Rubenstein Jeffrey E, Lowry Marcus B
Division of Prosthodontics, University of Washington School of Dentistry, Seattle 98195-7452, USA.
J Prosthet Dent. 2006 May;95(5):379-91. doi: 10.1016/j.prosdent.2006.02.013.
Use of a segmental indexing/soldering approach for assembly of complete arch implant frameworks has been advocated by some clinicians to achieve a passively fitting framework. To the authors' knowledge, a mathematical assessment using a 3-dimensional (3-D) distortion analysis has not been performed comparing segmental framework assembly to reassembly of 1-piece complete arch frameworks that required sectioning, indexing, and soldering.
The present study compared the use of 2 indexing materials, autopolymerizing acrylic resin and light-polymerized composite resin, for use in solder registration of complete-arch implant frameworks using 3 framework/indexing material combinations: gold/light-polymerized composite resin, silver palladium/autopolymerizing acrylic resin, and silver palladium/light-polymerized composite resin.
Five frameworks for each alloy/index combination were fabricated, for a total of 15 frameworks. Each framework was fitted to 5 implant abutments. Measurements were made of the initial gold cylinder/abutment positions for each of the 5 sites for the 15 frameworks. The 3-D spatial orientation of each gold cylinder/abutment was calculated prior to the gold cylinders being incorporated into the framework casting and served as the control against which all measurements were compared. After the indexing/soldering procedures, the 3-D spatial orientations of the cylinders were measured, first as 2- and 3-unit solder assembled framework segments and, finally, for complete-arch frameworks. These measurements were recorded in micrometers for linear distortions and degrees for angular distortions using a coordinate measurement machine (CMM). These data were compared and statistically assessed using a 1-way analysis of variance (ANOVA). A Student-Newman-Keuls test was used to determine significance between cylinders within each indexing combination. A repeated-measures ANOVA and a Student-Newman-Keuls test were used to determine significance between alloy/index group and cylinders for each of the measurement variables with statistical significance at alpha=.05 for all statistical analyses.
Mean differences and SDs of total linear change for all groups found dR (total linear change) to be 33.56 +/- 27.70 mum for gold/light-polymerized composite resin, 34.87 +/- 27.99 mum for silver palladium/autopolymerizing acrylic resin, and 31.56 +/- 24.37 mum for silver palladium/light-polymerized composite resin. Total angular change, dtheta(R), was calculated to be 0.47 +/- 0.13 degrees for gold/light-polymerized composite resin, 0.46 +/- 0.17 degrees for silver palladium/autopolymerizing acrylic resin, and 0.52 +/- 0.15 degrees for silver palladium/light-polymerizing composite resin.
No significant differences were found between alloy/index combinations, except for the measured variable dtheta(y), angular change about the Y axis.
一些临床医生提倡采用分段式分度/焊接方法来组装全牙弓种植体框架，以实现框架的被动就位。据作者所知，尚未进行使用三维（3-D）变形分析的数学评估，以比较分段框架组装与需要切割、分度和焊接的一体式全牙弓框架重新组装的情况。
本研究比较了两种分度材料，即自凝丙烯酸树脂和光固化复合树脂，在全牙弓种植体框架焊接定位中的应用，使用了三种框架/分度材料组合：金/光固化复合树脂、银钯合金/自凝丙烯酸树脂和银钯合金/光固化复合树脂。
为每种合金/分度组合制作5个框架，共15个框架。每个框架适配5个种植体基台。对15个框架中每个框架5个部位的初始金柱/基台位置进行测量。在将金柱纳入框架铸造之前，计算每个金柱/基台的三维空间方向，并将其作为所有测量比较的对照。在分度/焊接程序之后，测量柱体的三维空间方向，首先是作为2单元和3单元焊接组装的框架部分，最后是全牙弓框架。使用坐标测量机（CMM）以微米记录线性变形的这些测量值，以度记录角度变形。使用单向方差分析（ANOVA）对这些数据进行比较和统计评估。使用Student-Newman-Keuls检验确定每个分度组合内柱体之间的显著性。使用重复测量方差分析和Student-Newman-Keuls检验确定合金/分度组与每个测量变量的柱体之间的显著性，所有统计分析的显著性水平为α = 0.05。
所有组的总线性变化的平均差异和标准差显示，金/光固化复合树脂的dR（总线性变化）为33.56±27.70μm，银钯合金/自凝丙烯酸树脂为34.87±27.99μm，银钯合金/光固化复合树脂为31.56±24.37μm。总角度变化dθ(R)计算得出，金/光固化复合树脂为0.47±0.13度，银钯合金/自凝丙烯酸树脂为0.46±0.17度，银钯合金/光固化复合树脂为0.52±0.15度。
除了测量变量dθ(y)（绕Y轴的角度变化）外，合金/分度组合之间未发现显著差异。
