Al-Dwairi Ziad N, Al-Sardi Moataz, Goodacre Brian J, Goodacre Charles J, Al Hamad Khaled Q, Özcan Mutlu, Al-Haj Husain Nadin, Baba Nadim Z
Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology (JUST), P.O. Box 3030, Irbid 22110, Jordan.
Division of General Dentistry, School of Dentistry, Loma Linda University, Loma Linda, CA 92350, USA.
Materials (Basel). 2023 Mar 8;16(6):2181. doi: 10.3390/ma16062181.
The long-term success of ceramic laminate veneers (CLVs) is influenced by the marginal and internal fit of the restorations. However, studies comparing the fit of CLVs using different intraoral scanners or the indirect digitization technique are lacking. The purpose of this study was therefore to assess the marginal and internal fit of CAD/CAM-milled CLVs using different intraoral scanners and the indirect digitalization technique. An ivorine typodont maxillary left-central incisor was prepared; the tooth and the neighboring teeth were scanned and used as a template to print ninety 3D partial models. Thereafter, ceramic laminate veneers (CLVs) (N = 90) were milled from IPS-Emax CAD blocks and divided into six equal groups (15 specimens each) according to the type of intraoral scanner (IOS), as follows: Omnicam IOS, SC3600 IOS, Trios 3 IOS, Emerald IOS, I500 IOS. Fifteen further CLVs were fabricated using the conventional indirect digitalization technique. After cementation on the resin dies and embedding in clear epoxy resin, specimens were sectioned inciso-gingivally and mesio-distally. At the incisal and cervical positions, the marginal discrepancy was measured and evaluated in addition to the internal gap at six locations using SEM (200×). Differences between gap measurements among the six groups were determined using ANOVA. Games-Howell multiple comparisons for homogenous variances and LSD multiple comparisons for non-homogenous variances were used with 95% confidence intervals. The significance level was set at 0.05. The lowest mean absolute marginal gap at the incisal margins (AMGI) was recorded for Omnicam group (203.28 ± 80.14) µm, while the highest mean absolute marginal gap at the cervical margins (AMGC) was recorded for Omnicam group (147.16 ± 59.78) µm. The mean AMGC was reported to be significantly different between the conventional technique (146.75 ± 38.43) µm and Trios 3 (91.86 ± (35.51) µm; = 0.001) and between Emerald (112.37 ± (50.31) µm; = 0.042) and I500 (86.95 ± (41.55) µm; < 0.001). The mean MGI was found to be significantly different between the conventional technique (114.11 ± (43.45) µm and I500 group (186.99 ± (73.84) µm) only ( = 0.035). However, no significant differences were found in the mean MGI between all types of IOSs. The means of AMG and MG were significantly different at incisal or cervical areas between the conventional technique and IOSs and within the scanner groups ( > 0.05). Marginal gaps were higher in the incisal region compared to the cervical region with both the indirect digitization technique and the IOSs. Ceramic laminate veneers (CLVs) fabricated using IOSs produced overall internal and marginal fit adaptation results comparable to CLVs fabricated from the indirect digitalization method, and both techniques produced clinically acceptable results.
陶瓷贴面(CLV)的长期成功受修复体边缘适合性和内部适合性的影响。然而,缺乏比较使用不同口腔内扫描仪或间接数字化技术的CLV适合性的研究。因此,本研究的目的是使用不同的口腔内扫描仪和间接数字化技术评估CAD/CAM铣削CLV的边缘和内部适合性。制备了一个象牙质典型牙列的上颌左中切牙;扫描该牙齿及其相邻牙齿并用作模板来打印90个3D局部模型。此后,从IPS-Emax CAD块铣削陶瓷贴面(CLV)(N = 90),并根据口腔内扫描仪(IOS)的类型将其分为六个相等的组(每组15个标本),如下:Omnicam IOS、SC3600 IOS、Trios 3 IOS、Emerald IOS、I500 IOS。另外使用传统间接数字化技术制作了15个CLV。在树脂代型上粘结并嵌入透明环氧树脂后,将标本沿切龈向和近远中向切片。在切端和颈部位置,除了使用扫描电子显微镜(200×)在六个位置测量和评估内部间隙外,还测量边缘差异。使用方差分析确定六组之间间隙测量值的差异。对于齐次方差使用Games-Howell多重比较,对于非齐次方差使用LSD多重比较,置信区间为95%。显著性水平设定为0.05。Omnicam组在切端边缘记录到最低的平均绝对边缘间隙(AMGI)(203.28±80.14)µm,而Omnicam组在颈部边缘记录到最高的平均绝对边缘间隙(AMGC)(147.16±59.78)µm。据报道,传统技术(146.75±38.43)µm与Trios 3(91.86±(35.51)µm;P = 0.001)之间以及Emerald(112.37±(50.31)µm;P = 0.042)与I500(86.95±(41.55)µm;P < 0.001)之间的平均AMGC有显著差异。仅发现传统技术(114.11±(43.45)µm)与I500组(186.99±(73.84)µm)之间的平均边缘间隙指数(MGI)有显著差异(P = 0.035)。然而,在所有类型的IOS之间,平均MGI未发现显著差异。传统技术与IOS之间以及扫描仪组内,切端或颈部区域的AMG和MG平均值有显著差异(P > 0.05)。使用间接数字化技术和IOS时,切端区域的边缘间隙高于颈部区域。使用IOS制作的陶瓷贴面(CLV)产生的整体内部和边缘适合性结果与通过间接数字化方法制作的CLV相当,并且两种技术都产生了临床上可接受的结果。