Donmez Mustafa Borga, Yilmaz Burak, Yoon Hyung-In, Kahveci Çiğdem, Schimmel Martin, Çakmak Gülce
Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Ohio, USA.
J Dent. 2023 Mar;130:104434. doi: 10.1016/j.jdent.2023.104434. Epub 2023 Jan 21.
To evaluate the effect of additive and subtractive manufacturing on the accuracy (trueness and precision) of fixed partial denture patterns (FPDPs) used for casting or pressing.
A 3-unit complete coverage FPD on mandibular right first premolar and first molar teeth was virtually designed. Using the design data, FPD patterns were fabricated from an additively manufactured resin (PR, ProArt Print Wax) and 2 CAD-CAM wax discs (YW, ProArt CAD Wax Yellow and BW, ProArt CAD Wax Blue) (n = 10). Each pattern was then digitized with a scanner (CEREC Primescan) and evaluated for 3D surface deviation at 4 different surfaces (overall, external, marginal, and intaglio surfaces) by using a 3D analysis software (Medit Link). Root mean square (RMS) values were automatically calculated. Data were analyzed by using Kruskal-Wallis and Dunn's post hoc tests for trueness and precision (α= 0.05).
Significant differences were found among the RMS values for overall (P<.001) and each surface (P≤.040) evaluated. PR had the highest overall (P≤.011) and intaglio surface (P≤.01) deviations, while the difference between YW and BW was not significant (P≥.199). PR had the highest (P≤.027) and BW had the lowest (P≤.042) external surface mean RMS values. BW had higher mean marginal RMS value than YW (P=.047). For precision, significant differences were observed among test groups only for marginal RMS values (P=.002). PR had lower precision than BW (P=.002).
BW and YW FPDPs mostly had higher trueness compared with PR FPDPs. However, considering relatively smaller deviations at marginal and intaglio surfaces and the fact that patterns mostly had similar precision, clinical fit of FPDs fabricated by using tested patterns may be similar.
Definitive 3-unit fixed partial dentures fabricated by using tested patterns may be similar. However, FPDs fabricated with tested additively manufactured resin patterns might result in more chairside adjustments than those fabricated with tested subtractively manufactured wax patterns.
评估增材制造和减材制造对用于铸造或压制的固定局部义齿支架(FPDPs)精度(准确性和精密度)的影响。
虚拟设计下颌右侧第一前磨牙和第一磨牙上的3单位全冠固定局部义齿。利用设计数据,用增材制造树脂(PR,ProArt Print Wax)和2种CAD-CAM蜡盘(YW,ProArt CAD Wax Yellow和BW,ProArt CAD Wax Blue)制作固定局部义齿支架(n = 10)。然后用扫描仪(CEREC Primescan)对每个支架进行数字化处理,并使用三维分析软件(Medit Link)在4个不同表面(整体、外部、边缘和凹面)评估三维表面偏差。自动计算均方根(RMS)值。采用Kruskal-Wallis检验和Dunn事后检验分析准确性和精密度数据(α = 0.05)。
在评估的整体(P <.001)和每个表面(P≤.040)的RMS值之间发现显著差异。PR的整体(P≤.011)和凹面(P≤.01)偏差最高,而YW和BW之间的差异不显著(P≥.199)。PR的外表面平均RMS值最高(P≤.027),BW的最低(P≤.042)。BW的边缘平均RMS值高于YW(P =.047)。对于精密度,仅在边缘RMS值的测试组之间观察到显著差异(P =.002)。PR的精密度低于BW(P =.002)。
与PR固定局部义齿支架相比,BW和YW固定局部义齿支架大多具有更高的准确性。然而,考虑到边缘和凹面相对较小的偏差以及支架大多具有相似的精密度这一事实,使用测试支架制作的固定局部义齿的临床贴合度可能相似。
使用测试支架制作的确定性3单位固定局部义齿可能相似。然而,与使用测试的减材制造蜡支架制作的固定局部义齿相比,使用测试的增材制造树脂支架制作的固定局部义齿可能需要更多的椅旁调整。