Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey.
Associate Professor, Department of Restorative Science and Prosthodontics, The Ohio State University College of Dentistry, Columbus, Ohio.
J Prosthet Dent. 2017 Dec;118(6):736-741. doi: 10.1016/j.prosdent.2017.01.004. Epub 2017 Apr 21.
Monolithic zirconia crowns fabricated using computer-aided design and computer-aided manufacturing (CAD-CAM) technology have recently become an alternative dental prosthetic treatment. The marginal fit of monolithic zirconia crown may be affected by different stages of the fabrication procedures in the laboratory and cementation. Information regarding the accuracy of fit of monolithic zirconia crowns at different stages of fabrication and cementation is limited.
The purpose of this in vitro study was to evaluate the effect of different stages of fabrication and cementation on the vertical marginal discrepancy (VMD) of CAD-CAM fabricated monolithic zirconia crowns.
Six ivorine right maxillary first molar typodont teeth with standardized anatomic preparations for complete coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed using CAD software and milled from presintered monolithic zirconia blocks in a 5-axis dental milling machine. A cement space of 25 μm for the margins and a 50-μm space starting 1 mm above the finish lines of the teeth were virtually set in the CAD software. A total of 144 measurements were performed on 6 specimens with 8 measurement locations in 3 different stages using stereoscopic zoom microscopy; after initial production of the crowns (post-sintering group), after glazing (post-glazing group), and after cementation (post-cementation group). The VMD values were statistically analyzed with 1-way repeated measures ANOVA and the Holm-Sidak method (α=.05).
Different stages of fabrication and cementation significantly affected the VMD of tested crowns (P=.003). The mean VMD was 38 μm for post-sintering group, 38 μm for post-glazing group, and 60 μm for post-cementation group, with statistical differences between the post-sintering group, the post-cementation group (P<.002), and the post-glazing group and post-cementation group (P<.003); there were no statistical differences between the post-sintering group and the post-glazing group (P=.966).
Within the limitations of this in vitro study, glazing did not significantly change the VMD of CAD-CAM monolithic zirconia crowns. Cementation significantly increased the VMD values.
使用计算机辅助设计和计算机辅助制造(CAD-CAM)技术制造的整体氧化锆冠最近已成为一种替代的牙科修复治疗方法。整体氧化锆冠的边缘适合度可能会受到实验室和粘固不同阶段制造过程的影响。关于制造和粘固不同阶段的整体氧化锆冠适合度准确性的信息有限。
本体外研究的目的是评估不同制造和粘固阶段对 CAD-CAM 制造的整体氧化锆冠的垂直边缘差异(VMD)的影响。
使用三维实验室扫描仪对 6 个象牙右上颌第一磨牙模型牙进行扫描,这些牙齿具有标准化的全冠陶瓷覆盖解剖学准备。使用 CAD 软件设计牙冠,并使用五轴牙科铣床从预烧结整体氧化锆块中铣削而成。在 CAD 软件中,为边缘设置了 25 μm 的粘固空间,在牙齿的完成线以上 1 mm 处设置了 50 μm 的空间。使用立体变焦显微镜在 6 个样本的 8 个测量位置的 3 个不同阶段共进行了 144 次测量;在牙冠初始生产后(烧结后组)、上釉后(上釉后组)和粘固后(粘固后组)。使用单向重复测量方差分析和 Holm-Sidak 方法(α=.05)对 VMD 值进行统计分析。
制造和粘固的不同阶段显著影响了测试牙冠的 VMD(P=.003)。烧结后组的平均 VMD 为 38 μm,上釉后组为 38 μm,粘固后组为 60 μm,烧结后组、粘固后组之间存在统计学差异(P<.002),上釉后组和粘固后组之间存在统计学差异(P<.003);烧结后组和上釉后组之间无统计学差异(P=.966)。
在本体外研究的限制范围内,上釉并未显著改变 CAD-CAM 整体氧化锆冠的 VMD。粘固显著增加了 VMD 值。