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1.

Statement of problem

Dental laboratories use different computer-aided design and computer-aided manufacturing (CAD-CAM) systems to fabricate fixed prostheses; however, limited evidence is available concerning which system provides the best marginal discrepancy.

Purpose

The purpose of this in vitro study was to evaluate the marginal fit of 5 different monolithic zirconia restorations milled with different CAD-CAM systems.

Material and methods

Thirty monolithic zirconia crowns were fabricated on a custom-designed stainless steel die and were divided into 5 groups according to the type of monolithic zirconia crown and the CAD-CAM system used: group TZ, milled with an MCXL milling machine; group CZ, translucent zirconia milled with a motion milling machine; group ZZ, zirconia milled with a dental milling unit; group PZ, translucent zirconia milled with a zirconia milling unit; and group BZ, solid zirconia milled using an S1 VHF milling machine. The marginal fit was measured with a binocular microscope at an original magnification of ×100. The results were tabulated and statistically analyzed with 1-way ANOVA and post hoc surface range test, and pairwise multiple comparisons were made using Bonferroni correction (α=.05).

Results

The type of CAD-CAM used affected the marginal fit of the monolithic restoration. The mean (±SD) highest marginal discrepancy was recorded in group TZI at 39.3 ±2.3 μm, while the least mean marginal discrepancy was recorded in group IZ (22.8 ±8.9 μm). The Bonferroni post hoc test showed that group TZI was significantly different from all other groups tested (P<.05).

Conclusions

Within the limitation of this in vitro study, all tested CAD-CAM systems produced monolithic zirconia restorations with clinically acceptable marginal discrepancies; however, the CAD-CAM system with the 5-axis milling unit produced the best marginal fit.  相似文献   

2.

Statement of problem

Clinical studies comparing the retention values of milled denture bases with those of conventionally processed denture bases are lacking.

Purpose

The purpose of this clinical study was to compare the retention values of conventional heat-polymerized denture bases with those of digitally milled maxillary denture bases.

Material and methods

Twenty individuals with completely edentulous maxillary arches participated in this study. Definitive polyvinyl siloxane impressions were scanned (iSeries; Dental Wings), and the standard tessellation language files were sent to Global Dental Science for the fabrication of a computer-aided design and computer-aided manufacturing (CAD-CAM) milled denture base (group MB) (AvaDent). The impression was then poured to obtain a definitive cast that was used to fabricate a heat-polymerized acrylic resin denture base resin (group HB). A custom-designed testing device was used to measure denture retention (N). Each denture base was subjected to a vertical pulling force by using an advanced digital force gauge 3 times at 10-minute intervals. The average retention of the 2 fabrication methods was compared using repeated ANOVA (α=.05).

Results

Significantly increased retention was observed for the milled denture bases compared with that of the conventional heat-polymerized denture bases (P<.001).

Conclusions

The retention offered by milled complete denture bases from prepolymerized poly(methyl methacrylate) resin was significantly higher than that offered by conventional heat- polymerized denture bases.  相似文献   

3.

Statement of problem

Although new digital manufacturing techniques are attracting interest in dentistry, few studies have comprehensively investigated the marginal fit of fixed dental prostheses fabricated with such techniques.

Purpose

The purpose of this in vitro microcomputed tomography (μCT) study was to evaluate the marginal fit of cobalt-chromium (Co-Cr) alloy copings fabricated by casting and 3 different computer-aided design and computer-aided manufacturing (CAD-CAM)-based processing techniques and alloy systems.

Material and methods

Single Co-Cr metal crowns were fabricated using 4 different manufacturing techniques: casting (control), milling, selective laser melting, and milling/sintering. Two different commercial alloy systems were used for each fabrication technique (a total of 8 groups; n=10 for each group). The marginal discrepancy and absolute marginal discrepancy of the crowns were determined with μCT. For each specimen, the values were determined from 4 different regions (sagittal buccal, sagittal lingual, coronal mesial, and coronal distal) by using imaging software and recorded as the average of the 4 readings. For each parameter, the results were statistically compared with 2-way analysis of variance and appropriate post hoc analysis (using Tukey or Student t test) (α=.05).

Results

The milling and selective laser melting groups showed significantly larger marginal discrepancies than the control groups (70.4 ±12.0 and 65.3 ±10.1 μm, respectively; P<.001), whereas the milling/sintering groups exhibited significantly smaller values than the controls (P=.004). The milling groups showed significantly larger absolute marginal discrepancy than the control groups (137.4 ±29.0 and 139.2 ±18.9 μm, respectively; P<.05). In the selective laser melting and milling/sintering groups, the absolute marginal discrepancy values were material-specific (P<.05). Nonetheless, the milling/sintering groups yielded statistically comparable (P=.935) or smaller (P<.001) absolute marginal discrepancies to the control groups.

Conclusions

The findings of this in vitro μCT study showed that the marginal fit values of the Co-Cr alloy greatly depended on the fabrication methods and, occasionally, the alloy systems. Fixed dental prostheses produced by using the milling/sintering technique can be considered clinically acceptable in terms of marginal fit.  相似文献   

4.

Statement of problem

Several studies have shown the superiority of computer-assisted design and computer-assisted manufacturing (CAD-CAM) technology compared with conventional casting. However, an advanced technology exists for casting procedures (the overcasting technique), which may serve as an acceptable and affordable alternative to CAD-CAM technology for fabricating 3-unit implant-supported fixed dental prostheses (FDPs).

Purpose

The purpose of this in vitro study was to evaluate, using quantitative photoelastic analysis, the effect of the prosthetic framework fabrication method (CAD-CAM and overcasting) on the marginal fit and stress transmitted to implants. The correlation between marginal fit and stress was also investigated.

Material and methods

Three-unit implant-supported FDP frameworks were made using the CAD-CAM (n=10) and overcasting (n=10) methods. The frameworks were waxed to simulate a mandibular first premolar (PM region) to first molar (M region) FDP using overcast mini-abutment cylinders. The wax patterns were overcast (overcast experimental group) or scanned to obtain the frameworks (CAD-CAM control group). All frameworks were fabricated from cobalt-chromium (CoCr) alloy. The marginal fit was analyzed according to the single-screw test protocol, obtaining an average value for each region (M and PM) and each framework. The frameworks were tightened for the photoelastic model with standardized 10-Ncm torque. Stress was measured by quantitative photoelastic analysis. The results were submitted to the Student t test, 2-way ANOVA, and Pearson correlation test (α=.05).

Results

The framework fabrication method (FM) and evaluation site (ES; M and PM regions) did not affect the marginal fit values (P=.559 for FM and P=.065 for ES) and stress (P=.685 for FM and P=.468 for ES) in the implant-supported system. Positive correlations between marginal fit and stress were observed (CAD-CAM: r=0.922; P<.001; overcast: r=0.908; P<.001).

Conclusions

CAD-CAM and overcasting methods present similar marginal fit and stress values for 3-unit FDP frameworks. The decreased marginal fit of frameworks induces greater stress in the implant-supported system.  相似文献   

5.

Statement of problem

Complete-mouth implant-supported rehabilitations are challenging because of the multiple surgical and prosthetic steps involved in clinical evaluations to assure passive prosthesis fit and optimal esthetic and functional outcomes. As a result, these rehabilitations are usually associated with substantial clinical time, patient discomfort, and high treatment cost.

Purpose

The purpose of this pilot clinical study was to evaluate a novel digital approach integrating digital intraoral dental and extraoral facial scanning information to design and mill a computer-aided design and computer-aided manufacturing (CAD-CAM) implant-retained prosthesis for patients with complete edentulism.

Material and methods

Ten patients in need of complete-mouth rehabilitation were included in this pilot study. Digital intraoral records were obtained through optical scanning the duplicate interim prosthesis using a laboratory scanner, while digital extraoral records were obtained through facial scanning using an in-office scanner. The scanned impressions and occlusal records were used to create a virtual tooth arrangement, which was matched to the patient’s 3-dimensional face scan to create a virtual clinical evaluation phase. After applying the necessary adjustments, the virtual arrangement was submitted to a CAM procedure where a 5-axis industrial milling machine was used to fabricate an interim prosthesis.

Results

Digital intraoral and extraoral records were integrated and used to fabricate CAD-CAM milled interim prostheses, which were inserted and assessed for clinical fit, occlusion/articulation, and esthetics. The prostheses remained in function for at least 6 months with no notable technical or biological complications except for 1 prosthesis that fractured.

Conclusions

A novel digital workflow incorporating facial scanning in a CAD-CAM workflow was used to fully digitally design and mill 10 implant-retained interim prostheses. More research is required to further develop and assess the accuracy and applicability of this approach.  相似文献   

6.

Statement of problem

The precision of fit of chairside computer-aided design and computer-aided manufacturing (CAD-CAM) complete crowns is affected by digital impression and restorative material.

Purpose

The purpose of this in vitro study was to evaluate by microcomputed tomography (μCT) the marginal and internal adaptation of composite resin and ceramic complete crowns fabricated with 2 different intraoral cameras and 2 restorative materials.

Material and methods

Ten extracted human third molars received crown preparations. For each prepared molar, 2 digital impressions were made with different intraoral cameras of the CEREC system, Bluecam and Omnicam. Four groups were formed: LB (Lava Ultimate+Bluecam), EB (Emax+Bluecam), LO (Lava Ultimate+Omnicam), and EO (Emax+Omnicam). Before measuring the precision of fit, all crowns were stabilized with a silicone material. Each unit (crown + prepared tooth) was imaged with μCT, and marginal and internal discrepancies were analyzed. For the 2D analysis, 120 measurements were made of each crown for marginal adaptation, 20 for marginal discrepancy (MD), and 20 for absolute marginal discrepancy (AMD); and for internal adaptation, 40 for axial space (AS) and 40 for occlusal space (OS). After reconstructing the 3D images, the average internal space (AIS) was calculated by dividing the total volume of the internal space by the contact surface. Data were analyzed with 2-way ANOVA and quantile regression.

Results

Regarding marginal adaptation, no significant differences were observed among groups. For internal adaptation measured in the 2D evaluation, a significant difference was observed between LO and EO for the AS variable (Mann-Whitney test; P<.008). In assessment of AIS by the 3D reconstruction, LB presented significantly lower values than the other groups (Tukey post hoc test; P<.05). Bluecam presented lower values of AIS than Omnicam, and composite resin crowns showed less discrepancy than did ceramic crowns.

Conclusions

The marginal adaptations assessed in all groups showed values within the clinically accepted range. Moreover, the composite resin blocks associated with the Bluecam intraoral camera demonstrated the best results for AIS compared with those of the other groups.  相似文献   

7.

Statement of problem

Marginal adaptation plays an important role in the survival of metal-ceramic restorations. Porcelain firings and cementation may affect the adaptation of restorations. Moreover, conventional casting procedures and casting imperfections may cause deteriorations in the marginal adaptation of metal-ceramic restorations.

Purpose

The purpose of this in vitro study was to compare the marginal adaptation after fabrication of the framework, porcelain application, and cementation of metal-ceramic restorations prepared by using the conventional lost-wax technique, milling, direct metal laser sintering (DMLS), and LaserCUSING, a direct process powder-bed system. Alterations in the marginal adaptation of the metal frameworks during the fabrication stages and the precision of fabrication methods were evaluated.

Material and methods

Forty-eight metal dies simulating prepared premolar and molar abutment teeth were fabricated to investigate marginal adaptation. They were divided into 4 groups (n=12) according to the fabrication method used (group C serving as the control group: lost-wax method; group M: milling method; group LS: DMLS method; group DP: direct process powder-bed method). Sixty marginal discrepancy measurements were recorded separately on each abutment tooth after fabrication of the framework, porcelain application, and cementation by using a stereomicroscope. Thereafter, each group was divided into 3 subgroups according to the measurements recorded in each fabrication stage: subgroup F (framework), subgroup P (porcelain application), and subgroup C (cementation). Data were statistically analyzed with univariate analysis of variance (followed by 1-way ANOVA and Tamhane T2 test (α=.05).

Results

The lowest marginal discrepancy values were observed in restorations prepared by using the direct process powder-bed method, and this was significantly different (P<.001) from the other methods. The highest marginal discrepancy values were recorded after the cementation procedure in all groups.

Conclusions

The results showed that the direct process powder-bed method is quite successful in terms of marginal adaptation. The marginal discrepancy increased after porcelain application and cementation.  相似文献   

8.

Statement of problem

The marginal and internal discrepancies of computer-aided design and computer-aided manufacturing (CAD-CAM) endocrowns are unknown.

Purpose

The purpose of this in vitro study was to evaluate the marginal and internal discrepancies of endocrowns with different cavity depths by measuring them with microcomputed tomography (μCT).

Material and methods

Endocrowns (n=48) of 2 different cavity depths (2 mm and 4 mm) were fabricated in 2 different chairside CAD-CAM systems (CEREC AC and E4D). A μCT scan was made before and after cementation. For analysis of the marginal and internal discrepancies, reference points were selected in 2-dimensional views of 3 buccolingual cross-sections and 3 mesiodistal cross-sections. To calculate the total discrepancy volume, the μCT sections were reconstructed 3-dimensional views, and changes in volume and surface area were examined. Statistical analysis was performed using 2-way ANOVA with Bonferroni correction (α=.05).

Results

An endocrown with a 4-mm cavity showed a larger marginal and internal volume than one with a 2-mm cavity. Cementation did not show significant differences in total discrepancy thickness. Discrepancies on the pulpal floor were largest in other sites. Both chairside CAD-CAM systems showed similar discrepancy in the endocrowns.

Conclusions

Based on the present study, marginal and internal discrepancies increased depending on cavity depth. Cementation did not increase the dimension of the discrepancy between the restoration and the cavity wall. The discrepancy on the pulpal floor appeared to affect these results.  相似文献   

9.

Statement of problem

In addition to the original abutments provided by implant companies, compatible computer-aided design and computer-aided manufacturing (CAD-CAM) abutments are also available from different manufacturers. However, the combination of abutments and implant systems from different manufacturers may lead to mechanical problems between components. Little has been reported on the clinical performance of this treatment option.

Purpose

The purpose of this retrospective case series was to evaluate the outcome of compatible CAD-CAM titanium abutments (TiAs) for posterior single-implant tooth replacement (PSITR) up to 6 years after insertion.

Material and methods

Eighty-one patients (34 men, 47 women) who received PSITR restored with compatible CAD-CAM TiAs and had a final recall examination between May 2014 and April 2015 were included in this study. Clinical and radiographic examinations were documented. Retrospective evaluation of the patient records was also performed. Correlations between bone-level changes and variables were calculated using the Spearman correlation.

Results

Implant and prosthesis survival rates were 100%. Twenty technical complications were observed, including 9 decementations of the crown, 6 screw loosenings, and 5 ceramic fractures. Periimplant mucositis was diagnosed in 36 patients (44.4%) and periimplantitis in 6 patients (7.4%). Correlation analysis showed a significant effect of the extent of periodontal bone loss of the remaining teeth on the marginal bone-level changes around implants (r=0.548, P<.001).

Conclusions

Compatible CAD-CAM TiAs provide a viable treatment option for PSITR. However, in light of relatively high screw-loosening and decementation rates, choosing appropriate cements and abutment manufacturers is essential to improve the clinical performance of this treatment option.  相似文献   

10.

Statement of problem

Given the limitations of conventional waxing, computer-aided design and computer-aided manufacturing (CAD-CAM) technologies have been developed as alternative methods of making patterns.

Purpose

The purpose of this in vitro study was to compare the marginal and internal fit of metal copings derived from wax patterns fabricated by rapid prototyping (RP) to those created by the conventional handmade technique.

Material and methods

Twenty-four standardized brass dies were milled and divided into 2 groups (n=12) according to the wax pattern fabrication method. The CAD-RP group was assigned to the experimental group, and the conventional group to the control group. The cross-sectional technique was used to assess the marginal and internal discrepancies at 15 points on the master die by using a digital microscope. An independent t test was used for statistical analysis (α=.01).

Results

The CAD-RP group had a total mean (±SD) for absolute marginal discrepancy of 117.1 (±11.5) μm and a mean marginal discrepancy of 89.8 (±8.3) μm. The conventional group had an absolute marginal discrepancy 88.1 (±10.7) μm and a mean marginal discrepancy of 69.5 (±15.6) μm. The overall mean (±SD) of the total internal discrepancy, separately calculated as the axial internal discrepancy and occlusal internal discrepancy, was 95.9 (±8.0) μm for the CAD-RP group and 76.9 (±10.2) μm for the conventional group. The independent t test results showed significant differences between the 2 groups. The CAD-RP group had larger discrepancies at all measured areas than the conventional group, which was statistically significant (P<.01).

Conclusions

Within the limitations of this in vitro study, the conventional method of wax pattern fabrication produced copings with better marginal and internal fit than the CAD-RP method. However, the marginal and internal fit for both groups were within clinically acceptable ranges.  相似文献   

11.

Statement of problem

The optimal retention of implant-supported ceramic crowns on zirconia abutments is a goal of prosthodontic treatment.

Purpose

The purpose of this in vitro study was to evaluate the retentive strength of implant-supported IPS e.max CAD-CAM (e.max) crowns bonded to custom zirconia implant abutments with different cements.

Material and methods

An optical scan of a zirconia custom abutment and a complete-coverage modified crown was designed using an intraoral E4D scanner. One hundred twenty lithium disilicate crowns (IPS e.max CAD) were cemented to 120 zirconia abutment replicas with 1 of 6 cements: Panavia 21 (P21), Multilink Hybrid Abutment (MHA), RelyX Unicem 2 (RXU), RelyX Luting Plus (RLP), Ketac Cem (KC), and Premier Implant (PI). The specimens were stored at 37°C in 100% humidity for 24 hours. Half of the specimens were thermocycled for 500 cycles. The retentive force was measured using a pull-out test with a universal testing machine. Mean retentive strengths (MRS) were calculated using 2-way ANOVA and the Tukey-Kramer test (α=.05).

Results

The MRS (MPa) after 24-hour storage were P21 (3.1), MHA (2.5), RXU (2.5), RLP (1.3), KC (0.9), and PI (0.5). The MRS after thermocycling were MHA (2.5), P21 (2.2), RLP (1.8), KC (1.4), RXU (1.1), and PI (0.3). P21 had the highest MRS after 24-hour storage (P<.001), but after thermocycling MHA had the highest MRS (P<.001). RXU showed a significant decrease in MRS after thermocycling (P<.05). Cement residue was mostly retained on the zirconia abutments for P21, while for the other cements’ residue was retained on the lithium disilicate crowns.

Conclusions

The cements tested presented a range of retentive strengths, providing the clinician with a choice of more or less retentive cements. MHA was the most retentive cement after thermocycling. Thermocycling significantly affected the retentive strengths of the P21 and RXU cements.  相似文献   

12.

Statement of problem

Proper marginal, axial, and occlusal adaptation of dental restorations is essential for their long-term success. Production protocols including digital impression systems have been developed, but little information is available on the adaptation of zirconia restorations produced via them.

Purpose

The purpose of this in vitro study was to compare the effects of digital impression protocols on the marginal, axial, and occlusal adaptation of zirconia copings.

Material and methods

Thirty extracted human maxillary premolar teeth without caries or defects were used. The teeth were prepared for zirconia crowns and randomly divided into 3 groups. Zirconia copings were designed at a thickness of 0.5 mm with 30 μm of simulated die spacer starting 1 mm from the margin of preparations. They were produced using computer-aided design-computer-aided manufacture (CAD-CAM) protocol with a conventional impression (group Cn) and 2 different production protocols with digital impressions (group C) and group Tr. The marginal, axial, and occlusal discrepancies of these copings were measured using the silicone replica technique with stereomicroscopy at ×50 magnification, and the data were analyzed with 1-way ANOVAs (α=.05).

Results

The mean marginal discrepancy values were 85.6 μm for group Cn, 58.7 μm for group C, and 47.7 μm for the Tr group. Significant differences were found among the production protocols in marginal, axial, and occlusal discrepancies (P<.05). Copings fabricated with the aid of digital impressions had significantly fewer marginal discrepancies than those of group Cn (P<.05). Group Tr exhibited the lowest marginal discrepancy, whereas groups Cn and C demonstrated similar axial adaptations (P>.05), and group Tr revealed the lowest axial discrepancy (P<.05). With regard to the occlusal discrepancy evaluation, group Tr had the lowest discrepancy. However, no significant differences was found between groups C and Cn (P>.05).

Conclusions

The copings produced with the aid of digital impression systems exhibited better marginal and occlusal adaptation than those of the copings produced with the aid of conventional impression.  相似文献   

13.

Statement of problem

Reports on computer-engineered complete dentures (CECDs) continue to increase. Systematic reviews on clinical outcomes and applications associated with CECDs are lacking in the literature.

Purpose

The purpose of this systematic review was to determine the clinical outcomes and applications of CECDs.

Material and methods

Electronic searches of the English literature from January 1984 to May 2016 were performed in MEDLINE and Cochrane databases, with the results enriched by hand searches and citation mining to address 2 relevant population intervention comparison outcome (PICO) questions: What are the clinical outcomes associated with CECDs? Are there specific applications and significant advantages for CECDs?

Results

A review of the selected articles on CECDs revealed significantly better retention and reduced clinical time for the milled CECDs compared with conventional complete dentures. An advantage associated with CECDs is the possibility of electronically archiving data using digital technology for rapid fabrication. Applications reported in the literature with CECDs were also identified.

Conclusions

A positive trend was seen in the outcomes with CECDs, although patient selection might have also contributed to favorable outcomes. Significantly reduced clinical time, improved retention, and digital archiving were the main advantages associated with CECDs.  相似文献   

14.

Statement of problem

The comparative assessment of computer-aided design and computer-aided manufacturing (CAD-CAM) technology and other fabrication techniques pertaining to marginal adaptation should be documented. Limited evidence exists on the effect of restorative material on the performance of a CAD-CAM system relative to marginal adaptation.

Purpose

The purpose of this systematic review was to investigate whether the marginal adaptation of CAD-CAM single crowns, fixed dental prostheses, and implant-retained fixed dental prostheses or their infrastructures differs from that obtained by other fabrication techniques using a similar restorative material and whether it depends on the type of restorative material.

Material and methods

An electronic search of English-language literature published between January 1, 2000, and June 30, 2016, was conducted of the Medline/PubMed database.

Results

Of the 55 included comparative studies, 28 compared CAD-CAM technology with conventional fabrication techniques, 12 contrasted CAD-CAM technology and copy milling, 4 compared CAD-CAM milling with direct metal laser sintering (DMLS), and 22 investigated the performance of a CAD-CAM system regarding marginal adaptation in restorations/infrastructures produced with different restorative materials.

Conclusions

Most of the CAD-CAM restorations/infrastructures were within the clinically acceptable marginal discrepancy (MD) range. The performance of a CAD-CAM system relative to marginal adaptation is influenced by the restorative material. Compared with CAD-CAM, most of the heat-pressed lithium disilicate crowns displayed equal or smaller MD values. Slip-casting crowns exhibited similar or better marginal accuracy than those fabricated with CAD-CAM. Cobalt-chromium and titanium implant infrastructures produced using a CAD-CAM system elicited smaller MD values than zirconia. The majority of cobalt-chromium restorations/infrastructures produced by DMLS displayed better marginal accuracy than those fabricated with the casting technique. Compared with copy milling, the majority of zirconia restorations/infrastructures produced by CAD-CAM milling exhibited better marginal adaptation. No clear conclusions can be drawn about the superiority of CAD-CAM milling over the casting technique and DMLS regarding marginal adaptation.  相似文献   

15.

Statement of problem

The definition of centric relation (CR) has been both controversial and divisive, with little consensus.

Purpose

The purpose of this study was to determine whether agreement can be reached on a definition for CR among the Fellows of the Academy of Prosthodontics, the organization that writes the Glossary of Prosthodontic Terms.

Material and methods

A survey of the Fellows of the Academy of Prosthodontics was conducted at the organization’s annual business meeting.

Results

Of the 83 eligible Fellows in attendance, 72 responded to the survey, a response rate of 86%. Of those, the 5 responders who did not indicate a preferred definition and the 2 that chose 2 definitions were censored, yielding an analyzable sample of 65 for the definitions. The most common definition received 19 votes, the next 16, and the third 13, with the other 6 definitions receiving from 2 to 5 votes. Some of the variability in definition depended on the era of training.

Conclusions

Disagreement and confusion continues regarding the definition of centric relation. Some of this disagreement can be explained by training era.  相似文献   

16.

Statement of problem

With the increased number of published systematic reviews and in view of their wide clinical applicability, these studies must be carefully assessed before professionals begin to use their recommendations in daily practice, and above all, the methodological quality of this study design must be considered. In implant dentistry, one topic that has been arousing particular interest is the immediate placement of dental implants into infected sites.

Purpose

The purpose of this systematic review was to determine the methodological quality of systematic reviews that evaluated the immediate placement of dental implants into infected sites.

Material and methods

A systematic search was performed by 2 independent reviewers of PubMed, LILACS, and ISI Web of Knowledge up to March 2016. All selected articles were published in the English language. Systematic reviews of original papers that assessed the immediate placement of dental implants into infected sites were eligible for the overview. Narrative reviews, randomized clinical trials, and case reports were excluded. Methodological quality assessment was performed using A Measurement Tool to Assess Systematic Reviews.

Results

Of the 5 selected systematic reviews, 3 were low methodological quality and 2 were assessed as moderate. None were high methodological quality. The first systematic review of the topic was published in 2010, and the most recent, published in 2015, was the only one that performed meta-analysis.

Conclusions

The systematic reviews that assessed the immediate placement of dental implants into infected sites were assessed as low or moderate methodological quality. The topic focus remains controversial because the implant survival rate, the main outcome considered for the implant placement prognosis, presents contradictory results.  相似文献   

17.

Statement of problem

The whitish color of zirconia (ZrO2) abutments offers favorable esthetics compared with the grayish color of titanium (Ti) abutments. Nonetheless, ZrO2 has greater opacity, making it difficult to achieve natural tooth color. Therefore, lithium disilicate (LaT) abutments have been suggested to replace metal abutments.

Purpose

The purpose of this in vitro study was to evaluate the fracture strength and failure mode of single-tooth implant restorations using ZrO2 and LaT abutments, and to compare them with titanium (Ti) abutments.

Material and methods

Five different types of abutments, Ti; ZrO2 with no metal base; ZrO2 with a metal base (ZrT); LaT; and LaT combination abutment and crown (LcT) were assembled on 40 Ti implants and restored with LaT crowns. Specimens were subjected to quasistatic loading using a universal testing machine, until the implant-abutment connection failed. As bending of the metal would be considered a clinical failure, the values of force (N) at which the plastic deformation of the metal occurred were calculated, and the rate of deformation was analyzed. Statistical analysis was done using the Mann-Whitney U test (α=.05).

Results

Group ZrO2 revealed the lowest resistance to failure with a mean of 202 ±33 N. Groups ZrT, LaT, and LaC withstood higher forces without fracture or debonding of the ceramic suprastructure, and failure was due to deformation of metal bases, with no statistically significant differences between these groups regarding the bending behavior.

Conclusions

Within the limitations of this in vitro study, it was concluded that LaT abutments have the potential to withstand the physiological occlusal forces that occur in the anterior region and that ZrO2 abutments combined with Ti inserts have much higher fracture strength than pure ZrO2 abutments.  相似文献   

18.

Statement of problem

Oral metal exposure has been associated with systemic and local adverse reactions, probably due to elemental release from the alloys. Although supraphysiological concentrations of salts from dentally applied metals can activate innate cells through TLR4 (Ni, Co, Pd) and TLR3 (Au), whether direct exposure to solid alloys can also trigger innate immune reactivity is still unknown.

Purpose

The purpose of this in vitro study was to determine whether dental cast alloy specimens can activate innate cells and influence their responsiveness to bacterial endotoxin.

Material and methods

Human monocyte-derived dendritic cells (MoDC) and THP-1 cells were cultured on top of different alloy specimens (Ni-Cr, Co-Cr, Pd-Cu, Pd-Ag, Ti-6Al-4V, amalgam, gold, and stainless steel) or in alloy-exposed culture medium with or without endotoxin (lipopolysaccharide [LPS]; Escherichia coli 055:B5). Interleukin-8 (IL-8) production was used as the parameter for innate stimulation and evaluated by enzyme-linked immunosorbent assay after 24 hours of culture. The statistical significance of the effects of various casting alloys on the secretion of IL-8 was analyzed by using the nonparametric Wilcoxon rank sum test (α=.05).

Results

Dental cast alloys induced IL-8 production in MoDC and THP-1 cells, with Au and Pd-Cu providing the strongest stimulation. The alloy-exposed culture media tested contained sufficient stimulatory metal ions to induce detectable IL-8 production in THP-1 cells, except for the Ni-Cr and stainless steel exposed media. Au and Pd-Cu alloys were also most effective in potentiating LPS responsiveness as measured by IL-8 production.

Conclusions

Using an in vitro culture system to expose MoDC and THP-1 cells to different alloy specimens this study showed that contact with the solid alloys, in particular when they contain Pd or Au, can trigger innate immune responses and augment responsiveness to bacterial endotoxin.  相似文献   

19.

Statement of problem

Reproducing the characteristics of natural teeth in ceramic crowns remains a complex and difficult process.

Purpose

The purpose of this in vitro study was to evaluate the effect of the substrate, cement, type, and thickness of the ceramic on the resulting color of a lithium disilicate ceramic.

Material and methods

Forty ceramic disks were prepared from IPS e.max Press LT (low translucency) and HO (high opacity) in 2 different thicknesses (1.5 and 2 mm). The LT groups were composed of monolithic ceramic disks, and the HO groups were composed of disks fabricated with a 0.5-mm thickness combined with a 1- or 1.5-mm veneering ceramic thickness. Disks made of composite resin (R) and alloy (A) were used as substrate structures. The resin cement used was Variolink II. Color was measured with a spectrophotometer and expressed in CIELAB coordinates. Color differences (ΔE) were calculated. The data were analyzed with ANOVA and the Tukey HSD test (α=.05).

Results

When the ΔE of ceramic disks with both substrates, with and without cement, were compared, the lowest value (3) was obtained for ceramic HO with a 2-mm thickness/alloy substrate/without cement; the highest value (10) was obtained for ceramic LT with a1.5-mm thickness/alloy substrate/with cement. This difference was statistically significant. When the effect of cement on the ΔE of ceramics in both substrates was compared, the lowest value (1.1) occurred with ceramic HO with a 1.5-mm thickness/resin substrate, and the highest was observed for ceramic LT with a 1.5-mm thickness/alloy substrate (6.4). This difference was statistically significant.

Conclusions

The substrate color, type and thickness of ceramic, and presence of the cement significantly influenced the resulting optical color. The ΔE values of cemented HO ceramics were lower than that of the LT ceramic.  相似文献   

20.

Statement of problem

Whether the implant abutment in implant-assisted removable partial dentures (IARPDs) functions as a natural removable partial denture (RPD) tooth abutment is unknown.

Purpose

The purpose of this 3-dimensional finite element study was to analyze the biomechanical behavior of implant crown, bone, RPD, and IARPD.

Material and methods

Finite element models of the partial maxilla, teeth, and prostheses were generated on the basis of a patient’s computed tomographic data. The teeth, surveyed crowns, and RPDs were created in the model. With the generated components, four 3-dimensional finite element models of the partial maxilla were constructed: tooth-supported RPD (TB), implant-supported RPD (IB), tooth-tissue-supported RPD (TT), and implant-tissue-supported RPD (IT) models. Oblique loading of 300 N was applied on the crowns and denture teeth. The von Mises stress and displacement of the denture abutment tooth and implant system were identified.

Results

The highest von Mises stress values of both IARPDs occurred on the implants, while those of both natural tooth RPDs occurred on the frameworks of the RPDs. The highest von Mises stress of model IT was about twice that of model IB, while the value of model TT was similar to that of model TB. The maximum displacement was greater in models TB and TT than in models IB and IT. Among the 4 models, the highest maximum displacement value was observed in the model TT and the lowest value was in the model IB.

Conclusions

Finite element analysis revealed that the stress distribution pattern of the IARPDs was different from that of the natural tooth RPDs and the stress distribution of implant-supported RPD was different from that of implant-tissue-supported RPD. When implants are used for RPD abutments, more consideration concerning the RPD design and the number or location of the implant is necessary.  相似文献   

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