Virtual implant scan body switch by using computer-aided design programs avoiding the need of obtaining a new intraoral implant digital scan: A novel protocol.

OBJECTIVE: The present manuscript describes a technique to virtually switch an implant scan body eliminating the need of obtaining a new intraoral implant digital scan. CLINICAL CONSIDERATIONS: Implant scan bodies assist on transferring the 3-dimensional position of the implants into the virtual definitive implant cast. However, if a different implant part is desired during the designing procedures of the implant restoration such as selecting a different implant abutment of varying height, angulation, or manufacturer, a new intraoral implant digital scan with the specific implant scan body is required. CONCLUSIONS: This novel protocol aims to reduce possible complications that require capturing a new intraoral implant digital scan, facilitate prostheses design modifications after the obtention of the definitive intraoral implant digital scan, and to ease the manufacturing procedures. CLINICAL SIGNIFICANCE: The novel technique may provide a solution for virtually switch implant scan bodies for fabricating implant-supported single crowns or short-span prostheses. Additional studies are needed before its clinical implementation.

Influence of print orientation on the accuracy (trueness and precision) of diagnostic casts manufactured with a daylight polymer printer.

STATEMENT OF PROBLEM: Print orientation may affect the manufacturing accuracy of vat-polymerized diagnostic casts. However, its influence should be analyzed based on the manufacturing trinomial (technology, printer, and material) and printing protocol used to manufacture the casts. PURPOSE: The purpose of this in vitro study was to measure the influence of different print orientations on the manufacturing accuracy of vat-polymerized polymer diagnostic casts. MATERIAL AND METHODS: A standard tessellation language (STL) reference file containing a maxillary virtual cast was used to manufacture all specimens using a vat-polymerization daylight polymer printer (Photon mono SE. LCD 2K) and a model resin (Phrozen Aqua Gray 4K). All specimens were manufactured using the same printing parameters, except for print orientation. Five groups were created depending on the print orientation: 0, 22.5, 45, 67.5, and 90 degrees (n=10). Each specimen was digitized using a desktop scanner. The discrepancy between the reference file and each of the digitized printed casts was measured using the Euclidean measurements and root mean square (RMS) error (Geomagic Wrap v.2017). Independent (unpaired) sample t tests and multiple pairwise comparisons using the Bonferroni test were used to analyze the trueness of the Euclidean distances and RMS data. Precision was assessed using the Levene test (α=.05). RESULTS: In terms of Euclidean measurements, significant differences in trueness and precision values were found among the groups tested (P<.001). The 22.5- and 45-degree groups resulted in the best trueness values, and the 67.5-degree group had the lowest trueness value. The 0- and 90-degree groups led to the best precision values, while the 22.5-, 45-, and 67.5-degree groups showed the lowest precision values. Analyzing the RMS error calculations, significant differences in trueness and precision values were found among the groups tested (P<.001). The 22.5-degree group had the best trueness value, and the 90-degree group resulted in the lowest trueness value among the groups. The 67.5-degree group led to the best precision value, and the 90-degree group to the lowest precision value among the groups. CONCLUSIONS: Print orientation influenced the accuracy of diagnostic casts fabricated by using the selected printer and material. However, all specimens had clinically acceptable manufacturing accuracy ranging between 92 µm and 131 µm.

Implant-Supported Fixed Partial Dentures with Posterior Cantilevers: In Vitro Study of Mechanical Behavior.

Rehabilitation with dental implants is not always possible due to the lack of bone quality or quantity, in many cases due to bone atrophy or the morbidity of regenerative treatments. We find ourselves in situations of performing dental prostheses with cantilevers in order to rehabilitate our patients, thus simplifying the treatment. The aim of this study was to analyze the mechanical behavior of four types of fixed partial dentures with posterior cantilevers on two dental implants (convergent collar and transmucosal internal connection) through an in vitro study (compressive loading and cyclic loading). This study comprised four groups (n = 76): in Group 1, the prosthesis was screwed directly to the implant platform (DS; n = 19); in Group 2, the prosthesis was screwed to the telescopic interface on the implant head (INS; n = 19); in Group 3, the prosthesis was cemented to the telescopic abutment (INC; n = 19); and in Group 4, the prosthesis was cemented to the abutment (DC; n = 19). The sets were subjected to a cyclic loading test (80 N load for 240,000 cycles) and compressive loading test (100 KN load at a displacement rate of 0.5 mm/min), applying the load until failure occurred to any of the components at the abutment-prosthesis-implant interface. Subsequently, an optical microscopy analysis was performed to obtain more data on what had occurred in each group. Results: Group 1 (direct screw-retained prosthesis, DS) obtained the highest mean strength value of 663.5 ± 196.0 N. The other three groups were very homogeneous: 428.4 ± 63.1 N for Group 2 (INS), 486.7 ± 67.8 N for Group 3 (INC), and 458.9 ± 38.9 N for Group 4 (DC). The mean strength was significantly dependent on the type of connection (p < 0.001), and this difference was similar for all of the test conditions (cyclic and compressive loading) (p = 0.689). Implant-borne prostheses with convergent collars and transmucosal internal connections with posterior cantilevers screwed directly to the implant connection are a good solution in cases where implant placement cannot avoid extensions.