Comparison of denture tooth movement between CAD-CAM and conventional fabrication techniques
Comparison of denture tooth movement between CAD-CAM and conventional fabrication techniques
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DOI：
10.1016/j.prosdent.2017.02.009
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发表时间：
2018-01-01
影响因子：
4.6
通讯作者：
Kattadiyil, Mathew T.
中科院分区：
文献类型：
--
作者：
Goodacre, Brian J.;Goodacre, Charles J.;Kattadiyil, Mathew T.
问题陈述。计算机辅助设计和计算机辅助制造（CAD-CAM）与传统义齿加工技术比较的数据缺乏。本体外研究的目的是比较包装-压牙、流体树脂、注射、CAD-CAM结合和CAD-CAM整体制造假牙的技术，以确定哪种工艺生产出最准确和可复制的义齿。材料和方法。共评估50个义齿，5组各10个。以预聚合聚甲基丙烯酸甲酯为原料，制备了一副主义齿。对于传统的加工技术（包装-压制，流体树脂和注射），制作了一个总义齿的聚乙烯醇硅氧烷腻子模具，其中放置义齿并注入熔融蜡。对每个蜡饰义齿的浮雕表面进行激光扫描，得到标准镶嵌语言（STL）格式文件。CAD-CAM义齿包括2个亚组：将义齿粘接在磨铣后的义齿基托内的CAD-CAM粘接义齿和将义齿磨铣后作为义齿基托一部分的CAD-CAM整体义齿。所有标本制作完成后，水化24小时，激光扫描浮雕表面。采用表面匹配软件对每个义齿的预处理和后处理扫描文件进行叠加。测量在64个位置进行，允许评估义齿在颊，舌，中-远端和咬合方向的运动。使用中位数和四分位数范围值来评估准确性和再现性。采用Levene和Kruskal-Wallis方差分析来评价处理技术之间的差异（alpha= 0.05）。CAD- cam整体技术是最精确的，其次是流体树脂，CAD- cam粘合，包装-压制和注射。CAD-CAM整体技术的可重复性最高，其次是包装-压制、CAD-CAM粘合、注射和流体树脂。在处理过程中进行压缩的技术与不进行压缩的技术相比，显示出积极的咬合牙齿运动增加。CAD-CAM整体义齿产生了测试技术的准确性和可重复性的最佳组合。本研究的结果表明，根据加工技术的不同，可以预期不同数量的牙齿运动。然而，这些差异的临床意义尚不清楚。
Statement of problem. Data comparing the denture tooth movement of computer-aided design and computer-aided manufacturing (CAD-CAM) and conventional denture processing techniques are lacking.Purpose. The purpose of this in vitro study was to compare the denture tooth movement of pack-and press, fluid resin, injection, CAD-CAM-bonded, and CAD-CAM monolithic techniques for fabricating dentures to determine which process produces the most accurate and reproducible prosthesis.Material and methods. A total of 50 dentures were evaluated, 10 for each of the 5 groups. A master denture was fabricated and milled from prepolymerized poly(methyl methacrylate). For the conventional processing techniques (pack-and-press, fluid resin, and injection) a polyvinyl siloxane putty mold of the master denture was made in which denture teeth were placed and molten wax injected. The cameo surface of each wax-festooned denture was laser scanned, resulting in a standard tessellation language (STL) format file. The CAD-CAM dentures included 2 subgroups: CAD-CAM-bonded teeth in which the denture teeth were bonded into the milled denture base and CAD-CAM monolithic teeth in which the denture teeth were milled as part of the denture base. After all specimens had been fabricated, they were hydrated for 24 hours, and the cameo surface laser scanned. The preprocessing and postprocessing scan files of each denture were superimposed using surface-matching software. Measurements were made at 64 locations, allowing evaluation of denture tooth movement in a buccal, lingual, mesial-distal, and occlusal direction. The use of median and interquartile range values was used to assess accuracy and reproducibility. Levene and Kruskal-Wallis analyses of variance were used to evaluate differences between processing techniques (alpha=.05).Results. The CAD-CAM monolithic technique was the most accurate, followed by fluid resin, CAD CAM-bonded, pack-and-press, and injection. CAD-CAM monolithic technique was the most reproducible, followed by pack-and-press, CAD-CAM-bonded, injection, and fluid resin. Techniques involving compression during processing showed increased positive occlusal tooth movement compared with techniques not involving compression.Conclusions. CAD-CAM monolithic dentures produced the best combination of accuracy and reproducibility of the tested techniques. The results from this study demonstrate that varying amounts of tooth movement can be expected depending on the processing technique. However, the clinical significance of these differences is unknown.