Journal of prosthodontic research最新文献

Purpose: This study evaluated the wear behavior of dental materials for definitive fixed prostheses, including computer-aided design (CAD)- and manufacturing (CAM) composite resins, polyether-ether-ketone (PEEK), Ag-Pd-Au alloys, titanium, and zirconia, under standardized experimental conditions.

Methods: Three CAD-CAM-produced composite resins (HC, HCH, and CS), PEEK (SPE), Ag-Pd-Au alloys (CW), pure titanium class II (TJ), and zirconia (ZL) were tested. Two-body wear tests were conducted using an abrasion-testing machine under wet conditions using stainless-steel styluses as antagonists. Wear traces were examined using laser confocal scanning microscopy and scanning electron microscopy (SEM). Wear depths and heights were analyzed by one-way analysis of variance with Tukey's multiple comparison test.

Results: The wear depths of CS and TJ were significantly greater than those of the other materials (P < 0.05), whereas ZL exhibited the lowest wear depth. No significant differences were found among HC, HCH, SPE, and CW. The stylus opposing the SPE exhibited the smallest wear height, whereas TJ caused the most antagonist wear. SEM revealed distinct wear mechanisms, including adhesive and abrasive wear, depending on the material.

Conclusions: The SPE and CW showed similar wear behavior. CAD/CAM composite resins demonstrated variable wear rates, which was likely attributable to variations in the composition and morphology of the constituent fillers. The TJ exhibited excessive antagonist wear, suggesting the need for improved tribological properties. These findings provide guidance for selecting materials that preserve occlusion and prevent excessive wear.

Purpose: To assess the time efficiency of an innovative workflow (SafetyCrown) for implant-supported rehabilitation of posterior single-tooth sites against the standard workflow. The hypothesis was that there is no difference in treatment duration and accuracy, as represented by the number of clinical adjustments and additional visits required.

Methods: 31 participants (16 females, 15 males) were included in this analysis from a randomized clinical trial. Participants were randomly assigned to the test group (SafetyCrown workflow, three visits) or control group (conventional digital workflow, six visits). The SafetyCrown workflow combined immediate restoration with a prefabricated definitive abutment and chairside provisional restoration. The control group followed a conventional digital approach in six visits. Treatment times per visit were recorded with a stopwatch; clinical adjustments and additional visits were documented.

Results: The SafetyCrown workflow was completed in three visits in 53% of cases, with a mean of 3.5 visits compared with 6.1 visits in the control group. The total treatment time differed insignificantly by 10 minutes (test: 126.4 minutes; 95% CI: 116.4-136.5; control: 116.8 minutes; 95% CI: 104.4-129.3; P = 0.232), and individual visits lasted longer in the test group (e.g., surgical visit: 62 minutes vs. 33 minutes in control). Clinical adjustments were common in both groups when using model-free workflows.

Conclusions: Limitations aside, the SafetyCrown workflow reduced the total visits while maintaining the overall treatment time despite longer individual appointments, thus increasing efficiency. Both fully digital workflows were feasible, although frequent adjustments highlight the need to investigate sources of inaccuracy to improve the precision and efficiency further.

Purpose: This guideline aimed to make evidence-based clinical practice guidelines for the primary treatment of temporomandibular disorders (TMDs) for general practitioners who do not specialize in TMD.

Review process: Following the principles of evidence-based medicine, a systematic review and network meta-analysis (NMA) of multiple treatments was conducted, assessing the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Randomized controlled trials published between January 2000 and December 2020 were included. Patients diagnosed with TMD according to the Diagnostic Criteria for Temporomandibular Disorders were considered. Myalgia, arthralgia, and maximal mouth opening were selected as outcomes, and 12 treatments were included in the NMA. The modified Delphi method was used to reach a consensus on recommendations during clinical guideline panel meetings of the Japanese Society for the Temporomandibular Joint.

Results: Self-administered mouth opening exercises, stabilization-type oral appliances, and low-level laser therapy (LLLT) were recognized as effective primary treatments, although the evidence level was graded as "very low" (Grade 2D). During the clinical guideline panel meetings, decisions were developed based on the NMA results, and recommendations for clinical practice guidelines were finalized following consensus.

Conclusions: This guideline recommends mouth opening exercises and the use of stabilization-type oral appliances as primary treatments for TMD. Additionally, it suggests that LLLT be a conditional recommendation, supplemented with additional considerations.

Purpose: This study evaluated the use of pre-sintered cobalt-chromium (Co-Cr) alloy discs in the fabrication of clasps for removable partial dentures, comparing their accuracy and mechanical properties, as determined via tensile testing, with those of conventional fabrication methods.

Methods: Accuracy of the clasps was assessed by obtaining three-dimensional (3D) data (design data) of the Akers clasp. The clasps were fabricated under three conditions: (1) pre-sintered, fabricated from pre-sintered Co-Cr alloy discs; (2) fully sintered, fabricated from fully sintered Co-Cr alloy discs; and (3) cast, fabricated via casting. For each method, 3D data were collected (fabrication data). The design and fabrication data were subsequently superimposed, and the accuracy of the clasps was investigated based on their inner surfaces. The mechanical properties were assessed via tensile testing of dumbbell-shaped Co-Cr alloy specimens fabricated under the same conditions used for accuracy testing (pre-sintered, fully sintered, and cast).

Results: Cast clasps typically exhibited the highest trueness values and fully sintered clasps exhibited the highest precision values. The pre-sintered clasps exhibited high trueness in every part of the rest area; however, the accuracy at the clasp tip was low. In terms of mechanical properties, the pre-sintered clasps exhibited the highest elongation, meeting the standards for Type 4 metals as specified by ISO 22674:2022.

Conclusions: The present study demonstrates that pre-sintered Co-Cr alloy discs are suitable for fabrication of clasps with good fit and mechanical properties, provided that the accuracy of the clasp tip is improved.

Purpose: The hyoid bone plays a key role in several physiological functions by interacting with the attached muscles. Understanding its kinematics and positional stability is essential for evaluating its functions: swallowing, mastication, intraoral transport, vocalization, and respiration. This study aimed to assess the position of the hyoid bone relative to the cranial base and mandible using cephalometric imaging and to examine its stability.

Methods: Cephalometric images of 140 patients were analyzed using specialized software. The positional relationship between the cranial base and hyoid bone was assessed by measuring the Porion-Hyoid distance (Po-Hy) and the angle between the Po-Hy and the Nasion-Porion line (∠CB-Hy). The relationship between the mandible and the hyoid bone and the cervical angle was also evaluated.

Results: The ∠CB-Hy showed a narrow distribution (mean ± SD: 89.2 ± 5.12°). A weak, but statistically significant, correlation was observed between age and the ∠CB-Hy. Additionally, a significant negative correlation was found between the number of missing molars and ∠CB-Hy, while a strong positive correlation was identified between the cervical angle and ∠CB-Hy. The relationship between the cervical angle and ∠CB-Hy was represented by the following linear regression equation: ∠CB-Hy = 0.484 × Cervical angle + 37.4.

Conclusions: Our findings suggest that the hyoid bone maintains a relatively stable position with respect to the cranial base with only slight variation. However, a significant relationship exists between ∠CB-Hy and cervical inclination. Clinicians and researchers should consider this relationship when assessing the hyoid position in clinical and research settings.

Purpose: This clinical study aimed to evaluate the effects of various head positions within physiological movement limits on occlusal contacts (OCs) in digital bite registrations (BRs) obtained using an intraoral scanner (IOS).

Methods: This study included 36 individuals with natural dentition without missing teeth. Maxillary and mandibular scans were performed using an IOS (Trios4). The natural (NHP), forward (FHP), and backward (BHP) head positions were determined using a manual goniometer, and three BRs were obtained using an IOS. A new assessment method, the "digital occlusion analysis" module (oJMA, Zebris), was used to assess the OCs in these BRs. Dental arch scans and BRs were imported into the digital occlusion module. OC evaluation was performed on buccal-lingual cross-sections obtained at 1 mm intervals on the four left and right posterior teeth of the mandible. Each section was evaluated for the number, intensity, and location of OCs between pairwise comparison groups of head positions.

Results: The number of OCs significantly decreased in the BHP-FHP group with respect to contact points (P = 0.03). OC intensity was similar among the three groups. However, OC location was significantly reduced in the NHP-BHP and NHP-FHP groups compared with the NHP group, specifically for functional cusp contacts (P = 0.03, P = 0.018).

Conclusions: Digital BRs obtained in different head positions showed significant differences only in the OC locations in the FHP and BHP compared with the NHP. The effect on the number of OCs was observed as the angle between the head positions increased from FHP to BHP.

Purpose: To evaluate stress distribution in short-crowned molars with distal subgingival defects with various restorations and materials.

Methods: Residual crowns were restored using a post-and-core crown (model A), a full crown (model B), a fissure-post endocrown (model C), an endocrown (model D), an onlay (model E), and an overlay (model F). The ceramic materials used were IPS e.max (EM), Vita Enamic (VE), and Lava Ultimate (LU). Subsequently, finite element analysis was performed by applying 600 N vertical load (0° to the long axis) and 200 N oblique load (45° to the long axis) to simulate chewing loads.

Results: As the elastic modulus of the material increased, the stress on the restorations also increased, particularly under an oblique loading condition. Under vertical and oblique loading conditions, the peak maximum principal stress (MPS) in the dentin was lowest in Group A-EM (17.28 MPa and 5.61 MPa, respectively), following the trend A < B, C < D, F < E. The MPS within the cement was lowest in Group A-EM (2.74 MPa and 2.58 MPa under vertical and oblique loading conditions, respectively). The MPS within the cement in Group H (4.11 MPa) was reduced to approximately one-third of that in Group G (12.35 MPa).

Conclusions: EM exhibited a more uniform stress distribution than other materials and is a promising material for short-crowned molars. A fissure-post endocrown design is a potentially favorable restorative option for short-crowned molars. Fiber posts should be used with full crown restorations.