Alenezi Ali, Yehya Mohammed, Alkhodary Mohamed
Department of Prosthodontics, College of Dentistry, Qassim University, Saudi Arabia.
Faculty of Dentistry, Alexandria University, Egypt.
Saudi Dent J. 2022 Nov;34(7):553-564. doi: 10.1016/j.sdentj.2022.08.007. Epub 2022 Aug 28.
This work evaluates the internal and marginal adaptation of implant-assisted overdenture cobalt-chromium (Co-Cr) bars manufactured using conventional as well as CAD/CAM subtractive and selective laser melting (SLM) utilizing two scanning techniques.
An edentulous study model containing four dental implants placed at teeth sites 36, 33, 43, and 46 was used. The study cast was scanned and compared to the virtual casts developed from two scanning techniques, straight and zigzag motion, using the in silico superimposition process. Then, conventional techniques were used to produce full-arch bars that were compared to the bars fabricated using the two scanning techniques and CAD/CAM subtractive and additive techniques.
The conventional impression and casting techniques had the smallest marginal gap among the groups (-value < 0.05). The CAD/CAM subtractive milling techniques in groups II and III had significantly smaller marginal gaps than SLM technique used in groups IV and V (-value < 0.05). The analysis of the internal gap within each group showed statistically significant differences between different implant sites in all groups (-value < 0.001), except when using the conventional impression and casting techniques in group I (-value = 0.20).
The conventional impression and fabrication techniques were better than the digital impression and CAD/CAM subtractive and additive techniques for the fabrication of full-arch bars. However, both straight and zigzag scanning techniques and the CAD/CAM subtractive technique had marginal and internal gaps that were within clinically accepted ranges, and the SLM was found to be unsuitable for long-span framework fabrication with either scanning technique used.
本研究评估了使用传统方法以及CAD/CAM减材和选择性激光熔化(SLM)技术并采用两种扫描技术制造的种植体支持覆盖义齿钴铬(Co-Cr)杆的内部和边缘适合性。
使用一个无牙颌研究模型,在牙齿位点36、33、43和46处植入四个牙种植体。对研究模型进行扫描,并使用计算机模拟叠加过程与通过直线和之字形运动这两种扫描技术生成的虚拟模型进行比较。然后,使用传统技术制作全牙弓杆,并与使用两种扫描技术以及CAD/CAM减材和增材技术制作的杆进行比较。
在所有组中,传统印模和铸造技术的边缘间隙最小(P值<0.05)。第二组和第三组中的CAD/CAM减材铣削技术的边缘间隙明显小于第四组和第五组中使用的SLM技术(P值<0.05)。对每组内部间隙的分析表明,除第一组使用传统印模和铸造技术时(P值=0.20)外,所有组中不同种植位点之间在统计学上存在显著差异(P值<0.001)。
对于全牙弓杆的制作,传统印模和制作技术优于数字印模以及CAD/CAM减材和增材技术。然而,直线和之字形扫描技术以及CAD/CAM减材技术的边缘和内部间隙均在临床可接受范围内,并且发现SLM技术不适用于使用任何一种扫描技术的长跨度框架制作。