RESUMO
Inadequate restorative space can result in mechanical, biologic, and esthetic complications with full-arch fixed implant-supported prosthetics. As such, clinicians often reduce bone to create clearance. The aim of this paper was to present a protocol using stacking computer-aided design/computer-assisted manufacturing (CAD/CAM) guides to minimize and accurately obtain the desired bone reduction, immediately place prosthetically guided implants, and load a provisional that replicates predetermined tissue contour. This protocol can help clinicians minimize bone reduction and place the implants in an ideal position that allows them to emerge from the soft tissue interface with a natural, pink-free zirconia fixed dental prostheses.
Assuntos
Implantes Dentários , Desenho Assistido por Computador , Humanos , Estudo de Prova de Conceito , ZircônioRESUMO
A method for digital fabrication of an implant-supported soft tissue graft stent to protect, shape, and ensure intimate adaptation of the complete arch graft to the periosteum surrounding dental implants is described. To fabricate the stent, an extraoral scanner was used to convert the implant cast into digital data. Dental design software was then used to fabricate the stent, which is produced by 3-dimensional (3D) printing. Due to the lack of long-term biocompatible 3D printing material, the stent was duplicated in bisacryl resin. The patient reported more comfort and stability with the implant-supported stent than the conventional stent received following a previous debulking surgical procedure.
Assuntos
Desenho Assistido por Computador , Planejamento de Prótese Dentária , Reconstrução Mandibular , Impressão Tridimensional , Transplante de Pele/métodos , Stents , Adulto , Placas Ósseas , Técnica de Moldagem Odontológica , Prótese Dentária Fixada por Implante , Fíbula/transplante , Humanos , Masculino , Retalhos CirúrgicosRESUMO
OBJECTIVES: To examine the effects of composite type (bulk-fill/conventional) and placement (4-mm bulk/2-mm increments) on internal marginal adaptation of Class I preparations. METHODS: Cylindrical, Class I, 4-mm×4-mm preparations were made on 50 recently extracted human molars and restored using either a bulk-fill (SureFil SDR Flow (SDR), Quixx (QX), SonicFill (SF), Tetric EvoCeram Bulk (TEC)) or a conventional composite designed for 2-mm increments (Filtek Supreme Ultra (FSU)). Restorations were placed in 1 or 2 increments using the manufacturer's bonding agent and curing light (n=5). Teeth were sectioned occluso-gingivally and dye was placed on the internal margin and visually examined by 3 observers. Gap-free marginal lengths were analysed within three different regions of the sectioned tooth: enamel, mid-dentine, and pulpal floor. RESULTS: Marginal integrity was unaffected by placement method. Bulk-placement demonstrated significantly fewer gap-free margins at the pulpal floor than in enamel, for all materials except SDR. Greater percentages of gap-free margins were found within the mid-dentine than at the pulpal floor for FSU. QX had more gap-free margins in enamel compared with the mid-dentine. Proportion of gap-free margins within enamel and mid-dentine was not significantly different for any incrementally placed product. Excluding FSU, gap-free margins within enamel were significantly greater than at the pulpal floor. Notably, significantly more gap-free margins were found within mid-dentine than at the pulpal floor for SF. CONCLUSIONS: No significant differences in gap-free margins were found between placement methods within a given product per location. Except for SDR, percentage of gap-free margins was significantly lower at the pulpal floor interface than at the enamel interface for bulk-fill.