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比较 3D 打印和常规铸造制作不同腭穹窿深度患者可摘局部义齿金属支架的准确性:一项体外研究。

Comparing the trueness of 3D printing and conventional casting for the fabrication of removable partial denture metal frameworks for patients with different palatal vault depths: An in vitro study.

机构信息

Graduate student, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.

Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.

出版信息

J Prosthet Dent. 2024 Aug;132(2):434.e1-434.e6. doi: 10.1016/j.prosdent.2024.05.009. Epub 2024 Jun 6.

Abstract

STATEMENT OF PROBLEM

The success of a removable partial denture depends on its fit, and, with conventional casting, the framework is more distorted in patients with a deep palatal vault. Questions remain about whether the three-dimensional (3D) printing technique for fabricating a framework can improve the accuracy of fit for these patients.

PURPOSE

The purpose of this in vitro study was to compare the trueness of metal frameworks fabricated by selective laser melting, 3D printing pattern casting, and conventional casting for different palatal vault depths.

MATERIAL AND METHODS

A total of 30 partially edentulous maxillary casts were custom-made in 15 medium and 15 deep palatal vaults. All stone casts were scanned as reference models in digital files. For the medium palatal vault casts, Co-Cr frameworks of the conventional casting (CON) group (n=5) were fabricated with the lost wax technique. For the 3D printing pattern casting (PPC) group (n=5), wax patterns of the framework were printed, followed by metal casting. The frameworks created for the selective laser melting (SLM) group (n=5) were printed directly by using the SLM machine. The same procedures were followed for the deep palatal vault group. All the metal frameworks were scanned and superimposed with the reference casts by using the Geomagic Control X software program. Discrepancies were measured as mean ±standard deviation (trueness), and the data were statistically analyzed with a 2-way ANOVA test to evaluate the interaction of 2 independent factors (fabrication techniques and palatal vault depths) on a trueness outcome (α=.05).

RESULTS

The lowest mean ±standard deviation value was 0.092 ±0.023 mm, found from the SLM framework with deep palatal vault group, while the highest value was 0.194 ±0.017 mm, found from the CON framework with deep palatal vault group. Different fabrication techniques interacted with different palatal vault depths in terms of trueness (P<.05); however, no significant differences were observed in the medium palatal vault groups (P>.05). Additionally, color mapping demonstrated the gaps of metal frameworks among the 6 groups.

CONCLUSIONS

With the conventional casting technique, the accuracy of the metal framework was affected by the depth of the palate. For medium palatal vaults, all fabricated frameworks had clinically acceptable fit. For deep palatal vaults, the SLM frameworks showed the lowest discrepancy. As a result, the SLM technique is advised for fabricating a better-fitting metal framework for patients with a deep palatal vault.

摘要

问题陈述

可摘局部义齿的成功取决于其适配性,而对于传统铸造,在腭穹隆较深的患者中,支架的变形更为严重。对于制造支架的三维(3D)打印技术是否可以提高这些患者的适配精度,仍存在疑问。

目的

本体外研究的目的是比较选择性激光熔化、3D 打印图案铸造和传统铸造制造不同腭穹隆深度的金属支架的准确性。

材料和方法

共制作 30 个上颌半牙列缺失的石膏模型,其中 15 个模型的腭穹隆深度为中等,15 个模型的腭穹隆深度为深。所有石模型均扫描为数字文件参考模型。对于中等腭穹隆模型,采用失蜡技术制作常规铸造(CON)组(n=5)的 Co-Cr 支架。对于 3D 打印图案铸造(PPC)组(n=5),首先打印支架的蜡型,然后进行金属铸造。使用选择性激光熔化(SLM)机直接打印 SLM 组(n=5)的支架。深腭穹隆组采用相同的程序。使用 Geomagic Control X 软件程序将所有金属支架与参考模型进行扫描并叠加。以平均值±标准差(准确性)测量差异,并使用双向方差分析检验两种独立因素(制造技术和腭穹隆深度)对准确性结果的交互作用(α=.05)。

结果

在深腭穹隆组中,最低的平均值±标准差值为 0.092±0.023mm,来自 SLM 支架;在深腭穹隆组中,最高的平均值±标准差值为 0.194±0.017mm,来自 CON 支架。不同的制造技术与不同的腭穹隆深度在准确性方面存在相互作用(P<.05);然而,在中等腭穹隆组中未观察到显著差异(P>.05)。此外,颜色映射显示了 6 组金属支架之间的间隙。

结论

对于传统铸造技术,金属支架的准确性受腭穹隆深度的影响。对于中等腭穹隆,所有制造的支架都具有可接受的适配性。对于深腭穹隆,SLM 支架的差异最小。因此,建议使用 SLM 技术为腭穹隆较深的患者制造更适配的金属支架。

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