Three-dimensional assessment of internal adaptation measurement of three cad/cam ceramic systems

Abstract This study aimed to evaluate the internal adaptation of three different computer-aided design/computer-aided manufacturing (CAD/CAM) ceramic crowns. The internal adaptation of a polymer-infiltrated ceramic network material (Vita Enamic [VE]) was compared to two machinable glass-ceramics; Zirconia-reinforced lithium silicate (Vita Suprinity [VS]) and a lithium disilicate glass-ceramic (IPS e.max. CAD). Thirty human premolars of average size were prepared (n=10 each group) by computer numerical control to fulfill the criteria of all-ceramic crown design. Optical impressions were taken for each tooth preparation using the CAD/CAM scanner. Thirty crowns were fabricated using CAD/CAM system and divided into three groups (IPS e.max, VE, and VS). To assess the internal fit of tested crowns, the gap between the intaglio of each crown and the corresponding tooth surface was evaluated using a 3D digital scanner using the Triple-scan Protocol. One-way ANOVA followed by Tukey Post Hoc statistical tests were used to statistically analyze results of the internal fit. There was a statistically significant difference for all groups at the four axial walls (p = 0.000002). For total internal fit between groups, comparisons showed a statistically significant difference between all tested groups (p=0.000002). When each pair of groups was statistically compared with each other, all pair comparisons showed a statistically significant difference. IPS e.max CAD had the best internal fit, followed by Vita Enamic, then Vita Suprinity. For all ceramics tested, values of internal fit of all ceramics tested were within the clinically acceptable range.

Resumo Este estudo teve como objetivo avaliar a adaptação interna de três diferentes coroas cerâmicas CAD/CAM (Computer-aided design/computer-aided manufacturing). A adaptação interna de um material cerâmico de rede com infiltração de polímero (Vita Enamic [VE]) foi comparada com duas cerâmicas de vidro maquináveis; silicato de lítio reforçado com zircónio (Vita Suprinity [VS]) e uma cerâmica-vidro de dissilicato de lítio (IPS e.max. CAD). Trinta dentes pré-molares humanos de tamanho médio foram preparados (n=10 cada grupo) por controle numérico computadorizado para preencher os critérios de desenho de coroa em cerâmica pura. Foram tiradas impressões ópticas para cada preparação dentária utilizando o scanner CAD/CAM. Trinta coroas foram fabricadas usando o sistema CAD/CAM e divididas em três grupos (IPS e.max, VE, e VS). Para avaliar o ajuste interno das coroas testadas, o espaço entre o entalhe de cada coroa e a superfície dentária correspondente foi avaliado usando um scanner digital 3D usando o Protocolo Triple-scan. Para analisar estatisticamente os resultados do ajuste interno, utilizou-se a ANOVA unidirecional seguida dos testes estatísticos Tukey Post Hoc. Houve uma diferença estatisticamente significativa para todos os grupos nas quatro paredes axiais (p = 0,000002). Para o ajuste interno total entre grupos, as comparações mostraram uma diferença estatisticamente significativa entre todos os grupos testados (p=0,000002). Quando cada par de grupos foi comparado estatisticamente uns com os outros, todas as comparações de pares mostraram uma diferença estatisticamente significativa. IPS e.max CAD teve o melhor ajuste interno, seguido por Vita Enamic, depois Vita Suprinity. Para todas as cerâmicas testadas, os valores de ajuste interno de todas as cerâmicas testadas encontravam-se dentro da gama clinicamente aceitável.

Adaptación de cofias metálicas confeccionadas con dos técnicas: cera pérdida colado por centrifugación convencional e inducción / Adaptation of metallic copings made with two techniques: loss wax cast conventional centrifugation and induction

Nuevas técnicas nos están permitiendo migrar de la técnica de cera perdida colado por centrifugado convencional (CPCC) a técnicas como la cera perdida colado por inducción (CPCI). Objetivos: Comparar la discrepancia marginal e interna de cofias unitarias de aleación Cobalto-Cromo (Co-Cr) sobre una línea de terminación chamfer, confeccionadas con dos técnicas: CPCC y CPCI, determinando cual técnica tuvo mejor adaptación marginal e interna. Material y Métodos: Se fabricaron13 cofias metálicas unitarias de aleación Co-Cr para cada técnica a evaluar. Se utilizó la réplica de silicona para evaluar las discrepancias marginales e internas, cada muestra fue seccionada en cruz en sentido vestíbulo-palatino y en sentido mesio-distal, luego con un estéreomicroscopio se evaluó la zona cervical, axial y oclusal. Resultados: Se evaluó los supuestos de normalidad con la prueba de Shapiro-Wilk. Los análisis estadísticos fueron la prueba t de Student y U Mann-Whitney. La CPCI obtuvo una menor discrepancia marginal e interna en comparación con la CPC pero no se encontró diferencias estadísticamente significativas (p>0,05) entre ambas técnicas. Conclusiones: Aunque en la mayoría de los puntos de evaluación las cofias realizadas mediante la CPCI presento mejores valores de adaptación marginal e interna en comparación con la CPCC estos resultados sólo son valores descriptivos que no fueron concluyentes, ya que en la mayoría de los puntos evaluados no existió diferencia estadísticamente significativa (p>0,05). Observamos que la mayoría de los valores de ambas técnicas se encuentran dentro del rango clínicamente aceptable.

New techniques are allowing us to migrate from the technique of lost wax cast by conventional centrifugation (CPCC) to techniques such as lost wax cast by induction (CPCI). Objectives: To compare the marginal and internal discrepancy of cobalt-chromium (Co-Cr) alloy unit copes on a chamfer termination line, made with two techniques: CPCC and CPCI, determining which technique had better marginal and internal adaptation. Material and Methods: 13 Co-Cr alloy unit copings were fabricated for each technique to be evaluated. Silicon replication was used to evaluate the marginal and internal discrepancies. Each sample was cross-sectioned in the vestibular-palatine and mesio-distal directions, then the cervical, axial and occlusal zones were evaluated with a stereomicroscope. Results: 13 unitary Co-Cr alloy metal cops were manufactured for each technique to be evaluated. The silicone replica was used to evaluate the marginal and internal discrepancies, each sample was cross-sectioned in the vestibulo-palatal direction and in the mesio-distal sense, then with a stereomicroscope, the cervical, axial and occlusal areas were evaluated. Conclusions: The assumptions of normality were evaluated with the Shapiro-Wilk test. The statistical analyzes were Student s t test and U Mann-Whitney test. The CPCI obtained a lower marginal and internal discrepancy compared to the CPC, but no statistically significant differences were found (p >0.05) between both techniques. Conclusions: Although in most of the evaluation points the copings made by the CPCI presented better values of marginal and internal adaptation compared to the CPCC, these results are only descriptive values that were not conclusive, since in most of the evaluated points there was no statistically significant difference (p >0.05). We observed that most of the values of both techniques are within the clinically acceptable range.

Evaluation of the marginal and internal fit of a single crown fabricated based on a three-dimensional printed model

PURPOSE: To evaluate the fit of a crown produced based on a 3D printed model and to investigate its clinical applicability. MATERIALS AND METHODS: A master die was fabricated with epoxy. Stone dies were fabricated from conventional impressions (Conventional stone die group: CS, n=10). Digital virtual dies were fabricated by making digital impressions (Digital Virtual die group: VD, n=10). 3D data obtained from the digital impression was used to fabricate 3D printed models (DLP die group: DD, n=10, PolyJet die group: PD, n=10). A total of 40 crowns were fabricated with a milling machine, based on CS, VD, DD and PD. The inner surface of all crowns was superimposed with the master die files by the “Best-fit alignment” method using the analysis software. One-way and 2-way ANOVA were performed to identify significant differences among the groups and areas and their interactive effects (α=.05). Tukey's HSD was used for post-hoc analysis. RESULTS: One-way ANOVA results revealed a significantly higher RMS value in the 3D printed models (DD and PD) than in the CS and DV. The RMS values of PD were the largest among the four groups. Statistically significant differences among groups (P < .001) and between areas (P < .001) were further revealed by 2-way ANOVA. CONCLUSION: Although the fit of crowns fabricated based on the 3D printed models (DD and PD) was inferior to that of crowns prepared with CS and DV, the values of all four groups were within the clinically acceptable range ( < 120 µm).

In vitro evaluation methods on adaptation of fixed dental prosthesis

Clinically, the fit of fixed prosthesis is an essential element for successful restoration. The fit of prosthesis is largely classified into marginal fit and internal fit, and various methods to assess these have been introduced including microscopic margin measurement, cross-sectional measurement, silicone replica technique, 3-dimensional scanning data superposition, weight technique and micro CT scanning. Thus, this study is aimed at proposing a more convenient and accurate measurement method of fits in a digital environment by comparatively analyzing the advantages and disadvantages of each known method based on existing literature.

An experimental study on the fit of Co-Cr basal crowns fabricated by different technology / 实用口腔医学杂志

Objective:To compare the fit of Co-Cr basal crowns fabricated by three kinds of technology. Methods:18 laser cured resin dies were divided into A, B and C groups(n=6) randomly. Co-Cr basal crowns of group A, B and C were made by traditional casting technology, CAD/CAM cutting metal technology and direct metal laser sintering technology( DMLS) respectively. The crowns were cemented to the corresponding dies and the basal crowns and dies were embedded in methyl acrylic. The thickness of the cement layer of the samples was measured under a stero microscope. Data were analyzed with SPSS13. 0 statistical software. Results:Marginal gap of group A, B and C was (66.08 ±3.90) μm, (29.21 ±3.31) μm and (24.96 ±2.99) μm respectively(P0. 05). Conclusion:DMLS technology may make the best marginal fit, CAD/CAM and DMLS technology may pro-duce better internal fit. The marginal fit and the internal fit of the crowns prepared by the 3 methods can meet the clinical requirements.

Study on methodology for the assessment of internal and marginal adaptation on fixed dental prosthesis

This article is to review various methods used to investigate internal and marginal adaptation of fixed dental prostheses, and to summarize a merit, worth, and limitation of each method, using some results of previous studies. The methods of measuring internal and marginal gap are divided into two categories in this study; in vivo and in vitro. In vivo methods are clinical evaluations, including exploration, radiography, and impression technique. In vitro methods are laboratory evaluations such as direct view, cross-sectioning, and silicone replica technique using microscope. Measuring by micro computed tomography (CT) or profilometer is also in vitro methods. In recent years, the development of scanning systems is able to analyze 3-dimensional internal and marginal space in detail. As measuring and analyzing technology become more advanced, the ability to thoroughly examine crown adaptation is becoming both simpler and more efficient.

Comparison of micro CT and cross-section technique for evaluation of marginal and internal fit of lithium disilicate crowns / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the adaptation of lithium disilicate crowns fabricated by CAD-CAM (computer aided design-computer aided manufacturing) and heat-press technique to compare two different measurement methods in assessing fit of the ceramic crowns: micro CT and cross-section technique. MATERIALS AND METHODS: A prepared typodont mandibular molar for ceramic crown was duplicated and ten dies were produced by milling the PMMA (polymethylmethacrylate) resin. Ten vinyl polysiloxane impressions were made and stone casts were produced. Five dies were used for IPS e.max Press crowns with heat-press technique. The other five dies were used for IPS e.max CAD crowns with CAD-CAM technique. Ten lithium disilicate crowns were cemented on the resin dies using zinc phosphate cement with finger pressure. The marginal and internal fits in central buccolingual plane were evaluated using a micro CT. Then the specimens were embedded and cross-sectioned and the marginal and internal fits were measured using scanning electronic microscope. The two measurement methods and two manufacturing methods were compared using Mann-Whitney U test (SPSS 22.0). RESULTS: The marginal and internal fit values using micro CT and cross-section technique were similar, showing no significant differences. There were no significant differences in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique. CONCLUSION: Both micro CT and cross-section technique were acceptable methods in the evaluation of marginal and internal fit of lithium disilicate crown. There was no difference in adaptation between lithium disilicate crowns fabricated with CAD-CAM and heat-press technique except occlusal fit.

Accuracy evaluation of metal copings fabricated by computer-aided milling and direct metal laser sintering systems

PURPOSE: To assess the marginal and internal gaps of the copings fabricated by computer-aided milling and direct metal laser sintering (DMLS) systems in comparison to casting method. MATERIALS AND METHODS: Ten metal copings were fabricated by casting, computer-aided milling, and DMLS. Seven mesiodistal and labiolingual positions were then measured, and each of these were divided into the categories; marginal gap (MG), cervical gap (CG), axial wall at internal gap (AG), and incisal edge at internal gap (IG). Evaluation was performed by a silicone replica technique. A digital microscope was used for measurement of silicone layer. Statistical analyses included one-way and repeated measure ANOVA to test the difference between the fabrication methods and categories of measured points (alpha=.05), respectively. RESULTS: The mean gap differed significantly with fabrication methods (P<.001). Casting produced the narrowest gap in each of the four measured positions, whereas CG, AG, and IG proved narrower in computer-aided milling than in DMLS. Thus, with the exception of MG, all positions exhibited a significant difference between computer-aided milling and DMLS (P<.05). CONCLUSION: Although the gap was found to vary with fabrication methods, the marginal and internal gaps of the copings fabricated by computer-aided milling and DMLS fell within the range of clinical acceptance (<120 microm). However, the statistically significant difference to conventional casting indicates that the gaps in computer-aided milling and DMLS fabricated restorations still need to be further reduced.

Accuracy evaluation of metal copings fabricated by computer-aided milling and direct metal laser sintering systems

PURPOSE: To assess the marginal and internal gaps of the copings fabricated by computer-aided milling and direct metal laser sintering (DMLS) systems in comparison to casting method. MATERIALS AND METHODS: Ten metal copings were fabricated by casting, computer-aided milling, and DMLS. Seven mesiodistal and labiolingual positions were then measured, and each of these were divided into the categories; marginal gap (MG), cervical gap (CG), axial wall at internal gap (AG), and incisal edge at internal gap (IG). Evaluation was performed by a silicone replica technique. A digital microscope was used for measurement of silicone layer. Statistical analyses included one-way and repeated measure ANOVA to test the difference between the fabrication methods and categories of measured points (alpha=.05), respectively. RESULTS: The mean gap differed significantly with fabrication methods (P<.001). Casting produced the narrowest gap in each of the four measured positions, whereas CG, AG, and IG proved narrower in computer-aided milling than in DMLS. Thus, with the exception of MG, all positions exhibited a significant difference between computer-aided milling and DMLS (P<.05). CONCLUSION: Although the gap was found to vary with fabrication methods, the marginal and internal gaps of the copings fabricated by computer-aided milling and DMLS fell within the range of clinical acceptance (<120 microm). However, the statistically significant difference to conventional casting indicates that the gaps in computer-aided milling and DMLS fabricated restorations still need to be further reduced.