Katsoulis Joannis, Müller Philipp, Mericske-Stern Regina, Blatz Markus B
Department of Prosthodontics, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA.
Clin Oral Implants Res. 2015 Mar;26(3):245-9. doi: 10.1111/clr.12522. Epub 2014 Nov 3.
To compare the precision of fit of long-span vs. short-span implant-supported screw-retained fixed dental prostheses (FDPs) made from computer-aided-design/computer-aided-manufactured (CAD/CAM) titanium and veneered with ceramic. The null hypothesis was that there is no difference in the vertical microgap between long-span and short-span FDPs.
CAD/CAM titanium frameworks for an implant-supported maxillary FDP on implants with a flat platform were fabricated on one single master cast. Group A consisted of six 10-unit FDPs connected to six implants (FDI positions 15, 13, 11, 21, 23, 25) and group B of six 5-unit FDPs (three implants, FDI positions 21, 23, 25). The CAD/CAM system from Biodenta Swiss AG (Berneck, Switzerland) was used for digitizing (laser scanner) the master cast and anatomical CAD of each framework separately. The frameworks were milled (CAM) from a titanium grade V monobloc and veneered with porcelain. Median vertical distance between implant and FDP platforms from the non-tightened implants (one-screw test on implant 25) was calculated from mesial, buccal, and distal scanning electron microscope measurements.
All measurements showed values <40 μm. Total median vertical microgaps were 23 μm (range 2-38 μm) for group A and 7 μm (4-24 μm) for group B. The difference between the groups was statistically significant at implant 21 (P = 0.002; 97.5% CI -27.3 to -4.9) and insignificant at implant 23 (P = 0.093; -3.9 to 1.0).
CAD/CAM fabrication including laboratory scanning and porcelain firing was highly precise and reproducible for all long- and short-span FDPs. While all FDPs showed clinically acceptable values, the short-span FDPs were statistically more precise at the 5-unit span distance.
比较由计算机辅助设计/计算机辅助制造(CAD/CAM)钛制成并 veneered with ceramic的长跨度与短跨度种植体支持的螺丝固位固定义齿(FDP)的贴合精度。原假设是长跨度和短跨度FDP之间的垂直微间隙没有差异。
在一个单一的主模型上制作用于种植体支持的上颌FDP的CAD/CAM钛框架,该种植体具有平坦平台。A组由连接到六个种植体(FDI位置15、13、11、21、23、25)的六个10单位FDP组成,B组由六个5单位FDP(三个种植体,FDI位置21、23、25)组成。使用来自Biodenta Swiss AG(瑞士伯内克)的CAD/CAM系统分别对主模型和每个框架的解剖CAD进行数字化(激光扫描仪)。框架由五级钛整体铣削(CAM)而成,并用瓷 veneered with porcelain。通过近中、颊侧和远中扫描电子显微镜测量,计算未拧紧种植体(种植体25上的单螺丝测试)的种植体与FDP平台之间的中位垂直距离。
所有测量值均<40μm。A组的总中位垂直微间隙为23μm(范围2-38μm),B组为7μm(4-24μm)。两组之间的差异在种植体21处具有统计学意义(P = 0.002;97.5%CI -27.3至-4.9),在种植体23处无统计学意义(P = 0.093;-3.9至1.0)。
包括实验室扫描和烤瓷在内的CAD/CAM制作对于所有长跨度和短跨度FDP都具有高度精确性和可重复性。虽然所有FDP都显示出临床可接受的值,但短跨度FDP在5单位跨度距离处统计学上更精确。