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基牙几何形态对数字化和传统流程获取的固定修复体模型精度的影响——体外研究

Effect of Abutment Tooth Geometry On The Accuracy of Fixed Prosthodontics Casts Obtained by Digital and Analog Workflows-In Vitro Study.

作者信息

Parize Hian, Macedo Ana Paula, Gribel Bruno Frazão, Bohner Lauren, Provinciatti Mauricio Martins, Muglia Valdir Antonio

机构信息

Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.

Private Practice, Belo Horizonte, Brazil.

出版信息

J Esthet Restor Dent. 2025 Apr;37(4):1024-1035. doi: 10.1111/jerd.13375. Epub 2024 Nov 30.

Abstract

OBJECTIVE

Physical and digital casts are required for fixed dental prosthesis (FDP) fabrication. However, the effect of abutment tooth geometry on the accuracy of FDP casts obtained by digital and analog workflows remains unclear. This study evaluated the accuracy of obtaining dental casts for veneer and full crowns with digital and analog workflows.

MATERIALS AND METHODS

A typodont model of the maxilla with unprepared teeth and veneer and full crown preparations was digitalized with intraoral scanning (TRIOS 3; 3Shape), digital model (DM) group, and the digital files were exported to two additive manufacturing technologies, resulting in the groups digital light processing (DLP) (Hunter; FlashForge) and polyjet (PLJ) (Eden 500 V; Stratasys). In addition, plaster casts (PCs) were obtained with polyvinyl siloxane (Express XT; 3M ESPE) double impressions and type IV plaster (FujiRock; GC America) as a control group. The sample size per group (n = 6) was defined in the pilot study. The digitization of the typodont and experimental casts was performed with a laboratory scanner (inEos X5; Dentsply Sirona). The measurement deviation (trueness and precision) to the reference model was performed with reverse engineering software (Geomagic Control X 2018; 3D Systems). Two-way ANOVA was used to assess the effect of manufacturing techniques and abutment tooth geometry on model accuracy (primary outcome). In addition, one-way ANOVA was used to assess significant differences between manufacturing techniques for complete arches, including abutments and unprepared teeth (secondary outcome). Tukey post hoc tests were used to compare means among groups. All statistical analyses considered a significant level of p ≤ 0.05.

RESULTS

Statistically significant interactions were observed between manufacturing technique and abutment tooth geometry, affecting both trueness (p < 0.001) and precision (p < 0.001). For trueness, DM exhibited the lowest RMS values (p < 0.001), PC and DLP showed no significant difference (p = 0.056), and PLJ had significantly higher values than other techniques (p < 0.001), while premolar and molar preparations displayed significantly lower discrepancies compared to other types (p < 0.002). For precision, DM had the lowest values (p < 0.001), with PC also showing low values (p < 0.001), and no significant differences were observed between DLP and PLJ (p = 0.986). Veneer, premolar, and molar crown preparations demonstrated significantly lower RMS compared to anterior crowns.

CONCLUSION

The design of the abutment tooth significantly influenced the trueness and precision of FDP casts obtained by digital and analog workflow. For trueness, DM exhibited the highest accuracy, outperforming PC, DLP, and PLJ and achieving better results with premolar and molar preparations compared to anterior crowns and veneers. For precision, DM was most accurate, followed by PC, DLP, and PLJ, with veneer, premolar, and molar crowns consistently outperforming anterior crowns.

摘要

目的

固定义齿(FDP)制作需要实体模型和数字模型。然而,基牙几何形状对通过数字和模拟工作流程获得的FDP模型准确性的影响尚不清楚。本研究评估了通过数字和模拟工作流程获取贴面和全冠牙模型的准确性。

材料与方法

使用口内扫描仪(TRIOS 3;3Shape)对上颌带有未预备牙齿以及贴面和全冠预备体的典型牙列模型进行数字化处理,形成数字模型(DM)组,然后将数字文件导出至两种增材制造技术,从而得到数字光处理(DLP)组(Hunter;FlashForge)和聚喷射(PLJ)组(Eden 500 V;Stratasys)。此外,使用聚乙烯基硅氧烷(Express XT;3M ESPE)双重印模和IV型石膏(FujiRock;GC America)获取石膏模型(PC)作为对照组。在预试验中确定每组的样本量(n = 6)。使用实验室扫描仪(inEos X5;Dentsply Sirona)对典型牙列模型和实验模型进行数字化处理。使用逆向工程软件(Geomagic Control X 2018;3D Systems)测量与参考模型的偏差(准确性和精密度)。采用双向方差分析评估制造技术和基牙几何形状对模型准确性的影响(主要结果)。此外,采用单向方差分析评估包括基牙和未预备牙齿的完整牙弓在制造技术之间的显著差异(次要结果)。使用Tukey事后检验比较各组均值。所有统计分析的显著性水平设定为p≤0.05。

结果

观察到制造技术和基牙几何形状之间存在统计学上的显著交互作用,对准确性(p < 0.001)和精密度(p < 0.001)均有影响。对于准确性,DM表现出最低的均方根值(p < 0.001),PC和DLP无显著差异(p = 0.056),PLJ的值显著高于其他技术(p < 0.001),而与其他类型相比,前磨牙和磨牙预备体的差异显著更低(p < 0.002)。对于精密度,DM的值最低(p < 0.001),PC的值也较低(p < 0.001),DLP和PLJ之间未观察到显著差异(p = 0.986)。与前牙冠相比,贴面、前磨牙和磨牙冠预备体的均方根值显著更低。

结论

基牙的设计显著影响通过数字和模拟工作流程获得的FDP模型的准确性和精密度。对于准确性,DM表现出最高的精度,优于PC、DLP和PLJ,并且与前牙冠和贴面相比,前磨牙和磨牙预备体取得了更好的结果。对于精密度,DM最准确,其次是PC、DLP和PLJ,贴面、前磨牙和磨牙冠始终优于前牙冠。

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