Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio.
Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, İstanbul, Turkey; Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Prosthet Dent. 2022 Dec;128(6):1318.e1-1318.e9. doi: 10.1016/j.prosdent.2022.10.011. Epub 2022 Nov 23.
Additive manufacturing is commonly used for the fabrication of definitive casts with removable dies. However, how the trueness and fit of removable dies are affected by printing layer thickness is lacking.
The purpose of this in vitro study was to investigate the trueness and fit of additively manufactured removable dies printed in different layer thicknesses.
A mandibular cast with a prepared right first molar tooth was digitized (CEREC Primescan), and its standard tessellation language (STL) file was imported into a software program (DentalCAD 3.0). A removable die (D-STL) and a hollow cast with (M-STL) or without the die (SM-STL) were designed. D-STL and SM-STL were imported into a nesting software program (Composer), and 45 removable dies in 3 layer thicknesses (100 μm, 50 μm, and 50 to 100 μm) (n=15) and 1 cast (100-μm) were additively manufactured. Each removable die (TD-STLs), the cast with each die (TM-STLs), and the cast without the die (TSM-STL) were digitized by using the same scanner. All STL files were imported into a software program (Medit Link v 2.4.4), and TD-STLs were superimposed over D-STL. The root mean square (RMS) method was used to analyze the trueness of the dies at 2 different areas (crown and root portion) and as a complete unit (overall). Overall RMS values of the cast with and without the die were also calculated after superimposing TM-STLs over M-STL. The fit of the dies in the cast was evaluated by using a triple-scan protocol to measure deviations at 5 different points (point M: most mesial point of the margin; point TM: tip of the mesial cusp; point O: deepest point of the occlusal fossa; point TD: tip of the distal cusp; point D: most distal point of the margin) on the crown portion. One-way ANOVA and Tukey honestly significant difference tests were used to evaluate data (α=.05).
The RMS values of removable dies showed significant differences at each area (P≤.002). The 50- to 100-μm group had higher overall RMS values than the 100-μm group (P=.017). The 100-μm group had the highest RMS values for the crown portion (P≤.019), while the 50-μm group had the highest RMS values for the root portion (P<.001). The 50-μm group had the lowest RMS values for the crown portion when the die was in the cast (P<.001). Except for point TM (P=.228), significant differences were observed among the test groups at all points (P<.001). The 50-μm group had the lowest distance deviations at points M, TD, and D (P≤.005), while the 100-μm group had the highest distance deviations at points O and D (P≤.010).
Removable dies fabricated by using a 100-μm or 50- to 100-μm combined layer thickness had trueness that was either similar to or better than that of dies fabricated with a 50-μm layer thickness. When the die was on the cast, the 50-μm layer thickness resulted in the best crown portion trueness. However, because the deviation differences among groups were clinically small, the 100-μm layer thickness can be considered for the efficient fabrication of removable dies when the tested printer and resin are used.
增材制造常用于制作带有可移动模具的最终模型。然而,打印层厚度如何影响可移动模具的准确性和适配性还不清楚。
本体外研究旨在探讨不同层厚下增材制造的可移动模具的准确性和适配性。
数字化一个带有预备好的右第一磨牙的下颌模型(CEREC Primescan),并将其标准 tessellation language(STL)文件导入软件程序(DentalCAD 3.0)。设计了一个可移动模具(D-STL)和一个带有(M-STL)或不带有模具的空心模型(SM-STL)。将 D-STL 和 SM-STL 导入嵌套软件程序(Composer),并在 3 种层厚(100μm、50μm 和 50μm 至 100μm)下制造了 45 个可移动模具(n=15)和 1 个模型(100-μm)。使用相同的扫描仪对每个可移动模具(TD-STLs)、带有每个模具的模型(TM-STLs)和没有模具的模型(TSM-STL)进行数字化。所有 STL 文件均被导入到一个软件程序(Medit Link v 2.4.4)中,然后将 TD-STLs 叠加在 D-STL 上。使用均方根(RMS)方法分析了在 2 个不同区域(冠部和根部)以及整体上模具的准确性。在将 TM-STLs 叠加在 M-STL 上后,还计算了带有和不带有模具的模型的整体 RMS 值。使用三重扫描协议评估模具在模型中的适配性,以测量冠部 5 个不同点(点 M:边缘最近点;点 TM:近中尖的尖端;点 O:咬合窝最深点;点 TD:远中尖的尖端;点 D:边缘最远端)的偏差。使用单因素方差分析和 Tukey Honestly Significant Difference 检验来评估数据(α=.05)。
可移动模具的 RMS 值在每个区域均显示出显著差异(P≤.002)。50μm 至 100μm 组的整体 RMS 值高于 100μm 组(P=.017)。100μm 组的冠部 RMS 值最高(P≤.019),而 50μm 组的根部 RMS 值最高(P<.001)。当模具在模型中时,50μm 组的冠部 RMS 值最低(P<.001)。除了点 TM(P=.228)外,在所有测试组中,所有点均观察到显著差异(P<.001)。50μm 组在点 M、TD 和 D 处的距离偏差最小(P≤.005),而 100μm 组在点 O 和 D 处的距离偏差最大(P≤.010)。
使用 100μm 或 50μm 至 100μm 组合层厚制造的可移动模具的准确性与使用 50μm 层厚制造的模具相似或更好。当模具在模型上时,50μm 层厚可获得最佳的冠部准确性。然而,由于组间的偏差差异在临床上较小,因此在使用测试打印机和树脂时,可以考虑使用 100μm 层厚来提高可移动模具的制造效率。