Journal of Advanced Prosthodontics最新文献

Purpose: Masticatory loading triggers active bone remodeling, altering alveolar bone mineral density (BMD). While dental implants are placed to bear masticatory loading, their influence on changing bone properties has not been fully investigated. Objective of this pilot study was to examine whether the dental implantation has an effect on BMD distribution of bone by comparing dentate, edentulous, and edentulous patients with implants.

Materials and methods: Cone beam computed tomography (CBCT) images of 19 partially edentulous patients (Dent), 19 edentulous patients (Edent), and 16 edentulous patients who received implants in the mandible (Edent+Im), were obtained. CBCT images were also obtained from 5 patients within Edent+Im group, before implant placement and after implant loading. Basal cortical bone region of the mandible was digitally isolated. A histogram of gray levels proportional to BMD was obtained to assess mean, histogram standard deviation (HSD), fifth percentile of low and high values (Low₅ and High₅) of the BMD distribution. Multivariate analysis of variance and paired t-test were used to compare the BMD parameters among the 3 dental status groups and between pre- and post-implantation, respectively.

Results: Edentulous patients with implants had significantly greater HSD and High₅ values compared to edentulous patients (P < .013). All other comparisons were not significant (P > .097). Mean, HSD, and High₅ values significantly increased after receiving implants (P < .022).

Conclusion: The current findings suggested that receiving dental implants promoted oral bone mineralization for edentulous patients. The longitudinal investigation could provide valuable information on understanding the effects of implantation on the behavior of oral bone quality.

Purpose: The aim of this study is to summarize various biomechanical aspects in evaluating the long-term stability of dental implants based on finite element method (FEM).

Materials and methods: A comprehensive search was performed among published studies over the last 20 years in three databases; PubMed, Scopus, and Google Scholar. The studies are arranged in a comparative table based on their publication date. Also, the variety of modeling is shown in the form of graphs and tables. Various aspects of the studies conducted were discussed here.

Results: By reviewing the titles and abstracts, 9 main categories were extracted and discussed as follows: implant materials, the focus of the study on bone or implant as well as the interface area, type of loading, element shape, parts of the model, boundary conditions, failure criteria, statistical analysis, and experimental tests performed to validate the results. It was found that most of the studied articles contain a model of the jaw bone (cortical and cancellous bone). The material properties were generally derived from the literature. Approximately 43% of the studies attempted to examine the implant and surrounding bone simultaneously. Almost 42% of the studies performed experimental tests to validate the modeling.

Conclusion: Based on the results of the studies reviewed, there is no "optimal" design guideline, but more reliable design of implant is possible. This review study can be a starting point for more detailed investigations of dental implant longevity.

Purpose: This analysis aimed to evaluate the intaglio surface trueness, antagonist's wear volume loss, and fracture resistance of full-contour crowns of (Y, Nb)-stabilized fully-sintered zirconia (FSZ), 4 mol% or 5 mol% yttria-stabilized partially sintered zirconia (4YZ or 5YZ) with high-speed sintering.

Materials and methods: A total of 42 zirconia crowns were separated into three groups: FSZ, 4YZ, and 5YZ (n = 14). The intaglio surface trueness of the crowns was evaluated at the inner surface, occlusal, margin, and axial areas and reported as root-mean-square, positive and negative average deviation. Half of the specimens were aged for 120,000 cycles in the chewing simulator, and the wear volume loss of antagonist was measured. Before and after chewing, the fracture load was measured for each group. The trueness values were analyzed with Welch's ANOVA, and the wear volume loss with the Kruskal-Wallis tests. Effect of the zirconia type and aging on fracture resistance of crowns was tested using two-way ANOVA.

Results: The intaglio surface trueness measured at four different areas of the crown was less than 50 µm, regardless of the type of zirconia. No significant P in wear volume loss of antagonists were detected among the groups (P > .05). Both the type of zirconia and aging showed statistically significant effects on fracture resistance (P < .05).

Conclusion: The full-contour crowns of FSZ as well as 4YZ or 5YZ with high-speed sintering were clinically acceptable, in terms of intaglio surface trueness, antagonist's wear volume loss, and fracture resistance after simulated mastication.

Purpose: The purpose of the study was to assess the influence of build orientations and density of support structures on the trueness of the 3D printed removable partial denture (RPD) frameworks.

Materials and methods: A maxillary Kennedy class III and mandibular class I casts were 3D scanned and used to design and produce two 3D virtual models of RPD frameworks. Using digital light processing (DLP) 3D printing, 47 RPD frameworks were fabricated at 3 different build orientations (100, 135 and 150-degree angles) and 2 support structure densities. All frameworks were scanned and 3D compared to the original virtual RPD models by metrology software to check 3D deviations quantitatively and qualitatively. The accuracy data were statistically analyzed using one-way ANOVA for build orientation comparison and independent sample t-test for structure density comparison at (α = .05). Points study analysis targeting RPD components and representative color maps were also studied.

Results: The build orientation of 135-degree angle of the maxillary frameworks showed the lowest deviation at the clasp arms of tooth 26 of the 135-degree angle group. The mandibular frameworks with 150-degree angle build orientation showed the least deviation at the rest on tooth 44 and the arm of the I-bar clasp of tooth 45. No significant difference was seen between different support structure densities.

Conclusion: Build orientation had an influence on the accuracy of the frameworks, especially at a 135-degree angle of maxillary design and 150-degree of mandibular design. The difference in the support's density structure revealed no considerable effect on the accuracy.

Purpose: A large number of studies have suggested the practicability and predictability of immediate implant function, but few studies have reported marginal bone level changes during sequential loading periods. The purpose of this study was to evaluate the marginal bone remodeling of immediately loaded self-tapping implants both at each time point and during each loading period between two time points.

Materials and methods: The patients included in this retrospective study were treated with immediately loaded NobelSpeedy Replace implants between August 2008 and July 2009. Differences in the marginal bone level (MBL) at each time point and the marginal bone level change (ΔMBL) between two time points were analyzed with Bonferroni correction (P < .05).

Results: Overall, 24 patients (mean age, 47.3 ± 12.8 years) with 42 immediately loaded implants and a median follow-up of 6.5 years (IQR, 67.8 months) were included. The cumulative survival rate after 10 - 12 years was 95.2%. Continuous but slow marginal bone loss was observed during long-term follow-up. MBL at both 7.5 years and 11 years was significantly lower than that at loading, 6 months, 2 years and 4 years (P < .05). No bone loss difference was found in any period before 4 years of follow up (P > .05). The loading period of 4 years to 7.5 years showed the largest ΔMBL compared to those of other time periods (P < .05).

Conclusion: Slight bone loss occurred continuously, and more radical changes of marginal bone can be observed during the period of 4-7.5 years. Thus, long-term effective follow-up of immediately loaded implants is needed.

Purpose: Microstructural and physico-mechanical characterization of highly translucent zirconia, prepared by milling technology (CAD-CAM) and repeated firing cycles, was the main aim of this in vitro study.

Materials and methods: Two groups of samples of two commercial highly-translucent yttria-stabilized dental zirconia, VITA YZ-HT^White (Group A) and Zolid HT + White (Group B), with dimensions according to the ISO 6872 "Dentistry - Ceramic materials", were prepared. The specimens of each group were divided into two subgroups. The specimens of the first subgroups (Group A₁ and Group B₁) were merely the sintered specimens. The specimens of the second subgroups (Group A₂ and Group B₂) were subjected to 4 heat treatment cycles. The microstructural features (microstructure, density, grain size, crystalline phases, and crystallite size) and four mechanical properties (flexural strength, modulus of elasticity, Vickers hardness, and fracture toughness) of the subgroups (i.e. before and after heat treatment) were compared. The statistical significance between the subgroups (A₁/A₂, and B₁/B₂) was evaluated by the t-test. In all tests, P values smaller than 5% were considered statistically significant.

Results: A homogenous microstructure, with no residual porosity and grains sized between 500 and 450 nm for group A and B, respectively, was observed. Crystalline yttria-stabilized tetragonal zirconia was exclusively registered in the X-ray diffractograms. The mechanical properties decreased after the heat treatment procedure, but the differences were not statistically significant.

Conclusion: The produced zirconia ceramic materials can be safely (i.e., according to the ISO 6872) used in extensive fixed prosthetic restorations, such as substructure ceramics for three-unit prostheses involving the molar restoration and substructure ceramics for prostheses involving four or more units. Consequently, milling technology is an effective manufacturing technology for producing zirconia substructures for dental fixed all-ceramic prosthetic restorations.

Purpose: This in-vitro analysis aimed to compare the intaglio trueness, the antagonist's wear volume loss, and fracture load of various single-unit zirconia prostheses fabricated by different manufacturing techniques.

Materials and methods: Zirconia crowns were prepared into four different groups (n = 14 per group) according to the manufacturing techniques and generations of the materials. The intaglio surface trueness (root-mean-square estimates, RMS) of the crown was measured at the marginal, axial, occlusal, and inner surface areas. Half of the specimens were artificially aged in the chewing simulator with 120,000 cycles, and the antagonist's volume loss after aging was calculated. The fracture load for each crown group was measured before and after hydrothermal aging. The intaglio trueness was evaluated with Welch's ANOVA and the antagonist's volume loss was assessed by the Kruskal-Wallis tests. The effects of manufacturing and aging on the fracture resistance of the tested zirconia crowns were determined by two-way ANOVA.

Results: The trueness analysis of the crown intaglio surfaces showed surface deviation (RMS) within 50 µm, regardless of the manufacturing methods (P = .053). After simulated mastication, no significant differences in the volume loss of the antagonists were observed among the zirconia groups (P = .946). The manufacturing methods and simulated chewing had statistically significant effects on the fracture resistance (P < .001).

Conclusion: The intaglio surface trueness, fracture resistance, and antagonist's wear volume of the additively manufactured 3Y-TZP crown were clinically acceptable, as compared with those of the 4Y- or 5Y-PSZ crowns produced by subtractive milling.