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Statement of problem Cement at the restorative margin after implementation of the manufacturer’s recommended procedure for cement cleanup has not been extensively evaluated. Purpose The purpose of this in vitro study was to use microcomputed tomography (μCT) to evaluate the number, volume, and width of voids left at the margin when dental cement is cleaned during the cementation process as per 2 manufacturer-prescribed methods for cement cleanup by evaluating a self-adhesive resin cement and a resin-modified glass ionomer cement. Material and methods Twenty molar Ivorine Typodont prepared teeth were scanned, and lithium disilicate crowns were milled and cemented to the prepared teeth as per the manufacturer-recommended cementation process. Two methods of cement cleanup were performed: the excess cement was tack-polymerized with a polymerization light, or a delay of 3 minutes was used for the excess cement to reach partial polymerization, and the excess cement was removed with a sharp sickle scaler. These 2 methods of cement cleanup were performed with 2 cements: a resin-modified glass ionomer cement and a self-adhesive resin. Each specimen was then scanned with a μCT machine. The buccal margin of each specimen, from mesiobuccal line angle to distobuccal line angle, was examined, and the number, volume, and width of any voids remaining at the margin open to the environment were measured. For statistical analysis, the specimens were first grouped by method of cement cleanup and then grouped by cement type. The Wilcoxon ranked sum test was implemented because of the lack of a normal distribution and the heterogeneity of the data (α=.05). Results No statistically significant difference was found in the median number of voids, median volume of voids, or median width per void between the 2 cleanup methods, irrespective of cement type (P>.05). Significant differences were found in the median number of voids, median volume of voids, and median width per void when comparing cement types, irrespective of cement cleanup methods (P Conclusions The choice of cement may be more important than the method of cement cleanup when considering voids left at the margin. Microcomputed tomography is an excellent nondestructive tool for volumetric measurements of voids at the margin.

The absolute marginal fit of CAD-CAM presintered fixed partial dentures has been poorly documented.The purpose of this in vitro study was to evaluate the marginal fit of presintered cobalt-chromium (Co-Cr) and zirconia 3-unit fixed partial dentures by using X-ray microcomputed tomography (μCT).A metal model was prepared from a typodont to receive fixed partial dentures (N=12). The maxillary first premolar and first molar were prepared with a circumferential 1.2-mm chamfer and 2-mm occlusal reduction. The dies were scanned and assigned to 1 of 2 groups to receive the prostheses made of presintered Co-Cr or presintered zirconia (n=6). Each framework was seated on its model without load application. The abutments were scanned by using μCT. A circle with 10 diameters, with a step of 18 degrees, was projected at the center of the obtained image. Absolute marginal discrepancy and marginal gap mean values were measured, and overextended and underextended margins determined. The data were analyzed by using the Levene t test and ANOVA (α=.05).No statistically significant difference was found in the marginal fit between the materials tested (P=.939). The mean values were 66 ±14 μm for Co-Cr and 61 ±12 μm for zirconia. The absolute marginal discrepancy mean value for the premolar was 69 ±12 μm and 41 ±9 μm for the molar (P.001). Overextension was predominant for both materials tested, with a higher percentage reported for the zirconia group.Presintered alloys presented clinically acceptable adaptation with a predominance of marginal overextensions.

Purpose To compare the accuracy of three commercially available intraoral scanners when imaging various dental material substrates. Materials and methods A maxillary dentate typodont model with 11 different dental material substrates was prepared and scanned using three intraoral scanners (TRIOS 3, 3Shape; CS 3600, Carestream; and Emerald S, Planmeca). The model was further scanned with a laboratory scanner (7series, Dental Wings) for reference. Files were exported in standard tessellation language format and inserted into a metrology 3D mesh software (CloudCompare). Results In terms of influence of different substrates on IOS trueness, a significant effect on the performance of TRIOS 3 and Emerald S was revealed. Concerning the accuracy of different intraoral scanners when scanning more translucent and reflective materials, pairwise comparisons revealed significant differences among scanners. In terms of complete-arch trueness and precision, pairwise comparisons revealed that TRIOS 3 had significantly higher trueness and precision compared to CS3600 and Emerald S. The complete-arch trueness and precision of CS3600 and Emerald S did not differ significantly. Conclusions Dental material substrates influenced the accuracy of all three tested scanners. The full metal crown exhibited significantly lower trueness compared to other substrates across all three scanners. For the high-translucency substrate group, TRIOS 3 exhibited significantly higher trueness compared to CS 3600. Polished and unpolished class II amalgam restorations of similar dimensions did not exhibit significant differences in trueness regardless of intraoral scanner. In terms of complete-arch accuracy, TRIOS 3 had significantly higher trueness and precision compared to CS 3600 and Emerald S. All three scanners exhibited complete-arch average accuracy below 100 μm.

Statement of problem Although studies have reported on selective laser melting (SLM)-fabricated removable partial dentures (RPDs), research addressing the trueness of SLM-fabricated RPD metal frameworks is sparse. Purpose The purpose of this in vitro study was to evaluate the trueness of powdered cobalt-chromium (Co-Cr) or titanium-6 aluminum-4 vanadium (Ti-6Al-4V) alloy frameworks for RPDs fabricated by SLM. Material and methods A digital scan of a Kennedy class II mandible typodont was obtained to design an RPD framework by using a computer-aided design (CAD) software program (denoted as CRF). Two experimental groups of frameworks were fabricated from the CRF by using SLM in alloys of Co-Cr (SLM-Co-Cr, n=6) and in Ti-6Al-4V (SLM-Ti-6Al-4V, n=6) while a control group was fabricated by using traditional lost-wax casting following stereolithography (CA-Co-Cr, n=6). In total, 18 RPD frameworks were digitally scanned (denoted as CRF), with each scan then superimposed on the CRF and evaluated for discrepancies by using a 3D analysis software program. A nonparametric Kruskal-Wallis test was performed to determine differences in trueness among groups (α=.05). Results The CA-Co-Cr group showed the highest discrepancy between CEF and CRF. Statistically significant differences were found between the CA-Co-Cr and SLM-fabricated groups (P=.03 for Co-Cr, and P=.016 for Ti-6Al-4V). However, no significant difference was found between the SLM-Co-Cr and SLM-Ti-6Al-4V groups (P=.787). Conclusions SLM-fabricated RPD frameworks exhibited higher trueness than CA-Co-Cr fabricated ones, indicating the potential of selective laser melting to produce the geometric shapes required for accurate dental restorations.

Whether cone beam computed tomography (CBCT) scans can be used for the fabrication of computer-aided design and computer-aided manufacturing (CAD–CAM) fixed dental prostheses (FDPs) is not known. The purpose of the present study was to compare the marginal fit of 3-unit zirconia FDPs fabricated by using CBCT or 3-dimensional (3D) laboratory scanning. Extracted second premolar and molar teeth in a maxillary typodont model were prepared. The first molar was removed and the typodont model was scanned with a laboratory or a CBCT scanner to generate two virtual 3D cast groups (3DL and CBCT). Forty four 3-unit zirconia FDPs were designed on virtual casts and milled. The vertical marginal discrepancy (VMD) was measured by ×100-magnification microscopy at seven locations on each abutment. A total of 616 measurements were made at 14 fixed locations in two groups of 22 specimens. The VMD data for 3DL and CBCT groups were statistically analyzed using the Mann–Whitney U test (α = 0.05). The mean VMDs on premolar ranged between 44 and 55 µm (median: 43–55 µm) in 3DL, and 74 and 100 µm (median: 72–93 µm) in CBCT; and on the molar, between 47 and 114 µm (median: 46–114 µm) in 3DL, and 91 and 162 µm (median: 93–156 µm) in CBCT. There was a significant difference between the gaps in 3DL and CBCT groups (p

Purpose: To evaluate the marginal and internal fit of endocrowns with different computer-aided design/computer-aided manufacturing (CAD-CAM) materials by measuring them with a stereomicroscope (μm). Materials and Methods: A mandibular first molar typodont tooth was prepared to receive an endocrown. The preparation was scanned using an extra-oral scanner. Endocrowns (n = 20) were fabricated using lithium disilicate (IPS e. max CAD LT block; CEREC Ivoclar Vivadent, Liechtenstein) and polyetheretherketone (PEEK) (breCAM. BioHPP®; Bredent, UK) using CAD-CAM technique. Marginal gap was evaluated using a stereomicroscope at the midpoint of all four surfaces (mid buccal, mid lingual, mid mesial, mid distal). This was followed by sectioning of the endocrowns in a sagittal plane along with the prepared tooth to evaluate the internal fit at four different points (A, B, C, D) using a stereomicroscope. Statistical analysis was performed using one-way analysis of variance test. Results: Mean values of marginal gap of lithium disilicate and PEEK endocrowns are 56.6 ± 6.1 μm and 81.3 ± 10.1 μm, respectively. Mean value internal gaps of lithium disilicate and PEEK endocrowns are 158.2 ± 11.1 μm and 199.1 ± 13 μm, respectively. Results in the present study have shown that the marginal and internal fits of lithium disilicate endocrowns are superior to that of PEEK endocrowns. Conclusions: Based on the outcomes of this in vitro study, the marginal and internal fit of lithium disilicate endocrowns is better than PEEK endocrowns. The marginal gap clinically acceptable is

Background/purpose The orthodontic aligner becomes popular worldwide in orthodontic therapy as an esthetic alternative to fixed labial braces. This study evaluated orthodontic tooth movement behavior using different aligner materials and attachment shapes for the movement of a single tooth. Materials and methods First bicuspid extracted resin typodont models were printed with a 3D printer. Three type of attachments, an ellipsoid shape (thick and thin) and a bar, were designed to fit the canine crown surface. Three types of aligner materials, Polyethylene Terephthalate enhanced with glycol (BIOSTAR) Polyethylene Terephthalate (BenQ), and Thermoplastic polyurethanes (TPU) were used to fabricate different aligners. The typodonts with aligners were sunk in a water bath to simulate canine distal movement in vivo. The canine crown, root movement, and long axis angle changes in each step were calculated and recorded. The data were analysed using a oneway ANOVA statistical method. Results Comparing the three aligners, the changes the long axis of the canine showed that the BENQ group had a smaller change in the long axis angle. The BENQ group canine involved bodily movement, but the canine movement of the BIOSTAR and TPU group involved tipping. Comparing the three attachments, the bar type attachment had more canine crown tipping in the BIOSTAR and TPU groups. The thick and thin ellipsoid-shaped attachments showed no statistical differences in tooth movement. Conclusion Attachment shape or size had little influence on the bodily movement of the tooth. A high modulus material may thus be suitable for clinical applications.

Purpose To evaluate the marginal and internal adaptation of all-ceramic crowns and inlays fabricated by different scanners of the same CAD/CAM system. Materials and methods All-ceramic crown preparations were performed on typodont maxillary first premolars, and mandibular first molars were prepared for ceramic Class II mesio-occlusal inlays. Two intraoral scanners (CEREC Bluecam and Omnicam, Dentsply Sirona) and one model scanner (CEREC inEos X5, Dentsply Sirona) were used to scan the preparations. All restorations were fabricated by milling single-feldspathic ceramic blocks (CEREC Blocks). The marginal and internal discrepancies of restorations were evaluated via micro-CT analyses. Results For linear crown measurements, the marginal gaps were 63.75 μm, 88.24 μm, and 90.89 μm for Bluecam, Omnicam, and inEos X5, respectively. For crowns at central groove areas, the maximum values for Bluecam, Omnicam, and inEos X5 were found to be 144.78 μm, 165.19 μm, and 129.49 μm, respectively. For inlays, the highest range at the midpoint of the axiopulpal line angle for Bluecam, Omnicam, and inEos X5 were determined as 138.57 μm, 184.33 μm, and 179.71 μm, respectively. In volumetric measurements, inEos X5 showed lower gap for both crowns (11.47 mm3) and inlays (5.65 mm3) compared to both intraoral scanners. These results are within a clinically acceptable range. Conclusion When all-ceramic crowns were evaluated, there were generally no significant differences found between scanners for the regional linear measurements, but more gaps occurred in restorations obtained with intraoral scanners for volumetric measurements. On the other hand, when the inlay restorations were evaluated, significant differences were found between groups except for the midpoint of the axio-pulpal line angle and the midpoint of the mesio-gingival margin. However, marginal and internal gaps of both crowns and inlays presented mean values less than 150 μm in many surfaces, which could be considered clinically acceptable.

Purpose To evaluate the effect of three two-retainer designs of a resin-bonded fixed dental prosthesis (RBFDP) on fracture resistance. Materials and methods A total of 21 three-unit, all-ceramic RBFPDs were fabricated to replace a missing maxillary lateral incisor. The prostheses were divided into three groups of 7 each: Group L (labial RBFPD); Group ML (modified labial RBFPD, fabricated the same as in Group L with additional preparation that included a shallow proximal groove at the pontic side); and Group P, an all-ceramic palatal RBFPD that acted as control. Preparations were done on the maxillary left central incisor and canine of a typodont model, and 21 epoxy resin models were duplicated for the three groups. The RBFPDs were designed using CAD software and constructed using the heat-pressed technique, after which the prostheses were bonded to their corresponding epoxy resin model according to the manufacturer's instructions. A fracture resistance test was performed on all specimens following aging. Data were analyzed using one-way ANOVA. Results The highest fracture load values were recorded in Group P (547.5 N), followed by Group ML (462.6 N) and then Group L (418.3 N). The difference among the three designs was not statistically significant (F = 2.5, P = 0.1). Conclusion Both labial and modified labial RBFDPs could be a viable alternative treatment option for replacement of missing maxillary lateral incisors.

Information on the morphological accuracy of crowns produced by different technologies is limited.The purpose of this in vitro study was to compare the morphology and contacts of crowns fabricated with intraoral systems, extraoral systems, and conventional method.A typodont mandibular first molar (Nissin Dental Product) received a complete ceramic crown preparation and a reference crown. Microcomputed tomography (μCT) was used to obtain the virtual data (REF) of the reference crown. Three groups of replicated crowns were made: intraoral scanning system (TRIOS), extraoral scanning system (D700), and the conventional method (CONV) (n=8). The groups TRIOS and D700 were designed by the correlation method. All crowns were scanned with μCT to obtain 3D data. The data were superimposed on each other or the REF in an inspection software to evaluate precision and trueness. The contact penetration area of the occlusal surfaces of the crowns was calculated. An independent sample t test and 1-way ANOVA with the post hoc least significant difference (LSD) test were used to compare the data (α=.05).The crowns fabricated with the extraoral scanners showed significantly lower root mean square (RMS) values for trueness (F=1456.90, df=2, P.001) and precision (F=188.88, df=2, P.001) than the others. The penetration contact area ratio and the differences in the CONV group were both significantly higher than those of the other groups.The average discrepancies of the crown morphology fabricated from the extraoral scanning were significantly lower than those from others. The conventional method restored the occlusal contact with significantly less accuracy than the other groups.

The stereolithography technique has been a promising method of fabricating fracture-resistant ceramic restorations efficiently. However, studies on the dimensional accuracy and clinical adaptation of ceramic crowns fabricated with the technique are lacking.The purpose of this in vitro study was to evaluate the dimensional accuracy and clinical adaptation of ceramic crowns fabricated with the stereolithography technique.A typodont maxillary right first molar abutment tooth was scanned by using an extraoral scanner, and a crown was designed by using 3Shape Dental System CAD software. Ten ceramic crowns were fabricated with 2 different stereolithography systems, CeraFab7500 (CF) alumina and CSL150 (CL) zirconia, and a conventional computer-aided design and computer-aided manufacturing system, X-MILL500 (XM) zirconia. The crowns were scanned, and the digital casts were exported. Dimensional accuracy was measured by superimposing the digital casts with the reference model by using Geomagic Qualify software. The silicone replica method was applied to measure clinical adaptation. Results were statistically analyzed by using a 1-way analysis of variance (α=.05).CeraFab7500 reported better dimensional accuracy (41 ±11 μm) than CSL150 (65 ±6 μm) or X-MILL500 (72 ±13 μm) (P.001). No significant difference was found between the CSL150 and X-MILL500 groups (P.05). X-MILL500 reported significantly better adaptation in the marginal, corner, and occlusal areas but inferior adaptation in the axial area compared with CeraFab7500 and CSL150 (P.05). Significant differences were only apparent in the axial and occlusal areas between CeraFab7500 and CSL150 (P.05). No significant difference was found in the marginal or corner area between CeraFab7500 and CSL150 (P.05).Both CeraFab7500 and CSL150 can fabricate ceramic crowns with high dimensional accuracy and marginal adaptation within clinically acceptable limits. The results indicate that the fabrication of ceramic crowns by using the stereolithography technique seems to be promising.

Background In restorative dentistry, the use of high-speed air turbine, which generates aerosols, can be associated with the transmission of airborne diseases. New laser technologies could be useful in reducing the amount of aerosols, but there is a lack of scientific research on this topic. Material and methods This is a descriptive study to analyze the amount of aerosols produced after class I cavity preparation using high-speed air turbine (group 1) and Er,Cr:YSGG laser with two different parameters (groups 2 and 3). Fluorescein dye was incorporated into the coolant reservoir in order to visualize the production of aerosols during each procedure. Tooth preparation was performed in a typodont with human lower molar tooth under rubber dam isolation. The procedure was carried out in a transparent plastic box to avoid aerosols dispersion. Sixteen grade I cellulose filter discs were distributed along the surfaces of the box. The area contaminated with aerosols in the filters was measured using ultraviolet illumination. Results In group 1, the contaminated surface area covered with fluorescein dye reached 77.3% (1349 cm2) of the total; in group 2 (laser with 80% water) we observed 7.3% (128 cm2) and in group 3 (laser with 40% water) it was 3.8% (68 cm2). The reduction in water parameter from 80% to 40% coincided with 48% reduction of the contaminated area on the filter discs. Focusing on the surfaces of the box, we noted that the mean contamination on the left side was more than on the right side in all three experimental groups. In group 1 using air turbine, we measured a mean of 102.6[±7.5 SD]cm2 on the left side, compared to 70.6[±32.3 SD]cm2 on the right side. In laser groups 2 and 3, a mean of 12.8[±14.9 SD]cm2 and 6.8 [±5.7SD]cm2, respectively, was described on the left surface versus 0 cm2 of surface contamination on the right surface. Conclusions The contaminated area during the procedure of class I cavity preparation, is reduced by 70% using Er,Cr:YSGG laser compared to high-speed turbine. A slightly higher contamination was observed between laser groups with 80% versus 40% water. The use of Er,Cr:YSGG laser in restorative dentistry can be a valid treatment alternative to reduce aerosols production compared to conventional high-speed rotary instruments. Key words:Er,Cr:YSGG laser, Aerosols, SARS-CoV-2, Rotary instruments, conservative dentistry.

There has been an increase in utilizing 3D printers in dental restorations. The purpose of the study is to compare mechanical properties of 3D-printed prostheses to those of self-cured and/or computer-aided design-computer-aided manufacturing (CAD-CAM) restorations. A metal master typodont was prepared for the mandibular left sextant with implant analogs embedded at the first premolar and first molar positions with a missing second premolar. Three-unit provisional fixed dental prosthesis (FDP) was designed utilizing the 3Shape tooth library and forty-five uniform specimens were fabricated with different materials: self-cured poly(methyl methacrylate) (PMMA) (N = 15), milled PMMA CAD-CAM blocks (N = 15) and 3D-printed resin (N = 15). All specimens were tested using an Instron machine at a crosshead speed of 0.5 mm/min by an axial load on the occlusal surface of the second premolar pontic site. Statistical analysis was completed with Shapiro-Wilk, ANOVA and Tukey post-hoc tests. Mean fracture force was 300.61 N, 294.64 N and 408.49 N for self-cured PMMA, milled PMMA and 3D-printed resin, respectively. Mean force at FDP fracture of 3D-printed resin was significantly greater than the mean fracture force of either self-cured (p = 0.016, 95% CI [17.86, 197.91]) or milled (p = 0.010, 95% CI [23.83, 203.88]) PMMA.

The aim of this study was to compare the fit of feldspathic ceramic crowns fabricated via 3 different extraoral digitizing methods. Twelve maxillary first premolars were prepared and 36 single crowns were fabricated via 3 extraoral digitizing methods using a laboratory scanner (n = 12): (1) scanning the typodont (ST [control] group); (2) scanning the impression (SI group); (3) scanning the stone cast (SC group). Micro-computed tomography was used to calculate two-dimensional marginal-internal gap and the three-dimensional volumetric gap between the crowns and their corresponding dies. The measured gaps were divided into 6 location categories as follows: marginal gap (MG), finish line gap (FLG), axial wall gap (AWG), cuspal gap (CG), proximal transition gap (PTG), and central fossa gap (CFG). The correlation between each of the 3 extraoral digitizing methods and the adaptation status of the crown margins were also evaluated. The Wilcoxon signed-rank test, Spearman's rank test, and Chi-square test were used for data analysis (α = 0.05). The marginal gaps in the ST, SI, and SC groups differed significantly (24, 198 and 117.6 µm, respectively) (p 0.05). Significant differences were found between the groups with regard to internal gap measurements, with SI representing higher gap measurements at FLG, PTG and CFG locations (p 0.05). 3D volumetric gap measurements did not differ significantly (p 0.05). Under-extended margins observed in the SI and SC groups were correlated with the digitizing method (Cramer's V-square: 0.14). When performing extraoral digitalization, clinicians should choose to scan the stone cast as scanning the stone cast resulted in better internal and marginal fit compared to scanning the impression.

INTRODUCTION: No studies on the marginal gap or internal fit of crowns have reported the effect of non-axial seating which may often occur inadvertently clinically. AIM: Therefore this in vitro study sought to investigate the off-axis seating of CAD/CAM crowns and its effect on the marginal gap and internal fit. METHOD: A standardised crown preparation on a typodont tooth was used to design and mill 30 crowns with a flat occlusal surface. Ten Zirconia (Dentsply Sirona, Germany), 10 Enamic (Vita, Austria), and 10 Brilliant Crios (Coltene, Switzerland) crowns were milled, Ave of each milled with a luting space of 100µm, and Ave of 200µm. The marginal gap was measured in two and three dimensions after luting with silicone on a 3D-printed metal replica. Seating occurred axially, at 5° buccally and 5° lingually. The silicone was used to calculate the internal fit RESULTS: Axial seating with a 100 µm luting space obtained the smallest marginal gap, irrespective of material or luting space. 3D measurements were larger than 2D measurements, but not significantly. The maximum off-axis gap was 117µm, on the opposite side to which pressure was applied. CONCLUSIONS: Care must be taken clinically to ensure that luting takes place in an axial direction only.

PURPOSE The precision of soft metal processing technologies is poorly documented. This study compared marginal and internal fit of presintered cobalt-chromium (Co-Cr) and zirconia three-unit fixed dental prostheses (FDPs) to cast Co-Cr. MATERIALS AND METHODS Three-unit FDPs were prepared on metal dies (N = 60) from typodont preparations of the maxillary right first premolar and molar. A standardized preparation of a metal-ceramic restoration was done on abutment teeth. The dies (N = 60) were scanned and divided into three groups (n = 20/group) to receive the FDP made of presintered Co-Cr (Ceramill Si), presintered zirconia (Ceramill Zi), and cast Co-Cr (Girobond NB). Each framework was seated on its specific cast. A replica technique was used for marginal and internal discrepancies measurements in mesiodistal and buccolingual planes. Data were analyzed using the Levene test, t-test, and analysis of variance (α = 0.05). RESULTS When the overall mean discrepancy values were compared in the mesiodistal plane, a significant difference was found between Ceramill Sintron and Ceramill Zi groups (p = 0.026). No significant difference was detected between Girobond NB and Ceramill Sintron groups and between Girobond NB and Ceramill Zi groups (p = 0.537 and p = 0.569, respectively). In the buccolingual plane, there was no significant difference in the overall mean discrepancy between the three groups: CS/CZ (p = 1.000), GI/CS (p = 0.51), and GI/CZ (p = 0.87). Significant differences at several measurement points were found at the inter or intramaterial level. The increase in discrepancy values between marginal and occlusal measurements was evident for the three groups. CONCLUSIONS Presintered three-unit FDPs fabricated from zirconia and Co-Cr exhibited internal and marginal discrepancy values similar to cast Co-Cr. A significant difference was reported between CS and CZ in mesiodistal planes. The axial and marginal differences in values for the three tested groups were below or around the 120 µm clinically acceptable threshold except for the occlusal area. When comparing first premolar to first molar, the internal and marginal discrepancies were similar with no apparent distortion of the framework after the sintering process.

Statement of problem Whether the precision of fit of computer-aided design and computer-aided manufacturing (CAD-CAM) complete crowns is affected by the finish line configuration is unclear. Purpose The purpose of this in vitro study was to evaluate the marginal and internal fit of CAD-CAM ceramic crowns made from lithium disilicate based on 3 different finish lines (rounded shoulder, chamfer, feather-edge). Materials and methods Thirty anterior lithium disilicate complete crowns (n=10 per finish line group) were fabricated by following a completely digital workflow based on digital scans made with the TRIOS scanner. The crowns were adhesively cemented on duplicate dies of the respective prepared Typodont teeth, and the marginal gap, absolute marginal discrepancy, and internal gap were evaluated by using microcomputed tomography (μCT). A total of 66 values were obtained for each specimen from sagittal and transaxial sections, and a rendering software program was used to calculate the volume of the cement gap for each specimen by means of 3D region growing. Two-way ANOVA, Tukey post hoc tests with Bonferroni correction, and the Kruskal-Wallis test were used to compare the values between the experimental groups (α=.05). Results Marginal gap and absolute marginal discrepancy values were statistically significantly different between groups. In ascending order, marginal gap values were 23 ±14 μm for rounded shoulder, 54 ±28 μm for chamfer, and 96 ±36 μm for feather-edge finish lines. Absolute marginal discrepancy values were 96 ±34 μm for rounded shoulder, 124 ±37 μm for chamfer, and 157 ±34 μm for feather-edge finish lines. Internal gap values were 111 ±14 μm for feather-edge, 136 ±22 μm for chamfer, and 168 ±25 μm for rounded shoulder finish lines. The differences in cement volume between groups were not statistically significant (P=.200). Conclusions All 3 finish lines produced marginal gaps within the range of clinically accep table values. Lithium disilicate CAD crowns with a rounded shoulder finish line had the best marginal fit but the poorest internal fit, and lithium disilicate CAD crowns with a feather-edge finish line had the best internal fit but the poorest marginal fit.

Objective Evaluate the effects of the scanning techniques and the crystallization in the internal and marginal adaptation of milled lithium disilicate crowns by two techniques computer microtomography analysis. Materials and methods Sixteen polyurethane teeth prepared for a complete crown were divided into two groups according to the scanner method (n = 8): indirect (IND), dental stone models were scanned with laser-surface scanner, and direct (DIR), digital typodont creates with an intraoral scanner. Internal and marginal gap were evaluated by micro-computed tomography (microCT). The replica technique (RT) was applied for analysis of total volume (TV) and marginal volume (MV) gap in microCT. The data showed normal distribution (Shapiro-Wilk test). One-way ANOVA (scanner techniques) with repeated measures (crystallization) was performed. Multiple comparisons were performed with Bonferroni adjustment (α = .05). Results The axial gap showed a significant difference between the times (P = .017) for lower values after crystallization. The vertical marginal gap presented a significant difference in times for higher value after crystallization (P = .001). The marginal horizontal gap IND was greater than DIR after crystallization (P = .001) and IND before lower than after crystallization. For TV was not significant difference and MV in DIR was reduction (P = .002) after crystallization. Conclusion Crystallization changes the relationship between the crown and tooth, reducing internal gap and preventing the adequate fit in indirect and direct scanning. Clinical significance The measure gap under technological methodology is useful for adjust clinical parameters prosthetic in the CAD/CAM and the applicability of the new possibilities of analysis.

Statement of the problem: The curiosity of many prosthodontists was attracted towards CAD/CAM technology combined with the newly specifically designed ceramic materials to achieve superb esthetic restorations for their patients. The new ceramic materials with their different mechanical properties might have an impact on their machinability particularly for producing thin esthetic restorations.Purpose: The purpose of this investigation was to evaluate the marginal quality of three different ceramic veneers: Leucite reinforced, hybrid and lithium di-silicate in terms of edge chipping and chipping factor using different machining protocols.Materials and methods: In order to achieve the purpose of this study, a maxillary central incisor of a Typodont was prepared for a feather edge veneer preparation to receive forty five ceramic veneers that were milled from three different materials using the Cerec CAD/CAM system. The three tested materials were leucite-reinforced glass ceramic (IPS Empress CAD), hybrid ceramic (Vita Enamic), and lithium di-silicate glass ceramic (IPS e.max CAD). The forty five veneers were classified into three groups according to the type of the material fifteen each, that were further divided into three subgroups of five specimens each according to the three tested machining speeds: normal, fast, and two-step. A digital camera was used for taking top images for the tested veneer margins that were imported into image analysis software to measure the peripheral veneer circumference (P). A stereomicroscope was used to measure the amount of marginal chipping of each veneer in microns (L). The chipping factor (CF) was calculated using the following equation: CF= L/P x 100, where (L) is the amount of marginal chipping and (P) is the marginal circumference of each veneer. The data of the chipping factor of each veneer margins were recorded and tabulated to be statistically analyzed in order to detect the influence of either the ceramic material or the machining protocol on the quality of the veneer margins in terms of edge chipping.Results: Effect of ceramic type regardless of machining protocol: The statistical analysis of the obtained data revealed that e.max CAD (LD) showed the statistically significant highest mean chipping factor value (7.25 ± 2.56) followed by IPS Empress CAD (LR) (4.01 ± 0.83), and the least mean value was obtained with Vita Enamic (HC) (2.83 ± 1.56). Effect of machining protocol regardless of ceramic type: there was a statistically significant difference between the three milling techniques, where fast milling showed the highest mean chipping factor value (6.30±2.97), followed by normal milling (4.89±2.22) where the least chipping factor mean value (2.90±1.60) was obtained with the two-step milling.Conclusions:The edge quality of thin ceramic CAD/CAM restorations proved to be material dependent.The machinability for producing thin CAD/CAM ceramic restorations influenced significantly their marginal quality.The prosthodontist should be aware and knowledgeable about the mechanical properties of the recent CAD/CAM ceramic materials in order to choose the optimum one with the convenient milling protocol during the treatment planning to get the best clinical performance.

Digital impressions have been studied for better gingival retraction in including the under subgingival finish line condition. Here, we employed swept-source optical coherence tomography (SS-OCT) of 1310 nm wavelength, which is capable of noninvasive, high-resolution, and high-speed, to discern the utilization-possibility for supporting the fabrication of the dental crown. A three-dimensional (3D) abutment was used at the 0.5 mm of the subgingival finish line below the level of the gingiva. The SS-OCT system scanned a field of view of 10 mm × 10 mm using the 3D working model by the depth-directional three focal points. The obtained 1500 images of OCT cross-sections, which are 1221 × 1220 pixels, were rendered to the 3D model for the effective design of a virtual crown. Then, the ceramic crown was fabricated through a milling machine with a computer-aided design and computer-aided manufacturing (CAD/CAM) software. The marginal fit of the crown was evaluated 219.1 ± 48.9 μm by a silicone replica technique. Although the marginal fit is not sufficient for the clinical allowable gap at one resin typodont, this study can be anticipated to encourage further researches for the enhanced fabrication of dental crown under subgingival finish line conditions.

Background and Objectives: One of the important steps toward achieving a successful fixed partial denture treatment is the fabrication of interim restorations with good marginal adaptation. Poor marginal adaptation of the interim restorations will allow ingress of fluids and microorganisms between the restorations and may lead to caries and pulpitis. The objective of this study was to evaluate and compare the marginal accuracy of interim restorations made from two polymethyl methacrylate (PMMA) and two bis-acryl materials. Materials and Methods: An in vitro method was used to replicate a clinical procedure in which the interim crown was made using a direct technique. A maxillary first molar typodont tooth was prepared to receive a full cast crown restoration having 1 mm chamfer and a taper of 5°, and then the prepared artificial tooth was cast into a cobalt chromium metal die. Wax patterns were prepared on the metal die using type 2 inlay wax for full metal crowns. The impression of the die along with the wax pattern was made with a putty-type polyvinyl siloxane, and this impression was used as a mold for making interim restorations. Two PMMA and two bis-acryl provisional crown materials were distributed as follows: Group A: Unifast Trad (GC Dental), Group B: DPI self-cure tooth molding material, Group C: Structur 2 QM (VOCO), and Group D: Cool Temp Natural (Coltene/Whaledent). A total of 60 interim restorations from all the four materials were fabricated (15 interim restorations from each material). The marginal discrepancy of the interim restoration was determined by measuring the space between the margin of the interim restoration and the finish line of the metal die at four vertical reference lines previously marked at the midpoint of the metal die finish line at the buccal, palatal, mesial, and distal surfaces of the die. The marginal gaps were visualized at ×45 magnification using a stereomicroscope and interpreted using ProgRes image capture software. Results: The mean marginal discrepancy calculated in PMMA materials was 269 µm for DPI and 205 µm for Unifast Trad, and the mean marginal gap for the bis-acryl material was 171 µm for Cool Temp and 140 µm for Structur 2 QM. Interpretation and Conclusion: Comparison of marginal accuracy showed that bis-acryl provisional crown material showed better marginal accuracy than PMMA provisional crown material. Among the materials tested, Structur 2 QM showed the best marginal accuracy, and the least marginal accuracy was shown by DPI.

Purpose The presented study utilized an in vitro Orthodontic SIMulator (OSIM) to study how Class II elastic configuration effects the forces and moments acting on maxillary canine teeth when using a straight archwire fixed lingual appliance. Materials and methods Maxillary in-Ovation L self-ligating brackets were bonded to anatomically shaped stainless steel teeth on OSIM. A 0.016″ × 0.022″ stainless steel straight lingual archwire was used to provide a relevant arch shape and to position simulated teeth in a passive position. A mandibular typodont was positioned above the OSIM arch in a half cusp Class II malocclusion to serve as attachment points for elastics. Four different elastic configurations were tested: 1. maxillary–buccal to mandibular-buccal; 2. maxillary–lingual to mandibular–lingual; 3. maxillary–buccal to mandibular–lingual; 4. maxillary–lingual to mandibular–buccal. A new 4.5 oz 3/16″ elastic (n = 40 per configuration) was attached to the maxillary canine and mandibular first molar teeth for each trial. Forces and moments at the maxillary canine simulated center of resistance were considered. ANOVA was used to assess the effect of elastic configuration, and pairwise comparisons using Bonferroni correction were conducted to investigate configuration differences. Results Of the thirty-four pairwise comparisons, only two were statistically insignificant. Configurations 1, 2, and 4 were found to produce over 1 N of force in the desired distal direction, whereas Configuration 3 was significantly lower at 0.65 N. Conclusions Overall, the configuration of Class II elastics had a significant effect on forces and moments at maxillary canine teeth for a simulated straight archwire fixed lingual appliance.

Background/purpose: En masse retraction was still controversy in orthodontics. The aim of this study was to investigate the effect of force directions created by different miniscrew positions and lever arm heights on maxillary central incisor movement using Finite Element (FE) simulation and a Typodont model. Materials and methods: A typodont model and 3-dimensional FE were used to simulate en masse anterior teeth retraction in sliding mechanics. The lever arm and the miniscrew positions were varied to change the force direction. The maxillary central incisor displacement was recorded and analyzed. Results: The typodont results revealed that miniscrew vertical position and lever arm height affected the type of tooth movement. The best control in the vertical plane was achieved by a 7 mm lever arm height and miniscrew 9 mm from the archwire. When the lever arm height and miniscrew were 7 mm from the archwire, the tooth extruded. When the lever arm height was 9 mm and the miniscrew was 7 or 9 mm from the archwire, the tooth intruded. The FE stimulation determined that near bodily movement of the maxillary central incisor was achieved when the lever arm height and miniscrew was 9 mm from the archwire. The highest strain distribution in the periodontal ligament was observed at the apical third of the lateral incisor. Conclusion: In en masse retraction, the appropriate direction of force or the height of the miniscrew and the lever arm may enable orthodontists to maintain better control of the anterior teeth in sliding mechanics. Keywords: En masse retraction, Finite element, Lever arm, Miniscrew, Typodont

Purpose : The aim of this study was to evaluate the influence of intraoral and extraoral scanning techniques on the vertical marginal gap distance of two types of computer aided designing/computer aided manufacturing (CAD/CAM) fabricated all-ceramic monolithic crowns. Materials and methods: Maxillary and mandibular typodont models were used in this study in which a standardized all-ceramic preparation of lower first molar tooth was carried out. These typodont models with the prepared tooth were representing the patient’s mouth. Thirty all-ceramic crowns were fabricated by CAD/CAM technique and divided into three groups(10 crowns each) according to their scanning technique; Group I: scanning of the typodont models by intraoral scanner. Group II: scanning of silicon impressions by extraoral scanner. Group III : scanning of stone casts by extraoral scanner. Each group was further sub-divided into 2 sub-groups (5 crowns each) according to the type of crown material. Sub-group(A): zirconia(BruxZir) crowns and Sub-group (B): hybrid ceramic(Vita Enamic) crowns. The vertical marginal gap distance between each crown margin and finish line of the prepared tooth was measured using a Digital microscope of 40X at 16 points / crown. Data were collected, tabulated and statistically analyzed using Tukey’s post-hoc and Two-way ANOVA tests (P< 0.05). Results: Different scanning techniques as well as crown materials had a statistically significant effect on vertical marginal gap distance (µm) at P-value 0.026. The intraoral scanning technique recorded the lowest statistically significant vertical marginal gap distance mean values for both crown materials among the three scanning techniques. Regarding the crown material, hybrid ceramic Vita Enamic crowns had a lower statistically significant vertical marginal gap distance values than zirconia BruxZir crowns with all the tested scanning techniques. Conclusion: The vertical marginal gap distance of monolithic crowns was significantly affected by the scanning techniques and crown materials with the superiority of the intraoral scanning technique. Vita Enamic crowns had lower vertical marginal gap distance than BruxZir crowns with different scanning techniques. All the tested monolithic crowns had vertical marginal gap distance values within the clinically acceptable levels.Key words: intraoral scanner, extraoral scanner, vertical marginal gap distance, monolithic, hybrid ceramics, Vita Enamic, zirconia, BruxZir.

Aims: The purpose of this study is to compare and evaluate the failure modes and load-bearing capacity of different surface-treated polyether ether ketone (PEEK) copings when veneered with lithium di-silicate with that of PEEK veneered with composite. Settings and Design: In vitro; comparative study. Materials and Methods: Congruently anatomically shaped single unit PEEK copings (n = 40) were fabricated by scanning a prepared typodont tooth. The PEEK copings were subdivided among four groups (n = 10/group). Among all, one group of PEEK coping was veneered with Urethane dimethacrylate (UDMA)-based composite and other groups were veneered with lithium-di-silicate after different surface treatment on peek copings, i.e., (i) composite veneered PEEK fixed dental prosthesis (FDP) (control group: Group PC), (ii) lithium di-silicate veneered PEEK FDP (no surface treatment: Group PCeN), (iii) lithium di-silicate veneered PEEK FDP (sandblasting with 50 μm alumina: Group PCeS), and (iv) lithium di-silicate veneered PEEK FDP (chemical etching with 98% sulfuric acid: Group PCeE). The load-bearing capacity of all specimens was assessed using a universal test machine. All the samples were loaded till the cracking point and load at that point and failure modes were noted down. Statistical Analysis Used: One-way ANOVA and post hoc Tukey tests. Results: The highest load-bearing capacity was recorded for lithium di-silicate veneered PEEK copings which were chemically etched with 98% sulfuric acid (Group PCeE: 1040.25 ± 77.46) followed by Group PCeS (1017.20 ± 53.70), then Group PC (965 ± 51.57) and least was for Group PCeN (933 ± 97.54). There was a significant reduction in mean load-bearing capacity in Group PCeN (P < 0.05). Conclusions: Veneering of PEEK with pressed lithium di-silicate seems to be a viable clinical option in terms of adequate load-bearing capacity. Lithium di-silicate veneered PEEK FDPs were successful against physiological occlusal forces and are a suitable material for FDPs.

Statement of problem Making impressions of 2-piece implants is typically associated with the repeated disassembly and reassembly of superstructures and related to soft-tissue trauma. Intraoral scanning of 1-piece zirconia implants is problematic because scan bodies are not readily available. Whether using virtual hybrid casts generated by merging intraoral scan data with the known surface geometry of abutments can solve these difficulties is not clear because data on accuracy of the workflow are sparse. Purpose The purpose of this in vitro study was to evaluate the accuracy of virtual hybrid casts with respect to the impact of different gingival situations. The workflow was designed to render pointless the use of impression posts and scan bodies and avoid any displacement of the gingiva. Material and methods The mandibular right first molar in a typodont was replaced with a 2-piece titanium implant with a custom abutment and then a 1-piece zirconia implant. Three situations representing different gingival heights covering the abutments were simulated. Twelve intraoral scans were made for each situation to capture the recordable parts of the abutments, and virtual hybrid casts were constructed by superimposing and merging the intraoral scan data with the original laboratory scan data of the abutments. Hybrid casts were compared with reference data by using the root mean square error. Scan body–related and cast scan–related protocols were performed representing conventional digital workflows. Statistical analysis with the Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests with the Bonferroni correction was conducted with a statistical software program (α=.05). Results Deviation was low in the hybrid casts of the custom abutment when the entire abutment was recorded (6.5 μm; IQR: 3.0 μm), when the preparation margin was disguised (7.0 μm; IQR: 1.0 μm), and when half of the abutment was covered (8.0 μm; IQR: 4.0 μm). The accuracy in the 1-piece zirconia implant was 10.0 μm (IQR: 4.0 μm) when the whole surface of the abutment was visible and 12.5 μm (IQR: 6.0 μm) when the preparation margin was covered. When only half of the abutment was captured, a larger deviation of 22.0 μm (IQR: 7.0 μm) was observed. The hybrid cast concept demonstrated superior accuracy compared with protocols using scan body scans (76.0 μm; IQR: 27.0 μm) and cast scans (23.0 μm; IQR: 15.0 μm). Conclusions Digital intraoral scanning and the generation of virtual hybrid casts provide high accuracy and are suitable for the fabrication of single-implant-supported restorations. The atraumatic procedure avoids tissue manipulation and reduces clinical effort.

As an innovative approach to overcome the rate-limiting staging of conventional aligners, using shape memory polymers (SMPs) as aligners’ materials was investigated in this in vitro study. The ability of SMPs to shape recover and consequently move tooth, upon appropriate stimuli, was evaluated on a typodont model before clinical application. The study design was to achieve 1.9 mm correction movement of an upper central incisor by one aligner after multiple steps/activation. A custom-made aligned typodont model with a movable upper central incisor was scanned. Using an orthodontic software and a 3D printer, resin-models were generated. Seven aligners of ClearX sheets (SMPs) were fabricated by thermoforming on the resin aligned model. Each aligner was tested for repositioning of the central incisor in the typodont model. The model was scanned after each step and the corrective movement was measured through the superimposition of scans. Results showed that the total correction efficiency of the SMPs’ aligner was ≈93% (1.76 mm). The corrective movement was 0.94 ± 0.04 mm after the reforming step, 0.66 ± 0.07 mm after the first activation step, and 0.15 ± 0.10 mm after the second activation step. It was concluded that aligners made of SMPs could have a promising future-use in orthodontic aesthetic treatment.

Background: Marginal and internal fit are believed to be one of the most important guideline in the assessment of ceramic restorations and are one of the most remarkable requirement for the long-term performance of fixed dental prostheses. PURPOSE: Was to evaluate the influence of different CAD-CAM systems on the marginal and internal adaptation of hybrid ceramic restorations. Materials and Methods: Lower right six of a typodont resin cast with a 1.0 mm circumferential chamfer finish line, an occlusal reduction of 2.0 mm, and an average of 10-12° convergence angle was prepared. This master die was duplicated to thirty acrylic resin dies milled from PMMA discs using CAD-CAM technique. Vita Enamic monolithic crowns were manufactured using three different CAD-CAM systems Ceramill, Zirkonzahn and CEREC InLab systems (n=10). Replica technique procedure was used to assess marginal and internal fit of the fabricated prostheses by measuring the thickness of light body impression material between the master die and the restoration at five points using digital microscope. Results: Measurements were collected for each group and appropriate statistical analysis was carried out. Conclusion: CEREC system showed relatively lower marginal and internal discrepancy in a comparison with the other systems. Therefore, there is a significant difference among the three systems.

The accuracy of newly developed ceramic materials is still being studied. Marginal and internal adaptation are known factors that have an essential impact on the long term success of dental restorations. The aim of this in vitro study was to evaluate the marginal and internal fit of heat-pressed and milled monolithic glass-ceramic restorations based on their ceramic type, processing technique, and in vitro thermocycling. Thirty-two crowns were studied and divided into four groups (n = 8), according to the ceramic material (feldspathic glass-ceramic (F) and zirconia reinforced lithium silicate glass-ceramic (ZLS)) and to their technological obtaining processes (milling (M) and heat-pressing (P)). A typodont preparation was scanned with a D2000 3D scanner to obtain identical 32 resin 3D-printed abutment teeth. Marginal and internal gaps were measured using the silicone replica technique under 40&times, magnification. The crowns were further cemented and thermally aged for 10,000 cycles After cementation and thermocycling of the samples, marginal and internal gaps were assessed using micro-CT (micro-computed tomography)) analysis. Data were statistically analyzed using statistical tests. Significant differences were found before and after cementation and thermocycling among the tested materials (p &lt, 0.05). Related to technological processing, significant differences were seen in the marginal area between FP and FM (p &lt, 0.05) Significant differences were also found in the axial and occlusal areas between the ZLSP and ZLSM. Thermocycling and cementation did not have a significant effect on the tested materials (p &lt, 0.05). The technological processes influenced the marginal and internal fit of the crowns in favor of the CAD/CAM (computer aided design/computer aided manufacturing)technologies. Thermal aging had little effect on marginal adaptability, it increased the values for all the tested samples in a small way, but the values remained in their clinically acceptable range for all of the crowns.

Objective The purpose of this in vitro study was to compare the marginal and internal fit of pressed lithium disilicate veneers fabricated from a 3D printed castable wax resin versus a manual waxing technique. Materials and methods A typodont model central incisor was prepared for a porcelain veneer. Following stone model fabrication from a polyvinyl siloxane impression, the model was digitized using a laboratory scanner. Group 1 veneers were designed digitally and 3D printed with a castable wax resin, then pressed. Group 2 veneers were fabricated using a manual wax and press approach. Veneers from both groups were bonded to printed dies. Following measurements of marginal adaptation under a stereo microscope, the dies were sectioned and measurements were made for internal adaption. Statistical analysis included a Kolmogorov test and a Mann-Whitney U test. Results Average marginal gap (μm) for Group 1 was 40.37 ± 11.75 and 50.63 ± 16.99 for Group 2 (p = 0.51). Average internal gap (μm) for Group 1 was 61.21 ± 18.20 and 68.03 ± 14.07 for Group 2 (p = 0.178). Conclusion There was no difference in marginal fit or internal fit between pressed lithium disilicate veneers fabricated with a 3D printed castable resin and those fabricated with a manual waxing technique. The use of digital technologies and 3D printing provide significant advantages in the fabrication of pressed glass ceramic veneers, with marginal and internal adaptation comparable to manual wax and press techniques.

Statement of problem The primary manufacturing method of zirconia ceramic crowns is computer-aided design and computer-aided manufacture (CAD-CAM), but a disadvantage of this technique is material waste. Three-dimensional (3D) printing, which has been recently introduced into dentistry, has improved the processing of polymers and metals, but not yet of ceramic crowns. Purpose The purpose of this in vitro study was to evaluate the 3D trueness of zirconia crowns fabricated by 3D printing to investigate the potential application of this technology in dental ceramic restorations. Material and methods A typodont tooth was prepared for a ceramic crown, and a digital crown was designed using the CAD software. The digital crown was processed either with a 3D-printing system or with a dental milling system. The crowns were scanned using a dental laboratory scanner, and the data collected for each crown were divided into 4 parts (the external surface, intaglio surface, marginal area, and intaglio occlusal surface). Finally, the trueness of each part was determined using the 3D inspection software. The 3D trueness of the crowns fabricated by either 3D printing or milling was compared by a 1-sided test (α=.05). Results The trueness of the external surface, intaglio surface, marginal area, and intaglio occlusal surface of the 3D-printed crowns was no worse than the corresponding trueness of the CAD-CAM crowns (P Conclusions Zirconia crowns produced by 3D printing meet the trueness requirements, and 3D printing may be suitable for fabricating zirconia crowns.

Statement of problem Hot-pressing and computer-aided design and computer-aided manufacturing (CAD-CAM) are major techniques for the fabrication of lithium disilicate crowns. They exhibit different accuracies regarding marginal fit, an important factor in restoration survival. However, studies comparing the marginal fit of different fabrication methods are lacking. Purpose The purpose of this in vitro study was to compare the marginal discrepancy (MD) and absolute marginal discrepancy (AMD) of lithium disilicate crowns produced by the hot-press and CAD-CAM techniques. Material and Methods Thirty typodont teeth were divided into 2 groups. Fifteen teeth were scanned with the CEREC Omnicam intraoral scanner, and crowns were fabricated with the CEREC MC XL chairside CAD-CAM milling unit from IPS e.max CAD blocks. Fifteen typodont teeth were sent to a dental laboratory, and lithium disilicate crowns were fabricated from IPS e.max press ingots using the hot-press technique. The 30 crowns were cemented and then sectioned with a precision saw. The MD and AMD were measured for each crown with a light microscope. One-way ANOVA was conducted to analyze significant differences in crown marginal fit between the fabrication systems (α=.05). Results For the CAD-CAM technique, the mean values of the AMD measurements were 115 μm, and for the hot-press technique, 130 μm. The MD measurements were 87 μm for the CAD-CAM technique and 90 μm for the hot-press technique. One-way ANOVA revealed no significant differences between the fabrication methods regarding marginal fit (P>.05). Conclusions No significant differences were found between the fabrication methods tested. Both the CAD-CAM and hot-press techniques for producing monolithic lithium disilicate crowns produced MD values of less than 120 μm, within the clinically acceptable range.

Aim: The aim of the study was to evaluate and compare the vertical marginal discrepancy of computer-aided design (CAD)/computer-aided manufacturing (CAM) and pressable lithium disilicate onlays. Materials and Methods: A maxillary first premolar typodont tooth was prepared to receive lithium disilicate onlay. Mesio-occluso-distal cavity was prepared with palatal cusp reduction and collar preparation. In the proximal box, gingival seat was placed 1 mm coronal to the cementoenamel junction and mesiodistal width of the seat was kept to 1 mm. Thirty stone models were prepared from thirty rubber base impressions and divided into two groups, based on the technique of fabrication of onlays: (1) Group CL (CAD/CAM lithium disilicate) and (2) Group PL (Pressable lithium disilicate). Fifteen onlays per each group were fabricated by following the manufacturer instructions. Marginal fit of all the samples were analyzed by using stereomicroscope with Image Analysis software. Statistical analysis was done by t-test. Results: Statistical significant difference was found between both the groups. The lowest marginal discrepancy (41.46 μm) was measured for Group CL (CAD/CAM lithium disilicate) specimens, and the highest (55.95 μm) discrepancy was observed on the Group PL (Pressable lithium disilicate) specimens. Conclusion: Although there was a statistically significant difference between the two groups, marginal gap of both the groups were in clinically acceptable levels.

Limited information is available on the precision of new metal processing technologies.The purpose of this in vitro study was to evaluate the marginal and internal fit of pre-sintered cobalt-chromium (Co-Cr) and zirconia 3-unit fixed dental prostheses using x-ray microcomputed tomography.Three-unit fixed dental prostheses were prepared on metal dies (N=12) using a typodont model from the maxillary first premolar to the first molar. A standardized preparation with a 1.2-mm chamfer (360 degrees) and a 2-mm occlusal reduction was prepared on abutment teeth. The dies were scanned and divided into 2 groups to receive the fixed dental prostheses (n=6) made of pre-sintered Co-Cr and pre-sintered zirconia. Each framework was seated on its cast, and marginal and internal discrepancies were measured at 9 points, starting from the most distal point from the pontic for the maxillary first premolar and the first molar (points 1-4, mesial; point 5, occlusal; points 6-9, distal) of each abutment tooth using microcomputed tomography. The data were analyzed using the Levene test, t test, and ANOVA (α=.05).When overall mean discrepancy values were compared, no significant difference was observed between pre-sintered Co-Cr and pre-sintered zirconia (P=.085). Discrepancy values for points 1, 2, and 3 were significantly different for pre-sintered Co-Cr and pre-sintered zirconia, with the lowest mean values for point 1 and the highest for point 5. On the abutment tooth basis, for the maxillary first premolar and the first molar, a significant difference was found only in points 6 (P.001) and 8 (P.003) for both materials. When the discrepancies for the maxillary first premolar were considered for pre-sintered Co-Cr and pre-sintered zirconia, the mean values were significantly different only at points 1 (P.001), 2 (P=.007), and 3 (P=.003) and were smaller for pre-sintered zirconia. For the tooth the first molar, a significant difference was observed at point 2 (P=.002) and point 3 (P=.008) for both materials, where the mean values were higher for pre-sintered Co-Cr than for pre-sintered zirconia. The pairwise comparison between points showed a significant difference between measurement points within each material (P.05). The increase in values between points 1 and 5 was evident for both pre-sintered Co-Cr and pre-sintered zirconia materials.Three-unit fixed dental prostheses made of pre-sintered Co-Cr or zirconia showed similar marginal and internal discrepancy values, with the highest discrepancy values at the occlusal region in both the first premolar and first molar.

Statement of problem Veneering with porcelain may adversely affect the marginal fit of long-span computer-aided design and computer-aided manufacturing (CAD-CAM) implant-supported fixed prostheses. Moreover, data regarding the precision of fit of CAD-CAM–fabricated implant-supported complete zirconia fixed dental prostheses (FDPs) before and after porcelain layering are limited. Purpose The purpose of this in vitro study was to evaluate the effect of porcelain layering on the marginal fit of CAD-CAM–fabricated complete-arch implant-supported, screw-retained FDPs with presintered zirconia frameworks compared with titanium. Material and methods An autopolymerizing acrylic resin–fixed complete denture framework prototype was fabricated on an edentulous typodont master model (all-on-4 concept; Nobel Biocare) with 2 straight in the anterior and 2 distally tilted internal-hexagon dental implants in the posterior with multiunit abutments bilaterally in canine and first molar locations. A 3-dimensional (3D) laser scanner (S600 ARTI; Zirkonzahn) was used to digitize the prototype and the master model by using scan bodies to generate a virtual 3D CAD framework. Five presintered zirconia (ICE Zirkon Translucent - 95H16; Zirkonzahn) and 5 titanium (Titan 5 - 95H14; Zirkonzahn) frameworks were fabricated using the CAM milling unit (M1 Wet Heavy Metal Milling Unit; Zirkonzahn).The 1-screw test was applied by fixing the frameworks at the location of the maxillary left first molar abutment, and an industrial computed tomography (CT) scanner (XT H 225 - Basic Configuration; Nikon) was used to scan the framework-model complex to evaluate the passive fit of the frameworks on the master model. The scanned data were transported in standard tessellation language (STL) from Volume Graphics analysis software to PolyWorks analysis software by using the maximum-fit algorithm to fit scanned planes in order to mimic the mating surfaces in the best way. 3D virtual assessment of the marginal fit was performed at the abutment-framework interface at the maxillary right canine (gap 3) and right first molar (gap 4) abutments without prosthetic screws. The facial or buccal aspects of the teeth on frameworks were layered with corresponding porcelain (Initial Dental Ceramic System; GC) and CT-scanned again using the same protocol. Marginal fit measurements were made for 4 groups: titanium (Ti) (control), porcelain-layered titanium (Ti-P) (control), zirconia (Zr), and porcelain-layered zirconia (Zr-P). 3D discrepancy mean values were computed and calculated, and the results were analyzed with a repeated measures 3-way ANOVA using the maximum likelihood estimation method and Bonferroni adjustments for selected pairwise comparison t- tests (α=.05). Results The 3D fit was measured at gap 3 and gap 4. Statistically significant differences in mean 3D discrepancies were observed between Zr-P (175 μm) and Zr (89 μm) and between Zr-P and Ti-P (71 μm) ( P Conclusions Porcelain layering had a significant effect on the marginal fit of CAD-CAM–fabricated complete-arch implant-supported, screw-retained FDPs with partially sintered zirconia frameworks. 3D marginal discrepancy mean values for all groups were within clinically acceptable limits (

Statement of the Problem: Management of severe occlusal erosive lesions constitutes a challenging therapeutic approach to the restorative dentist. Bonded occlusal veneers have been introduced as a conservative solution to traditional onlays or complete coverage crowns. Still, there is lack of information and conflict in the data concerning the mechanical performance of the occlusal veneer materials and designs.Purpose: The purpose of this in vitro investigation was to evaluate and compare the fracture resistance and failure mode of a newly proposed occlusal veneer design constructed of zirconia reinforced lithium silicate and hybrid ceramic materials with the conventional design restored with the same tested materials.Materials and Methods: Two mandibular first molars of a typodont were chosen to perform the master preparations; one for the conventional planar occlusal veneer design, and the second for the proposed modified design which consisted of occlusal veneer preparation with circumferential chamfer finish line and two shallow proximal slots. Ten elastomeric impressions were taken for each design using the putty and light polysiloxane addition silicone impression material. The twenty impressions were poured using type IV dental stone to produce twenty stone casts, ten for each design. Each group of stone casts was subdivided randomly into two equal subgroups according to the ceramic material to be tested; the zirconia reinforced lithium silicate “Celtra Duo” and the hybrid resin nano ceramic “Lava Ultimate”. All the occlusal veneers were fabricated using the CAD/CAM Cerec InLab SW 4.2.5 System. The veneers were then checked on both the stone casts and the master preparation on the typodont for perfect seating, after the Celtra veneers were crystallized and glazed and the Lava veneers being subjected to finishing and polishing. The preparations were duplicated to obtain twenty epoxy casts over which the occlusal veneers were adhesively cemented using a standard bonding protocol. The samples were then subjected to thermal cycling program. All the samples were individually mounted on the Instron testing machine with a loadcell of 5 KN and fracture test was done by compressive mode of load applied occlusally using a metallic rod with spherical tip (5.6 mm diameter) at cross-head speed of 1mm/min. The load required to fracture was recorded in Newton and tabulated to be statistically analyzed. The fractured specimens were examined to detect the mode of failure. Results: Regardless of the ceramic type, the modified occlusal veneer design showed statistically significant higher fracture resistance mean value (1106.0 N) than conventional design (957.6 N) at P ≤ 0.05. Irrespective of the design, the Lava Ultimate revealed higher statistically significant fracture resistance mean value (1114.1 N) than Celtra (949.5 N) at P ≤ 0.05. The Celtra veneers showed higher fracture resistance mean value (1016.9N) with the conventional design than the modified design (882.2 N), the difference was statistically significant at P ≤ 0.05. While the lava veneers presented higher statistically significant fracture resistance mean value with the modified design (1329.9 N) than the conventional design (898.3 N) at P ≤ 0.05. All the specimens exhibited cracks limited to the veneer material, except one revealed catastrophic failure.Conclusions: 1- The modified occlusal veneer design offered promising results as far as fracture resistance is concerned particularly with the nano-hybrid ceramic which presented the highest statistically significant fracture resistance mean values.2- The conventional planar occlusal veneer design proved to be superior with zirconia lithium silicate ceramic (ZLS) as it presented highly significant fracture resistance mean values than with the modified design.3- Both the conventional and modified occlusal veneer designs presented fracture resistance mean values with the two tested materials “Celtra and Lava Ultimate” that exceed the range of clinical acceptability.4- Rating of the tested occlusal veneers according to their fracture resistance mean values is as follows: the highest for the Lava Ultimate with the modified design, followed by Celtra Duo with conventional design, then Lava Ultimate with conventional design and Celtra Duo with modified design.5- It can be recommended that in cases with increased occlusal stresses, Lava Ultimate occlusal veneer with the modified design be the first choice, followed by the Celtra Duo with the conventional design as a second choice.

The manufacturers of computer-aided design and computer-aided manufacturing (CAD-CAM) systems emphasize that new technologies can improve the marginal fit of dental crowns. However, data supporting this claim are limited.The purpose of this in vitro study was to investigate the differences among the following fabrication methods on the marginal discrepancy of dental crowns: intraoral optical scanners, powder application, and adjustments of intaglio surface.A single human premolar was fixed on a typodont and prepared to receive crowns prepared by the CEREC CAD-CAM system. Three fabrication techniques were used: digital scans using the CEREC Bluecam scanner with titanium dioxide powder (TDP), digital scans using the CEREC Omnicam scanner without TDP, and digital scans using the Omnicam scanner with TDP. Five experimental groups (n=10) were designated: Bluecam (group B), Bluecam with adjustments (group BA), Omnicam (group O), Omnicam with adjustments (group OA), and Omnicam with TDP (group OP). The specimens were scanned using microcomputed tomography to measure the vertical, horizontal, and internal fit and volumetric 3-dimensional (3D) internal fit values of each luting space. The paired t test was used to evaluate mean marginal fit change after adjustments within the same group. One-way analysis of variance and post hoc tests were used to compare groups B, O, and OP (α=.05).Mean vertical fit values ±standard deviations of group B=29.5 ±13.2 μm; BA=26.9 ±7.7 μm; O=149.4 ±64.4 μm; OA=49.4 ±12.7 μm; and OP=33.0 ±8.3 μm. Adjustments in the intaglio surface and TDP application statistically influenced the vertical fit of group O (P.001). The percentage of vertical fit values 75 μm in group B=89.3%, BA=92.7%, O=31.0%, OA=73.5%, and OP=92.0%. Mean horizontal fit values for group B=56.2 ±21.5 μm; 85.8 ±44.4 μm for group BA; 77.5 ±11.8 μm for group O; 102.5 ±16.2 μm for group OA; and 91.4 ±19.4 μm for group OP. Results from group B were significantly different from those of the other test groups (P.05). The percentages of horizontal misfit were 61.2% in group B; 73.5% in group BA; 88.1% in group O; 92.4% in group OA; and 85.0% in group OP. Volumetric 3D internal fit values in group B were 9.4 ±1.3 mmDifferent intraoral optical scanners, powder application, and internal adjustments influenced the marginal discrepancy of crowns. Crowns fabricated using the Omnicam system had significantly higher vertical discrepancy and volumetric 3D internal fit than those fabricated using the Bluecam scanner with TDP. Adjustments of the intaglio surface improved the vertical fit of crowns made using the Omnicam scanner; however, TDP application before Omnicam scanning improved the vertical fit as well as the volumetric 3D internal fit value of the luting space of crowns.

Purpose: To evaluate the influence of fabrication method and finish line design on marginal and internal fit of full-coverage interim restorations. Methods: Four typodont models of maxillary central-incisor were prepared for full-coverage restorations. Four groups were defined; knife-edge (KE), chamfer (C), rounded-shoulder (RS), rounded-shoulder with bevel (RSB). All preparations were digitally scanned. A total of 80 restorations were fabricated; 20 per group (SLA/3D-printed n = 10, milled n = 10). All restorations were positioned on the master die and scanned using micro-computed tomography. The mean gaps were measured digitally (ImageJ). The results were compared using MANOVA (α =.05). Results: Internal and marginal gaps were significantly influenced by fabrication method (P =.000) and finish-line design (P =.000). 3D-Printed restorations showed statistically significant lower mean gap compared to milled restorations at all points (P =.000). The mean internal gap for 3D-printed restorations were 66, 149, 130, 95 μm and for milled restorations were 89, 177, 185, 154 μm for KE, C, RS, RSB respectively. The mean absolute marginal discrepancy in 3D-printed restorations were (30, 41, 30, 28 μm) and in milled restorations were (56, 54, 52, 38 μm) for KE, C, RS, RSB respectively. Conclusions: The fabrication methods showed more of an influence on the fit compared to the effect of the finish-line design in both milled and printed restorations. SLA-printed interim restorations exhibit lower marginal and internal gap than milled restorations. Nonetheless, for both techniques, all values were within the reported values for CAD/CAM restorations. Significance: 3D-printing can offer an alternative fabrication method comparable to those of milled restorations.

Suboptimal adaptation of fixed dental prostheses (FDPs) can lead to technical and biological complications. It is unclear if the computer-aided design/computer-aided manufacturing (CAD/CAM) technique improves adaptation of FDPs compared with FDPs made using the lost-wax and metal casting technique. Three-unit FDPs were manufactured by CAD/CAM based on digital impression of a typodont model. The FDPs were made from one of five materials: pre-sintered zirconium dioxide; hot isostatic pressed zirconium dioxide; lithium disilicate glass-ceramic; milled cobalt-chromium; and laser-sintered cobalt-chromium. The FDPs made using the lost-wax and metal casting technique were used as reference. The fit of the FDPs was analysed using the triple-scan method. The fit was evaluated for both single abutments and three-unit FDPs. The average cement space varied between 50 μm and 300 μm. Insignificant differences in internal fit were observed between the CAD/CAM-manufactured FDPs, and none of the FPDs had cement spaces that were statistically significantly different from those of the reference FDP. For all FDPs, the cement space at a marginal band 0.5-1.0 mm from the preparation margin was less than 100 μm. The milled cobalt-chromium FDP had the closest fit. The cement space of FDPs produced using the CAD/CAM technique was similar to that of FDPs produced using the conventional lost-wax and metal casting technique.

PURPOSE To compare the marginal fit of lithium disilicate (LD) crowns fabricated with digital impression and manufacturing (DD), digital impression and traditional pressed manufacturing (DP), and traditional impression and manufacturing (TP). MATERIALS AND METHODS Tooth #15 was prepared for all-ceramic crowns on an ivorine typodont. There were 45 LD crowns fabricated using three techniques: DD, DP, and TP. Microcomputed tomography (micro-CT) was used to assess the 2D and 3D marginal fit of crowns in all three groups. The 2D vertical marginal gap (MG) measurements were done at 20 systematically selected points/crown, while the 3D measurements represented the 3D volume of the gap measured circumferentially at the crown margin. Frequencies of different marginal discrepancies were also recorded, including overextension (OE), underextension (UE), and marginal chipping. Crowns with vertical MG > 120 μm at more than five points were considered unacceptable and were rejected. The results were analyzed by one-way ANOVA with Scheffe post hoc test (α = 0.05). RESULTS DD crowns demonstrated significantly smaller mean vertical MG (33.3 ± 19.99 μm) compared to DP (54.08 ± 32.34 μm) and TP (51.88 ± 35.34 μm) crowns. Similarly, MG volume was significantly lower in the DD group (3.32 ± 0.58 mm3 ) compared to TP group (4.16 ± 0.59 mm3 ). The mean MG volume for the DP group (3.55 ± 0.78 mm3 ) was not significantly different from the other groups. The occurrence of underextension error was higher in DP (6.25%) and TP (5.4%) than in DD (0.33%) group, while overextension was more frequent in DD (37.67%) than in TP (28.85%) and DP (18.75%) groups. Overall, 4 out of 45 crowns fabricated were deemed unacceptable based on the vertical MG measurements (three in TP group and one in DP group; all crowns in DD group were deemed acceptable). CONCLUSION The results suggested that digital impression and CAD/CAM technology is a suitable, better alternative to traditional impression and manufacturing.

PURPOSE This in vitro study aimed to analyze and compare the reproducibility of zirconia and lithium disilicate crowns manufactured by digital workflow. MATERIALS AND METHODS A typodont model with a prepped upper first molar was set in a phantom head, and a digital impression was obtained with a video intraoral scanner (CEREC Omnicam; Sirona GmbH), from which a single crown was designed and manufactured with CAD/CAM into a zirconia crown and lithium disilicate crown (n=12). Reproducibility of each crown was quantitatively retrieved by superimposing the digitized data of the crown in 3D inspection software, and differences were graphically mapped in color. Areas with large differences were analyzed with digital microscopy. Mean quadratic deviations (RMS) quantitatively obtained from each ceramic group were statistically analyzed with Student's t-test (α=.05). RESULTS The RMS value of lithium disilicate crown was 29.2 (4.1) µm and 17.6 (5.5) µm on the outer and inner surfaces, respectively, whereas these values were 18.6 (2.0) µm and 20.6 (5.1) µm for the zirconia crown. Reproducibility of zirconia and lithium disilicate crowns had a statistically significant difference only on the outer surface (P

Objective This study aimed to evaluate the ability of the proposed technique in producing restorations that exhibit mimesis with tooth structure and to define a restorative clinical protocol. Materials and Methods For this study a typodont was used. The right upper central incisor with Class IV lesion was restored with the layering technique (reference tooth, RT). For the left upper central incisor with Class IV lesion, six teeth were restored monochromatically (test teeth, TT), using DA3.5 (n = 3) and DA4 (n = 3) composite resins—resulting in six unsatisfactory color restorations. TT were divided into six groups depending on the color of unsatisfactory restoration and preparation depth. First, a preparation was realized on the labial surface with 0.5 mm, 0.7 mm or 1.0 mm of depth. A second preparation was then performed to reproduce the dentinal mamelons. Next, adhesive procedures were performed and the teeth restored. Opaque halo, opalescent halo and vestibular enamel were then reproduced by the addition of different composite resins. The RT and TT were photographed side by side in typodont to obtain six photographic prints. The photographs of the groups were subjected to visual evaluation by 120 volunteers via a questionnaire. Data were analyzed by the prevalence of answers, and Chi-square test was used to investigate the association between variables at .05 significance. Furthermore, ΔE of groups was evaluated in comparison RT. Results The results demonstrated that the moderate intensity restorations (DA3.5) with depths of 0.5 mm and 0.7 mm had the highest prevalence of acceptance. For severe intensity restorations (DA4), the preparation depth of 1.0 mm obtained better acceptance. Conclusions The technique was able to modify the final color of Class IV restorations, producing satisfactory color restorations. CLINICAL SIGNIFICANCE This technique can be used for color correction in cases of Class IV restorations, in situations where there is no time for immediate layered restoration, and as a restorative technique.

Purpose Recently, we developed glass fiber-reinforced plastic (GFRP) orthodontic wire made from polycarbonate and E-glass fiber. The purpose of this study was to investigate the utility of GFRP wire in a clinical orthodontic treatment setting, the typodont model was simulated with a Class I malocclusion and mild crowding (arch length discrepancy: 4.5 mm). Materials and methods GFRP round wire with a diameter of 0.45 mm (0.018 in.) was prepared using 7 μm glass fibers. As control, nickeltitanium (Ni–Ti: 0.018 inch) alloy was also evaluated. For both wire groups, we examined the difference the arch widh and the arch length in the maxillary and mandibular using superimposition of 3D virtual models before and after immersion in typodont model. We also examined the strain force and permanent deformation. Results The inclination toward the labial aspect and the major axis of the upper and lower incisors increased, respectively, after the experiment. No significant differences before and after treatment were noted between the wires. On comparing the strain force of both wires after ligating the wire (4 weeks) in the strain test, the force of the GFRP wire was slightly lower than that of the Ni–Ti wires. In addition, there was more permanent deformation in the GFRP wire than in the Ni–Ti wire (P Conclusion GFRP wire showed equivalent efficiency to that of commercial Ni–Ti wire in improving mild anterior crowding in a typodont experiment. Therefore, GFRP wire can be used in place of Ni–Ti wire during the initial leveling stage.

Purpose To evaluate the marginal gaps of CAD/CAM (CEREC 3) produced crowns made from leucite-reinforced glass-ceramic (IPS Empress CAD) blocks (LG), and lithium-disilicate (IPS e.max CAD) blocks before (LD-B), and after (LD-A) crystallization firing. Materials and Methods A human molar tooth (#19) was mounted with adjacent teeth on a typodont and prepared for a full-coverage ceramic crown. The typodont was assembled in the mannequin head to simulate clinical conditions. After tooth preparation 15 individual optical impressions were taken by the same operator using titanium dioxide powder and a CEREC 3 camera per manufacturer's instructions. One operator designed and machined the crowns in leucite-reinforced glass-ceramic blocks (n = 5) and lithium-disilicate blocks (n = 10) using the CEREC 3 system. The crowns were rigidly seated on the prepared tooth, and marginal gaps (μm) were measured with an optical microscope (500×) at 12 points, 3 on each of the M, B, D, and L surfaces of the leucite-reinforced glass-ceramic crowns and the lithium-disilicate crowns before and after crystallization firing. Results were analyzed by two-way ANOVA followed by a Tukey's post hoc multiple comparison test (α = 0.05). Results The overall mean marginal gaps (μm) for the crowns evaluated were: LG = 49.2 ± 5.5, LD-B = 42.9 ± 12.2, and LD-A = 57.2 ± 16.0. The marginal gaps for LG and LD-B were not significantly different, but both were significantly less than for LD-A. Conclusions The type of ceramic material did not affect the marginal gap of CAD/CAM crowns. The crystallization firing process required for lithium-disilicate crowns resulted in a significant increase in marginal gap size, likely due to shrinkage of the ceramic during the crystallization process. Clinical Relevance: The marginal gap of CAD/CAM-fabricated lithium disilicate crowns increases following crystallization firing. The marginal gap still remains within clinically acceptable parameters.

Purpose: Evaluate and compare the effect of using die spacer on marginal accuracy and fit of indirectly fabricated temporary restorations using silicone model material and stone dies. Problem statement: Chairside temporary restorations fabricated by the direct method commonly show binding on seating, or short margins or premature contacts after temporary cementation. Temporary restorations are fabricated without spacer which may compromise the fit. Therefore it would be an advantage to provide adequate internal fitting space to optimize marginal adaptation.Methodology: Master die was typodont .Maxillary first molar was manually prepared as in an actual clinical situation. A vacuu-pressed tooth index was made before preparation to standardize the dimension of the temporary restoration. A total of twenty temporary crowns were fabricated from autopolymerizing Bis-acryl resin material and divided into two groups according to the model material used (n=10) stone (Fuji rock; type IV die stone, GC & Modellsilikon, VOCO GmbH, Cuxhaven, Germany) poured from alginate impressions. Each group was subdivided into two subgroups according to spacer used; with and without spacer (n=5). Two coats (approximately 30 µm) were painted on the dies. All the fabricated temporary restorations were visually examined internally and verified for complete seating on its corresponding die. Seating and fit of each crown were evaluated on the master die and were stored in distilled water overnight till testing took place. Margins were inspected and photographed under magnification of 45X using USB Digital microscope measurements. The generated data was statistically analyzed. The significance level was set at P ≤ 0.05Results: There was no statistically significant difference between vertical marginal gap distances in the two groups; (79.9+15.0 µm) (66.4+10.0 µm) without spacer and with spacer respectively at P ≤ 0.05Conclusion & Clinical implications: Despite that the resulted difference in gap is insignificant however painting spacer seems to provide better cement escape vent thus easing fit, also the use of silicone model material offers a practical, speedy and simplified method to conveniently fabricate a good fitting temporary restoration.

Objective This in vitro study aims to evaluate load-to-failure of ceramic veneers with butt joint (BJ) and feathered edge (FE) incisal preparation designs, and to correlate these results to the failure mode of the restorations. Materials and methods One hundred and forty-eight typodont teeth (customized Nissin A25A-UL19B) were divided into two different preparation configurations BJ and FE and two different loading angulations, 0° and 20°. Lithium disilicate ceramic veneers (IPS e.max CAD, Ivoclar Vivadent) were milled using computer-aided-design-and-computer-aided-manufacturing (CAD/CAM) techniques. Veneers were bonded to typodont teeth with resin cement (IPS Variolink Esthetic, Ivoclar Vivadent). Each group was loaded at the incisal edge using an Instron Universal Testing Machine at a crosshead speed of 0.01 mm/s till failure. Results Pairwise comparison showed veneers from the BJ groups had a significantly higher load-to-failure value compared to the FE groups. Veneers with a FE preparation design loaded at 20° angulation had the lowest load-to-failure value. Conclusions Within the limitations of the present study, both incisal preparation designs and loading angulations have significant effects on the load-to-failure values of ceramic veneers. BJ group exhibits a significantly higher load-to-failure value compared to the FE group. Clinical significance BJ incisal preparation is preferred over FE preparation design.

Statement of problem Additive manufacturing (AM) technologies can be used to fabricate definitive casts for implant-supported restorations. However, information regarding the accuracy of the implant replica position on the polymeric AM cast generated with different scan bodies and digital implant replica systems is lacking. Purpose The purpose of this in vitro study was to compare with a conventional stone cast the linear and angular discrepancies of the implant analog positions in a polymeric AM cast obtained from 3 different scan body and digital implant replica systems. Material and methods A partially edentulous maxillary typodont with 3 implant replicas (Implant replica RP Branemark system; Nobel Biocare) was prepared. Two duplicating methods were evaluated: conventional (CNV group) and AM (AM group) procedures. For the CNV group, polyvinyl siloxane open-tray implant impressions (CNV) were made at room temperature (23 °C). The AM group was further divided into the subgroups Elos Medtech, Nt-Trading, and Dynamic Abutment. For the Elos Medtech subgroup, the corresponding scan bodies were placed on each implant, and the typodont was digitized by using a laboratory scanner (E3 scanner; 3Shape A/S). The same procedure was repeated with the remaining subgroups. All the AM polymer casts were fabricated at once by using the same 3D printer (Eden 500V; Stratasys). Ten specimens of each group were obtained (n=10). A coordinate-measuring machine (CMM) was used to measure the position of each implant replica, and distortion was calculated for each system at the x-, y-, and z-axes and 3D distortion measurement ( 3 D = x 2 + y 2 + z 2 ). The Shapiro-Wilk test revealed that the data were not normally distributed. The Kruskal-Wallis and pairwise Mann-Whitney U tests (α=.05) were used for the analysis. Results The CNV group presented significantly higher linear discrepancy than the Dynamic Abutment group on the x- and y-axes. On the z-axis, however, the CNV group showed significantly lower linear discrepancy than the Nt-Trading and Dynamic Abutment groups. The 3D linear discrepancy was 12 ±12 μm for the CNV group, 4 ±100 μm for the Elos Medtech group, 8 ±52 μm for the Nt-Trading group, and 5 ±19 μm for the Dynamic Abutment. The CNV group demonstrated a significantly higher angle than the Nt-Trading group but a significantly smaller angle than the Elos Medtech and Dynamic Abutment groups. Conclusions The AM groups had lower 3D discrepancies than the CNV group. The Dynamic Abutment group had significantly better accuracy for the mesiodistal and buccolingual implant replica positions than the CNV group, but the conventional procedures had significantly better results for the apicocoronal implant replica position. Scan body and digital implant replica design systems only influenced the accuracy of the angular implant replica position on the AM casts.

Objectives Magnets have many advantages in orthodontics, and our previous studies confirmed their therapeutic potential through 3D-data analysis. The aim of this study was to compare tooth movements, including rotation, obtained via magnetic and elastic forces in crowded cases in vitro. Methods Typodont models mimicking a crowded case were prepared. In the magnetic force-driven orthodontics (MG) group, Nd-Fe-B magnets were attached to the labial surfaces from UR4 to UL4 for attracting force, and to UR6 and UL6 for repulsing force. For the elastic force-driven orthodontic (EL) group, brackets were placed on labial surfaces from UR2 to UL2 with power-chain elastics. A NiTi archwire was used in both groups. The models were 3D scanned before and after tooth movement and exported as STL files. The pre- and post-movement STL files were superimposed. The 3D coordinates of the measurement points of the crown and root apex were obtained, and tooth displacement, 3D movements (X, Y, and Z-axis), and rotation (yaw, pitch, and roll) were calculated. Two-tailed Student's t-test was performed for comparison of the results between MG and EL groups (n = 3). Results Overall, both groups indicated similar movement and rotation to achieve the planned arch form. In the crown movement and rotation, no significant differences were observed between MG and EL groups. However, in the root movement, there was a significant difference between MG and EL groups in X and Z axis for the canines. Conclusions Magnetic force-driven orthodontics demonstrated comparable results to elastics with less tipping movement, suggesting a potential future orthodontic modality. Clinical significance This in vitro study showed the potential of magnetic force for orthodontic application. The magnetic force-driven orthodontics might provide less tipping tooth movement compared to conventional methods, such as power chains, and could be a future technique for comprehensive orthodontic treatment., Magnets; Elastics; CAD/CAM; Orthodontics; 3D printer; 3D scanner.

Monolithic zirconia crowns fabricated with computer-aided design and computer-aided manufacturing (CAD-CAM) have recently become a common practice for the restoration of posterior teeth. The marginal fit of monolithic zirconia crowns may be affected by different cement space parameters set in the CAD software. Information is scarce regarding the effect of cement space on the marginal fit of monolithic zirconia crowns fabricated with CAD-CAM technology.The purpose of this in vitro study was to evaluate the effect of cement space on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns before cementation.Fifteen right maxillary first molar typodont teeth with standardized anatomic preparations for complete-coverage ceramic crowns were scanned with a 3-dimensional laboratory scanner. Crowns were designed 3-dimensionally using software and then milled from presintered monolithic zirconia blocks in a computer numerical control dental milling machine. The cement space was set at 25 μm around the margins for all groups, and additional cement space starting 1 mm above the finish lines of the teeth was set at 30 μm for group 25-30, 40 μm for group 25-40, and 50 μm for group 25-50 in the CAD software. A total of 120 images (3 groups, 5 crowns per group, 8 sites per crown) were measured for vertical marginal discrepancy under a stereoscopic zoom microscope and the data were statistically analyzed with 1-way analysis of variance, followed by the Tukey honestly significant difference test (α=.05).The results showed that different cement space values had statistically significant effect on the mean vertical marginal discrepancy value of tested crowns (P.001). The mean marginal discrepancy was 85 μm for group 25-30, 68 μm for group 25-40, and 53 μm for group 25-50.Within the limitations of this in vitro study, it was concluded that the cement space had a significant effect on the marginal fit of CAD-CAM-fabricated monolithic zirconia crowns. The marginal fit improved as the cement space decreased.