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1.

Statement of problem

Trials comparing the overall performances of digital and conventional workflows in restorative dentistry are lacking.

Purpose

The purpose of the third part of this clinical study was to test whether the fit of zirconia 3-unit frameworks for fixed partial dentures fabricated with fully digital workflows differed from that of metal frameworks fabricated with the conventional workflow.

Material and methods

In each of 10 participants, 4 fixed-partial-denture frameworks were fabricated for the same abutment teeth according to a randomly generated sequence. Digital workflows were applied for the fabrication of 3 zirconia frameworks with Lava, iTero, and Cerec infiniDent systems. The conventional workflow included a polyether impression, manual waxing, the lost-wax technique, and the casting of a metal framework. The discrepancies between the frameworks and the abutment teeth were registered using the replica technique with polyvinyl siloxane. The dimensions of the marginal discrepancy (Discrepancymarginal) and the internal discrepancy in 4 different regions of interest (Discrepancyshoulder, Discrepancyaxial, Discrepancycusp, and Discrepancyocclusal) were assessed using a light microscope. Post hoc t tests with Bonferroni correction were applied to detect differences (α=.05).

Results

Discrepancyshoulder was 96.1 ±61.7 μm for the iTero, 106.9 ±96.0 μm for the Lava, 112.2 ±76.7 μm for the Cerec infiniDent, and 126.5 ±91.0 μm for the conventional workflow. The difference between the iTero and the conventional workflow was statistically significant (P=.029). Discrepancyocclusal was 153.5 ±66.8 μm for the iTero, 203.3 ±127.9 μm for the Lava, 179.7 ±63.1 μm for the Cerec infiniDent, and 148.8 ±66.8 μm for the conventional workflow. Discrepancyocclusal was significantly lower for the conventional workflow than for the Lava and the Cerec infindent workflows (P<.01). The iTero resulted in significantly lower values of Discrepancyocclusal than the Lava and the Cerec infiniDent workflows (P<.01).

Conclusions

In terms of framework fit in the region of the shoulder, digitally fabricated zirconia 3-unit frameworks presented similar or better fit than the conventionally fabricated metal frameworks. In the occlusal regions, the conventionally fabricated metal frameworks achieved a more favorable fit than the CAD-CAM zirconia frameworks.  相似文献   

2.

Statement of problem

Trials comparing the overall performance of digital with that of conventional workflows in restorative dentistry are needed.

Purpose

The purpose of the third part of a series of investigations was to test whether the marginal and internal fit of monolithic crowns fabricated with fully digital workflows differed from that of crowns fabricated with the conventional workflow.

Material and methods

In each of 10 participants, 5 monolithic lithium disilicate crowns were fabricated for the same abutment tooth according to a randomly generated sequence. Digital workflows were applied for the fabrication of 4 crowns using the Lava, iTero, Cerec inLab, and Cerec infinident systems. The conventional workflow included a polyvinyl siloxane impression, manual waxing, and heat-press technique. The discrepancy between the crown and the tooth was registered using the replica technique with polyvinyl siloxane material. The dimensions of the marginal discrepancy (Discrepancymarginal) and the internal discrepancy in 4 different regions of interest (Discrepancyshoulder, Discrepancyaxial, Discrepancycusp, and Discrepancyocclusal) were assessed using light microscopy. Post hoc Student t test with Bonferroni correction was applied to detect differences (α=.05).

Results

Discrepancymarginal was 83.6 ±51.1 μm for the Cerec infinident, 90.4 ±66.1 μm for the conventional, 94.3 ±58.3 μm for the Lava, 127.8 ±58.3 μm for the iTero, and 141.5 ±106.2 μm for the Cerec inLab workflow. The differences between the treatment modalities were not statistically significant (P>.05). Discrepancyshoulder was 82.2 ±42.4 μm for the Cerec infinident, 97.2 ±63.8 μm for the conventional, 103.4 ±52.0 μm for the Lava, 133.5 ±73.0 μm for the iTero, and 140.0 ±86.6 μm for the Cerec inLab workflow. Only the differences between the Cerec infinident and the Cerec inLab were statistically significant (P=.036). The conventionally fabricated crowns revealed significantly lower values in Discrepancycusp and Discrepancyocclusal than all the crowns fabricated with digital workflows (P<.05).

Conclusions

In terms of marginal crown fit, no significant differences were found between the conventional and digital workflows for the fabrication of monolithic lithium disilicate crowns. In the occlusal regions, the conventionally manufactured crowns revealed better fit than the digitally fabricated crowns. Chairside milling resulted in less favorable crown fit than centralized milling production.  相似文献   

3.

Objectives

Quadrant impressions are commonly used as alternative to full-arch impressions. Digital impression systems provide the ability to take these impressions very quickly; however, few studies have investigated the accuracy of the technique in vivo. The aim of this study is to assess the precision of digital quadrant impressions in vivo in comparison to conventional impression techniques.

Materials and methods

Impressions were obtained via two conventional (metal full-arch tray, CI, and triple tray, T-Tray) and seven digital impression systems (Lava True Definition Scanner, T-Def; Lava Chairside Oral Scanner, COS; Cadent iTero, ITE; 3Shape Trios, TRI; 3Shape Trios Color, TRC; CEREC Bluecam, Software 4.0, BC4.0; CEREC Bluecam, Software 4.2, BC4.2; and CEREC Omnicam, OC). Impressions were taken three times for each of five subjects (n = 15). The impressions were then superimposed within the test groups. Differences from model surfaces were measured using a normal surface distance method. Precision was calculated using the Perc90_10 value. The values for all test groups were statistically compared.

Results

The precision ranged from 18.8 (CI) to 58.5 μm (T-Tray), with the highest precision in the CI, T-Def, BC4.0, TRC, and TRI groups. The deviation pattern varied distinctly depending on the impression method. Impression systems with single-shot capture exhibited greater deviations at the tooth surface whereas high-frame rate impression systems differed more in gingival areas. Triple tray impressions displayed higher local deviation at the occlusal contact areas of upper and lower jaw.

Conclusions

Digital quadrant impression methods achieve a level of precision, comparable to conventional impression techniques. However, there are significant differences in terms of absolute values and deviation pattern.

Clinical relevance

With all tested digital impression systems, time efficient capturing of quadrant impressions is possible. The clinical precision of digital quadrant impression models is sufficient to cover a broad variety of restorative indications. Yet the precision differs significantly between the digital impression systems.
  相似文献   

4.

Statement of problem

Conventional cast metal posts and cores are fabricated using direct and indirect techniques, both of which need impression materials and considerable laboratory work. Digital techniques have the capacity to substitute for conventional methods in fabricating the posts and cores. However, the accuracy of restorations resulting from a digital workflow is unknown.

Purpose

The purpose of this in vitro study was to compare the retention of posts and cores fabricated using full-digital, half-digital, and conventional techniques and to define the accuracy of each technique in terms of the apical gap.

Method and materials

Thirty newly extracted mandibular first and second premolar teeth were selected for this in vitro study. Impressions were made using direct acrylic resin patterns (conventional), indirect silicone impressions of the intracanal which scanned with a 3Shape laboratory scanner (half digital), and intracanal scan posts captured with an intraoral 3Shape scanner (full digital). Casting and milling were conducted for the conventional impression and digital scans. The obtained posts were cemented using zinc phosphate cement. A universal pullout test was used to measure retention at a crosshead speed of 0.5 mm/min. The apical gap of each post in the canals was defined with parallel digital radiography. The data were analyzed using the Kruskal-Wallis test (α=.05) and Mann-Whitney test at the adjusted α=.016.

Results

Significant differences were found among the conventional, full-digital, and half-digital techniques in terms of the apical gap (0.11, 0.29, and 0.66 mm; P<.001) and retention (171.6 ±1.9, 107.1 ±5.6 and 91.8 ±6.6 N; P<.001). The correlation between gap and retention in conventional (P=.43), full-digital (P=.09), and half-digital techniques (P=.06) was not statistically significantly different.

Conclusions

The conventional technique was more accurate and resulted in higher retention than both the full- and half-digital techniques. However, the retention and gap of all the posts fell within clinical guidelines.  相似文献   

5.

Statement of problem

Clinical trials are needed to evaluate the digital and conventional fabrication technology for providing fixed partial dentures (FPDs).

Purpose

The purpose of the second part of this clinical study was to compare the laboratory production time for tooth-supported, 3-unit FPDs by means of computer-aided design and computer-aided manufacturing (CAD-CAM) systems and a conventional workflow. In addition, the quality of the 3-unit framework of each treatment group was evaluated clinically.

Material and methods

For each of 10 participants, a 3-unit FPD was fabricated. Zirconia was used as the framework material in the CAD-CAM systems and included Lava C.O.S. CAD software (3M) and centralized CAM (group L); CARES CAD software (Institut Straumann AG) and centralized CAM (group iT); and CEREC Connect CAD software (Dentsply Sirona) and centralized CAM (group C). The noble metal framework in the conventional workflow (group K) was fabricated by means of the traditional lost-wax technique. All frameworks were evaluated clinically before veneering. The time for the fabrication of the cast, the 3-unit framework, and the veneering process was recorded. In addition, chairside time during the clinical appointment for the evaluation of the framework was recorded. The paired Wilcoxon test together with appropriate Bonferroni correction was applied to detect differences among treatment groups (α=.05).

Results

The total effective working time (mean ±standard deviation) for the dental technician was 220 ±29 minutes in group L, 217 ±23 minutes in group iT, 262 ±22 minutes in group C, and 370 ±34 minutes in group K. The dental technician spent significantly more time in the conventional workflow than in the digital workflow, independent of the CAD-CAM systems used (P<.001).

Conclusions

Irrespective of the CAD-CAM system, the overall laboratory time for the dental technician was significantly less for a digital workflow than for the conventional workflow.  相似文献   

6.

Statement of problem

To the authors’ knowledge, while accuracy outcomes of the TRIOS scanner have been compared with conventional impressions, no available data are available regarding the accuracy of digital scans with the Omnicam and True Definition scanners versus conventional impressions for partially edentulous arches.

Purpose

The purpose of this in vitro study was to compare the accuracy of digital implant scans using 2 different intraoral scanners (IOSs) with that of conventional impressions for partially edentulous arches.

Material and methods

Two partially edentulous mandibular casts with 2 implant analogs with a 30-degree angulation from 2 different implant systems (Replace Select RP; Nobel Biocare and Tissue level RN; Straumann) were used as controls. Sixty digital models were made from these 2 definitive casts in 6 different groups (n=10). Splinted implant-level impression procedures followed by digitization were used to produce the first 2 groups. The next 2 groups were produced by digital scanning with Omnicam. The last 2 groups were produced by digital scanning with the True Definition scanner. Accuracy was evaluated by superimposing the digital files of each test group onto the digital file of the controls with inspection software.

Results

The difference in 3-dimensional (3D) deviations (median ±interquartile range) among the 3 impression groups for Nobel Biocare was statistically significant among all groups (P<.001), except for the Omnicam (20 ±4 μm) and True Definition (15 ±6 μm) groups; the median ±interquartile range for the conventional group was 39 ±18 μm. The difference in 3D deviations among the 3 impression groups for Straumann was statistically significant among all groups (P=.003), except for the conventional impression (22 ±5 μm) and True Definition (17 ±5 μm) groups; the median ±interquartile range for the Omnicam group was 26 ±15 μm. The difference in 3D deviations between the 2 implant systems was significant for the Omnicam (P=.011) and conventional (P<.001) impression techniques but not for the True Definition technique (P=.247).

Conclusions

Within the limitations of this study, both the impression technique and the implant system affected accuracy. The True Definition technique had the fewest 3D deviations compared with the other 2 techniques; however, the accuracy of all impression techniques was within clinically acceptable levels, and not all differences were statistically significant.  相似文献   

7.

Statement of problem

The accuracy of digital scanners is acceptable for scanning a complete dental arch. However, whether that accuracy is sufficient for only 1 tooth within the dental scan of a complete dental arch is unclear.

Purpose

The purpose of this in vitro study was to evaluate and compare the accuracy of 4 intraoral scanners on a complete dental arch and on prepared teeth digitally isolated from the digital scan in terms of trueness and precision.

Material and methods

A model of a complete dental arch with tooth preparations was scanned 40 times with each of the 4 digital scanners. Their accuracy was evaluated by using 3-dimensional (3D) software to compare the test models with a highly accurate reference model. The data were digitally processed to isolate the prepared teeth and evaluate them in the same way. The data were statistically analyzed using the Levene test and the Tamhane's T2 test (α=.05).

Results

In scans of a complete dental arch, the True Definition scanner had the best accuracy values, followed by TRIOS, iTero, and Omnicam. For prepared teeth isolated from the dental arch, both True Definition and TRIOS had the best values, followed by iTero and Omnicam.

Conclusions

In both long-span scans of the complete dental arch and isolated prepared teeth, the True Definition scanner had the greatest accuracy, closely followed by TRIOS.  相似文献   

8.

Statement of problem

Simplified edentulous jaw impression techniques have gained popularity, while their validity has not yet been evaluated.

Purpose

The purpose of this clinical study was to compare the trueness of maxillary edentulous jaw impressions made with irreversible hydrocolloid (ALG), polyvinyl siloxane (PVS), PVS modified with zinc oxide eugenol (ZOE) (PVSM), and an intraoral scanner (TRI) with a conventionally border-molded ZOE impression (control).

Material and methods

Twelve edentulous maxillary impressions were made with the impression techniques. The analog impressions were scanned using a laboratory scanner, imported into 3-dimensional comparison software, and superimposed against the corresponding control. Trueness was evaluated by calculating the effective deviation known as root mean square (RMS) for the entire surface (ES) and for specific regions of interest such as peripheral border, inner seal, midpalatal suture, ridge, and posterior palatal seal. The secondary outcomes for this study were the patients' perception of the impression techniques. Statistical analyses with the Wilcoxon tests were carried out (α=.05).

Results

For ES, significant differences were found when comparing ALG (1.21 ±0.35 mm) with PVS (0.75 ±0.17 mm; P=.008), PVSM (0.75 ±0.19 mm; P=.012), and TRI (0.70 ±0.18 mm; P=.006) but not among the other groups. Significant differences were found for peripheral border when comparing ALG (2.03 ±0.55 mm) with PVS (1.12 ±0.32 mm; P=.006), PVSM (1.05 ±0.29 mm; P=.003), and TRI (1.38 ±0.25 mm; P=.008), as well as TRI and PVSM (P=.028). Significant differences were also found for inner seal when comparing ALG (0.74 ±0.36 mm) with PVSM (0.52 ±0.13 mm; P=.041), as well as TRI (0.8 ±0.25 mm) versus PVS (0.56 ±0.14 mm; P=.005) and PVSM (P=.005). The difference at the ridge was significant when comparing PVS (0.18 ±0.07 mm) with PVSM (0.28 ±0.19 mm; P=.015) but not among the other groups. A significant difference was also found for posterior palatal seal when comparing PVS (0.55 ±0.41 mm) with PVSM (0.60 ±0.43 mm; P=.034). Patient perceptions showed significantly better satisfaction scores for ALG (1.83 ±2.03) and PVS (3.17 ±2.40) than for TRI (4.08 ±2.71), PVSM (4.58 ±2.35), and ZOE (6.83 ±1.75).

Conclusions

Edentulous impressions made with PVS, PVSM, and TRI had similar deviations and may yield clinically acceptable results. Irreversible hydrocolloids are contraindicated for definitive impression making in completely edentulous jaws.  相似文献   

9.

Statement of problem

Studies that evaluate the survival rate and load to fracture of premolars restored with inlays produced using different methods are lacking.

Purpose

The purpose of this in vitro study was to compare the survival rate and fracture load of premolars restored with inlays fabricated using different methods.

Material and methods

Thirty maxillary premolars were selected, embedded, and prepared to receive inlays fabricated using different methods (n=10): LaCom-digital scanning with Lava C.O.S. scanner (3M ESPE), followed by milling of composite resin block (Lava Ultimate; 3M ESPE) in a milling unit; CeCom-digital scanning with Cerec 3D Bluecam scanner (Dentsply Sirona), followed by milling of a Lava Ultimate block in Cerec (Dentsply Sirona); PresDis-impression with polyvinyl siloxane, inlay made using the lost wax technique, and IPS e.max Press (Ivoclar Vivadent AG) pressed ceramic (lithium disilicate). A dual-polymerizing resin cement system was used to lute the inlays. Inlays were mechanically cycled (2 Hz, 106 mechanical pulses, 80 N) after 24 hours, and the specimens were stored in distilled water at 37°C for 11 months. Then, a fatigue test was conducted using a 10-Hz frequency and 400-N load on the inner inclines of the cusps. The test was complete when the specimen fractured or when the specimen reached 1.5×106 cycles. The specimens that survived fatigue testing were submitted to a single-load fracture test in a universal testing machine and analyzed using a stereoscope for failure classification. Survival rates were estimated using the Kaplan-Meier method and log-rank test (Mantel-Cox). Fracture load data were analyzed using 1-way ANOVA (α=.05).

Results

No significant differences were detected among the groups for the survival rate (P=.87) or for the load to fracture (P=.78). Most failures were longitudinal, catastrophic fractures.

Conclusions

Premolars restored with inlays fabricated using the tested methods had similar survival rates and loads to fracture.  相似文献   

10.

Objectives

Digital impression techniques are advertised as an alternative to conventional impressioning. The purpose of this in vitro study was to compare the accuracy of full ceramic crowns obtained from intraoral scans with Lava C.O.S. (3M ESPE), CEREC (Sirona), and iTero (Straumann) with conventional impression techniques.

Materials and methods

A model of a simplified molar was fabricated. Ten 2-step and 10 single-step putty-wash impressions were taken using silicone impression material and poured with type IV plaster. For both techniques 10 crowns were made of two materials (Lava zirconia, Cera E cast crowns). Then, 10 digital impressions (Lava C.O.S.) were taken and Lava zirconia crowns manufactured, 10 full ceramic crowns were fabricated with CEREC (Empress CAD) and 10 full ceramic crowns were made with iTero (Copran Zr-i). The accessible marginal inaccuracy (AMI) and the internal fit (IF) were measured.

Results

For AMI, the following results were obtained (mean?±?SD): overall groups, 44?±?26 μm; single-step putty-wash impression (Lava zirconia), 33?±?19 μm; single-step putty-wash impression (Cera-E), 38?±?25 μm; two-step putty-wash impression (Lava zirconia), 60?±?30 μm; two-step putty-wash impression (Cera-E), 68?±?29 μm; Lava C.O.S., 48?±?25 μm; CEREC, 30?±?17 μm; and iTero, 41?±?16 μm. With regard to IF, errors were assessed as follows (mean?±?SD): overall groups, 49?±?25 μm; single-step putty-wash impression (Lava zirconia), 36?±?5 μm; single-step putty-wash impression (Cera-E), 44?±?22 μm; two-step putty-wash impression (Lava zirconia), 35?±?7 μm; two-step putty-wash impression (Cera-E), 56?±?36 μm; Lava C.O.S., 29?±?7 μm; CEREC, 88?±?20 μm; and iTero, 50?±?2 μm.

Conclusions

Within the limitations of this in vitro study, it can be stated that digital impression systems allow the fabrication of fixed prosthetic restorations with similar accuracy as conventional impression methods.

Clinical relevance

Digital impression techniques can be regarded as a clinical alternative to conventional impressions for fixed dental restorations.  相似文献   

11.

Statement of problem

Obtaining reliable digital scans of edentulous patients is challenging because of the absence of anatomic landmarks/geometric variations along the dental arch. Whether adding an auxiliary geometric device (AGD) will improve scanning is unclear.

Purpose

The purpose of this in vitro study was to analyze the accuracy of complete-arch digital scans of completely edentulous arches by placing a consumable AGD.

Material and methods

A stainless-steel model of the maxilla of a completely edentulous arch with 4 implants was built. The model was scanned using a reference industrial scanner as the control and using 3 intraoral scanners (True Definition [3M ESPE], TRIOS 3 [3Shape A/S], and iTero [Align Technology, Inc]). Each intraoral scanner was used 10 times without the AGD in place and 10 more times with the AGD fixed on the model. Accuracy in terms of trueness and precision was established by comparing 5 reference distances with or without the AGD in place. A software program for analyzing 3D data was used to measure these 5 distances, and a data analysis software program was used for statistical and measurements analysis (α=.05).

Results

Significant differences (P<.05) were found in all reference distances for trueness and in 4 of the 5 reference distances for precision depending on whether the AGD had been used or not. Without the AGD in place, trueness ranged from 21 ±16 μm in the shortest reference distance to 125 ±80 μm in the largest reference distance. With the AGD in place, trueness ranged from 11 ±8 μm in the shortest reference distance to 64 ±51 μm in the largest reference distance. Precision ranged from 18 ±14 μm in the shortest reference distance to 84 ±74 μm in the largest reference distance without the AGD and from 7 ±7 μm in the shortest to 63 ±46 μm in the largest with it.

Conclusions

Complete-arch digital scans of edentulous jaws are more accurate when an AGD is used to resolve the lack of anatomic landmarks. An additional advantage is that the use of the AGD allows for a more fluent scanning process.  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

The introduction of intraoral scanners has increased the use of digital technology in dental procedures. However, research on the extent of clinically recommended scans is lacking.

Purpose

The purpose of this in vitro study was to compare 3D arch distortion according to the distance from the tooth at the beginning of a complete-arch scan made using an intraoral scanner.

Material and methods

An industrial scanner was used to digitize a master model for a computer-aided design (CAD) reference model. In addition, the master model was digitized using 4 intraoral scanners (TRIOS2, TRIOS3, CS3500, and CS3600) and 1 dental laboratory scanner (FREEDOM HD) to make the CAD test model (N=20). The scanned teeth were divided using an inspection software program (Geomagic control X), and overlapping and 3D analyses of the CAD reference model and CAD test model were performed. The presence or absence of normal distribution in the root mean square (RMS) values of all divided teeth was assessed and evaluated with the Kruskal-Wallis test (α=.05), and post hoc comparison was performed using the Mann-Whitney U-test and Bonferroni correction method (α=.005).

Results

The overall RMS value was significantly different for all scanners (P<.001). The dental laboratory scanner showed the lowest value (47.5 ±1.6 μm), whereas TRIOS2 showed the highest value (343.4 ±56.4 μm). TRIOS3 (9.6 ±1.2 μm) showed the best trueness in those teeth where the scan started. However, the larger the scan range, the lower the RMS value difference between TRIOS3 and CS3500. The RMS values of the dental laboratory scanners were higher than those of the intraoral scanners in the narrow scan range. CS3600 showed an RMS value less than or equal to that of the dental laboratory scanner at 5 teeth scan ranges. However, the wider the scan range, the lower the RMS values of all the intraoral scanners.

Conclusions

Current complete-arch scanning is not sufficiently accurate for fabricating fixed prostheses. However, intraoral scanners are useful for short scans, such as those for single (TRIOS2, TRIOS3, and CS3500) or short-span prostheses (CS3600).  相似文献   

14.

Statement of problem

Accuracy in impression making may be enhanced by digitizing the physical impression directly and thereby be unhampered by errors introduced by gypsum casts.

Purpose

The purpose of this in vitro study was to compare the dimensional accuracy of microcomputed tomography (micro-CT) scans of impressions with that of optical scans of impressions and gypsum casts.

Material and methods

A titanium maxillary cast with 3 metrology-grade ruby spheres in place of 3 teeth was used as a reference. Sphere 1 (S1) to sphere 2 (S2) distance (S1-S2) was 25.036 mm, and sphere 1 (S1) to sphere 3 (S3) distance (S1-S3) was 41.846 mm. Half-arch impressions were made of the titanium cast using polyvinyl siloxane impression material with a 1-step 2-phase technique. The polyvinyl siloxane impressions were then micro-CT scanned and optically scanned, and the resulting stone casts were also optically scanned. Scans from the 3 groups—CT scanning of impressions (CT), optical scanning of impressions (OP), and optical scanning of stone casts (SC)—were used to measure the distances between the 3 ruby spheres and were compared with the reference titanium model. The Wilcoxon signed-rank test for matched pairs was used to compare the groups (α=.01).

Results

For the distance of 25.036 mm, S1-S2 distance, CT scans of impressions (CT) showed an error of 20 ±20 μm, whereas optical scans of stone casts (SC) showed an error of 0 ±20 μm. At a distance of 41.846 mm, S1-S3 distance, CT showed an error of 0 ±40 μm, whereas SC showed an error of ?40 ±40 μm. The difference in error between measurements at both distances was statistically significant (P<.01). The group of optical scans of impressions (OP) had to be excluded because of missing data and deformed features on the scan.

Conclusions

Although optically scanned stone models are more dimensionally accurate than micro-CT scanned impressions at a 25.036-mm distance, at a distance of 41.846 mm, micro-CT scanned impressions showed less error than optically scanned stone models. Micro-CT scanning of half-arch impressions is a viable method of digitizing a physical impression of dental structures and capturing data about the patient's oral structures. A digital image obtained by micro-CT scanning is more accurate than that obtained by optical scans of stone casts for long-span restorations.  相似文献   

15.

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   

16.

Statement of problem

The accuracy of the virtual images used in digital dentistry is essential to the success of oral rehabilitation.

Purpose

The purpose of this systematic review was to estimate the mean accuracy of digital technologies used to scan facial, skeletal, and intraoral tissues.

Material and methods

A search strategy was applied in 4 databases and in the non–peer-reviewed literature from April through June 2017 and was updated in July 2017. Studies evaluating the dimensional accuracy of 3-dimensional images acquired by the scanning of hard and soft tissues were included.

Results

A total of 2093 studies were identified by the search strategy, of which 183 were initially screened for full-text reading and 34 were considered eligible for this review. The scanning of facial tissues showed deviation values ranging between 140 and 1330 μm, whereas the 3D reconstruction of the jaw bone ranged between 106 and 760 μm. The scanning of a dentate arch by intraoral and laboratorial scanners varied from 17 μm to 378 μm. For edentulous arches, the scanners showed a trueness ranging between 44.1 and 591 μm and between 19.32 and 112 μm for dental implant digital scanning.

Conclusions

The current digital technologies are reported to be accurate for specific applications. However, the scanning of edentulous arches still represents a challenge.  相似文献   

17.

Background

The primary objective of this systematic review was to investigate the survival of full-coverage restorations fabricated by using digital impressions (DIs) versus that of those fabricated by using conventional impressions. The authors also compared secondary outcomes of marginal and internal fit and occlusal and interproximal contacts.

Types of Studies Reviewed

The authors conducted a systematic literature search in multiple databases to identify clinical trials with no restrictions by publication type, date, or language. The authors assessed study-level risk of bias and outcome-level strength of evidence. The authors performed a meta-analysis by using a random-effects model.

Results

Ten studies met the inclusion criteria. The authors identified no studies in which the investigators compared the impression techniques with respect to survival of full-coverage restorations. Mean differences for marginal gap and internal gap were ?9.0 micrometers (95% confidence interval, ?18.9 to 0.9) and ?15.6 μm (95% confidence interval, ?42.6 to 11.4), respectively. Studies assessing internal gap were substantially heterogeneous (I2 = 72%; P = .003).

Conclusions and Practical Implications

Research is lacking to draw robust conclusions about the relative benefits of DIs in terms of restoration survival. Low-quality evidence for marginal fit and internal fit suggested similar performance for both techniques. Evidence quality for interproximal contact and occlusal contact was very low and insufficient to draw any conclusions regarding how the impression techniques compared. Given the uncertainty of the evidence, results should be interpreted with caution. With increasing popularity and adoption of digital scanners by dentists, pragmatic practice-based trials involving standardized, patient-centered outcomes may improve confidence in the comparative effectiveness of DIs.  相似文献   

18.
The digital intraoral impression has become a central part of the CAD/CAM technique. The objective of the present study was to compare the accuracy (trueness and precision) of digital impressions of the full arch with that of conventional impressions on the in-vitro model. For this purpose, a master model was acquired with a new reference scanning process, the measuring trueness of which was +/- 4.1 microm and the precision +/- 2.5 microm. On the one hand, conventional impressions and then plaster models (n = 5) were produced from this master model, and on the other hand, digital impressions were made with the Cerec AC Bluecam and the Lava COS system (each n = 5). The plaster models were also scanned with the reference scanner. The available data records were superimposed and the differences determined. The deviation from the master model defines the trueness of the impression method. The deviations of the models among one another demonstrate the precision of the method. The trueness of the impressions was 55 +/- 21.8 microm in the conventional impression group, for digital impressions with Cerec Bluecam it was 49 +/- 14.2 microm and for digital impressions with Lava COS 40.3 +/- 14.1 microm. The precision was 61.3 +/- 17.9 microm for conventional impression with Impregum, 30.9 +/- 7.1 microm for digital impression with the Cerec Bluecam and 60.1 +/- 31.3 microm for digital impression with Lava COS. These in-vitro results show that accuracy of the digital impression is similar to that of the conventional impression. These results will have to be confirmed in further clinical studies.  相似文献   

19.

Statement of problem

Consensus is lacking regarding the optimal number of implants for supporting complete-arch prostheses with good survival rates and lower prosthetic complications and marginal bone loss.

Purpose

The purpose of this systematic review was to evaluate the influence of the number of implants used for complete-arch prostheses with at least 5 years of follow-up.

Material and methods

A search was performed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and was registered in The International Prospective Register of Systematic Reviews (CRD42016048468). The following was the population, intervention, comparison, outcome (PICO) question: Does the number of implants influence the longevity of complete-arch prostheses?

Results

Nineteen studies including 1006 patients with a mean age of 61.44 years were selected for evaluation. The number of implants per jaw ranged between 2 and 9 in the maxilla, mandible, or both jaws. For implant survival rate in complete-arch prostheses with fewer than 5 implants per jaw, the pooled weighted event rate was 1.4% (I2=25.26%; P=.211) and 4.2% (I2=81.35%; P<.001) for complete arches with more than 4 implants per jaw. For the prosthesis survival rate, the pooled weighted event rate for a complete-arch with fewer than 5 implants per jaw was 1.5% (I2=0%; P=.677) and 9% (I2=17.33%; P=.304) for complete arches with more than 4 implants per jaw. For prosthesis complications for complete arches with fewer than 5 implants per jaw, the pooled weighted event rate was 19.9% (I2=93.5%; P<.001) and 24.5% (I2=88.89; P<.001) for complete arches with more than 4 implants per jaw. The mean marginal bone loss for complete arches with fewer than 5 implants per jaw was 1.22 ±0.49 mm (I2=99.46; P<.001) and 1.46 ±0.46 mm (I2=99.6; P <.001) for more than 4 implants per jaw.

Conclusions

The current systematic review indicated no relationship of the number of implants used to support a complete-arch prosthesis with implant survival rate, prosthesis survival rate, prosthesis complications, or marginal bone loss in studies with follow-up periods of between 5 and 15 years.  相似文献   

20.

Statement of problem

Despite the increasing demand for a digital workflow in the fabrication of indirect restorations, information on the accuracy of the resulting definitive casts is limited.

Purpose

The purpose of this in vitro study was to compare the accuracy of definitive casts produced with digital scans and conventional impressions.

Material and methods

Chamfer preparations were made on the maxillary right canine and second molar of a typodont. Subsequently, 9 conventional impressions were made to produce 9 gypsum casts, and 9 digital scans were made to produce stereolithography additive (SLA) casts from 2 manufacturers: 9 Dreve SLA casts and 9 Scanbiz SLA casts. All casts were then scanned 9 times with an extraoral scanner to produce the reference data set. Trueness was evaluated by superimposing the data sets obtained by scanning the casts with the reference data set. Precision was evaluated by analyzing the deviations among repeated scans. The root mean square (RMS) and percentage of points aligned within the nominal values (±50 μm) of the 3-dimensional analysis were calculated by the software.

Results

Gypsum had the best alignment (within 50 μm) with the reference data set (median 95.3%, IQR 16.7) and the least RMS (median 25.8 μm, IQR 14.6), followed by Dreve and Scanbiz. Differences in RMS were observed between gypsum and the SLA casts (P<.001). Within 50 μm, gypsum was superior to Scanbiz (P<.001). Gypsum casts exhibited the highest precision, showing the best alignment (within 50 μm) and the least RMS, followed by Scanbiz and Dreve.

Conclusions

This study found that gypsum casts had higher accuracy than SLA casts. Within 50 μm, gypsum casts were better than Scanbiz SLA casts, while gypsum casts and Dreve SLA casts had similar trueness. Significant differences were found among the investigated SLA casts used in the digital workflow.  相似文献   

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