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Dönmez MB, Çakmak G, Güven ME, Dede DÖ, Abou-Ayash S, Yilmaz B. Fatigue behavior of implant-supported cantilevered prostheses in recently introduced CAD-CAM polymers: An in vitro study. J Prosthet Dent 2024:S0022-3913(24)00306-8. [PMID: 38760311 DOI: 10.1016/j.prosdent.2024.05.001] [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: 02/19/2024] [Revised: 04/29/2024] [Accepted: 05/02/2024] [Indexed: 05/19/2024]
Abstract
STATEMENT OF PROBLEM Cantilevered complete arch implant-supported prostheses are commonly fabricated from zirconia and more recently from strength gradient zirconia. Different polymer-based materials indicated for definitive fixed prostheses that could be used with additive or subtractive manufacturing have also been marketed recently. However, knowledge on the long-term fatigue behavior of cantilevered implant-supported prostheses made from these polymer-based materials and strength gradient zirconia is lacking. PURPOSE The purpose of this in vitro study was to evaluate the fatigue behavior of implant-supported cantilevered prostheses of recently introduced computer-aided design and computer-aided manufacturing polymers and zirconia. MATERIAL AND METHODS A master standard tessellation language file of a 9×11×20-mm specimen with a titanium base (Ti-base) space that represented an implant-supported cantilevered prosthesis was used to fabricate specimens from additively manufactured interim resin (AM), polymethyl methacrylate (SM-PM), nanographene-reinforced polymethyl methacrylate (SM-GR), high-impact polymer composite resin (SM-CR), and strength gradient zirconia (SM-ZR) (n=10). Each specimen was prepared by following the respective manufacturer's recommendations, and Ti-base abutments were cemented with an autopolymerizing luting composite resin. After cementation, the specimens were mounted in a mastication simulator and subjected to 1.2 million loading cycles under 100 N at 1.5 Hz; surviving specimens were subjected to another 1.2 million loading cycles under 200 N at 1.5 Hz. The load was applied to the cantilever extension, 12-mm from the clamp of the mastication simulator. The Kaplan-Meier survival analysis and Cox proportional hazards model were used to evaluate the data (α=.05). RESULTS Significant differences in survival rate and hazard ratio were observed among materials (P<.001). Among tested materials, SM-ZR had the highest and AM had the lowest survival rate (P≤.031). All materials had a significantly higher hazard ratio than SM-ZR (P≤.011) in the increasing order of SM-GR, SM-PM, SM-CR, and AM. CONCLUSIONS SM-ZR had the highest survival rate with no failed specimens. Even though most of the tested polymer-based materials failed during cyclic loading, these failures were commonly observed during the second 1.2 million loading cycles with 200 N. All materials had a higher hazard ratio than SM-ZR.
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Affiliation(s)
- Mustafa Borga Dönmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey; and ITI Scholar, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Gülce Çakmak
- Senior Resarch Associate, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mehmet Esad Güven
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Doğu Ömür Dede
- Professor, Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Samir Abou-Ayash
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
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Çakmak G, Rusa AM, Donmez MB, Akay C, Kahveci Ç, Schimmel M, Yilmaz B. Trueness of crowns fabricated by using additively and subtractively manufactured resin-based CAD-CAM materials. J Prosthet Dent 2024; 131:951-958. [PMID: 36470758 DOI: 10.1016/j.prosdent.2022.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 12/03/2022]
Abstract
STATEMENT OF PROBLEM Advancements in digital dental technologies have enabled the use of different resin-based materials that can be fabricated either additively or subtractively. However, knowledge on the fabrication trueness of these materials is scarce. PURPOSE The purpose of this in vitro study was to investigate the trueness of crowns fabricated by using different resin-based computer-aided design and computer-aided manufacturing (CAD-CAM) materials. MATERIAL AND METHODS A complete crown for a mandibular right first molar with a 30-μm cement space was designed in standard tessellation language (STL) format. This master STL (MC-STL) was used to fabricate 40 complete crowns with 4 different resin-based CAD-CAM materials and either additive (Crowntec [MS]) or subtractive techniques (Brilliant Crios [BC], breCAM.monoCOM [PMMA], and G-CAM [GR]; n=10). All crowns were digitized with an intraoral scanner (CEREC Primescan SW 5.2) to generate their STL files (TC-STLs). MC-STL and TC-STLs were transferred into a 3-dimensional analysis software program (Medit Link v2.4.4), and a trueness (overall, external, occlusal, intaglio occlusal, and marginal) analysis was performed by using the root mean square (RMS) method. The Kruskal-Wallis and Dunn tests were performed to analyze data (α=.05). RESULTS The test groups had significantly different deviations on all surfaces (P≤.001). MS crowns had higher overall (P≤.007) and external surface (P≤.001) deviations than GR and PMMA crowns, while the differences between GR and PMMA crowns were not significant (P≥.441). BC crowns had higher external surface deviations than GR crowns (P=.005), higher occlusal deviations than GR and MS crowns (P≤.007), and higher intaglio occlusal deviations than GR and MS crowns (P≤.009). However, BC crowns had lower marginal deviations than MS and GR crowns (P≤.018). CONCLUSIONS The brand of resin-based CAD-CAM materials affected the trueness of crowns. Additively manufactured crowns (MS) mostly had lower overall and external surface trueness than the other groups. Nevertheless, the deviation values of occlusal, intaglio occlusal, and marginal trueness were generally small; thus, the effect of the tested materials on clinical crown fit may be negligible.
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Affiliation(s)
- Gülce Çakmak
- Senior Research Associate, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ana Maria Rusa
- Dissertation Student, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Donmez
- Asisstant Professor, Department of Prosthodontics, Istinye University, Faculty of Dentistry, İstanbul, Turkey; Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Canan Akay
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Osmangazi University, Eskisehir, Turkey; Associate Professor, Translational Medicine Research and Clinical Center, Osmangazi University, Eskisehir, Turkey
| | - Çiğdem Kahveci
- Assistant Professor, Department of Prosthodontics, Giresun University Faculty of Dentistry, Giresun, Turkey
| | - Martin Schimmel
- Chairman, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; External Research Associate, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
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Topkan E, Somay E, Yilmaz B, Selek U. Comment on "Management of the neck in T1 and T2 buccal squamous cell carcinoma". Int J Oral Maxillofac Surg 2024; 53:444-445. [PMID: 38143219 DOI: 10.1016/j.ijom.2023.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023]
Affiliation(s)
- E Topkan
- Department of Radiation Oncology, Faculty of Medicine, Başkent University, Adana, Turkey
| | - E Somay
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Başkent University, Ankara, Turkey.
| | - B Yilmaz
- Department of Oral and Maxillofacial Radiology, School of Dental Medicine, Bahcesehir University, Istanbul, Turkey
| | - U Selek
- Department of Radiation Oncology, School of Medicine, Koç University, Istanbul, Turkey
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Çakmak G, Donmez MB, Yılmaz D, Yoon HI, Kahveci Ç, Abou-Ayash S, Yilmaz B. Fabrication trueness and marginal quality of additively manufactured resin-based definitive laminate veneers with different restoration thicknesses. J Dent 2024; 144:104941. [PMID: 38490323 DOI: 10.1016/j.jdent.2024.104941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/11/2024] [Accepted: 03/13/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES To evaluate how restoration thickness (0.5 mm and 0.7 mm) affects the fabrication trueness of additively manufactured definitive resin-based laminate veneers, and to analyze the effect of restoration thickness and margin location on margin quality. METHODS Two maxillary central incisors were prepared either for a 0.5 mm- or 0.7 mm-thick laminate veneer. After acquiring the partial-arch scans of each preparation, laminate veneers were designed and stored as reference data. By using these reference data, a total of 30 resin-based laminate veneers were additively manufactured (n = 15 per thickness). All veneers were digitized and stored as test data. The reference and test data were superimposed to calculate the root mean square values at overall, external, intaglio, and marginal surfaces. The margin quality at labial, incisal, mesial, and distal surfaces was evaluated. Fabrication trueness at each surface was analyzed with independent t-tests, while 2-way analysis of variance was used to analyze the effect of thickness and margin location on margin quality (α = 0.05). RESULTS Regardless of the evaluated surface, 0.7 mm-thick veneers had lower deviations (P < 0.001). Only the margin location (P < 0.001) affected the margin quality as labial margins had the lowest quality (P < 0.001). CONCLUSION Restoration thickness affected the fabrication trueness of resin-based laminate veneers as 0.7 mm-thick veneers had significantly higher trueness. However, restoration thickness did not affect the margin quality and labial margins had the lowest quality. CLINICAL SIGNIFICANCE Laminate veneers fabricated by using tested urethane-based acrylic resin may require less adjustment when fabricated in 0.7 mm thickness. However, marginal integrity issues may be encountered at the labial surface.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey.
| | - Deniz Yılmaz
- Department of Prosthodontics, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Hyung-In Yoon
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | | | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, OH, USA
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Revilla-León M, Gómez-Polo M, Barmak AB, Yilmaz B, Kois JC, Alonso Pérez-Barquero J. Influence of scan extension and starting quadrant on the accuracy of four intraoral scanners for fabricating tooth-supported crowns. J Prosthet Dent 2024:S0022-3913(24)00208-7. [PMID: 38641480 DOI: 10.1016/j.prosdent.2024.03.017] [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: 12/22/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/21/2024]
Abstract
STATEMENT OF PROBLEM Multiple factors can influence the accuracy of intraoral scanners (IOSs). However, the impact of scan extension and starting quadrant on the accuracy of IOSs for fabricating tooth-supported crowns remains uncertain. PURPOSE The purpose of the present in vitro study was to measure the influence of scan extension (half or complete arch scan) and the starting quadrant (same quadrant or contralateral quadrant of the location of the crown preparation) on the accuracy of four IOSs. MATERIAL AND METHODS A typodont with a crown preparation on the left first molar was digitized (T710) to obtain a reference scan. Four scanner groups were created: TRIOS 5, PrimeScan, i700, and iTero. Then, 3 subgroups were defined based on the scan extension and starting quadrant: half arch (HA subgroup), complete arch scan starting on the left quadrant (CA-same subgroup), and complete arch scan starting on the right quadrant (CA-contralateral subgroup), (n=15). The reference scan was used as a control to measure the root mean square (RMS) error discrepancies with each experimental scan on the tooth preparation, margin of the tooth preparation, and adjacent tooth areas. Two-way ANOVA and pairwise multiple comparisons were used to analyze trueness (α=.05). The Levene and pairwise comparisons using the Wilcoxon Rank sum tests were used to analyze precision (α=.05). RESULTS For the tooth preparation analysis, significant trueness and precision differences were found among the groups (P<.001) and subgroups (P<.001), with a significant interaction group×subgroup (P=.002). The iTero and TRIOS5 groups obtained better trueness than the PrimeScan and i700 groups (P<.001). Moreover, half arch scans obtained the best trueness, while the CA-contralateral scans obtained the worst trueness (P<.001). The iTero group showed the worst precision among the IOSs tested. For the margin of the tooth preparation evaluation, significant trueness and precision differences were found among the groups (P<.001) and subgroups (P<.001), with a significant interaction group×subgroup (P=.005). The iTero group obtained best trueness (P<.001), but the worst precision (P<.001) among the IOSs tested. Half arch scans obtained the best trueness and precision values. For the adjacent tooth analysis, trueness and precision differences were found among the groups (P<.001) and subgroups tested (P<.001), with a significant interaction group×subgroup (P=.005). The TRIOS 5 obtained the best trueness and precision. Half arch scans obtained the best accuracy. CONCLUSIONS Scan extension and the starting quadrant impacted the scanning trueness and precision of the IOSs tested. Additionally, the IOSs showed varying scanning discrepancies depending on the scanning area assessed. Half arch scans presented the highest trueness and precision, and the complete arch scans in which the scan started in the contralateral quadrant of where the crown preparation was obtained the worst trueness and precision.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash; and Adjunct Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
| | - Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Abdul B Barmak
- Associate Professor, Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| | - John C Kois
- Founder and Director Kois Center, Seattle, Wash.; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash.; and Private practice, Seattle, Wash
| | - Jorge Alonso Pérez-Barquero
- Adjunct Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Çakmak G, Cuellar AR, Donmez MB, Abou-Ayash S, Lu WE, Schimmel M, Yilmaz B. Effect of printing layer thickness on the trueness of 3-unit interim fixed partial dentures. J Prosthet Dent 2024; 131:718-725. [PMID: 35636984 DOI: 10.1016/j.prosdent.2022.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Three-dimensional printing has facilitated the fabrication processes in dentistry. However, knowledge on the effect of layer thickness on the trueness of 3D printed fixed partial dentures (FPDs) is lacking. PURPOSE The purpose of this in vitro study was to compare the effect of printing layer thickness on the trueness of 3-unit interim FPDs fabricated by using additive manufacturing with that of those fabricated by subtractive manufacturing. MATERIAL AND METHODS The right first premolar and first molar teeth of a dentate mandibular model were prepared for a 3-unit restoration and then digitized by using an intraoral scanner. A 3-unit interim FPD was designed to fabricate 40 restorations by using either the additive (NextDent C&B MFH) with layer thicknesses of 20 μm (n=10), 50 μm (n=10), and 100 μm (n=10) or subtractive manufacturing technique (Upcera) (milled, n=10). After fabrication, the interim FPDs were digitized by using the same intraoral scanner and were superimposed over the design data by using a 3D analysis software program. Root mean square (RMS) was used to analyze the trueness of the restorations at 4 different surfaces (external, intaglio, marginal area, and intaglio occlusal) and as a complete unit (overall). Data were analyzed with the Kruskal-Wallis and Wilcoxon tests with Bonferroni correction (α=.05). RESULTS The 100-μm-layer thickness interim FPDs showed the greatest overall (P≤.015), external (P≤.021), and intaglio occlusal (P≤.021) deviations, whereas the milled interim FPDs showed the lowest (P=.001). No significant differences were found among the test groups for marginal RMS (P≥.108). The differences between the 50-μm-layer thickness and 100-μm-layer thickness interim FPDs for the intaglio surface deviations (P=.064) and between the 20-μm-layer thickness and 50-μm-layer thickness interim FPDs for each surface tested were not statistically significant (P≥.108). CONCLUSIONS The printing layer thickness had a significant effect on the trueness of the additively manufactured interim FPDs. However, subtractively manufactured interim FPDs presented higher trueness than those additively manufactured, regardless of the printing layer thickness.
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Affiliation(s)
- Gülce Çakmak
- Buser Foundation Scholar for Implant Dentistry, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Alfonso Rodriguez Cuellar
- Professor, Department of Periodontology, Clinica Dental Rodriguez Dental Clinic, Mexico City, Mexico
| | - Mustafa Borga Donmez
- Assistant Professor, Department of Prosthodontics, Istinye University Faculty of Dentistry, Istanbul, Turkey; Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Senior Lecturer and Head of the Section of Digital Implant and Reconstructive Dentistry, Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Wei-En Lu
- PhD student, Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio
| | - Martin Schimmel
- Chairman, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; External Researcher, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
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Yilmaz B, Selek U. Comments on "An umbrella review exploring the effect of radiotherapy for head and neck cancer patients on the frequency of jaws osteoradionecrosis". Cancer Radiother 2024; 28:206-207. [PMID: 38485574 DOI: 10.1016/j.canrad.2023.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/18/2023] [Indexed: 04/22/2024]
Affiliation(s)
- B Yilmaz
- Department of Oral and Maxillofacial Radiology, School of Dental Medicine, Bahcesehir University, Istanbul, Turkey.
| | - U Selek
- Department of Radiation Oncology, School of Medicine, Koc University, Istanbul, Turkey.
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Azpiazu-Flores FX, Borga Donmez M, Lin WS, Morton D, Yilmaz B. Verifying the seating of a 3D-printed removable die using elastomeric matrices: A dental technique. J Prosthodont 2024. [PMID: 38502812 DOI: 10.1111/jopr.13839] [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: 01/08/2024] [Revised: 02/27/2024] [Accepted: 03/01/2024] [Indexed: 03/21/2024] Open
Abstract
Computer-aided design and computer-aided manufacturing systems enable digital designing and 3-dimensional (3D) printing of definitive casts with removable dies. However, the fit of the removable dies should be without interferences for their accurate positioning in the cast. Given that the accuracy of additive manufacturing depends on design- and manufacturing-related factors, verifying the accuracy of the position of 3D-printed removable dies in their cast is essential to fabricate positionally accurate definitive prostheses, which would enable minimal or no laboratory and clinical adjustments. This dental technique article presents a straightforward approach to verify the seating of a 3D-printed removable die by using verification matrices made of a polyvinylsiloxane interocclusal registration material.
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Affiliation(s)
- Francisco X Azpiazu-Flores
- Center for Implant, Esthetic and Innovative Dentistry, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
- Department of Prosthodontics, Istinye University Faculty of Dentistry, Istanbul, Turkey
| | - Wei-Shao Lin
- Chair of the Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Dean Morton
- Center for Implant, Esthetic and Innovative Dentistry, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Ohio, USA
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Sasany R, Donmez MB, de Paula MS, Kahveci Ç, Ceylan G, Yilmaz B, Çakmak G. Stainability and translucency of potassium aluminum sulfate applied computer-aided design and computer-aided manufacturing materials after coffee thermocycling. J ESTHET RESTOR DENT 2024; 36:477-483. [PMID: 37877244 DOI: 10.1111/jerd.13154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE The purpose of this in vitro study was to evaluate the effect of potassium aluminum sulfate (alum) application on the stainability and translucency of computer-aided design and computer-aided manufacturing (CAD-CAM) materials after coffee thermocycling (CTC). MATERIALS AND METHODS Disk-shaped specimens (Ø10 × 1 mm; N = 200) were fabricated by using additively (Crowntec [CT] and Varseo Smile Crown Plus [VS]) and subtractively manufactured (Brilliant Crios [RCR], CEREC Block [FC], and Vita Enamic [VE]) CAD-CAM materials and polished. All specimens were randomly divided into two groups as alum applied and control (n = 10). All specimens were then subjected to CTC (10,000 cycles at 5-55°C) and color coordinates were measured at each time interval. Color differences (ΔE00 ) and relative translucency parameters (RTPs) were calculated and the data were statistically analyzed (a = 0.05). RESULTS Among tested time intervals, alum applied specimens had their lowest ΔE00 after alum application (p ≤ 0.006), except for FC (p = 0.177). In addition, alum applied RCR had lower ΔE00 values than its control specimens (p = 0.029). Alum applied specimens had their lowest RTP after CTC (p < 0.001) and alum application decreased the RTP of CT (p = 0.010). CTC reduced the RTP of all materials in control groups (p < 0.001). Alum applied CT had higher RTP than its control specimens (p = 0.049). CONCLUSIONS Alum application's effect on color change varied depending on the material and alum mostly resulted in clinically acceptable changes in translucency. CTC led to unacceptable color and translucency changes based on previously reported threshold values. CLINICAL SIGNIFICANCE Optical properties of CAD-CAM materials and the sustainability of these properties over time is critical for longevity. Alum may improve the color stability of reinforced composite resin when subjected to long-term coffee consumption.
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Affiliation(s)
- Rafat Sasany
- Department of Prosthodontics, Faculty of Dentistry, Biruni University, İstanbul, Turkey
| | - Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Marcella Silva de Paula
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prevention and Oral Rehabilitation, Universidade Federal de Goiás (UFG), Goiânia, Brazil
| | | | - Gözlem Ceylan
- Department of Prosthodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Molinero-Mourelle P, Abou-Ayash S, Brägger U, Schimmel M, Özcan M, Yilmaz B, Buser R, Al-Haj Husain N. Load bearing capacity of 3-unit screw-retained implant-supported fixed dental prostheses with a mesial and distal cantilever on a single implant: A comparative in vitro study. J Mech Behav Biomed Mater 2024; 151:106395. [PMID: 38244420 DOI: 10.1016/j.jmbbm.2024.106395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/22/2024]
Abstract
OBJECTIVES To assess the mechanical durability of monolithic zirconia implant-supported fixed dental prostheses (iFDP) design on one implant, with a distal and a mesial extension cantilever bonded to a titanium base compared to established designs on two implants. MATERIALS AND METHODS Roxolid Tissue level (TL), and tissue level x (TLX) implants were used to manufacture screw-retained 3-unit iFDPs (n = 60, n = 10 per group), with following configurations (X: Cantilever; I: Implant, T: Test group, C: Control group): T1: X-I-X (TL); T2: X-I-X (TLX); T3: I-I-X (TL); T4: I-I-X (TLX); C1: I-X-I (TL); C2: I-X-I (TLX). The iFDPs were thermomechanically aged and subsequently loaded until fracture using a universal testing machine. The failure load at first crack (Finitial) and at catastrophic fracture (Fmax) were measured and statistical evaluation was performed using two-way ANOVA and Tukey's post-hoc tests. RESULTS The mean values ranged between 190 ± 73 and 510 ± 459 N for Finitial groups, and between 468 ± 76 and 1579 ± 249 N for Fmax, respectively. Regarding Finitial, neither the implant type, nor the iFDP configuration significantly influenced measured failure loads (all p > 0.05). The choice of implant type did not show any significant effect (p > 0.05), while reconstruction design significantly affected Fmax data (I-I-Xa < X-I-Xb < I-X-Ic) (p < 0.05). The mesial and distal extension groups (X-I-X) showed fractures only at the cantilever extension site, while the distal extension group (I-I-X) showed one abutment and one connector fracture at the implant/reconstruction interface. CONCLUSION Results suggest that iFDPs with I-X-I design can be recommended regardless of tested implant type followed by the mesial and distal extension design on one implant abutment (X-I-X).
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Switzerland
| | - Mutlu Özcan
- Clinic of Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH, USA
| | - Ramona Buser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Nadin Al-Haj Husain
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Switzerland; Clinic of Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Çakmak G, Weber FA, Donmez MB, Kahveci Ç, Schimmel M, Yilmaz B. Effect of coffee thermocycling on the surface roughness and stainability of denture base materials with different chemical compositions manufactured with additive and subtractive technologies. J ESTHET RESTOR DENT 2024; 36:453-459. [PMID: 37705502 DOI: 10.1111/jerd.13136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To evaluate the effect of coffee thermocycling (CTC) on the surface roughness (Ra ) and stainability of denture base materials with different chemical compositions fabricated by using additive and subtractive manufacturing. MATERIALS AND METHODS Disk-shaped specimens were additively (FREEPRINT denture, AM) or subtractively (G-CAM, GSM and M-PM, SM) fabricated from three pink denture base materials in different chemical compositions (n = 10). Ra was measured before and after polishing, while color coordinates were measured after polishing. Specimens were subjected to CTC (5000 cycles) and measurements were repeated. Color differences (ΔE00 ) after CTC were calculated. Ra among different time intervals within materials was evaluated by using repeated measures analysis of variance (ANOVA), while 1-way ANOVA was used to evaluate the Ra of different materials within each time interval and the ΔE00 values. Color coordinates within each material were compared by using paired samples t-tests (α = 0.05). RESULTS Ra before polishing was the highest for all materials (p < 0.001), while SM had its lowest Ra after CTC and AM had its lowest Ra after polishing (p ≤ 0.008). Before polishing, AM had the highest Ra among the materials (p < 0.001). After polishing, SM had higher Ra than AM (p < 0.001). After CTC, GSM had the lowest Ra (p ≤ 0.048). SM had the lowest (p ≤ 0.031) and AM had the highest (p < 0.001) ΔE00 . CTC decreased the a* and b* values of SM and AM (p ≤ 0.017), and increased the L* values of AM (p < 0.001). CONCLUSIONS Polishing significantly reduced the surface roughness of all materials. CTC did not increase the surface roughness of materials above the clinically acceptable threshold. Only AM had perceptible color change when previously reported threshold values for denture base materials were considered. CLINICAL SIGNIFICANCE Tested denture base materials may have similar surface stability after coffee thermocycling. However, subtractively manufactured denture base materials may have improved color stability when subjected to long-term coffee consumption.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Franziska Alexandra Weber
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Zahnarztpraxis Landmesser, Spiez, Switzerland
- Zahnarztpraxis Krebs, Oey, Switzerland
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey
| | | | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
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Yilmaz B, Gouveia D, Schimmel M, Lu WE, Özcan M, Abou-Ayash S. Effect of adhesive system, resin cement, heat-pressing technique, and thermomechanical aging on the adhesion between titanium base and a high-performance polymer. J Prosthet Dent 2024; 131:468-474. [PMID: 35513915 DOI: 10.1016/j.prosdent.2022.03.026] [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: 01/05/2022] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Even though polyetheretherketone (PEEK) has become popular for various prosthetic indications, a standard adhesive protocol to bond the PEEK to titanium bases has not been yet established. How the heat-pressing technique performs in this respect is also not clear. PURPOSE The purpose of this in vitro study was to investigate the effect of an adhesive system-cement combination, the heat-pressing technique, and thermomechanical aging on the retention force between titanium bases and PEEK specimens. MATERIAL AND METHODS Sixty 9×11×20-mm PEEK specimens with a titanium base slot integrated into the design were milled to simulate an implant-supported PEEK framework for a cantilevered fixed prosthesis. The specimens were assigned to 8 groups (n=10) according to the titanium base primer (MKZ or Monobond) and resin cement (DTK or Multilink hybrid) used and with or without thermomechanical aging. Twenty PEEK specimens were directly heat-pressed on titanium bases, and half of the specimens were not subjected to thermomechanical aging (n=10). For nonaged groups, the PEEK specimen complex was tightened to an implant analog and secured on a custom-made pull-off device. Retention forces were measured by using the pull-off tensile test in a universal testing machine, and the maximum tensile bond strength (MPa) was calculated. The aged groups were subjected to 5000 cycles of thermal aging (5 °C to 55 °C), and the specimens were clamped to load the extension (cantilever) for 1 200 000 cycles with 120 N and 200 N at 1.5-Hz frequency. After aging, the pull-off test was performed for those specimens that survived thermomechanical aging. A nonparametric Kruskal-Wallis test was used to determine whether there was a difference among the groups, followed by pairwise Wilcoxon rank tests with Bonferroni correction. The Wilcoxon rank test was used to analyze the effect of thermomechanical aging in each adhesive system-cement or heat-press group (α=.05 for all tests). RESULTS None of the specimens failed during cyclic loading. According to the Kruskal-Wallis test, the effect of the PEEK-Ti base bonding technique on the retention force in the nonaged (P=.019) and thermomechanically aged groups was significant (P=.010). In the nonaged groups, the heat-pressing technique resulted in a higher retention force than when the specimens were bonded by using the Monobond-Multilink hybrid combination (P=.031). Thermomechanical aging did not significantly affect the results (P>.241). All failures were adhesive, with cement remaining only on the Ti-bases. CONCLUSIONS All bonding protocols tested resulted in a stable bond between PEEK and Ti-bases, as all specimens survived thermomechanical aging. The heat-pressing technique resulted in mean bond strength values similar to those obtained with the tested adhesive system-cement combinations with 1 exception; the nonaged heat-pressed groups presented higher bond strength than the Monobond-Multilink hybrid combination. Failure types indicated that the weaker bond was between the PEEK and the cements tested rather than between the titanium base and the cements, regardless of the adhesive system-cement combination.
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Affiliation(s)
- Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| | - Diogo Gouveia
- Assistant Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Martin Schimmel
- Professor and Head, Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland; Senior Lecturer, Extra muros, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Wei-En Lu
- PhD Candidate, Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio
| | - Mutlu Özcan
- Professor and Head, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Samir Abou-Ayash
- Senior Lecturer and Head, Section of Digital Implant and Reconstructive Dentistry, Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.
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Dönmez MB, Wepfer AB, Güven ME, Çakmak G, Schimmel M, Yilmaz B. Dimensional Stability of Additively Manufactured Diagnostic Maxillary Casts Fabricated with Different Model Resins. INT J PROSTHODONT 2024; 37:119-126. [PMID: 38498863 DOI: 10.11607/ijp.8877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
PURPOSE To evaluate the effect of model resin type and time interval on the dimensional stability of additively manufactured diagnostic casts. MATERIALS AND METHODS Ten irreversible hydrocolloid impressions and 10 impressions from an intraoral scanner were made from a reference maxillary stone cast, which was also digitized with a laboratory scanner. Conventional impressions were poured in type III stone (SC), while digital impressions were used to additively manufacture casts with a nanographene-reinforced model resin (GP) or a model resin (DM). All casts were digitized with the same laboratory scanner 1 day (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4) after fabrication. Cast scans were superimposed over the reference cast scan to evaluate dimensional stability. Data were analyzed with Bonferroni-corrected repeated measures ANOVA (α = .05). RESULTS The interaction between the main factors (material type and time interval) affected anterior teeth deviations, while the individual main factors affected anterior teeth and entire-cast deviations (P ≤ .008). Within anterior teeth, DM had the lowest deviations at T3, and GP mostly had lower values at T2 and lower deviations at T3 than at T0 (P ≤ .041). SC had the highest pooled anterior teeth deviations, and GP had the highest pooled entire cast deviations (P < .001). T3 had lower pooled anterior teeth deviations than at T0, T1, and T4, and higher pooled entire cast deviations than T1 were demonstrated (P ≤ .027). CONCLUSIONS The trueness of nanographene-reinforced casts was either similar to or higher than that of other casts. Dimensional changes were acceptable during the course of 1 month.
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Yılmaz D, Sabatini GP, Kahveci Ç, Yoon HI, Yilmaz B, Çakmak G, Dönmez MB. Effect of Material Thickness and Coffee Thermocycling on the Color Stability and Translucency of Additively and Subtractively Manufactured Resin-Based Materials for Definitive Restorations. INT J PROSTHODONT 2024; 37:143-150. [PMID: 37988420 DOI: 10.11607/ijp.8870] [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: 11/23/2023]
Abstract
PURPOSE To evaluate the effect of material thickness and coffee thermocycling on the optical properties of definitive resin-based materials created via additive manufacturing (AM) and subtractive manufacturing (SM). MATERIALS AND METHODS Specimens were prepared in three thicknesses (1, 1.5, and 2 mm) from three AM (3D-CB, 3D-TH, and 3D-CT) and two SM (G-CAM and VE) resin-based materials (n = 15 per material and thickness combination). Color coordinates of each specimen were measured after polishing and after 10,000 cycles of coffee thermocycling. Color differences (ΔE00s) and relative translucency parameter (RTP) values were calculated. After logarithmic transformation, ΔE00 values were analyzed with two-way ANOVA, while RTP values were analyzed with generalized linear model test (α = .05). RESULTS 3D-TH had the highest pooled ΔE00 and G-CAM had the lowest (P ≤ .004). 3D-CB had higher pooled ΔE00 than VE and 3D-CT (P ≤ .002). For the SM group, the 1.5-mm and 2-mm 3DCT specimens and 1-mm 3D-TH specimens had lower ΔE00 than 1.5-mm and 2-mm 3D-TH specimens (P ≤ .036). Most of the AM specimens and 1-mm VE specimens had higher ΔE00 than 2-mm G-CAM specimens (P ≤ .029). Further, most AM specimens had higher ΔE00 than 1.5-mm G-CAM specimens (P ≤ .006). RTP values increased in order of 3D-CT, G-CAM, VE, 3D-CB, and 3D-TH specimens (P < .001). Increased thickness and coffee thermocycling mostly reduced RTP (P < .001). CONCLUSIONS 3D-TH typically had higher color change values than SM specimens, while G-CAM typically had lower color change values than AM specimens. Only the 1.5-mm and 2-mm 3D-TH specimens had unacceptable color changes. Thickness and coffee thermocycling mostly reduced the translucency.
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Yılmaz D, Çakmak G, Güven ME, Pieralli S, Yoon HI, Revilla-León M, Yilmaz B. Effect of Hydrothermal Aging on the Flexural Strength and Microhardness of Materials Used for Additive or Subtractive Manufacturing of Definitive Restorations. INT J PROSTHODONT 2024; 37:133-141. [PMID: 38498865 DOI: 10.11607/ijp.8847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
PURPOSE To evaluate the flexural strength (FS) and microhardness of various CAD/CAM restorative materials intended for definitive use. The effect of hydrothermal aging on the mechanical properties of these materials was also investigated. MATERIALS AND METHODS A total of 210 bar-shaped specimens (17 × 4 × 1.5 mm ± 0.02 mm) were fabricated via either subtractive manufacturing (SM) methods-reinforced composite resin (SM-CR), polymer-infiltrated ceramic network (SM-PICN), fine-structured feldspathic ceramic (SMFC), nanographene-reinforced polymethyl methacrylate (PMMA; SM-GPMMA), PMMAbased resin (SM-PMMA)-or additive manufacturing (AM) methods with urethane acrylate-based resins (AM-UA1 and AM-UA2). Specimens were then divided into two subgroups (nonaged or hydrothermal aging; n = 15). A three-point flexural strength test was performed, and five specimens from the nonaged group were submitted to microhardness testing. Specimens were subjected to 10,000 thermal cycles, and the measurements were repeated. RESULTS Regardless of aging, SM-CR had the highest FS (P < .001), followed by SM-GPMMA (P ≤ .042). In nonaged groups, AM-UA2 had a lower FS than all other materials except SM-FC (P = 1.000). In hydrothermal aging groups, AM specimens had lower FS values than other materials, except SM-PMMA. With regard to microhardness, there was no significant difference found between any of the tested materials (P ≥ .945) in the nonaged and hydrothermal aging groups. CONCLUSIONS The effect of hydrothermal aging on FS varied depending on the type of restorative material. Regardless of aging condition, SM-CR showed the highest FS values, whereas SM-FC had the highest microhardness. Hydrothermal aging had no significant influence on the microhardness of the tested materials.
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Çakmak G, Steigmeier D, Güven ME, Yilmaz D, Schimmel M, Yoon HI, Yilmaz B. Fabrication Trueness, Intaglio Surface Adaptation, and Marginal Integrity of Resin-Based Onlay Restorations Fabricated by Additive and Subtractive Manufacturing. INT J PROSTHODONT 2024; 37:99-107. [PMID: 37988421 DOI: 10.11607/ijp.8802] [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: 11/23/2023]
Abstract
PURPOSE To evaluate the fabrication trueness, intaglio surface adaptation, and marginal integrity of resin-based onlay restorations made via additive manufacturing (AM) or subtractive manufacturing (SM). MATERIALS AND METHODS An onlay restoration was designed (DentalCAD Galway 3.0) and saved as an STL file to generate a design STL file (DO-STL). Using this design, 45 onlays were fabricated either with AM (3D-printed resin for definitive [AM-D; Tera Harz TC-80DP] and interim [AM-I; Freeprint temp] restorations) or SM (composite resin, Tetric CAD) technologies. Onlays were scanned with an intraoral scanner (CEREC Primescan SW 5.2), and the scans were saved as test STL files (TO-STLs). For trueness evaluation, TO-STLs were superimposed over the DO-STL, and root mean square (RMS) values of overall and intaglio surfaces were measured (Geomagic Control X). For the intaglio surface adaptation and marginal integrity, a triple-scan protocol was performed. Kolmogorov-Smirnov, one-way ANOVA, and post-hoc Tukey honestly significant difference tests were used to analyze data (α = .05). RESULTS RMS values of intaglio and overall surfaces, intaglio adaptation, and marginal integrity varied among test groups (P < .001). AM-D had the greatest overall surface RMS (P < .001), while SM had the greatest intaglio surface RMS (P < .001). SM had the highest average distance deviations for intaglio surface adaptation and marginal integrity, whereas AM-D had the lowest (P < .001). CONCLUSIONS AM-D onlays showed lower overall trueness than AM-I onlays and SM definitive onlays. However, AM-D onlays presented high intaglio surface trueness, intaglio surface adaptation, and marginal integrity.
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Zandinejad A, Yilmaz B. 3D Printing in Clinical Dentistry. INT J PROSTHODONT 2024; 37:3. [PMID: 38489215 DOI: 10.11607/ijp.2024.s1.e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
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Çakmak G, Chebaro J, Donmez MB, Yılmaz D, Yoon HI, Kahveci Ç, Schimmel M, Yilmaz B. Influence of intraoral scanner and finish line location on the fabrication trueness and margin quality of additively manufactured laminate veneers fabricated with a completely digital workflow. J Prosthet Dent 2024; 131:313.e1-313.e9. [PMID: 37978007 DOI: 10.1016/j.prosdent.2023.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 10/23/2023] [Accepted: 10/23/2023] [Indexed: 11/19/2023]
Abstract
STATEMENT OF PROBLEM Knowledge of the fabrication trueness and margin quality of additively manufactured (AM) laminate veneers (LVs) when different intraoral scanners (IOSs) and finish line locations are used is limited. PURPOSE The purpose of this in vitro study was to evaluate the fabrication trueness and margin quality of AM LVs with different finish line locations digitized by using different IOSs. MATERIAL AND METHODS An LV preparation with a subgingival (sub), equigingival (equi), or supragingival (supra) finish line was performed on 3 identical maxillary right central incisor typodont teeth. Each preparation was digitized by using 2 IOSs, (CEREC Primescan [PS] and TRIOS 3 [TS]), and a reference LV for each finish line-IOS pair (n=6) was designed. A total of 90 LVs were fabricated by using these files and urethane acrylate-based definitive resin (Tera Harz TC-80DP) (n=15). Each LV was then digitized by using PS to evaluate fabrication trueness (overall, external, intaglio, and marginal surfaces). Each LV was also qualitatively evaluated under a stereomicroscope (×60), and the cervical and incisal margin quality was graded. Fabrication trueness and cervical margin quality were evaluated by using 2-way analysis of variance, while Kruskal-Wallis and Mann Whitney-U tests were used to evaluate incisal margin quality (α=.05). RESULTS The interaction between the IOS type and the finish line location affected measured deviations at each surface (P≤.020). PS-sub and TS-supra had higher overall trueness than their counterparts. and the subgingival finish line resulted in the lowest trueness (P≤.005). PS and the subgingival finish line led to the lowest trueness of the external surface (P≤.001). TS-sub had the lowest intaglio surface trueness among the TS subgroups, and PS-sub had higher trueness than TS-sub (P<.001). PS-sub and PS-supra had higher marginal surface trueness than their TS counterparts (P<.001). TS resulted in higher cervical margin quality (P=.001). CONCLUSIONS Regardless of the IOS tested, subgingival finish lines resulted in the lowest trueness. The effect of IOS on the measured deviations varied according to the surface evaluated and finish line location. The cervical margin quality of AM LVs was higher when TS was used.
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Affiliation(s)
- Gülce Çakmak
- Senior Resarch Associate, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jad Chebaro
- Predoctoral student, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; and Private Practice, Bellinzona, Switzerland
| | - Mustafa Borga Donmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey; and ITI Scholar, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Deniz Yılmaz
- Lecturer, Department of Prosthodontics, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Hyung-In Yoon
- Associate Professor, Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea; and Adjunct Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Çiğdem Kahveci
- Prosthodontist, Ordu Oral and Dental Health Center, Ordu, Turkey
| | - Martin Schimmel
- Professor and Head, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; and External Research Associate, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
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Cho JH, Çakmak G, Yi Y, Yoon HI, Yilmaz B, Schimmel M. Tooth morphology, internal fit, occlusion and proximal contacts of dental crowns designed by deep learning-based dental software: A comparative study. J Dent 2024; 141:104830. [PMID: 38163455 DOI: 10.1016/j.jdent.2023.104830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES This study compared the tooth morphology, internal fit, occlusion, and proximal contacts of dental crowns automatically generated via two deep learning (DL)-based dental software systems with those manually designed by an experienced dental technician using conventional software. METHODS Thirty partial arch scans of prepared posterior teeth were used. The crowns were designed using two DL-based methods (AA and AD) and a technician-based method (NC). The crown design outcomes were three-dimensionally compared, focusing on tooth morphology, internal fit, occlusion, and proximal contacts, by calculating the geometric relationship. Statistical analysis utilized the independent t-test, Mann-Whitney test, one-way ANOVA, and Kruskal-Wallis test with post hoc pairwise comparisons (α = 0.05). RESULTS The AA and AD groups, with the NC group as a reference, exhibited no significant tooth morphology discrepancies across entire external or occlusal surfaces. The AD group exhibited higher root mean square and positive average values on the axial surface (P < .05). The AD and NC groups exhibited a better internal fit than the AA group (P < .001). The cusp angles were similar across all groups (P = .065). The NC group yielded more occlusal contact points than the AD group (P = .006). Occlusal and proximal contact intensities varied among the groups (both P < .001). CONCLUSIONS Crowns designed by using both DL-based software programs exhibited similar morphologies on the occlusal and axial surfaces; however, they differed in internal fit, occlusion, and proximal contacts. Their overall performance was clinically comparable to that of the technician-based method in terms of the internal fit and number of occlusal contact points. CLINICAL SIGNIFICANCE DL-based dental software for crown design can streamline the digital workflow in restorative dentistry, ensuring clinically-acceptable outcomes on tooth morphology, internal fit, occlusion, and proximal contacts. It can minimize the necessity of additional design optimization by dental technician.
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Affiliation(s)
- Jun-Ho Cho
- Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Yuseung Yi
- Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH, USA
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Jo YH, Cho JH, Park DH, Yoon HI, Han SH, Yilmaz B. Antimicrobial activity, surface properties, and cytotoxicity of microencapsulated phytochemicals incorporated into three-dimensionally printable dental polymers. J Dent 2024; 141:104820. [PMID: 38128820 DOI: 10.1016/j.jdent.2023.104820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/09/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES This study aimed to investigate the antimicrobial properties of three dimensionally-printed dental polymers (3DPs) incorporated with microencapsulated phytochemicals (MPs) and to assess their surface characteristics and cytotoxicity. METHODS MPs derived from phytoncide oil and their specific chemical components were introduced into suspensions of three microbial species: Streptococcus gordonii, Streptococcus oralis, and Candida albicans. Optical density was measured to determine the microbial growth in the presence of MPs for testing their antimicrobial activity. MPs at 5% (w/w) were mixed with dental polymers and dispersants to 3DP discs. These microbial species were then seeded onto the discs and incubated for 24 h. The antibacterial and antifungal activities of MP-containing 3DPs were evaluated by counting the colony-forming units (n = 3). The biofilm formation on the 3DP was assessed by crystal violet staining assay (n = 3). Microbial viability was determined using a live-dead staining and CLSM observation (n = 3). Surface roughness and water contact angle were assessed (n = 10). Cytotoxicity of MP-containing 3DPs for human gingival fibroblast was evaluated by MTT assay. RESULTS MPs, particularly (-)-α-pinene, suppressed the growth of all tested microbial species. MP-containing 3DPs significantly reduced the colony count (P ≤ 0.001) and biofilm formation (P ≤ 0.009), of all tested microbial species. Both surface roughness (P < 0.001) and water contact angle (P < 0.001) increased. The cytotoxicity remained unchanged after incorporating MPs to the 3DPs (P = 0.310). CONCLUSIONS MPs effectively controlled the microbial growth on 3DPs as evidenced by the colony count, biofilm formation, and cell viability. Although MPs modified the surface characteristics, they did not influence the cytotoxicity of 3DPs. CLINICAL SIGNIFICANCE Integration of MPs into 3DPs could produce dental prostheses or appliances with antimicrobial properties. This approach not only provides a proactive solution to reduce the risk of oral biofilm-related infection but also ensures the safety and biocompatibility of the material, thereby improving dental care.
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Affiliation(s)
- Ye-Hyeon Jo
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Jun-Ho Cho
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Dong Hyun Park
- Department of Oral Microbiology and Immunology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Seung Hyun Han
- Department of Oral Microbiology and Immunology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH, USA
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Borga Donmez M, Çakmak G, Schimmel M, Yilmaz B. Implementation of triple-scan protocol to evaluate the fit of complete-arch implant-supported fixed prostheses. J Prosthodont 2024. [PMID: 38291720 DOI: 10.1111/jopr.13830] [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: 10/13/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024] Open
Abstract
Passive fit is essential for multiple-unit implant-supported prostheses. Conventional methods to assess the passivity of complete-arch implant-supported prostheses do not allow 3-dimensional (3D) visualization and quantification of misfit. This report describes the marginal and internal fit evaluation of a complete-arch implant-supported prosthesis by using the triple-scan protocol involving a scanner and a 3D analysis freeware. This technique allows researchers, clinicians, or dental technicians to detect and quantify 3D prosthetic misfit, which may facilitate the preparation for dental appointments and objective measurement of misfit for research studies.
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Affiliation(s)
- Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Ohio, USA
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22
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Yilmaz B, Topkan E. Regarding 'Extra-mandibular Osteoradionecrosis After the Treatment of Head and Neck Cancer' by Kovarik et al. Clin Oncol (R Coll Radiol) 2024; 36:e72-e73. [PMID: 37805353 DOI: 10.1016/j.clon.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 09/26/2023] [Indexed: 10/09/2023]
Affiliation(s)
- B Yilmaz
- Department of Oral and Maxillofacial Radiology, School of Dental Medicine, Bahcesehir University, Istanbul, Turkey.
| | - E Topkan
- Department of Radiation Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
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23
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Yilmaz H, Arınç H, Çakmak G, Atalay S, Donmez MB, Kökat AM, Yilmaz B. Effect of scan pattern on the scan accuracy of a combined healing abutment scan body system. J Prosthet Dent 2024; 131:110-118. [PMID: 35219530 DOI: 10.1016/j.prosdent.2022.01.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 01/04/2022] [Accepted: 01/04/2022] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM A recently introduced scan body combined with a contoured healing abutment enables digital scans of the implant while its healing abutment shapes the soft tissue for an appropriate emergence profile. However, information on the effect of different scan patterns on the scan accuracy of this new system is lacking. PURPOSE The purpose of this in vitro study was to evaluate the effect of scan pattern on the accuracy of digital implant scans by using a combined healing abutment-scan body system. MATERIAL AND METHODS A combined healing abutment-scan body system was secured on a single implant at the right first molar site in a dentate mandibular model. A master reference model was generated by scanning the model with an industrial light scanner. The model was then scanned with 4 different scan patterns (SP-A, SP-B, SP-C, and SP-D) by using an intraoral scanner (TRIOS 3). Test scans (n=8) were superimposed over the master reference model by using a metrology software, and distance and angular deviations were calculated. Distance and angular deviation data were analyzed with a multivariate analysis of variance and the Tukey honestly significant difference tests for trueness and precision (α=.05). RESULTS Distance deviations (trueness [P=.461] and precision [P=.533] deviations) in the scans were not significantly affected by the scan pattern. Scan pattern affected the trueness (P=.001) and precision (P=.002) when angular deviations were considered. In terms of trueness, SP-D resulted in the highest angular deviations in scans (P≤.031), while the difference in deviations in scans obtained by using other scan patterns was not significant (P≥.378). When angular deviation data were considered, SP-D resulted in lower scan precision than SP-A (P=.014) and SP-B (P=.007). The precision of scans using SP-C was similar to the precision of the scans made by using other scan patterns (P≥.055) in terms of angular deviations. CONCLUSIONS The scan accuracy of a combined healing abutment-scan body system was affected by the scan pattern. The scans performed with SP-D presented the lowest accuracy considering the angular deviation data and, therefore, may be the least favored among the patterns tested for scanning a combined healing abutment-scan body system.
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Affiliation(s)
- Hakan Yilmaz
- Orthodontist, Private Practice, İstanbul, Turkey
| | - Hakan Arınç
- Prosthodontist, Private Practice, İstanbul, Turkey
| | - Gülce Çakmak
- Buser Foundation Scholar for Implant Dentistry, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Sevda Atalay
- Prosthodontist, Private Practice, İstanbul, Turkey
| | - Mustafa Borga Donmez
- Assistant Professor, Biruni University, Faculty of Dentistry, Department of Prosthodontics, İstanbul, Turkey; Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ali Murat Kökat
- Professor, İstanbul Aydın University, Faculty of Dentistry, Department of Prosthodontics, İstanbul, Turkey
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Ohio
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24
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Çakmak G, Cuellar AR, Treviño Santos A, Johnston WM, Dönmez MB, Yilmaz B. Color and translucency of milled polymethyl methacrylate crowns on non-tooth-colored interim abutments with different surface treatments. J Prosthet Dent 2024; 131:102-109. [PMID: 35341600 DOI: 10.1016/j.prosdent.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM The interim rehabilitation of implants has become a necessity, particularly for those placed in the esthetic regions. However, the optical properties of computer-aided design and computer-aided manufacturing (CAD-CAM) polymethyl methacrylate (PMMA) crowns on interim abutments with different surface treatments are unclear. PURPOSE The purpose of this in vitro study was to investigate the color and translucency of CAD-CAM PMMA crowns when different surface treatments were used on titanium interim abutments. MATERIAL AND METHODS A maxillary dentate stone cast with a narrow-diameter implant analog at the left lateral incisor site was used. Three titanium interim abutments (blue) were divided into 3 groups according to the surface treatment they received: control (steam cleaning), opaqued (120-μm Al2O3 airborne-particle abrasion and opaque application), and airborne-particle abraded (120-μm Al2O3). Thirty PMMA crowns (A2 shade) were milled (n=10). The color coordinates of the crown-interim abutment pairs and a shade tab (A2) were measured by using a colorimeter. The color differences (ΔE00) between the crowns and the shade tab and the relative translucency parameter (RTP) values of the crowns were calculated by using the CIEDE2000 formula. One-way ANOVA was used to analyze the ΔE00 and RTP values with subsequent Tukey honestly significant difference tests (α=.05). RESULTS The abutment surface treatment significantly affected the ΔE00 of interim crowns from the shade tab (P<.001), but no significant effect was found on RTP (P=.26). The control group had the highest ΔE00 from the shade tab (P≤.011). No significant difference (P=.14) was found between the opaqued and the ΔE00 of the airborne-particle abraded groups from the shade tab. CONCLUSIONS The surface treatments of interim abutments affected the color of CAD-CAM PMMA crowns, which differed from that of the shade tab. The color of crowns on opaqued or airborne-particle abraded interim abutments was closer to the color of the shade tab. Abutment surface treatments did not affect the translucency of crown-interim abutment pairs.
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Affiliation(s)
- Gülce Çakmak
- Buser Foundation Scholar for Implant Dentistry, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | | | - Alejandro Treviño Santos
- Professor, Postdoctoral and Research Division, Faculty of Dentistry, National Autonomous University of Mexico UNAM, Mexico City, Mexico
| | - William M Johnston
- Professor Emeritus, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Mustafa Borga Dönmez
- Assistant Prosfessor, Department of Prosthodontics, Faculty of Dentistry, İstinye University, İstanbul, Turkey; Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
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25
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Yilmaz B, Lee DJ, Amer R, Rastogi V, Braegger U, Johnston WM. Evaluation of Prosthetic Complications with Metal-Acrylic Resin Implant-Fixed Complete Dentures: A Medium- and Long-Term Retrospective Analysis with Up to 13 Years of Follow-up. INT J PROSTHODONT 2023; 36:697-703. [PMID: 38109390 DOI: 10.11607/ijp.8124] [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: 12/20/2023]
Abstract
PURPOSE To present prosthetic complications observed in the medium and long term in patients treated with metal-acrylic resin implant-supported fixed complete dentures (MAIFCDs). MATERIALS AND METHODS A total of 87 patients who were treated with MAIFCDs were included. Acrylic resin (denture teeth and base) fracture, screw loosening (prosthetic or abutment), screw (prosthetic or abutment), and framework fracture were analyzed for descriptive statistics. Product-limit survival estimates were used for the cumulative no-complication rate (CNCR) of prostheses. All results were assessed using α = .05. RESULTS The average observation time was 42.9 months (range: 19 to 153). Of 597 implants, 8 mandibular (44.4%) and 10 maxillary implants (55.6%) failed. In total, 29 patients (33.3%) experienced no complications in an average of 7 years, and 58 patients (66.6%) experienced at least one complication. The average time for the first complication to occur was 23 months (range: 1 to 97 months). The average number of complications was 5.9/patient. Acrylic resin complications were the most frequent, followed by screw loosening, screw fracture, and framework fracture. Of those patients with complications, 9 (16%) had maxillary MAIFCDs with an average of 4 complications. In total, 28 patients (48%) had only mandibular MAIFCDs with an average of 5 complications, and 21 patients (36%) had both arches treated with MAIFCDs with an average of 9 complications. Mandibular MAIFCDPs in women had a higher CNCR compared to maxillary MAIFCDs of both women and men and when both arches of women were treated with MAIFCDs (P < .05). CONCLUSIONS The CNCR of MAIFCDs differed depending on the arch treated and sex. Mandibular MAIFCDs in women had a lower complication rate than MAIFCDs in other arch-sex pairs. Acrylic resin related complications were commonly observed as well as prosthetic screw loosening.
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26
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Gómez-Polo M, Donmez MB, Çakmak G, Yilmaz B, Revilla-León M. Influence of implant scan body design (height, diameter, geometry, material, and retention system) on intraoral scanning accuracy: A systematic review. J Prosthodont 2023; 32:165-180. [PMID: 37771200 DOI: 10.1111/jopr.13774] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 09/30/2023] Open
Abstract
PURPOSE To evaluate the influence of implant scan body (ISB) design (height, diameter, geometry, material, and retention system) on the accuracy of digital implant scans. MATERIAL AND METHODS A literature search was completed in five databases: PubMed/Medline, Scopus, Embase, World of Science, and Cochrane. A manual search was also conducted. Studies reporting the evaluation of ISB design on the accuracy of digital scans obtained by using IOSs were included. Two investigators evaluated the studies independently by applying the Joanna Briggs Institute critical appraisal. A third examiner was consulted to resolve any lack of consensus. Articles were classified based on the ISB features of height, geometry, material, and retention system. RESULTS Twenty articles were included. Among the reviewed studies, 11 investigations analyzed the influence of different ISB geometries, 1 study assessed the impact of ISB diameter, 4 studies investigated the effect of ISB splinting, 2 articles evaluated ISB height, and 2 studies focused on the effect of ISB material on scan accuracy. In addition, 8 studies involved ISBs fabricated with different materials (1- and 2-piece polyetheretherketone and 1-piece titanium ISBs), and all of the reviewed articles tested screw-retained ISBs, except for 3 in vitro studies. CONCLUSIONS The findings did not enable concrete conclusions regarding the optimal ISB design, whether there is a relationship between IOS technology and a specific ISB design, or the clinical condition that maximizes intraoral scanning accuracy. Research efforts are needed to identify the optimal ISB design and its possible relationship with the IOS selected for acquiring intraoral digital implant scans.
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Affiliation(s)
- Miguel Gómez-Polo
- Department of Prosthetic Dentistry, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye Univeristy, İstanbul, Turkey
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, University of Washington, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
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27
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Sisli SN, Gul-Ates E, Ozcelik TB, Yilmaz B, Revilla-León M. Survival of root canal-treated teeth adjacent to an implant: A retrospective case-control study. J Dent 2023; 139:104742. [PMID: 37839623 DOI: 10.1016/j.jdent.2023.104742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/29/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES To evaluate the survival of root canal treated (RCT) teeth adjacent to an implant compared with that of RCT teeth of the same patient non-adjacent to an implant. MATERIALS AND METHODS RCT tooth of each patient adjacent to an implant were included in the test group. The control group consisted of another RCT tooth of the same patient; the control RCT tooth was not adjacent to an implant and selected to be of the same type of the RCT tooth in the test group. 72 teeth of 36 patients with at least 4-year follow-up were included. In addition to survival, other clinical and demographic parameters investigated were age, sex, tooth type and position, presence of a crown, presence of retreatment, presence of a post-core, presence of adjacent edentulous area, presence of implant-supported fixed prosthetic restoration on the antagonist tooth and periapical health status. Pearson Chi-Square and Fisher Exact tests were used to compare the test and the control groups with categorical variables (α=0.05). Survival curves were obtained by the Kaplan-Meier method, and the Log-rank test was performed to compare the survival probabilities (α=0.05). RESULTS No significant difference in survival rates was observed between the test and the control groups (p = 0.72). Similarly, no significant relationship was found between the investigated clinical variables and the survival rates of RCT teeth (p>0.05). Survival times differed depending on the presence of an adjacent edentulous area (p<0.001) and the periapical health status (p = 0.026). CONCLUSIONS RCT teeth with unhealed periapical tissues had a shorter cumulative survival time. Similarly, those adjacent to an edentulous area had shorter cumulative and complication-free survival times. CLINICAL SIGNIFICANCE This is the first study to determine the survival outcome of a RCT tooth adjacent to an implant compared to a non-adjacent one in the same patient. Being adjacent to an implant did not have a detrimental effect on the survival time and rate of RCT teeth.
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Affiliation(s)
- S N Sisli
- Department of Endodontics, School of Dentistry, Baskent University, Ankara, Turkey.
| | - E Gul-Ates
- Department of Biostatistics, Faculty of Medicine, Baskent University, Ankara 06490, Turkey; Institutional Big Data Management Coordination Office, Middle East Technical University, Ankara, Turkey
| | - T B Ozcelik
- Department of Prosthodontics, School of Dentistry, Baskent University, Ankara, Turkey
| | - B Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, OH, USA
| | - M Revilla-León
- AEGD Residency, Comprehensive Dentistry Department, College of Dentistry, Texas A&M University, Dallas, TX, USA; Affiliate Faculty Graduate Prosthodontics, Restorative Dentistry Department, School of Dentistry, University of Washington, Seattle, WA, USA; Researcher at Revilla Research Center, Madrid, Spain
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Guirao S, Llansana F, Button H, Yilmaz B, Kois JC, Revilla-León M. Additively manufactured devices with varying designs and sizes for acquiring initial intraoral implant scans. J Prosthodont 2023; 32:181-185. [PMID: 37585338 DOI: 10.1111/jopr.13750] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/14/2023] [Indexed: 08/18/2023] Open
Abstract
Dental literature has reported greater intraoral scanning accuracy when implant scan bodies (ISBs) are connected compared with non-connected methods. Initial intraoral digital implant scans are required for the fabrication of a custom framework to connect implant scan bodies (IOSFix; IOSFix Dental). This calibrated metal framework is used to acquire definitive intraoral implant scans. However, the acquisition of initial intraoral implant scans can be challenging when ISBs are not connected. This article describes a step-by-step technique for connecting ISBs by using additively manufactured devices to acquire initial intraoral implant scans. This technique aims to facilitate the recording of initial intraoral implant scans, provide different device designs and sizes to connect ISBs, and reduce chairside time.
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Affiliation(s)
| | | | | | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - John C Kois
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - Marta Revilla-León
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
- Department of Prosthodontics, Tufts University, Boston, Massachusetts, USA
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29
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Revilla-León M, Lanis A, Yilmaz B, Kois JC, Gallucci GO. Intraoral digital implant scans: Parameters to improve accuracy. J Prosthodont 2023; 32:150-164. [PMID: 37586762 DOI: 10.1111/jopr.13749] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/06/2023] [Indexed: 08/18/2023] Open
Abstract
PURPOSE To report the means to maximize the predictability and accuracy of intraoral digital implant scans through the evaluation of operator and patient-related factors. MATERIALS AND METHODS A search of published articles related to factors that can decrease the scanning accuracy of intraoral digital implant scans was completed in four data sources:MEDLINE, EMBASE, EBSCO, and Web of Science. All studies related to variables that can influence the accuracy of intraoral digital implant scans obtained by using intraoral scanners (IOSs) were considered. These variables included ambient lighting, scanning pattern, implant scan body (ISB) design, techniques for splinting ISBs, arch location, implant position, and inter-implant distance. RESULTS Among operator-related factors, ambient lighting conditions, scanning pattern, and ISB design (material, geometry, and retention design) can impact the accuracy of intraoral digital implant scans. The optimal ISB for maximizing IOS accuracy is unclear; however, polymer ISB can wear with multiple reuse and sterilization methods. Among patient-related factors, additional variables should be considered, namely arch (maxillary vs. mandibular arch), implant position in the arch, inter-implant distance, implant depth, and angulation. CONCLUSIONS Ambient lighting conditions should be established based on the IOS selected to optimize the accuracy of intraoral digital implant scans. The optimal scanning pattern may vary based on the IOS, clinical situation, and the number of implants. The optimal ISB design may vary depending on the IOS used. Metallic implant scan bodies are preferred over polymer ISB designs to minimize wear due to multiple use and sterilization distortion. Among patient-related factors, additional variables should be considered namely the arch scanned, implant position in the arch, inter-implant distance, implant depth, and angulation. The impact of these factors may vary depending on the IOS selected.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Alejandro Lanis
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - John C Kois
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Taskiran E, Yilmaz B, Akgun MY, Kemerdere R, Uzan M, Isler C. Neurophysiologic cut off values for safe resection of patients with supratentorial gliomas. Acta Neurochir (Wien) 2023; 165:4227-4234. [PMID: 37917380 DOI: 10.1007/s00701-023-05865-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/21/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Gliomas have infiltrative nature and tumor volume has direct prognostic value. Optimal resection limits delineated by high-frequency monopolar stimulation with multipulse short train technique is still a matter of debate for safe surgery without (or with acceptable) neurological deficits. It is also an enigma whether the same cut-off values are valid for high and low grades. We aimed to analyze the value of motor mapping/monitoring findings on postoperative motor outcome in diffuse glioma surgery. METHODS Patients who were operated on due to glioma with intraoperative neuromonitorization at our institution between 2017 and 2021 were analyzed. Demographic information, pre- and post-operative neurological deficit, magnetic resonance images, resection rates, and motor evoked potential (MEP) findings were analyzed. RESULTS Eighty-seven patients of whom 55 had high-grade tumors were included in the study. Total/near-total resection was achieved in 85%. Subcortical motor threshold (ScMTh) from resection cavity to the corticospinal tract was ≤ 2mA in 17; 3 mA in 14; 4 mA in 6; 5 mA in 7, and ≥5mA in 50 patients. On the 6th month examination, six patients (5 with high-grade tumor) had motor deficits. These patients had changes in MEP that exceeded critical threshold during monitoring. Receiver operating characteristic analysis revealed 2.5 mA ScMTh as the cut-off point for limb paresis after awakening and 6 months for the groups. CONCLUSIONS Subcortical mapping with MEP monitoring helps to achieve safe wider resection. The optimal safe limit for SCMTh was determined as 2.5 mA. Provided that safe threshold values are maintained in MEP, surgeon may force the functional limits by lowering the SCMTh to 1 mA, especially in low-grade gliomas.
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Affiliation(s)
- E Taskiran
- Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - B Yilmaz
- Department of Neurology, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - M Y Akgun
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - R Kemerdere
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - M Uzan
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - C Isler
- Department of Neurosurgery, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
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Donmez MB, Güven ME, Yılmaz D, Abou-Ayash S, Çakmak G, Yilmaz B. Trueness and precision of combined healing abutment scan body system scans at different sites of maxilla after multiple repositioning of the scan body. J Dent 2023; 139:104716. [PMID: 37739057 DOI: 10.1016/j.jdent.2023.104716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/23/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVES To evaluate the accuracy of the scans of the combined healing abutment-scan body (CHA-SB) system located at different sites of the maxilla when SBs are replaced in between each scan. METHODS Three SBs were seated into HAs located at the central incisor, first premolar, and first molar sites of a maxillary model inside a phantom head, and the model was scanned extraorally (CEREC Primescan SW 5.2). This procedure was repeated with new SBs until a total of 10 scans were performed. Standard tessellation language files of CHA-SBs at each implant location were isolated, transferred into analysis software (Geomagic Control X), and superimposed over the proprietary library files to analyze surface (root mean square), linear, and angular deviations. Trueness and precision were evaluated with one-way analysis of variance and Tukey tests. The correlation between surface and angular deviations was analyzed with Pearson's correlation (α=0.05). RESULTS Molar implant scans had the highest surface and angular deviations (P≤.006), while central incisor implant scans had higher precision (surface deviations) than premolar implant scans (P=.041). Premolar implant scans had higher accuracy than central incisor implant scans on the y-axis (P≤.029). Central incisor implant scans had the highest accuracy on the z-axis (P≤.018). A strong positive correlation was observed between surface and angular deviations (r = 0.864, P<.001). CONCLUSION Central incisor implant scans mostly had high accuracy and molar implant scans mostly had lower trueness. SBs were mostly positioned apically; however, the effect of SB replacement can be considered small as measured deviations were similar to those in previous studies and the precision of scans was high. CLINICAL SIGNIFICANCE Repositioning of scan bodies into healing abutments would be expected to result in similar single crown positioning regardless of the location of the implant, considering high scan precision with the healing abutment-scan body system. The duration of the chairside adjustments of crowns in the posterior maxilla may be longer than those in the anterior region.
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Affiliation(s)
- Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Mehmet Esad Güven
- Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Deniz Yılmaz
- Department of Prosthodontics, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Ohio, United States of America
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Çakmak G, Asadolahi NW, Schimmel M, Molinero-Mourelle P, Akay C, Donmez MB, Yilmaz B. Effect of coffee thermal cycling on the surface properties and stainability of additively manufactured denture base resins in different layer thicknesses. J Prosthodont 2023. [PMID: 37968565 DOI: 10.1111/jopr.13803] [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: 02/16/2023] [Revised: 10/25/2023] [Accepted: 11/09/2023] [Indexed: 11/17/2023] Open
Abstract
PURPOSE To compare the effect of coffee thermal cycling on surface roughness (Ra), Vickers microhardness (MH), and stainability of denture base resins additively manufactured in different layer thicknesses with those of subtractively manufactured denture base materials. MATERIALS AND METHODS Eighty disk-shaped specimens (Ø10×2 mm) were fabricated from two subtractively (Merz M-PM [SM-M] and G-CAM [SM-G]) and three additively (NextDent 3D+ [50 µm, AM-N-50; 100 µm, AM-N-100], FREEPRINT Denture [50 µm, AM-F-50; 100 µm, AM-F-100], and Denturetec [50 µm, AM-S-50; 100 µm, AM-S-100]) manufactured denture base materials (n = 10). Ra measurements were performed before and after polishing by using a non-contact optical profilometer, while MH values and color coordinates were measured after polishing. Specimens were then subjected to 5000 cycles of coffee thermal cycling, all measurements were repeated, and color differences (ΔE00) were calculated. A linear mixed effect model was used to analyze Ra and MH data, while one-way analysis of variance was used to analyze ΔE00 data (α = 0.05). Ra values were further evaluated according to a clinically acceptable threshold of 0.2 µm, while ΔE00 values were evaluated according to perceptibility (1.72 units) and acceptability (4.08 units) thresholds. The interaction between the material type and the time interval affected both Ra and MH (p ≤ 0.001). Tested materials had their highest Ra before polishing (p ≤ 0.029). Before polishing, AM-F-100 had the highest, and SM-M and SM-G had the lowest Ra (p < 0.001). After polishing and after coffee thermal cycling, SM-G mostly had lower Ra than those of other materials (p ≤ 0.036). SM-G mostly had higher MH than that of other materials before and after coffee thermal cycling (p ≤ 0.025). Coffee thermal cycling reduced the MH of SM-M and increased that of AM-S-100 (p ≤ 0.024). AM-N-100 had higher ΔE00 than AM-F, AM-S-100, and SM-G (p ≤ 0.009), while AM-F and SM-G had lower ΔE00 than AM-S-50 and AM-N-50 (p ≤ 0.024). CONCLUSIONS Polishing reduced the surface roughness of all materials, whereas the effect of coffee thermal cycling was nonsignificant. Most of the tested materials had acceptable surface roughness after polishing and after coffee thermal cycling according to the reported threshold. Layer thickness only affected the microhardness of tested additively manufactured resins, which was material-dependent. Subtractively manufactured specimens mostly had high microhardness and that of nonreinforced subtractively manufactured resin decreased after coffee thermal cycling. When reported color thresholds are considered, all materials had acceptable color stability.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Nura Watson Asadolahi
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Canan Akay
- Department of Prosthodontics, Faculty of Dentistry, Osmangazi University, Eskisehir, Turkey
- Translational Medicine Research and Clinical Center, Osmangazi University, Eskisehir, Turkey
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Ohio, USA
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Raabe C, Abou-Ayash S, Yilmaz B, Surbek FJ, Chappuis V, Couso-Queiruga E. Positional accuracy during the sequence of static computer-assisted implant surgery in three alveolar ridge morphologies: An in vitro study. J Prosthodont 2023. [PMID: 37955870 DOI: 10.1111/jopr.13798] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/10/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023] Open
Abstract
PURPOSE This in vitro study aimed to assess the positional accuracy during the sequence of static computer-assisted implant surgery (sCAIS) according to the anatomical characteristics of the alveolar ridge. MATERIAL AND METHODS Maxillary bone models with six single tooth gaps including clinical scenarios of healed alveolar ridge (HR), single-rooted (SRS), and three-rooted socket (TRS) morphologies were used in this study. Positional deviations during implant placement procedures were evaluated after the pilot osteotomy (PD), final osteotomy (FD), and implant placement with respect to the pre-planned implant position by using a software package. ANOVA and post hoc analyses were performed. RESULTS A total of 90 implants were included in this study. Higher mean angular, crestal, and apical deviations were found after the PD and FD (3.5 ± 2.4°, 0.7 ± 0.3 mm, and 1.4 ± 0.8 mm versus 3.6 ±2.2°, 0.6 ± 0.3 mm, and 1.2 ± 0.6 mm) compared to IP (2.8 ± 1.6°, 0.7 ± 0.3 mm, and 1.2 ± 0.5 mm, p ≤ 0.004). Implants placed in TRS demonstrated higher mean angular, crestal, and apical deviations (4.0 ± 1.7°, 0.8 ± 0.3 mm, and 1.6 ± 0.5 mm) compared to implants placed in SRS (2.5 ± 1.2°, 0.7 ± 0.3 mm, and 1.1 ± 0.4 mm) or HR (2.0 ± 0.9°, 0.5 ± 0.3 mm, and 0.8 ± 0.4 mm, p < 0.001). CONCLUSIONS Positional deviations during sCAIS procedures are initiated with the first implant osteotomy and persist throughout the drilling sequence. However, deviations slightly decreased after implant placement. The alveolar ridge morphology is strongly associated with positional deviations. Higher deviations were observed in three-rooted and single-rooted sockets simulating an immediate approach compared to healed sites simulating a delayed protocol.
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Affiliation(s)
- Clemens Raabe
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Fiona Jennifer Surbek
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Emilio Couso-Queiruga
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Çakmak G, Donmez MB, de Paula MS, Akay C, Fonseca M, Kahveci Ç, Abou-Ayash S, Yilmaz B. Surface roughness, optical properties, and microhardness of additively and subtractively manufactured CAD-CAM materials after brushing and coffee thermal cycling. J Prosthodont 2023. [PMID: 37947220 DOI: 10.1111/jopr.13796] [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: 05/30/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 11/12/2023] Open
Abstract
PURPOSE To evaluate the surface roughness, optical properties, and microhardness of additively or subtractively manufactured CAD-CAM materials after simulated brushing and coffee thermal cycling. MATERIAL AND METHODS Two additively manufactured resins (Crowntec, CT and VarseoSmile Crown Plus, VS) and 3 subtractively manufactured materials (a reinforced composite (Brilliant Crios, BC), a polymer-infiltrated ceramic network (Enamic, VE), and a feldspathic ceramic (Mark II, VM)) were used to fabricate disk-shaped specimens (Ø10×1-mm) (n = 10). Surface roughness, Vickers microhardness, and color coordinates were measured after polishing, while surface roughness was also measured before polishing. Specimens were then subjected to 25000 cycles of brushing and 10000 cycles of coffee thermal cycling, and measurements were repeated after each time interval. Color difference (ΔE00 ) and relative translucency parameter (RTP) were calculated. Robust analysis of variance test was used to evaluate surface roughness, ΔE00 , and RTP data, while generalized linear model analysis was used for microhardness data (α = 0.05). RESULTS Material type and time interval interaction affected tested parameters (p ≤ 0.002). In addition, material type affected all parameters (p < 0.001) other than surface roughness (p = 0.051), and time interval affected surface roughness and microhardness values (p < 0.001). Tested materials mostly had their highest surface roughness before polishing (p ≤ 0.026); however, there was no clear trend regarding the roughness of materials within different time intervals along with ΔE00 and RTP values within materials or time intervals. VS and CT had the lowest microhardness regardless of the time interval, while the remaining materials were listed as VM, VE, and BC in decreasing order (p < 0.001). Coffee thermal cycling only reduced the microhardness of VM (p < 0.001). CONCLUSIONS Tested additively manufactured resins can be considered more susceptible to simulated brushing and coffee thermal cycling than the other materials, given the fact that their surface roughness and ΔE00 values were higher than previously reported acceptability thresholds and because they had the lowest microhardness after all procedures were complete.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prosthodontics, Faculty of Dentistry, Istinye Univeristy, İstanbul, Turkey
| | - Marcella Silva de Paula
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prevention and Oral Rehabilitation, Universidade Federal de Goiás, Goiánia, GO, Brazil
| | - Canan Akay
- Department of Prosthodontics, Faculty of Dentistry, Eskisehir Osmangazi Univeristy, Eskisehir, Turkey
- Translational Medicine Research and Clinical Center, Osmangazi University, Eskisehir, Turkey
| | - Manrique Fonseca
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
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Atalay S, Çakmak G, Fonseca M, Schimmel M, Yilmaz B. Effect of different disinfection protocols on the surface properties of CAD-CAM denture base materials. J Prosthet Dent 2023; 130:787-795. [PMID: 35148889 DOI: 10.1016/j.prosdent.2021.12.007] [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: 07/21/2021] [Revised: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 02/04/2023]
Abstract
STATEMENT OF PROBLEM Which disinfection protocol provides optimal water contact angle and microhardness for computer-aided design and computer-aided manufacturing (CAD-CAM) polymethyl methacrylate (PMMA) materials is unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of different disinfection protocols (1% sodium hypochlorite, denture cleanser gel, and effervescent tablet) on the water contact angle and microhardness of different CAD-CAM PMMA denture base materials by comparing them with a heat-polymerized PMMA. MATERIAL AND METHODS Disk-shaped specimens (Ø10×2 mm) were fabricated from 3 different CAD-CAM PMMAs-AvaDent (AV), Merz M-PM (M-PM), and Polident (Poli)-and a heat-polymerized PMMA (Vynacron) (CV) (n=21). Three disinfection protocols (1% sodium hypochlorite [HC], denture cleanser gel [GEL], an effervescent tablet [TAB]) were applied to simulate 180 days of cleansing. The water contact angle and microhardness of specimens were measured before and after disinfection and compared by using a 2-way ANOVA (α=.05). RESULTS For water contact angle, material (P=.010) and disinfection protocol (P=.002) had a significant effect. The material (P<.001), disinfection protocol (P=.001), and their interaction (P<.001) significantly affected the microhardness after disinfection. When the condition after disinfection was compared with that before disinfection, the water contact angle increased significantly in all material-disinfection protocol pairs (P≤.025), and microhardness increased significantly in all material-disinfection protocol pairs (P≤.040), except for GEL- (P=.689) or TAB-applied (P=.307) AV, HC-applied M-PM (P=.219), and TAB-applied Poli (P=.159). CONCLUSIONS The material and disinfection protocol affected the water contact angle of all tested PMMAs after disinfection, resulting in more hydrophobic surfaces for heat-polymerized or CAD-CAM PMMAs. The microhardness of heat-polymerized PMMA was less than that of all CAD-CAM PMMAs after disinfection, regardless of the protocol.
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Affiliation(s)
- Sevda Atalay
- Assistant Professor, Department of Prosthodontics, Istanbul Okan University, Faculty of Dentistry, Istanbul, Turkey
| | - Gülce Çakmak
- Buser Foundation Scholar for Implant Dentistry, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Manrique Fonseca
- Senior Lecturer, Department of Reconstructive Dentistry and Gerodontology. School of Dental Medicine University of Bern, Bern, Switzerland.
| | - Martin Schimmel
- Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; External Researcher, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
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Revilla-León M, Barmak AB, Tohme H, Yilmaz B, Kois JC, Gómez-Polo M. Factors that influence the accuracy of maxillomandibular relationship at maximum intercuspation acquired by using intraoral scanners: A systematic review. J Dent 2023; 138:104718. [PMID: 37775027 DOI: 10.1016/j.jdent.2023.104718] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/11/2023] [Accepted: 09/20/2023] [Indexed: 10/01/2023] Open
Abstract
OBJECTIVE To review the factors that influence the accuracy of the maxillomandibular relationship at maximum intercuspation (MIP) acquired by using intraoral scanners (IOSs). MATERIAL AND METHODS A systematic search was performed using five databases: MEDLINE/PubMed, Cochrane, Embase, World of Science, and Scopus. A manual search was also completed. Studies assessing the factors that influence the MIP acquired by using IOSs were included and organized based on the analyzed factor. Studies were evaluated by applying the Joanna Briggs Institute Critical Appraisal Checklist. RESULTS Twenty-nine articles were included. Seven factors have been identified: IOS system, scan extension, edentulous areas, number, location, and extension of occlusal records, occlusal force, tooth mobility, and alignment methods. Nine studies evaluated the influence of IOS system. Four studies assessed the influence of the extension of the arch scan. Three studies evaluated the effect of edentulous spaces. Four studies agreed on the impact of the number, location, and extension of the occlusal records on the MIP accuracy. One study assessed the influence of the occlusal force, showing a smaller average interocclusal space with increased occlusal force. One study evaluated the influence of tooth mobility. Seven studies analyzed the influence of the alignment method on the MIP accuracy. CONCLUSIONS Most of the studies reported no difference on the MIP accuracy between half- and complete-arch scans. Areas with 2 or more missing teeth reduce the MIP accuracy. A bilateral and frontal record including 2 teeth or a bilateral posterior occlusal including at least 4-teeth is indicated for maximizing the MIP accuracy. CLINICAL IMPLICATIONS When a complete-arch intraoral scans is obtained, a bilateral and frontal record including 2 teeth or a bilateral posterior occlusal record including at least 4-teeth is recommended for maximizing the accuracy of the MIP. When a half-arch intraoral scan is acquired, a posterior occlusal record including at least 4-teeth is indicated for optimizing the accuracy of the MIP.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA; Faculty & Director of Research and Digital Dentistry, Kois Center, Seattle, WA, USA; Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, MA, USA.
| | - Abdul B Barmak
- Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Hani Tohme
- Founder and Head of Digital, AI, and Evolving Technologies, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Ohio, USA
| | - John C Kois
- Founder and Director Kois Center, Seattle, WA, USA; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, WA, USA; Private Practice, Seattle, WA, USA
| | - Miguel Gómez-Polo
- School of Dentistry, Complutense University of Madrid, Madrid, Spain
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Yilmaz B, Guo X, Schimmel M, Abou-Ayash S. Effect of industrial scanner and framework material interaction on the marginal gaps of CAD-CAM complete arch implant frameworks. J Prosthet Dent 2023; 130:723-730. [PMID: 34998580 DOI: 10.1016/j.prosdent.2021.10.013] [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: 07/18/2021] [Revised: 10/18/2021] [Accepted: 10/18/2021] [Indexed: 12/27/2022]
Abstract
STATEMENT OF PROBLEM Structured-light and computed tomography industrial scanners have been used as reference scanners to measure marginal gaps between implants and superstructures. However, the effect of framework material on the scanners' ability to detect gaps and on precision has not yet been evaluated. PURPOSE The purpose of this in vitro study was to investigate the interaction between the industrial scanner and framework material on measured marginal gaps of implant-supported fixed complete arch frameworks made from titanium and polymethylmethacrylate and on the precision of scans. MATERIAL AND METHODS A completely edentulous maxillary model with 4 implants and multiunit abutments at the first molar and canine sites was digitized by using a laboratory scanner. Implant-supported frameworks were milled from titanium and polymethylmethacrylate (n=5). Each framework was secured on the left molar site abutment. The marginal gaps between the frameworks and abutment sites without a screw were measured by using an industrial structured-light scanner and an industrial computed tomography scanner. The effect of the scanner, the framework material, and their interaction on measured gaps was analyzed by applying linear regressions and weighted least square methods. The F-statistics was used with Bonferroni corrections for precision analysis (α=.05). RESULTS No significant effect of scanner, material, or their interaction was found on the marginal gaps at the canine sites. The titanium framework gaps detected by using the computed tomography scanner were greater than those detected by using the structured-light scanner at the right molar site (estimated difference in means=0.054 mm; P=.003) and overall (estimated difference in means=0.023 mm; P=.033). The structured-light scanner's precision was higher than that of the computed tomography scanner when titanium frameworks were scanned (P=.001). The computed tomography scanner's precision was higher when scanning polymethylmethacrylate frameworks than when scanning titanium frameworks (P=.03). CONCLUSIONS Framework material and industrial scanner interaction affected the measured gaps. The computed tomography scanner detected greater marginal gaps with low precision when scanning titanium frameworks than the structured-light scanner. The sample size, the use of only 2 types of materials, and a laboratory scanner to obtain the computer-aided design file should be considered when interpreting the results.
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Affiliation(s)
- Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Xiaohan Guo
- PhD student, Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Martin Schimmel
- Department Head, Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland; Senior Lecturer, Extra muros, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Samir Abou-Ayash
- Senior Lecturer and Head of the Section of Digital Implant and Reconstructive Dentistry, Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.
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Donmez MB, Çakmak G, Dede DÖ, Küçükekenci AS, Lu WE, Schumacher FL, Revilla-León M, Yilmaz B. Effect of scan powder and scanning technology on measured deviations of complete-arch implant supported frameworks digitized with industrial and intraoral scanners. J Dent 2023; 138:104736. [PMID: 37802291 DOI: 10.1016/j.jdent.2023.104736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/08/2023] [Accepted: 10/03/2023] [Indexed: 10/08/2023] Open
Abstract
OBJECTIVES To evaluate the suitability of intraoral scanners (IOSs) to analyze the fabrication trueness of titanium complete-arch implant-supported frameworks by comparing with an industrial-grade scanner and investigate how anti-reflective scan powder affects measured deviations. METHODS Ten titanium complete-arch implant-supported frameworks were milled from a reference standard tessellation language (STL) file. An industrial-grade blue light scanner (ATOS Core 80 (AT)) and three IOSs (Primescan (PS), TRIOS T3 (T3), and TRIOS T4 (T4)) with (PS-P, T3-P, and T4-P) or without (PS, T3, and T4) anti-reflective scan powder application were used to generate test STL (TSTL) files of the frameworks. Reference STL and TSTLs were imported into a metrology-grade analysis software (Geomagic Control X) and whole surface root mean square (RMS) values were calculated. Another software (Medit Link v 2.4.4) was used to virtually isolate marginal surfaces of all STL files and marginal RMS values were calculated by using the same metrology-grade analysis software. A linear mixed effects model was used to compare the transformed deviations of the scans performed by using each IOS (with or without powder) with the deviations of those performed by using the reference AT scanner within each surface, where a Box-Cox type transformation was used for variance stability. Bonferroni corrected post-hoc tests were used to compare conditions within each IOS (α=0.05). RESULTS All IOSs had significantly higher whole surface and marginal RMS values than AT, regardless of the condition (P≤.002). However, scan powder application did not affect the whole surface and marginal RMS values in scans of tested IOSs (P≥.054). CONCLUSION Measured whole surface and marginal deviations in all IOS scans performed with or without the use of scan powder were higher than those in AT scans. The application of anti-reflective scan powder did not affect the deviations in scans of tested IOSs. CLINICAL SIGNIFICANCE Even though deviations measured in the scans of tested scanners were significantly different than those in the reference scanner, the maximum raw mean difference was 37.33 µm and the maximum raw confidence interval value of estimated differences was 47.88 µm, which can be considered clinically small taking into account the size of the frameworks tested. Therefore, tested intraoral scanners may be feasible to scan prostheses similar to or smaller than tested frameworks for fabrication trueness analysis, which may facilitate potential clinical adjustments.
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Affiliation(s)
- Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Doğu Ömür Dede
- Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | | | - Wei-En Lu
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Fernanda Lang Schumacher
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Washington, USA; Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Çakmak G, Güven ME, Donmez MB, Kahveci Ç, Schimmel M, Abou-Ayash S, Yilmaz B. Effect of internal connection type and screw channel angle on the screw stability of anterior implant-supported zirconia crowns. Clin Oral Implants Res 2023; 34:1248-1256. [PMID: 37578653 DOI: 10.1111/clr.14165] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/14/2023] [Accepted: 08/02/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVES To investigate the effect of implant-abutment connection and screw channel angle on screw stability by comparing a newly introduced and an established connection, before and after cyclic loading. MATERIALS AND METHODS Implants (N = 44) with Torcfit (TF) or Crossfit (CF) connection were divided to be restored with a straight (CFS and TFS) or an angled screw access channel (CFA and TFA) titanium-base abutment (n = 11). CFA and TFA received screw-retained crowns, whereas CFS and TFS received hybrid zirconia abutments and cement-retained crowns. The initial torque value (ITV) of each complex (ITVI ) and removal torque value (RTV) after 24 h (RTVI ) were measured. Screws were replaced with new ones, ITVs were recorded again (ITVF ), and crowns were cyclically loaded (2.4 million cycles, 98 N) to measure RTVs again (RTVF ). Percentage torque loss was calculated. Data were analyzed (α = 0.05). RESULTS ITVs were similar among groups (p ≥ .089). CF led to higher RTVs (p ≤ .002), while CFS had higher RTVI than CFA (p = .023). After 24 h, CFS had lower percentage torque loss than TF, while CFA had lower percentage torque loss than TFA (p ≤ .011). After cyclic loading, CF led to lower percentage torque (p < .001). CONCLUSION The implant-abutment connection affected the removal torque values. However, no screw loosening occurred during cyclic loading, which indicated a stable connection for all groups. Screw access channel angle did not affect screw stability after cyclic loading.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mehmet Esad Güven
- Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey
| | | | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Samir Abou-Ayash
- Section of Digital Implant and Reconstructive Dentistry, Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Yilmaz B, Dede DÖ, Donmez MB, Küçükekenci AS, Lu WE, Schumacher FL, Çakmak G. Comparison of intraoral and laboratory scanners to an industrial-grade scanner while analyzing the fabrication trueness of polymer and titanium complete-arch implant-supported frameworks. J Dent 2023; 138:104697. [PMID: 37696469 DOI: 10.1016/j.jdent.2023.104697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES To compare the scans of different intraoral scanners (IOSs) and laboratory scanners (LBSs) to those of an industrial-grade optical scanner by measuring deviations of complete-arch implant-supported frameworks from their virtual design file. MATERIAL AND METHODS Ten polyetheretherketone (PEEK) and 10 titanium (Ti) complete-arch implant-supported frameworks were milled from a master standard tessellation language (STL) file. An industrial-grade blue light scanner (AT), 2 LBSs (MT and E4), and 3 IOSs (PS, T3, and T4) were used to generate STL files of these frameworks. All STLs were imported into an analysis software (Geomagic Control X) and overall root mean square (RMS) values were calculated. Marginal surfaces of all STL files were then virtually isolated (Medit Link v 2.4.4) and marginal RMS values were calculated. Deviations in scans of tested scanners were compared with those in scans of AT by using a linear mixed effects model (α = 0.05). RESULTS When the scans of PEEK frameworks were considered, PS and T3 had similar overall RMS to those of AT (p ≥ .076). However, E4 and T4 had higher and MT had lower overall RMS than AT (p ≤ .002) with a maximum estimated mean difference of 13.41 µm. When the scans of Ti frameworks were considered, AT had significantly lower overall RMS than tested scanners (p ≤ .010) with a maximum estimated mean difference of 31.35 µm. Scans of tested scanners led to significantly higher marginal RMS than scans of AT (p ≤ .006) with a maximum estimated mean difference of 53.90 µm for PEEK and 40.50 µm for Ti frameworks. CONCLUSION Only the PEEK framework scans of PS and T3 led to similar overall deviations to those of AT. However, scans of all tested scanners resulted in higher marginal deviations than those of AT scans. CLINICAL SIGNIFICANCE Scans performed by using PS and T3 may be alternatives to those of tested reference industrial scanner AT, for the overall fabrication trueness analysis of complete-arch implant-supported PEEK frameworks.
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Affiliation(s)
- Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, OH, USA
| | - Doğu Ömür Dede
- Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey.
| | | | - Wei-En Lu
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Fernanda Lang Schumacher
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH, USA
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Cho JH, Yi Y, Choi J, Ahn J, Yoon HI, Yilmaz B. Time efficiency, occlusal morphology, and internal fit of anatomic contour crowns designed by dental software powered by generative adversarial network: A comparative study. J Dent 2023; 138:104739. [PMID: 37804938 DOI: 10.1016/j.jdent.2023.104739] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/26/2023] [Accepted: 10/05/2023] [Indexed: 10/09/2023] Open
Abstract
OBJECTIVES To evaluate the time efficiency, occlusal morphology, and internal fit of dental crowns designed using generative adversarial network (GAN)-based dental software compared to conventional dental software. METHODS Thirty datasets of partial arch scans for prepared posterior teeth were analyzed. Each crown was designed on each abutment using GAN-based software (AI) and conventional dental software (non-AI). The AI and non-AI groups were compared in terms of time efficiency by measuring the elapsed work time. The difference in the occlusal morphology of the crowns before and after design optimization and the internal fit of the crown to the prepared abutment were also evaluated by superimposition for each software. Data were analyzed using independent t tests or Mann-Whitney test with statistical significance (α=.05). RESULTS The working time was significantly less for the AI group than the non-AI group at T1, T5, and T6 (P≤.043). The working time with AI was significantly shorter at T1, T3, T5, and T6 for the intraoral scan (P≤.036). Only at T2 (P≤.001) did the cast scan show a significant difference between the two groups. The crowns in the AI group showed less deviation in occlusal morphology and significantly better internal fit to the abutment than those in the non-AI group (both P<.001). CONCLUSIONS Crowns designed by AI software showed improved outcomes than that designed by non-AI software, in terms of time efficiency, difference in occlusal morphology, and internal fit. CLINICAL SIGNIFICANCE The GAN-based software showed better time efficiency and less deviation in occlusal morphology during the design process than the conventional software, suggesting a higher probability of optimized outcomes of crown design.
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Affiliation(s)
- Jun-Ho Cho
- Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Yuseung Yi
- Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Jinhyeok Choi
- Department of Biomedical Sciences, Seoul National University, Seoul, Republic of Korea
| | - Junseong Ahn
- Department of Computer Science, Korea University, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, United States
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Dönmez MB, Çakmak G, Sabatini GP, Kahveci Ç, Orgev A, Yoon HI, Revilla-Léon M, Yilmaz B. Effect of polymerization unit, polishing, and coffee thermocycling on the color and translucency of additively manufactured resins used for definitive prostheses. INT J PROSTHODONT 2023; 0:4500423. [PMID: 37824339 DOI: 10.11607/ijp.7406] [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: 10/14/2023]
Abstract
PURPOSE To evaluate the effect of polymerization unit, polishing, and coffee thermocycling on the color and translucency of additively manufactured polyurethane-based resins with different viscosities. In addition, their color behavior was compared with the color of the shade tab throughout the fabrication steps and aging. MATERIALS AND METHODS Disk-shaped specimens (Ø10x2 mm) were fabricated from polyurethane-based resins with different viscosities (Tera Harz TC-80DP and C&B permanent) (N=30). Baseline color coordinates were measured after cleaning. The specimens were divided into 3 to be polymerized with different polymerization units (Otoflash G171, FLN; Wash and Cure 2.0, CLED1; CARES P Cure, CLED2) (n=10), polished, and subjected to coffee thermocycling. Color coordinates were remeasured after each process. Color differences (ΔE00) and relative translucency parameter (RTP) values were calculated. Data were statistically analyzed (α=.05). RESULTS Time points and polymerization units affected the ΔE00 for each material (P≤.049). ΔE00 of each polymerization unit pair had significant differences within and among different time points within each material (P≤.024). ΔE00, when compared with the shade tab, and RTP were mostly affected by polymerization units and time points within both materials (P≤.042). CONCLUSION Tested polymerization units, polishing, and coffee thermocycling affected the color difference and translucency of tested resins. Color differences ranged from moderately unacceptable to extremely unacceptable and the differences in translucency values mostly ranged from perceptible to unacceptable according to previous thresholds. In addition, tested resin-polymerization unit pairs had unacceptable color differences when compared to the shade tab. CLED1 may enable higher color stability for tested resins.
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Fonseca M, Molinero-Mourelle P, Donmez MB, Abou-Ayash S, Buser D, Sculean A, Yilmaz B. Management of compromised spacing in the esthetic zone by combining an ultra-thin partial ceramic veneer and a ceramic implant crown: a case report of a multi-disciplinary approach and technique description. INT J PERIODONT REST 2023; 0:4497207. [PMID: 37819849 DOI: 10.11607/prd.6626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Dental implants have been commonly used to replace missing single teeth. However, esthetic rehabilitation of an adjacent tooth may also be required due to diastemas, crowding, or existing large direct restorations to improve the final esthetic outcome. With the advancements in ceramics and bonding techniques, minimally invasive esthetic approaches have become viable for compromised spacing issues. This case report describes a dental technique for the esthetic rehabilitation of compromised anterior spacing with a customized zirconia implant abutment at maxillary central incisor site and a partial ceramic veneer bonded to adjacent central incisor.
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Azpiazu-Flores FX, Johnston WM, Mata-Mata SJ, Yilmaz B. Positional trueness of three removable die designs with different root geometries manufactured using stereolithographic 3D printing. J Prosthet Dent 2023:S0022-3913(23)00606-6. [PMID: 37802737 DOI: 10.1016/j.prosdent.2023.08.036] [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: 06/28/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 10/08/2023]
Abstract
STATEMENT OF PROBLEM Three-dimensional (3D) printed casts are a suitable alternative to dental stone casts. Contemporary dental design computer programs permit designing definitive casts with removable dies with different root geometries and retention mechanisms. Studies on the positional trueness of 3D-printed removable dies with different root geometries are lacking. PURPOSE The purpose of this in vitro study was to investigate the 3D displacements of three 3D-printed removable die designs with different root geometries. MATERIAL AND METHODS The digital file of a dental stone alveolar cast with root-form removable dies (MOD UJ IV Fixed Prosthetics; Ivoclar AG) was used as a reference to create 3 removable die and alveolar cast designs (Root Form, RF; Conical, CON; Cylindric, CYL) with different root geometries in 2 dental design computer programs (DentalCAD 3.1 Rijeka; exocad; GmbH; InLab CAD 22.0; Dentsply Sirona). 3 equidistant Ø1-mm spheres (C, Cervical; M, Middle; O, Occlusal) were designed on the buccal surface of the coronal portion of the removable die to evaluate their displacement. A total of 45 alveolar casts with 45 removable dies were fabricated using a stereolithographic 3D printer (Form 3; Formlabs); each die group consisted of 15 specimens. After fabrication and postprocessing, the specimens were scanned, and their digital files were analyzed in a metrology-grade computer program to evaluate the displacement of the removable dies with respect to the position of the die in the master reference file. Subsequently, the data were analyzed using a 3-way analysis of variance (ANOVA) followed by step-down Bonferroni-corrected pairwise comparisons (α=.05). RESULTS Two statistically significant 2-way interactions were detected between the independent variables, die design and direction (P<.001), and location and direction (P<.001). The post hoc analysis identified significant differences between the displacement values of RF and CYL (P<.001) and RF and the CON (P<.001) designs on the Y axis. The measured displacements were statistically different between the C and O locations on the Y axis (P=.001) and the M and O locations on the Z axis (P=.006). CONCLUSIONS The root geometry of a 3D-printed removable die and alveolar cast can affect seating, and variable degrees of tipping of the removable die can be seen. The seating and congruence of the removable die with the interocclusal space and relationships observed intraorally should be confirmed before adjusting indirect restorations.
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Affiliation(s)
- Francisco X Azpiazu-Flores
- ITI Scholar, Department of Prosthodontics, School of Dentistry, Indiana Univeristy, Indianapolis, Ind; and Assistant Professor, Department of Restorative Dentistry, Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Canada
| | - William M Johnston
- Professor Emeritus, Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio
| | - Severino J Mata-Mata
- Assistant Professor, Faculty of Dentistry, Francisco Marroquín University (UFM), Guatemala City, Guatemala
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio..
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Kois JC, Zeitler JM, Barmak AB, Yilmaz B, Gómez-Polo M, Revilla-León M. Discrepancies in the occlusal devices designed by an experienced dental laboratory technician and by 2 artificial intelligence-based automatic programs. J Prosthet Dent 2023:S0022-3913(23)00551-6. [PMID: 37798183 DOI: 10.1016/j.prosdent.2023.08.015] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 10/07/2023]
Abstract
STATEMENT OF PROBLEM Artificial intelligence (AI) models have been developed for different applications, including the automatic design of occlusal devices; however, the design discrepancies of an experienced dental laboratory technician and these AI automatic programs remain unknown. PURPOSE The purpose of this in vitro study was to compare the overall, intaglio, and occlusal surface discrepancies of the occlusal device designs completed by an experienced dental laboratory technician and two AI automatic design programs. MATERIAL AND METHODS Virtually articulated maxillary and mandibular diagnostic casts were obtained in a standard tessellation language (STL) file format. Three groups were created depending on the operator or program used to design the occlusal devices: an experienced dental laboratory technician (control group) and two AI programs, namely Medit Splints from Medit (Medit group) and Automate from 3Shape A/S (3Shape group) (n=10). To minimize the discrepancies in the parameter designs among the groups tested, the same printing material and design parameters were selected. In the control group, the dental laboratory technician imported the articulated scans into a dental design program (DentalCAD) and designed a maxillary occlusal device. The occlusal device designs were exported in STL format. In the Medit and 3Shape groups, the diagnostic casts were imported into the respective AI programs. The AI programs automatically designed the occlusal device without any further operator intervention. The occlusal device designs were exported in STL format. Among the 10 occlusal designs of the control group, a random design (shuffle deck of cards) was used as a reference file to calculate the overall, intaglio, and occlusal discrepancies in the specimens of the AI groups by using a program (Medit Design). The root mean square (RMS) error was calculated. Kruskal-Wallis, and post hoc Dwass-Steel-Critchlow-Fligner pairwise comparison tests were used to analyze the trueness of the data. The Levene test was used to assess the precision data (α=.05). RESULTS Significant overall (P<.001), intaglio (P<.001), and occlusal RMS median value (P<.001) discrepancies were found among the groups. Significant overall RMS median discrepancies were observed between the control and the Medit groups (P<.001) and the control and 3Shape groups (P<.001). Additionally, significant intaglio RMS median discrepancies were found between the control and the Medit groups (P<.001), the Medit and 3Shape groups (P<.001), and the control and 3Shape groups (P=.008). Lastly, significant occlusal RMS median discrepancies were found between the control and the 3Shape groups (P<.001) and the Medit and 3Shape groups (P<.001). The AI-based software programs tested were able to automatically design occlusal devices with less than a 100-µm trueness discrepancy compared with the dental laboratory technician. The Levene test revealed significant overall (P<.001), intaglio (P<.001), and occlusal (P<.001) precision among the groups tested. CONCLUSIONS The use of a dental laboratory technique influenced the overall, intaglio, and occlusal trueness of the occlusal device designs obtained. No differences were observed in the precision of occlusal device designs acquired among the groups tested.
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Affiliation(s)
- John C Kois
- Founder and Director, Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Private practice, Seattle, Wash
| | | | - Abdul B Barmak
- Associate Professor, Clinical Research and Biostatistics, Eastman Institute for Oral Health (EIOH), Medical Center, University of Rochester, Rochester, NY
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| | - Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain; Director, Specialist in Advanced Implant-Prosthesis Postgraduate Program, Complutense University of Madrid, Madrid, Spain
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass..
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Lee WJ, Jo YH, Yilmaz B, Yoon HI. Effect of build angle, resin layer thickness and viscosity on the surface properties and microbial adhesion of denture bases manufactured using digital light processing. J Dent 2023; 137:104608. [PMID: 37433380 DOI: 10.1016/j.jdent.2023.104608] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 06/20/2023] [Accepted: 07/08/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVES To investigate differences in the surface properties and microbial adhesion of denture base resins for digital light processing (DLP) with varying resin layer thicknesses (LT), build angles (BA), and resin viscosities. METHODS Two denture base resins for DLP with different viscosities (high and low) were used to prepare disk specimens applying two manufacturing parameters: 1) LT (50 or 100 μm) and 2) BA (0-, 45-, and 90-degree). Surface roughness and contact angle values were measured on the test surfaces (n=10 per group). Streptococcus oralis and Candida albicans absorbance was measured to assess microorganism attachment (n=6 per group). A three-way analysis of variance (ANOVA) was conducted, considering the main effects and their interactions (viscosity, LT, and BA). Post-hoc multiple pairwise comparisons were performed. All data were analyzed at a level of significance (P) of 0.05. RESULTS LT and BA significantly affected the surface roughness and contact angle of the specimens, depending on resin viscosity (P<.001). Absorbance measurement showed no significant interaction between the three factors (P>.05). However, significant interactions were observed between viscosity and BA (P<.05) and between LT and BA (P<.05). CONCLUSIONS Regardless of the viscosity and LT, discs with a 0-degree BA showed the least roughness. High-viscosity specimens fabricated with a 0-degree BA had the lowest contact angle. Regardless of the LT and viscosity, discs with a 0-degree BA showed the lowest S. oralis attachment. Attachment of C. albicans was the least on the disk with 50 μm LT, irrespective of the viscosity. CLINICAL SIGNIFICANCE Clinicians should consider the effects of LT and BA on surface roughness, contact angle, and microbial adhesion of DLP-generated dentures, which can differ depending on resin viscosity. A 50 μm LT and 0-degree BA can be used with a high-viscosity resin to fabricate denture bases with less microbial adhesion.
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Affiliation(s)
- Won-Jun Lee
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ye-Hyeon Jo
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - Hyung-In Yoon
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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Ciftci G, Somay SD, Ozcan I, Ozcelik TB, Yilmaz B. Prosthetic complications with mandibular bar-retained implant overdentures having distal attachments and metal frameworks: A 2- to 12-year retrospective analysis. J Prosthet Dent 2023; 130:573-580. [PMID: 34998584 DOI: 10.1016/j.prosdent.2021.11.016] [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: 04/19/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Abstract
STATEMENT OF PROBLEM Long-term reports on 2-implant-retained overdentures having metal frameworks and bars containing distal attachments are scarce. PURPOSE The purpose of this retrospective study was to evaluate prosthetic complications with 2-implant-retained mandibular overdentures with metal frameworks having either screw- or cement-retained cantilevered bars with distal attachments. MATERIAL AND METHODS Seventy-three edentulous study participants who had been treated with mandibular overdentures with 2 implants were included. The parameters assessed were acrylic resin fractures (base fracture, fracture at midline), debonding of teeth, opposing prosthesis fracture, need for relining or rebasing, abutment and bar screw loosening and fracture, ball or bar attachment or clip wear, fracture or detachment, bar fracture, and implant loss. Statistical analysis was performed by using the Mann-Whitney U test as the data were not normally distributed. The categorical variables between the groups were analyzed by using the Fisher exact test (α=.05). RESULTS Twenty-seven prostheses had a cement-retained bar, and 46 bars were screw-retained. Of 73 overdentures, 68 were metal-reinforced. The mean observation time was 5.9 years with a range between 2 and 12 years. The most common complication was wear of the Rhein 83 polymer attachment followed by bar screw loosening. The cumulative survival rate for overdentures was 91.9% at 6.8 years. The service life of cement-retained prostheses was significantly longer (P<.05). Bar, resin base, and mid-line fractures were only seen with cement-retained prostheses. The number of times an attachment change was required did not differ between cement- and screw-retained bars. Of 191 implants, 3 were lost, and the cumulative survival rate was 93.5% at 7.5 years. No significant difference was found between retention types in terms of implant loss (P>.05). CONCLUSIONS Based on the participant population observed, the survival rates of 2-implant-retained mandibular overdentures and their implants in the medium term were high. Wear of the polymer attachment was commonly seen. Overdentures with cement-retained bars had bar or acrylic resin fractures. Mandibular 2-implant-retained overdentures with a screw-retained bar containing bilateral distal attachments had fewer prosthetic complications and high implant survival in the medium term.
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Affiliation(s)
- Gozde Ciftci
- Postdoctoral Fellow, Baskent University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey
| | - Suphi Deniz Somay
- Postdoctoral Fellow, Baskent University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey
| | - Işıl Ozcan
- Postdoctoral Fellow, Baskent University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey
| | - Tuncer Burak Ozcelik
- Professor, Baskent University, Faculty of Dentistry, Department of Prosthodontics, Ankara, Turkey
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio.
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Yilmaz B, Dede DÖ, Diker E, Fonseca M, Johnston WM, Küçükekenci AS. Effect of cross-polarization filters on the trueness of colors obtained with a single-lens reflex camera, macro lens, and a ring flash. J ESTHET RESTOR DENT 2023; 35:878-885. [PMID: 37073977 DOI: 10.1111/jerd.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE To investigate the effect of cross-polarization filters on the colors of shade tabs obtained with a digital single-lens reflex (DSLR) camera, macrolens, and a ring flash. MATERIALS AND METHODS Digital images of four shade tables (1M1, 3L2.5, 3R2.5, and 5M3) from the VITA Toothguide 3D-Master shade guide were taken using a DSLR camera, 100 mm macrolens, and ring flash with two different cross-polarizing filters (Polar_eyes and Filtropolar), and without (Nonpolarizer; n = 7). The CIE L*a*b* color coordinates of digital images were calculated and remeasured with a spectroradiometer (SR). The color differences (ΔE00 ) between the SR and digital images were calculated and analyzed with the two-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05). RESULTS ΔE00 values of all test groups were higher than the clinically acceptable threshold (∆E00 > 1.80). While the ∆E00 values of Filtropolar (6.19 ± 0.44) and Polar_eyes (7.82 ± 0.23) groups were significantly higher than the Nonpolarizer (4.69 ± 0.32) for the 1M1 shade tab, ∆E00 value of Polar_eyes (6.23 ± 0.34) was significantly lower than Nonpolarizer (10.71 ± 0.48) group for 5M3 shade tab (p < 0.05). CONCLUSION The color-matching results of tested digital photography techniques with and without cross-polarization were unacceptable, compared to a spectroradiometer. While digital photography with Polar_eyes cross-polarizing filter has closer results to the reference device for the low-in-value shade table (5M3), for the high-in-value shade table (1M1), improved results were obtained without a cross-polarizing filter. CLINICAL SIGNIFICANCE The cross-polarization filters are increasingly used in dentistry for tooth color communication with digital photography techniques. However, the digital photography techniques with-without cross-polarization filterers should be improved to obtain clinically acceptable color-matching results.
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Affiliation(s)
- Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Doğu Ömür Dede
- Department of Prosthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkey
| | - Emre Diker
- Department of Prosthodontics, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Manrique Fonseca
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - William Michael Johnston
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Çakmak G, Hess JA, Dönmez MB, Yılmaz D, Alhotan A, Schimmel M, Peutzfeldt A, Yilmaz B. Effect of polishing and denture cleansers on the surface roughness of new-generation denture base materials and their color change after cleansing. J Prosthodont 2023. [PMID: 37624691 DOI: 10.1111/jopr.13755] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/20/2023] [Accepted: 08/21/2023] [Indexed: 08/27/2023] Open
Abstract
PURPOSE To evaluate the effect of polishing and denture cleansers on the surface roughness (Ra ) of new-generation denture base materials that are additively, subtractively, and conventionally fabricated, while also assessing their color change after cleansing. MATERIAL AND METHODS One hundred and fifty disk-shaped specimens (Ø10 × 2 mm) were prepared from five denture base materials (one subtractively manufactured nanographene-reinforced prepolymerized polymethylmethacrylate (PMMA) (SM-GC), one subtractively manufactured prepolymerized PMMA (SM-PM), two additively manufactured denture base resins (AM-DT and AM-ND), and one heat-polymerized PMMA (CV) (n = 30). The Ra of the specimens was measured before and after conventional laboratory polishing, while color coordinates were measured after polishing. Specimens were then divided into three subgroups based on the denture cleanser: distilled water, 1% sodium hypochlorite (NaOCl), and effervescent tablet (n = 10). The Ra and color coordinates were remeasured after nine cleansing cycles over a period of 20 days. The CIEDE2000 formula was used to calculate the color differences (ΔE00 ). Two-way analysis of variance (ANOVA) was used to analyze the Ra values before (n = 30) and after (n = 10) cleansing, while repeated measures ANOVA was used to analyze the Ra of material-time point pairs within each denture cleanser (n = 10). ΔE00 data after denture cleansing was also analyzed by using two-way ANOVA (n = 10) (α = 0.05). RESULTS Before polishing, Ra varied significantly among the materials. SM-GC and SM-PM had the lowest and AM-ND the highest Ra values (P < 0.001). Polishing significantly reduced Ra of all materials (P < 0.001), and after polishing, Ra differences among materials were nonsignificant (P ≥ 0.072). Regardless of the denture cleanser, the Ra of AM-DT, AM-ND, and CV was the highest before polishing when different time points were considered (P < 0.001). After cleansing, AM-ND had the highest Ra of all the materials, regardless of the cleanser (P ≤ 0.017). AM-DT had higher Ra than SM-PM when distilled water (P = 0.040) and higher Ra than SM-GC, SM-PM, and CV when NaOCl was used (P < 0.001). The type of cleanser significantly influenced the Ra of AM-DT, AM-ND, and CV. For AM-DT, NaOCl led to the highest Ra and the tablet led to the lowest Ra (P ≤ 0.042), while for AM-ND, distilled water led to the lowest Ra (P ≤ 0.024). For CV, the tablet led to lower Ra than distilled water (P = 0.009). Color change varied among the materials. When distilled water was used, SM-GC had higher ΔE00 than SM-PM and AM-DT (P ≤ 0.034). When NaOCl was used, AM-ND had higher ΔE00 than SM-GC, SM-PM, and AM-DT, while CV and SM-GC had higher ΔE00 than SM-PM and AM-DT (P ≤ 0.039). Finally, when the tablet was used, AM-ND and CV had the highest ΔE00 , while AM-DT had lower ΔE00 than SM-GC (P ≤ 0.015). CONCLUSIONS The tested materials had unacceptable surface roughness (>0.2 μm) before polishing. Roughness decreased significantly after polishing (<0.2 μm). Denture cleansers did not significantly affect the surface roughness of the materials, and roughness remained clinically acceptable after cleansing (<0.2 μm). Considering previously reported color thresholds, AM-ND and CV had unacceptable color change regardless of the denture cleanser, and the effervescent tablet led to perceptible, but acceptable color change for SM-GC, SM-PM, and AM-DT.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Julia Anouk Hess
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Dönmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey
| | - Deniz Yılmaz
- Department of Prosthodontics, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Abdulaziz Alhotan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Anne Peutzfeldt
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
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Dede DÖ, Çakmak G, Donmez MB, Küçükekenci AS, Lu WE, Ni AA, Yilmaz B. Effect of analysis software program on measured deviations in complete arch, implant-supported framework scans. J Prosthet Dent 2023:S0022-3913(23)00436-5. [PMID: 37596157 DOI: 10.1016/j.prosdent.2023.06.028] [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: 03/17/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 08/20/2023]
Abstract
STATEMENT OF PROBLEM Implementation of fabrication trueness analysis by using a recently introduced nonmetrology-grade freeware program may help clinicians and dental laboratory technicians in their routine practice. However, knowledge of the performance of this freeware program when compared with the International Organization for Standardization recommended metrology-grade analysis software program is limited. PURPOSE The purpose of this in vitro study was to evaluate the effect of an analysis software program on measured deviations in the complete arch, implant-supported framework scans. MATERIAL AND METHODS A total of 20 complete arch, implant-supported frameworks were fabricated from a master standard tessellation language (STL) file from either polyetheretherketone (PEEK) or titanium (Ti) (n=10). All frameworks were then digitized by using different scanners to generate test STLs. All STL files were imported into a nonmetrology-grade freeware program (Medit Link) and a metrology-grade software program (Geomagic Control X) to measure the overall and marginal deviations of frameworks from the master STL file by using the root mean square (RMS) method. Data were analyzed by using the two 1-sided paired t test procedure, in which 50 µm was considered as the minimal clinically meaningful difference (α=.05). RESULTS When overall RMS values were considered, the nonmetrology-grade freeware program was not inferior to the metrology-grade software program (P<.05). When marginal RMS values were considered, the nonmetrology-grade freeware program was inferior to the metrology-grade software program only when PEEK frameworks were scanned with an E4 laboratory scanner (P>.05). CONCLUSIONS The use of the tested nonmetrology-grade freeware program resulted in overall deviation measurements similar to those when a metrology-grade software program was used. The freeware program was inferior when marginal deviations were analyzed on E4 scans of a PEEK framework, which was the only scanner-material pair that led to a significant difference, among the 15 pairs tested.
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Affiliation(s)
- Doğu Ömür Dede
- Department of Prosthodontics, Ordu University, Ordu, Turkey
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey.
| | | | - Wei-En Lu
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Andy Ai Ni
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive, and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, USA
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