Trueness and fit of complete-arch implant-supported frameworks in new-generation additively and subtractively manufactured polymers: An in-vitro study

IF 3.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Implant Dentistry and Related Research Pub Date : 2024-07-11 DOI:10.1111/cid.13362

Burak Yilmaz DDS, PhD, Mustafa Borga Donmez DDS, PhD, Mehmet Esad Güven DDS, PhD, Faris Z. Jamjoom BDS, MS, DMSc, FRCDC, Çiğdem Kahveci DDS, PhD, Martin Schimmel Med Dent, Gülce Çakmak DDS, PhD

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Abstract

Background

There is limited knowledge on the fabrication trueness and fit of additively or subtractively manufactured complete-arch implant-supported frameworks in recently introduced polymers.

Purpose

To evaluate the trueness and marginal fit of additively or subtractively manufactured polymer-based complete-arch implant-supported frameworks, comparing with those of strength gradient zirconia frameworks.

Materials and Methods

A typodont model with 4 implants (left first molar (abutment 1), left canine (abutment 2), right canine (abutment 3), and right first molar (abutment 4)) was digitized (ATOS Core 80 5MP) and an implant-supported complete-arch framework was designed. This design file was used to fabricate frameworks from 5 different materials: strength gradient zirconia (SM-ZR), high impact polymer composite (SM-CR), nanographene-reinforced PMMA (SM-GR), PMMA (SM-PM), and additively manufactured temporary resin (AM) (n = 10). These frameworks were digitized and each scan file was virtually segmented into 4 regions (abutments, occlusal, overall without occlusal, and overall). The surface deviations at these regions, and linear and interimplant distance deviations were evaluated (Geomagic Control X). Marginal gaps were evaluated according to triple-scan protocol after seating frameworks on the model with the 1-screw test. Data were statistically analyzed (α = 0.05).

Results

Surface deviations of all regions differed among tested materials (p ≤ 0.001). AM frameworks mostly had surface deviations that were similar to or lower than those of other materials (p ≤ 0.031), except for the occlusal surface, where it mostly had higher deviations (p ≤ 0.013). Abutment 4 of SM-CR had higher linear deviations than abutment 2 (p = 0.025), and material type did not affect the linear deviations within abutments (p ≥ 0.171). Interimplant distance deviations differed within and among materials (p ≤ 0.017), except for those between abutments 1 and 2 among materials (p = 0.387). Marginal gaps of subtractively manufactured materials differed among abutments, while those of abutments 3 and 4 differed among materials (p ≤ 0.003). AM frameworks mostly had lower marginal gaps at abutments 3 and 4 (p ≤ 0.048).

Conclusions

Although there was no clear trend among tested materials for measured deviations, marginal gaps of additively manufactured resin were mostly lower than those of subtractively manufactured materials and did not differ among abutment sites. Nevertheless, the differences in measured deviations among materials were small and marginal gaps were within the previously reported acceptability thresholds.

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使用新一代加法和减法聚合物制造的完整拱形种植体支撑框架的真实性和密合性：体外研究。

背景：目的：与强度梯度氧化锆骨架相比，评估加法或减法生产的聚合物基底全牙弓种植体支撑骨架的真实度和边缘密合度：将带有 4 个种植体（左侧第一磨牙（基台 1）、左侧犬齿（基台 2）、右侧犬齿（基台 3）和右侧第一磨牙（基台 4））的正畸模型数字化（ATOS Core 80 5MP），并设计了种植体支持的全牙弓框架。使用该设计文件制作了 5 种不同材料的骨架：强度梯度氧化锆（SM-ZR）、高抗冲聚合物复合材料（SM-CR）、纳米石墨烯增强 PMMA（SM-GR）、PMMA（SM-PM）和加成临时树脂（AM）（n = 10）。对这些牙架进行数字化处理，并将每个扫描文件虚拟分割成 4 个区域（基台、咬合面、无咬合面的整体和整体）。对这些区域的表面偏差以及线性和临时距离偏差进行了评估（Geomagic Control X）。在模型上安装框架后，根据三重扫描协议对边缘间隙进行评估。对数据进行统计分析（α = 0.05）：不同测试材料所有区域的表面偏差均有差异（p ≤ 0.001）。AM 框架的表面偏差大多与其他材料相似或更低（p ≤ 0.031），但咬合面除外，其偏差大多更高（p ≤ 0.013）。SM-CR 的 4 号基台的线性偏差高于 2 号基台（p = 0.025），材料类型对基台内的线性偏差没有影响（p ≥ 0.171）。除基台 1 和基台 2 之间的线性偏差（p = 0.387）外，不同材料内部和之间的间距偏差均存在差异（p ≤ 0.017）。减法制造材料的边缘间隙在不同基台之间存在差异，而 3 号和 4 号基台的边缘间隙在不同材料之间存在差异（p ≤ 0.003）。AM基台在3号和4号基台的边缘间隙大多较小（p ≤ 0.048）：结论：虽然测试材料之间的测量偏差没有明显的趋势，但加成法制造的树脂的边缘间隙大多低于减成法制造的材料，并且在基台部位之间没有差异。不过，不同材料之间的测量偏差差异很小，边缘间隙也在之前报告的可接受性阈值范围内。

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来源期刊

Clinical Implant Dentistry and Related Research 医学-牙科与口腔外科

CiteScore

6.00

自引率

13.90%

发文量

103

审稿时长

4-8 weeks

期刊介绍： The goal of Clinical Implant Dentistry and Related Research is to advance the scientific and technical aspects relating to dental implants and related scientific subjects. Dissemination of new and evolving information related to dental implants and the related science is the primary goal of our journal. The range of topics covered by the journals will include but be not limited to: New scientific developments relating to bone Implant surfaces and their relationship to the surrounding tissues Computer aided implant designs Computer aided prosthetic designs Immediate implant loading Immediate implant placement Materials relating to bone induction and conduction New surgical methods relating to implant placement New materials and methods relating to implant restorations Methods for determining implant stability A primary focus of the journal is publication of evidenced based articles evaluating to new dental implants, techniques and multicenter studies evaluating these treatments. In addition basic science research relating to wound healing and osseointegration will be an important focus for the journal.