Department of Restorative Dentistry, University of Buffalo School of Dental Medicine, Buffalo, NY.
University of Buffalo School of Dental Medicine, Buffalo, NY.
J Prosthodont. 2021 Oct;30(8):720-724. doi: 10.1111/jopr.13325. Epub 2021 Feb 23.
To compare the fracture strength of three-unit provisional partial fixed dental prostheses (FDPs) fabricated by an indirect-direct technique from poly(methylmethacrylate) (PMMA) through digital and conventional workflows, and FDPs fabricated by a direct technique using Bisacryl (BisA) and externally reinforced BisA.
Forty partially edentulous typodonts with a missing mandibular left first molar and standard preparations on mandibular left second premolar and molar were used to fabricate three-unit provisional FDPs. Two materials and two techniques were used to fabricate a total of forty provisional FDPs: (1) BisA; (2) BisA reinforced with glass fiber strips [BisA-GFR]; (3) conventionally fabricated PMMA shell relined with PMMA [C-PMMA]; (4) CAD/CAM fabricated PMMA shell relined with PMMA [CAD/CAM-PMMA]. Provisional FDPs were then luted onto the preparations using a temporary cement. Specimens were mounted onto a chewing simulator; 20,000 cycles of 70 N forces were applied under 25°C distilled water. Specimens were then loaded to fracture using a universal testing machine (The Dillion Quantrol TC2i; Mecmesin) with a crosshead speed of 2 mm/min. One-way ANOVA, followed by Tukey post hoc test, was used to assess the effect of production technique on the fracture strength of the provisional FPDs (α = 0.5).
Mean fracture strengths recorded for the CAD/CAM-PMMA, C-PMMA, BisA, and BisA-GFR groups were 520 N, 448 N, 245 N, and 169 N, respectively. PMMA groups had significantly (p < 0.0001; F = 24.40) higher fracture strength compared to Bisacryl groups.
When high occlusal forces are expected, provisional FDPs fabricated with PMMA using the indirect-direct technique are recommended, irrespective of CAD/CAM or conventional workflow.
比较通过数字和传统工作流程间接-直接技术以及直接技术使用 Bisacryl(BisA)和外部增强 BisA 制造的三单位临时局部固定义齿(FDP)的三种单位临时局部固定义齿的断裂强度。
使用 40 个部分无牙的牙雕模型,每个模型缺失下颌左侧第一磨牙,下颌左侧第二前磨牙和磨牙有标准的预备,以制造三单位临时 FDP。使用两种材料和两种技术共制造 40 个临时 FDP:(1)BisA;(2)用玻璃纤维条增强的 BisA [BisA-GFR];(3)常规制造的 PMMA 壳衬 PMMA [C-PMMA];(4)CAD/CAM 制造的 PMMA 壳衬 PMMA [CAD/CAM-PMMA]。然后,使用临时水泥将临时 FDP 粘接到预备体上。将样本安装到咀嚼模拟器上;在 25°C 蒸馏水中施加 70N 的力,进行 20000 次循环。然后使用万能试验机(The Dillion Quantrol TC2i;Mecmesin)以 2mm/min 的十字头速度将样本加载至断裂。使用单向方差分析(one-way ANOVA),然后使用 Tukey 事后检验(Tukey post hoc test)评估生产技术对临时 FPD 断裂强度的影响(α=0.5)。
CAD/CAM-PMMA、C-PMMA、BisA 和 BisA-GFR 组记录的平均断裂强度分别为 520N、448N、245N 和 169N。PMMA 组的断裂强度明显(p <0.0001;F = 24.40)高于 Bisacryl 组。
当预期有高的咬合力时,建议使用间接-直接技术使用 PMMA 制造临时 FDP,无论 CAD/CAM 还是传统工作流程。