临时牙支持修复体的加减法制作方法的准确性：咬合面、轴面和内凹面的体外比较

Accuracy of additive and subtractive methods for interim tooth-supported restorations: An in vitro comparison of occlusal, axial, and intaglio surfaces.

作者信息

Nima Gabriel, Ratzeburg Fiorella Sueldo Guevara, Manrique Zaynifer, Mukai Eduardo, Bechtold Till Edward, Gallardo Yolanda Natali Raico

机构信息

Research Professor, School of Dentistry, Department of Biomedical Sciences, Ethics, Research and Education, Unviersity of the Andes (UANDES), Santiago, Chile.

Doctoral student, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), Center for Dental and Craniofacial Sciences (CC3), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany; Berlin Institute of Health, Berlin, Germany.

出版信息

J Prosthet Dent. 2025 Aug;134(2):408.e1-408.e8. doi: 10.1016/j.prosdent.2025.04.006. Epub 2025 Apr 24.

DOI:10.1016/j.prosdent.2025.04.006

PMID:40274499

Abstract

STATEMENT OF PROBLEM

Subtractive and additive manufacturing methods have been commonly used for interim tooth-supported restorations. However, the accuracy of the occlusal, axial, and intaglio surfaces remains unclear.

PURPOSE

The purpose of this in vitro study was to compare the accuracy of 1 subtractive and 2 additive manufacturing methods among occlusal, axial, and intaglio surfaces in the production of interim tooth-supported restorations.

MATERIAL AND METHODS

Interim crowns simulating a maxillary first molar were designed and manufactured using the following 3 methods: milling from polymethylmethacrylate (PMMA), stereolithography (SLA), and digital light projection (DLP), with 13 specimens per group. The manufacturing processes were standardized, and all specimens were scanned under consistent conditions with an intraoral scanner. The standard tessellation language (STL) files of the specimens were exported, and analyzed using a metrology software program. The analysis was performed for the overall crown and for the axial surfaces, nonfunctional and functional cusps, central fossa, margin, and intaglio. The root mean square (RMS) deviations were calculated, and color maps were generated. Statistical analyses including the Welch 1-way analysis of variance (ANOVA) with the Games-Howell post hoc tests (α=.05) and the 2-way ANOVA with the Bonferroni correction tests (α=.05), were performed to assess the impact of technology and crown surface on accuracy.

RESULTS

The milled PMMA method demonstrated significantly greater precision than the SLA or DLP methods (P<.001), with no significant difference in trueness between milled PMMA and SLA (P=.239). Milled PMMA and SLA methods exhibited the highest accuracy for the marginal area, whereas DLP showed the lowest. The intaglio surface accuracy was similar among all methods (P>.05).

CONCLUSIONS

Subtractive and additive manufacturing methods demonstrated comparable accuracy on the intaglio surface, remaining within clinically acceptable limits. Milled PMMA exhibited better occlusal accuracy.

摘要

问题陈述

减材制造和增材制造方法已普遍用于临时牙支持修复体。然而，咬合面、轴面和凹面的精度仍不明确。

目的

本体外研究的目的是比较1种减材制造方法和2种增材制造方法在制作临时牙支持修复体时，在咬合面、轴面和凹面的精度。

材料与方法

使用以下3种方法设计并制作模拟上颌第一磨牙的临时冠：从聚甲基丙烯酸甲酯（PMMA）铣削、立体光刻（SLA）和数字光投影（DLP），每组13个样本。制造过程标准化，所有样本在一致条件下用口腔内扫描仪进行扫描。导出样本的标准镶嵌语言（STL）文件，并用计量软件程序进行分析。对整个冠以及轴面、非功能尖和功能尖、中央窝、边缘和凹面进行分析。计算均方根（RMS）偏差，并生成彩色图。进行统计分析，包括采用Games-Howell事后检验（α = 0.05）的Welch单因素方差分析（ANOVA）和采用Bonferroni校正检验（α = 0.05）的双因素ANOVA，以评估技术和冠表面对精度的影响。