An Experimental Strategy for Capturing the Margins of Prepared Single Teeth with an Intraoral Scanner: A Prospective Clinical Study on 30 Patients.

Purpose: To present an experimental strategy for successfully capturing the margins of prepared single teeth with an intraoral scanner (IOS). Methods: The protocol was as follows: (1) an intraoral impression was captured with an IOS, without taking care of the visibility of the margins; (2) a partial analog impression was taken by means of a 3D-printed custom tray filled with polyvinylsiloxane light, after the removal of a retraction cord; (3) the hollow portion of the analog impression, with the preparation margins clearly visible, was scanned extraorally with the same IOS; (4) the scan of the analog impression was imported into computer-assisted-design (CAD) software, where its normals were inverted; (5) the scan with inverted normals was registered on the first intraoral scan, and replaced it; (6) the technician designed the final restoration, which was fabricated and delivered for application. The study outcomes were: (1) the marginal adaptation of the final crown; (2) the quality of interproximal contacts; and (3) the quality of occlusal contacts. Results: Thirty patients (18 males, 12 females; mean age 51.3 ± 11.6 years) were selected for this study. All these patients were restored with a monolithic translucent zirconia crown, fabricated following the aforementioned protocol. The clinical precision and the marginal adaptation of the crowns were optimal, interproximal contact points were perfect, and the only necessary adaptations were occlusal, with some minor precontacts that had to be polished. Conclusions: The present protocol seems to be compatible with the fabrication of clinically precise zirconia crowns. Further studies are needed to confirm these results.

Análise da dissipação das tensões em dentes humanos restaurados com facetas laminadas de cerâmica, com três tipos de preparos, através do método dos elementos finitos / Analysis of stress dissipation in human teeth restored with ceramic veneers, with three types of preparation, through the finite elements method

O objetivo deste trabalho é analisar in vitro a dissipação de tensões em incisivos centrais superiores humanos restaurados com facetas de cerâmica feldspática, através da análise do método dos elementos finitos, considerando cargas funcionais de mastigação e corte dos alimentos, em função de três tipos de preparos utilizados: sem proteção incisal; com proteção incisal em ângulo e com proteção incisal em degrau palatino. Foram utilizadas modelagens bidimensionais de um incisivo central superior e suas estruturas de suporte, simulando três situações: (Primeira modelagem) incisivo central superior com desgaste vestibular (em forma de janela); (Segunda modelagem) incisivo central superior com desgaste vestibular e proteção incisal em plano inclinado; (Terceira modelagem) incisivo central superior com desgaste vestibular, e proteção incisal com degrau palatino. Foi considerada uma carga (P=100N) com uma inclinação de 45º concentrada, simulando a região de contato do incisivo central inferior com o superior durante a mastigação e uma na região de contato topo a topo dos incisivos superior e inferior, simulando o corte dos alimentos. Após a análise dos dados obtidos pela distribuição de tensões, pode-se concluir que quanto à dissipação das tensões em todo o sistema proposto, com a aplicação de carga em 45º, não foram observadas mudanças no estado tensional nos três diferentes preparos. Quando foi aplicada carga vertical, simulando o contato de topo, houve variação no estado tensional no sistema do dente com preparo em janela. Nas facetas, com a aplicação de carga em 45º, nos preparos em janela e com proteção incisal em plano inclinado o resultado foi semelhante nos valores tensionais enquanto, nas facetas em dentes preparados com proteção incisal com degrau palatino, a distribuição foi mais homogênea tendo valores superiores, mostrando que o abraçamento do dente diminuiu a flexão.

The aim of this study is to analyze in vitro stress dissipation on human maxillary central incisors restored with ceramic feldspathic veneers, through the finite element method. Functional chewing and food cutting loads were evaluated in three types of preparations of teeth: preparation without incisal protection, with incisal angle protection and with incisal protection with palatal step. Two-dimensional modeling of a maxillary central incisor and its supporting structures were used, simulating three conditions: 1) First modeling - maxillary central incisor with facial preparation (window shape); 2) Second modeling - maxillary central incisor with facial preparation and incisal protection on an inclined plane; 3) Third modeling - maxillary central incisor with facial preparation and incisal protection with palatal step. The chosen load (P = 100N) was applied to two different points: one of them to the palatal aspect with an inclination of 45° in order to simulate the contact area of the mandibular and the maxillary central incisors during chewing and the other one to the region of contact with edge-to-edge upper/lower central incisors, simulating food cutting. After analyzing the data obtained from the stress distribution it is possible to conclude that there are no alterations in tensional characteristics of the three different preparations concerning the stress dissipation on the whole proposed system, considering the application of load in 45°. When the vertical load was applied, simulating an edge-to-edge contact, a variation in the stress state of tooth with window preparation was observed. For veneers with 45° load application, both the window preparation teeth and teeth with incisal protection on an inclined plane presented similar tensional values. For veneers of prepared teeth with incisal protection with palatal step, the stress distribution was more homogeneous with higher values, showing that tooth embracement reduced flexion.