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1.

Aim

The current study was based on the hypothesis that the use of PRF with bone graft materials might increase bone regeneration and focus on the histopathological and immunohistochemical aspects following application of PRF with autogenous graft, xenograft and B-TCP in a rabbit model.

Material and methods

This study was performed on the twenty-eight male New Zealand divided into four group. Two defects with a diameter 10 mm were opened in calvarium. After PRF preparation, right defects were evaluated as empty defect or graft group, and left defects were evaluated as PRF test group. All animals were sacrificed at the end of 8 weeks and specimens were examined histopathologically and immunohistochemically.

Results

The most superior histopathological results were obtained in the autograft group. The combination of β-TCP-PRF could not provide superiority over the β-TCP group. The immunohistochemical results showed that, in the PRF/BTCP group, the expression of osteopontin and osteonectin was relatively higher compared to the only-BTCP group.

Conclusion

In terms of new bone formation, autograft combined with PRF yielded superior results but the combination of β-TCP-PRF had no effect compared to the only-BTCP group. However, further experimental and clinical studies might be beneficial to clarify the exact mechanism and results of combining PRF with bone grafts on bone healing process.  相似文献   

2.

Statement of problem

Hot-pressing and computer-aided design and computer-aided manufacturing (CAD-CAM) are major techniques for the fabrication of lithium disilicate crowns. They exhibit different accuracies regarding marginal fit, an important factor in restoration survival. However, studies comparing the marginal fit of different fabrication methods are lacking.

Purpose

The purpose of this in vitro study was to compare the marginal discrepancy (MD) and absolute marginal discrepancy (AMD) of lithium disilicate crowns produced by the hot-press and CAD-CAM techniques.

Material and Methods

Thirty typodont teeth were divided into 2 groups. Fifteen teeth were scanned with the CEREC Omnicam intraoral scanner, and crowns were fabricated with the CEREC MC XL chairside CAD-CAM milling unit from IPS e.max CAD blocks. Fifteen typodont teeth were sent to a dental laboratory, and lithium disilicate crowns were fabricated from IPS e.max press ingots using the hot-press technique. The 30 crowns were cemented and then sectioned with a precision saw. The MD and AMD were measured for each crown with a light microscope. One-way ANOVA was conducted to analyze significant differences in crown marginal fit between the fabrication systems (α=.05).

Results

For the CAD-CAM technique, the mean values of the AMD measurements were 115 μm, and for the hot-press technique, 130 μm. The MD measurements were 87 μm for the CAD-CAM technique and 90 μm for the hot-press technique. One-way ANOVA revealed no significant differences between the fabrication methods regarding marginal fit (P>.05).

Conclusions

No significant differences were found between the fabrication methods tested. Both the CAD-CAM and hot-press techniques for producing monolithic lithium disilicate crowns produced MD values of less than 120 μm, within the clinically acceptable range.  相似文献   

3.

Statement of problem

Studies of the color stability, relative translucency, and surface roughness of newly introduced computer-assisted design and computer-assisted manufacturing (CAD-CAM) prepolymerized poly(methyl methacrylate) (PMMA) denture base materials are lacking.

Purpose

The purpose of this in vitro study was to evaluate the color stability, relative translucency, and surface roughness of conventional and different prepolymerized CAD-CAM PMMA denture base materials after coffee thermocycling (CTC).

Material and methods

Six disk-shaped specimens (10×2 mm) were prepared from 3 different brands of prepolymerized CAD-CAM PMMA and a conventional heat-polymerized PMMA denture base material (N=24). Specimens were polished conventionally in 2 stages. The specimens were subjected to 5000 coffee thermocycles. The surface roughness (Ra) of each specimen was measured 3 times before and after CTC, using a contact profilometer, and the mean roughness (Ra) values were calculated. The color coordinates of the specimens were determined by using a noncontact spectroradiometer, and color differences and relative translucency parameter (RTP) values were calculated by using CIEDE2000 color difference and RTPCIEDE2000 formulas. ANOVA was used to analyze surface roughness values, CIEDE2000 color differences, and RTP values (α=.05).

Results

CTC did not change the color of the tested materials. However, with regard to relative translucency, 2-way ANOVA revealed a significant interaction between the material and CTC (P=.011). Also, although CTC increased the surface roughness of all tested materials (P=.031), Ra values were lower than the plaque accumulation threshold of Ra=0.2 μm.

Conclusions

Mean color changes in all materials were clinically imperceptible after 5000 coffee thermocycles. One tested material had significantly lower relative translucency than other materials before and after CTC. The surface roughness values of all tested denture base materials were below the plaque accumulation threshold.  相似文献   

4.

Objective

To evaluate the quality of life in patients with moderate or large cranial bone defects before and after late cranioplasty.

Methods

Authors performed a prospective clinical trial including all consecutive patients that filled inclusion criteria during a period of 1 year. All patients answered the quality of life SF-36 questionnaire in 5 different times. Besides authors gathered information about the primary trauma and demographic characteristics.

Results

A total of 70 consecutive patients were admitted to the hospital during the study period, and 62 were included in the project. Cranioplasty statistically improved patients' quality of life in all 8 domains after a 24 months follow-up.

Conclusion

Cranioplasty has a significant impact over the quality of life in brain trauma victims who survived the primary trauma and harbor a large cranial bone defect.  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.

Aims

To evaluate the efficiency of reconstruction of long span mandibular defects using split rib bundle bone graft.

Materials and methods

Six hundred patients with long span mandibular defects (more than 6 cm long), following resection of aggressive mandibular tumours, were reconstructed with split rib bundle bone graft technique. Immediate reconstruction was performed in all patients. A reconstruction plate was used to support the graft. Two ribs were harvested from the right side of the chest, split into four halves and used to restore the continuity of the mandible. The inclusion criterion was post-surgical mandibular bony defects without soft tissue deficiency. Defects with a history of previous or need of future irradiation were excluded.

Results

The appearance of the patients was accepted in 550 patients. Functional reconstruction was done in 320 patients by osseointegrated dental implants (after 15 months), and removable prosthesis in 150 patients. Infection was minor in 31 patients, moderate in 47 patients and severe in 42 patients. Partial loss of graft, up to 25%, due to moderate infection was reported. Total or near total loss of graft due to severe infection was corrected by reoperation six months later.

Conclusions

This technique is simple, safe, and can be effectively used to reconstruct long-span mandibular defects with minimal complications in selected patients.  相似文献   

7.

Background

Cranioplasty is a surgical procedure used to treat a bone defect or deformity in the skull. To date, there is little consensus on the standard-of-care for graft materials used in such a procedure. Graft materials must have sufficient mechanical strength to protect the underlying brain as well as the ability to integrate and support new bone growth. Also, the ideal graft material should be individually customized to the contours of the defect to ensure a suitable aesthetic outcome for the patient.

Purpose

Customized 3D-printed scaffolds comprising of polycaprolactone-β-tricalcium phosphate (PCL-TCP) have been developed with mechanical properties suitable for cranioplasty. Osteostimulation of PCL-TCP was enhanced through the addition of a bone matrix-mimicking heparan sulphate glycosaminoglycan (HS3) with increased affinity for bone morphogenetic protein-2 (BMP-2). Efficacy of this PCL-TCP/HS3 combination device was assessed in a rat critical-sized calvarial defect model.

Method

Critical-sized defects (5 mm) were created in both parietal bones of 19 Sprague Dawley rats (Male, 450–550 g). Each cranial defect was randomly assigned to 1 of 4 treatment groups: (1) A control group consisting of PCL-TCP/Fibrin alone (n = 5); (2) PCL-TCP/Fibrin-HSft (30 μg) (n = 6) (HSft is the flow-through during HS3 isolation that has reduced affinity for BMP-2); (3) PCL-TCP/Fibrin-HS3 (5 μg) (n = 6); (4) PCL-TCP/Fibrin-HS3 (30 μg) (n = 6). Scaffold integration and bone formation was evaluated 12-weeks post implantation by μCT and histology.

Results

Treatment with PCL-TCP/Fibrin alone (control) resulted in 23.7% ± 1.55% (BV/TV) of the calvarial defect being filled with new bone, a result similar to treatment with PCL-TCP/Fibrin scaffolds containing either HSft or HS3 (5 μg). At increased amounts of HS3 (30 μg), enhanced bone formation was evident (BV/TV = 38.6% ± 9.38%), a result 1.6-fold higher than control. Further assessment by 2D μCT and histology confirmed the presence of enhanced bone formation and scaffold integration with surrounding host bone only when scaffolds contained sufficient bone matrix-mimicking HS3.

Conclusion

Enhancing the biomimicry of devices using a heparan sulphate with increased affinity to BMP-2 can serve to improve the performance of PCL-TCP scaffolds and provides a suitable treatment for cranioplasty.  相似文献   

8.

Statement of problem

Selective laser melting (SLM) has become popular in prosthetic dentistry. However, only limited information is available for the internal adaptation of cobalt-chromium (Co-Cr) posts fabricated by SLM.

Purpose

The purpose of this in vitro study was to investigate the internal adaptation of Co-Cr metal posts fabricated by SLM technique.

Material and methods

Thirty-six Co-Cr metal posts were fabricated by conventional casting, subtractive computer-aided design and computer-aided manufacturing (CAD-CAM), and additive CAD-CAM, by making an impression from a standardized model of a tooth with a single root canal. Posts and the dies were bonded with cement. Specimens were then sectioned horizontally by using a grinding and polishing machine, and 3 different cross-sections of each post were chosen to represent the apical, middle, and coronal regions. The areas of cement were photographed by using a stereomicroscope at an original magnification of ×32 and measured using image-measuring software. From each group, 1 specimen was randomly selected and observed by using scanning electron microscopy. One-way ANOVA and Tukey honestly significant difference test were performed to identify differences among groups with regard to internal adaptation (α=.05).

Result

The internal adaptation of the SLM group did not differ from that of the CAD-CAM milling group at 3 cross-section levels (P>.05). At the apical and coronal cross-section levels, the cement area of SLM group was smaller than that of the cast group (P<.05). However, at the middle cross-section level, the cement area of the cast group was significantly smaller than that of the SLM group (P<.05). Use of scanning electron microscopy showed both the SLM group and the CAD-CAM milling group exhibited homogeneous microstructures. However, the cast group showed a typical discontinuous dendritic solidification microstructure.

Conclusions

The internal adaptation of SLM was not inferior to that of the CAD-CAM milling group or the cast group. The SLM technique seems a promising choice for fabricating dental posts.  相似文献   

9.

Statement of problem

The primary manufacturing method of zirconia ceramic crowns is computer-aided design and computer-aided manufacture (CAD-CAM), but a disadvantage of this technique is material waste. Three-dimensional (3D) printing, which has been recently introduced into dentistry, has improved the processing of polymers and metals, but not yet of ceramic crowns.

Purpose

The purpose of this in vitro study was to evaluate the 3D trueness of zirconia crowns fabricated by 3D printing to investigate the potential application of this technology in dental ceramic restorations.

Material and methods

A typodont tooth was prepared for a ceramic crown, and a digital crown was designed using the CAD software. The digital crown was processed either with a 3D-printing system or with a dental milling system. The crowns were scanned using a dental laboratory scanner, and the data collected for each crown were divided into 4 parts (the external surface, intaglio surface, marginal area, and intaglio occlusal surface). Finally, the trueness of each part was determined using the 3D inspection software. The 3D trueness of the crowns fabricated by either 3D printing or milling was compared by a 1-sided test (α=.05).

Results

The trueness of the external surface, intaglio surface, marginal area, and intaglio occlusal surface of the 3D-printed crowns was no worse than the corresponding trueness of the CAD-CAM crowns (P<.05).

Conclusions

Zirconia crowns produced by 3D printing meet the trueness requirements, and 3D printing may be suitable for fabricating zirconia crowns.  相似文献   

10.

Objective

To evaluate the effects of short-term teriparatide administration on healing of autologous bone graft in mandibular critical-size defects.

Subjects and methods

A 5-mm mandibular bone defect was created and iliac bone graft was harvested in 135 rats. Rats were randomly divided into 3 groups of negative control (NC), control (C), and study (S). In groups S and C, iliac graft was placed in defect and 2 μg/kg/day teriparatide or saline, respectively, was administered for 20 days. In group NC, iliac graft was not transferred to the defect and saline was injected for 20 days. Twenty, 40, and 60 days after surgery, 15 rats in each group were euthanized and the healing process was histologically evaluated and scored using a grading system (1–6).

Results

In group NC, defects did not heal or were predominantly filled with fibrous tissue. At day 20, bone defects in both C and S groups contained a large area of graft particles, numerous collagen fibers and some areas of new trabeculae. At the day 40, defects in group S showed a larger bone graft area, more new bone formation, smaller connective tissue area, and a higher healing score compared to group C (P < 0.05). At day 60, most of the defect in group S was filled with graft particles and mature bone while in group C, new trabecular bone formation was still underway (P < 0.05).

Conclusion

Teriparatide therapy improves healing of bone defects reconstructed with autograft by reducing bone graft resorption and enhancing new bone formation and maturation.  相似文献   

11.

Purpose

The aim of this study was to describe the surgical technique of immediate dental implant placement in calvarial grafts for augmentation of the severely resorbed maxilla and to assess the treatment results.

Methods

In 13 patients the maxilla was augmented with calvarial bone followed by simultaneous dental implant placement (total: 68 implants). In the frontal “knife edge” region, implants were inserted in the buccal plated area. In the maxillary sinus area, implants were inserted into alveolar bone that was plated buccally or palatally through the sinus window. After 4 months, the implants were retrieved and subsequently loaded. Per-operative and post-operative variables were scored. One bone biopsy sample was taken for histological analysis.

Results

The surgical procedure and wound healing was uneventful. During abutment connection after 4 months, all implants were fully osseointegrated with no signs of graft resorption. Radiographically, the mean (±SD) peri-implant bone loss after 1 year of functional loading was 0.23 ± 0.44 mm. No implants were lost. Histological examination revealed vital calvarial and maxillary bone with active remodeling.

Conclusion

Immediate dental implant placement in calvarial bone grafts to rehabilitate severely resorbed maxilla is technically feasible and seems to have a high success rate.  相似文献   

12.

Statement of problem

The effect of clinical adjustments on the strength of cemented computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic materials under aging challenge is unclear.

Purpose

The purpose of this in vitro study was to assess the surface roughness and fracture resistance (with or without mechanical aging) of cemented CAD-CAM monolithic materials submitted to grinding and polishing procedures.

Material and methods

Disks of Lava Ultimate, Vita Enamic, crystallized Vita Suprinity, and IPS e.max CAD were analyzed for roughness after polishing by using silicon carbide papers (Lava Ultimate and Vita Enamic) or glazing (IPS e.max CAD and Vita Suprinity) (control), after grinding by using 30-μm grit diamond rotary instruments, and after grinding and polishing by using a polishing kit. For fracture resistance, a simplified trilayer model consisting of a restorative disk, an epoxy resin disk, and a steel ring was used. The bonded trilayer disks received the same treatments described for the roughness analysis. Half of the specimens underwent mechanical aging for 1×106 cycles. All specimens were loaded until failure. The Weibull modulus was calculated.

Results

The IPS e.max CAD and Vita Suprinity showed the highest roughness after grinding and the lowest at baseline. For the Lava Ultimate and Vita Enamic, polishing provided lower roughness than at baseline. Grinding, followed or not by polishing, and mechanical aging did not adversely affect the fracture resistance or the reliability of the materials.

Conclusions

Polishing did not recover the initial surface roughness of the glass-ceramic materials. Fracture resistance was not affected by grinding, followed or not by polishing, even after mechanical aging.  相似文献   

13.

Statement of problem

Implant placement in the anterior regions is often challenging because of limited space and bone volume availability.

Purpose

The purpose of this clinical study was to investigate the accuracy of computer-guided surgery with a long drill key to place implants in the anterior regions.

Material and methods

Computer-guided implant surgery was performed for 32 participants requiring implants in anterior regions. The procedure involved using a 12-mm-long drill key to guide the 2.0-mm-diameter drill. Deviations between the planned and actual implant positions were evaluated by using cone beam computed tomography (CBCT) scans obtained before and after surgery. A t test was used for comparisons between the planned and placed implants and to determine the influence of the arch (maxilla/mandible) and time (immediate/delayed) on accuracy.

Results

A total of 40 implants (20 implants in the maxilla and 20 implants in the mandible) were placed. The mean linear deviation was 0.46 mm (range, 0 to 1.15 mm) for the implant shoulder and 0.67 mm (range, 0.14 to 1.19 mm) for the implant apex. The mean angular deviation was 1.40 degrees (range, 0.30 to 2.57 degrees). The mean depth deviation was 0.15 mm (range, 0.10 to 0.82 mm).

Conclusions

This clinical study showed that the accuracy of computer-guided implant placement may be enhanced by using a long drill key and may thus enable more accurate implant placement in anterior regions.  相似文献   

14.

Statement of problem

With the development of new computer-aided design and computer-aided manufacturing (CAD-CAM) restorative dental materials, limited data regarding their survival rate and fracture strength are available when they are used as occlusal veneers. Therefore, these materials should be evaluated under conditions similar to those of the oral environment before being recommended for clinical use.

Purpose

To evaluate the influence of thermomechanical fatigue loading on the fracture strength of minimally invasive occlusal veneer restorations fabricated from different CAD-CAM materials and bonded to human maxillary premolars using self-etchnig bonding technique.

Material and methods

Sixty-four CAD-CAM occlusal veneer restorations were fabricated from group LD (lithium disilicate [e.max CAD]), LS (zirconia-reinforced lithium silicate [Vita Suprinity]), PI (polymer-infiltrated ceramic [Vita Enamic]), and PM (polymethylmethacrylate [Telio CAD]). The occlusal veneers were luted to enamel (n=16) using a self-etching primer (Multilink Primer A/B) and a luting composite resin (Multilink Automix). Half of the specimens of each group (n=8) were randomly selected and subjected to thermomechanical fatigue loading in a masticatory simulator (1.2 million cycles at 98 N with 5°C-55°C thermocycling). All specimens were quasistatically loaded until fracture. The statistical analysis was made using the Kruskal-Wallis and Mann-Whitney U tests (α=.05).

Results

According to the Kaplan-Meier analysis after the thermomechanical fatigue of the 4 groups, the cumulative survival rate was as follows: group LD, 50% group LS, 62.5% group PI, 37.5%; and group PM, 50%. Although some of the surviving specimens exhibited microcracking, their integrity or bonding to teeth was not affected. Thermomechanical fatigue significantly reduced the fracture strength of group PI (P=.047) and group PM (P=.025). Without thermomechanical fatigue, group PM showed significantly higher fracture strength than group LS (P=.015).

Conclusions

In general, thermomechanical fatigue decreased the survival rate and fracture strength in all test groups.  相似文献   

15.

Statement of problem

The design of porous tantalum trabecular metal–enhanced titanium (TM) dental implants promises improved osseointegration, especially when grafting materials such as demineralized bone matrix are used; however, studies are lacking.

Purpose

The purpose of this retrospective study was to compare TM implants with conventional titanium alloy (Ti) implants with and without demineralized bone matrix in terms of peri-implant bone remodeling in the first year after implant loading.

Material and methods

A chart review was used for all patients receiving Tapered Screw-Vent Ti and TM implants. Implants were placed and restored by a single provider between 2011 and 2015. Peri-implant bone remodeling was compared by using a paired t test (α=.05).

Results

A total of 82 patients received 205 implants, 44 TM and 161 Ti implants (control). No implants failed in the TM group (survival rate of 100%), and 3 implants in total, 1 immediate, failed in the Ti groups (survival rate of 98.1%). TM implants exhibited a 0.28-mm bone gain on average, whereas the control group demonstrated 0.20 mm of marginal bone loss after the first year of implant loading. Multivariate logistic regression analysis demonstrated that the odds of having bone loss was 64% less (odds ratio: 0.36; 95% confidence interval: 0.14-0.94) in the TM group than in the Ti group after controlling for bone grafting, implant location, immediate placement, bone type, and pretreatment bone level.

Conclusions

TM implants exhibited less peri-implant bone loss than the control Ti implants.  相似文献   

16.

Statement of problem

Different parameters can influence the adaptation of computer-assisted design and computer-assisted manufacturing (CAD-CAM) inlay/onlay restorations. However, systematic reviews to identify and discuss these parameters are lacking.

Purpose

The purpose of this systematic review was to summarize the scienti?c literature investigating all parameters that can influence both the marginal and internal adaptation of CAD-CAM inlay/onlay restorations.

Material and methods

An electronic search was conducted by 2 independent reviewers for studies published in English between January 1, 2007 and September 20, 2017 on the PubMed/MEDLINE, Scopus, and Web of Science databases and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Factors investigated in the selected articles included the type of CAD-CAM system, virtual space parameters, version of the software, type of block, luting procedure, type of restoration, sample size and aging procedure, evaluation method, and number of measurement points per specimen.

Results

A total of 162 articles were identi?ed, of which 23 articles met the inclusion criteria. Nine studies investigated adaptation with different restorative materials, 2 evaluated adaptation according to the type of preparation design, 9 compared adaptation before/after thermomechanical loading, and 2 before/after cementation, 1 study investigated marginal adaptation based on whether the optical scan was made intraorally or extraorally, 1 compared adaptation with 5 and 3 axis CAM systems, and 1 assessed adaptation with 4 different intraoral scanners. The risk of bias was high for 7, medium for 15, and low for 1 of the studies reviewed. The high level of heterogeneity across the studies excluded meta-analysis.

Conclusions

Most of the studies reported clinically acceptable values for marginal adaptation. The performance of a CAD-CAM system is influenced by the type of restorative material. A nonretentive cavity preparation exhibited better adaptation than a retentive preparation. Most studies showed that thermomechanical loading affected the quality of marginal adaptation. Cementation increased marginal discrepancies. No statistically significant difference was found for marginal fit of onlays between intraoral and extraoral optical scans using a stone die. The number of milling axes, the type of digital camera, and the region measured were statistically significant in relation to marginal/internal adaptation. Values of adaptation recorded failed to reproduce the preestablished spacer parameters in the software. Clarification is needed concerning adaptation according to the type of preparation design, the type of material, the choice of intrinsic parameters for the CAD process, the type and shape of milling instruments, and the behavior of the material during milling. Adaptation of CAD-CAM inlay/onlays should be evaluated under clinical conditions.  相似文献   

17.

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   

18.

Statement of problem

The polymerization of computer-aided design and computer-aided manufacturing (CAD-CAM) composite resins during their manufacture enhances their physical properties and biocompatibility but might compromise their reparability.

Purpose

The purpose of this in vitro study was to determine the microtensile bond strength and nanoleakage (NL) of aged LAVA Ultimate (LU) CAD-CAM composite resin after different repair protocols.

Material and methods

Fifty-eight LU miniblocks were prepared, thermocycled (10 000 cycles, 5°C to 55°C), and assigned to 10 surface pretreatment and bonding protocols: (1) tribochemical silica coating (CoJet, CoJet Sand; 3M ESPE)+Scotchbond Universal Adhesive (SBU; 3M ESPE); (2) CoJet+silane (SI, ESPE Sil; 3M ESPE)+Adper Scotchbond 1 XT Adhesive (XT; 3M ESPE); (3) CoJet+10-methacryloyloxydecyl dihydrogen phosphate–based silane (MO; Monobond Plus; Ivoclar Vivadent AG)+XT; (4) CoJet+XT; (5) 30-μm alumina airborne-particle abrasion (AL)+SBU; (6) AL+SI+XT; (7) AL+MO+XT; (8) AL+XT; (9) no pretreatment+SBU; and (10) no pretreatment+XT. All blocks were repaired using the Filtek Supreme XTE (3M ESPE) composite resin. Stick-shaped specimens (0.9×0.9 mm) were obtained and submitted to microtensile bond strength (μTBS) and %NL testing after 24 hours. μTBS data were analyzed with 1-way ANOVA, followed by the Tukey post hoc test, and NL data with nonparametric Kruskal-Wallis and Dunn tests (α=.05).

Results

For μTBS, CoJet, and AL pretreatments showed significantly higher mean μTBS, especially when used together with SBU. No pretreatment+XT yielded the lowest mean μTBS. For NL, marginal sealing improved significantly after the use of SBU regardless of the surface treatment. This improvement was only statistically different after tribochemical silica coating.

Conclusions

Airborne-particle abrasion with alumina particles, silica coated or not, together with the application of SBU resulted in the highest mean μTBS. The lowest %NL was recorded when aged LU blocks were repaired using SBU.  相似文献   

19.

Background

Transport distraction osteogenesis is challenged as a potential alternative to free-flap reconstruction of segmental jaw defects due to its longer treatment time, vector control difficulties, need for additional bone-grafting, and problems creating a curvilinear shape. We propose a new technique of acute open callus manipulation and fixation (AOCMF), which addresses these challenges.

Methods

A retrospective analysis of all patients with jaw defects who underwent DO and AOCMF between 2006 and 2015 was performed. Clinical and demographic data were recorded and analysed. Representative treated cases were presented.

Results

Fourteen adult patients were treated, seven for maxillary and seven for mandibular defects of mixed etiology. The mean length of distraction was 4.9 cm (range 3–8 cm). AOCMF was performed between the first and third week of the consolidation phase. Average treatment time was 7.6 weeks (range 4–13 weeks). Mean follow-up was 38 months (range 25–76 months). Stable curvilinear bone shape and soft tissue coverage was achieved in all patients except one. Four complications were recorded.

Conclusions

AOCMF following DO is a safe and reliable technique for reconstruction of segmental defects. It represents a useful alternative to free-flap reconstruction in selected patients. When compared with traditional bone transport techniques, it allows a decrease in the number of surgical procedures and in average treatment time.  相似文献   

20.

Introduction

In edentulous patients the form and size of the maxillary sinus vary greatly. Therefore sinus floor augmentation is a standard procedure for implantological purposes. As the sinus membrane cannot be characterized as periosteum, various augmentation materials are used.

Hypothesis

an artificially generated space underneath the sinus membrane in the floor of the sinus will lead to spontaneous callus forming and a stable bony consolidation without augmentation material.

Methods

Ten edentulous patients with highly atrophic maxillae were selected. Augmentation of the sinus floor was carried out in a split-mouth study design: On one side a combination of autogenous and xenogenous bone was used, and on the contralateral side a sinus membrane elevation was performed without using any substitutes. After a 6-month interval bone specimens from the test regions were harvested during implant placement.

Results

Clear histological evidence of new bone formation was found in all human bone specimens. An active de-novo bone formation process could be proven by the presence of Haversian systems (osteons) displaying osteoblastic and osteoclastic activity.

Conclusion

In the maxillary sinus of edentulous patients a spontaneous callus-derived de-novo bone formation is possible by elevating the sinus membrane without using augmentation materials.  相似文献   

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