Quantitative evaluation of the proximal contact area gap change characterization under intercuspal occlusion by intraoral 3D scanning: Food impaction with tight proximal contact.

OBJECTIVE: This study aimed to present three indicators that represent the proximal contact area gap change under intercuspal occlusion and to see if and how these indicators influence food impaction with tight proximal contact. MATERIALS AND METHODS: Ninety volunteers were recruited for bite force measurement and intraoral scanning. Three-dimensional surface data and buccal bite data were obtained for 60 impacted and 60 non-impacted teeth. The scanning data were imported into the Geomagic Studio 2013 to measure three indicators, which included the gap change maximum (Δdm, µm), the buccolingual position of Δdm (P), and the gap expanded buccolingual range (S, mm). The difference between two groups of three indicators and their relationship with food impaction with tight proximal contact were analyzed by the t test, the Pearson chi-squared test, the nonparametric Mann-Whitney U test, and the binary logistic regression analysis (a = 0.05). RESULTS: All indicators (Δdm, P, and S) were statistically different (p < 0.001, p = 0.002, and p < 0.001) in the impacted and non-impacted groups. Food impaction with tight proximal contact was affected by Δdm and S (p < 0.001, p = 0.039), but not by P (p = 0.409). CONCLUSION: The excessive increase of the gap change maximum and the gap expanded buccolingual range under bite force promoted the occurrence of food impaction with tight proximal contact. CLINICAL SIGNIFICANCE: The use of intraoral scanning to measure the characteristics of the proximal contact area gap change under bite force may help to deepen our understanding of the pathogenesis of food impaction with tight proximal contact. Importantly it can provide a reference basis for individualizing and quantifying occlusal adjustment treatment.

A digital technique for occlusal design of a posterior full crown based on physiological tooth displacement and occlusion of adjacent teeth.

This article presents a digital technique to construct a virtual occlusion in the maximal intercuspal position (MIP), considering physiological tooth displacement and reducing intermesh penetrations between occlusal surfaces, in order to design more precise and accurate occlusal contacts of a posterior full crown.

Clinical evaluation of a one-piece polyetheretherketone removable partial denture fabricated using a novel digital workflow: A self-controlled clinical trial.

PURPOSE: To explore the clinical application of one-piece polyetheretherketone (PEEK) removable partial dentures (RPDs) fabricated using a novel digital workflow and to evaluate their weights and fits in vivo and patient satisfaction. MATERIALS AND METHODS: Fifteen cases with posterior partially edentulous situations were selected, and each patient received two types of RPDs, including a novel digital workflow (test group) and a conventional workflow (control group). For the test group, one-piece RPDs were designed through three-dimensional (3D) methods by scanning stone casts and fabricated by milling PEEK discs. Each RPD was weighed. The gaps between the oral tissue and RPDs in each group were duplicated using a polyvinylsiloxane (PVS) replica and measured by 3D analysis. A visual analog scale (VAS) was used to evaluate the patient's satisfaction. Paired t-tests were used to compare the differences in the weight, the gaps of each RPD, and VAS values between the two groups. One-way analysis of variance tests was used to compare the differences in the gap among different components in each group. RESULTS: The RPD in the test group weighed less than that in the control group (p < 0.01). No statistically significant differences in the gaps of denture bases and rests (p > 0.05) were found between the two groups, but the gaps of major connectors in the test group were significantly smaller than in the control group (p < 0.05). The VAS scores for comfortableness and masticatory efficiency were not significantly different between the two groups (p > 0.05) but the scores for the aesthetic appearance of the clasps in the test group were significantly higher than that in the control group (p < 0.05). CONCLUSIONS: One-piece PEEK RPDs manufactured using a novel digital workflow weighed less than conventional RPDs and exhibited a clinically acceptable internal fit. Although the aesthetic appearance of the PEEK clasps was superior to the control, there is still room for improvement.

Characterization of photochemical losses of volatile organic compounds and their implications for ozone formation potential and source apportionment during summer in suburban Jinan, China.

Volatile organic compounds (VOCs) undergo substantial photochemical losses during their transport from emission sources to receptor sites, resulting in serious implications for their source apportionment and ozone (O3) formation. Based on the continuous measurements of VOCs in suburban Jinan in August 2022, the effects of photochemical losses on VOC source contributions and O3 formation were evaluated in this study. The observed and initial concentrations of total VOCs (TVOC) were 12.0 ± 5.1 and 16.0 ± 7.4 ppbv, respectively. Throughout the observation period, alkenes had the most prominent photochemical losses (58.2%), followed by aromatic hydrocarbons (23.1%), accounting for 80.6% and 6.9% of the total losses, respectively. During high O3 episodes, the photochemical loss of VOCs was 6.9 times higher than that during the cleaning period. Alkene losses (exceeding 67.3%), specifically losses of isoprene, propylene, ethylene, and n-butene, dominated the total losses of VOCs during the O3 increase period. Eight sources of VOCs were identified by positive matrix factorization (PMF) based on the observed and initial concentration data (OC-PMF and IC-PMF, respectively). Concentrations of all emission sources in the OC-PMF were underestimated by 2.4%-57.1%. Moreover, the contribution of each emission source was over- or underestimated compared with that in case of the IC-PMF. The contributions of biogenic and motor vehicle exhaust emissions were underestimated by 5.3 and 2.8 percentage points, respectively, which was associated with substantial oxidation of the emitted high-reactive species. The contributions of coal/biomass burning and natural gas were overestimated by 2.4 and 3.9 percentage points, respectively, which were related to the emission of low-reactive species (acetylene, ethane, and propane). Based on our results, the photochemical losses of VOCs grossly affect their source apportionment and O3 formation. Thus, photochemical losses of VOCs must be thoroughly accounted to establish a precise scientific foundation for air-pollution control strategies.

Accuracy of digital implant impressions using a novel structured light scanning system assisted by a planar mirror in the edentulous maxilla: An in vitro study.

OBJECTIVES: This study aimed to develop a structured light scanning system with a planar mirror to enhance the digital full-arch implant impression accuracy and to compare it with photogrammetry and intraoral scanner methods. MATERIALS AND METHODS: An edentulous maxillary stone cast with six scan bodies was scanned as the reference model using a laboratory scanner. Three scanning modalities were compared (n = 10): (1) self-developed structured light scanning with a mirror (SSLS); (2) intraoral scanner (IOS); and (3) photogrammetry system (PG). The scanners were stopped for 1 min after each scan. Six scan bodies were analysed within each scan model. Linear deviations between the scan bodies (1-2, 1-3, 1-4, 1-5, and 1-6) and 3D mucosal deviations were established. The overall deviation was calculated as the mean of all linear deviations. "Trueness" represented the discrepancy between the test and reference files, while "precision" denoted the consistency among the test files. Kruskal-Wallis and Mann-Whitney U tests were used for statistical analyses. RESULTS: Significant overall linear discrepancies were noted among the SSLS, PG, and IOS groups (p < .001). SSLS showed the best overall trueness and precision (6.6, 5.7 µm), followed by PG (58.4, 6.8 µm) and IOS (214.6, 329.1 µm). For the 3D mucosal deviation, the trueness (p < .001) and precision (p < .001) of the SSLS group were significantly better than those of the IOS group. CONCLUSIONS: The SSLS exhibited higher accuracy in determining the implant positions than the PG and IOS. Additionally, it demonstrated better accuracy in capturing the mucosa than IOS.

Comparison of the dimensional and morphological accuracy of three-dimensional digital dental casts digitized using different methods.

The purpose of this study was to compare the accuracy of digital dental casts from plaster cast scanning (PCS), impression scanning (IPS), intraoral scanning (IOS), and cone-beam computed tomography (CBCT) scanning (CCS) methods. The maxillary and mandibular dental casts of 15 patients who needed CBCT scans for oral examination or treatment were digitized via four methods. 12 linear distance measurements of all digital dental casts were selected and acquired with software and compared to those of the reference plaster cast to evaluate the dimensional accuracy. Three-dimensional deviation analysis of the IPS, IOS and CCS groups with respect to the reference PCS group was performed to evaluate the morphological accuracy. The discrepancy in linear distances between the digital dental casts and reference plaster casts was statistically significant (p < 0.01). The dimensional accuracies of the PCS (0.06 ± 0.12 mm) and IPS (0.03 ± 0.05 mm) casts were better than those of the IOS (0.37 ± 0.30 mm) and CCS (0.54 ± 0.40 mm) casts. The one-sample t test showed that there were statistically significant differences between the discrepancies in 8 of the linear distances for the PCS group and 9 of the linear distances for the IPS group between the digital dental casts and reference plaster casts, with an ideal error of 0.00 (p < 0.05). The sequence of morphological accuracy from good to poor was maxillary and mandibular IPS, mandibular IOS; maxillary IOS; and maxillary and mandibular CCS. The accuracy of the digital dental casts from the PCS and IPS methods was greater than that of IOS and CCS methods. Although accuracy of the digital dental cast from IOS was low, it satisfied the clinical requirements for fixed restorations in small units. The accuracy of the digital dental cast from CCS was poorest and could only be used for procedures with lower accuracy requirements.

Accuracy of zirconia crowns manufactured by stereolithography with an occlusal full-supporting structure: An in vitro study.

STATEMENT OF PROBLEM: Additive manufacturing is emerging as an alternative method of fabricating dental restorations, but the support design needs to be optimized. PURPOSE: The purpose of this in vitro study was to evaluate the 3-dimensional trueness and adaptations of zirconia crowns manufactured by stereolithography (SLA) with an occlusal full-supporting structure, compared with those SLA-printed with pillar supports, and those made by milling. MATERIAL AND METHODS: A zirconia abutment was prepared, and an anatomic contour crown was designed. The crowns were manufactured by SLA and milling (n=6). For SLA manufacturing, a full-supporting base and pillar supports were designed. The 3-dimensional (3D) trueness of the fabricated crowns was characterized by 3D deviation analysis. The adaptations of crowns in the SLA-base and milling groups were measured by using a triple-scan method. Color-difference maps and the root mean square (RMS) values were used to characterize the 3D trueness. One-way analysis of variance (ANOVA) and Tukey post hoc test were used to analyze the difference in RMS values among the 3 groups, and Student t test was used to analyze the difference in cement-gap width between the milling group and the SLA group with the full-supporting base (α=.05). RESULTS: The 3D deviation analysis showed that in the external area, the RMS value of the SLA-pillar group was significantly higher than that of the SLA-base and the milling groups (P<.05). In the intaglio area, the milling group showed a lower RMS value than the 2 SLA groups (P<.05). The color-difference maps showed the SLA-base group had smaller positive errors at the cusp inclines than the SLA-pillar group. No statistically significant difference was found in adaptations between the SLA-base and milling groups (P>.05). CONCLUSIONS: The occlusal full-supporting base provided improved support in fabricating the crowns, and no remnants were left after removal. The zirconia crowns manufactured by SLA with an occlusal full-supporting structure had good external 3D trueness and clinically acceptable adaptation.

Knife-edged crown fabricated by 3-dimensional gel deposition and soft milling.

STATEMENT OF PROBLEM: Restorations with knife-edge margins are more prone to margin chipping during the manufacturing process. Three-dimensional gel deposition shows potential for fabricating zirconia restorations with good margin quality, but studies on its performance in fabricating knife-edged crowns are lacking. PURPOSE: The purpose of this in vitro study was to compare the 3-dimensional trueness, surface morphology, and margin quality of self-glazed zirconia and soft-milled zirconia crowns with knife-edge margins. MATERIAL AND METHODS: An abutment with a knife-edge finish line design was prepared and scanned with a laboratory scanner. Anatomic contour crowns were designed and fabricated by 3-dimensional gel deposition and soft milling (n=5). The crowns were digitalized, and the scan data were superimposed on the computer-aided design (CAD) data for 3-dimensional deviation analysis. Surface morphology and margin quality were characterized with microscopic examination. RESULTS: The self-glazed zirconia crowns showed a smooth and glossy appearance. The soft-milled crowns showed traces left by the removal of support bars and numerous micropits of various sizes. In internal areas, no significant difference was found in root mean square values between the 2 groups (P＞.05). For the external surface, self-glazed zirconia showed statistically lower root mean square values than the soft-milled crowns (P＜.05). When observed at ×5 magnification, all the self-glazed zirconia crowns showed smooth edges with no defects, whereas small or large margin defects were found in the soft-milled crowns. When characterized at ×200 magnification, minor margin flaws were observed in the self-glazed zirconia crowns. More and larger margin defects were found in the soft-milled crowns. CONCLUSIONS: Three-dimensional gel deposition forms a smoother and more homogeneous surface than soft milling. Knife-edged self-glazed zirconia crowns have good dimensional accuracy and margin quality.

Design of wear facets of mandibular first molar crowns by using patient-specific motion with an intraoral scanner: A clinical study.

STATEMENT OF PROBLEM: Although computer-aided design has become popular, restorations are typically designed from static occlusion and dynamically by using an average-value virtual articulator. Patient-specific motion recorded by using an intraoral scanner has rarely been used to design restorations, and its design ability has not been analyzed. PURPOSE: The purpose of this clinical study was to record patient-specific motion by using an intraoral scanner and to analyze its ability to design the morphology of the wear facets on mandibular first molar crowns. MATERIAL AND METHODS: An intraoral scanner was used to scan complete arch digital casts and to record patient-specific motion of 11 participants. Right and left mandibular first molars were selected as the target teeth. The complete crown preparations of the target teeth were virtually prepared on the digital mandibular casts by using the Geomagic Studio 2013 software program. High points were created by elevating the wear facets of the target teeth by 0.3 mm in the occlusal direction to generate digital wax patterns. The Dental System software program was used to design crowns with the anatomic coping design method. Occlusal adjustment with static occlusion (STA crown), with the average-value virtual articulator (DYN crown), and with patient-specific motion (FUN crown) was carried out. The crowns adjusted with these 3 methods were compared with the original wear facets. The mean value and root mean square (RMS) of 3D deviation were measured. One-way ANOVA was used to analyze the influence of the occlusal surface design methods on the morphology of the wear facets (α=.05). RESULTS: The STA crowns had the poorest results with the mean ±standard deviation 3D deviation value of 0.15 ±0.05 mm and RMS value of 0.19 ±0.04 mm. The best results occurred in the FUN group, with the mean ±standard deviation 3D deviation value of 0.05 ±0.06 mm and RMS value of 0.13 ±0.03 mm. Significant differences were found among the 3 groups (P<.01). Except for the RMS value between the STA and DYN groups, significant differences were found between groups from the pairwise comparisons. CONCLUSIONS: The occlusal surface of the crowns designed by using the patient-specific motion recorded with the intraoral scanner had the best coincidence with the morphology of the wear facets on the original teeth.

Assessment of physiological posterior-tooth displacement under habitual occlusal force by intraoral scanning using implant-supported crowns as the reference.

STATEMENT OF PROBLEM: Studies that have used digital methods to quantitatively evaluate physiological tooth displacement under occlusal force are sparse. PURPOSE: The purpose of this clinical study was to measure physiological posterior tooth displacement under occlusal force by intraoral scanning and reverse engineering technology by using implants as the reference. MATERIAL AND METHODS: A total of 14 participants received 15 implant-supported single mandibular first molar crowns. The surface data of maxillary and mandibular posterior teeth (U1 and L1) and the buccal occlusal data in the maximum intercuspal position (MIP) with habitual occlusal force were obtained by using an intraoral scanner (TRIOS 3, v20.1.2). The U1 and L1 data were segmented into single teeth, which were then aligned to the buccal occlusal data by using the "best-fit alignment" command to build the data under occlusal force (U2 and L2). U1 and L1 data were compared with U2 and L2 data to calculate the centroid and functional cusp vertex displacements and the long axis deflections of the second premolars and second molars, taking the first molar as the reference. The medians, and first quartile (Q1), third quartile (Q3) of the above data were reported, and the Shapiro-Wilk and Wilcoxon tests were used to analyze the differences (α=.05). RESULTS: Under occlusal force, the median (Q1, Q3) centroid displacements of posterior teeth ranged from 61 (52, 101) µm to 146 (80, 186) µm; the functional cusp vertex displacements ranged from 82 (62, 117) µm to 146 (98, 189) µm, and the long axis deflections ranged from 0.45 (0.25, 0.87) degrees to 1.03 (0.52, 1.41) degrees. Mandibular second premolars displaced lingually, mesially, and apically; mandibular second molars displaced distally and apically; and maxillary second premolars and second molars displaced lingually and apically. CONCLUSIONS: A digital method taking implant-supported single crowns as the reference was used to demonstrate physiological posterior-tooth displacement under habitual occlusal force.

Digital measurement method for comparing the absolute marginal discrepancy of three-unit ceramic fixed dental prostheses fabricated using conventional and digital technologies.

BACKGROUND: In clinical practice, control of the marginal fit of fixed dental prostheses is hindered by evaluation method, which needs to be further improved to increase its clinical applicability. This study aimed to quantitatively analyze the absolute marginal discrepancy of three-unit ceramic fixed dental prostheses fabricated by conventional and digital technologies using a digital measurement method based on the digital impression technology and open source software. METHODS: A digital workflow and the conventional impression combined with the lost-wax heat-pressed technique were adopted to separately fabricate 10 glass ceramic fixed dental prostheses. Three-dimensional data for the abutments, fixed dental prostheses, and fixed dental prostheses seated on the abutments, were obtained using a dental scanner. The two datasets were aligned using registration technology, specifically "multi-points registration" and "best fit alignment," by reverse engineering software. Subsequently, the three-dimensional seated fit between the fixed dental prostheses and abutments were reconstructed. The margin of the abutment and crown was extracted using edge-sharpening and other functional modules, and the absolute marginal discrepancy was measured by the distance between the margin of the abutment and crown. One-way analysis of variance was used to statistically analyze the measurement results. RESULTS: Using the digital measurement method, the mean value of absolute marginal discrepancy for fixed dental prostheses fabricated by the conventional method was 106.69 ± 6.46 µm, and that fabricated by the digital workflow was 102.55 ± 6.96 µm. The difference in the absolute marginal discrepancy of three-unit all-ceramic fixed dental prostheses fabricated using the two methods was not statistically significant (p > 0.05). CONCLUSIONS: The digital measurement method for absolute marginal discrepancy was preliminarily established based on open source software and applied in three-unit ceramic fixed dental prostheses. The absolute marginal discrepancy of three-unit ceramic fixed dental prostheses fabricated using digital technology was comparable to that of conventional technique.

Occlusal contact and clearance of posterior implant-supported single crowns designed by two different methods: a self-controlled study.

BACKGROUND: Precise occlusal design of implant-supported fixed prostheses is difficult to achieve by the conventional wax-up method, often requiring chairside adjustments. The computer-aided design (CAD) method is promising. This study aims to compare the occlusal contacts and clearance of posterior implant-supported single crowns designed by the CAD and conventional methods. METHODS: Sample size calculation indicated fourteen samples per group. Two sets of type-IV plaster casts with a single implant analog inserted in the posterior teeth region were mounted as master casts in a mechanical articulator in maximal intercuspal position (MIP). Seven working cast sets were obtained from each master cast by a closed tray technique, and mounted in MIP. Two implant-supported single crowns were designed with an occlusal clearance to achieve light occlusal contact in each working cast set by CAD and conventional method, separately. For the CAD group, the crown was designed in digital models obtained by scanning the working casts. For the conventional group, wax-up of the crown was prepared on the working casts and scanned to generate a STL file. In the working and master casts, mean and minimum occlusal clearances in the designed occlusal contact area of the both finished prostheses were calculated using the occlusal clearance (OC) and occlusal record (OR) method. The prostheses' occlusion was evaluated in master casts. RESULTS: For the evaluation in the working casts, both design methods had similar mean occlusal clearances by the OC method (195.4 ± 43.8 vs. 179.8 ± 41.8 µm; P = 0.300), while CAD group resulted in a significantly larger minimum occlusal clearance in the designed occlusal contact area (139.5 ± 52.3 vs. 99.8 ± 43.8 µm; P = 0.043). Both design methods had similar mean and minimum occlusal clearances by the OR method (P > 0.05). For the evaluation in the master casts, both design techniques had similar mean and minimum occlusal clearances, number and distribution of occlusal contacts, and lateral interference ratios (P > 0.05). CONCLUSION: Occlusal contact and clearance of posterior implant-supported single crowns designed by the CAD method can be at least as good as those designed by the conventional wax-up method.

Establishment and evaluation of a three-dimensional quantitative analysis method of dental plaque based on intraoral scanner technique.

AIM: Quantitative dental plaque evaluation is necessary for clinical and scientific work. This study aimed to examine the reliability of this 3D image analysis method by digitally analysing the colour 3D images obtained from an intraoral scanner, and then detecting and quantifying the plaque information and comparing it with the clinical examination results. MATERIALS AND METHODS: A total of 140 teeth from 5 subjects with a standard dentition were enrolled in this study, and plaque examination was performed at two different stages: after 24 hours without oral hygiene (T1) and after habitual brushing (T2). At each time point, the Quigley-Hein plaque index of each tooth surface was recorded separately, followed by colour 3D images obtained using an intraoral scanner, and image analysis and calculation using Geomagic Wrap 2021. RESULTS: It was found that the percentage of plaque staining area calculated from the 3D image analysis correlated well with the plaque index recorded during the clinical examination: the Spearman correlation coefficients were 0.9136 and 0.9061 (p<0.001) for all tooth surfaces at T1 and T2, respectively. The measurements of the three investigators were in good agreement, with intraclass correlation coefficients of 0.989 and 0.992 (P<0.001) for the vestibular and lingual surfaces at T1, and 0.964 and 0.983 (P<0.001) for the vestibular and lingual surfaces at T2. CONCLUSION: In this study, we initially developed a digital 3D evaluation system of dental plaque suitable for research and clinical practice and demonstrated its reliability.

Morphological design of occlusal wear facets for the mandibular first molar crown using different bite registration methods.

PURPOSE: To compare the accuracy of occlusal wear facet morphology designed using different bite registration methods for mandibular first molar crowns. MATERIALS AND METHODS: The posterior teeth and intraoral intercuspal occlusions of 12 participants were scanned. The abutment shape of the mandibular first molars for complete crowns was virtually designed, and the anatomic coping design method was used to design crowns. In the anatomic coping design, digital wax patterns were constructed by elevating the wear facets on the original surface of the first molars and then adjusting the facets with 2 types of virtual occlusions determined by buccal bite registration (BBR) or segmented tooth registration (STR) methods, where the displacement of teeth under bite force was considered (STR) or not (BBR). The occlusal distance between the original wear facets and the antagonists as well as 3D deviations between the facets on the designed crowns and on the surfaces of the original teeth were measured. Paired-samples t-test was used to analyze the results (α = 0.05). RESULTS: Regarding occlusal distance, the mean 3D deviation and the root mean square (RMS) values of BBR were greater than those of the STR groups (p < 0.001 and p = 0.008). The mean 3D deviations of the crowns of the BBR and STR groups were 0.19 ±0.04 mm and 0.14 ±0.06 mm, respectively and the RMS values were 0.22 ±0.03 mm and 0.18 ±0.04 mm (p < 0.001), respectively. CONCLUSIONS: The morphology of occlusal wear facets of mandibular first molar crowns designed with the occlusion constructed using the segmented tooth registration method are more coincident with the original morphology.

Surface Characteristics and Flexural Strength of Porous-Surface Designed Zirconia Manufactured via Stereolithography.

PURPOSE: To design and fabricate zirconia bars with porous surfaces using stereolithography and evaluate their surface characteristics and flexural strengths. MATERIALS AND METHODS: Five groups of zirconia bars (20 mm × 4 mm × 2 mm) with interconnected porous surfaces were designed and manufactured: (i) 400-µm pore size and 50% porosity (D400-P50 group), (ii) 400-µm pore size and 30% porosity (D400-P30 group), (iii) 200-µm pore size and 50% porosity (D200-P50 group), (iv) 200-µm pore size and 30% porosity (D200-P30 group), and (v) 100-µm pore size and 30% porosity (D100-P30 group). Zirconia bars without a porous surface (NP) were used as controls. The surface topographies and pore structures were investigated using scanning electron microscopy and three-dimensional laser microscopy. The printed porosity was calculated using the Archimedes method. Fifteen specimens from each group were subjected to a three-point bending test according to the ISO 6872:2015 standard. A Weibull analysis was performed, and the fractured surfaces were examined using scanning electron microscopy. RESULTS: Zirconia bars with porous surfaces were designed and successfully manufactured. The designed pore size, porosity, and shape of the printed pores were approximately achieved for all the porous surfaces. The flexural strength of the control group was significantly higher than those of the groups with porous surfaces (p < 0.001). For the same porosity, groups with a pore size of 400 µm exhibited a lower flexural strength than the other groups (p<0.001). Additionally, for the same pore-size design, the flexural strengths of group D400-P50 and D400-P30 exhibited no significant differences (p = 0.150), while the flexural strengths of D200-P30 were significantly higher than that of the D200-P50 group (p = 0.043). The control group and D400-P50 group had higher Weibull moduli than the other groups. The fractography of the specimens with porous surfaces indicated more than one crack origin, mainly owing to defects, including pores and cracks. CONCLUSION: Zirconia bars with porous surfaces were successfully designed and fabricated using the stereolithography technique. Although porous surfaces may be advantageous for osteogenesis, the porous-surface design can reduce the flexural strength of the printed zirconia bars. By reducing the pore size, controlling the porosity, and improving the printing accuracy, a higher strength can be achieved.

The accuracies of three intraoral scanners with regard to shade determination: An in vitro study.

PURPOSE: To compare the accuracies of three intraoral scanners for shade determination function in vitro, and to preliminarily investigate the shade-matching characteristics of the three intraoral scanners. MATERIALS AND METHODS: The shade of the middle third region of each shade tab on the Vita Classical A1-D4 shade guide (VC) was measured with a spectrophotometer (Vita Easyshade V, VE) and three intraoral scanners, including CEREC Omnicam (OM), 3Shape TRIOS 3 (T3), and TRIOS 4 (T4). A conversion table between VC values and CIELAB values was established from the database of VE to analyze the trueness. The reproducibility of the instruments was then compared by repeating the measurements five times. RESULTS: The mean color difference for each instrument was highest in the OM, followed by the T4, and lowest in the T3 and VE, respectively. The L* and a* value for OM, and the b* value for T4, were significantly different from those for VE (p <0.05). The reproducibility of the instrument was highest in the VE (Fleiss' kappa: 0.95), followed by the T3 (Fleiss' kappa: 0.89), T4 (Fleiss' kappa: 0.87), and OM (Fleiss' kappa: 0.78). CONCLUSIONS: Of the three intraoral scanners, the trueness was best on the T3. The reproducibility of all the instruments was excellent.

Accuracy of a chairside, fused deposition modeling three-dimensional-printed, single tooth surgical guide for implant placement: A randomized controlled clinical trial.

PURPOSE: To compare the accuracy of chairside, fused deposition modeling (FDM) three-dimensional (3D)-printed surgical guides with that of stereolithographic guides for implant placement in single edentulous sites within a clinical setting. MATERIALS AND METHODS: A total of 28 participants with 30 single posterior edentulous sites were included. The sites were randomized into a FDM 3D-printed surgical guide group (test) or stereolithographic guide group (control) of equal size (n = 15). In both groups, digital implant planning was performed using data from cone beam-computed tomography and intraoral scans. The test group's surgical guides were fabricated using a chairside, FDM 3D-printer; those in the control group were fabricated using a light-curing 3D-printer. Postoperative intraoral scans were used to obtain the 3D position of the implants. Compared to preoperative design, the angular, 3D, mesiodistal, buccolingual and apicocoronal deviations at the implant shoulder and apex were recorded. RESULTS: The workflow for the design and chairside fabrication of implant guides was established. The mean angular deviations of the test and control group were (4.23 ± 2.38) ° and (4.13 ± 2.42) ° (p > .05), respectively. The respective 3D deviations at the implant shoulder were (0.70 ± 0.44) mm and (0.55 ± 0.27) mm (p > .05); those at the implant apex were (1.25 ± 0.61) mm and (1.11 ± 0.54) mm (p > .05). The mesiodistal, buccolingual, and apicocoronal deviations at the implant shoulder and apex did not significantly differ between the groups (p > .05). CONCLUSIONS: Implants for single posterior edentulous spaces were placed as accurately with the test guide as with the control. Further research under more complex situations involving multiple missing teeth is needed.

Evaluation of accuracy and characteristics of tooth-color matching by intraoral scanners based on Munsell color system: an in vivo study.

To compare the accuracy of visual and instrumental methods for tooth-color matching based on three attributes in the Munsell color system and to investigate the characteristics of intraoral scanners for tooth-color matching. Shades of the cervical, middle, and incisal third region of 130 maxillary anterior teeth were matched visually by an experienced prosthodontist (EP) using Vita classical A1-D4 (VC) and Vita System 3D-Master (V3D) shade guides, and digitally by a spectrophotometer (Vita Easyshade V, VE) and two intraoral scanners (3Shape TRIOS 3, T3; TRIOS 4, T4). VE was used as a reference. The reproducibility of the three test groups was examined by repeating the measurements in triplicate. The overall trueness of the three test groups (from high to low) was T3 > EP > T4 for VC values (p < 0.01), and T3, EP > T4 (p < 0.01) for V3D. The trueness of T3 in incisal regions was lower than cervical and middle regions. When hue or lightness was correct, the mismatched chroma in test groups was smaller than VE (p < 0.01). The repeatability of EP was the poorest (p < 0.01). The color-matching trueness of T3 was higher than EP and T4. The reproducibility of intraoral scanners was better than visual methodology.

Design parameters of polylactic acid custom trays manufactured by fused deposition modeling for partial edentulism: Consideration of the accuracy of the definitive cast.

STATEMENT OF PROBLEM: The effects of design parameters of polylactic acid (PLA) custom trays manufactured by fused deposition modeling (FDM) on the accuracy of partially edentulous definitive casts have not been thoroughly explored. PURPOSE: The purpose of this in vitro study was to explore the effects of the impression gap and base thickness of FDM-printed PLA custom trays on the accuracy of maxillary and mandibular definitive casts with Kennedy class II, modification I partial edentulism and to optimize these 2 design parameters. MATERIAL AND METHODS: Custom trays with a 1-mm, 2-mm, or 3-mm impression gap and 1-mm, 1.5-mm, or 2-mm base thickness were designed on a pair of maxillary and mandibular resin casts and printed with PLA materials by using an FDM printer. Two-step silicone impressions were made by using these custom trays or stock metal trays on resin casts. Digital scans of definitive casts from these impressions were aligned one by one with those of resin casts. Three-dimensional deviations of the tooth area, mucosal area, and overall area were analyzed by using root mean square (RMS) as a metric. Two-way and 1-way analyses of variance with the RMSs as the dependent variable were carried out (α=.05). RESULTS: The accuracy of definitive casts from custom trays with a 2.0-mm or 3.0-mm impression gap and 1.5-mm or 2.0-mm base thickness was significantly better than that of definitive casts from custom trays with a 1.0-mm impression gap or 1.0-mm base thickness and was not significantly different from that of definitive casts from stock metal trays. CONCLUSIONS: Considering the accuracy of definitive casts, the optimal base thickness of FDM-printed PLA custom trays was 1.5 mm or 2.0 mm and the optimal impression gap was 2.0 mm or 3.0 mm for Kennedy class II, modification I partial edentulism.

Design of occlusal wear facets of fixed dental prostheses driven by personalized mandibular movement.

STATEMENT OF PROBLEM: Existing virtual articulators simulate mandibular movement by using various parameters and are used to design restorations. However, they are not able to reproduce actual patient movements, and the designs of occlusal wear facets by them and by personalized mandibular movement have not been compared. PURPOSE: The purpose of this clinical study was to establish a clinical application protocol for a virtual articulator based on previous research and to evaluate the accuracy of the occlusal wear facets designed by it. MATERIAL AND METHODS: The gypsum casts of 12 participants were scanned with a cast scanner as the original data. A single crown, 3-unit splinted crowns, a 5-unit fixed partial denture, and a fixed complete denture were virtually prepared on the digital mandibular casts by using the Geomagic Studio 2013 software program. High points were created at the wear facets, and corresponding digital wax patterns with occlusal interferences were generated. The exocad software program was used to design corresponding restorations with the copy method. Static (STA restoration) and dynamic (DYN restoration) occlusal adjustments were carried out with the built-in virtual articulator. The mandibular movements of participants were recorded by the novel virtual articulator system, and the occlusal surfaces of the digital wax patterns were adjusted (FUN restoration). The restorations adjusted with the 3 methods were compared with the original data. The mean value and root mean square (RMS) of 3D deviation and positive volumes (V+) in the occlusal direction were measured. Depending on the normality, 1-way ANOVA and the Kruskal-Wallis test were used to analyze the influence of occlusal surface design methods on the morphology of occlusal wear facets (α=.05). RESULTS: The mean deviation of the 4 kinds of STA restorations ranged from 0.19 mm to 0.22 mm, the DYN restorations from 0.13 mm to 0.17 mm, and the FUN restorations from 0.03 mm to 0.09 mm. A significant difference was found between the STA and FUN restorations of the 3-unit splinted crowns and 5-unit fixed partial dentures (Ρ=.013, Ρ=.021). The mean values of 3D deviation and V+ decreased from the STA group to the DYN group and then to the FUN group. The RMS and V+ were statistically similar (Ρ>.05). CONCLUSIONS: The preliminary results of the study indicate that the FUN 3-unit splinted crowns and 5-unit fixed partial dentures designed with the self-developed virtual articulator were better than the STA restorations. The FUN restorations were more coincident with the morphology of the wear facets on the original teeth.