Yılmaz Deniz, Çakmak Gülce, Güven Mehmet Esad, Yoon Hyung-In, Schimmel Martin, Yilmaz Burak
Lecturer, Department of Prosthodontics, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey.
Senior Research Associate, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Prosthet Dent. 2025 Jan;133(1):184-192. doi: 10.1016/j.prosdent.2023.09.011. Epub 2023 Oct 28.
Currently available 3-dimensional (3D) additively manufactured (AM) resins used for definitive restorations have different chemical compositions and viscosities. The fabrication trueness and margin quality of laminate veneers additively manufactured with different resins have not been extensively studied.
The purpose of this in vitro study was to evaluate the fabrication trueness and margin quality of AM and subtractively manufactured (SM) definitive resin-based laminate veneers.
A laminate veneer restoration for a maxillary right central incisor with a 25-µm cement space was designed to generate a reference laminate veneer standard tessellation language (STL) file (RLV-STL). This RLV-STL was used to fabricate resin-based laminate veneers (N=60) for definitive use, either using AM (a low-viscosity, urethane acrylate-based resin (C&B Permanent, AM-LV), a high-viscosity, urethane acrylate-based resin (Tera Harz TC-80DP, AM-HV), and a glass-reinforced composite resin (Crowntec, AM-S) or SM (glass-filler reinforced composite resin blocks (Tetric CAD, SM) technologies. All laminate veneers were digitized with an intraoral scanner (CEREC Primescan SW 5.2) to generate their test STL files (TLV-STLs). RLV-STL and TLV-STLs were transferred into a 3D analysis software program (Geomagic Control X), and a trueness (external, intaglio, and marginal surface) analysis was performed by using the root mean square (RMS) method. The margin quality of laminate veneers was examined visually under a stereomicroscope and graded. The Kruskal-Wallis and Dunn tests were performed to analyze the data (α=.05).
External, intaglio, and marginal RMS values showed statistically significant differences among test groups (P<.001). The SM group had the highest RMS values for the external surface (P<.001), whereas the AM-LV group had the lowest RMS values. The AM-HV group had the highest RMS values for the intaglio surface (P<.001). No significant difference was found between the SM and AM-HV groups for marginal RMS values, which were higher than for the other groups (P=.830). All average values for the axial mesial, axial distal, and incisal edge margin quality of laminate veneers were found to be similar and Grade 3 (smooth edge) in all groups.
Regardless of the evaluated surface, the fabrication technique affected the trueness of laminate veneers. The low-viscosity AM laminate veneers and AM laminate veneers reinforced with glass fillers had higher trueness than the SM laminate veneers at all surfaces. The low-viscosity AM laminate veneers had the highest trueness on external and marginal surfaces among the test groups and had higher trueness than the high-viscosity AM laminate veneers.
当前用于最终修复的三维(3D)增材制造(AM)树脂具有不同的化学成分和粘度。使用不同树脂增材制造的层压贴面的制作精度和边缘质量尚未得到广泛研究。
本体外研究的目的是评估增材制造(AM)和减材制造(SM)的最终树脂基层压贴面的制作精度和边缘质量。
设计了一个用于上颌右中切牙的层压贴面修复体,有25μm的粘结剂间隙,以生成参考层压贴面标准镶嵌语言(STL)文件(RLV-STL)。该RLV-STL用于制造最终使用的树脂基层压贴面(N=60),采用增材制造(一种低粘度、基于聚氨酯丙烯酸酯的树脂(C&B Permanent,AM-LV)、一种高粘度、基于聚氨酯丙烯酸酯的树脂(Tera Harz TC-80DP,AM-HV)和一种玻璃增强复合树脂(Crowntec,AM-S))或减材制造(玻璃填料增强复合树脂块(Tetric CAD,SM)技术)。所有层压贴面均使用口腔内扫描仪(CEREC Primescan SW 5.2)进行数字化处理,以生成其测试STL文件(TLV-STLs)。RLV-STL和TLV-STLs被传输到三维分析软件程序(Geomagic Control X)中,并使用均方根(RMS)方法进行精度(外部、凹面和边缘表面)分析。在立体显微镜下目视检查层压贴面的边缘质量并进行分级。进行Kruskal-Wallis和Dunn检验以分析数据(α=0.05)。
测试组之间的外部、凹面和边缘RMS值显示出统计学上的显著差异(P<0.001)。减材制造组的外表面RMS值最高(P<0.001),而低粘度增材制造组的RMS值最低。高粘度增材制造组的凹面RMS值最高(P<0.001)。减材制造组和高粘度增材制造组的边缘RMS值之间没有显著差异,两者均高于其他组(P=0.830)。所有层压贴面的轴向近中、轴向远中和切缘边缘质量的平均值在所有组中均相似且为3级(边缘光滑)。
无论评估的是哪个表面,制作技术都会影响层压贴面的精度。低粘度增材制造层压贴面和玻璃填料增强的增材制造层压贴面在所有表面上的精度均高于减材制造层压贴面。在测试组中,低粘度增材制造层压贴面在外部和边缘表面上的精度最高,且比高粘度增材制造层压贴面的精度更高。