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四种不同方法的诊断性试验修复转移尺寸精度比较:一项随机临床试验

Comparison of Dimensional Accuracy of Diagnostic Trial Restoration Transfer with Four Different Methods: A Randomized Clinical Trial.

作者信息

Caponi Lucas Queiroz, Fenoy-Illacer Pilar, Figueras-Álvarez Oscar, de Lima Flor Eduardo, Vidal-Ponsoda Carla, Roig Miguel

机构信息

Department of Restorative Dentistry, School of Dentistry, Hospital Universitari General de Catalunya, International University of Catalunya, Carrer Josep Trueta s/n, 08195 San Cugat del Vallés, Spain.

Private Practice, 63074 San Benedetto del Tronto, Italy.

出版信息

J Clin Med. 2025 May 7;14(9):3240. doi: 10.3390/jcm14093240.

Abstract

Diagnostic trial restorations play a crucial role in restorative dentistry by allowing clinicians to evaluate aesthetics, function, and phonetics before finalizing definitive restorations. These restorations facilitate communication between patients, clinicians, and dental technicians, ensuring treatment alignment and predictable outcomes. The accuracy of transferring diagnostic trial restorations to the oral cavity is essential to maintain the integrity of the planned design. Various fabrication techniques, including conventional silicone matrices and computer-aided design/computer-aided manufacturing (CAD-CAM)-based methods, have been developed to improve transfer precision. However, there is limited evidence directly comparing their dimensional accuracy. This randomized in vivo study aimed to evaluate and compare the accuracy of four commonly used techniques-condensation silicone, addition PVS silicone, transparent PVS silicone, and CAD-CAM combination matrices-by assessing their linear and volumetric discrepancies. : Twenty patients requiring aesthetic rehabilitation of their anterior maxillary teeth participated. The sequence of matrix usage was determined through randomization. Four techniques for transferring diagnostic trial restorations were evaluated: (1) condensation silicone matrix, (2) addition polyvinyl siloxane (PVS) silicone matrix, (3) transparent PVS silicone matrix, and (4) CAD-CAM combination matrix. Dimensional accuracy was assessed by comparing intraoral scans (IOSs) of the transferred restorations to the original diagnostic wax-up. Linear discrepancies were measured at four buccal landmarks (cervical, medial, lower medial, and incisal), and volumetric deviation was evaluated using reverse engineering alignment software. Significant differences were observed among the groups in both linear and volumetric discrepancies ( < 0.05). The CAD-CAM combination matrix showed superior volumetric accuracy, with minimal deviations from the diagnostic wax-up. The addition PVS silicone matrix demonstrated consistent linear accuracy, particularly at the cervical and medial landmarks. The condensation silicone matrix exhibited moderate performance across both linear and volumetric accuracy. The transparent PVS silicone matrix showed the highest variability, with greater volumetric deviations. The study highlights that the choice of matrix material and technique significantly impacts the dimensional accuracy of diagnostic trial restoration transfers. The CAD-CAM combination matrix and the addition PVS silicone matrix demonstrated superior advantages compared to the other techniques. Clinicians should consider the specific requirements of each case, including accuracy and ease of use, when selecting a transfer technique for aesthetic rehabilitations.

摘要

诊断性试戴修复体在修复牙科中起着至关重要的作用,它能让临床医生在确定最终修复体之前评估美观、功能和语音效果。这些修复体有助于患者、临床医生和牙科技师之间的沟通,确保治疗的一致性和可预测的结果。将诊断性试戴修复体准确转移到口腔对于维持计划设计的完整性至关重要。为了提高转移精度,已经开发了各种制作技术,包括传统的硅橡胶基质和基于计算机辅助设计/计算机辅助制造(CAD-CAM)的方法。然而,直接比较它们尺寸精度的证据有限。这项随机体内研究旨在通过评估四种常用技术——缩合硅橡胶、加成型聚硅氧烷(PVS)硅橡胶、透明PVS硅橡胶和CAD-CAM组合基质——的线性和体积差异,来评估和比较它们的精度。20名需要对上颌前牙进行美学修复的患者参与了研究。基质使用顺序通过随机化确定。评估了四种转移诊断性试戴修复体的技术:(1)缩合硅橡胶基质,(2)加成型聚硅氧烷(PVS)硅橡胶基质,(3)透明PVS硅橡胶基质,以及(4)CAD-CAM组合基质。通过将转移修复体的口内扫描(IOS)与原始诊断蜡型进行比较来评估尺寸精度。在四个颊侧标志点(颈部、中部、下部中部和切端)测量线性差异,并使用逆向工程对齐软件评估体积偏差。各组在线性和体积差异方面均观察到显著差异(<0.05)。CAD-CAM组合基质显示出卓越的体积精度,与诊断蜡型的偏差最小。加成型PVS硅橡胶基质表现出一致的线性精度,特别是在颈部和中部标志点。缩合硅橡胶基质在线性和体积精度方面表现中等。透明PVS硅橡胶基质显示出最高的变异性,体积偏差更大。该研究强调,基质材料和技术的选择对诊断性试戴修复体转移的尺寸精度有显著影响。与其他技术相比,CAD-CAM组合基质和加成型PVS硅橡胶基质显示出卓越的优势。临床医生在为美学修复选择转移技术时,应考虑每个病例的具体要求,包括精度和易用性。

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