Mata-Mata Severino J, Donmez Mustafa Borga, Meirelles Luiz, Johnston William Michael, Yilmaz Burak
Private Practice, Ciudad de Guatemala, Guatemala, Guatemala.
Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Clin Implant Dent Relat Res. 2022 Dec;24(6):821-830. doi: 10.1111/cid.13137. Epub 2022 Oct 5.
Limited evidence exists regarding the accuracy of implant analog position in printed models, particularly when implant analogs with varying designs are used.
To evaluate the effect of digital implant analog (DIA) design on the trueness of their position in additively manufactured digital implant models (DIMs) and to compare with that of a conventional implant analog in a stone cast.
A dentate maxillary model with a conventional implant analog (Nobel Biocare Implant Replica 4.3 mm CC RP) at left second premolar site was digitized by using a laboratory scanner (3Shape D2000) and a (SB) scan body to generate the master standard tessellation language (STL) file (M0). 12 custom trays were fabricated on M0 file and conventional polyvinylsiloxane impressions of the model were made. All impressions were poured after inserting conventional implant analogs (Nobel RP Implant Replica) (Group A). Model was then digitized with an intraoral scanner (TRIOS 3) and the same SB, and DIMs with three different DIA designs (Nobel Biocare [Group B], Elos [Group C], and NT-trading [Group D]) were generated (Dental System-Model Builder). 12 DIMs of each design were additively manufactured and corresponding DIAs were inserted. All models were digitized by using the same laboratory scanner and SB, and these STLs were transferred to a 3D analysis software (Geomagic Control X), where the STL files of the models were superimposed over M0. Linear and 3D deviations at three selected points on SB (implant-abutment connection, most cervical point on SB, and most coronal point on SB) as well as angular deviations on two planes (buccolingual and mesiodistal) were calculated. Analysis of variance (ANOVA) and Bonferroni corrected t-tests were used to analyze the trueness of implant analog positions (α = 0.05).
The interaction of main effects significantly affected linear (p < 0.001) and angular deviations (p = 0.020). At point 1, group D had higher deviations than groups A and B (p ≤ 0.015). In addition, groups A and D had higher deviations than group B at point 4 (p < 0.001). While group C had similar linear deviations to those of other groups at point 1 and point 4 (p ≥ 0.192), the differences among test groups at point 2 were nonsignificant (p ≥ 0.276). Group B had lower angular deviations than groups C (p = 0.039) and D (p = 0.006) on buccolingual plane.
Analog design affected the trueness of analog position as proprietary, pressure/friction fit DIA (group B) had higher linear trueness than screw-retained DIA (Group D) and conventional implant analog (group A). In addition, pressure/friction fit DIA had the highest angular trueness among tested DIAs.
关于种植体替代物在打印模型中的准确性,现有证据有限,尤其是当使用不同设计的种植体替代物时。
评估数字种植体替代物(DIA)设计对其在增材制造的数字种植体模型(DIM)中位置真实性的影响,并与传统石膏模型中的种植体替代物进行比较。
使用实验室扫描仪(3Shape D2000)和扫描体(SB)对左上第二前磨牙位点带有传统种植体替代物(Nobel Biocare种植体复制品4.3毫米CC RP)的有牙上颌模型进行数字化处理,以生成主标准镶嵌语言(STL)文件(M0)。在M0文件上制作12个定制托盘,并对模型制作传统的聚硅氧烷印模。插入传统种植体替代物(Nobel RP种植体复制品)后灌注所有印模(A组)。然后使用口腔内扫描仪(TRIOS 3)和相同的SB对模型进行数字化处理,并生成具有三种不同DIA设计的DIM(Nobel Biocare [B组]、Elos [C组]和NT-trading [D组])(牙科系统-模型构建器)。对每种设计的12个DIM进行增材制造,并插入相应的DIA。所有模型均使用相同的实验室扫描仪和SB进行数字化处理,这些STL文件被传输到三维分析软件(Geomagic Control X)中,在该软件中模型的STL文件与M0进行叠加。计算SB上三个选定点(种植体-基台连接处、SB上最颈缘点和SB上最冠方点)的线性和三维偏差以及两个平面(颊舌向和近远中向)上的角度偏差。采用方差分析(ANOVA)和Bonferroni校正t检验分析种植体替代物位置的真实性(α = 0.05)。
主效应的交互作用显著影响线性偏差(p < 0.001)和角度偏差(p = 0.020)。在点1处,D组的偏差高于A组和B组(p≤0.015)。此外,在点4处,A组和D组的偏差高于B组(p < 0.001)。虽然C组在点1和点4处的线性偏差与其他组相似(p≥0.192),但测试组在点2处的差异不显著(p≥0.276)。在颊舌向平面上,B组的角度偏差低于C组(p = 0.039)和D组(p = 0.006)。
替代物设计影响替代物位置的真实性,因为专有的、压力/摩擦配合的DIA(B组)比螺丝固位的DIA(D组)和传统种植体替代物(A组)具有更高的线性真实性。此外,在测试的DIA中,压力/摩擦配合的DIA具有最高的角度真实性。