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3D打印机和CAD/CAM制作的两种类型的乳磨牙间接冠修复大面积龋坏乳磨牙的临床性能

Clinical Performance of Two Types of Primary Molar Indirect Crowns Fabricated by 3D Printer and CAD/CAM for Rehabilitation of Large Carious Primary Molars.

作者信息

Al-Halabi Mohammed Nour, Bshara Nada, Nassar Jihad Abou, Comisi John C, Rizk Charline K

机构信息

Pediatric Dentistry Department, Dental College, Damascus University, Al-Mazzeh Street, Damascus, Syria.

Department of Fixed Prosthodontics, Dental College, Damascus University, Damascus, Syria.

出版信息

Eur J Dent. 2021 Jul;15(3):463-468. doi: 10.1055/s-0040-1721905. Epub 2021 Feb 3.

Abstract

OBJECTIVES

This randomized clinical trial aimed to evaluate clinical outcomes of two types of esthetic crowns fabricated using a three-dimensional (3D) dental printer and computer-aided design and manufacturing (CAD/CAM) system as an alternative full-coronal restoration for extensively carious pulp-treated primary molars.

MATERIALS AND METHODS

Randomization was done for 50 lower primary molars in 50 child patients, split into two groups based on the fabrication method used: Group A: CAD/CAM crowns using polymethyl methacrylate (PMMA) blocks and Group B: 3D dental printed crowns using GC photopolymer resin. All crowns were evaluated at baseline and at 3rd, 6th, and 12th months using the U.S. Public Health Service criteria for gingival health, retention, and marginal integrity for both groups.

STATISTICAL ANALYSIS

The survival rate of 3D-printable crowns was 84% compared with 80% survival rate using CAD/CAM fabricated crowns at the end of the 12th-month follow-up. No statistically significant differences were noted in restoration failure. In the evaluation of gingival health between the two groups' follow-up times, no statistically significant differences were noted at the 3rd- and 6th-month follow-ups, yet at the 12th month, statistically significant differences were noted ( = 0.022) when comparing gingival health. No statistically significant differences were noted between the two groups when comparing marginal integrity scores in all the follow-up periods.

CONCLUSION

Resin crowns fabricated via 3D dental printer and PMMA crowns fabricated using CAD/CAM are acceptable esthetic choices in restoring pulp-treated primary molars with great marginal integrity and crowns retention. 3D-printed resin crowns showed less cementing failure and performed better regarding gingival response compared with PMMA crowns.

摘要

目的

本随机临床试验旨在评估使用三维(3D)牙科打印机和计算机辅助设计与制造(CAD/CAM)系统制作的两种美学冠作为广泛龋坏的牙髓治疗后乳磨牙的全冠修复替代方案的临床效果。

材料与方法

对50例儿童患者的50颗下颌乳磨牙进行随机分组,根据制作方法分为两组:A组:使用聚甲基丙烯酸甲酯(PMMA)块制作的CAD/CAM冠;B组:使用GC光固化树脂3D打印的冠。使用美国公共卫生服务标准,在基线以及第3、6和12个月对两组的牙龈健康、固位和边缘完整性进行评估。

统计分析

在第12个月随访结束时,3D可打印冠的生存率为84%,而使用CAD/CAM制作的冠的生存率为80%。在修复失败方面未发现统计学显著差异。在两组随访期间的牙龈健康评估中,第3个月和第6个月随访时未发现统计学显著差异,但在第12个月,比较牙龈健康时发现统计学显著差异(P = 0.022)。在所有随访期间比较边缘完整性评分时,两组之间未发现统计学显著差异。

结论

通过3D牙科打印机制作的树脂冠和使用CAD/CAM制作的PMMA冠是修复牙髓治疗后乳磨牙的可接受的美学选择,具有良好的边缘完整性和冠固位。与PMMA冠相比,3D打印树脂冠的粘结失败较少,牙龈反应更好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f7e/8382452/8f951bfef311/10-1055-s-0040-1721905_10_1068_01.jpg

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