Reliability of light microscopy and a computer-assisted replica measurement technique for evaluating the fit of dental copings

Abstract The aim of this in vitro study was to assess the reliability of two measurement systems for evaluating the marginal and internal fit of dental copings. Material and Methods: Sixteen CAD/CAM titanium copings were produced for a prepared maxillary canine. To modify the CAD surface model using different parameters (data density; enlargement in different directions), varying fit was created. Five light-body silicone replicas representing the gap between the canine and the coping were made for each coping and for each measurement method: (1) light microscopy measurements (LMMs); and (2) computer-assisted measurements (CASMs) using an optical digitizing system. Two investigators independently measured the marginal and internal fit using both methods. The inter-rater reliability [intraclass correlation coefficient (ICC)] and agreement [Bland-Altman (bias) analyses]: mean of the differences (bias) between two measurements [the closer to zero the mean (bias) is, the higher the agreement between the two measurements] were calculated for several measurement points (marginal-distal, marginal-buccal, axial-buccal, incisal). For the LMM technique, one investigator repeated the measurements to determine repeatability (intra-rater reliability and agreement). Results: For inter-rater reliability, the ICC was 0.848-0.998 for LMMs and 0.945-0.999 for CASMs, depending on the measurement point. Bland-Altman bias was −15.7 to 3.5 μm for LMMs and −3.0 to 1.9 μm for CASMs. For LMMs, the marginal-distal and marginal-buccal measurement points showed the lowest ICC (0.848/0.978) and the highest bias (-15.7 μm/-7.6 μm). With the intra-rater reliability and agreement (repeatability) for LMMs, the ICC was 0.970-0.998 and bias was −1.3 to 2.3 μm. Conclusion: LMMs showed lower interrater reliability and agreement at the marginal measurement points than CASMs, which indicates a more subjective influence with LMMs at these measurement points. The values, however, were still clinically acceptable. LMMs showed very high intra-rater reliability and agreement for all measurement points, indicating high repeatability.

Evaluation of adaptation of ceramic inlays using optical coherence tomography and replica technique

Abstract Optical coherence tomography (OCT) has generally been used as a nondestructive technique to evaluate integrities of composite restorations. We investigated marginal and internal adaptations of ceramic inlay restorations with OCT and compared them to results with the silicone replica technique. Round-shaped class I cavities were prepared on 16 human maxillary first premolar teeth. Ceramic inlays were fabricated. Silicone replicas from inlays were obtained and sectioned to measure marginal and internal adaptations with a stereomicroscope (Leica Dfc 295, Bensheim, Germany). Inlays were cemented on respective teeth. Marginal and internal adaptations were then measured with the OCT system (Thorlabs, New Jersey, USA) in 200- μm intervals. Replica and OCT measurements were compared with independent samples t-tests. A paired t-test was used to evaluate the marginal and internal adaptations of each group (p < 0.05). Marginal and internal adaptations were 100.97 ± 31.36 and 113.94 ± 39.75 μm, respectively, using the replica technique and 28.97 ± 17.86 and 97.87 ± 21.83 μm, respectively, using OCT. The differences between the techniques were significant (p = 0.00 and p = 0.01, respectively). On evaluation within the groups, internal adaptation values were found to be significantly higher than the marginal adaptation values for the replica technique (p = 0.00) and OCT (p = 0.00). Therefore, the replica and OCT techniques showed different results, with higher values of marginal and internal adaptation found with the replica technique. Marginal and internal adaptation values of ceramic inlays, whether measured by replica or OCT techniques, were within clinically acceptable limits.

Técnica de replicação de amostras em positivo. Análise no Microscópio Eletrônico de Varredura / Positive replication tehcnique. Scanning Electron Microscope Assessment

A Microscopia Eletrônica de Varredura apresenta algumas desvantagens como a formação de trincas ou contração do dente durante seu preparo, assim como a impossibilidade de realizar observações in vivo. Para diminuir estes problemas, têm-se desenvolvido técnicas de replicação, avaliando a cópia e não o dente, o que permite estudar processos e seqüências de tratamento na mesma amostra, tanto in vitro como in vivo. Dessa forma, a proposição deste trabalho é avaliar morfologicamente a fidelidade de uma técnica de replicação, utilizando 2 resinas epóxicas e uma técnica de moldagem em dentes humanos extraídos. Uma vez eliminado o cemento no terço cervical radicular dos dentes com alta rotação, delimitou-se uma área de 4X4 na qual foi aplicado EDTA-T 24% por 3 minutos, seguindo da lavagem com soro e secagem com jato de ar, expondo túbulos dentinários. Estes seguimentos foram moldados, utilizando silicona de adição Aquasil (pesada e leve). Posteriormente, as moldagens foram vazadas com as resinas CMR 028-endurecedor CME-251 (Polipox, São Paulo) e o Epoxiglass 1504 e endurecedor 1603 (Epoxiglass-SP). Todas as réplicas e dentes naturais foram avaliados no MEV tomando fotomicrografias que foram avaliadas de acordo com o grau de fidelidade na réplica dos túbulos dentinários. Os resultados mostraram que a técnica de replicação reproduziu satisfatoriamente as características da superfície dentária.

Diagnostic and therapeutic value of the replica technique in herpetic keratitis

The recommendation of corneal replicas in the management of superficial herpetic keratitis serves a dual purpose. The first purpose is diagnostic to facilitate histopathological examination of the intact corneal epithelium including the herpetic lesions. The second purpose is therapeutic to promote uneventful healing of the corneal ulcer without any complications and perhaps to reduce the recurrence rate. The causes of recurrences may be either due to stromal affections in which the epithelial lesion only was cured. In cases of simple epithelial herpetic keratitis, corneal replicas proved to be effective in healing the condition within 3-5 days without any complications. If the recurrence has occured and it is very low percentage, it may be attributed to insufficient amount of replica or missed diagnosis of significant stromal affection