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首页> 外文期刊>The Journal of Prosthetic Dentistry >Marginal adaptation of CAD-CAM onlays: Influence of preparation design and impression technique
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Marginal adaptation of CAD-CAM onlays: Influence of preparation design and impression technique

机译：CAD-CAM托盘的边缘适应：制备设计和印模技术的影响

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Statement of problemFactors that may affect the marginal adaptation of computer-aided design and computer-aided manufacturing (CAD-CAM) restorations include preparation design, impression technique, and CAD-CAM system. The influence of impression technique and preparation design on CAD-CAM partial coverage restorations has not been fully addressed. PurposeThe purpose of this in?vitro study was to investigate the influence of direct and indirect digital scanning techniques and 2 preparation designs on the marginal adaptation of CAD-CAM onlays. Material and methodsTwo mesio-occlusal buccal onlay preparations with reduction of the mesiobuccal cusp were made: conventional preparation (CP) with a 1.2-mm modified shoulder margin and modified preparation (MP) flat cuspal reduction without shoulder. Virtual models were generated from each preparation by using a digital scanner (BlueCam; Dentsply Sirona) from the plastic teeth (direct digital scan) or from the stone dies (indirect digital scan). Onlays were designed using a CAD-CAM system (CEREC 4.0; Dentsply Sirona), and nanoceramic resin blocks (Lava Ultimate Restorative; 3M ESPE) were milled using the CEREC MCX milling machine. Marginal discrepancy was evaluated using an optical stereomicroscope at?×25 magnification in 18 locations distributed along the margins of the preparation. The data were analyzed by using 3-way ANOVA followed by the Tukey HSD test (α=.05). ResultsCP presented a statistically significant reduced average marginal adaptation (59 ±50 μm) than did MP (69 ±58 μm) (P<.001). The Tukey HSD test showed the presence of a significantly larger marginal discrepancy in the mesial and buccal locations of MP when compared with CP. Regarding impression techniques, the buccal location presented the smallest average marginal discrepancy in restorations fabricated with indirect impression when compared with direct impression (42 ±33 μm and 60 ±39 μm) (P<.001). ConclusionsThe results showed that conventional preparation with a modified shoulder margin presented improved marginal adaptation compared with modified preparation with flat cuspal reduction. Direct and indirect digital scanning techniques produced restorations within a clinically acceptable range; however, the indirect scanning technique resulted in the fabrication of restorations with superior marginal adaptation on the buccal location.
机译：可能影响计算机辅助设计和计算机辅助制造（CAD-CAM）修复的边际适应的问题，包括准备设计，印模技术和CAD-CAM系统。印模技术和制备设计对CAD-CAM部分覆盖修复物的影响尚未得到完全解决。目的的目的是在体外研究中，研究了直接和间接数字扫描技术的影响和2种制备设计对CAD-CAM onlay的边际适应性。制备了具有减少骨磁琥珀骨折的材料和方法 - 咬合颊骨颊镶嵌制剂：常规制剂（CP），具有1.2mm改性的肩部裕度和改性制剂（MP）平坦的尖端，无肩部减少。通过使用来自塑料牙齿（直接数字扫描）或石头模具（间接数字扫描）的数字扫描仪（Bluecam; Bluecam; Lentsply Sirona）从每种准备产生虚拟模型。使用CEREC MCX铣床研磨CAD-CAM系统（CEREC 4.0;浪藏SIRONA）和纳米陶瓷树脂块（LAVA终极修复; 3M ESPE）设计了托盘。使用光学立体显微镜在沿着制剂的边缘分布的18个位置中的光学立体显微镜评估边缘差异。通过使用3向ANOVA进行分析数据，然后进行Tukey HSD测试（α= .05）。结果施加了比MP（69±58μm）（P <.001）的统计学上显着的平均边缘适应（59±50μm）。 Tukey HSD测试显示与CP相比MP的间隙和口腔位置中的显着更大的边际差异存在。关于印模技术，与直接印象（42±33μm和60±39μm）相比，颊位位置呈现出在间接印象的修复体中的最小平均边缘差异。（42±33μm和60±39μm）（p <.001）。结论结果表明，与具有平坦尖端减少的改性制剂相比，具有改性肩部边缘的常规制备提高了边缘适应。直接和间接的数字扫描技术在临床上可接受的范围内产生修复物;然而，间接扫描技术导致在颊位位置上具有卓越的边际适应性的修复体。

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