Influence of postprinting cleaning methods on the cleaning efficiency and surface and mechanical properties of three-dimensionally printed resins.

STATEMENT OF PROBLEM: The outcome of photopolymerized 3-dimensional (3D) printing is influenced by the methods used for postprinting cleaning, yet information on postprinting cleaning is sparse. PURPOSE: The purpose of this in vitro study was to assess the cleaning efficiency and surface and mechanical properties of 3D printed resin according to postprinting cleaning methods. MATERIAL AND METHODS: Specimens were fabricated from a 3D model using resin materials (NextDent C&B MFH and DIOnavi-P. MAX) and were tested for postprinting cleaning methods for 5 minutes with isopropyl alcohol, isopropyl alcohol + ultrasonic, ethyl alcohol, ethyl alcohol + ultrasonic, and ultrasonic alone. Postpolymerization was followed for 5 minutes. The cleaning efficiency, microcomputed tomography (µCT), surface roughness, Vickers hardness, and flexural strength of the specimens were evaluated. The 1-way ANOVA test was performed after considering normality. A post hoc analysis with Bonferroni was also performed (α=.008 or.005). RESULTS: Ultrasonic in addition to cleaning solutions significantly improved the cleaning efficiency in NextDent C&B MFH specimens (P<.005), whereas ultrasonic did not affect the efficiency in DIOnavi-P. MAX specimens. No significant differences were found in surface roughness by postprinting cleaning methods in either NextDent C&B MFH or DIOnavi-P. MAX (P>.005). No significant changes in surface hardness were observed by postprinting cleaning methods (P>.008). In the NextDent C&B MFH, ethyl alcohol + ultrasonic significantly decreased the flexural strength (P<.005). There were no significant differences in the flexural strength in the DIOnavi-P. MAX (P>.005). CONCLUSIONS: Ethyl alcohol was comparable with isopropyl alcohol for use as a postprinting cleaning solution for both NextDent C&B MFH and DIOnavi-P. MAX. The addition of ultrasonic to cleaning solutions should be applied with caution. These findings suggest that different postprinting cleaning methods can be recommended depending on the 3D printed resin materials.

Influence of crown shade, translucency, and scan powder application on the trueness of intraoral scanners.

OBJECTIVES: Natural teeth and dental restorations present with various shades and levels of translucency. This study aimed to determine whether these variations in ceramic crowns and scan powder application affect the trueness of intraoral scanners. METHODS: Eight identical premade resin typodonts, each prepared for a crown on the maxillary right second molar, were used. Eight lithium disilicate crowns, distinguished by two levels of translucency (high and low) and four shades (BL1, A2, A3, and A4), were fabricated to an identical design and cemented onto each typodont, providing eight distinct experimental groups (2 levels of translucency × 4 shades). Reference scans were acquired using a desktop scanner. Test scans were performed ten times for each experimental group using two different intraoral scanners (Medit i700 and CEREC Primescan AC), with and without the application of scan powder (n = 10). Three-dimensional metrology software was used to assess the trueness of the intraoral scan datasets. Statistical analysis involved the Kruskal-Wallis H test, Mann-Whitney U test, and independent t-test (α=0.05). RESULTS: For powder-free intraoral scan datasets, the crown shade did not significantly affect trueness within each translucency group (P = 1.000). For both intraoral scanners, compared with low translucency groups, higher marked deviations were exhibited by high translucency groups (P<.001). Scan powder use largely mitigated these differences (P>.05) and enhanced the trueness of the intraoral scan (P<.01). CONCLUSIONS: Shade did not significantly influence the trueness of intraoral scans. High-translucency crowns were scanned with less accuracy than were low-translucency crowns. CLINICAL SIGNIFICANCE: Unlike tooth shade, translucency significantly affected the accuracy of intraoral scans. Therefore, considering the use of scan powder when scanning objects with high translucency may be beneficial.

Three-Dimensional Peri-Implant Tissue Changes in Immediately vs. Early Placed Tapered Implants Restored with Two Different Ceramic Materials-1 Year Results.

BACKGROUND: A prospective multi-center randomized controlled clinical trial was performed to digitally analyze tissue volume changes in immediately and early placed implants with simultaneous bone augmentation restored with two different all-ceramic materials. METHODS: A total of 60 patients received 60 bone-level tapered implants (BLT, Straumann AG) immediately (n = 30) or early placed, 8-10 weeks after tooth extraction, (n = 30). Implants were restored with all-ceramic single crowns fabricated out of zirconia (Lava Plus, 3M), or lithium disilicate (E.max CAD, Ivoclar Vivadent AG) bonded to titanium base abutments (Variobase for Cerec, Straumann AG). Impressions were taken at baseline (BL), 6 and 12 months, and STL data were used to define an area of interest (AOI) to analyze peri-implant volume changes and midfacial recessions. RESULTS: For immediate placement, a mean volume loss of -5.56 mm3 (±5.83 mm3) was found at 6 months, and of -6.62 mm3 (±6.56 mm3) at 12 months. For early placement, a mean volume loss of -1.99 mm3 (±5.82 mm3) at 6 months, and of -3.7 mm3 (±5.62 mm3) at 12 months was found. The differences in volume loss at 12 months between the two implant placement protocols were significant (p = 0.005). In both groups, mean midfacial recessions of 0.48 mm (±0.52) occurred. CONCLUSIONS: A more pronounced peri-implant volume loss can be expected 12 months after immediate implant placement compared with early placement.

A comprehensive study on the mechanical effects of implant-supported prostheses under multi-directional loading and different occlusal contact points.

AIMS: To evaluate screw loosening and fracture load and angular deviation of a single implant-supported prosthesis under multi-directional loading condition at three different occlusal contact points. METHODS: A total of 40 metal crowns were cemented to external connection implants and were embedded vertically and obliquely. The occlusal surface of the crown was designed with three flat surfaces, contact a, b, and c, representing outer and inner 20-degree inclination for buccal and lingual cusps. The angular deviations of implant crown under static 50N of loading were measured. And screw removal torque was evaluated before and after 57,600 load cycles. Then, fracture load was measured for each specimen. Data analysis was performed using one-way analysis of variance test of significance followed by Tukey honest significant difference (HSD) test(p < 0.05). RESULTS: Angular deviation results showed statistical significance between all contact points in vertically embedded group compared to obliquely embedded group, which showed similar results between contact A and B compared to C. In the other hand, screw loosening evaluation did not show statistical significance among the tested groups. And for the fracture load evaluation the maximum values reached twice the yield values in all contact areas. CONCLUSIONS: Mechanical effects were different regarding to diverse loading direction and contact points. The results of this study suggest that the stress concentration might increase in unfavorable vector direction.

3D analysis of occlusal registration through geometry embedded library matching between quadrant and full-arch digital impression.

OBJECTIVE: This study aimed to compare the accuracy of occlusal registration for single-unit restorations in the posterior area of the jaw using the complete-arch or quadrant scan techniques. MATERIALS AND METHODS: A master cast was prepared and articulated on a nonadjustable articulator, and the maxillary left first molar was prepared for a full-coverage crown. The master cast was digitized as the reference data using a laboratory scanner (E3 scanner, 3Shape, Copenhagen, Denmark). It was scanned 10 times in the complete arch and 10 times in the quadrant, with an occlusal registration in each, using four intraoral scanners (i500, Primescan, TRIOS 3, and TRIOS 4). The scanned data were aligned to the reference data using GOM Inspect software. A three-dimensional analysis of the surface-based occlusal clearance and angular deviation, focusing on the prepared tooth, was performed. RESULTS: The mean surface-based occlusal clearance in the quadrant and complete-arch scans was 1.622 ± 0.032 mm and 1.642 ± 0.043 mm, respectively. Angular deviations compared to the reference cast showed a difference of 0.10° distally and 0.09° buccally for the quadrant scan and 0.12° distally and buccally for the complete-arch scan. Statistical analysis was performed using one-way analysis of variance and post hoc Scheffe's test. No significant differences were observed between the test groups. CONCLUSIONS: No significant differences were found between occlusal registrations of the complete-arch and quadrant scans. Therefore, a quadrant scan can achieve the same outcome as a complete-arch scan for single-unit restoration in the posterior area of the jaw. CLINICAL RELEVANCE: Quadrant scanning for single-unit restoration showed similar outcomes as complete-arch scans.

Automated vector analysis to design implant-supported prostheses: A dental technique.

The prosthesis loading force is an important factor for dental implant survival. Even if adequate osseointegration of the dental implant has been achieved, if the occlusal forces are not correctly distributed, lateral torque can be generated causing high stress on surrounding tissues. The stress value of implant prostheses could be different whether the direction of load is vertical or oblique, affected by the shape of the occlusal surface. When an implant-supported prosthesis is designed with a dental computer-aided design software program, the average vectors from each occlusal contact point can be visualized. If the visualized vector generates lateral torque, the occlusal surface design can be modified before finalizing the design. The described technique uses automated vector analysis to enable visualization of the occlusal vector to improve prosthesis design, optimizing occlusal forces.

Comparison of digital and conventional assessment methods for a single tooth preparation and educational satisfaction.

INTRODUCTION: Digital feedback for tooth preparation can provide dental practitioners with more objective and accurate evaluations compared to conventional methods. This study aimed to evaluate the educational effect and satisfaction of digital feedback compared with those of the conventional putty index method for tooth preparation. MATERIAL AND METHODS: Forty-eight third-grade dental students were selected. All students performed a full-coverage preparation on a right mandibular first molar resin tooth. They were randomly divided into four groups (n = 12)-no guide (control), putty index, digital feedback, and digital and putty index assessment. Three-dimensional analysis was performed using an analysis software (GomInspect 2018, Gom) to evaluate the amount of tooth structure removed. At the end of the practice, the students completed a questionnaire to evaluate the educational satisfaction of the respective methods. RESULTS: There was no statistical significance of the amount of preparation amongst groups in most of the measured areas only except for several specific points. Overall occlusal surface showed 0.99 ± 0.27 mm in the N group (no guide) and 1.15 ± 0.31 mm in the D group (digital feedback), and overall axial surface showed no statistical differences (p > .05). The groups that used digital assessment showed a high level of satisfaction compared with conventional assessment. CONCLUSIONS: It was difficult to confirm that the digital-based feedback promotes accurate tooth preparation compared to conventional feedback within the limitation of this study. However, it improved educational satisfaction and permitted objective evaluation.