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通过复制称重、三重扫描和扫描电子显微镜比较 CAD/CAM 和失蜡技术在所有制作阶段的金属陶瓷冠的内部适合性。

Comparison of internal fit of metal-ceramic crowns in CAD/CAM and lost-wax techniques in all fabrication stages through replica weighting, triple scanning, and scanning electron microscope.

机构信息

Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.

Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Clin Exp Dent Res. 2022 Jun;8(3):763-770. doi: 10.1002/cre2.529. Epub 2022 Feb 20.

Abstract

OBJECTIVES

Restoration fit is one of the prerequisites of clinical durability. It is controversial as to whether computer-assisted design/computer-aided milling (CAD/CAM) or lost-wax fabrication methods result in more fit metal-ceramic crowns. This in-vitro study was conducted to examine the internal fit of porcelain fused to metal crowns fabricated using CAD/CAM and lost-wax techniques during fabrication stages (framework, porcelain, cementation) through digital triple scanning, replica weighting, and observation with electron microscopy.

MATERIAL AND METHODS

Twenty uniform resin dies of prepared first maxillary molars were randomly divided into two groups according to the fabrication technique: lost wax and CAD/CAM. The internal fit was measured in all steps of completing the crowns (framework, porcelain, and cementation) using different methods, including triple scanning, replica weighting, and scanning electron microscopy. The data were statistically analyzed using t test, Pearson, and repeated measures analysis of variance (α = .05).

RESULTS

Triple scanning revealed no difference in the internal fit of CAD/CAM and lost-wax groups in all the fabrication steps (p > .05). The replica weighting method showed no difference between groups in the framework step (p > .05), while the internal fit was significantly better in the CAD/CAM group after porcelain application (p < .05). After cementation, electron microscopy measurements showed no difference between CAD/CAM and lost wax groups (p > .05). The Pearson correlation test showed no significant correlation between electron microscopy, replica weighing, and triple scanning methods (p > .05).

CONCLUSION

According to scanning electron microscopy as the superior evaluation method, the internal fit of cobalt-chrome PFM crown of both CAD/CAM and lost wax groups was within the acceptable clinical range and there was no significant difference between them. Triple scanning revealed no difference in the internal fit of framework and porcelain steps but a better fit after cementation. According to replica weighting, the internal fit in the porcelain step was higher than the framework.

摘要

目的

修复适合度是临床耐用性的前提之一。关于计算机辅助设计/计算机辅助制造(CAD/CAM)或失蜡铸造方法是否能产生更适合的金属陶瓷冠,这一点存在争议。本体外研究通过数字三重扫描、复制称重和电子显微镜观察,检查 CAD/CAM 和失蜡技术制造的金属烤瓷冠在制作阶段(基底、瓷、粘结)的内部适合度。

材料和方法

将 20 个均匀的预备上颌第一磨牙树脂模型随机分为两组,根据制作技术分为失蜡组和 CAD/CAM 组。使用不同的方法(三重扫描、复制称重和扫描电子显微镜)测量在完成牙冠的所有步骤(基底、瓷和粘结)的内部适合度。使用 t 检验、Pearson 和重复测量方差分析对数据进行统计分析(α=0.05)。

结果

三重扫描显示,在所有制作步骤中,CAD/CAM 组和失蜡组的内部适合度没有差异(p>0.05)。在基底步骤中,复制称重法两组之间没有差异(p>0.05),而在施加瓷后,CAD/CAM 组的内部适合度明显更好(p<0.05)。粘结后,扫描电子显微镜测量显示 CAD/CAM 组和失蜡组之间没有差异(p>0.05)。Pearson 相关检验显示,扫描电子显微镜、复制称重和三重扫描方法之间没有显著相关性(p>0.05)。

结论

根据扫描电子显微镜作为优越的评价方法,CAD/CAM 和失蜡组的钴铬金属烤瓷冠的内部适合度在可接受的临床范围内,两者之间没有显著差异。三重扫描显示基底和瓷阶段的内部适合度没有差异,但粘结后更适合。根据复制称重,瓷阶段的内部适合度高于基底。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/135d/9209789/f81d1a2e298d/CRE2-8-763-g004.jpg

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