BİLGİSAYAR DESTEKLİ TASARIM-BİLGİSAYAR DESTEKLİ ÜRETİM SİSTEMLERİNİN FARKLI DENTAL RESTORASYONLARIN KENAR VE İÇ YÜZEY UYUMLARINA ETKİSİNİN DEĞERLENDİRİLMESİ: İN-VİTRO ÇALIŞMA

Yıl 2020, Cilt: 30 Sayı: 1, 1 - 11, 15.01.2020

Merve Benli , Bilge Gökçen-rohlig

https://doi.org/10.17567/ataunidfd.599380

Öz

Amaç: Bu çalışmanın
amacı, direkt (ağız-içi tarayıcı) ve indirekt (ağız-dışı tarayıcı) dijital
teknikle üretilen kron ve inley restorasyonlarının kenar ve iç yüzey uyumunu
değerlendirmek ve geleneksel teknikle bilgisayar destekli tasarım ve bilgisayar
destekli üretim (CAD/CAM) kullanılarak üretilen restorasyonları
karşılaştırmaktır.

Gereç
ve yöntem: Kron ve inley
restorasyonların üretimi için mandibular sağ ve sol birinci büyük azı fantom
dişler kullanılmıştır. Çalışmada 6 grup kron (n=10), 3 grup inley (n=10) olmak
üzere toplamda 9 grup ve 90 adet örnek bulunmaktadır. Her iki restorasyon
tipinin üretiminde direkt dijital, indirekt dijital ve geleneksel yöntem
kullanılmıştır. Örneklerin kenar ve iç yüzey uyumunun değerlendirilmesinde
replika tekniği kullanılmış olup, ölçümler 50x büyütmeli stereomikroskop
altında gerçekleştirilmiştir. İstatistiksel değerlendirme tek yönlü varyans
analizi ve tekrarlı ölçümler varyans analizi yöntemleri ile yapılmış olup,
gruplar arası karşılaştırmalarda ise Tukey HSD ve Tamhane’s T2 testleri
kullanılmıştır(p<0,05).

Bulgular: Elde edilen
sonuçlara göre, kenar ve iç yüzey uyum değerlerinin ölçü ve üretim tekniğinden
etkilendiği görülmüştür. Direkt dijital teknik, indirekt dijital teknik ve
geleneksel yönteme göre her iki restorasyon grubunda en iyi sonuçları
vermiştir. Tüm gruplarda elde edilen iç yüzey aralık değerlerinin, kenar aralık
değerlerinden daha yüksek olduğu saptanmıştır (p<,001).

Sonuç: Çalışmanın kısıtlılıkları dahilinde, direkt dijital yolla
elde edilen kron ve inley restorasyonlarına ait kenar ve iç yüzey uyumları, indirekt
dijital ve geleneksel yöntemle üretilen restorasyonlara göre istatistiksel
olarak daha iyidir.

Anahtar
kelimeler: CAD/CAM, inley, kron, replika
teknikleri.

Evaluation of the
effect of computer aided design- computer aided manufacturing systems on
marginal and internal fit of different dental restorations: An in-vitro study

ABSTRACT

Aim: The aim of this study was to evaluate the marginal and
internal fit of crown and inlay restorations that produced with direct
(intra-oral scanner) and indirect (extra-oral scanner) digital methods and
compare the computer-aided design and computer-aided manufacturing (CAD / CAM)
restorations  with conventional ones.

Material and Methods: Mandibulary right
and left first molar phantom teeth were used to produce the crown and inlay
restorations. Totally, there
were 9 groups and 90 samples in the study, including 6 groups of crowns (n = 10)
and 3 groups of inlays (n = 10). Direct digital, indirect digital and
traditional methods were used in the production of both restoration types.
Replica
technique was used to evaluate the marginal and internal fit of the samples,
and the measurements were performed under a 50x magnification stereomicroscope.
One-way analysis of variance and repeated measures of
variance analysis were performed for statistical evaluation, and Tukey HSD and
Tamhane’s T2 tests were used for comparisons between groups (p <0.05).

Results: According to the obtained results, marginal and
internal fit values were influenced by impression and production technique. Direct digital technique gave the best results in both
restoration groups compared to indirect digital technique and the conventional
method. Internal gap
values obtained in all groups were found to be higher than marginal gap values
(p <.001).

Conclusion: Within
the limitations of the study, marginal and internal fit values of the crown and
inlay restorations obtained with direct digital method were statistically
better than the restorations produced by the indirect digital and conventional
methods.

Keywords: CAD/CAM, inlay, crown, replica techniques.

Anahtar Kelimeler

CAD/CAM, inley, kron

Kaynakça

• 1.Rekow ED. High-technology innovations-and limitations-for restorative dentistry. Dent Clin North Am 1993; 37: 513–24.
• 2.Piwowarczyk A, Ottl P, Büchler A, Lauer HC, Hoffmann A. In vitro study on the dimensional accuracy of selected materials for monophase elastic impression making. Int J Prosthodont 2002; 15: 168-74.
• 3. Chandran DT, Jagger DC, Jagger RG, Barbour ME. Two- and three-dimensional accuracy of dental impression materials: Effects of storage time and moisture contamination. Biomed Mater Eng 2010; 20: 243-9.
• 4. Thongthammachat S, Moore BK, Barco TM, Hovijitra S, Brown DT, Andres CJ. Dimensional accuracy of dental casts: Influence of tray material, impression material, and time. J Prosthodont 2002; 11: 98-108.
• 5. Wassell RW, Barker D, Walls AW. Crowns and other extra-coronal restorations: impression materials and technique. Br Dent J 2002; 192:679–84,687-90.
• 6.Mehl A, Ender A, Mormann W, Attin T. Accuracy testing of a new intraoral 3D camera. Int J Comput Dent 2009; 12:11–28.
• 7.Luthardt R, Weber A, Rudolph H, Schöne C, Quaas S, Walter M. Design and production of dental prosthetic restorations: Basic research on dental CAD/CAM technology. Int J Comput Dent 2002; 5:165–76.
• 8. Vlaar ST, Van der Zel JM. Accuracy of dental digitizers. Int Dent J 2006; 56: 301–9.
• 9. Miyazaki T, Hotta Y, Kunii J, Kuriyama S, Tamaki Y. A review of dental CAD/CAM: Current status and future perspectives from 20 years of experience. Dent Mater J 2009; 28: 44–56.
• 10. Mörmann WH. The evolution of the CEREC system. J Am Dent Assoc 2006; 137:7–13.
• 11.Tinschert J, Natt G, Spiekermann H, Spiekermann H, Anusavice KJ. Marginal fit of alumina- and zirconia-based fixed partial dentures produced by a CAD/CAM system. Oper Dent 2001; 26: 367–74.
• 12. Suarez MJ, Gonzalez de Villaumbrosia P, Pradies G, Lozano JF. Comparison of the marginal fit of Procera AllCeram crowns with two finish lines. Int J Prosthodont 2003; 16: 229–32.
• 13. Bindl A, Mörmann WH. Marginal and internal fit of all ceramic CAD/CAM crown-copings on chamfer preparations. J Oral Rehabil 2005; 32: 441–7.
• 14. Ender A, Mehl A. Influence of scanning strategies on the accuracy of digital intraoral scanning systems. Int J Comput Dent 2013; 16: 11–21.
• 15. Schaefer O, Watts DC, Sigusch BW, Kuepper H, Guentsch A. Marginal and internal fit of pressed lithium disilicate partial crowns in vitro: A three-dimensional analysis of accuracy and reproducibility. Dent Mater 2012; 28: 320–6.
• 16. Grasso JE, Nalbandian J, Sanford C, Bailit H. Effect of restoration quality on periodontal health. J Prosthet Dent 1985; 53: 14– 9.
• 17. Tan PL, Gratton DG, Arnold AMD, Holmes DC. An in vitro comparison of vertical marginal gaps of CAD/CAM titanium and conventional cast restorations. J Prosthet Dent 2008; 17:378–83
• 18. Dedmon HW. The relationship between open margins and marginal designs on full cast crowns made by commercial dental laboratories. J Prosthet Dent 1985; 53: 463–6.
• 19. Holden JE, Goldstein GR, Hittleman EL, Clark EA. Comparison of the marginal fit of pressable ceramic to metal ceramic restorations. J Prosthet Dent 2009;18: 645–8.
• 20.Kokubo Y, Ohkubo C, Tsumita Met, Miyashita A, Vult von Steyern P, Fukushima S. Clinical marginal and internal gaps of Procera All Ceram crowns. J Oral Rehabil 2005; 32: 526–30.
• 21. Martins LM, Lorenzoni F, Melo AO, Silva LM, Oliveira JL, Oliveira PC, Bonfante G. Internal fit of two all-ceramic systems and metal-ceramic crowns. J Appl Oral Sci 2012; 20:235–40.
• 22.Contrepois M, Soenen A, Bartala Met, Laviole O. Marginal adaptation of ceramic crowns: A systematic review. J Prosthet Dent 2013; 110:447–54.
• 23.Naumann M, Ernst J, Reich S, Weißhaupt P, Beuer F. Galvano- vs. metal-ceramic crowns: up to 5-year results of a randomized split-mouth study. Clin Oral Invest 2011; 15: 657–60.
• 24. https://kemaldis.com/magaza/ana-4-zp/
• 25.Monaco C, Rosentritt M, Llukacej A, Baldissara P, Scotti R. Marginal adaptation, gap width, and fracture strength of teeth restored with different all-ceramic vs metal ceramic crown systems: An in vitro study. Eur J Prosthodont Restor Dent 2016; 24:130-7.
• 26.Holmes JR, Bayne SC, Holland GA, Sulik WD. Considerations in measurement of marginal fit. J Prosthet Dent 1989; 62: 405-8.
• 27.Carlile RS, Owens WH, Greenwood WJ, Guevara PH. A comparison of marginal fit between press-fabricated and CAD/CAM lithium disilicate crowns. Gen Dent 2018; 66:45-8.
• 28.Yeo IS, Yang JH, Lee JB. In vitro marginal fit of three all-ceramic crown systems. J Prosthet Dent 2003; 90: 459–64.
• 29. Coli P, Carlsson S. Precision of a CAD/CAM technique for the production of zirconium dioxide copings. Int J Prosthodont 2004; 17:577-80.
• 30. Wolfart S, Wegner SM, Al-Halabi A, Kern M. Clinical evaluation of marginal fit of a new experimental all-ceramic system before and after cementation. Int J Prosthodont 2003; 16: 587-92.
• 31. Park SH, Yoo YJ, Shin YJ, Cho BH, Baek SH. Marginal and internal fit of nano-composite CAD/CAM restorations. Restor Dent Endod 2016; 41:37-43.
• 32.Syrek A, Reich G, Ranftl D, Klein C, Cerny B, Brodesser J. Clinical evaluation of all ceramic crowns fabricated from intraoral digital impressions based on the principle of active wavefront sampling. J Dent 2010; 38: 553–9.
• 33.Scotti R, Cardelli P, Baldissara P, Monaco C. Clinical fitting of CAD-CAM zirconia single crowns generated from digital intraoral impressions based on active wavefront sampling. J Dent 2011 DOI: 10. 1016/ j. jdent.2011.10.005.
• 34. Huang Z, Zhang L, Zhu J, Zhao Y, Zhang X. Clinical marginal and internal fit of crowns fabricated using different CAD/CAM technologies. J Prosthodont 2015; 24:291-5.
• 35. Reich S, Kappe K, Teschner H, Schmitt J. Clinical fit of four-unit zirconia posterior fixed dental prostheses. Eur J Oral Sci 2008; 116:579–84.
• 36.Abduo J, Lyons K, Swain M. Fit of zirconia fixed partial denture: A systematic review. J Oral Rehabil 2010; 37:866–76.
• 37.Mert Yüce Ş, Türk AG. Bilgisayar destekli tasarım-bilgisayar destekli üretim ve presleme sistemleriyle üretilen porselen laminat venerlerin kenar ve internal uyumlarının karşılaştırılması: İn vitro çalışma. Atatürk Üniv. Diş Hek. Fak. Derg 2017; 27:19-26.
• 38.Jeong ID, Lee JJ, Jeon JH, Kim JH, Kim HY, Kim WC. Accuracy of complete-arch model using an intraoral video scanner: An in vitro study. J Prosthet Dent 2016; 115:755-9.
• 39. Aboushelib MN, Elmahy WA, Ghazy MH. Internal adaptation, marginal accuracy and microleakage of a pressable versus a machinable ceramic laminate veneers. J Dent 2012; 40:670-7.
• 40.Kim JH, Cho BH, Lee JH, Kwon SJ, Yi YA, Shin Y, Roh BD, Seo DG. Influence of preparation design on fit and ceramic thickness of CEREC 3 partial ceramic crowns after cementation. Acta Odontol Scand 2015; 73:107-13.