Effect of virtual cement gap settings on the marginal fit of cemented resin-ceramic crowns on implant abutments.

STATEMENT OF PROBLEM: Agreement on the perfect virtual cement space value for computer-aided design and computer-aided manufacturing (CAD-CAM) implant-supported resin-ceramic crowns with the best marginal adaptation is lacking. The range of cement gap settings in some CAD design software programs is wide (0 to 200 µm), and manufacturer recommendations regarding the best cement gap setting for certain types of ceramics is not specific. PURPOSE: The purpose of this in vitro study was to evaluate the effect of virtual cement gap settings on the marginal fit of cemented resin-ceramic crowns on implant abutments. MATERIAL AND METHODS: Thirty implant analogs and matching stock abutments were coupled and implanted into autopolymerizing acrylic resin blocks. Three groups (n=10) of resin-ceramic molar crowns with 3 different virtual cement space settings (40, 60, and 100 µm) were designed by using a CAD design software program. The crowns were cemented over their corresponding abutments under a static load by using a specially designed cementing device. A scanning electron microscope was used to measure the mean vertical marginal gap (MG) for each group, where a total of 120 measurements for each of the 3 groups (12 sites per crown and 10 crowns per group) were evaluated. One-way analysis of variance and the post hoc Tukey pairwise comparison tests were used to analyze the data (α=.05). RESULTS: A significant difference (P<.001) was found between the MG values of the resin-ceramic implant-supported crowns fabricated by using the 3 cement space settings. The smallest MG was obtained with the 60-µm setting as compared with the 40-µm and 100-µm settings. CONCLUSIONS: A limited inverse relation was found between the MGs of CAD-CAM-fabricated resin-ceramic implant-supported crowns and the cement gap settings in the exocad software program. The smallest MGs were obtained when a 60-µm cement space value was used (P<.001).

Suicide by burns: a tragic end.

Through the period of 20 months from May 1995 to December 1996, of the 759 patients who presented to the burn unit of Ain Shams University in Cairo Egypt, 23 had attempted suicide by self-immolation. 21 patients were females and 2 were males. The total body surface area burn ranged between 15 to 95% with a mean of 45% and the mortality rate was 73%. Kerosene was used by all the patients to ignite the fire.