg Germany
| | - Marc Schmitter
- Department of Prosthodontics University of Würzburg Pleicherwall 2 97070 Würzburg Germany
| |
Collapse
|
16
|
Hinz S, Bensel T, Bömicke W, Henningsen A, Rudolph J, Boeckler AF. Impact of the Veneering Technique and Framework Material on the Failure Loads of All-Ceramic Computer-Aided Design/Computer-Aided Manufacturing Fixed Partial Dentures. Materials 2022; 15:ma15030756. [PMID: 35160701 PMCID: PMC8836578 DOI: 10.3390/ma15030756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/08/2022] [Accepted: 01/15/2022] [Indexed: 02/04/2023]
Abstract
Objectives: Zirconia (Y-TZP) ceramics are considered as posterior fixed partial denture (FPD) materials; however, their applications are limited due to chipping. The use of monolithic lithium disilicate (LiDi) glass ceramics in posterior FPDs can be advantageous. This in vitro study aims to compare the loads until failure of posterior Y-TZP-FPDs and LiDi-FPDs before and after aging.
Collapse
Affiliation(s)
- Sebastian Hinz
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
- Correspondence: (S.H.); (T.B.)
| | - Tobias Bensel
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
- Correspondence: (S.H.); (T.B.)
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany;
| | - Anders Henningsen
- Department of Oral and Maxillofacial Surgery, University Hospital Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Judith Rudolph
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
| | - Arne F. Boeckler
- Department of Prosthodontics, Martin-Luther-University Halle-Wittenberg, Magdeburgerstraße 16, 06112 Halle, Germany; (J.R.); (A.F.B.)
| |
Collapse
|
17
|
Waldecker M, Bömicke W, Behnisch R, Rammelsberg P, Rues S. In-vitro accuracy of complete arch scans of the fully dentate and the partially edentulous maxilla. J Prosthodont Res 2021; 66:538-545. [PMID: 34880160 DOI: 10.2186/jpr.jpr_d_21_00100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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 This in-vitro study aimed to compare the accuracy of complete arch scans (CAS) of a fully dentate (FD) and a partially edentulous (PE) maxillary model. Three intraoral scanning systems were used: Omnicam AC (OC), TRIOS 4 (TR), and Primescan (PS). METHODS Each intraoral scanner was used to take 30 scans each of two clinical scenarios (FD and PE) simulated by a reference model. The PE model simulated a maxilla with six prepared teeth to accommodate a jaw-spanning fixed partial denture (FPD). The missing teeth were then added to create an FD model. Five ceramic precision balls (ball centers P1-P5) mounted on metal pins were welded to the metal base on the buccal side of the dental arch. These were later used to determine dimensional (given by each 2 ball centers) and angular changes (given by each 3 or 4 ball centers) between the reference model (digitized with high precision before the tests) and the intraoral scans. Data were statistically analyzed using a type II ANOVA. RESULTS The maximum mean absolute distance deviations were as follows. OC: 147 µm (FD) and 139 µm (PE). TR: 133 µm (FD) and 136 µm (PE). PS: 87 µm (FD) and 80 µm (PE). The scanning system used had a significant effect on distance deviations (p < 0.027) and CAS scanning time (p < 0.001). Dental status had no clear effect on distance deviations but did significantly affect angular changes (p < 0.001) and scanning time (p < 0.001). CONCLUSION The manufacture of jaw-spanning FPDs based on a CAS cannot yet be recommended.
Collapse
Affiliation(s)
- Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Stefan Rues
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
18
|
Ohlmann B, Bömicke W, Behnisch R, Rammelsberg P, Schmitter M. Variability of sleep bruxism-findings from consecutive nights of monitoring. Clin Oral Investig 2021; 26:3459-3466. [PMID: 34862565 PMCID: PMC8979926 DOI: 10.1007/s00784-021-04314-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine sleep bruxism (SB) behavior during five consecutive nights and to identify correlations between SB episodes per hour (SB index) and sleep-time masseter-muscle activity (sMMA). MATERIAL AND METHODS Thirty-one participants were included in the study. Of these, 10 were classified as sleep bruxers (group SB-1) and nine as non-sleep bruxers (group non-SB). The bruxism status of these 19 patients was identified by means of questionnaires, an assessment of clinical symptoms, and electromyographic/electrocardiographic data (Bruxoff® device). The remaining 12 participants were also identified as bruxers, but based exclusively on data from the Bruxoff device (group SB-2). Data analysis included descriptive statistics and Spearman's correlation to assess the relationship between the SB index and sMMA. RESULTS Participants in group SB-1 showed an overall mean SB index of 3.1 ± 1.6 and a mean total sMMA per night of 62.9 ± 38.3. Participants in group SB-2 had an overall mean SB index of 2.7 ± 1.5 and a mean total sMMA of 56.0 ± 29.3. In the non-SB group, participants showed an overall mean SB index of 0.8 ± 0.5 and a mean total sMMA of 56.8 ± 30.3. Spearman's correlation yielded values of - 0.27 to 0.71 for the correlation between sMMA and SB index. CONCLUSIONS The data revealed variable SB activity and the absence of a reliable correlation between sMMA and the SB index. CLINICAL RELEVANCE The high variation in SB activity and lack of correlation between sMMA and the SB index should be considered when diagnosing SB. TRIAL REGISTRATION Clinical Trials [NIH], clinical trial no. NCT03039985.
Collapse
Affiliation(s)
- Brigitte Ohlmann
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Wolfgang Bömicke
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Marc Schmitter
- Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
- Department of Prosthodontics, University of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| |
Collapse
|
19
|
Waldecker M, Behnisch R, Rammelsberg P, Bömicke W. Five-year clinical performance of monolithic and partially veneered zirconia single crowns-a prospective observational study. J Prosthodont Res 2021; 66:339-345. [PMID: 34556602 DOI: 10.2186/jpr.jpr_d_21_00024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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 The purpose of this study was to prospectively evaluate the medium-term clinical performance and esthetics of monolithic and partially (i.e., facially) veneered zirconia single crowns (MZ-SC and PZ-SC, respectively). METHODS Between September 2011 and June 2013, 68 participants received 90 MZ-SC and 72 PZ-SC. Clinical study documentation was performed at crown cementation (baseline), at 6-month follow-up, and then yearly thereafter using standardized report forms. Three participants with four MZ-SC dropped out during clinical follow-up. Thus, 65 participants (n = 31, 47.7% men) fitted with 158 restorations (86 MZ-SC, 72 PZ-SC) were evaluated. The mean observation period of the restorations was 5.8 ±2.5 years; 6.3 ±2.2 for MZ-SC and 5.2 ±2.6 for PZ-SC. RESULTS The 5-year rate of complication-free survival (success) was 87.0% for MZ-SC and 95.8% for PZ-SC (log-rank test, p = 0.026). The 5-year failure-free survival rate was 93.1% for MZ-SC and 96.2% for PZ-SC (log-rank test, p = 0.111), and the 5-year ceramic fracture-free survival rate was 100% for MZ-SC and 98.6% for PZ-SC (log-rank test, p = 0.274). Crowns of both designs were awarded excellent scores for esthetics by participants and dentists. CONCLUSIONS Monolithic and partially veneered zirconia crowns can be used clinically with high medium-term survival and success and uncompromised esthetic results.
Collapse
Affiliation(s)
- Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| |
Collapse
|
20
|
Zenthöfer A, Bermejo JL, Bömicke W, Frese C, Gülmez R, Rammelsberg P, Ohlmann B. Early failures when using three different adhesively retained core build-up materials-a randomized controlled trial. Clin Oral Investig 2021; 26:1927-1936. [PMID: 34491449 PMCID: PMC8816765 DOI: 10.1007/s00784-021-04170-6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 08/27/2021] [Indexed: 11/05/2022]
Abstract
Objectives To compare the failure rates for three different adhesively retained core build-up composites up to the incorporation of a permanent fixed dental prosthesis (FDP), and to identify potential failure risk factors. Material and methods A randomized controlled trial of 300 participants in need of a core build-up to restore a vital abutment tooth before prosthetic treatment was conducted. Participants were assigned by stratified block randomization to one of three study groups: Rebilda DC (RDC), Clearfil DC Core (CDC), or Multicore Flow (MF). Test teeth were prepared by use of the respective manufacturer’s adhesive system. The total-etch technique was used for RDC and MF, and the self-etch technique for CDC. Participants were treated by dentists (n = 150) or dental students (n = 150). Failure rates of core build-ups before incorporation of FDPs were investigated using univariate and multiple logistic regression. Results The overall failure rate was 8% (n = 23). Rate differences between the three investigated groups did not reach statistical significance (p > 0.05). The mean time between placement of core build-ups and placement of fixed dental prostheses was 12.2 (SD: 14.2) weeks. Conversely, larger cavities (> 3 surfaces) and treatment by dental students were independently associated with an increased failure risk (p < 0.05). Conclusions The main risk factors for early failure seem to be the size of the core build-up and clinical experience of the operator, whereas failure rates of core build-up materials combined with a self-etch approach seem to be similar to the rates of materials combined with the total-etch technique. Clinical significance This research article should give clinicians an impression of the short-term performance of different adhesively retained core build-ups using different adhesive techniques/materials. Moreover, predominant influencing factors for the success or failure should be pictured.
Collapse
Affiliation(s)
- Andreas Zenthöfer
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Justo Lorenzo Bermejo
- Institute of Medical Biometry, University of Heidelberg, INF 130.3, 69120, Heidelberg, Germany
| | - Wolfgang Bömicke
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Cornelia Frese
- Department of Operative Dentistry, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Rumeysa Gülmez
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Brigitte Ohlmann
- Department of Prosthodontics, Dental School, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
21
|
Waldecker M, Trebing C, Rues S, Behnisch R, Rammelsberg P, Bömicke W. Effects of Training on the Execution of Complete-Arch Scans. Part 1: Scanning Time. INT J PROSTHODONT 2021; 34:21-26. [PMID: 33570516 DOI: 10.11607/ijp.6903] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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
PURPOSE To investigate the effect of training on scanning times of complete-arch scans (CAS) performed by first-time users, with a distinction made between specific training (repeated practice of CAS) and nonspecific training (simple use of an intraoral scanner for a sextant scan in the context of a student CAD/CAM course). METHODS Thirty-six students with no experience in intraoral scanning were randomized into three groups (n = 12 per group) according to the number of specific CAS training sessions: three sessions (3S), two sessions (2S), and one session (1S). Each student performed 10 CAS per scanning session. These sessions were scheduled at baseline (T0), T1 (2 weeks after T0), and T2 (4 weeks after T0) for group 3S; at T0 and T2 for group 2S; and at T2 for group 1S. Before the final scanning session in each group (ie, the first scanning session in group 1S), the students participated in a CAD/CAM course (3 weeks after T0) in which a monolithic crown was fabricated in a fully digital chairside workflow. The scanning time was measured as the time between the activation and termination of the scanning mode of the intraoral device. Data were analyzed using SPSS Statistics 25 (IBM). The level of significance was set to α = .05. RESULTS A continual decrease in scanning time was observed for all groups as experience in intraoral scanning increased. The mean scanning times were as follows: for group 3S, 305 seconds at T0, 246 seconds at T1, and 233 seconds at T2; for group 2S, 380 seconds at T0 and 303 seconds at T2; and for group 1S, 355 seconds at T2. When compared to group 1S after it had received nonspecific training only, the effect of a single specific training session in groups 3S and 2S was not significant (P = .4428). However, two specific training sessions had a significant effect on scanning time compared to nonspecific training only (P = .0005). CONCLUSION Training does affect the scanning time required for CAS. To perform such scans in a time-efficient manner, dental practitioners should undertake training that comprises at least 12 CAS.
Collapse
|
22
|
Waldecker M, Rues S, Trebing C, Behnisch R, Rammelsberg P, Bömicke W. Effects of Training on the Execution of Complete-Arch Scans. Part 2: Scanning Accuracy. INT J PROSTHODONT 2021; 34:27-36. [PMID: 33570517 DOI: 10.11607/ijp.6940] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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
PURPOSE To investigate the effect of training on scanning accuracy of complete arch scans (CAS) performed by first-time users, with a distinction made between specific training (repeated performance of CAS) and nonspecific training (simple use of an intraoral optical scanner for a sextant scan in the context of a CAD/CAM teaching module). MATERIALS AND METHODS A total of 36 students with no experience in intraoral scanning were randomized into three groups (n = 12 per group) according to the number of CAS sessions: three sessions (3S), two sessions (2S), and one session (1S). Each student had to perform 10 CAS per scanning session. Sessions were scheduled at T0, T1, and T2 for group 3S; at T0 and T2 for group 2S; and at T2 for group 1S. Before the final scanning session in each group (ie, the first scanning session in group 1S), the students completed a CAD/CAM teaching module, which included fabrication of a monolithic crown in a fully digital chairside workflow. RESULTS In all groups, repeated CAS resulted in improved scanning accuracy. Participation in the CAD/CAM module had a positive effect on initial accuracy for CAS. Mean absolute deviations in cross-arch distance were 84 μm (T0), 68 μm (T1), and 63 μm (T2) for group 3S; 79 μm (T0) and 61 μm (T2) for group 2S; and 67 μm (T2) for group 1S. CONCLUSION To perform CAS with the best possible accuracy, specific training is highly recommended. In addition, nonspecific training leads to an improvement in initial scanning accuracy.
Collapse
|
23
|
Bömicke W, Rathmann F, Pilz M, Bermejo JL, Waldecker M, Ohlmann B, Rammelsberg P, Zenthöfer A. Clinical Performance of Posterior Inlay-Retained and Wing-Retained Monolithic Zirconia Resin-Bonded Fixed Partial Dentures: Stage One Results of a Randomized Controlled Trial. J Prosthodont 2020; 30:384-393. [PMID: 32924240 DOI: 10.1111/jopr.13258] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To prospectively compare the clinical performance of posterior inlay-retained and wing-retained monolithic zirconia fixed partial dentures (FPDs). MATERIALS AND METHODS After simple randomization, 30 participants received either one inlay-retained (n = 15; mean age: 56.38 ± 12.70 years; 10 men [66.7%]) or one wing-retained (n = 15; mean age: 45.90 ±13.24 years; 7 men [46.7%]) FPD. The restorations, which predominantly replaced first molars, were fabricated from translucent, 3 mol% yttria-stabilized zirconia and attached with self-etching resin cement. Restorations and abutment teeth were clinically followed up for complications one week and 3, 6, and 12 months after cementation. Plaque and gingival scores, probing pocket depths, and attachment levels were recorded for the abutment and contralateral reference teeth both before treatment and during follow-up examinations. The restorations were also assessed in accordance with FDI World Dental Federation criteria. Statistical analyses were conducted with R (α = 0.05). An adaptive, 2-stage study design based on the incidence of failure-free survival in the groups after 12 months (stage 1) was implemented. Predefined decision rules were used to determine whether further recruitment (stage 2) would enable the detection of a statistically significant difference between the restoration designs with sufficient power. RESULTS During 12 months, only one wing retainer debonded which required removal of the FPD. Failure-free survival was thus 93.3% for wing-retained and 100% for inlay-retained FPDs (log-rank test, p = 0.317). Moderate aftercare resulted in intervention-free rates of 78.8% and 86.7% for inlay-retained and wing-retained restorations, respectively (log-rank test, p = 0.605). Based on FDI World Dental Federation criteria, all restorations were acceptable at the 12-month follow-up (Fisher-Boschloo test, p = 0.161). Plaque, gingival, and periodontal scores remained practically unchanged from before treatment to the 12-month follow-up. Recruitment was stopped after stage 1 because, based on the small difference in the incidence of failure-free survival in the groups, it was accepted that it would not be possible to recruit the necessary number of participants to show a statistically significant difference between the retainer designs. CONCLUSIONS Both inlay-retained and wing-retained monolithic zirconia resin-bonded FPDs performed well for the 12-month, short-term follow-up period.
Collapse
Affiliation(s)
- Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Friederike Rathmann
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Maximilian Pilz
- Department of Medical Biometry, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Justo Lorenzo Bermejo
- Department of Medical Biometry, Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Brigitte Ohlmann
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Andreas Zenthöfer
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
24
|
Habibi Y, Dawid M, Waldecker M, Rammelsberg P, Bömicke W. Three‐year clinical performance of monolithic and partially veneered zirconia ceramic fixed partial dentures. J ESTHET RESTOR DENT 2020; 32:395-402. [DOI: 10.1111/jerd.12568] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 01/16/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Yasamin Habibi
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Marie‐Theres Dawid
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Moritz Waldecker
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Peter Rammelsberg
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| | - Wolfgang Bömicke
- Department of Prosthetic DentistryUniversity Hospital Heidelberg, University of Heidelberg Heidelberg Germany
| |
Collapse
|
25
|
Bömicke W, Rammelsberg P, Krisam J, Rues S. The Effects of Surface Conditioning and Aging on the Bond Strength Between Composite Cement and Zirconia-reinforced Lithium-Silicate Glass-Ceramics. J Adhes Dent 2019; 21:567-576. [PMID: 31802073 DOI: 10.3290/j.jad.a43650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To determine the effects of ceramic-surface conditioning and aging on the bond strength between composite cement and zirconia-reinforced lithium-silicate glass-ceramics (ZLS) under simulated clinical conditions. MATERIALS AND METHODS ZLS disks (Celtra Duo, Dentsply Sirona, n = 110 test group n = 10, diameter: 8.3 mm, height: 3.4 mm) were assigned to four surface-conditioning groups: (I) 30 s of ~5% hydrofluoric-acid etching (Vita Ceramics Etch, Vita; HF), silanization (Calibra Silane; SIL); (II) successive contamination with saliva and silicone (CONT), HF, SIL; (III) CONT, tribochemical silicatization (CoJet), SIL; (IV) HF, SIL, application and light polymerization of an adhesive (Prime&Bond Active), CONT, reapplication and light polymerization of the adhesive. The ZLS disks were bonded to composite-resin cylinders in acrylic tubes (inner diameter: 3.3 mm) using self-adhesive composite cement (Calibra Universal). The tensile-bond strength (TBS) was measured after both 24 h and 6 months of water storage (WS). Additional aging protocols were tested for group I (3-day WS; 30-day WS including 7500 thermocycles between 6.5 and 60°C; 150-day WS including 37,500 thermocycles). RESULTS After 24 h, the mean TBS ranged between 21 MPa (group III) and 30-35 MPa (remaining groups). With the exception of 3-day WS, TBS was statistically significantly reduced by aging. The greatest reduction was observed for silicatized specimens (group III, mean TBS after aging: 9.8 MPa). CONCLUSION Both ceramic surface conditioning and aging had a statistically significant effect on the bond strength between composite cement and ZLS. A treatment protocol based on tribochemical silicatization cannot be recommended for the adhesive cementation of ZLS.
Collapse
|
26
|
Bömicke W, Rammelsberg P, Zenthöfer A, Ohlmann B. Clinical performance of zirconia-ceramic cantilever fixed partial dentures-Longitudinal nine-year results from a prospective, randomized, controlled pilot study. J Prosthodont Res 2019; 63:334-339. [PMID: 30803899 DOI: 10.1016/j.jpor.2019.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 10/04/2018] [Revised: 01/08/2019] [Accepted: 01/21/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE The aim of this study was to prospectively compare the clinical performance of veneered zirconia cantilever fixed partial dentures (Z-CFPDs) and metal-ceramic CFPDs (MC-CFPDs) over 9 years of follow-up in terms of survival. METHODS Twenty-one participants were assigned by simple randomization to receive either 1 Z-CFPD (n=11) or 1 MC-CFPD (n=10). CFPDs were retained by 2 full crowns and replaced a missing premolar or a central or lateral incisor. Modified USPHS (United States Public Health Service) criteria were used to classify material chipping, retention, marginal integrity, secondary caries, and color of the restorations. The satisfaction of the study participants with the esthetics of their restorations was surveyed; pocket probing depths (PPD), plaque index (PI), and gingival index (GI) were also measured. Study groups were compared by use of U tests (continuous variables), or by use of Fisher exact probability tests (categorical variables) with α=0.05. RESULTS Sixteen participants (n=8 with a Z-CFPD and n=8 with an MC-CFPD) attended the 9-year follow-up examination (response rate: 76.2%). Over the 9-year study period, survival of 50% for Z-CFPDs and 75% for MC-CFPDs was recorded (p=0.608). No framework fractures occurred, and no statistically significant differences were observed between the groups regarding changes in PPD, PI, GI, or participant satisfaction (p>0.05). USPHS criteria revealed statistically significantly poorer marginal quality for Z-CFPDs than for MC-CFPDs (p=0.009). CONCLUSION Within the limitations of this study, Z and MC-CFPDs demonstrated no statistically significant difference in terms of survival.
Collapse
Affiliation(s)
- Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany.
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Andreas Zenthöfer
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Brigitte Ohlmann
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
27
|
Danielczak RA, Stober T, Bömicke W. Treatment with a CAD-CAM–fabricated, double-crown–retained, removable partial denture: A clinical report. J Prosthet Dent 2019; 121:220-224. [DOI: 10.1016/j.prosdent.2018.02.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/26/2018] [Accepted: 02/26/2018] [Indexed: 11/29/2022]
|
28
|
Waldecker M, Rues S, Rammelsberg P, Bömicke W. Validation of in-vitro tests of zirconia-ceramic inlay-retained fixed partial dentures: A finite element analysis. Dent Mater 2019; 35:e53-e62. [PMID: 30686709 DOI: 10.1016/j.dental.2019.01.017] [Citation(s) in RCA: 10] [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] [Received: 09/14/2018] [Revised: 12/13/2018] [Accepted: 01/13/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE In the past, discrepancies between laboratory results and clinical behavior have been observed for all-ceramic restorations. This analysis of fracture resistance of zirconia-based inlay-retained fixed partial dentures (IRFPDs) aimed at identifying correlations between an in-vitro test setup and the clinical situation. The effects of tooth material, tooth mobility, restoration design, load direction, and different cements were taken into account. METHODS The in-vitro test model and IRFPD were reverse engineered (Geomagic DesignX) and meshed predominantly with hexahedral elements (approx. 230,000 elements). Homogenous, linear-elastic behavior was assumed for all materials. On the basis of the calculated stresses (ANSYS 18.2) and already known strength distributions for the restorative materials fracture resistance of the complete restoration and force at initial damage (fracture within the veneer) was estimated on the basis of the principal stress hypothesis. Differences depending on the assumed clinical situation and effects of different variables on fracture resistance were evaluated. RESULTS All variables tested in the finite element analysis affected the calculated fracture resistance of the IRFPD. Use of resin teeth led to an underestimation of fracture resistance by up to -57%, whereas fracture resistance of IRFPDs on metal abutment teeth was close to the clinical reference (-6% to +15%). Good correlation between the clinical scenario and that using metal teeth could only be achieved when the natural resilience of the abutment teeth was simulated. SIGNIFICANCE When testing fracture resistance of zirconia-based IRFPDs, metal abutment teeth in combination with simulated tooth resilience can reflect the clinical situation accurately.
Collapse
Affiliation(s)
- M Waldecker
- Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany.
| | - S Rues
- Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - P Rammelsberg
- Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - W Bömicke
- Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
29
|
Waldecker M, Leckel M, Rammelsberg P, Bömicke W. Fully digital fabrication of an occlusal device using an intraoral scanner and 3D printing: A dental technique. J Prosthet Dent 2018; 121:576-580. [PMID: 30598305 DOI: 10.1016/j.prosdent.2018.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 10/27/2022]
Abstract
This dental technique describes a fully digital method for fabricating occlusal devices using a complete-arch intraoral scan and 3D printing. The maxillary and mandibular arches of a healthy, fully dentate volunteer were digitized using an intraoral scanner. A second scan and modified recording of the centric relation enabled a virtual arrangement of the maxillary and mandibular arches, both in centric relation and in the desired vertical dimension of occlusion. An occlusal device was subsequently designed virtually and fabricated from a light-polymerizing acrylic resin using a 3D printer. The occlusal device was tested for fit, occlusion, and patient-friendly handling. As only minor occlusal corrections were required, the fully digital procedure described is suitable for the fabrication of occlusal devices.
Collapse
Affiliation(s)
- Moritz Waldecker
- Assistant Professor, Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany.
| | - Michael Leckel
- Assistant Professor, Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Peter Rammelsberg
- Director, Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| | - Wolfgang Bömicke
- Assistant Professor, Department of Prosthodontics, Heidelberg University Hospital, University of Heidelberg, Heidelberg, Germany
| |
Collapse
|
30
|
Ohlmann B, Bömicke W, Habibi Y, Rammelsberg P, Schmitter M. Are there associations between sleep bruxism, chronic stress, and sleep quality? J Dent 2018; 74:101-106. [DOI: 10.1016/j.jdent.2018.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/02/2018] [Accepted: 05/13/2018] [Indexed: 12/20/2022] Open
|
31
|
Bömicke W, Waldecker M, Krisam J, Rammelsberg P, Rues S. In vitro comparison of the load-bearing capacity of ceramic and metal-ceramic resin-bonded fixed dental prostheses in the posterior region. J Prosthet Dent 2018; 119:89-96. [DOI: 10.1016/j.prosdent.2017.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 03/07/2017] [Accepted: 03/07/2017] [Indexed: 10/19/2022]
|
32
|
Rathmann F, Bömicke W, Rammelsberg P, Ohlmann B. Veneered zirconia inlay-retained fixed dental prostheses: 10-Year results from a prospective clinical study. J Dent 2017. [DOI: 10.1016/j.jdent.2017.06.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
33
|
Bömicke W, Karl J, Rammelsberg P. Minimally invasive prosthetic restoration of posterior tooth loss with resin-bonded, wing-retained, and inlay-retained fixed dental prostheses fabricated from monolithic zirconia: A clinical report of two patients. J Prosthet Dent 2017; 117:459-462. [DOI: 10.1016/j.prosdent.2016.08.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/29/2016] [Accepted: 08/29/2016] [Indexed: 11/26/2022]
|
34
|
Bömicke W, Gabbert O, Koob A, Krisam J, Rammelsberg P. Comparison of immediately loaded flapless-placed one-piece implants and flapped-placed conventionally loaded two-piece implants, both fitted with all-ceramic single crowns,
in the posterior mandible: 3-year results from
a randomised controlled pilot trial. Eur J Oral Implantol 2017; 10:179-195. [PMID: 28555208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE To compare outcomes for immediately loaded one-piece implants (OPI), placed flapless, and conventionally loaded two-piece implants (TPI), placed after two-stage flapped surgery. MATERIALS AND METHODS Thirty-eight participants were randomised to receive either one OPI (19 participants, OPI group) or one TPI (19 participants, TPI group) inserted in the posterior mandible with a torque of at least 35 Ncm according to a parallel group design. OPI were immediately loaded with non-occluding temporary crowns. After 3 months, TPI were exposed and implants in both groups were occlusally loaded with zirconia crowns. Outcome measures were implant failure, prosthesis failure, any complication and changes of probing pocket depth (PPD), plaque index (PI), gingiva index (GI), and peri-implant marginal bone level, recorded by unblinded assessors. RESULTS Three years after occlusal loading, three participants dropped out from the TPI group. There were no statistically significant differences between the groups with regard to participants with implant failure (OPI group 1/19; TPI group 0/16; difference in proportions (DIP), -5.3%; 95% confidence interval (CI) -15.3 to 4.8; P = 1.000), prosthesis failure (OPI group 3/19, TPI group 5/16; DIP, 15.5%; 95% CI -12.6 to 43.5; P = 0.424), any complication (OPI group 6/19, TPI group 5/16; DIP, -0.3%; 95% CI -31.2 to 30.5; P = 1.000), or changes of PPD (P =0.174), PI (P = 0.222), or GI (P = 0.415). Veneer chipping accounted for most prosthesis failures and complications. On average OPI and TPI lost 1.34 mm and 0.67 mm of marginal bone, respectively, the difference between groups being statistically significant (mean difference, 0.66 mm; 95% CI -0.02 to 1.34; P = 0.024) in favour of TPI implants. CONCLUSIONS Both implant procedures might be viable in the short term, but statistically significantly more bone loss might be indicative of future problems with OPI. Because of the high incidence of chipping, veneered zirconia crowns cannot be recommended on posterior implants. Conflict-of-interest statement: The authors are grateful to Nobel Biocare for providing the study materials free of charge. Money received from the manufacturer was used to reimburse participants for regular attendance at follow-up appointments and to finance data management. The authors declare no conflict of interest.
Collapse
|
35
|
Bömicke W, Rammelsberg P, Stober T, Schmitter M. Short-Term Prospective Clinical Evaluation of Monolithic and Partially Veneered Zirconia Single Crowns. J ESTHET RESTOR DENT 2016; 29:22-30. [DOI: 10.1111/jerd.12270] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Wolfgang Bömicke
- Dr. med. Dent, Department of Prosthodontics; Heidelberg University Hospital, University of Heidelberg; Heidelberg Germany
| | - Peter Rammelsberg
- Prof. Dr. med. Dent, Department of Prosthodontics; Heidelberg University Hospital, University of Heidelberg; Heidelberg Germany
| | - Thomas Stober
- Prof. Dr. med. Dent, Department of Prosthodontics; Heidelberg University Hospital, University of Heidelberg; Heidelberg Germany
| | - Marc Schmitter
- Prof. Dr. med. Dent, Department of Prosthodontics; Würzburg University Hospital, University of Würzburg; Würzburg Germany
| |
Collapse
|
36
|
Bömicke W, Rues S, Hlavacek V, Rammelsberg P, Schmitter M. Fracture Behavior of Minimally Invasive, Posterior, and Fixed Dental Prostheses Manufactured from Monolithic Zirconia. J ESTHET RESTOR DENT 2016; 28:367-381. [DOI: 10.1111/jerd.12242] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Wolfgang Bömicke
- Doctor of Medical Dentistry, Department of Prosthodontics; Heidelberg University Hospital, University of Heidelberg; Germany
| | - Stefan Rues
- Engineer Diploma, Department of Prosthodontics; Heidelberg University Hospital, University of Heidelberg; Germany
| | - Verena Hlavacek
- Doctor of Medical Dentistry, Department of Prosthodontics; Heidelberg University Hospital, University of Heidelberg; Germany
| | - Peter Rammelsberg
- Professor Doctor of Medical Dentistry, Department of Prosthodontics; Heidelberg University Hospital, University of Heidelberg; Germany
| | - Marc Schmitter
- Professor Doctor of Medical Dentistry, Department of Prosthodontics; Heidelberg University Hospital, University of Heidelberg; Germany
| |
Collapse
|
37
|
Bömicke W, Schürz A, Krisam J, Rammelsberg P, Rues S. Durability of Resin-Zirconia Bonds Produced Using Methods Available in Dental Practice. J Adhes Dent 2016; 18:17-27. [PMID: 26814317 DOI: 10.3290/j.jad.a35517] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the strength, after artificial aging, of resin-zirconia bonds yielded by methods available in dental practice. MATERIALS AND METHODS Standardized test specimens consisting of composite resin cylinders cemented to Y-TZP disks were assigned to 24 groups (n=20 per group) on the basis of the surface conditioning of the disks and the adhesive used (cement+manufacturer-specific primer). Conditioning methods were: none (control), airborne particle abrasion (50-μm Al2O3 at 0.05, 0.10, or 0.25 MPa), or tribochemical silica coating (Rocatec or CoJet). Panavia 21+Clearfil Ceramic Primer, Multilink Automix+Monobond Plus, BiFix QM+Ceramic bond, or RelyX Ultimate+Scotchbond Universal were used for cementation. Specimens were stored in water at 37°C either for 3 days or for 150 days in conjunction with 37,500 thermocycles before being submitted to a tensile test (crosshead speed: 1 mm/min). Nonparametric ANOVA and post-hoc tests within the same model were applied to the results (α=0.05). RESULTS Conditioning, cement, aging, and all their interactions significantly affected bond strength (p<0.0001). After storage in water for 3 days, bond strengths ranged between 4 and 45 MPa (values were lowest in the BiFix QM groups). After long-term aging, the best results were obtained for silica-coated (Rocatec) zirconia samples cemented with Panavia 21/Clearfil Ceramic Primer; this was the only group for which bond strengths were >10 MPa. Premature failure of the resin-ceramic bond was usually observed during long-term aging, the only exception being the non-control groups cemented with Panavia. CONCLUSION Most bonding strategies failed to create bonds to zirconia with acceptable strength after long-term aging. It might therefore be unwise to rely solely on adhesion for retention of load-bearing Y-TZP restorations.
Collapse
|
38
|
Schmitter M, Lotze G, Bömicke W, Rues S. Influence of surface treatment on the in-vitro fracture resistance of zirconia-based all-ceramic anterior crowns. Dent Mater 2015; 31:1552-60. [DOI: 10.1016/j.dental.2015.10.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 03/30/2015] [Accepted: 10/12/2015] [Indexed: 11/16/2022]
|
39
|
Zenthöfer A, Ohlmann B, Rammelsberg P, Bömicke W. Performance of zirconia ceramic cantilever fixed dental prostheses: 3-Year results from a prospective, randomized, controlled pilot study. J Prosthet Dent 2015; 114:34-9. [DOI: 10.1016/j.prosdent.2015.02.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 02/13/2015] [Accepted: 02/16/2015] [Indexed: 10/23/2022]
|
40
|
Stober T, Danner D, Bömicke W, Hassel AJ. Improvement of oral health-related quality-of-life by use of different kinds of double-crown-retained removable partial dentures. Acta Odontol Scand 2015; 74:1-6. [PMID: 25891131 DOI: 10.3109/00016357.2014.976262] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To verify the hypotheses that treatment with double-crown-retained removable partial dentures (RPDs) improves oral health-related quality-of life (OHRQoL) over a 36-month period and that the performance of RPDs retained by use of electroplated double crowns (EP-RPDs) was different to that of RPDs retained by use of cast double crowns (C-RPDs). MATERIALS AND METHODS Fifty-four patients (mean age = 64 years, 63% men) were recruited and randomly assigned to C-RPD or EP-RPD. OHRQoL was assessed pre-treatment, post-treatment and 6, 12, 24 and 36 months after insertion, by use of the oral health impact profile (OHIP). An unweighted total score was calculated (OHIP-SUM). A two-level hierarchical model was used for statistical analysis. First-level units were the measurements on the six occasions; second-level units were the patients. RESULTS Improvement of OHRQoL was observed in both groups after treatment (t = 7.27, p < 0.001). Whereas a treatment-material interaction indicated that treatment with EP-RPDs resulted in greater immediate improvement of OHRQoL, a time-material interaction indicated that long-term improvement was greater for C-RPDs. CONCLUSIONS Treatment with EP-RPDs and C-RPDs improved OHRQoL initially. Over a period of 36 months the effect was significant. The treatment is, therefore, a promising therapeutic option. The cast conical design seems to have advantages with regard to long-term OHRQoL.
Collapse
Affiliation(s)
- Thomas Stober
- a 1 Department of Prosthodontics, University Hospital Heidelberg , Heidelberg, Germany
| | - Daniel Danner
- b 2 Gesis-Leibniz-Institute for the Social Sciences , Mannheim, Germany
| | - Wolfgang Bömicke
- a 1 Department of Prosthodontics, University Hospital Heidelberg , Heidelberg, Germany
| | - Alexander J Hassel
- a 1 Department of Prosthodontics, University Hospital Heidelberg , Heidelberg, Germany
| |
Collapse
|
41
|
Schwarz S, Schröder C, Hassel A, Bömicke W, Rammelsberg P. Survival and chipping of zirconia-based and metal-ceramic implant-supported single crowns. Clin Implant Dent Relat Res 2011; 14 Suppl 1:e119-25. [PMID: 21985745 DOI: 10.1111/j.1708-8208.2011.00388.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE The objective of this retrospective study was to compare the incidence of chipping of implant-supported, all-ceramic, and metal-ceramic single crowns. MATERIAL AND METHODS One hundred fifty-three patients (51.7% male, mean age 55.0 years) received 232 cemented implant-supported single crowns. One hundred and seventy-nine crowns had a metal framework (gold alloy) and 53 crowns were all-ceramic (zirconia framework and glass-ceramic veneer material). Age, gender, kind of cementation, and location of the restorations were assessed as possible factors affecting chipping. RESULTS During the observation period of up to 5.8 years (mean 2.1 years; standard deviation 1.4), a total of 13 (24.5%) all-ceramic and 17 (9.5%) metal-ceramic crowns suffered from chipping, a difference that was statistically significant. A total of ten single crowns had to be remade resulting in survival of 86.8% (all-ceramic) and 98.3% (metal-ceramic). The other possible factors did not have a significant effect on the chipping. CONCLUSION Chipping was found to be more frequent for all-ceramic implant-supported single crowns. If the reasons for the vulnerability of all-ceramic crowns remain unknown, implants with all-ceramic single crowns should generally be recommended with care.
Collapse
Affiliation(s)
- Stefanie Schwarz
- Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
| | | | | | | | | |
Collapse
|
42
|
Eberhard L, Hassel A, Bäumer A, Becker F, Beck-Mubotter J, Bömicke W, Corcodel N, Cosgarea R, Eiffler C, Giannakopoulos NN, Kraus T, Mahabadi J, Rues S, Schmitter M, Wolff D, Wege KC. Analysis of quality and feasibility of an objective structured clinical examination (OSCE) in preclinical dental education. Eur J Dent Educ 2011; 15:172-8. [PMID: 21762322 DOI: 10.1111/j.1600-0579.2010.00653.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
INTRODUCTION An objective structured clinical examination (OSCE) has been implemented in preclinical dentistry. It was taken at an early stage (propaedeutics course). The objectives of this study were to evaluate the reliability, validity, and feasibility of the examination, and the effect of circuit number on OSCE score. METHODS The OSCE was designed by an expert committee on the basis of pre-reviewed blueprints and checklists. Eleven stations formed an interdisciplinary circuit. Six groups of students (n = 62) passed sequentially round the same circuit. Statistical analysis was performed by using SPSS. Reliability was determined by measurement of internal consistency (Cronbach's α, Guttman's λ(2) ), standard error of measurement (SEM) (comprising generalisability index α, dependability index ϕ and pass 150;fail reliability p(c) ), consistency coefficient κ, item 150;scale correlation (Pearson correlation), and, because the unidimensionality of the stations could not be assumed, factor analysis including varimax rotation. Convergent validity (Pearson correlation, t-test), and predictive validity for future preclinical courses and the final preclinical examination were assessed by analysis of variance (ANOVA). The effect of the circuit number on score improvement was calculated, including a correction for the general competence of the students (ANOVA). Cost was calculated on the basis of the time invested. RESULTS Fifty-three out of sixty-two students passed the OSCE (mean score: 67%, SD 7.7, range, 47-81). Scores for each station correlated significantly with total scores (r = 0.35-0.54, P < 0.01). For internal consistency, α = 0.75 (relative SEM 3.8) and λ(2) = 0.766. The dependability index was ϕ = 0.694 (absolute SEM 4.4), p(c) = 0.89 and κ = 0.61. Factor analysis yielded two components: dental-materials-oriented stations and all other stations (explained variance 43%). Scores correlated significantly with success in passing practical tests (i.e. performing dental procedures under examination conditions) (known group validity, P < 0.01) and with scores for subsequent courses and the final preclinical examination (Physikum) (predictive validity, P < 0.001). Later groups performed 4% better on average (CI 95%: 1.2-6.8%; P < 0.01). The cost was 181 Euro per student. CONCLUSIONS The OSCE is reliable and valid in the context of preclinical dentistry. The cost is substantial. The problem of improvement of students' results with ascending circuit number has to be addressed.
Collapse
Affiliation(s)
- L Eberhard
- Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|