Digital technology has changed various aspects of the clinical dentistry. The intraoral scanner and Computer-aided design / Computer-aided manufacturing (CAD-CAM) technology are widely used in fabricating fixed prostheses and in implant surgery. These technologies greatly improved the efficiency of clinical and laboratory procedures. With all newly introduced software, devices, and clinical studies, digital technology has been actively applied in removable prostheses. It is now possible to fabricate the removable prostheses more quickly and easily through subtractive and additive manufacturing. Various clinical and laboratory protocols were introduced by many manufacturers. The purpose of this review is to summarize the literature on digital technology for fabricating complete denture with current status and future perspectives.
Journal of Dental Rehabilitation and Applied Science
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v.25
no.3
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pp.243-253
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2009
This report described a technique utilizing a computer-aided design (CAD) /computer-aided machining (CAM) - guided surgical implant placement and prefabricated fixed complete denture for an immediately loaded restoration. A patient with an edentulous maxilla and mandible received 6 implants in maxilla and 6 implants in the mandible using CAD/CAM surgical templates. Prefabricated provisional maxillary and mandibular implant supported fixed prostheses were connected immediately after implant installation. Provisional prostheses were evaluated for aesthetics, function during 6 months. Definitive prostheses were fabricated.
Journal of Dental Rehabilitation and Applied Science
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v.22
no.1
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pp.75-87
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2006
The purpose of this study was to investigate the effects of prostheses misfit, cantilever on the stress distribution in the implant components and surrounding bone using three dimensional finite element analysis. Two standard 3-dimensional finite element models were constructed: (1) 3 ITI implant supported, 3-unit fixed partial denture and (2) 3 ITI implant supported, 3-unit fixed partial denture with a distal cantilever. variations of the standard finite element models were made by placing a $100{\mu}m$ or $200{\mu}m$ gap between the fixture, the abutment and the crown on the second premolar and first molar. Total 14 models were constructed. In each model, 244 N of vertical load and 244 N of $30^{\circ}$ oblique load were placed on the distal marginal ridge of the distal molar. von Mises stresses were recorded and compared in the crowns, abutments, crestal compact bones, and trabecular bones. The results were obtained as follows: 1. In the ITI implant system, cement-retained prostheses showed comparatively low stress distributions on all the implant components and fixtures regardless of the misfit sizes under vertical loading. The stresses were increased twice under oblique loading especially in the prostheses with cantilever, but neither showed the effects of misfit size. 2. Under the oblique loading and posterior cantilever, the stresses were highly increased in the crestal bones around ITI implants, but effects of misfit were not shown. Although higher stresses were shown on the apical portion of trabecular bones, the effects by misfit were little and the stresses were increased by the posterior cantilever. 3. When the cement loss happened in the ITI implant supported FPD with misfit, the stresses were increased in the implant componets and supporting structures.
Glucker, Carolin;Rauch, Angelika;Hahnel, Sebastian
The Journal of Advanced Prosthodontics
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v.12
no.1
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pp.15-21
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2020
PURPOSE. The aim of the current study was to analyze treatment concepts of a cohort of German dentists for planning, fabrication, and maintenance of implant-supported fixed and removable restorations. MATERIALS AND METHODS. A questionnaire including queries about experiences with implant-supported restorations as well as prosthetic and maintenance treatment concepts for supplying patients with fixed and removable implant-supported prosthetic restorations was developed and sent to 350 dental offices registered in the municipal area of Leipzig, Germany. RESULTS. An overall total of 62 returned questionnaires were included in the analyses, which relates to a response rate of 17.7%. Participating dentists were more involved in the prosthetic aspects of implant dentistry rather than surgery, while prosthetic concepts such as backward planning, digital processing, and application of all-ceramic materials were not commonly performed. Simple attachments were preferred over complex retention systems in removable implant-supported restorations. Tooth/implant-supported fixed denture prostheses as well as removable denture prostheses with supporting posterior implants were not regarded as a favorable treatment option. CONCLUSION. Within the limitations of the study, the data indicate that dentists favor simple and conventional treatment approaches in implant prosthetics. Prosthetic aspects in the planning of implant-supported restorations are often neglected. Prosthetic treatment guidelines and aspects should commonly be considered in the planning phase of implant-supported prosthetic restorations, and awareness should be increased in postgraduate education.
Purpose: The purpose of this study is to analyze the factors affecting the longevity of failed prosthesis and the success rate of the prosthesis based on the data evaluated with the newly developed Korean Academy of Prosthodontics (KAP) criteria. Materials and methods: Evaluation was performed in the restored prosthesis for patients who visited the prosthodontics department of the 13 dental university hospitals and general hospitals. The status of the prosthesis was classified into four categories: Good, Fair, Bad, Worst. The success was recorded if only the category was classified in 'good'. The mean duration of failed prostheses and the success rate through Kaplan-Meier method were analyzed. Results: A total of 1,804 cases of prosthesis were evaluated: 810 cases of fixed dental prostheses (FDP), 519 cases of Removable Dental Prostheses (RDP), and 475 cases of implant prosthesis. The mean duration of failed FDP was $11.41{\pm}0.30years$ and the median was 10 years. The mean duration of failed RDP was $8.18{\pm}0.29years$ and the median was 7 years. The mean duration of failed implant prosthesis was $7.99{\pm}0.30years$ and the median was 7 years. The factors related to the failure were as follows: number of units, abutments, abutments treated with root canal, and plaque index in FDPs; treated and opposing dentition in RDPs; the number of implants, duration of use, and plaque index in implant prostheses. Conclusion: The average duration of failed prosthesis was 11.41 years for FDPs, 8.18 years for RDPs, and 7.99 years for implant prosthesis, according to the evaluation with newly developed KAP criteria.
Journal of Dental Rehabilitation and Applied Science
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v.16
no.3
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pp.221-227
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2000
Provisional fixed partial dentures(FPDs) are an important part of many prosthodontic treatment procedures. These provisional fixed prostheses must fulfill biologic, mechanical, and esthetic requirements to be considered successful. Consideration of all these factors and requirements are important because provisional resin restorations may be worn over a long period to assess the results of periodontal and endodontics therapies, and also during the restorative phase of implant reconstructive procedures. This in vitro study examined flexual strength of four resins commonly used for fixed provisional prostheses. The effects of polymerization conditions were also evaluated. The four resins tested were : Caulk Temporary bridge resin(L.D. Caulk Co. Dentsply International Millford), Jet(Lang Dental Mfg. Co. Chicago. ILL. U.S.A), Alike (Coe Laboratories. Inc. Chicago. ILL. U.S.A) and Tokuso Curefast (Coe Laboratories. Inc. Chicago. ILL. U.S.A) The test specimens were 65mm long, 14mm wide, and 3.5mm thickness. 10 specimens of four resins were cured for 15 minutes at atmospheric pressure and 10 specimens of four resins were cured at an additional pressure of approximately 20 psi. A total of 80 specimens were prepared. The flexual strength was determined by three-point bending test. Data were analysed with the Paired samples T-test and Tukey student-range test Within the limitations imposed in this study, the following conclusions can be drawn : 1. Under the condition of bench curing, Caulk Temporary bridge resin showed the highest flexual strength. In decreasing order, the flexual strength of the other materials was as follows : Jet, Tokuso Curefast, Alike, and Caulk Temporary bridge resin demonstrated significantly higher strength than other resins. 2. Under the condition of pressure curing, Jet showed the highest flexual strength. In decreasing order, the flexual strength of the other materials was as follows : Caulk Temporary bridge resin, Tokuso Curefast, and Alike. There were all statistically significant differences among four resins 3. There was a statistically significant difference between bench- and pressure-cured specimens in all four materials.
Purpose: The purpose of this study was to measure and compare the strain value exerted on the cervical area using different screw tightening protocols in implant-supported, screw-retained 3-unit prostheses. Materials and methods: Strain gauges were attached to four implants: two external and two internal. Thereafter, two study model were designed each type using acrylic resin. CAD-CAM was used to design hex and nonhex abutments for each group (EH, ENH, IH, and INH group) and Screw-cement-retained prostheses were also designed using a nonprecious base metal. Abutment was fixed with 10 Ncm torque, and the prosthesis was cemented. Screws were fixed with 30 Ncm torque using different three protocols. After 5 min, the strain gauge level was measured, and group analysis was performed (α=.05). Results: External group showed significantly lower strain values than internal group and the EH group showed significantly lower strain values than the ENH group (P<.05). There was no difference in strain value based on the types of screw tightening protocols in same group (P>.05). The IH group exhibited significantly higher strain values than the INH group and the IH group showed a significant difference in strain values based on the types of screw tightening protocols used (P<.05). Conclusion: There was no significant effect on the external type in the implant-supported, screw-retained prostheses. However, strain values were high in the internal type, and the types of screw tightening protocol significantly affected these implants.
Barbin, Thais;Silva, Leticia Del Rio;Veloso, Daniele Valente;Borges, Guilherme Almeida;Presotto, Anna Gabriella Camacho;Barao, Valentim Adelino Ricardo;Groppo, Francisco Carlos;Mesquita, Marcelo Ferraz
The Journal of Advanced Prosthodontics
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v.12
no.6
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pp.329-337
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2020
PURPOSE. To verify the influence of computer-aided design/computer-aided manufacturing (CAD/CAM) implant-supported prostheses manufactured with cobalt-chromium (Co-Cr) and zirconia (Zr), and whether ceramic application, spark erosion, and simulation of masticatory cycles modify biomechanical parameters (marginal fit, screw-loosening torque, and strain) on the implant-supported system. MATERIALS AND METHODS. Ten full-arch fixed frameworks were manufactured by a CAD/CAM milling system with Co-Cr and Zr (n=5/group). The marginal fit between the abutment and frameworks was measured as stated by single-screw test. Screw-loosening torque evaluated screw stability, and strain analysis was explored on the implant-supported system. All analyses were performed at 3 distinct times: after framework manufacturing; after ceramic application in both materials' frameworks; and after the spark erosion in Co-Cr frameworks. Afterward, stability analysis was re-evaluated after 106 mechanical cycles (2 Hz/150-N) for both materials. Statistical analyses were performed by Kruskal-Wallis and Dunn tests (α=.05). RESULTS. No difference between the two materials was found for marginal fit, screwloosening torque, and strain after framework manufacturing (P>.05). Ceramic application did not affect the variables (P>.05). Spark erosion optimized marginal fit and strain medians for Co-Cr frameworks (P<.05). Screw-loosening torque was significantly reduced by masticatory simulation (P<.05) regardless of the framework materials. CONCLUSION. Co-Cr and Zr frameworks presented similar biomechanical behavior. Ceramic application had no effect on the biomechanical behavior of either material. Spark erosion was an effective technique to improve Co-Cr biomechanical behavior on the implant-supported system. Screw-loosening torque was reduced for both materials after masticatory simulation.
Purpose: The most important factor in longevity studies of dental prostheses is objective and consistent evaluation of the prosthesis. The Korean Academy of Prosthodontics suggested developing a standardized method for longevity studies of dental prostheses. The purpose of this study is to evaluate previously-used criteria and to develop new criteria, in the form of a procedure flowchart and an evaluation sheet. These new criteria may be able to provide a unified standard for future longevity studies of dental prostheses. Materials and methods: A literature review was performed about the evaluation of dental prostheses. Taking into account the strengths and weaknesses of previously used criteria, a novel, intuitive and objective method was developed for assessment of dental prostheses. Then, a pilot survey was performed with the newly developed flowchart and evaluation sheet to determine problems and implement possible improvements. Results: Thirty cases of fixed dental prosthesis (FDP), 25 cases of removable dental prosthesis (RDP), and 13 cases of implant supported prosthesis (ISP) were evaluated. The average life expectancy estimate was 12.82 years for FDP, 5.96 years for RDP, and 4.82 years for ISP with Kaplan-Meier survival analysis. Additionally, possible improvements discovered by the pilot survey were reflected in the flowchart and evaluation sheet. Conclusion: The newly developed KAP criteria, flowchart and evaluation sheet enabled objective and consistent results in trial longevity studies of dental prostheses. It is expected that future studies will not only use the KAP criteria but also further improvement will be made on them.
Purpose: The purpose of this study is to evaluate the quality of dental fixed prostheses fabricated by 3DP (three-dimensional printing). Methods: Ten main models were prepared for the study. Ten specimens were printed by 3DP (3DP group). Ten specimens were fabricated by the lost wax technique and casting method to complete the control group (LWC group). The marginal fit was measured for 20 specimens. The measurement of marginal fit was performed using the silicon replica technique. Finally, the marginal fit of 10 specimens from each group was calculated. An independent sample t-test was run to see if the calculated averages for the two groups were mutually significant (α=0.05). Results: According to the experimental results, the mean marginal fit of the 3DP group was 71.9 ㎛, and the LWC group was 55.3 ㎛. The means of the two groups were found to be significantly different (p<0.001) in the results of the independent sample t-test. Conclusion: The marginal fit of fixed dental prostheses produced by 3DP technology was examined with values greater than those fabricated by traditional technology. However, as it appeared to be a value within the range of clinically acceptable range recommended by numerous studies, it was determined that clinical application would be feasible.
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