Private practice, Seattle, Wash.
Private practice, Orange, Calif.
J Prosthet Dent. 2019 Feb;121(2):276-284. doi: 10.1016/j.prosdent.2018.04.026. Epub 2018 Nov 3.
The accuracy of a full digital workflow using an Atlantis abutment and a milled zirconia crown; a full digital workflow with a 3Shape split-file workflow using a zirconia abutment and crown; and an interrupted digital workflow using an Atlantis abutment and a milled zirconia crown is unclear.
The purpose of this in vitro study was to compare 2 full digital workflows relative to an interrupted workflow for restoring an implant with a custom abutment and crown. The secondary purpose of this study was to validate a digital means of measuring internal fit and marginal discrepancy using engineering software programs.
Three workflows were evaluated. The first group, interrupted digital Atlantis (IDA) workflow, included a customized Atlantis abutment that was designed, received, and then rescanned for the definitive crown design. The second group, full digital Atlantis (FDA) workflow, included a customized Atlantis abutment and its corresponding standard tessellation language (STL) file, the Atlantis Core File, which was immediately imported into design software and used for crown design and milling. The third group, full digital split-file (FDSF) workflow, used 3Shape's full digital workflow for abutment and crown design called the split-file workflow, in which the crown and abutment were designed and milled simultaneously. All restorations were evaluated with standardized measurements using a scanning electron microscope (SEM) for 2D measurements, followed by standardized measurements using Geomagic Control, an engineering software program, which facilitated 3D evaluations of the specimens.
The 2 Atlantis workflows, IDA and FDA, had statistically smaller marginal openings (P=.002) than the FDSF when measured using 2D SEM. The FDA had a statistically smaller 2D SEM marginal gap than the other 2 groups, IDA (P=.002) and FDSF (P=.002). The FDA had a statistically smaller 3D Geomagic marginal gap than the other 2 groups, IDA (P=.004) and FDSF (P=.006). The FDSF had a statistically smaller 3D Geomagic internal fit than the other 2 groups, FDA and IDA (both P=.006).
All 3 workflows evaluated in this study showed clinically acceptable results in terms of mean marginal gap below 120 μm. The SEM evaluation of mean marginal opening revealed that IDA and FDA mean marginal openings were statistically smaller than the FDSF mean marginal opening. SEM and Geomagic measurements revealed that the FDA mean marginal gap was significantly smaller than IDA and FDSF mean marginal gaps. Geomagic evaluation of mean internal fit revealed that the FDSF was significantly smaller than IDA and FDA. The use of Geomagic to measure and evaluate mean marginal gap and mean internal fit as defined in this study proved to be an acceptable form of measurement with statistical validation.
使用 Atlantis 基台和铣削氧化锆冠的全数字工作流程的准确性；使用 3Shape 分体文件工作流程和氧化锆基台和冠的全数字工作流程的准确性；以及使用 Atlantis 基台和铣削氧化锆冠的间断数字工作流程的准确性尚不清楚。
本体外研究的目的是比较 2 种全数字工作流程相对于使用定制 Atlantis 基台和冠的间断工作流程对植入物进行修复的情况。本研究的次要目的是验证使用工程软件程序测量内部拟合和边缘差异的数字方法。
评估了三种工作流程。第一组，间断数字 Atlantis（IDA）工作流程，包括定制的 Atlantis 基台，该基台经过设计、接收，然后重新扫描以用于最终冠设计。第二组，全数字 Atlantis（FDA）工作流程，包括定制的 Atlantis 基台及其相应的标准 tessellation language（STL）文件 Atlantis Core File，该文件立即导入设计软件，用于冠设计和铣削。第三组，全数字分体文件（FDSF）工作流程，使用 3Shape 的全数字工作流程进行基台和冠设计，称为分体文件工作流程，其中冠和基台同时设计和铣削。所有修复体均使用扫描电子显微镜（SEM）进行标准化测量，以进行 2D 测量，然后使用 Geomagic Control（一种工程软件程序）进行标准化测量，该程序便于对样本进行 3D 评估。
使用 2D SEM 测量时，IDA 和 FDA 这两个 Atlantis 工作流程的边缘开口（边际间隙）明显小于 FDSF（P=.002）。FDA 的 2D SEM 边缘间隙明显小于其他两组，IDA（P=.002）和 FDSF（P=.002）。FDA 的 3D Geomagic 边缘间隙明显小于其他两组，IDA（P=.004）和 FDSF（P=.006）。FDSF 的 3D Geomagic 内部拟合明显小于其他两组，FDA 和 IDA（均 P=.006）。
本研究评估的所有 3 种工作流程在平均边缘间隙低于 120μm 的情况下均显示出临床可接受的结果。SEM 评估平均边缘开口表明，IDA 和 FDA 的平均边缘开口明显小于 FDSF 的平均边缘开口。SEM 和 Geomagic 测量结果表明，FDA 的平均边缘间隙明显小于 IDA 和 FDSF 的平均边缘间隙。Geomagic 评估平均内部拟合表明，FDSF 明显小于 IDA 和 FDA。使用 Geomagic 进行测量和评估本研究中定义的平均边缘间隙和平均内部拟合的方法被证明是一种具有统计学验证的可接受的测量方法。
