Effect of different disinfection protocols on the surface properties of CAD-CAM denture base materials.

STATEMENT OF PROBLEM: Which disinfection protocol provides optimal water contact angle and microhardness for computer-aided design and computer-aided manufacturing (CAD-CAM) polymethyl methacrylate (PMMA) materials is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of different disinfection protocols (1% sodium hypochlorite, denture cleanser gel, and effervescent tablet) on the water contact angle and microhardness of different CAD-CAM PMMA denture base materials by comparing them with a heat-polymerized PMMA. MATERIAL AND METHODS: Disk-shaped specimens (Ø10×2 mm) were fabricated from 3 different CAD-CAM PMMAs-AvaDent (AV), Merz M-PM (M-PM), and Polident (Poli)-and a heat-polymerized PMMA (Vynacron) (CV) (n=21). Three disinfection protocols (1% sodium hypochlorite [HC], denture cleanser gel [GEL], an effervescent tablet [TAB]) were applied to simulate 180 days of cleansing. The water contact angle and microhardness of specimens were measured before and after disinfection and compared by using a 2-way ANOVA (α=.05). RESULTS: For water contact angle, material (P=.010) and disinfection protocol (P=.002) had a significant effect. The material (P<.001), disinfection protocol (P=.001), and their interaction (P<.001) significantly affected the microhardness after disinfection. When the condition after disinfection was compared with that before disinfection, the water contact angle increased significantly in all material-disinfection protocol pairs (P≤.025), and microhardness increased significantly in all material-disinfection protocol pairs (P≤.040), except for GEL- (P=.689) or TAB-applied (P=.307) AV, HC-applied M-PM (P=.219), and TAB-applied Poli (P=.159). CONCLUSIONS: The material and disinfection protocol affected the water contact angle of all tested PMMAs after disinfection, resulting in more hydrophobic surfaces for heat-polymerized or CAD-CAM PMMAs. The microhardness of heat-polymerized PMMA was less than that of all CAD-CAM PMMAs after disinfection, regardless of the protocol.

Surface roughness and stainability of CAD-CAM denture base materials after simulated brushing and coffee thermocycling.

STATEMENT OF PROBLEM: Denture bases machined from prepolymerized materials have become popular. However, information on the effect of simulated brushing and coffee thermocycling (CTC) on their surface roughness and stainability is lacking. PURPOSE: The purpose of this in vitro study was to compare the effect of simulated brushing and CTC on the surface roughness (Ra) and stainability of computer-aided design and computer-aided manufacturing (CAD-CAM) denture base materials and a heat-polymerized denture base material. MATERIAL AND METHODS: Forty disk-shaped specimens were prepared from 3 CAD-CAM denture base resins (AvaDent, AV; Merz M-PM, M-PM; and Polident d.o.o, Poli) and a heat-polymerized polymethylmethacrylate resin (Promolux, CV) (n=10). Ra values of the specimens were measured by using a noncontact profilometer after conventional polishing. The color coordinates were also measured over a gray background with a spectrophotometer. Specimens were then consecutively subjected to simulated brushing for 20 000 cycles, CTC for 5000 cycles, and another 10 000 brushing cycles. Ra and color coordinates were measured after each interval. Color differences (ΔE00) were calculated by using the CIEDE2000 formula, and the data were analyzed by using 2-way analysis of variance and Tukey honestly significant difference tests (α=0.05). RESULTS: The time interval had a significant effect on Ra (P<.001) as brushing cycles resulted in higher values than those at baseline and after CTC (P<.001). However, the differences between brushing cycles (P=.143) and between the baseline and after CTC (P=.994) were not significant. The interaction between the material type and time interval was significant for ΔE00 (P=.016). The only significant difference in ΔE00 values was observed between M-PM and CV after all treatments were completed (P=.029). CONCLUSIONS: Brushing increased the Ra of all materials when compared with the baseline. All materials showed similar stainability throughout the brushing and CTC processes. However, M-PM CAD-CAM denture base resin underwent a greater color change after all treatments were completed than conventional denture base resin. All color changes can be considered clinically small, considering reported perceptibility and acceptability thresholds.

Effect of simulated brushing and disinfection on the surface roughness and color stability of CAD-CAM denture base materials.

PURPOSE: To evaluate the effect of simulated brushing and chemical disinfection on the surface roughness and color stability of CAD-CAM denture base materials and to compare with those of a heat-cured denture base material. MATERIAL AND METHODS: Disk-shaped specimens (Ø 10mm × 2 mm) were prepared from 3 CAD-CAM denture base resins (AvaDent, Ava; Merz M-PM, Merz; Polident d.o.o, Poli) and a heat-cured polymethylmethacrylate resin (Promolux, Conv) (n = 30). After polishing, baseline surface roughness (Ra) and color coordinates were measured. The measurements were repeated after 20000 cycles of simulated brushing, and the specimens were divided into 3 groups according to disinfection protocol (distilled water, 1% sodium hypochlorite (NaOCl), and effervescent tablet) (n = 10). After 9 cleaning cycles over a period of 20 days, Ra and color coordinates were remeasured. Color differences (ΔE00) were calculated by using CIEDE2000 formula. One-way analysis of variance (ANOVA) and pairwise t-tests were used to analyze Ra and ΔE00 data, while repeated measures ANOVA test was used to compare baseline, after brush, and after disinfection Ra values (α = 0.05). RESULTS: Brushing did not affect the Ra values of tested materials (P ≥ .08). Both before and after brushing, Merz and Conv had higher Ra values than Poli and Ava (P < .001). Among disinfectants, effervescent tablet led to the lowest Ra for Merz (P = .003) and the highest Ra for Poli (P ≤ .039). Only NaOCl resulted in significant differences among the Ra of materials (P < .001), as Merz and Conv had higher Ra values than Poli (P ≤ .002). Repeated measures ANOVA revealed that effervescent tablet disinfection of Merz led to lower Ra values than those of baseline and after brushing (P ≤ .042). After brushing, Ava and Conv had higher ΔE00 values compared with Merz and Poli (P ≤ .015). When compared with other disinfection protocols, effervescent tablet led to higher ΔE00 values for Merz and Poli (P < .001). Significant differences were observed among materials when NaOCl was used; Conv had higher ΔE00 values than Ava and Merz (P = .004). CONCLUSIONS: Brushing did not increase the surface roughness of materials. Disinfection protocol's effect on the surface roughness varied. The effect of brushing on the color of materials varied; color of Ava and Conv was affected from brushing more than the other materials. Color stability of materials varied depending on the disinfection protocol. Effervescent tablet caused higher color change with Merz and Poli compared with other disinfectants. NaOCl led to small color change for Poli, Ava, and Merz materials.

Trueness and precision of combined healing abutment-scan body system depending on the scan pattern and implant location: An in-vitro study.

OBJECTIVE: To test the effect of scan pattern and the location of the implant on the trueness and precision of implant scans when the combined healing abutment-scan body (CHA-SB) system is used. MATERIAL AND METHODS: A partially edentulous maxillary model with CHA-SBs secured on implants at 3 different sites in the left quadrant (central incisor, first premolar, and first molar) was fabricated. The model was scanned with an industrial light scanner to generate a master reference model (MRM) file. An intraoral scanner (TRIOS 3) was used to perform the test scans (n = 8) with 4 different scan patterns (SP1, SP2, SP3, and SP4) with an intraoral scanner. The test scans were superimposed over the MRM file with a metrology software to calculate the distance deviations of the CHA-SB system. Data were analyzed with a 2-way analysis of variance and Tukey's honestly significant difference tests for accuracy (α = .05). RESULTS: Trueness (P = .001) and precision (P = .018) were significantly affected by the interaction between the scan pattern and implant location. The implant located at the central incisor site (56.7 ± 35.9, 36.2 ± 18.6) had higher trueness than that of located at the premolar site (94.1 ± 20.4, 100.3 ± 20) when SP2 (P = .037) and SP4 (P = .002) were used. The implant at the molar site (71.9 ± 25.7, 147.2 ± 49.7) had trueness either similar to (when SP2 was used, P ≥ .276) or lower than (when SP4 was used, P ≤ .024) those of others. Scans of the central incisor and premolar implants had the lowest trueness when scanned with SP1 (P ≤ .009), while the scans of molar implant showed higher trueness when performed by using SP2 and SP3 when compared with SP4 (P ≤ .005). When SP4 was used, the implant at the molar site had lower precision (43 ± 18.9) than the implants located at the central incisor (14.1 ± 11) and premolar sites (15.4 ± 11.3) (P = .002). Scan patterns affected the scan precision of central incisor implant (P = .009), as SP4 (14.1 ± 11) led to a higher precision than SP1 (47.7 ± 27) (P = .006). CONCLUSIONS: The scan accuracy of combined healing abutment-scan body system was affected by scan pattern and implant location. SP1, which involved palatal and rotational scans resulted in the lowest trueness for central incisor and premolar implants, while the scans of the central incisor implant showed the highest trueness among different sites when SP4 was used. However, the scan pattern and implant site had a minor effect on precision. Scan precision at different implant sites only differed when SP4 was used, which resulted in the lowest precision for molar implant.

Effect of scan pattern on the scan accuracy of a combined healing abutment scan body system.

STATEMENT OF PROBLEM: A recently introduced scan body combined with a contoured healing abutment enables digital scans of the implant while its healing abutment shapes the soft tissue for an appropriate emergence profile. However, information on the effect of different scan patterns on the scan accuracy of this new system is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the effect of scan pattern on the accuracy of digital implant scans by using a combined healing abutment-scan body system. MATERIAL AND METHODS: A combined healing abutment-scan body system was secured on a single implant at the right first molar site in a dentate mandibular model. A master reference model was generated by scanning the model with an industrial light scanner. The model was then scanned with 4 different scan patterns (SP-A, SP-B, SP-C, and SP-D) by using an intraoral scanner (TRIOS 3). Test scans (n=8) were superimposed over the master reference model by using a metrology software, and distance and angular deviations were calculated. Distance and angular deviation data were analyzed with a multivariate analysis of variance and the Tukey honestly significant difference tests for trueness and precision (α=.05). RESULTS: Distance deviations (trueness [P=.461] and precision [P=.533] deviations) in the scans were not significantly affected by the scan pattern. Scan pattern affected the trueness (P=.001) and precision (P=.002) when angular deviations were considered. In terms of trueness, SP-D resulted in the highest angular deviations in scans (P≤.031), while the difference in deviations in scans obtained by using other scan patterns was not significant (P≥.378). When angular deviation data were considered, SP-D resulted in lower scan precision than SP-A (P=.014) and SP-B (P=.007). The precision of scans using SP-C was similar to the precision of the scans made by using other scan patterns (P≥.055) in terms of angular deviations. CONCLUSIONS: The scan accuracy of a combined healing abutment-scan body system was affected by the scan pattern. The scans performed with SP-D presented the lowest accuracy considering the angular deviation data and, therefore, may be the least favored among the patterns tested for scanning a combined healing abutment-scan body system.

Effect of implant location and operator on the accuracy of implant scans using a combined healing abutment-scan body system.

OBJECTIVES: To investigate the effect of implant location and operator on the accuracy of implant scans conducted with a combined healing abutment-scan body (CHA-SB) system. MATERIAL AND METHODS: A CHA-SB system was fixed on implants at left central incisor, first premolar, and first molar sites in a dentate maxillary model. An industrial optical scanner (ATOS Core 80) was utilized to scan and generate a reference model (RM). The model was scanned by three operators (n = 8) using an intraoral scanner (TRIOS 3). A software (GOM Inspect) was used to superimpose IOS test scans over RM and calculations (distance and angular deviations) were carried out to evaluate the accuracy of the scans. Data were compared with a 2-way ANOVA and Tukey HSD tests were employed to resolve significant interactions for trueness and precision (α = .05). RESULTS: Implant location affected the trueness (P ≤ .001) and the precision (P ≤ .020) (distance and angular deviations). The scans of the implant at the central incisor site had the highest trueness (distance and angular deviations) (P ≤ .016). The scans of the implant at molar site had the lowest precision (distance deviation data) (P ≤ .012). The scans of the implant at premolar site had lower precision (angular deviation data) than the scans of the implant at central incisor site (P = .016). Operators' effect on the accuracy of scans was not significant (P ≥  .051). CONCLUSION: Implant location affected the scan accuracy of the combined healing abutment-scan body system. The scans of the implant at central incisor site had high trueness. The posterior the implant location, the lower was the precision of the scans. The accuracy of scans of different operators was similar. CLINICAL SIGNIFICANCE: Higher deviations found in scans of posterior maxilla compared with those in the anterior region may require increased chairside adjustments when crowns are to be fabricated using the scans of the tested healing abutment-scan body system. However, clinical studies are necessary to corroborate the findings.

Accuracy of single implant scans with a combined healing abutment-scan body system and different intraoral scanners: An in vitro study.

OBJECTIVE: The aim of the present study was to evaluate the accuracy of single implant scans with a combined healing abutment-scan body (CHA-SB) system using different intraoral scanners. METHODS: A partially edentulous model with an implant was fabricated, and a CHA-SB system was secured on the implant. The model was scanned using an industrial-grade blue light scanner (ATOS Core 80) and a master reference model was generated (MRM). The model was also scanned with 4 different intraoral scanners (IOSs) [(Virtuo Vivo (VV), TRIOS 3 (T3), Omnicam (CO), and Primescan (PS)]. Test scans (n = 8) were superimposed over the MRM using the best fit algorithm (GOM Inspect 2018; GOM GmbH). After superimpositions, distance and angular deviations at selected areas on CHA-SB system were calculated. The data were analyzed with a 1-way ANOVA and Tukey HSD tests for trueness and precision (α=0.05). RESULTS: The differences in trueness (distance deviations) among tested IOSs were nonsignificant (P=.652). VV presented the highest angular deviations (P ≤.031), and the angular deviations in other IOS scans were not found different (P ≥.378). The precision of distance deviation data was not significantly different among scanners (P=.052). For the precision of angular deviation data, significant differences were found among IOSs (P=.002). Compared with PS (P=.007) and T3 (P=.014), VV had significantly lower precision, which was not significantly different than that of CO (P=.815). CONCLUSIONS: The accuracy (angular deviation) of scans of a combined healing abutment-scan body system on a single implant varied depending on the IOS. VirtuoVivo scans had the lowest accuracy in terms of angular deviations. When the distance deviation data were considered, scan accuracy of scanners was similar. CLINICAL SIGNIFICANCE: A recently introduced combined healing abutment-scan body system combines the acquisition of both the implant and the soft tissue. When different intraoral scanners scan the combined healing abutment-scan body system, the scan accuracy may vary.

Effect of thermocycling on the surface properties of CAD-CAM denture base materials after different surface treatments.

PURPOSE: To evaluate the effect of thermocycling on the water contact angle (WCA), surface roughness (SR), and microhardness (MH) of different CAD-CAM PMMA denture base materials after different surface treatments (conventional laboratory polishing, polishing kit, or surface sealant). MATERIALS AND METHODS: Disk-shaped specimens (10 × 2 mm) of 3 different CAD-CAM PMMAs, AvaDent (AV); Merz M-PM (M-PM); Polident (Poli), and a conventional heat-polymerized PMMA (Vynacron) (CV) (n=21) were divided into 3 different surface treatment groups (n=7): conventional laboratory polishing (CLP), polishing with acrylic resin polisher kit (PK), and a surface sealant (Palaseal) (SSC). Stereomicroscopic images were taken both before and after thermocycling. WCA, SR, and MH of all specimens were measured before and after thermocycling and compared by using a 2-way ANOVA (α=0.05). RESULTS: After thermocycling, WCA significantly increased for CLP- or PK -applied (P<.001) specimens of all materials and SSC-applied M-PM (P=.002), SR significantly increased for CLP-applied M-PM (P=.027) and PK-applied Poli (P=.041), and MH significantly decreased for CLP- or PK-applied AV (P = .001, P < .001, respectively), CV (P=.033, P=.023, respectively), and M-PM (P=.003, P=.001, respectively), SSC-applied M-PM (P<.001), and CLP-applied Poli (P<.001). Stereomicroscopic images revealed rougher surfaces for PK-applied specimens. CONCLUSIONS: After thermocycling, surface treatment had a significant effect on water contact angle and surface roughness. CLP or PK application resulted in hydrophobic surfaces compared with before thermocycling. CLP or SSC application on CAD-CAM PMMAs resulted in smoother surfaces. Thermocycling lowered the microhardness of all PMMAs, and the decrease was significant in CLP- or PK-applied PMMAs, except for PK-applied Poli.