Journal of prosthodontic research最新文献

Purpose: This study examined the effect of assistive device use on the precision of digital impressions for multiple implants placed in a fully edentulous maxilla in vivo.

Methods: A total of eight participants with fully edentulous maxillae and four implants at position #15, #12, #22, and #25 were included in the study. The assistive device was made using CAD/CAM technology. Digital impressions were obtained using an intraoral scanner with (AD+) and without (AD-) the assistive device that attached to the scan bodies. Each participant underwent five digital and conventional impressions (verification casts (VC)). Dimensional deviations for each impression method were measured using the least-squares best-fit method to assess precision. Statistical analysis was performed using one-way analysis of variance (ANOVA) with Tukey's post-hoc adjustments for multiple comparisons.

Results: The dimensional deviations were as follows: AD- (37.56 ± 7.43 µm), AD+ (16.23 ± 2.56 µm), and VC (26.48 ± 5.13 µm). One-way ANOVA revealed significant differences between the groups (F = 31.04, P < 0.0001), which remained after Tukey adjustment (P < 0.01). The AD+ group exhibited the highest precision, while the AD- group had the lowest.

Conclusions: For implants placed in a fully edentulous maxilla in vivo, digital impressions with assistive devices demonstrated superior precision compared with those obtained without assistive devices or conventional impressions obtained with an implant indexing device.

Purpose: This study was aimed at investigating the thermal stresses in monolithic zirconia crowns (MZC) of various thicknesses and elucidating their thermal behavior under cooling or heating changes in the oral cavity. Additionally, the clinical availability and potential issues of MZC were examined by comparing them with other crown materials.

Methods: Finite element models comprising MZC (0.5-, 1.0-, and 1.5-mm thick), cement layers, and abutment teeth were subjected to thermal changes from 37 to 5 °C or 60 °C. Using a thermal distribution at 5 s, the thermal stress was calculated and compared with those of gold alloy and resin composite crowns. The loads corresponding to the thermal stresses were also estimated by comparing them with the stresses induced by vertical loading on the occlusal surface.

Results: Tensile stress occurred primarily in the crowns and cement during cooling, whereas compressive stress was generated during heating. Thermal stresses increased from 16.0 to 27.2 MPa with decreasing crown thickness from 1.5 to 0.5 mm and varied with different materials. Although the MZC exhibited the highest thermal stress, the estimated load (200 N) corresponding to the thermal stress was smaller than that of the resin composite (1280 N).

Conclusions: Thinner crowns exhibited higher thermal stress, suggesting an increased risk of failure owing to thermal changes. Despite the higher thermal stress in thinner MZC, the stresses were below the fatigue strength of the material, indicating sufficient resistance to thermal changes in the oral cavity.

Patient: A 26-year-old man with localized tooth wear and demand for aesthetic rehabilitation of the anterior teeth presented to our department. The patient reported excessive consumption of energy drinks. Furthermore, multiple trauma and tooth fractures have occurred in the past.

Discussion: In the present case, three-dimensional (3D)-printed restorations were used to restore the vertical dimensions according to the Dahl concept. An indirect build-up using noninvasive restorations has been demonstrated to be beneficial due to its pleasing aesthetic outcome and the advantage of the 3D printing process. Adhesive bonding was adapted from previous studies using direct composite materials. Thus far, whether, and to what extent, the color of these restorations changes remains unclear. Furthermore, the material wear should be evaluated in future studies.

Conclusions: Moreover, 3D-printed, noninvasive restorations made of a computer-aided design/computer-aided manufacturing hybrid material are suitable for the application of the Dahl concept. Aesthetic improvement in combination with minimally invasive pretreatment of the teeth and subsequent noninvasive restorations led to the rehabilitation of the vertical dimension of occlusion. After a follow-up period of two years, harmonious occlusal conditions were observed in the posterior region.

Purpose: This retrospective clinical study aimed to evaluate the clinical outcomes of surveyed monolithic computer-aided design and computer-aided manufacturing (CAD/CAM) zirconia crowns for abutment teeth in removable partial dentures (RPDs).

Methods: Patients who received monolithic surveyed zirconia crowns were clinically examined. The crowns were examined according to the modified United States Public Health Service criteria, and Kaplan-Meier survival was determined. The effect of different variables on the survival and success rates was assessed using Cox regression analysis (α = 0.05).

Results: A total of 297 crowns of 275 patients were evaluated over a mean period of 7 years. The cumulative survival and success rates were 95.6% and 91.2%, respectively. Complications were in the form of secondary caries (n=12), minor chipping (n=9), and debonding (n=5). A higher number of failures was observed in the mandibular molars (P < 0.05).

Conclusions: Surveyed monolithic zirconia crowns demonstrated high survival after 7 years of service. Monolithic zirconia is an excellent alternative to metal ceramic crowns for RPD abutments.

Purpose: This systematic review evaluated the effect of different printing orientations on the physical-mechanical properties and accuracy of resin denture bases and related specimens.

Study selection: Utilizing PRISMA 2020 guidelines, a comprehensive search of PubMed, Web of Science, Cochrane, and Scopus databases was conducted until June 2024. Included studies examined the accuracy, volumetric changes, and mechanical or physical properties of 3D-printed denture bases in various orientations. Studies without relevant data were excluded. Bias risk was assessed using a modified CONSORT checklist.

Results: This review included 24 studies on 3D-printed denture base resins, mainly based on stereolithography and digital light processing. Horizontal orientation (0°) generally enhanced flexural strength, while tilted and vertical orientations (90°) reduced it. Microhardness results varied due to differences in materials, layer thicknesses, and post-curing. Surface roughness was highest at 45°. Vertical orientation uses less material but is less time-efficient. Microbial adhesion, influenced by surface roughness, varied with printing orientation without a clear consensus on the optimal direction.

Conclusions: Printing orientation significantly impacts the physical and mechanical properties and accuracy of 3D-printed resin dentures. A horizontal orientation (0°) improved flexural strength, while accuracy and adaptability were better at 45° and 90°. Surface roughness, translucency, and chemical stability are also affected by orientation, post-curing, and material choice. Although a 90° orientation reduces material use, it increases printing time. Standardized study designs are recommended for drawing definitive conclusions in future research.

Purpose: To determine the effects of K18 quaternary ammonium methacryloxy silane (QAS) on tissue conditioner materials and their antimicrobial properties.

Methods: 30% K18 QAS in methyl methacrylate (MMA; K18-MMA; 0%, 15%, and 20% w/w) was incorporated into a commercial tissue conditioner (Coe comfort). The degree of curing (Shore A hardness), hydrophilicity (contact angle), flow, liquid sorption, mass loss, and antimicrobial properties of Streptococcus mutans, Streptococcus sanguinis, and Candida albicans were determined. Statistical analysis included analysis of variance with Tukey HSD and Kruskal-Wallis with Bonferroni correction.

Results: Hardness increased significantly at higher K18-MMA concentrations. The contact angles did not differ between the groups. Although the control and K18-containing tissue conditioner flow decreased significantly at each successive time point and with increasing K18 QAS MMA concentration, the flow was still within the ISO 10139-1 specifications for class 2 (high-flow) soft lining materials until 2 min 30 s. The highest liquid sorption happened between 1 and 4 weeks. The controls absorbed more acid than water or base, and the K18 groups absorbed more water and acid than base. With increasing K18-MMA concentration, the mass loss increased at all times and in all three media, except in base, after 4 weeks. Both 15% and 20% K18-MMA showed significant antimicrobial activity against S. mutans, S. sanguinis, and C. albicans.

Conclusions: K18-MMA imparted significant antimicrobial properties to tissue conditioners against S. mutans, S. sanguinis, and C. albicans without compromising the flow, hardness, or hydrophilicity. However, K18-MMA addition led to increased water sorption and mass loss after 4 weeks.

Purpose: This study explored the bio-mechanical properties of polyether ether ketone (PEEK) and carbon fiber reinforced-PEEK (CFR-PEEK) as potential alternatives to traditional dental implant materials, such as titanium (Ti) and zirconia (ZrO₂). Conventional implant materials often exhibit stress shielding leading to peri-implant bone loss and implant failure.

Study selection: Finite element analysis using a three-dimensional computer-aided-design (3D CAD) model of the jawbone with various implant materials (titanium, zirconia, PEEK, and CFR-PEEK) incorporated was implemented to assess the effectiveness of PEEK and CFR-PEEK. Two loading conditions (50 and 100 N) were applied in centric (case-1) and eccentric (case-2) to mimic the oral loading conditions.

Results: Titanium and zirconia implants were found to exhibit higher levels of stress shielding and therefore pose greater risks of bone loss and implant failure. Conversely, CFR-PEEK implants demonstrated more-uniform stress distributions that reduce the likelihood of stress shielding compared to their conventional counterparts; consequently, CFR-PEEK implants are particularly suitable for load-bearing applications. Furthermore, maximum strain values on PEEK-implanted cortical bone reached a state of adaptation, referred to as the "lazy zone" in which bone growth and bone loss rates are equal, indicating PEEK's potential for a long-term implant utilization.

Conclusions: PEEK and CFR-PEEK implants are promising alternatives to conventional dental implants because they provide stress shielding and promote bone health. Improved stress distribution enhances long-term success and durability while mitigating complications, and highlights their applicability to dental implant procedures.

Purpose: This study aimed to provide the latest updates on the therapeutic effectiveness of keratinized mucosa (KM) augmentation using autogenous soft tissue grafts for dental implants retaining prostheses.

Study selection: A systematic search of electronic databases was conducted on autogenous soft tissue grafts to create and/or augment KM for functioning dental implants. Two investigators independently extracted data from the selected 11 clinical studies, including 290 participants, from the initially retrieved 573 publications.

Results: A lack of KM surrounding dental implants was associated with greater mucosal inflammation. A free gingival graft (FGG) was used to increase the KM width, and a connective tissue graft (CTG) was used to manage peri-implant mucosal recession (MR). The weighted mean gain in KM was 2.6 mm from the selected FGG studies, with a significant reduction in mucosal inflammation and no changes in crestal bone levels for up to 4 years. The weighted mean reduction in MR was 2 mm in selected CTG studies.

Conclusions: A lack of KM negatively affects soft tissue health around dental implants. FGG was effective in increasing KM and reducing mucosal inflammation, whereas CTG was effective in decreasing MR.