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CAD-CAM 铣削与快速原型制造(3D 打印)全口义齿:准确性的体外评估。

CAD-CAM milled versus rapidly prototyped (3D-printed) complete dentures: An in vitro evaluation of trueness.

机构信息

Research and Teaching Assistant, Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland.

Professor, Division of Computerized Restorative Dentistry, Clinic of Preventive Dentistry, Periodontology, and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.

出版信息

J Prosthet Dent. 2019 Apr;121(4):637-643. doi: 10.1016/j.prosdent.2018.09.001. Epub 2019 Jan 31.

Abstract

STATEMENT OF PROBLEM

Complete dentures fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM) techniques have become popular. The 2 principal CAD-CAM techniques, milling and rapid prototyping (3D printing), used in the fabrication of complete dentures have been reported to yield clinically acceptable results. However, clinical trials or in vitro studies that evaluated the accuracy of the 2 manufacturing techniques are lacking.

PURPOSE

The purpose of this in vitro study was to compare the differences in trueness between the CAD-CAM milled and 3D-printed complete dentures.

MATERIAL AND METHODS

Two groups of identical maxillary complete dentures were fabricated. A 3D-printed denture group (3DPD) (n=10) and a milled denture group (MDG) (n=10) from a reference maxillary edentulous model. The intaglio surfaces of the fabricated complete dentures were scanned at baseline using a laboratory scanner. The complete dentures were then immersed in an artificial saliva solution for a period of 21 days, followed by a second scan (after immersion in saliva). A third scan (after the wet-dry cycle) was then made after 21 days, during which the complete dentures were maintained in the artificial saliva solution during the day and stored dry at night. A purpose-built 3D comparison software program was used to analyze the differences in the trueness of the complete dentures. The analyses were performed for the entire intaglio surface and specific regions of interest: posterior crest, palatal vault, posterior palatal seal area, tuberosity, anterior ridge, vestibular flange, and mid-palatal raphae. Independent t tests, ANOVA, and post hoc tests were used for statistical analyses (α=.05).

RESULTS

The trueness of the milled prostheses was significantly better than that of the rapid prototyping group with regard to the entire intaglio surface (P<.001), posterior crest (P<.001), palatal vault (P<.001), posterior palatal seal area (P<.001), tuberosity (P<.001), anterior ridge (baseline: P<.001; after immersion in saliva: P=.001; after the wet-dry cycle: P=.011), vestibular flange (P<.001), and mid-palatal raphae (P<.001).

CONCLUSIONS

The CAD-CAM, milled complete dentures, under the present manufacturing standards, were superior to the rapidly prototyped complete dentures in terms of trueness of the intaglio surfaces. However, further research is needed on the biomechanical, clinical, and patient-centered outcome measures to determine the true superiority of one technique over the other with regard to fabricating complete dentures by CAD-CAM techniques.

摘要

问题陈述

计算机辅助设计和计算机辅助制造(CAD-CAM)技术制作的全口义齿已经变得流行起来。用于制作全口义齿的两种主要 CAD-CAM 技术,铣削和快速原型制作(3D 打印),已被报道可获得临床可接受的结果。然而,缺乏评估这两种制造技术准确性的临床试验或体外研究。

目的

本体外研究的目的是比较 CAD-CAM 铣削和 3D 打印全口义齿之间的精度差异。

材料和方法

制作两组相同的上颌全口义齿。一组为 3D 打印义齿组(3DPD)(n=10),另一组为铣削义齿组(MDG)(n=10),均来自参考上颌无牙模型。使用实验室扫描仪在基线时扫描制作的全口义齿的凹面。然后,将全口义齿浸入人工唾液溶液中 21 天,然后进行第二次扫描(在唾液浸泡后)。21 天后,进行第三次扫描(在干湿循环后),在此期间,全口义齿在白天保持在人工唾液溶液中,晚上干燥存放。使用专门设计的 3D 比较软件程序分析全口义齿的精度差异。分析针对整个凹面和特定感兴趣区域进行:后嵴、腭穹窿、后腭封闭区、结节、前嵴、颊侧翼缘和中腭嵴。使用独立 t 检验、方差分析和事后检验进行统计分析(α=.05)。

结果

就整个凹面(P<.001)、后嵴(P<.001)、腭穹窿(P<.001)、后腭封闭区(P<.001)、结节(P<.001)、前嵴(基线:P<.001;唾液浸泡后:P=.001;干湿循环后:P=.011)、颊侧翼缘(P<.001)和中腭嵴(P<.001)而言,铣削义齿的精度明显优于快速原型制作义齿。

结论

根据目前的制造标准,CAD-CAM 铣削的全口义齿在凹面精度方面优于快速原型制作的全口义齿。然而,需要进一步研究生物力学、临床和以患者为中心的结果测量,以确定 CAD-CAM 技术制作全口义齿时一种技术相对于另一种技术的真正优势。

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