Ntovas Panagiotis, Ladia Ourania, Barmak Basir, Fehmer Vincent, Sailer Irena
Adjunct faculty, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA; Adjunct scientific collaborator, Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland; PhD Candidate, Department of Operative Dentistry, National and Kapodistrian University of Athens.
Researcher, Dental School, National and Kapodistrian University of Athens, Athens, Greece.
J Dent. 2025 Nov;162:106013. doi: 10.1016/j.jdent.2025.106013. Epub 2025 Jul 30.
To investigate the impact of material selection and silicone index support, provided by an additively manufactured tray, on the trueness of diagnostic trial restorations (mock-ups), fabricated using bis-acrylic resin loaded into silicone indexes.
A scan of a fully dentate patient was obtained, and diagnostic virtual waxing was performed to create two different designs: one representing a purely additive and the other featuring a combination of additive and non-additive approach. For each design, 60 silicone indexes were fabricated and divided into six groups. Four groups were based on 4 different additional silicone impression materials. Two additional groups were fabricated using silicone indexes supported by additively manufactured trays. The fabricated indexes were loaded with a self-cure bis-acrylic composite and fitted onto 3D-printed models. The linear discrepancy and 3D quantitative deviation between each diagnostic trial restoration and the digital waxing were calculated using metrology software.
The type of addition silicone used for fabricating the indexes, as well as their support by an additively manufactured try had a significant effect on the trueness of the fabricated diagnostic trial restorations (p < 0.05). The thickness of the fabricated diagnostic trial restorations was influenced by the thickness of the diagnostic waxing, the tooth type and section (p < 0.05).
Diagnostic trial restorations fabricated through molding presented an increased thickness compared to the corresponding virtual diagnostic waxing, regardless of the silicone index material or support. The use of an additively manufactured tray to support the silicone index can be beneficial, reducing the discrepancy between the produced diagnostic trial restorations and virtual diagnostic waxing.
The use of an additively manufactured tray in conjunction with the silicone index can standardize the fabrication of the silicone index and increase the accuracy of diagnostic trial restorations fabricated though the molding technique, potentially resulting in a more precise treatment plan, avoiding the drawbacks associated with extremely hard silicone indices.
研究增材制造托盘提供的材料选择和硅橡胶指数支撑对使用装入硅橡胶指数中的双丙烯酸树脂制作的诊断性试戴修复体（模型）准确性的影响。
获取一名全口牙齿患者的扫描数据，并进行诊断性虚拟蜡型制作，以创建两种不同设计：一种代表纯增材方式，另一种采用增材与非增材相结合的方式。对于每种设计，制作60个硅橡胶指数，并分为六组。四组基于4种不同的额外硅橡胶印模材料。另外两组使用增材制造托盘支撑的硅橡胶指数制作。将制作好的指数装入自凝双丙烯酸复合材料，并安装到3D打印模型上。使用计量软件计算每个诊断性试戴修复体与数字蜡型之间的线性差异和三维定量偏差。
用于制作指数的额外硅橡胶类型及其由增材制造托盘的支撑对制作的诊断性试戴修复体的准确性有显著影响（p < 0.05）。制作的诊断性试戴修复体的厚度受诊断蜡型厚度、牙齿类型和部位的影响（p < 0.05）。
无论硅橡胶指数材料或支撑如何，通过成型制作的诊断性试戴修复体与相应的虚拟诊断蜡型相比厚度增加。使用增材制造托盘支撑硅橡胶指数可能有益，可减少制作的诊断性试戴修复体与虚拟诊断蜡型之间的差异。
将增材制造托盘与硅橡胶指数结合使用可使硅橡胶指数的制作标准化，并提高通过成型技术制作的诊断性试戴修复体的准确性，可能产生更精确的治疗计划，避免与极硬硅橡胶指数相关的缺点。
