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Abulhamael SM, Papathanasiou A, Kostagianni A, Jain S, Finkelman M, Mourão CF, Ali A. Evaluation of marginal and internal adaptation of veneers generated by the guided prosthetic tooth preparation system. J ESTHET RESTOR DENT 2024; 36:911-919. [PMID: 38407478 DOI: 10.1111/jerd.13210] [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: 09/27/2023] [Revised: 01/22/2024] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE This in vitro study aimed to assess and contrast the marginal and internal adaptation of all-ceramic prefabricated veneers manufactured via the FirstFit guided tooth preparation system against all-ceramic veneers produced using the chairside Computer-Aided Design/Computer Aided Manufacture (CAD/CAM) system following identical guided preparation protocols. MATERIALS AND METHODS Two main groups were included, with 16 lithium disilicate veneers per group. Four typodonts were used for the test (FirstFit) and control CAD/CAM groups. Intraoral scans created master casts and preparation guides. Guides performed preparations on typodont teeth (two central incisors and two lateral incisors). Prepared teeth were scanned (CEREC Omnicam) to design and mill CAD/CAM veneers. Marginal gap thickness and cement space thickness were measured using light microscopy at four locations: marginal, cervical internal, middle internal, and incisal internal. RESULTS No significant difference existed between groups for marginal adaptation (p = 0.058) or incisal internal adaptation (p = 0.076). The control group had significantly lower values for middle internal adaptation (p = 0.023) and cervical internal adaptation (p = 0.019). CONCLUSIONS Guided preparation evaluation showed no significant differences in marginal or incisal internal adaptation. The CAD/CAM group had significantly lower middle and cervical internal adaptation values.
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Affiliation(s)
- Shahad M Abulhamael
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Aikaterini Papathanasiou
- Department of Comprehensive Care, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Aikaterini Kostagianni
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- Prosthodontist, Private Practice Los Altos, Los Altos, California, USA
| | - Shruti Jain
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Matthew Finkelman
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Carlos Fernando Mourão
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Ala Ali
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
- Prosthodontics, Private Practice, Malden, Massachusetts, USA
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Khairy NM, Elkholany NR, Elembaby AE. Evaluation of surface microhardness and gingival marginal adaptation of three different bulk-fill flowable resin composites: A comparative study. J ESTHET RESTOR DENT 2024; 36:920-929. [PMID: 38404208 DOI: 10.1111/jerd.13211] [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: 01/10/2024] [Revised: 02/03/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES To evaluate surface microhardness and gingival marginal adaptation of three different bulk-fill flowable resin composites (FB-RBCs) in Class V cavities with enamel or dentin margins before and after thermocycling (TMC). MATERIALS AND METHODS Three available FB-RBCs were used; Palfique Bulk Flow (PaBF) (Tokuyama Dental), SDR Flow+ Bulk Fill Flowable (Dentsply Sirona), and I-Flow Bulk Fill (I-Dental). Thirty discs were prepared from each type of FB-RBCs. The discs were subjected to Vickers microhardness tester machine. Class V cavities were prepared on 180 molars. Gingival margins of half the specimens were prepared above CEJ and the other half below CEJ. Cavities were restored with FB-RBCs for gingival marginal adaptation test. Two-way ANOVA was used in microhardness, while three-way ANOVA was used for marginal adaptation. RESULTS The used materials showed statistically significant differences in microhardness and marginal adaptation. CONCLUSIONS Regarding microhardness, PaBF showed the highest value before TMC and SDR was the highest after TMC. Regarding marginal adaptation, SDR revealed the best marginal adaptation than PaBF and I-flow, either subjected to TMC or not. CLINICAL SIGNIFICANCE The longevity of cervical restorations depend on both the location of the cavity margin and the material used. The microfractures in resin composite surface due to low surface microhardness as well as marginal gaps seen in laboratory studies could be considered as an indicative parameter for clinical problem associated with marginal differences.
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Affiliation(s)
- Nourhan Medhat Khairy
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Aldakhlia, Egypt
| | - Naglaa Rizk Elkholany
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Aldakhlia, Egypt
| | - Abeer Elsayed Elembaby
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Aldakhlia, Egypt
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Demirel M, Donmez MB. Fabrication trueness and internal fit of different lithium disilicate ceramics according to post-milling firing and material type. J Dent 2024; 144:104987. [PMID: 38580056 DOI: 10.1016/j.jdent.2024.104987] [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: 01/17/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVES To evaluate whether post-milling firing and material type affect the fabrication trueness and internal fit of lithium disilicate crowns. METHODS A prefabricated cobalt chromium abutment was digitized to design a mandibular right first molar crown. This design file was used to fabricate crowns from different lithium disilicate ceramics (nano-lithium disilicate (AM), fully crystallized lithium disilicate (IN), advanced lithium disilicate (TS), and lithium disilicate (EX)) (n = 10). Crowns, the abutment, and the crowns when seated on the abutment were digitized by using an intraoral scanner. Fabrication trueness was assessed by using the root mean square method, while the internal fit was evaluated according to the triple scan method. These processes were repeated after the post-milling firing of AM, TS, and EX. Paired samples t-tests were used to analyze the effect of post-milling firing within AM, TS, and EX, while all materials were compared with 1-way analysis of variance and Tukey HSD tests (α = 0.05). RESULTS Post-milling firing reduced the surface deviations and internal gap of AM and EX (P ≤ 0.014). AM mostly had higher deviations and internal gaps than other materials (P ≤ 0.030). CONCLUSIONS Post-milling firing increased the trueness and internal fit of tested nano-lithium disilicate and lithium disilicate ceramics. Nano-lithium disilicate mostly had lower trueness and higher internal gap; however, the maximum meaningful differences among tested materials were small. Therefore, the adjustment duration and clinical fit of tested crowns may be similar. CLINICAL SIGNIFICANCE Tested lithium disilicate ceramics may be suitable alternatives to one another in terms of fabrication trueness and internal fit, considering the small differences in measured deviations and internal gaps.
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Affiliation(s)
- Münir Demirel
- Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - 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.
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Pilecco RO, Machry RV, Baldi A, Tribst JPM, Sarkis-Onofre R, Valandro LF, Kleverlaan CJ, Scotti N, Pereira GKR. Influence of CAD-CAM milling strategies on the outcome of indirect restorations: A scoping review. J Prosthet Dent 2024; 131:811.e1-811.e10. [PMID: 38480018 DOI: 10.1016/j.prosdent.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 05/13/2024]
Abstract
STATEMENT OF PROBLEM The influence of computer-aided manufacturing (CAM) parameters and settings on the outcomes of milled indirect restorations is poorly understood. PURPOSE The purpose of this scoping review was to summarize the current CAM systems, parameters, and setting changes, and their effects on different outcomes of milled indirect restorations and aspects related to their manufacture. MATERIAL AND METHODS The protocol of this review is available online (https://osf.io/x28ps/). Studies that used at least 2 different parameters (CAM units, number of axes, digital spacers, or protocols with different rotatory instruments, grit-sizes, milling speed, or others) for milling indirect restorations were included. A structured search up to July 2023 was performed by 2 independent reviewers for articles written in English in LILACS, MEDLINE via PubMed, EMBASE, Web of Science, and Scopus. RESULTS Of 1546 studies identified, 22 were included in the review. Discrepancies were found between the planned and actual measured cement space, with a decreasing linear relationship impacting restoration adaptation at different points. The CEREC MC XL milling machine was the most used system in the included studies, with variations in bur types, milling modes, and number of burs uses affecting internal fit and surface trueness. The results demonstrated the better adaptation of restorations made with 5-axis over 3-axis milling machines. Lithium disilicate and zirconia were the most commonly used materials, and crowns and inlays were popular designs. Marginal and internal adaptation were the primary outcomes assessed using the various techniques. CONCLUSIONS The study presented a comprehensive exploration of CAM systems and parameters, and their influence on indirect restorations. The planned cement space was not properly reproduced by the milling. Bur characteristics can affect restoration fit and trueness. The 5-axis units seem to result in better-adapted restorations compared with 3- and 4-axis units.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Postgraduate student, Postgraduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Renan Vaz Machry
- Postdoctoral student, Postgraduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Andrea Baldi
- Postdoctoral student, Department of Surgical Sciences, Dental School, Turin, Italy
| | - João Paulo Mendes Tribst
- Assistant Professor, Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands.
| | - Rafael Sarkis-Onofre
- Associate Professor, Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Brazil
| | - Luiz Felipe Valandro
- Full Professor, Postgraduate Program in Oral Sciences (Prosthodontics Unit), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Cornelis Johannes Kleverlaan
- Full Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands
| | - Nicola Scotti
- Associate Professor, Department of Surgical Sciences, Dental School, Turin, Italy
| | - Gabriel Kalil Rocha Pereira
- Adjunct Professor, Postgraduate Program in Oral Sciences (Prosthodontics Unit), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Uyumaz FÜ, Abaklı İnci M, Özer H. Could bulk fill glass hybrid restorative materials replace composite resins in treating permanent teeth? A randomized controlled clinical trial. J ESTHET RESTOR DENT 2024; 36:702-709. [PMID: 38108583 DOI: 10.1111/jerd.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE This study aims to compare the clinical and radiographic efficacy of Equia system bulk fill glass hybrid material with composite resins in the permanent restoration of pediatric patients' permanent teeth. MATERIALS AND METHODS The study included 44 pediatric patients aged 8-16 who applied to Necmettin Erbakan University Pediatric Dentistry Department. The groups were formed as symmetrical teeth in the same patient using the split-mouth design. The study included class I caries lesions of 144 permanent teeth. Group 1 was restored with the Equia system bulk fill glass hybrid material (Equia Forte HT + Equia Forte Coat [GC, Co, Tokyo, Japan]) (n = 72) and Group 2 with the Charisma Smart universal composite resin (Kulzer, Gmbh, Hanau, Germany) + Clearfil SE Bond (Kuraray, Noritake, Sakazu, Okayama) (n = 72). Evaluations were performed clinically and radiographically by two physicians in 2nd week, 3rd month, 6th month, and 12th month and the results were recorded. Clinical evaluation was carried out using modified-USPHS criteria. Obtained data were statistically analyzed using Kendall's W test and Cochran's Q test for the comparison within the group, and the Chi-square test for the comparison between groups. RESULTS Among the materials utilized in the study, there was no statistically significant difference in marginal adaptation, marginal discoloration, retention, anatomical form, postoperative sensitivity, and secondary caries according (p > 0.05). Group 2 outperformed statistically significant Group 1 in terms of color match in all periods (p < 0.05). While there was no statistically significant difference in surface structure between the groups in 2nd week and 3rd month (p > 0.05), there was a statistically substantial difference in 6th, and 12th months (p < 0.05). No secondary caries or periapical lesions were found in any restorations during radiographic evaluation. CONCLUSION After a year, the clinical performance of both Equia and composite resins was equivalent and successful in the majority of the measures against which they were evaluated. CLINICAL SIGNIFICANCE Based on the results of the research, Equia system bulk fill glass hybrid restorations are considered a viable alternative to composite resins in class I permanent teeth restorations.
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Affiliation(s)
- Fatma Üzümcü Uyumaz
- Department of Pediatric Dentistry, Bursa Oral and Dental Health Training and Research Hospital, Bursa, Turkey
| | - Merve Abaklı İnci
- Faculty of Dentistry, Department of Pediatric Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Hazal Özer
- Faculty of Dentistry, Department of Pediatric Dentistry, Necmettin Erbakan University, Konya, 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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Elkady M, Abdelhakim S, Riad M. The clinical performance of dental resin composite repeatedly preheated: A randomized controlled clinical trial. J Dent 2024; 144:104940. [PMID: 38490324 DOI: 10.1016/j.jdent.2024.104940] [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: 01/17/2024] [Revised: 02/22/2024] [Accepted: 03/12/2024] [Indexed: 03/17/2024] Open
Abstract
OBJECTIVES To assess the clinical performance of class II restorations performed by repeatedly preheated resin composite "RC" at 68 °C up to ten times. METHODS 105 patients were selected and randomized into three groups, each comprising 35 patients. Each patient was provided with a single class II Bulk-fill resin composite "BF-RC" posterior restoration based on the number of preheating cycles; group I (H0): The BF-RC was packed non-heated, group II (H1): BF-RC preheated once, and group III(H10): BF-RC preheated ten cycles. These restorations were evaluated at 1, 3,6, and 12 months, using the modified United States Public Health Service "USPHS". Statistical analysis was performed using Kruskal-Wallis test, Mann Whitney U test, and Friedmann test, where p = 0.05. RESULTS All the 105 restorations did not suffer from any clinical situation that recommended replacement regarding retention, fracture, secondary caries, or anatomical form. Although all performed restorations did have Alpha and Bravo scores with good clinical performance, the non-preheated RC restorations"" suffered from relatively inferior clinical performance through the follow-up period regarding marginal adaptation, marginal discoloration, and color matching when compared to preheated groups. One and ten times of preheating conducted better clinical performance. CONCLUSIONS After 12-months follow-up, although no restoration needed replacement or repair in the 3 tested groups, restorations with single and ten times of preheating aided in better clinical performance of RC restorations compared to the non-preheated restorations. Preheating of RC for 10 times could be used safely with good clinical performance of restorations. CLINICAL SIGNIFICANCE By continually preheating RC syringe up to ten times, the dentist will not only benefit from the enhanced clinical performance and easiness of application but also will use preheated RC syringes without hesitation, relying on the absence of drawbacks related to multiple preheating cycles.
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Affiliation(s)
- Mahmoud Elkady
- Conservative Dentistry Department, Faculty of Dentistry, Assiut University, Egypt
| | - Safaa Abdelhakim
- Operative Dentistry Department, Faculty of Dentistry, Minia University, Egypt
| | - Mona Riad
- Conservative Dentistry Department, Faculty of Dentistry, 11 El-Saraya St, Cairo UniversityManial, Cairo 11553, Egypt.
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Cameron AB, Choi JJE, Ip A, Lyons N, Yaparathna N, Dehaghani AE, Feih S. Assessment of the trueness of additively manufactured mol3% zirconia crowns at different printing orientations with an industrial and desktop 3D printer compared to subtractive manufacturing. J Dent 2024; 144:104942. [PMID: 38494044 DOI: 10.1016/j.jdent.2024.104942] [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: 01/08/2024] [Revised: 03/03/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024] Open
Abstract
OBJECTIVES This study endeavours to investigate the effect of printing orientation on the trueness of additively manufactured molar zirconia crowns. The areal surface roughness and the characteristics of the marginal regions of the crowns were also considered. METHODS Twelve molar crowns were manufactured at 0°, 45°, and, 90° printing orientations in a Lithoz and AON zirconia printer, respectively. Twelve milled crowns were used as a comparison. Samples were scanned and analysed in metrology software to determine the trueness of the groups. Regions of interest were defined as the margins, intaglio surface and contact points. Areal surface roughness and print layer thickness were further analysed using a confocal laser scanning microscope. RESULTS The results indicate that there are clear differences between the investigated desktop (AON) and industrial (Lithoz) 3D printer. The 45° Lithoz group is the only sample group showing no significantly different results in trueness for all regions analysed compared to the milled group. Areal surface roughness analysis indicates that the print layers in the marginal regions are within clinically tolerable limits and surface characteristics. CONCLUSIONS The printing orientation for zirconia crowns is critical to trueness, and differences are evident between different AM apparatuses. Considerations for design and orientation between different apparatuses should therefore be considered when utilising direct additive manufacturing processes. The areal surface roughness of the marginal regions is within acceptable clinical limits for all manufacturing processes and print orientations considered. CLINICAL SIGNIFICANCE The materials and apparatuses for additive manufacturing of zirconia crowns are now clinically acceptable from the perspective of the trueness of a final crown for critical functional surfaces and areal surface roughness of the marginal regions.
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Affiliation(s)
- Andrew B Cameron
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, 4222, Australia; Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute, Griffith University, Southport, Queensland, 4222, Australia.
| | - Joanne Jung Eun Choi
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | | | - Nathan Lyons
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute, Griffith University, Southport, Queensland, 4222, Australia; Queensland College of Art, Griffith University, Southport, Queensland, 4222, Australia
| | - Navodika Yaparathna
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, 4222, Australia
| | - Ali Ebrahimzadeh Dehaghani
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute, Griffith University, Southport, Queensland, 4222, Australia; Advanced Design and Prototyping Technologies (ADaPT) Institute, Griffith University, Southport, Queensland, 4222, Australia
| | - Stefanie Feih
- Griffith Centre of Biomedical and Rehabilitation Engineering (GCORE), Menzies Health Institute, Griffith University, Southport, Queensland, 4222, Australia; School of Engineering and Built Environment, Griffith University, Southport, Queensland, 4222, Australia; Advanced Design and Prototyping Technologies (ADaPT) Institute, Griffith University, Southport, Queensland, 4222, Australia
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Haghi HR, Ghanbarzadeh J, Kiamanesh E. A randomized clinical trial comparing the clinical fit and chairside adjustment time for implant-supported crowns fabricated by fully digital and partially digital techniques. J Prosthet Dent 2024; 131:865-870. [PMID: 35525625 DOI: 10.1016/j.prosdent.2022.02.024] [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: 08/19/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Implant-supported crowns made in both fully and partially digital workflows have been evaluated, but these studies have been mainly performed in vitro. Moreover, data on the comparison of clinical fitting and adjustment time for implant-supported crowns are limited. PURPOSE The purpose of this randomized clinical trial was to evaluate the clinical fit and adjustment time for implant-supported crowns produced by a partially and fully digital workflow in partially edentulous participants. MATERIAL AND METHODS Twenty-eight participants who had received 2 adjacent implants in posterior sites were enrolled, each receiving 2 custom titanium abutments and a splinted monolithic zirconia restoration. Restorations of the control group (n=14) were produced from a digital scan and a cast-free digital workflow, while the restorations of the test group (n=14) were from a conventional impression and a partially digital workflow. A blinded investigator delivered the restorations. The clinical adjustment was performed incrementally, and a digital chronometer recorded the time required for the evaluation and adjustment at each step. An independent t test, Mann-Whitney U test, and the Fisher exact test were used to evaluate the results (α=.05). RESULTS The total mean adjustment time in the control group (12.49 minutes) was significantly longer than that of the test group (11.27 minutes) (P<.001). For the occlusal contact points, significantly less clinical adjustment time was required with the cast-free digital workflow (5.31 minutes) than with the model-based partially digital workflow (6.06 minutes) (P=.001). On other surfaces, no significant difference was found between the 2 groups (P>.05). All crowns could be successfully delivered after 2 clinical appointments (impression and delivery). Remakes were not necessary for any restorations in the test or control group. CONCLUSIONS The parameters of occlusal adjustment time and total adjustment time of the fully digital workflow were significantly shorter than those of the partially digital workflow.
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Affiliation(s)
- Hamidreza Rajati Haghi
- Associate Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jalil Ghanbarzadeh
- Associate Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Kiamanesh
- Assistant Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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El Halawani MT, Aboushady YS, Kader SMA, Benedicenti S, Solimei L, Signore A. Analysis of the Marginal Continuity in Different Designs of Monolithic Zirconia Inlay-Retained Fixed Dental Prostheses: An In Vitro Study. INT J PROSTHODONT 2024; 37:173-180. [PMID: 38648165 DOI: 10.11607/ijp.7875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE To evaluate the marginal integrity of three inlay-retained fixed dental prosthesis (IRFDP) designs fabricated using monolithic zirconia. MATERIALS AND METHODS In total, 30 IRFDPs were fabricated using 4-YTZP monolithic zirconia and randomly divided into three groups according to the cavity design. Groups ID2 and ID1.5 received an inlay cavity preparation, which includes a proximal box and an occlusal extension with a depth of 2 mm or 1.5 mm, respectively. Group PB received a proximal box cavity preparation without an occlusal extension. The restorations were fabricated and cemented using a dual-cure resin cement (Panavia V5) and subjected to an equivalent of 5 years of aging. The specimens were evaluated under an SEM to measure marginal continuity before and after the aging process. RESULTS During the whole 5-year aging process, no specimens showed signs of cracking, fracture, or loss of retention in any restorations. In the SEM analysis, most marginal defects observed in the restorations were areas of microgaps at the tooth/cement interface (TC) or zirconia/cement interface (ZC), resulting in loss of adaptation. There was a significant difference between the groups after the aging process at both the TC (F = 4.762, P < .05) and ZC (F = 6.975, P < .05), with Group ID2 presenting the best performance. There was a significant difference between TC and ZC in all groups (P < .05), with ZC presenting more gaps in all groups. CONCLUSIONS Inlay cavity designs including a proximal box and an occlusal extension exhibited better marginal stability than a proximal box without occlusal extension.
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Suksuphan P, Krajangta N, Didron PP, Wasanapiarnpong T, Rakmanee T. Marginal adaptation and fracture resistance of milled and 3D-printed CAD/CAM hybrid dental crown materials with various occlusal thicknesses. J Prosthodont Res 2024; 68:326-335. [PMID: 37438119 DOI: 10.2186/jpr.jpr_d_23_00089] [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] [Indexed: 07/14/2023]
Abstract
PURPOSE To evaluate the marginal adaptation and fracture resistance of three computer-aided design/computer-assisted manufacturing hybrid dental materials with different occlusal thicknesses. METHODS Ninety single-molar crowns were digitally fabricated using a milled hybrid nanoceramic (Cerasmart, CE), polymer-infiltrated ceramic network (PICN, Vita Enamic, VE), and 3D-printed materials (Varseosmile, VS) with occlusal thicknesses of 0.8, 1, and 1.5 mm (10 specimens/group). Anatomical 3D-printed resin dies (Rigid 10K) were used as supporting materials. A CEREC MCX milling unit and a DLP-based 3D printer, Freeform Pro 2, were utilized to produce the crown samples. Before cementation, the marginal adaptation, absolute marginal discrepancy (AMD), and marginal gap (MG) were assessed using micro-CT scanning. After cementation with self-adhesive resin cement, fracture resistance was evaluated using a universal testing machine. The number of fractured crowns and the maximum fracture values (N) were recorded. Data were statistically analyzed using both one- and two-way ANOVA, followed by Tukey's honestly significant difference (HSD) test. RESULTS For all occlusal thicknesses, the VS crowns demonstrated the lowest AMD and MG distances, significantly different from those of the other two milling groups (P < 0.05), whereas CE and VE did not differ significantly (P > 0.05). All VS crowns were fractured using the lowest loading forces (1480.3±226.1 to 1747.2±108.7 N). No CE and 1 and 1.5 mm VE crowns fractured under a 2000 N maximum load. CONCLUSIONS All hybrid-material crowns demonstrated favorable marginal adaptation within a clinically acceptable range, with 3D printing yielding superior results to milling. All materials could withstand normal occlusal force even with a 0.8 mm occlusal thickness.
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Affiliation(s)
- Pisit Suksuphan
- Department of Restorative and Esthetic Dentistry, Faculty of Dentistry, Thammasat University, Pathumtani, Thailand
| | - Nantawan Krajangta
- Department of Restorative and Esthetic Dentistry, Faculty of Dentistry, Thammasat University, Pathumtani, Thailand
| | | | | | - Thanasak Rakmanee
- Department of Restorative and Esthetic Dentistry, Faculty of Dentistry, Thammasat University, Pathumtani, Thailand
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González CC, Ñaupari-Villasante R, Dos Santos de Castro A, Mendez-Bauer L, Dávila-Sanchez A, Aliaga-Sancho P, Gutierrez MF, Reis A, Loguercio AD. Clinical evaluation of posterior restorations over wet and dry dentin using an etch-and-rinse adhesive: A 36-month randomized clinical trial. Dent Mater 2024; 40:619-628. [PMID: 38369403 DOI: 10.1016/j.dental.2024.02.009] [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: 11/18/2023] [Revised: 01/30/2024] [Accepted: 02/12/2024] [Indexed: 02/20/2024]
Abstract
OBJECTIVES To evaluate the clinical performance of posterior restorations over wet and dry dentin with an etch-and-rinse adhesive after 36 months of clinical service. METHODS Forty-five participants were recruited, each one had at least two posterior teeth that needed restoration. Ninety restorations were placed on Class I or Class II cavities. For the restoration protocol, a simplified etch-and-rinse adhesive (Adper Single Bond 2) was applied over wet (WD) or dry dentin (DD) and later restored with a bulk-fill composite (Filtek Bulk Fill) under rubber dam isolation. Each restoration was evaluated using the World Dental Federation (FDI) criteria after 6, 12, and 36 months of clinical service, regarding the following principal restoration characteristics: postoperative sensitivity, marginal discoloration, marginal adaptation, fracture of material and retention, and recurrence of caries. Kruskal Wallis analysis of variance rank (α = 0.05) and Kaplan-Meier survival analysis were used for statistical analysis. RESULTS After 36 months of clinical evaluation, no significant difference between groups was observed in each FDI criterion (p > 0.05). Twenty restorations (WD=10, DD=10) showed minor marginal staining, and twenty-two restorations (WD=11, DD=11) presented small marginal adaptation defects (p > 0.05). Four restorations were lost (WD = 2, DD = 2) and the fracture rates (95% confidence interval) were 94.9% for each one, without significant difference between wet and dry dentin (p > 0.05). SIGNIFICANCE The degree of dentin moisture does not seem to affect the clinical performance of a simplified etch-and-rinse adhesive in posterior restorations when the adhesive is applied vigorously over the dentine surface.
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Affiliation(s)
- Claudia C González
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta, Ponta Grossa, PR, Brazil
| | - Romina Ñaupari-Villasante
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta, Ponta Grossa, PR, Brazil
| | | | - Luján Mendez-Bauer
- Research Department, Faculty of Dentistry, Francisco Marroquím University, Guatemala city, Guatemala
| | - Andrés Dávila-Sanchez
- Universidad San Francisco de Quito USFQ, Department of Restorative Dentistry and Dental Materials, School of Dentistry, Quito, Ecuador
| | - Paulina Aliaga-Sancho
- Universidad San Francisco de Quito USFQ, Department of Restorative Dentistry and Dental Materials, School of Dentistry, Quito, Ecuador
| | - Mario Felipe Gutierrez
- Universidad de los Andes, Facultad de Odontología, Santiago, Chile; University of Chile, Institute for Research in Dental Sciences, Faculty of Dentistry, Santiago, Chile
| | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta, Ponta Grossa, PR, Brazil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta, Ponta Grossa, PR, Brazil.
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Daou EE. Effect of lamination layer thickness and abutment preparation on the fit of Co-Cr multi-unit prostheses fabricated by additive manufacturing: An in vitro study. J Prosthet Dent 2024; 131:652-657. [PMID: 35430049 DOI: 10.1016/j.prosdent.2022.02.005] [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: 07/05/2021] [Revised: 02/04/2022] [Accepted: 02/04/2022] [Indexed: 11/19/2022]
Abstract
STATEMENT OF PROBLEM Selective laser melting has been increasingly used in the fabrication of metal-ceramic prostheses. The lamination layer thickness may influence the fit of the restoration. However, data regarding its impact remain scarce. PURPOSE The purpose of this in vitro study was to evaluate the marginal and internal fit of cobalt-chromium (Co-Cr) 3-unit frameworks fabricated by additive manufacturing with different melting layer thicknesses on different abutments. MATERIAL AND METHODS The first right maxillary premolar and molar from a typodont were prepared with a circumferential 1.2-mm chamfer, 2-mm occlusal reduction, and total taper of 8 degrees to receive 3-unit fixed partial dentures. After framework design, the data were sent to a laser machine, and 30 specimens were fabricated from Co-Cr metal powder (Mediloy S-Co) by selective laser melting. Specimens were assigned to 3 groups (n=10) with different lamination layer thicknesses of 25 (L25), 50 (L50), and 100 (L100) μm. Marginal fit and internal fit were evaluated. Results were compared among layer thickness groups and abutments. Data were compared by using the Levene test, t test, and ANOVA (α=.05). RESULTS A statistical difference was found between different layer thickness groups (P=.016), but not between abutments (P=.429). On the abutment level, significant difference was found in the gap values for the molars (P=.049) between layer thickness groups, but not for the premolars (P=.126). Group L25 reported the smallest mean discrepancy values, and group L100 reported the highest, with statistical difference found between group L100 and groups L25 (P<.001) and L50 (P<.025), but not between groups L25 and L50 (P=.094). CONCLUSIONS The lamination layer thickness affected the adaptation of the metal frameworks. Framework fit did not significantly differ between abutments.
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Affiliation(s)
- Elie E Daou
- Assistant Professor, Department of Prosthodontics, School of Dentistry, Lebanese University, Beirut, Lebanon; Assistant Professor, Al-Ayen University, Nile Street, Nasiriyah.
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Adel M, Hamdy A, Sabet A, Ebeid K. Effect of cervical margin relocation on marginal adaptation and microleakage of indirect ceramic restorations. J Prosthodont 2024; 33:374-381. [PMID: 37186493 DOI: 10.1111/jopr.13696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/23/2023] [Indexed: 05/17/2023] Open
Abstract
PURPOSE This study evaluated the effect of cervical margin relocation (CMR) with two different materials and contamination with hemostatic agents on the margin adaptation and microleakage of ceramic restorations. MATERIALS AND METHODS Mesial-occlusal-distal cavities were prepared in 60 human first molars and distributed to 3 groups (n = 20) according to the margin relocation procedure. The groups were: group F; flowable composite applied in two 2 mm increments, group B; bulk-fill flowable composite applied as a bulk increment of 4 mm thickness and group C (control); no CMR was done. Each group was subdivided into two subgroups (subgroup N; no hemostatic agent applied and subgroup H; hemostatic agent was applied). In all groups, ceramic inlays were prepared and cemented. The samples were subjected to thermocycling (10,000 cycles). The adaptation of the cervical margin was evaluated with scanning electron microscopy (200×). Samples were then assessed for microleakage analysis with the dye penetration method. Marginal adaptation data were normally distributed and analyzed using two-way ANOVA followed by Tukey's post hoc test. Ordinal microleakage score data were analyzed using cumulative link models followed by the analysis of deviance using Wald chi-square tests. RESULTS Both CMR and contamination with a hemostatic agent had significant effects on the margin adaptation of the cervical margin. Group C showed the highest adaptation with no significant difference from group F. The lowest adaptation was revealed in group B with a significant difference from group C. Subgroup N (in all groups) showed a statistically higher adaptation than subgroup H. Regarding microleakage assessment, CMR had no significant effect but hemostatic agent application showed a significantly higher microleakage score for all groups. CONCLUSIONS Both the CMR procedure and contamination with AlCl3 hemostatic agent had a negative effect on marginal adaptation. For microleakage assessment, only contamination with hemostatic agent negatively affected the microleakage with no effect on the margin relocation procedure.
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Affiliation(s)
- Marwa Adel
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Amina Hamdy
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Ahmed Sabet
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
- Department of Fixed Prosthodontics, Faculty of Dentistry, British University in Egypt, Cairo, Egypt
| | - Kamal Ebeid
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Toksoy D, Önöral Ö. Influence of glazing and aging on the marginal, axial, axio-occlusal, and occlusal fit of 3-unit monolithic zirconia restorations fabricated using additive and subtractive techniques. J Prosthet Dent 2024; 131:658.e1-658.e9. [PMID: 38342643 DOI: 10.1016/j.prosdent.2024.01.010] [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: 10/04/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/13/2024]
Abstract
STATEMENT OF PROBLEM Studies are sparse on how glazing and aging influence the fit of additively fabricated monolithic zirconia restorations. PURPOSE The purpose of this in vitro study was to assess the effect of glazing and aging on the fit of 3-unit monolithic zirconia restorations fabricated using different techniques. MATERIAL AND METHODS A total of 32 monolithic zirconia restorations were fabricated for a typodont model by using 4 distinct techniques (subtractive fabrication [SF], stereolithography [SLA], digital light processing [DLP], and lithography-based ceramic manufacturing [LCM]). The silicone replica approach was adopted to measure the discrepancy values for premolar and molar abutments after sintering, glazing, and 1 year of aging. The silicone replicas were sliced into mesiodistal and buccopalatal cross-sections, and digital micrographs of the cross-sections were made with a ×80 stereomicroscope. An inherent measuring program was run to record the discrepancy values (µm). Repeated-measures 2-way ANOVAs with the Bonferroni post hoc test were used to statistically analyze the acquired data. (α=.05). RESULTS From the repeated measures 2-way ANOVAs, both the glazing×fabrication technique and the aging×fabrication technique interactions were not statistically significant (P>.05). Glazing significantly influenced premolar abutment marginal (P=.022) and occlusal (P=.007) discrepancy values, as well as molar abutment marginal discrepancy values (P=.047). Aging had a statistically significant effect on premolar abutment marginal (P=.008) and occlusal (P=.011) discrepancy values, as well as molar abutment occlusal discrepancy values (P=.039). In both the glazing and aging data, for all areas of interest, statistically significant differences were detected among the fabrication techniques (P<.05). The LCM group had the lowest discrepancy values, followed by the SLA, SF, and DLP groups. CONCLUSIONS The LCM and SLA groups outperformed the other groups in terms of fit accuracy. The glazing and aging procedures altered the discrepancy values. The marginal discrepancy values of all groups were below the threshold of clinical acceptability (<120 µm).
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Affiliation(s)
- Dilem Toksoy
- Research Assistant, Department of Prosthetic Dentistry, Faculty of Dentistry, Near East University, Nicosia, North Cyprus
| | - Özay Önöral
- Associate Professor, Department of Prosthetic Dentistry, Faculty of Dentistry, Near East University, Nicosia, North Cyprus.
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Ismail HS, Elawsya ME, Ali AI. Effect of light-, chemical-, and dual-cured universal adhesives on the internal adaptation of resin composites to pulpal and gingival internal walls. Am J Dent 2024; 37:91-100. [PMID: 38704852] [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] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
PURPOSE To compare the internal adaptation of restorative systems bonded to mid-coronal and gingival dentin using light-cured, chemical-cured, and dual-cured adhesives, both immediately and after aging. METHODS 60 molars were selected and received occluso-mesial preparations with dentin gingival margins. Restorations were performed using different restorative systems with light-cured, chemical-cured, and dual-cured adhesives. Internal adaptation was assessed by examining the percentage of continuous margin (%CM) at the pulpal and gingival dentin under a scanning electron microscope at x200 magnification. Half of the teeth were stored in sterile water for 24 hours, while the other half underwent 10,000 thermal cycles. Micro-morphological analysis was conducted on representative samples at x1,000 magnification. RESULTS The restorative system with light-cured adhesive exhibited significantly lower %CM values at the gingival dentin, particularly after aging. Aging had a negative impact on the %CM values of the pulpal and gingival dentin in restorative systems with light-cured and dual-cured adhesives. Regional dentin variations influenced the %CM values, especially after aging, regardless of the restorative system used. The tested restorative system with chemical-cured adhesive is preferable for achieving improved internal adaptation when bonding to both mid-coronal and gingival dentin, compared to the other tested systems. CLINICAL SIGNIFICANCE The study highlights the variations in adhesive performance between different regional dentin areas using the tested restorative systems.
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Affiliation(s)
- Hoda S Ismail
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt,
| | - Mohamed E Elawsya
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ashraf I Ali
- Conservative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Atlas AM, Janyavula S, Elsabee R, Alper E, Isleem WF, Bergler M, Setzer FC. Comparison of loupes versus microscope-enhanced CAD-CAM crown preparations: A microcomputed tomography analysis of marginal gaps. J Prosthet Dent 2024; 131:643-651. [PMID: 35643825 DOI: 10.1016/j.prosdent.2022.04.008] [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: 07/18/2021] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Long-term restoration success depends on a precision marginal fit to prevent marginal leakage and caries. The successful fit of a computer-aided design and computer-aided manufactured (CAD-CAM) crown may be affected by different workflow variables, including preparation, scanning, crown design, milling, sintering, and cementation. Discrepancies in any of these steps may result in poor marginal and internal fit. Evidence suggests that tooth preparation may be the most important step in the workflow for a successful outcome. Compared with the traditional means of crown preparation using the naked eye or loupes, the dental operating microscope provides higher magnification and more direct illumination. However, the impact of high magnification during preparation on the marginal quality of CAD-CAM crowns is unclear. PURPOSE The purpose of this in vitro study was to compare marginal fits of CAD-CAM crowns fabricated after initial preparation with loupes and subsequent preparation refinement with either loupes or a microscope. The null hypothesis was that no significant difference would be found in the marginal gap between the preparations with loupes and those with a microscope. MATERIAL AND METHODS Mounted extracted molars (N=18) received initial crown preparations with a coarse grit, rounded shoulder, diamond rotary instrument with loupes of ×3.0 magnification. The teeth were then randomly divided into 2 groups and refined for an additional 2 minutes with fine grit, rounded shoulder, diamond rotary instruments with either loupes (LOUP) or a microscope up to ×10.0 magnification (DOM). The prepared teeth were scanned with an intraoral scanner to fabricate zirconia-reinforced lithium silicate crowns manufactured with a 4-axis milling machine, sintered in a dental furnace in accordance with the manufacturer's instructions, and cemented with self-adhesive resin cement. All teeth with crowns were mounted and scanned with a microcomputed tomography (μCT) system at 21-μm nominal voxel size. The resulting Digital Imaging and Communications in Medicine (DICOM) images were imported into a semiautomatic segmentation software program. Marginal and absolute gaps were measured at 24 consistent circumferential points per specimen. Absolute gaps were labeled, and the total volume was calculated. Paired and unpaired t tests were used for statistical analysis (α=.05). RESULTS The mean marginal gap was 145.0 ±259.6 μm for LOUP and 35.6 ±110.6 μm for DOM, with a statistically significant difference (P<.001). The mean gap volume for LOUP was 0.975 ±0.811 mm3, and 0.250 ±0.477 mm3 for DOM, also statistically significantly different (P=.023). A significant difference was found between the absolute and marginal gaps for LOUP (P=.007), but for DOM, the difference was not significant (P=.063). CONCLUSIONS This study demonstrated that the higher magnification used during tooth preparation played a significant role in the size of marginal gaps present around CAD-CAM crowns. Crown preparations finished by using fine grit diamond rotary instruments with a microscope at higher magnification than loupes resulted in a more precise marginal fit with smaller gaps.
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Affiliation(s)
- Alan M Atlas
- Private practice, Philadelphia, Pa; and Clinical Professor, Department of Endodontics, Department of Preventive; Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa.
| | - Sridhar Janyavula
- Director of Clinical Affairs & Education, Geistlich Pharma, Princeton, NJ
| | - Rami Elsabee
- Private practice, Philadelphia, Pa; and Clinical Associate, Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | | | - Wael F Isleem
- Post-Doctoral Resident Periodontal Prosthesis Program, Department of Periodontics, Periodontal Prosthesis Program, Department of Periodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa; Private practice, Philadelphia, Pa
| | - Michael Bergler
- Director, Center for Virtual Treatment Planning, Faculty, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | - Frank C Setzer
- Assistant Professor, Director of Pre-Doctoral Endodontics Program, Department of Endodontics, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
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Naguib GH, Bakhsh T, Mazhar J, Turkistani A, Mira A, Aljawi R, Hamed MT. Noninvasive assessment of novel nanohybrid resin cement adaptation using cross-polarization optical coherence tomography. Dent Mater 2024; 40:643-652. [PMID: 38383250 DOI: 10.1016/j.dental.2024.02.004] [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: 11/11/2023] [Revised: 01/28/2024] [Accepted: 02/06/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVES Zein-coated magnesium oxide nanoparticles (zMgO NPs) can potentially improve cement adaptation to the tooth-restoration interface, which would aid in minimizing marginal leakage and secondary caries. The aim of this study was to assess the effect of incorporating zMgO NPs on the adaptation of self-adhesive resin cement using cross-polarization optical coherence tomography (CP-OCT) and scanning electron microscopy (SEM). METHODS Resin inlays were fabricated to be cemented in Class-I cavities of extracted human molars. All specimens were randomly divided into five groups (n = 10), and the resin inlays were cemented using self-adhesive resin cement with various concentrations of zMgO NPs (0% [control], 0.3%, 0.5%, 1%, 2%). Characterization was done by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and SEM. The specimens were examined for interfacial adaptation under CP-OCT. Floor and wall adaptation measurements were analyzed by software on 20 B-scans, and samples were sectioned for interfacial measurement by SEM. RESULTS Results for CP-OCT and SEM showed a statistically significant increase of adaptation in the floor and wall of resin cement filled with zMgO NPs compared to the control. The samples enhanced with 0.3% and 0.5% showed a statistically significantly better adaptation in floor and wall in CP-OCT and SEM. However, there was no significant difference between the 1%, 2%, and control groups for CP-OCT and SEM analysis. SIGNIFICANCE The incorporation of zMgO NPs in self-adhesive resin cement can enhance the cement's properties by significantly improving its wall and floor adaptation.
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Affiliation(s)
- Ghada H Naguib
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Oral Biology, Cairo University School of Dentistry, Cairo, Egypt.
| | - Turki Bakhsh
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | | | - Alaa Turkistani
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Abdulghani Mira
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Rabab Aljawi
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Mohamed T Hamed
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Department of Fixed Prosthodontics, Cairo University School of Dentistry, Cairo, Egypt.
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Lei B, Xiong H, Chen K. Comparison of wear and marginal fitness of 3D-printed deciduous molar crowns: An in vitro study. Dent Mater J 2024; 43:227-234. [PMID: 38417862 DOI: 10.4012/dmj.2022-143] [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] [Indexed: 03/01/2024]
Abstract
This study aimed to evaluate the wear resistance of primary tooth enamel and 3 kinds of 3D printing materials and to compare the marginal fitness and internal suitability of prefabricated all-ceramic crowns, computer-aided design/manufacturing (CAD/CAM) all-ceramic crowns, and three 3D-printed deciduous molar crowns. Multifunctional friction wear testing machine was used to image the wear surface of the sample and calculate the maximum wear depth and volume loss value of each sample. The internal fit evaluation used the silicon replica method, The four points were measured using scanning electron microscopy (SEM). The obtained data were statistically analyzed using ANOVA and Tukey HSD-test with a fully randomized design (p<0.05). The results showed the wear resistance of E-Dent400 was better than that of PEEK and three different 3D printed materials have good wear resistance compared with the primary tooth enamel. The measured values at M1 and M4 of E-Dent400 were both the smallest.
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Affiliation(s)
- Bin Lei
- Department of pedodontics, Stomatological Hospital, Southern Medical University
- School of Stomatology, Jinan University
| | - Huacui Xiong
- Department of pedodontics, Stomatological Hospital, Southern Medical University
| | - Ke Chen
- Department of pedodontics, Stomatological Hospital, Southern Medical University
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Koc Vural U, Meral E, Ergin E, Gurgan S. Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals. Clin Oral Investig 2024; 28:207. [PMID: 38459231 PMCID: PMC10924002 DOI: 10.1007/s00784-024-05570-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/20/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial. MATERIALS AND METHODS Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05). RESULTS After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months. CONCLUSION GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism. CLINICAL SIGNIFICANCE After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.
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Affiliation(s)
| | - Ece Meral
- Hacettepe University, Ankara, Turkey.
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Ñaupari-Villasante R, de Freitas A, Hass V, Matos TP, Parreiras SO, Reis A, Gutiérrez MF, Loguercio AD. Prolonged polymerization of a universal adhesive in non-carious cervical lesions: 36-month double-blind randomized clinical trial. J Dent 2024; 142:104823. [PMID: 38145806 DOI: 10.1016/j.jdent.2023.104823] [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: 11/04/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 12/27/2023] Open
Abstract
OBJECTIVE To evaluate the effect of prolonged (P) polymerization time of a universal adhesive system applied in etch-and-rinse (ER) or self-etch (SE) strategies on the clinical performance of restorations in non-carious cervical lesions (NCCLs), after 36 months of clinical service. METHODS A total of 140 restorations were randomly placed in 35 subjects according to the polymerization time groups: ER (10 s); ER-P (40 s); SE (10 s); and SE-P (40 s) at 1,200 mW/cm2. Composite resin was placed incrementally. The restorations were evaluated immediately and after 6, 12, 18, and 36 months using the FDI criteria. Data were analyzed using the Kaplan-Meier survival test for retention loss, and the Kruskal-Wallis' test for secondary outcomes (α = 0.05). RESULTS After 36 months, 19 restorations were lost: ER 6, ER-P 2, SE 9, SE-P 2. The retention rates were 82.3% for ER; 94.1 % for ER-P; 73.5 % for SE; and 94.1 % for SE-P, with a significant difference between ER vs. ER-P and SE vs. SE-P, as well as ER vs. SE-P and ER-P vs. SE (p < 0.0001). Minor defects were observed in 18 restorations for the marginal staining criteria: ER 5, ER-P 2, SE 8, SE-P 3; and in 33 restorations for the marginal adaptation criteria: ER 11, ER-P 4, SE 12, and SE-P 6 (p > 0.05). No restorations showed recurrence of caries or postoperative sensitivity. CONCLUSIONS A prolonged polymerization time of 40 s improves the clinical performance of the universal adhesive for both adhesive strategies evaluated, even after 36 months. CLINICAL SIGNIFICANCE Prolonging the polymerization time of a universal adhesive from 10 to 40 s has been shown to improve its clinical performance when used in NCCLs.
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Affiliation(s)
- Romina Ñaupari-Villasante
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - André de Freitas
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - Viviane Hass
- School of Dentistry, Oral and Craniofacial Sciences, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Thalita P Matos
- Department of Restorative Dentistry, School of Dentistry, Tuiuti University of Paraná, Curitiba, PR, Brazil
| | - Sibelli O Parreiras
- Department of Restorative Dentistry, State University of Northern Paraná, Jacarezinho, PR, Brazil
| | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - Mario F Gutiérrez
- Universidad de los Andes, Chile. Facultad de Odontología, Santiago, Chile; Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
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Eid HS, Zohdy MM, Nour M, Salah T. A comparative analysis of the passivity of fit of complete arch implant-supported frameworks fabricated using different acquisition techniques. J Prosthet Dent 2024; 131:477.e1-477.e8. [PMID: 38129259 DOI: 10.1016/j.prosdent.2023.11.032] [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: 07/15/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023]
Abstract
STATEMENT OF PROBLEM The accuracy of intraoral scanners (IOSs) in recording edentulous jaws has improved recently. However, improvement in accuracy does not necessarily imply the clinical validity of the scans, and limited information is available regarding the manufacture of passively fitting prostheses. PURPOSE The purpose of this in vitro study was to analyze the passivity of complete arch screw-retained frameworks fabricated using different acquisition techniques. MATERIAL AND METHODS A 3-dimensional maxillary edentulous model to receive all-on-4 screw-retained frameworks was prototyped. Eighteen polymethylmethacrylate (PMMA) frameworks were fabricated with a 5-axis milling machine and divided into 3 groups according to the acquisition technique (n=6): scanned by using an IOS (CEREC Primescan; Dentsply Sirona), scanned with the aid of an auxiliary device by using the same IOS, and by using a conventional impression and then scanning the stone cast with an extraoral scanner (EOS). The passivity of fit of the frameworks was tested with the 1-screw test, the terminal screw of the framework assembly was tightened on the multiunit abutment (MUA), and the vertical marginal gap (µm) was measured at the other 3 framework-to-abutment interfaces by using a digital microscope at ×40 magnification. A modification to the 1-screw test was analyzed by tightening all screws and then unscrewing all except 1 of the anterior abutments. Data were explored for normality by using the theoretical quantile-quantile (Q-Q) plots and the Shapiro-Wilk test of normality. The Friedman test compared data between the different acquisition techniques; the tightening methods and locations (buccal and palatal) were used as the block variable. The post hoc Dunn test was used when the Friedman test was significant. The Kruksal-Wallis test compared the data from the 2 groups of the tightening methods and the 2 location groups. The aligned rank transformation (ART) ANOVA test was used for the interaction effects among the 3 variables. A multiway ANOVA was applied to the ranked data. (α=.05 for all tests). RESULTS Significant differences were found among all groups (P<.001). Regarding the passivity of fit, the mean vertical marginal gap was 50 µm for frameworks fabricated from an intraoral scan with the aid of an auxiliary device, 62 µm for frameworks fabricated by using an IOS, and 140 µm for frameworks fabricated by using an EOS. No significant difference was found among all groups regarding the tightening method (P=.355) or location measured (P=.175). CONCLUSIONS Digital scanning with the aid of an auxiliary device resulted in the best fit; however, digital approaches with or without the auxiliary device resulted in a more accurate fit with a smaller marginal gap than with the conventional impression.
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Affiliation(s)
- Heba Shawky Eid
- Lecturer, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | - Maged Mohammed Zohdy
- Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams university, Cairo, Egypt
| | - Moustafa Nour
- Lecturer, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Tarek Salah
- Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams university, Cairo, Egypt; and Vice Dean, Postgraduate Affairs and Scientific Research, Faculty of Dentistry, Misr International University, Cairo, Egypt
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Calazans FS, Ferreira TDMJ, Ñaupari-Villasante R, Mendonça RP, Ornellas G, Albuquerque EG, Tardem C, de Miranda MS, Barceleiro MO, Loguercio AD. Influence of surface sealants on the quality of posterior restorations with bulk-fill composites: A 4-year randomized clinical trial. Dent Mater 2024; 40:466-476. [PMID: 38142146 DOI: 10.1016/j.dental.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical performance of surface sealants associated with a bulk-fill composite in posterior restorations after 4 years. METHODS A total of 174 posterior restorations were performed on 57 participants using a self-etch adhesive system and a bulk-fill composite. The groups were then divided into the following categories: 1) without surface sealant (NoS), 2) with surface sealant Biscover (Bisco, SBi), and 3) with surface sealant Permaseal (Ultradent, SPe). Restorations were evaluated using FDI criteria at baseline and after 1 and 4 years. Statistical analysis was conducted using Kaplan-Meier survival analysis and the Chi-square test (α = 0.05). RESULTS After 4 years, only one restoration was lost (1 in the NoS group). The fracture/retention rate (with 95% confidence interval) was 98% for NoS and 100% for both SBi and SPe (p = 0.76). The majority of secondary outcomes showed minor defects, with no significant differences among the groups (p > 0.05). However, significant differences were observed among the groups in terms of marginal staining and marginal adaptation (p = 0.03). In both items, twelve restorations (nine in NoS, one in SBi, and two in SPe) showed minor marginal discrepancies favoring the sealant groups (SBi and SPe). SIGNIFICANCE Regardless of the use of surface sealants, the bulk-fill composite restorations showed excellent clinical performance after 4 years. However, the groups that received sealants showed better marginal adaptation and less marginal discoloration compared to those that did not receive sealants.
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Affiliation(s)
- Fernanda Signorelli Calazans
- Department of Restorative Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil
| | | | - Romina Ñaupari-Villasante
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - Rafael Pinto Mendonça
- Department of Restorative Dentistry, Institute of Science and Technology of São José dos Campos, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - Giulia Ornellas
- Department of Restorative Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil
| | - Elisa Gomes Albuquerque
- Operative Dentistry Department, School of Dentistry, Juiz de Fora Federal University, Juiz de Fora, MG, Brazil
| | - Chane Tardem
- Department of Restorative Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil
| | - Mauro Sayao de Miranda
- Restorative Dentistry Department, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Marcos O Barceleiro
- Department of Restorative Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil.
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
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Sarkaria AS, Duke A. Digitally manufactured partial coverage restorations: is it time to down the impression trays or still a work in progress? Evid Based Dent 2024; 25:35-36. [PMID: 38243025 DOI: 10.1038/s41432-024-00971-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/21/2024]
Abstract
DATA SOURCES Pubmed, EMBASE, Scopus, Web of Science and Cochrane library databases were used as the data sources for this systematic review. Manual search of the reference lists of the included studies was also conducted. STUDY SELECTION The aim of the systematic review was to compare a fully digital workflow to a fully conventional workflow in the fabrication of partial coverage restorations. Partial coverage restorations were defined as inlays, onlays, overlays and endocrowns. Four independent calibrated reviewers screened studies that fulfilled a predefined PICOS framework. Population was specified as an abutment tooth requiring a partial coverage restoration. The intervention was a fully digital workflow compared to a fully conventional workflow. Outcomes were accuracy, marginal and internal fit, success, survival, complication rates and patient-reported outcomes. Study design included both clinical and in vitro studies. DATA EXTRACTION AND SYNTHESIS A total of 23 articles were included in qualitative synthesis ranging from 2007 to 2021. Twenty-one of these were in vitro studies. Two authors independently reviewed the included articles, performed data extraction, and evaluated the risk of bias via an adapted Checklist for Reporting In Vitro studies (CRIS) for in vitro studies and Reporting Randomised Clinical studies (RoB2) for clinical studies. RESULTS Seventeen studies assessed the marginal and internal fit of onlay and inlay restorations, eight of which found that a conventional workflow demonstrated improved fit compared to digital, whilst the remaining nine studies found the contrary. Differing methods were utilised across the studies to assess fit, including: the silicone replica method, microcomputed tomography, microscopy and software-based measurements. Similar fracture strengths were reported between both conventional and digital workflows in three studies. One clinical study assessed survival rates of both pressed and CAD/CAM ceramic restorations and found the survival outcomes to be similar after seven years. No studies were found that investigated patient-reported outcomes or endocrowns. CONCLUSIONS No consensus was reached as to whether the digital or conventional workflow is better.
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Affiliation(s)
- Amandeep Singh Sarkaria
- CT2 Restorative Dentistry, Aberdeen Dental Hospital and Institute of Dentistry, Aberdeen, Scotland, UK.
| | - Alice Duke
- StR Restorative Dentistry, Aberdeen Dental Hospital and Institute of Dentistry, Aberdeen, Scotland, UK
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Rivera M, Blatz MB. Precision Matters: The Evolution of Impression Systems and Materials. Compend Contin Educ Dent 2024; 45:158-159. [PMID: 38460141] [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] [Subscribe] [Scholar Register] [Indexed: 03/11/2024]
Abstract
The clinical success of indirect restorations is directly correlated with their specific anatomic shape and design as well as marginal accuracy and overall precision of fit. These factors require a precise impression of the preparation and, to the extent necessary and possible, other teeth and supporting hard and soft tissues.
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Affiliation(s)
- Macarena Rivera
- Assistant Professor, Department of Prosthodontics, University of Chile, Santiago, Chile; Adjunct Professor, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine,Philadelphia, Pennsylvania; Private Practice, Santiago, Chile
| | - Markus B Blatz
- Professor of Restorative Dentistry, Chair, Department of Preventive and Restorative Sciences, and Assistant Dean, Digital Innovation and Professional Development, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
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Liu X, Feng K, Dong L, Liu L, Ni L, Zheng D. Accuracy and Efficiency of Digitally Fabricated All-Ceramic Crowns from Conventional Impressions and Intraoral Scans: A Single-Blind Clinical Randomized Controlled Trial. INT J PROSTHODONT 2024; 37:8-15. [PMID: 36484666 DOI: 10.11607/ijp.8143] [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: 02/17/2024]
Abstract
PURPOSE To evaluate the accuracy of intraoral scanners by comparing the marginal fit of 70 all-ceramic crowns fabricated from both conventional impressions and intraoral scans. MATERIALS AND METHODS A total of 70 posterior teeth requiring single-crown restorations randomly underwent either intraoral scanning or conventional impression-taking, followed by laboratory scanning of the casts in a parallel-group randomized controlled trial (RCT). Subsequently, 70 monolithic all-ceramic crowns were CAD/CAM fabricated; only the impression technique differed. The marginal fit, internal fit, adjustment time required for insertion and occlusal contacts, and visual analog scale (VAS) scores assessing dentists' satisfaction with the crowns were clinically evaluated by a calibrated examiner who was blinded to the groups. Data were analyzed using independent samples t test and likelihood-ratio test or Fisher exact test. All tests were performed with α = .05. RESULTS The mean marginal fit with intraoral scanning (57.94 Å} 22.51 μm) was better than with diagnostic cast scanning (82.98 Å} 21.72 μm). The difference was statistically significant (P = .000). The differences in internal fit, adjustment time for crown insertion and occlusal contacts, and VAS scores were also significant, and the secondary outcomes were in favor of intraoral scanning. CONCLUSIONS Within the limitations of this clinical trial, CAD/CAM-fabricated single-tooth restorations in the posterior region produced with an intraoral scanning technique using TRIOS were found to be a more accurate, efficient alternative to restorations based on conventional impressions in combination with the laboratory scanning technique.
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Ahlholm P, Sipilä K, Tarvonen PL, Silvast T, Lappalainen R. Accuracy of Dental Restorations Fabricated Using Milling vs 3D-Printed Molds: A Pilot Study. INT J PROSTHODONT 2024; 37:79-88. [PMID: 38498860 DOI: 10.11607/ijp.8236] [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 compare the accuracy of 12 different dental restorations fabricated with milling or 3D-printed molds and robotically controlled casting. MATERIALS AND METHODS Twelve dental restorations (11 inlays and onlays and 1 crown) were made per restoration type, one per each of the 12 different teeth models (total of 24 restorations). On each tooth preparation, two restorations were manufactured using different CAD/ CAM techniques: (1) milling and (2) robotically controlled casting and 3D-printed molds. In addition, twolayer restorations were manufactured with 3D-printed molds. The marginal and internal gaps were evaluated at 120 points per restoration based on micro-CT 3D imaging. Internal gaps were evaluated using a replica technique with silicone. RESULTS Median values (interquartile ranges) for marginal gaps, middle internal gaps, and central internal gaps were significantly lower for 3D-printed mold restorations (44.3 [65.4] μm, 95.4 [96.2] μm, and 104.6 [78.1] μm) compared to milled restorations (58.4 [93] μm, 145.9 [85.8] μm, and 138.6 [65.7] μm). Internal gaps in the 3D-printed mold group were 6% to 51% smaller than in the milled group. CONCLUSIONS The accuracy of restorations fabricated with 3D-printed molds may be preferable compared to milled restorations, except in the case of crown restoration. However, additional studies with a larger number of samples and different types of restorations are needed to confirm the results.
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Alkaff NA, Ruse DN, Aminzadeh K, Hannam AG, Mostafa N. Marginal Fit and Internal Adaptation of Monolithic Zirconia 3-Unit Fixed Dental Prosthesis: In Vitro Study. INT J PROSTHODONT 2024; 37:109. [PMID: 38381993 DOI: 10.11607/ijp.8087] [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: 02/23/2024]
Abstract
PURPOSE To compare the marginal and internal fit of monolithic zirconia (MZ) 3-unit fixed dental prostheses (FDPs) fabricated using two CAD/CAM workflows: full-chairside (FCH) and lab (LAB). MATERIALS AND METHODS The right maxillary first premolar and first molar were prepared for MZ 3-unit FDPs on a typodont. CEREC Primescan digitized the typodont model 15 Omes. A total of 30 FDPs was fabricated using two processes: FCH (n = 15) and LAB (n = 15). FCH and LAB FDPs were designed using CEREC SW 4.5.1 and Exocad and milled using CEREC MC X and Zirkonzhan 600/V3, respectively. A fast-sintering protocol was used in both groups. A dual-scan technique was used to assess the cement space at the occlusal surface (OC), axial wall (AX), and margin (MA). Statistical analysis of the results was performed using univariate ANOVA with Scheff. post hoc test (a = .05). RESULTS Measurements in the FCH and LAB groups were within the clinically acceptable marginal and internal fit. The fit of FCH FDPs at MA, AX, and OC was 77.50 ± 29.99 μm, 99.67 ± 21.58 μm, and 150.03 ± 30.78 μm, respectively. The fit of LAB FDPs at MA, AX, and OC was 100.27 ± 27.06 μm, 116.53 ± 17.90 μm, and 142.30 ± 19.00 μm, respectively. The difference between the two groups was not statistically significant. CONCLUSIONS MZ 3-unit FDPs fabricated using FCH have clinically acceptable marginal and internal fit. This result verifies the ability of FCH workflow to fabricate MZ mulOunit FDPs in a single visit.
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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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No-Cortes J, Attard B, Mifsud DP, Lima JF, Markarian RA, Ayres AP, Cassar G, Cortes ARG, Attard NJ. Comparison of 3D-Printed Single Crown Outcomes Among Different Computer-Aided Design Software Programs. INT J PROSTHODONT 2024; 37:63-70. [PMID: 38489222 DOI: 10.11607/ijp.8718] [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: 03/17/2024]
Abstract
PURPOSE Low-cost resin 3D printers have been used to produce affordable interim single crowns in public and private dental practices. The purpose of this study was to assess the impact of different computer-aided design (CAD) software programs on 3D trueness, microscopic marginal and internal gaps, time to design, and interproximal contacts of low-cost 3D-printed single crowns. MATERIALS AND METHODS This in vitro study was performed on a total of 90 standardized resin-prepared teeth adapted to a dental manikin. For comparison among CAD software programs, 45 tooth preparations received 3D-printed crowns designed with one of three CAD software programs by an experienced technician and identified as groups TRIOS (n = 15), EXOCAD (n = 15), and ZZ (Zirkonzahn; n = 15). To assess interoperator reproducibility, 15 additional crowns were designed by a dental clinician (group ZZ-DENT) and 15 by a dental prosthetic technician (group ZZ-PROS), both with basic 1-week CAD/CAM training. Finally, as a control group, 15 crowns were milled using a high-end five-axis milling device (group ZZ-CONTROL). Statistically significant differences for 3D trueness, microscopic gaps, time to design, and interproximal contacts among groups were assessed with the Kruskal-Wallis test. RESULTS No statistically significant differences in 3D trueness or marginal or internal gaps were found, either among different software programs or CAD operators (P > .05). However, Group TRIOS took significantly longer to design than EXOCAD and ZZ groups (P = .001). Less-experienced operators were significantly outperformed in time and interproximal contacts (P = .001) by the CAD technician using the same software program. Finally, control milled crowns (ZZ-CONTROL) significantly outperformed the respective 3D-printed copies (ZZ) in all assessed variables (P < .001). CONCLUSIONS Different CAD software programs may affect the time required to design, but they do not significantly affect clinical outcomes of low-cost 3D-printed resin crowns if designed by an experienced CAD technician.
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D'haese R, Coopman R, Vrombaut T, de Bruyn H, Vadenweghe S. Fit and Strength of a Three-Unit Temporary Prosthesis Made by Different Manufacturing Techniques: An In Vitro Study. INT J PROSTHODONT 2024; 37:34-40. [PMID: 37222543 DOI: 10.11607/ijp.8365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE To compare the fit and fracture load of temporary fixed partial prostheses fabricated by means of a conventional direct technique, milling, or 3D printing. MATERIALS AND METHODS A maxillary right first premolar and molar were prepared on a Frasaco cast, which was then duplicated 40 times. In total, 10 provisional three-unit fixed prostheses (Protemp 4, 3M) were made using the conventional technique with a putty mold. The 30 remaining casts were scanned to design a provisional restoration using CAD software. A total of 10 designs were milled (CEREC MC X5/shaded PMMA Disk, Dentsply Sirona), while the other 20 were 3D printed with one of the two 3D printers (Asiga UV MAX or Nextdent 5100, C&B, Nextdent). Internal and marginal fit were examined using the replica technique. Next, the restorations were cemented on their respective casts and loaded until fracture using a universal testing machine. The location and propagation of the fracture were also evaluated. RESULTS 3D printing demonstrated the best internal fit. Nextdent (median internal fit: 132 μm) was significantly better compared to the milled (median internal fit: 185 μm; P = .006) and conventional restorations (median internal fit: 215 μm; P < .001), while the fit of Asiga (median internal fit: 152 μm) was only significantly better than the conventional restorations (P < .012). The lowest marginal discrepancy was found for the milled restorations (median marginal fit: 96 μm), but this was only significant when compared to the conventional group (median internal fit: 163 μm; P < .001). The conventional restorations demonstrated the lowest fracture load (median fracture load: 536 N), which was only significant when compared to Asiga (median fracture load: 892 N; P = .003). CONCLUSIONS Within the present in vitro study's limitations, CAD/CAM demonstrated superior fit and strength compared to the conventional technique.
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Daou EE. Does the Build Orientation Parameter Affect the Fit of Fixed Partial Dentures Fabricated by Additive Manufacturing? INT J PROSTHODONT 2024; 37:41-47. [PMID: 38489219 DOI: 10.11607/ijp.8343] [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: 02/17/2024]
Abstract
PURPOSE This in vitro study evaluated the adaptation of cobalt-chromium (Co-Cr) fixed dental prostheses (FDPs) fabricated by selective laser melting (SLM) with different build angles. MATERIALS AND METHODS Maxillary right first premolars and first molars from a typodont were prepared with 1-mm chamfer, 2-mm occlusal reduction, and total taper of 8 degrees to receive three-unit FDPs. After framework design, data were sent to a laser machine, and 30 specimens were fabricated from Co-Cr metal powder by SLM. Specimens were assigned to three groups (n = 10 per group) with different build angles of 0 (A0), 30 (A30), and 45 (A45) degrees. Marginal and internal fit were evaluated. Results were compared among build orientation groups and abutments. Data were analyzed using the Levene test, t test, and analysis of variance (α = .05). RESULTS A statistical difference was found between different angle groups (P = .015). At the abutment level, a significant difference was found in the gap values between build orientation groups for the molars (P = .048). Group A0 reported the smallest mean discrepancy values, and group A45 the highest. Statistical differences were found between group A45 and groups A0 (P < .001) and A30 (P < .024). CONCLUSIONS The fit of printed metal FDPs was affected by the build orientation but remained clinically acceptable.
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Bennani V, Aarts JM, Senthilkumar A. Effect of a modified laminate veneer preparation design on absolute margin discrepancy and marginal overhang. J Prosthet Dent 2024; 131:252.e1-252.e8. [PMID: 38042643 DOI: 10.1016/j.prosdent.2023.10.033] [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: 08/25/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 12/04/2023]
Abstract
STATEMENT OF PROBLEM Veneer preparation designs impact veneer accuracy. However, whether a modified design could reduce absolute margin discrepancy and marginal overhangs is unclear. PURPOSE The purpose of this in vitro study was to investigate whether a modified veneer preparation design enhances the absolute margin discrepancy and marginal overhang. MATERIAL AND METHODS The absolute margin discrepancy and the marginal overhang of 3 different veneer preparation designs on a typodont tooth (n=20): feather edge, shoulder, and shoulder with wings were measured. The feather edge design was prepared first and subsequently modified to create the shoulder and shoulder with wings preparations. Ceramic veneers were fabricated using computer-aided design and computer-aided manufacture with each veneer assessed for fit before cementation. Ten specimens were cut vertically, and 10 were cut horizontally in each group. The absolute margin discrepancy and marginal overhangs were measured for each cross-section with scanning electron microscopy. Descriptive data analysis and hypothesis testing were conducted using the nonparametric Kruskal Wallis test (α=.05). RESULTS On the vertical sections, the shoulder with wings preparation had the best absolute margin discrepancy and overhang. The design was also best for mesial overhang and mesial absolute margin discrepancy when measuring horizontally. CONCLUSIONS The shoulder with wings preparation design produced the smallest cervical absolute margin discrepancy and overhang. This design also produced absolute margin discrepancy and overhangs comparable with those of the shoulder design in the proximal areas.
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Affiliation(s)
- Vincent Bennani
- Associate Professor, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
| | - John M Aarts
- Senior Lecturer, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Arthi Senthilkumar
- Lecturer, Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Khanlar LN, Francis C, Basir Barmak A, Rios ALS, Ashtiani RE, Zandinejad A. Effect of a new support design on the marginal and internal gap of additively manufactured interim crowns using direct light deposition technology. J Prosthodont 2024; 33:188-194. [PMID: 36810925 DOI: 10.1111/jopr.13668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
PURPOSE To investigate the design and location of supporting structures on the marginal and internal gap of interim restorations. MATERIALS AND METHODS A mandibular right first molar resin tooth was prepared for a full coverage crown and scanned using a laboratory scanner (3Shape D900). The scanned data were converted into standard tessellation language (STL) format and an indirect prosthesis was designed using computer-aided design (CAD) software (exocad DentalCAD). The STL file was used to fabricate a total of 60 crowns with a 3D printer (EnvisionTEC Vida HD). The crowns were printed using E-Dent C&B MH resin and divided into 4 groups based on four different support structure designs, including supports on the occlusal (0° group), buccal and occlusal (45° group), buccal (90° group), and a new design consisting of horizontal bars placed on all surfaces and line angles (Bar) (n = 15). The silicone replica technique was used to determine the gap discrepancy. Fifty measurements were obtained for each specimen to examine the marginal and internal gaps by using a digital microscope (Olympus SZX16) at ×70 magnification. Additionally, the marginal discrepancy at different locations of the tested crowns, including buccal (B), lingual (L), mesial (M), and distal (D), as well as the maximum and minimum marginal gap intervals among groups, were analyzed. The collected data were analyzed using factorial ANOVA, followed by the Tukey HSD test for multiple comparisons (a = 0.05). RESULTS There was a significant difference in marginal and internal gaps among the groups (p < 0.001). The buccal placement supports (90° group) had the least marginal and internal discrepancies (p < 0.001). The new design group showed the highest marginal and internal gap. The marginal discrepancy in different locations of the tested crowns (B, L, M, D) was found to be significantly different among the groups (p < 0.001). The mesial margin of the Bar group had the largest marginal gap, whereas the buccal margin of the 90° group had the lowest marginal gap. The new design had a significantly smaller difference between the maximum and minimum marginal gap intervals than other groups (p < 0.001). CONCLUSION The location and design of the supporting structures affected the marginal and internal gaps of an interim crown. The buccal placement of supporting bars (90° printing orientation) showed the smallest mean internal and marginal discrepancies.
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Affiliation(s)
- Leila Nasiry Khanlar
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Claire Francis
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Abdul Basir Barmak
- Department of Comprehensive Dentistry, EIOH Medical Center, University of Rochester, Rochester, New York, USA
| | - Alma L Salazar Rios
- Department of Prosthodontics, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Reza Eftekhar Ashtiani
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirali Zandinejad
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
- Private Practice, Arlington, Texas, USA
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Ismail HS, Ali AI. Effect of different restorative systems and aging on marginal adaptation of resin composites to deep proximal margins. J ESTHET RESTOR DENT 2024; 36:346-355. [PMID: 37515523 DOI: 10.1111/jerd.13116] [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: 04/10/2023] [Revised: 06/16/2023] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVES To evaluate and compare the marginal integrity of different restorative systems bonded to proximal gingival dentin, and determine the consistency level of the results obtained by two in vitro methods. MATERIALS AND METHODS Thirty molars received occluso-mesial preparations with dentin/cementum gingival margins. They were divided into three groups and restored using different restorative systems with light-cured (Adhese Universal), self-cured (Palfique universal bond), and dual-cured (Futurabond U) adhesives. The restoration/gingival dentin interfaces were observed using scanning electron microscopy (SEM) and evaluated based on the World Dental Federation (FDI) criteria. After 10,000 thermal cycles, the marginal integrity was re-evaluated. Marginal integrity was evaluated by the percentage of continuous margin (% CM) at ×200 for SEM and as the frequency of each score within the FDI ranking. RESULTS No significant differences were found between the restorative systems immediately, however, the system with the light-cured adhesive had the lowest marginal integrity after aging. All tested restorative systems were adversely affected by aging. A moderate inverse correlation was identified between evaluation techniques. CONCLUSION The tested restorative systems utilizing self-cured and dual-cured adhesives may be preferable for achieving optimal marginal integrity when bonding to deep proximal margins, compared to the tested system with light-cured adhesive. CLINICAL SIGNIFICANCE When performing deep margin elevation, it is important to consider the adhesive system being used.
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Affiliation(s)
- Hoda S Ismail
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ashraf I Ali
- Operative Dentistry Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Mangano FG, Cianci D, Pranno N, Lerner H, Zarone F, Admakin O. Trueness, precision, time-efficiency and cost analysis of chairside additive and subtractive versus lab-based workflows for manufacturing single crowns: An in vitro study. J Dent 2024; 141:104792. [PMID: 38013004 DOI: 10.1016/j.jdent.2023.104792] [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: 11/08/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE To evaluate the trueness, precision, time efficiency, and cost of three different workflows for manufacturing single crowns (SCs). METHODS A plaster model with a prepared tooth (#15) was scanned with an industrial scanner, and an SC was designed in computer-assisted-design (CAD) software. Ten SCs were printed with a hybrid composite (additive chairside) and a stereolithographic (SLA) printer (Dfab®), 10 SCs were milled in lithium disilicate (subtractive chairside) using a chairside milling unit (inLab MC XL®), and 10 SCs were milled in zirconia (lab-based) using a five-axis laboratory machine (DWX-52D®). All SCs were scanned with the same scanner after polymerization/sinterization. Each scan was superimposed to the marginal area of the original CAD file to evaluate trueness: absolute average (ABS AVG), root mean square (RMS), and (90˚-10˚)/2 percentile were calculated for each group. Marginal adaptation and quality of the occlusal and interproximal contact points were also investigated by two prosthodontists on 3D printed and plaster models. Finally, the three workflows' time efficiency and costs were evaluated. RESULTS Additive chairside and subtractive lab-based SCs had significantly better marginal trueness than subtractive chairside SCs in all three parameters (ABS AVG, p < 0.01; RMS, p < 0.01; [90˚-10˚]/2, p < 0.01). However, the two prosthodontists found no significant differences between the three manufacturing procedures in the quality of the marginal closure (p = 0.186), interproximal (p = 0.319), and occlusal contacts (p = 0.218). Both time efficiency and cost show a trend favoring the chairside additive workflow. CONCLUSIONS Chairside additive technology seems to represent a valid alternative for manufacturing definitive SCs, given the high marginal trueness, precision, workflow efficiency and low costs. STATEMENT OF CLINICAL RELEVANCE Additive chairside manufacturing of definitive hybrid composite SCs is now possible and shows high accuracy, time efficiency, and competitive cost.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
| | | | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Henriette Lerner
- Department of Oral, Maxillofacial and Plastic Surgery, Goethe University, Frankfurt, Germany
| | - Fernando Zarone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Oleg Admakin
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia
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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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El-Ma'aita AM, Radwan H, Al-Rabab'ah MA. Deep Margin Elevation - A Retrospective Clinical Study. J Adhes Dent 2024; 26:117-124. [PMID: 38602235 DOI: 10.3290/j.jad.b5199089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
PURPOSE The aim of this retrospective study was to assess the short- to mid-term restorative and periodontal outcome of deep margin elevation (DME) performed using resin composite. MATERIALS AND METHODS Twenty-eight teeth treated with DME and indirect adhesive restorations were followed-up for a mean of 25.4 months (minimum: 12 months). Clinical and radiographic examination assessed the adaptation of the DME material and indirect restorations, presence of recurrent caries or discoloration, periodontal health at DME and non-DME sites, and periapical health. RESULTS The overall success rate was 96.6%. One tooth showed signs and symptoms of apical pathology after 34 months following DME. No caries, discoloration, or periodontal pockets were detected in any of the treated teeth. DME had no detrimental effect on the gingival/periodontal health or plaque accumulation. There was no correlation between the distance from the DME material to the marginal bone level and pocket depth, gingival inflammation, and plaque accumulation (p > 0.05). CONCLUSION Deep margin elevation might be considered a safe procedure for teeth with deep subgingival proximal caries in the short- and mid-term.
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Miranda AO, Favoreto MW, Matos TP, Castro AS, Kunz P, Souza JL, Carvalho P, Reis A, Loguercio AD. Color Match of a Universal-shade Composite Resin for Restoration of Non-carious Cervical Lesions: An Equivalence Randomized Clinical Trial. Oper Dent 2024; 49:20-33. [PMID: 38057996 DOI: 10.2341/23-021-c] [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] [Accepted: 07/03/2023] [Indexed: 12/08/2023]
Abstract
PURPOSE The objective of this double-blind, split-mouth, randomized clinical trial was to evaluate the color match of a single-shade composite resin Admira Fusion X-tra in comparison with a multi-shade composite resin Admira Fusion in non-carious cervical lesion restorations (NCCLs). METHODS AND MATERIALS One hundred and twenty restorations were performed on NCCLs with two restorative materials (n=60). After prophylaxis, the teeth were isolated with a rubber dam, and one universal adhesive was applied in the selective enamel etching strategy. For both groups, the restorations were inserted incrementally and light-cured. The values of the coordinates L*, a*, and b* in the cervical third before vs after the restorations and cervical vs middle third after the restorations were evaluated using a digital spectrophotometer after the coordinate values were used to calculate the CIEDE (ΔE00). The restorations were evaluated at baseline and after 7 days of clinical performance according to the FDI criteria. Statistical analysis was performed using the Chi-square test for all parameters. Color change was analyzed by Student t-test for paired samples (α=0.05). RESULTS All restorations were evaluated after 7 days. Regarding the color measurement, no significant difference was observed when Admira Fusion was compared to Admira Fusion X-tra for any of the comparisons performed (p>0.05). However, the values of ΔE00 in the cervical third before vs after the restorations were higher when compared with ΔE00 observed when the cervical vs middle third after restorations were compared. All restorations received the score "clinically very good" after 7 days for all outcomes, including the subjective color match, when evaluated for FDI criterion. CONCLUSIONS The single-shade composite resin used achieves the same color match when compared to a multi-shade composite resin after 7 days in NCCLs.
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Affiliation(s)
- A O Miranda
- Amanda de Oliveira de Miranda, graduate student, Department of Restorative Dentistry, School of Dentistry, Tuiuti University of Paraná, Curitiba, PR, Brazil
| | - M W Favoreto
- Michael Willian Favoreto, DDS, MSc, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Brazil
| | - T P Matos
- Thalita P. Matos, DDS, MSc, PhD, Department of Restorative Dentistry, School of Dentistry, Tuiuti University of Paraná, Curitiba, PR, Brazil
| | - A S Castro
- Andrea dos Santos de Castro, DDS, MSc, PhD, Department of Restorative Dentistry, School of Dentistry, Tuiuti University of Paraná, Curitiba, PR, Brazil
| | - Pvm Kunz
- Patrícia Valéria Manozzo Kunz, DDS, MSc, PhD, private clinic, Curitiba, PR, Brazil
| | - J L Souza
- Jaqueline de Lima de Souza, graduate student, Department of Restorative Dentistry, School of Dentistry, Tuiuti University of Paraná, Curitiba, PR, Brazil
| | - P Carvalho
- Pamela de Carvalho, graduate student, Department of Restorative Dentistry, School of Dentistry, Tuiuti University of Paraná, Curitiba, PR, Brazil
| | - A Reis
- Alessandra Reis, DDS, PhD, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Brazil
| | - A D Loguercio
- *Alessandro D. Loguercio, DDS, MSc, PhD, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Brazil
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Ozden YE, Ozkurt-Kayahan Z, Kazazoglu E. Effect of intraoral scanning distance on the marginal discrepancy of milled interim crowns. J Prosthodont 2024; 33:41-45. [PMID: 36649200 DOI: 10.1111/jopr.13646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/24/2022] [Accepted: 01/03/2023] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To compare the marginal discrepancy between milled interim crowns fabricated using intraoral digital scans acquired at different scanning distances. MATERIALS AND METHODS Ten acrylic typodont teeth were prepared for interim crowns. Three different resin frames of 2.5-, 5-, and 7.5-mm heights were fabricated and attached to an intraoral scanner (Omnicam). Three groups were created based on the different scanning distances tested: 2.5 mm (Group A), 5 mm (Group B), and 7.5 mm (Group C). Intraoral digital scans were performed on four tooth surfaces: mesial, distal, buccal, and lingual (n = 10). Each experimental scan was used to design and fabricate a milled polymethylmethacrylate anatomically contoured crown. Vinyl polyether silicone was used three times to assess the marginal discrepancy of the specimens by measuring five marginal points on digital photographs. One-way analysis of variance test was used to analyze the data, followed by Tukey's honestly significant difference test (α = 0.05). RESULTS The mean marginal discrepancy values in Group C were significantly higher than those in Groups A (p ≤ 0.000) and B (p = 0.001). There was no significant difference between Groups A and B (p = 0.702). There were no significant differences among the four surfaces in any of the scanning distance groups (p1 = 0.583, p2 = 0.390, and p3 = 0.135; p > 0.05). CONCLUSIONS The interim crowns fabricated with a scanning distance of 7.5 mm showed the greatest marginal discrepancy when compared with crowns fabricated using 2.5- and 5-mm scanning distances.
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Affiliation(s)
- Yunus Emre Ozden
- Department of Prosthodontics, Yeditepe University Faculty of Dentistry, Istanbul, Turkey
| | - Zeynep Ozkurt-Kayahan
- Department of Prosthodontics, Yeditepe University Faculty of Dentistry, Istanbul, Turkey
| | - Ender Kazazoglu
- Department of Prosthodontics, Yeditepe University Faculty of Dentistry, Istanbul, Turkey
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Ozkan Irem D, Alpkilic DS, Isler Deger S. The effect of pre-ceramic soldering on marginal and internal fit of 4-unit zirconia frameworks and monolithic zirconia fixed dental prostheses. Odontology 2024; 112:169-176. [PMID: 37422770 DOI: 10.1007/s10266-023-00826-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/31/2023] [Indexed: 07/11/2023]
Abstract
The aim of this study is to evaluate the effect of pre-ceramic soldering on the marginal and internal fit of 4-unit zirconia fixed dental prostheses (FPDs) that have two abutments and two pontics. 4-unit zirconia frameworks (Zirkonzahn ICE Translucent) (Z Group) and monolithic zirconia (Zirkonzahn Prettau) (M Group) FPDs were manufactured. Groups were divided into two groups (n = 10) control (ZC and MC) and soldering (ZS and MS). Samples of ZS and MS groups were cut into two pieces under cooling water and soldered with a bonding material (DCM Zircon HotBond). The marginal and internal fit of the restorations were measured from 36 points of each sample and cement space volume was calculated using reverse engineering software (Geomagic Design X). The mean and standard deviations were submitted to Generalized Linear Mixed Model (GLMM) analysis (α = 0.05). Statistical differences between groups before and after pre-ceramic soldering on point measurements were found. In total cement spacing measurements, a significant difference was found amongst all groups (P < 0.05). However, in premolars, a statistically significant difference was found between ZC and ZS groups and MC and MS groups (P < 0.05). All discrepancies after pre-ceramic soldering were found to be lower than before.
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Affiliation(s)
| | - Dilara Seyma Alpkilic
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Beyazit Yerleşkesi, Beyazit, 34452, Istanbul, Turkey.
| | - Sabire Isler Deger
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Beyazit Yerleşkesi, Beyazit, 34452, Istanbul, Turkey
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Baig MR, Qasim SSB, Baskaradoss JK. Marginal and internal fit of porcelain laminate veneers: A systematic review and meta-analysis. J Prosthet Dent 2024; 131:13-24. [PMID: 35260253 DOI: 10.1016/j.prosdent.2022.01.009] [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: 08/04/2021] [Revised: 01/01/2022] [Accepted: 01/04/2022] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM Marginal integrity and internal adaptation are key to the long-term success of porcelain laminate veneers. Evidence for their marginal and internal fit is unclear, and the factors affecting such fit have not been identified. PURPOSE The purpose of this systematic review and meta-analysis was to summarize the scientific literature assessing the effects of various parameters on the marginal and internal fit of porcelain laminate veneers. MATERIAL AND METHODS An electronic search was conducted to identify all relevant published articles on the fit accuracy of ceramic veneers between January 2000 and June 2021 in the PubMed-MEDLINE, Scopus, Embase, Google Scholar, and Web of Science databases. Information, including the study outcomes, in terms of the mean marginal gap, internal gap, and absolute marginal discrepancies of porcelain laminate veneers, was extracted from the selected studies. The inverse-variance random effects model was used to analyze the pooled results and estimate the overall effect based on the heterogeneity of studies (α=.05). RESULTS Twenty-one studies were selected for analysis, 2 clinical and 19 in vitro. The risk of bias was "medium" for most studies (19 of 21), and only 2 studies were classified as "high risk." A mean difference of -4.53 μm (95% CI: -21.46 to 12.41) was found, with no statistically significant difference in marginal gap between the pressed and milled fabrication modes (P=.600). As for the internal gap, significant differences were found (mean difference=-40.56 μm; 95% CI: -76.54 to -4.58), with pressed veneers performing better (P=.030). Butt joint preparation design produced significantly (P=.002) lower marginal gaps than the palatal chamfer (mean difference=-14.02 μm; 95% CI: -23.07 to -4.98). CONCLUSIONS No significant differences were found between the pressed and milled porcelain laminate veneers for marginal gap, but for the internal gap, the differences were significantly in favor of the pressed type. The butt joint veneer preparation design was significantly better than the palatal chamfer design in terms of marginal fit.
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Affiliation(s)
- Mirza Rustum Baig
- Associate Professor, Department of Restorative Sciences (Prosthodontics), Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait.
| | - Sayed Saad Bin Qasim
- Assistant Professor, Department of Bioclinical Sciences (Dental Materials), Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait
| | - Jagan Kumar Baskaradoss
- Assistant Professor, Department of Developmental and Preventive Sciences (Dental Public Health), Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait
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Ibrahim H, El Kateb M, Morsy N. Effect of modifying occlusal cement spacer on the fit accuracy of digitally manufactured zirconia crowns. J Prosthet Dent 2024; 131:93.e1-93.e6. [PMID: 37867014 DOI: 10.1016/j.prosdent.2023.09.035] [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: 06/25/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023]
Abstract
STATEMENT OF PROBLEM Cement spacer has a crucial influence on the adaptation of fixed restorations. Recently, digitally fabricated zirconia crowns have become more popular, but studies on the effect of occlusal cement spacer on the fit accuracy of digitally designed and milled zirconia crowns are lacking. PURPOSE The purpose of this in vitro study was to investigate the effect of modifying digital occlusal spacer on the marginal and internal fit of digitally manufactured zirconia crowns. MATERIAL AND METHODS A maxillary molar typodont tooth was prepared for a zirconia crown, scanned with the Medit i700 intraoral scanner (IOS), and the standard tessellation language (STL) file was used to produce 3-dimensionally (3D) printed definitive dies assigned to 3 groups (n=12). All dies were scanned with the IOS, and the obtained STL files were exported to a computer-aided design (CAD) software program for the designing and milling of 36 complete contour zirconia crowns. The zirconia crown design was identical in the 3 groups for all parameters (default parameters in the CAD software program) with a 80-µm radial spacer 1 mm from the finish lines. The occlusal cement spacer was adjusted to 80 µm, 40 µm, and 0 µm for group 80-80, group 40-80, and group 0-80 respectively. The internal and marginal fit of the crowns were measured on their corresponding definitive dies with the replica technique. The Kruskal-Wallis test followed by the Dunn test with the Bonferroni correction was used for statistical analysis of the results (α=.05). RESULTS The modification of occlusal cement spacer significantly affected the marginal and internal fit of digitally manufactured crowns (P<.05). Group 0-80 and group 40-80 had similar marginal gap values, which were significantly lower than those of group 80-80 (P<.017). For internal fit accuracy, group 0-80 displayed significantly lower gap values than group 40-80 and group 80-80 for all measured areas. Group 40-80 had significantly lower gap values than group 80-80 at the mid-occlusal and axio-occlusal areas (P<.017). CONCLUSIONS Modifying occlusal cement spacer significantly affected the fit of digitally fabricated zirconia crowns. Reducing or eliminating occlusal spacer resulted in significantly improved fit accuracy.
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Affiliation(s)
- Heba Ibrahim
- Senior Researcher in Fixed Prosthodontics, Department of Conservative Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohammed El Kateb
- Professor of Fixed Prosthodontics, Department of Conservative Dentistry, Alexandria University, Alexandria, Egypt
| | - Noha Morsy
- Lecturer of Fixed Prosthodontics, Department of Conservative Dentistry, Alexandria University, Alexandria, Egypt..
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De Almeida R, Siqueira F, Verde T, Ñaupari-Villasante R, Reis A, Loguercio AD, Cardenas A. Prolonged application time effects on universal adhesives in non-carious cervical lesions: An 18-month split mouth randomized clinical trial. J Dent 2024; 140:104800. [PMID: 38056759 DOI: 10.1016/j.jdent.2023.104800] [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: 11/16/2023] [Accepted: 12/03/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE This double-blind, split mouth randomized clinical trial aimed to assess the clinical performance of Clearfil Universal Bond Quick (CBUq) universal adhesive under different application times (no waiting and waiting) compared to Clearfil SE Bond adhesive in non-carious cervical lesions (NCCLs) over 18 months. METHODS One hundred and eighty-three restorations were distributed randomly into three groups based on the adhesive system and waiting time: CUBq without waiting time (CUBq-NW), CUBq with a 20 s waiting time (CUBq-W), and CSE with a 20 s waiting time. After placement, restorations were evaluated after 18 months using the International Dental Federation (FDI) and United States Public Health Service (USPHS) criteria. Statistical analyses involved Friedman repeated measures analysis of variance and Wilcoxon tests, with a significance level set at 5 %. RESULTS Over the 18-month period, no restorations were lost across the tested groups. Marginal adaptation evaluation indicated minor discrepancies in 21 restorations (8 CUBq-NW, 6 CUBq-W, and 7 CSE). There were no significant differences observed among the three groups following the 18-month clinical assessment (p > 0.05). Only two restorations showed marginal discoloration after 18 months (1 CUBq-NW and 1 CSE). CONCLUSIONS The application of Clearfil Universal Bond Quick using either the "waiting" or "no-waiting" technique exhibited excellent clinical results in NCCLs during the 18-month follow-up period, demonstrating comparable performance to Clearfil SE Bond in all assessed outcomes. CLINICAL SIGNIFICANCE The findings suggest that the new universal adhesive applied using the no-waiting technique demonstrates promising clinical performance when compared to conventional application methods. TRIAL REGISTRATION ClinicalTrials.gov identifer RBR-69p7mpr.
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Affiliation(s)
- Rab De Almeida
- Department of Postgraduate Program in Dentistry, CEUMA University, São Luis, Maranhão, Brazil
| | - Fsf Siqueira
- Department of Postgraduate Program in Dentistry, CEUMA University, São Luis, Maranhão, Brazil
| | - Thiago Verde
- Department of Postgraduate Program in Dentistry, CEUMA University, São Luis, Maranhão, Brazil
| | - R Ñaupari-Villasante
- Department of Restorative Dentistry, Dental Post-Graduate Program, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil
| | - A Reis
- Department of Restorative Dentistry, Dental Post-Graduate Program, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil
| | - A D Loguercio
- Department of Restorative Dentistry, Dental Post-Graduate Program, State University of Ponta Grossa, Rua Carlos Cavalcanti, 4748, Bloco M - Uvaranas, Ponta Grossa, Paraná, Brazil.
| | - Afm Cardenas
- Department of Postgraduate Program in Dentistry, CEUMA University, São Luis, Maranhão, Brazil
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Reda SA, Hussein YF, Riad M. The impact of Bis-GMA free and Bis-GMA containing resin composite as posterior restoration on marginal integrity: a randomized controlled clinical trial. BMC Oral Health 2023; 23:1022. [PMID: 38114979 PMCID: PMC10731870 DOI: 10.1186/s12903-023-03759-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/12/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND There have been concerns surrounding the utilization of Bis-GMA, a type of bisphenol A (BPA) derivative, within the dental industry. The aim of this study was to compare the performance of bulk fill Bis-GMA-free resin composite class II restorations in respect of its marginal integrity in comparison to bulk fill Bis-GMA-containing resin composite class II restorations over a 12-month period in a parallel clinical trial utilizing a split-mouth, double-blind, randomized strategy. METHODS 20 patients participated in this study. Each patient has received one pair of class II posterior restorations, Bis-GMA-free (Admira fusion x-tra), and Bis-GMA containing (x-tra fil) on each side of the mouth (split-mouth strategy), (n = 40). The restorations' marginal integrity was evaluated based on Ryge's criteria (modified USPHS) at baseline (after 1 week), as well as 1 month, 3 months, 6 months, 9 months, and after 12 months of follow-up by two calibrated examiners. The statistical analyses utilizing the Friedman and Wilcoxon tests, the significance level was adjusted to 0.05. RESULTS Following the 12-month period, all patients attended the recall visits to evaluate the restorations. The Wilcoxon signed-rank and Friedman tests, revealed that both types of bulk fill had 100% of Alpha (A) scores at baseline and after 1 month with no significant statistical differences. After 3, 6, 9, and 12 months, both tested bulk fill restorations showed Bravo (B) score with Bis-GMA free 10% and 5% for Bis-GMA containing with no statistically significant difference (p ≤ 0.05) for clinical marginal integrity parameter in USPHS criteria. CONCLUSIONS Bis-GMA-free resin composites demonstrated satisfactory, marginal integrity compared with Bis-GMA-containing resin composites within 12 months. TRIAL REGISTRATION The protocol of the current study was registered at www. CLINICALTRIALS gov , with the identification number NCT05480852 on 29/07/2022. All procedures involving human participants were performed in accordance with the ethical standards of the Research Ethics Committee of the Faculty of Dentistry, Minia University, Egypt, under the approval number 419 on 27/06/2020.
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Affiliation(s)
- Sara Ahmed Reda
- Operative Dentistry Department, Faculty of Dentistry, Minia University, Minia, Egypt
| | - Yasser Fathi Hussein
- Dental Biomaterials Department, Faculty of Dentistry, Minia University, Minia, 61519, Egypt
| | - Mona Riad
- Conservative Dentistry Department, Faculty of Dentistry, Cairo University, 11 El-Saraya St, Manial, Cairo, 11553, Egypt.
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Saeed EAM, Alaghbari SS, Lin N. The impact of digitization and conventional techniques on the fit of fixed partial dentures FPDs: systematic review and Meta-analysis. BMC Oral Health 2023; 23:965. [PMID: 38049754 PMCID: PMC10696807 DOI: 10.1186/s12903-023-03628-1] [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: 09/07/2023] [Accepted: 11/06/2023] [Indexed: 12/06/2023] Open
Abstract
PURPOSE OF THE STUDY The goal behind this study is to answer the question "In tooth-supported fixed partial dentures (FPDs), does the digital impression techniques compared to fabrications using conventional impression methods improve the marginal and internal fit? BACKGROUND The incorporation of digital technology in the fabrication of fixed partial dentures (FPDs) has accelerated over the past decade. This study is directed at evaluating the marginal and internal fit of FPDs manufactured using digital approaches compared to conventional techniques. The need for updated data has encouraged this review. MATERIALS AND METHODS An electronic search was conducted in PubMed, Scopus, Web of Science, and the Grey Database to identify relevant studies. The Modified Methodological Index for Non-Randomized Studies (MINORS) was used to assess the risk of bias in in vitro experiments. The key results of this meta-analysis were the standard mean differences (SMDs) and 95% confidence intervals (CI) of each main variance, marginal fit, and internal fit between the digital and conventional techniques. Additional analyses were performed to assess the significance of three subgroup parameters: method of digitalization, cement spacer thickness, and span length, and their influence on the fit of the FPDs. RESULTS Based on predefined criteria, of the seven articles included in this systematic review, only five were selected for the quantitative data analysis. The marginal fit results were (P = 0.06; SMD: -1.88; 95% CI: - 3.88, 0.11) (P > 0.05) and the internal fit results were (P = 0.02; SMD: -0.80; 95% CI: - 1.49, - 0.10) (P < 0.05). Regarding the subgroup analyses, the method of digitalization subgroup results were (P = 0.35; SMD: -1.89; 95% CI: - 3.89, 0.11) and (P = 0.80; SMD: -0.80; 95% CI: - 1.49, - 0.11) for marginal and internal fit, respectively. The span length results were (P = 0.10; SMD: -1.89; 95% CI: - 3.89, 0.11) for marginal fit and (P = 0.02; SMD: -0.80; 95% CI: - 1.49, - 0.11) for internal fit. The cement spacer thickness (P = 0.01; SMD: -1.89; 95% CI: - 3.89, 0.11) and (P = 0.04; SMD: -0.80; 95% CI: - 1.49, - 0.11) for marginal and internal fit, respectively. CONCLUSION Tooth-retained fixed partial dentures FPDs produced by digital scanning and computer-aided design/computer-aided manufacturing (CAD/CAM) systems can significantly enhance the internal fit compared with those manufactured by traditional methods. Intraoral scanners can replace conventional impressions for the fabrication of FPDs because they minimize the operating time and reduce patient pain. Further clinical studies are required to obtain more conclusive results. SYSTEMATIC REVIEW REGISTRATION This systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42021261397.
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Affiliation(s)
- Esraa A M Saeed
- Prosthodontic Department, Hospital of Stomatology, Xian Jiaotong University, No. 98, West 5th Road, Zhonglou Commercial District, Xian City, 710003, Shaanxi, China
| | - Samar S Alaghbari
- Prosthodontic Department, Hospital of Stomatology, Xian Jiaotong University, No. 98, West 5th Road, Zhonglou Commercial District, Xian City, 710003, Shaanxi, China
| | - Niu Lin
- Prosthodontic Department, Hospital of Stomatology, Xian Jiaotong University, No. 98, West 5th Road, Zhonglou Commercial District, Xian City, 710003, Shaanxi, China.
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Bandiaky ON, Clouet R, Le Bars P, Soueidan A, Le Guehennec L. Marginal and internal fit of five-unit zirconia-based fixed dental prostheses fabricated with digital scans and conventional impressions: A comparative in vitro study. J Prosthodont 2023; 32:846-853. [PMID: 36627825 DOI: 10.1111/jopr.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study aimed to compare the marginal and internal fit of five-unit zirconia-based fixed dental prostheses (FDPs) fabricated using digital scans and conventional impressions. MATERIALS AND METHODS Nine master models with three zirconia abutments were scanned with an intraoral scanner (test group), and nine conventional impressions (control group) of these same models were also made. The stone casts from these impressions were scanned with a laboratory extraoral scanner (D700, 3Shape, Copenhagen, Denmark). A total of 18 five-unit zirconia-based FDP frameworks (test group, n = 9; control group, n = 9) were manufactured. Marginal and internal fit (in μm) were evaluated using the replica method under micro-computed tomography. Analysis of variance (one-way ANOVA) and Kruskal-Wallis tests were used to compare continuous variables across two groups. A level of p < 0.05 was accepted as statistically significant. RESULTS The mean ± standard deviation of the marginal fit was 95.03 ± 12.74 μm in the test group and 106.02 ± 14.51 μm in the control group. The lowest marginal mean value was observed in the test group, with a statistically significant difference compared to the control group (F = 14.56, p < 0.05). The mean ± standard deviation of the internal fit was 103.61 ± 9.32 and 106.38 ± 7.64 μm, respectively, in the test and control groups, with no statistically significant difference (F = 1.56, p > 0.05). The mean values of both groups were clinically acceptable. CONCLUSIONS The five-unit zirconia-based FDPs fabricated with digital scans showed better fit than those in the conventional impression group. Within the limitations of this study, these results are encouraging, and continued progress in the digital field should allow for more accurate long-span restorations.
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Affiliation(s)
- Octave Nadile Bandiaky
- Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
| | - Roselyne Clouet
- Department of Prosthetic Dentistry, Nantes University, CHU Nantes, Nantes, France
| | - Pierre Le Bars
- Department of Prosthetic Dentistry, Nantes University, CHU Nantes, Nantes, France
| | - Assem Soueidan
- Department of Periodontology, Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
| | - Laurent Le Guehennec
- Department of Prosthodontics, Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
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Loguercio AD, Ñaupari-Villasante R, Gutierrez MF, Gonzalez MI, Reis A, Heintze SD. 5-year clinical performance of posterior bulk-filled resin composite restorations: A double-blind randomized controlled trial. Dent Mater 2023; 39:1159-1168. [PMID: 37839995 DOI: 10.1016/j.dental.2023.10.018] [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: 04/28/2023] [Revised: 09/07/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVES The aim of this double-blind, and randomized controlled clinical trial was to evaluate the 5-year clinical performance of posterior resin composite restorations placed with the incremental filling technique [IF] or the bulk-fill technique [BF]. Two different adhesive systems were used: etch-&-rinse (ER) or self-etch (SE). METHODS Posterior dental teeth of 72 participants (n = 236), with a cavity depth of at least 3 mm, were randomly divided into four groups. Restorations were applied with either Tetric N-Bond or Tetric N-Bond SE. The composite resin Tetric N-Ceram Bulk-Fill was placed either with IF or BF. Restorations were evaluated using FDI criteria at baseline and after 1, 2, 3, 4, and 5 years. Statistical analysis was performed using the Wilcoxon Signed rank test (a=0.05). RESULTS Two hundred and four restorations were evaluated after 5 years. Eleven restorations were considered 'failed', ten due to fracture (4 IF and 6 BF) and one due to secondary caries (IF). The annual failure rate was 1.2% for BF and 1% for IF (p = 0.35). When comparing BF and IF, no significant differences were found for any of the parameters evaluated (p > 0.05). Regarding the adhesive systems, 44 and 51 restorations showed minor problems in terms of marginal adaptation and staining, with significantly more marginal discoloration when the self-etch adhesive was used (p = 0.002). SIGNIFICANCE The bulk-fill restorative technique showed good clinical behavior compared to the incremental filling technique, especially when using an etch-&-rinse adhesive, after 5 years of clinical evaluation.
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Affiliation(s)
- Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - Romina Ñaupari-Villasante
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - Mario F Gutierrez
- Universidad de los Andes, Chile, Facultad de Odontologia, Chile; University of Chile, Department of Restorative Dentistry, Faculty of Dentistry, Chile
| | | | - Alessandra Reis
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
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Ellakwa A, Goh D. THE MARGINAL ACCURACY OF LITHIUM DISILICATE SINGLE CROWNS IS COMPAREABLE WHEN MADE FROM CONVENTIONAL OR DIGITAL (DIRECT OR INDIRECT) WORKFLOWS. J Evid Based Dent Pract 2023; 23:101914. [PMID: 38035892 DOI: 10.1016/j.jebdp.2023.101914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Tabesh M, Nejatidanesh F, Savabi G, Davoudi A, Savabi O. Marginal accuracy of lithium disilicate full coverage crowns made by direct and indirect digital or conventional workflows: a systematic review and meta-analysis. J Prosthodont. 2022;31(9):744-753. doi:10.1111/jopr.13515. SOURCE OF FUNDING Dental Research Center, Isfahan University of Medical Sciences Research Grant #298095. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data.
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Sun Z, Shen Z, Zhao J, Zheng Y. Adaptation and uniformity of monolithic zirconia crowns fabricated by additive 3-dimensional gel deposition. J Prosthet Dent 2023; 130:859-865. [PMID: 35135676 DOI: 10.1016/j.prosdent.2021.11.023] [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: 05/30/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 12/13/2022]
Abstract
STATEMENT OF PROBLEM A novel monolithic zirconia restoration fabricated by additive 3-dimensional (3D) gel deposition, named as self-glazed zirconia (SGZ), has recently been developed. SGZ crowns exhibit reliable mechanical properties and esthetic appearance, but their adaptation and uniformity are unclear. PURPOSE The purpose of this in vitro study was to compare the adaptation and uniformity of monolithic zirconia crowns fabricated by additive 3D gel deposition with that of milled zirconia and lithium disilicate crowns. MATERIAL AND METHODS Ten identical resin abutments were made based on the scanning data of an extracted and prepared human mandibular first molar. Three types of monolithic crowns were then fabricated by using 2 different processes: 3D gel deposition zirconia (SGZ), milled zirconia (ZZ), and milled lithium disilicate (EMX) (n=10) through a completely digital workflow. The nondestructive direct-view technique and replica technique were used to measure the marginal and internal discrepancy values individually. The uniformity index was calculated to describe the uniformity of the internal space. The results were analyzed by using 1-way ANOVA and Kruskal-Wallis statistical tests (α=.05). RESULTS The marginal discrepancy of EMX exhibited the highest values among the 3 groups (P=.001). The 2 types of zirconia crowns had comparable marginal discrepancy values (P>.05). The internal discrepancy values of SGZ were significantly lower than those of EMX at the occlusal region and of ZZ at all measured locations (P<.05). All 3 types of monolithic crowns showed comparable good uniformity (P=.056). CONCLUSIONS The marginal and internal adaptations of novel monolithic zirconia crowns were within clinical requirements. Compared with the zirconia and lithium disilicate crowns fabricated by subtractive milling, monolithic zirconia crowns fabricated by additive 3D gel deposition had comparable uniformity and better internal adaptation.
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Affiliation(s)
- Zhe Sun
- Practicing Physician, Department of General Dentistry, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Zhenyu Shen
- Graduate student, Graduate Prosthodontics, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Jing Zhao
- Attending Physician, Department of General Dentistry, Stomatological Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Yuanna Zheng
- Associate Professor, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China.
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