先进的增材制造和铣削氧化锆3单位固定义齿的精度、贴合度和边缘质量。

Accuracy, fit, and marginal quality of advanced additively manufactured and milled zirconia 3-unit fixed dental prostheses.

作者信息

Wang Yujie, Zhou Yi, Zhu Han, Jiang Jimin, He Fuming

机构信息

Doctoral student, Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, PR China.

Attending, Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, PR China.

出版信息

J Prosthet Dent. 2025 Jan;133(1):208.e1-208.e10. doi: 10.1016/j.prosdent.2024.09.016. Epub 2024 Oct 15.

DOI:10.1016/j.prosdent.2024.09.016

PMID:39414540

Abstract

STATEMENT OF PROBLEM

Advanced additive manufacturing (AM) of zirconia is an emerging technology that can explore the limitations of traditional computer-aided design and computer-aided manufacturing (CAD-CAM) milling techniques. However, a comprehensive evaluation of their differences in producing zirconia restorations, especially multi-unit restorations, is lacking.

PURPOSE

The purpose of this in vitro study was to compare the accuracy, fit, marginal quality, and surface roughness of zirconia 3-unit fixed dental prostheses (FDPs) by using advanced AM and 2 CAD-CAM milling materials.

MATERIAL AND METHODS

Based on the same CAD model, 30 3-unit posterior FDPs (n=10) were manufactured by using AM and 2 CAD-CAM milling materials (VT and UP). The accuracies of the total, intaglio, occlusal, axial, and marginal regions were calculated separately by comparing the scanned model with the design model by using 3-dimensional (3D) deviation analysis. The silicone layer was scanned to evaluate the marginal and intaglio fit in 3 dimensions. A 3D laser microscope was used for surface roughness detection, marginal quality assessment, and marginal defect measurement. The data were analyzed using ANOVA and the Tukey post hoc test (α=.05).

RESULTS

Compared with CAD-CAM milling, the AM group had higher accuracy and smaller positive deviations on the axial and intaglio regions (P<.001). Different manufacturing methods showed no statistically significant effect on the mean intaglio fit (P>.05), and all were within the clinically acceptable range (<100 µm). The intaglio gap was significantly higher than the target parameter in the occlusal regions. AM-fabricated FDPs had significantly higher surface roughness than milled ones, yet showed better margin quality with fewer marginal defects CONCLUSIONS: Compared with CAD-CAM milling, the advanced additively manufactured zirconia 3-unit FDPs provided better accuracy, improved margin quality, and clinically acceptable fit, but higher surface roughness, and may be a promising alternative for clinical applications.

摘要

问题陈述

氧化锆的先进增材制造（AM）是一项新兴技术，能够探究传统计算机辅助设计与计算机辅助制造（CAD-CAM）铣削技术的局限性。然而，目前缺乏对它们在制作氧化锆修复体，尤其是多单位修复体方面差异的全面评估。

目的

本体外研究的目的是比较使用先进增材制造技术和两种CAD-CAM铣削材料制作的氧化锆三单位固定义齿（FDP）的精度、适合性、边缘质量和表面粗糙度。

材料与方法

基于相同的CAD模型，使用增材制造技术和两种CAD-CAM铣削材料（VT和UP）制作30个三单位后牙FDP（n = 10）。通过三维（3D）偏差分析将扫描模型与设计模型进行比较，分别计算总体、内表面、咬合面、轴向和边缘区域的精度。扫描硅橡胶层以在三个维度上评估边缘和内表面适合性。使用3D激光显微镜进行表面粗糙度检测、边缘质量评估和边缘缺陷测量。采用方差分析和Tukey事后检验对数据进行分析（α = 0.05）。

结果

与CAD-CAM铣削相比，增材制造组在轴向和内表面区域具有更高的精度和更小的正偏差（P < 0.001）。不同制造方法对平均内表面适合性无统计学显著影响（P > 0.05），且均在临床可接受范围内（< 100 µm）。咬合面区域的内表面间隙显著高于目标参数。增材制造的FDP表面粗糙度显著高于铣削的FDP，但边缘质量更好，边缘缺陷更少。