Evaluation of die trim morphology made by CAD-CAM technology.

STATEMENT OF PROBLEM: The die contour can affect the emergence profile of prosthetic restorations. However, little information is available regarding the congruency between a stereolithographic (SLA) die and its corresponding natural tooth. PURPOSE: The purpose of this vitro study was to evaluate the shapes of SLA die in comparison with the subgingival contour of a prepared tooth to be restored with a ceramic crown. MATERIAL AND METHODS: Twenty extracted human teeth, 10 incisors, and 10 molars, were disinfected and mounted in a typodont model. The teeth were prepared for a ceramic restoration. Definitive impressions were made using an intraoral scanner from which 20 SLA casts with removable dies were fabricated. The removable dies and corresponding human teeth were digitized using a 3-dimensional desktop scanner and evaluated with computer-aided design software. The subgingival morphology with regard to angle, length, and volume at the buccolingual and mesiodistal surfaces and at zones A, B, C, and D were compared. Data were first analyzed with repeated measures analysis of variance (ANOVA), using locations (buccolingual and mesiodistal), zones (A, B, C, and D), and model type (SLA and Natural) as within-subject factors and tooth type (molar and incisor) as the between-subject factor. Post hoc analyses were performed to investigate the difference between natural teeth and corresponding SLA models, depending upon the interaction effect from the repeated measures ANOVA (α=.05). RESULTS: For angle analysis, the incisor group demonstrated a significant difference between the natural tooth and SLA die on the buccolingual surfaces (P<.05), whereas the molar group demonstrated a significant difference at the mesiodistal surfaces (P<.05). For the evaluation of length and volume, the incisor group showed significant differences in zone D on both the buccolingual (P<.05) and the mesiodistal (P<.05) surfaces. However, significant differences in zones C (P<.05) and D (P<.05) on the buccolingual surfaces and in all zones on the mesiodistal surfaces were observed in the molar group. CONCLUSIONS: For the comparison of angles, SLA dies did not replicate the subgingival contour of natural teeth on the buccolingual surfaces of the incisal groups. For the comparison of length and volume, SLA dies were more concave and did not replicate the subgingival contour of natural teeth in the incisal and molar groups.

Comparison of the Kois Dento-Facial Analyzer System with an earbow for mounting a maxillary cast.

STATEMENT OF PROBLEM: The Kois Dento-Facial Analyzer System (KDFA) is used by clinicians to mount maxillary casts and evaluate and treat patients. Limited information is available for understanding whether the KDFA should be considered as an alternative to an earbow. PURPOSE: The purpose of this study was to evaluate maxillary casts mounted using the KDFA with casts mounted using Panadent's Pana-Mount Facebow (PMF). Both articulation methods were compared against a lateral cephalometric radiograph. MATERIAL AND METHODS: Fifteen dried human skulls were used. Lateral cephalometric radiographs and 2 maxillary impressions were made of each skull. One cast from each skull was mounted on an articulator by means of the KDFA and the other by using the PMF. A standardized photograph of each articulation was made, and the distance from the articular center to the incisal edge position and the occlusal plane angle were measured. The distance from condylar center to the incisal edge and the occlusal plane angle were measured from cephalometric radiographs. Finally, the 3-dimensional position of each articulation was determined with a Panadent CPI-III. A randomized complete block design analysis of variance (RCBD) and post hoc tests (Tukey-Kramer HSD) (α=.05) were used to evaluate the occlusal plane angle and axis-central incisor distance. A paired 2-sample t test for means (α=.05) was used to compare the X, Y, and Z distance at the right and left condyle. RESULTS: The KDFA and PMF mounted the maxillary cast in a position that was not statistically different from the skull when comparing the occlusal plane angle (P=.165). Both the KDFA and the PMF located the maxillary central incisor edge position in a significantly different position compared with the skull (P=.001) but were not significantly different from each other. The 3-dimensional location of the maxillary casts varied at the condyles by approximately 9 to 10.3 mm. CONCLUSION: The KDFA mounted the maxillary cast in a position that was not statistically different from the PMF when comparing the incisal edge position and the occlusal plane angle. Both the KDFA and the PMF located the maxillary incisal edge position in a significantly different position compared with the anatomic position on dried human skulls.

Accuracy of successive casts for full-arch fixed prostheses.

This clinically simulated study examined the accuracy of full-arch impression materials using successive casts reproduced from single impressions. Materials tested included a polyether polyvinyl siloxane, medium viscosity material, and putty wash. Maxillary full-arch Dentoform models were created with four abutments prepared for complete crowns. Six impressions of each material produced successive first and second generation casts. Individual cast copings were then fabricated and assembled into full-arch fixed dental prostheses. Marginal discrepancies were measured on both the casts and Dentoform. Data analysis suggests insignificant differences between successive casts. However, among second generation casts, clinically similar marginal discrepancies were exhibited. Outcomes demonstrated that second generation casts enabled fabrication and assembly of full-arch restorations that were clinically equivalent to first generation casts obtained.

Metal-ceramic interface evaluation of a gold-infiltrated alloy.

PURPOSE: The success of metal-ceramic systems partially depends on the formation of a stable bond between metal and porcelain. The purpose of this study was to investigate the porcelain/metal interface and the mechanism of interfacial bonding in a gold-infiltrated alloy (Captek). MATERIALS AND METHODS: Captek specimens with feldspathic porcelain were evaluated by optical microscopy, scanning electron microscopy (SEM), electron probe microanalysis (EPMA), X-ray diffraction (XRD), and the Schwickerath crack initiation test for metal-ceramic bond compatibility. Specimens were processed with or without Capbond, a bonding agent. A traditional metal-ceramic alloy was also analyzed with microscopy for comparative purposes. RESULTS: Optical and scanning electron micrographs of Captek specimens processed with Capbond revealed close adaptation of porcelain to the surface of the metal with sporadic nodules extending from the Captek surface. In contrast, the specimens of Captek without Capbond showed a much flatter porcelain/metal interface. Comparatively, the porcelain/metal interface of the traditional metal-ceramic crown showed greater surface roughness than the Captek specimens. No metal oxides were observed at the porcelain/metal interface of the Captek specimens with XRD. During the Schwickerath test, the Captek specimens permanently deformed, not allowing for crack initiation at the porcelain/metal interface. CONCLUSIONS: Microscopy and XRD analysis showed that micromechanical interlocking is the primary mechanism of porcelain adherence to Captek metal. The use of Capbond prior to porcelain application to Captek results in gold nodules on the surface to aid retention. Existing metal-ceramic bond compatibility standardized tests are not sufficient for evaluating Captek, primarily due to the flexibility of the material.