Arnold Fiona Cornelia, Dönmez Mustafa Borga, Al-Johani Hanan, Kahveci Çiğdem, Schimmel Martin, Yilmaz Burak, Çakmak Gülce
Dissertation student, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey; and PhD student, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
J Prosthet Dent. 2025 Jun;133(6):1520.e1-1520.e10. doi: 10.1016/j.prosdent.2025.02.045. Epub 2025 Mar 17.
Additive manufacturing has enabled the fabrication of removable dies in various resins with different compositions. However, the knowledge on the dimensional stability and fit of removable dies fabricated with different dental cast resins is lacking.
The purpose of this in vitro study was to evaluate the effect of dental cast resin type and storage time on the dimensional stability and fit of AM removable dies throughout a 4-week period.
A typodont model with a prepared right first mandibular molar was digitized with an intraoral scanner (IOS) (CEREC Primescan) to generate a standard tessellation language (STL) file. The STL file was imported into a dental design software program to design a removable die with 10-degree shaft taper angle and a hollow partial arch cast with and without the die. The removable die and hollow partial arch cast without the die STLs were used to additively manufacture 48 removable dies (n=16) and 3 hollow casts (n=1) by using a dental cast resin (DentaMODEL) (AM-DM), a bio-based dental cast resin (FotoDent biobased model) (AM-FD), and a nanographene-reinforced dental cast resin (G-Print) (AM-GP). The same IOS was used to digitize each die and when the die was seated into its respective hollow cast 1 day (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4) after fabrication. All STL files were imported into a metrology-grade 3-dimensional analysis software program (Geomagic Control X). The root mean square (RMS) was used to assess deviations in different die regions (crown, root, base of the root, and overall) over 4 weeks, along with fit evaluation by calculating RMS for the crown portion within the cast and measuring mean distance deviations at 5 points on the die. The generalized linear model analysis and Bonferroni-corrected post hoc tests were used to evaluate the data (α=.05).
The dimensional stability of the removable dies was affected by the interaction between resin type and die region and by the interaction between the resin type and time point, while the fit of the dies was impacted by the interaction between resin type and time point (P<.001). AM-GP dies mostly had higher crown RMS than AM-FD dies (P<.001), while AM-DM dies had the highest root and base of the root RMS (P≤.027). AM-FD dies had the lowest overall RMS (P≤.038). The base of the root led to the highest RMS for each resin (P<.001). AM-FD dies had lower RMS than AM-GP at T0 and AM-DM at T2, while AM-GP dies had lower RMS than AM-DM at T1 (P≤.010). The RMS values of AM-GP dies were lower at T1 than at T0 and T3 (P<.001). When the fit of the dies was considered, AM-FD dies had the lowest and AM-DM dies had the highest crown portion RMS and point-based deviations at each time point (P<.001). In addition, AM-DM dies' RMS values and deviations were the lowest at T0, while AM-FD dies had the highest point-based deviations at T4 (P≤.034).
Within tested regions and time points, AM-FD dies mostly had higher dimensional stability and better fit. Therefore, the crowns to be adjusted on AM-FD dies may require fewer interproximal and occlusal adjustments.
增材制造能够使用不同成分的各种树脂制造可摘代型。然而,对于使用不同牙科铸造树脂制造的可摘代型的尺寸稳定性和适合度方面的知识却很缺乏。
本体外研究的目的是评估牙科铸造树脂类型和储存时间对增材制造的可摘代型在4周时间内的尺寸稳定性和适合度的影响。
使用口内扫描仪(IOS)(CEREC Primescan)对带有预备好的右下第一磨牙的牙列模型进行数字化处理,以生成标准镶嵌语言(STL)文件。将STL文件导入牙科设计软件程序,设计一个具有10度轴锥角的可摘代型以及带有和不带有代型的中空部分牙弓铸件。使用牙科铸造树脂(DentaMODEL)(AM-DM)、生物基牙科铸造树脂(FotoDent生物基模型)(AM-FD)和纳米石墨烯增强牙科铸造树脂(G-Print)(AM-GP),通过增材制造48个可摘代型(n = 16)和3个中空铸件(n = 1)。在制造后的第1天(T0)、1周(T1)、2周(T2)、3周(T3)和4周(T4),使用同一台IOS对每个代型进行数字化处理,并将代型就位到其各自的中空铸件中。所有STL文件均导入到计量级三维分析软件程序(Geomagic Control X)中。使用均方根(RMS)评估4周内不同代型区域(牙冠、牙根、牙根基部和整体)的偏差,同时通过计算铸件内牙冠部分的RMS以及测量代型上5个点的平均距离偏差来进行适合度评估。使用广义线性模型分析和Bonferroni校正的事后检验来评估数据(α = 0.05)。
可摘代型的尺寸稳定性受树脂类型与代型区域之间的相互作用以及树脂类型与时间点之间的相互作用影响,而代型的适合度受树脂类型与时间点之间的相互作用影响(P < 0.001)。AM-GP代型的牙冠RMS大多高于AM-FD代型(P < 0.001),而AM-DM代型的牙根和牙根基部RMS最高(P≤0.027)。AM-FD代型的整体RMS最低(P≤0.038)。每种树脂的牙根基部导致的RMS最高(P < 0.001)。在T0时,AM-FD代型的RMS低于AM-GP代型,在T2时低于AM-DM代型,而在T1时,AM-GP代型的RMS低于AM-DM代型(P≤0.010)。AM-GP代型在T1时的RMS值低于T0和T3时(P < 0.001)。当考虑代型的适合度时,在每个时间点,AM-FD代型的牙冠部分RMS和基于点的偏差最低,AM-DM代型最高(P < 0.001)。此外,AM-DM代型的RMS值和偏差在T0时最低,而AM-FD代型在T4时基于点的偏差最高(P≤0.034)。
在测试的区域和时间点内,AM-FD代型大多具有更高的尺寸稳定性和更好的适合度。因此,在AM-FD代型上进行调整的牙冠可能需要更少的邻间和咬合调整。