Computer-aided Design Manufacturing Research Articles

Evaluation of the accuracy of digital indirect bonding vs. conventional systems: a randomized clinical trial.

To compare the accuracy and chair time of self-ligating brackets using direct bonding, traditional indirect bonding (IB), and computer-aided design/computer-aided manufacturing (CAD/CAM) IB techniques after orthodontic leveling and alignment. Forty-five patients were randomly assigned to three bonding groups (G1 [n = 15], G2 [n = 15], and G3 [n = 15]). Evaluation after the alignment and leveling phases used two parameters of the objective grading system of the American Board of Orthodontics for root parallelism and posterior marginal ridges, assessed using panoramic radiographies (PR I and PR II), a digital model, and a plaster model. Blinding was only applied for outcome assessment. No serious harm was observed except for gingivitis associated with plaque accumulation. Although G3 showed better numerical results, they were not statistically significant in the radiographic or model evaluations (P > .001). Mean chair time was significantly shorter in G3 (1.1 ± 11.8 min) vs. G1 (56.7 ± 7.3 min) and G2 (52.8 ± 8.3 min; P < .001). The CAD/CAM IB system for self-ligating brackets was as effective as conventional methods, with a shorter chair time.

Characterization of SLA-printed ceramic composites for dental restorations

This study introduces a novel ceramic-composite resin specifically developed for stereolithography (SLA) 3D printing, aimed at enhancing dental restorations. The integration of advanced digital technologies in dentistry has shifted traditional methods towards more precise and efficient techniques such as computer-aided design/computer-aided manufacturing (CAD/CAM). However, these processes typically involve material waste due to their subtractive nature. Additive manufacturing, or 3D printing, particularly SLA, which uses ultraviolet light to cure photosensitive resins, presents a viable alternative with the potential for creating detailed, custom restorations with minimal waste. Our research focuses on formulating and evaluating a ceramic-composite resin that combines the benefits of light-cured materials with the mechanical robustness required for dental applications. We conducted comprehensive tests to assess the printability, mechanical properties and wear resistance of the developed material. The ceramic-composite resin demonstrated a tensile strength of approximately 73 MPa, significantly higher than the 42 MPa observed for traditional photopolymer resins. Additionally, the ceramic-composite resin showed ability to resist incidental friction and wear. This research could significantly impact the dental prosthetics field by providing a method for producing high-performance, patient-specific restorations efficiently and cost-effectively.

Treatment of distal femur aseptic nonunion after lateral locking plate fixation: results of medial custom made plating and free fibula flap transfer using CAD-CAM technology

BackgroundAim of the present paper is to report the preliminary results of CAD-CAM (Computer-Aided Design - Computer-Aided Manufacturing) technology application to distal femur nonunion treatment with free fibula flap, custom made medial plating and maintenance of a stable lateral locking plate. MethodsTwo cases of distal femur nonunion that occurred after lateral locking plating were treated and prospectively followed-up. Surgical planning followed the same preoperative protocol adopted for mandibular CAD-CAM reconstruction. Wide cutting sections were planned to obtain radical debridement. The tailored custom-made plate, a 3D rendering of bone defect and the cutting guides were produced and sterilized. Surgical intervention was conducted by steps (medial approach, bone resection, recipient vessels isolation, fibula harvesting and cutting, plate-fibula construct assembly, microvascular anastomosis, final fixation). ResultsThe mean follow-up was 13 (12-15) months. Bone union was achieved in both cases at mean 3.1 months. Full weight bearing without referred pain or discomfort was reached in both cases at mean 8,5 months (range 7 – 10). No complications occurred. ConclusionsCAD-CAM technology proved to be useful and reliable in custom made medial plating combined with free fibula transfer for the treatment of distal femur nonunion after lateral locking plating. Trial registrationnone.

Custom‐made surgical guide with mucoperiosteal flap elevation function for the removal of multiple impacted supernumerary teeth: A case report

AbstractBackgroundSurgical guides manufactured with computer‐aided design/computer‐aided manufacturing (CAD/CAM) technology are effective tools for oral surgeries.Case presentationA new type of surgical guide with mucoperiosteal flap elevation function was custom designed, printed, and applied for the safe and accurate removal of six impacted supernumerary teeth in a 12‐year‐old male patient. The surgical guides were designed with access holes corresponding to the positions of the impacted teeth and the elevation structures of the mucoperiosteal flap.ConclusionThe novel custom‐made surgical guide system introduced in the present report was successfully utilized for minimally invasive teeth removal procedures.

The Biocompatibility and the Effect of Titanium and PEKK on the Osseointegration of Customized Facial Implants.

The purpose of this study was to investigate the optimization of computer-aided design/computer-aided manufacturing (CAD/CAM) patient-specific implants for mandibular facial bone defects and compare the biocompatibility and osseointegration of machined titanium (Ma), Sandblasted/Large-grit/Acid-etched (SLA) titanium, and polyetherketoneketone (PEKK) facial implants. We hypothesized that the facial implants made of SLA titanium had superior osseointegration when applied to the gonial angle defect and prevented the senile atrophy of the bone. Histologic findings of the soft-tissue reaction, hard-tissue reaction, and bone-implant contact (BIC (%) of 24 Ma, SLA, and PEKK facial implants at 8 and 12 weeks were investigated. There was no statistical difference in the soft tissue reaction. Bone was formed below the periosteum in all facial implants at 12 weeks and the BIC values were significantly different at both 8 and 12 weeks (p < 0.05). Ma, SLA, and PEKK facial implants are biocompatible with osseointegration properties. SLA can enhance osseointegration and provoke minimal soft tissue reactions, making them the most suitable choice. They provide an excellent environment for bone regeneration and, over the long term, may prevent atrophy caused by an aging mandible. The bone formation between the lateral surface of the facial implant and periosteum may assist in osseointegration and stabilization.

Clinical assessment of monolithic zirconia crowns fabricated using an intraoral scanner.

This in vivo study assessed the accuracy of single-tooth monolithic zirconia crowns made using an intraoral scanner (IOS) and computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Thirty patients requiring single posterior crowns were selected. The teeth were prepared with a deep chamfer finish line with a 1-mm extension subgingivally and a 1-mm reduction in all surfaces by one prosthodontist. The gingival margins were retracted using a gingival retraction paste before making impressions using a Trios scanner. All the digital impression files were sent to one laboratory using the dental designer software (3Shape, Copenhagen, Denmark). After completing the milling and sintering processes, the crowns were dyed and glazed. After removing the temporary crown, the qualitative assessment of proximal contacts of definitive monolithic zirconia crowns was performed according to the CDA criteria. Data were analyzed with Friedman's two-way analysis and independent t-test at α=0.05. The difference in axial and total gaps between premolar and molar teeth was not significant; however, the mean marginal gap of molars was higher than that of the premolars (P=0.043). Furthermore, the comparison of the axial, total, and marginal gaps between the upper and lower jaws showed no significant difference (P>0.05). The distribution of occlusal and proximal contacts indicated 60% and 66.7% proper contacts and no contacts in 6.7% and 10% of cases, respectively. Using IOSs could result in accurate monolithic zirconia crowns in terms of adaptation. Also, most occlusal and proximal contacts did not need any adjustments.

Digital Surgical Guides in Mandibular Genioplasty: Evaluating Precision Against Conventional Techniques.

Mandibular genioplasty, a central procedure in oral and maxillofacial surgery, has traditionally relied on surgeon experience with potential limitations in precision. The advent of digital methods, particularly computer-aided design/computer-aided manufacturing (CAD/CAM), offers a promising alternative. This study aims to evaluate the efficacy of digital surgical guides in improving the precision of mandibular genioplasty. A prospective analysis of 50 patients undergoing genioplasty was performed, 30 in the experimental group using digital surgical guides and 20 in the control group using traditional methods. Three-dimensional reconstructions were obtained using cone-beam computed tomography (CBCT) and digital scans. Osteotomy guides were 3D-printed based on group assignment. Postoperatively, accuracy was assessed by measuring distances between landmarks. The experimental group showed significantly reduced horizontal positioning errors in genioplasty advancement, with no significant differences in vertical errors. For genioplasty retraction, the experimental group showed fewer vertical positioning errors, while horizontal errors remained consistent. The use of digital surgical guides in mandibular genioplasty significantly improves surgical accuracy, resulting in improved outcomes and patient satisfaction. This study highlights the potential of digital methods in refining oral and maxillofacial surgical procedures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Effect of the scanner type on the marginal gap and internal fit of two monolithic CAD/CAM esthetic crown materials: An in vitro study.

The durability of indirect restorations is significantly influenced by marginal adaptation and internal fit. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) with digital impressions has reduced dental prosthesis fabrication errors, improving the long-term survivability of the restorations. The present study assessed the impact of intraoral and extraoral scanning methods on the marginal adaptation and internal fit of 2 different types of monolithic crowns manufactured using CAD/CAM. A total of 40 three-dimensional (3D) resin-printed dies were randomly assigned to 2 groups based on the type of crown material (n = 20 per group). Each group was divided into 2 subgroups (n = 10 per group) according to the die-scanning technique: subgroup A, scanned using the intraoral scanner (IOS) Primescan; and subgroup B, scanned using the extraoral scanner (EOS) inEos X5. The digitized photos were converted into a 3D virtual crown design using CAD software. The internal discrepancy values, and the marginal gap between the 3D resin-printed die and the crown were assessed using a ×50 digital microscope. The data was checked for normality with the Kolmogorov-Smirnov test, and the Mann-Whitney U test was used to compare the tested groups. The collected data was analyzed at a significance level set at p < 0.05. The different scanning techniques used had a statistically significant effect on the vertical marginal gap and the internal fit [μm] (p < 0.05). As far as the crown materials are concerned, BRILLIANT Crios showed a significantly higher marginal gap as compared to Tetric CAD when scanned with inEos X5 (p = 0.004), whereas the differences were insignificant with regard to the internal fit (p > 0.05).The crown parameters tested with both scanning systems were within the clinically acceptable ranges. Scanning methods and crown materials had an impact on the internal fit and vertical marginal gap of monolithic crowns.

Effects of Different Concentrations of Carbamide Peroxide on Color, Surface Roughness, and Hardness of CAD/CAM Dental Ceramics.

This study assessed the effects of 15% and 20% carbamide peroxide (CP) on color, surface roughness, and hardness of computer-aided design/computer-aided manufacturing (CAD/CAM) dental ceramics. This in vitro study was conducted on 120 Vita Mark II, Celtra Duo, and Suprinity CAD/CAM ceramic specimens. The ceramic specimens in each group (n = 40) were randomly assigned to two subgroups (n = 20) for polishing and glazing, and their baseline color, surface roughness (Ra), and hardness were assessed. In each subgroup, half of the specimens were exposed to 15% CP, while the other half were exposed to 20% CP. Their color change (ΔE), surface roughness, and hardness were then measured again. Surface roughness, hardness, and color were analyzed sequentially by profilometer, Vickers hardness tester, and spectrophotometer, respectively. Data were analyzed by repeated measures ANOVA, one-way ANOVA, and post hoc Bonferroni test (α = 0.05). The surface roughness of all groups significantly increased after bleaching treatment (p < 0.05). Surface hardness of all groups decreased after bleaching treatment, but this reduction was only significant in Vita Mark II subgroups (glazed, polished, 15%, and 20% CP). The ΔE was not clinically and visually perceivable in any group. The present results revealed that concentration of CP and type of surface treatment affected the surface properties of CAD/CAM ceramics. Type of surface treatment only affected the surface hardness of Vita Mark II ceramics (p < 0.05). Concentration of CP had a significant effect only on polished Vita Mark II.

Enhancing Fixed Partial Denture Pontic Fabrication: An In Vitro Comparative Study of the Digital and Manual Techniques.

Background Advancements in computer-aided design (CAD) and computer-aided manufacturing (CAM) technology have significantly improved the accuracy and consistency of producing fixed partial dentures (FPDs) compared to traditional manual methods. However, the fully digital transfer of mock-up morphology to final FPDs is not yet fully explored. Proper pontic design, which avoids direct gingival contact, is essential for maintaining oral hygiene and preventing tissue irritation. Aim and objectives This study aims to compare the effectiveness of digital versus manual methods in FPD pontic fabrication, focusing on the trueness of digitally fabricated FPD patterns. Key objectives include assessing thickness, vertical gaps, and anatomical accuracy to determine the advantages of CAD-CAM technologies over traditional techniques. Materials and methods In this in vitro study, a total of 45 FPD pontics were fabricated and divided into three groups (15 each): digitally fabricated (using CAD software and CAM systems), manually fabricated (using traditional wax-up techniques), and a control group (typodont teeth). Tooth preparation was performed on a typodont, and impressions were taken to create casts. One cast was scanned and digitally designed, while the other was used for manual fabrication. Outcome assessments included vertical gap measurement using a stereo microscope, thickness evaluation with a digital caliper, and anatomical similarity assessment by independent evaluators. Statistical analysis involved one-way analysis of variance (ANOVA), post hoc Tukey's analysis, and unpaired t-tests using SPSS software version 26.0 (IBM Inc., Armonk, New York). Statistical significance was set at 0.05. Results The digital group exhibited lower mean thickness at the incisal (1.92±0.130 mm vs. 2.46±0.219 mm for manual, p=0.000), middle (7.00±0.223 mm vs. 8.88±0.983 mm for manual, p=0.001), and cervical sites (9.06±0.134 mm vs. 10.08±0.454 mm for manual, p=0.000). No significant differences were found between the digital and control groups. No significant differences were observed between digital, manual, and control groups at any site (p=0.688 to 0.997). The digital group demonstrated superior accuracy and consistency compared to the control group (mean value of 1.00±0.00 vs. 2.93±0.798, p=0.000). Conclusion CAD-CAM technology greatly improves the precision and consistency of FPD pontic fabrication compared to traditional manual techniques. Digital methods produce thinner pontics with superior anatomical accuracy, although vertical gap measurements are similar across methods. These findings emphasize the benefits of CAD-CAM in enhancing prosthetic outcomes and suggest potential improvements in clinical practices for prosthodontic rehabilitation.

Effect of zirconia personalized gingival penetration on peri-implant soft and hard tissue of thin gingival biotypes in the anterior region: a retrospective study

Objective: To investigate the effect of zirconia personalized gingival structure on peri-implant soft and hard tissue stability after single-tooth implant restorations in patients with thin gingival biotypes in the anterior region, with a view to provide a clinical guideline. Methods: This retrospective study included 20 patients with thin gingival biotype and implant restorations in the anterior region. These patients included 9 males and 11 females, and the age was (35.2± 10.3) years. The patients were from the Department of Periodontal Implantology, Stomatology Hospital, Southern Medical University from January 2018 to December 2022. Computer-aided design/computer-aided manufacturing (CAD/CAM) techniques were used to fabricate a titanium base zirconia personalized gingival structure to maintain the soft-tissue perforated gingival contour of the anterior esthetic zone. This structure consists of two modalities: titanium base + zirconia outer crown or titanium base personalized zirconia abutment + zirconia outer crown. Clinical outcomes were recorded immediately and after delivery of the final restorations. Implant retention was recorded, esthetic scoring was performed using the pink esthetic index, the amount of bone resorption at the implant margins was measured based on digitized apical radiographs, and periodontal health was evaluated using the modified plaque index and the modified bleeding index. Results: The survival rate of the 20 implants was 100% after 3 years of wearing the final restorations, with a pink aesthetic score of 9.3±0.9. Bone resorption at the proximal and distal mesial margins of the implants was 0.09 (-0.21, 0.20) mm, 0.17 (-0.12, 0.27) mm after 3 years, respectively, and the difference was not statistically significant when compared to bone resorption immediately after placement of the final restoration [0(0, 0) mm] (Z=-1.03, P=0.394; Z=-2.05, P=0.065). Conclusions: Zirconia personalized gingival structure maintains the stability of peri-implant hard and soft tissues of thin gingival biotypes in the anterior region.

Impact of CAD/CAM burs lifetime on surface properties of dental zirconia: Implications for biocompatibility of custom abutments.

To evaluate the effect of the deterioration of computer aided design/computer aided manufacturing (CAD/CAM) burs during zirconia milling, on surface roughness, contact angle, and fibroblast viability. Ceramic blocks were milled and 75 ceramic disks (8 × 1.5 mm) made and allocated into three groups (n = 25): G1-brand new 2L and 1L burs, G2-2L bur at the end of lifetime and brand new 1L bur and G3-both burs at the end of their lifetimes. Roughness (Ra, Rq, and Rz) was evaluated using a 3D optical profilometer, the contact angle by the sessile drop method and the cell viability of the mouse NIH/3T3 fibroblast, using the Alamar Blue assay at intervals of 24, 48, and 72 h (ISO 10993-5). Data were analyzed by one-way ANOVA and Kruskal-Wallis tests (p ≤ 0.05). Roughness increased as the burs deteriorated and G3 (0.27 ± 0.04) presented a higher value for Ra (p < 0.001). The highest contact angle was observed in G3 (86.2 ± 2.66) when compared with G1 (63.7 ± 12.49) and G2 (75.3 ± 6.36) (p < 0.001). Alamar Blue indicated an increase in cell proliferation, with no significant differences among the groups at 24 and 72 h (p > 0.05). The deterioration of the burs increased the surface roughness and decreased the wettability, but did not interfere in cell viability and proliferation. The use of custom zirconia abutments represents an effective strategy for single crowns restorations. Our findings suggest that these abutments can be efficiently milled using CAD/CAM burs within their recommended lifetime.

Influence of conical hybrid stock and computer-aided design/computer-aided manufacturing abutments on the strain developed around implant and the screw loosening

Abstract Aim Evaluate effect of conical hybrid stock and computer-aided design/computer-aided manufacturing (CAD/CAM) abutments on the strain developed around implant and the screw loosening. Patients and methods Sixteen epoxy resin blocks containing implant assembly (fixture, abutment, abutment screw, cemented zirconia crown) divided into two equal groups (eight blocks) in each group as fallow: group (A): eight blocks with implants attached to Stock abutment with conical hybrid connection to retain the crown to the implant. Group (B): Eight blocks with implants attached to customized CAD/CAM milled abutment with the same size and connection to retain the crown to the implant. The samples were subjected to dynamic cyclic loading 150 000 cycles using chewing simulator. A digital torque gauge was used to evaluate screw loosening by measuring removal torque value (RTV) before and after cyclic loading. Strain gauge was installed around implants in buccal, palatal aspects of each implant, and a load of 100 N was applied vertically and another load of 65 N was applied obliquely by using universal testing machine and the strain was determined using strain meter. Results For GA, percentage of initial removal torque loss (RTL) was (17.988 ± 1.248%) and significantly increased after loading (30.763 ± 1.176%). For GB, percentage of initial removal torque loss was (24.350 ± 1.239%) and increased significantly after loading (33.313 ± 2.840%). For strain results under vertical and oblique loading, there was no statistically significant difference in both groups in stock and cad cam abutments and the strain measurement under oblique loading were significantly higher than the strains measured under vertical loading in both groups. Conclusions Screw loosening occurred in both stock abutments and CAD/CAM abutments but CAD/CAM abutments yielded greater removal torque reduction (RTV) reduction% than the stock abutments and stock abutments showed little stress values around implant than CAD/CAM abutment without statistically significant difference. Off-axial loads will generate more stresses around implants.

A comparative evaluation of marginal fit and microleakage of computer-aided design/computer-aided manufacturing-milled zirconia and prefabricated posterior occlusal veneers: An in vitrostudy.

The aim of this study was to compare the marginal fit of prefabricated occlusal veneers with computer-aided design/computer-aided manufacturing (CAD-CAM)-milled zirconia occlusal veneers in the posterior teeth. Forty extracted human maxillary premolars were divided into two groups of 20 each. Group 1 was prepared to receive prefabricated occlusal veneers, and Group 2 was prepared to receive CAD-CAM-milled zirconia occlusal veneers. Prefabricated samples (Edelweiss) were selected for Group 1, whereas for Group 2, the tooth preparations were scanned, and occlusal veneers were fabricated using Exocad designing software and milling machine. After luting, both the groups were submerged in dye, sectioned, and evaluated for marginal fit and microleakage under a stereomicroscope using the microscope imaging software and its measurement tool. Data collected were subjected to statistical analysis using SPSS 27.0. Intragroup and intergroup comparison was done using the Mann-Whitney U test. The Chi-square test was applied to check the depth of penetration of dye based on percentages. The marginal gap of zirconia occlusal veneers fabricated with CAD-CAM is higher compared to that of prefabricated occlusal veneers. Similarly, the depth of penetration of dye is higher in CAD-CAM-milled zirconia occlusal veneers than prefabricated occlusal veneers. The marginal fit of prefabricated occlusal veneer is better than the marginal fit of zirconia occlusal veneers fabricated with CAD-CAM. Similarly, it can also be concluded that the microleakage of prefabricated occlusal veneer is less compared to the CAD-CAM-milled zirconia occlusal veneers.

Correction to "Marginal fit of three different nanocomposite inlays fabricated with computer-aided design/computer-aided manufacturing (CAD/CAM) technology: a comparative study".

Correction to "Marginal fit of three different nanocomposite inlays fabricated with computer-aided design/computer-aided manufacturing (CAD/CAM) technology: a comparative study".

A Comparative Evaluation of Marginal and Internal Fitness of Zirconia Monolithic Crown Fabricated with Different CAD\CAM Systems: (In Vitro Study)

The precision of computer-aided design/computer-aided manufacturing (CAD/CAM) systems is reliant upon their technical attributes and reliability in producing the designated restorations. The evaluation of this precision is primarily conducted through the examination of the marginal and internal fitness of said restorations. Consequently, the objective of this research endeavor was to analyze and compare the marginal and internal fitness of zirconia crowns fabricated using various CAD/CAM systems. The samples were categorized into four groups, each consisting of 10 samples, based on the specific CAD/CAM equipment employed for crown fabrication as follows: Group I fabricated using Sirona CAD\CAM milling machine, Group II fabricated using Dentium CAD\CAM machine, Group III fabricated using XTCERA CAD\CAM machine and Group IV fabricated using IMES-ICORE CAD\CAM machine. Tooth preparation done following the guidelines recommended by KATANA TM Zirconia (Kurary Noritake Dental Inc., Japan). To ensure standardization, one CAD/CAM program designed parameters was selected to be used for all CAD/CAM machines. Cement thickness was directly measured using sectioning technique to assess the crown's internal and marginal fitness. After performing sectioning, measurements were conducted using a digital microscope with a magnification of 230x. Eleven predetermined measuring locations were selected for each sample, representing four distinct areas: two marginal points, two chamfer points, four axial points, and three occlusal points. Results showed that none of four CAD\CAM machines tested was able to accurately reproduce the designed cement space parameter except Group I (Sirona) showed the closest results. As a conclusion, no CAD\CAM system is 100% accurate however, crowns fabricated using Sirona CAD\CAM milling machine showed the closest recordings to selected parameters among other CAD\CAM milling machines tested.

A Novel Device for the Evaluation of In Vitro Bacterial Colonization in Membranes for Guided Tissue and Bone Regeneration.

Purpose: To evaluate, in vitro, the efficiency of a novel apparatus to test the adherence and penetration of bacteria on different membranes for guided regeneration. Methodology: To create the 3D device, Computer Aided Design/Computer Aided Manufacturing (CAD/CAM) systems were used. Three types of biomaterials were tested (n = 6): (DT) a collagen membrane; (DS) a polymer membrane; and (LP) a dense polytetrafluoroethylene barrier. The biomaterials were adapted to the apparatuses and challenged with two different monospecies bacterial culture of A. actinomycetemcomitans b and S. mutans. After 2 h, bacterial adherence and penetration were quantified by counting the number of colony-forming units (CFUs). Two specimens from each group were used for image analysis using Confocal Laser Scanning Microscopy. Statistical analysis was performed. Findings: The DS group had a higher adherence of S. mutans compared to A. actinomycetemcomitans b (p = 0.05). There was less adherence of A. actinomycetemcomitans b in the DS group, compared to the LP (p = 0.011) and DT (p < 0.001) groups. Only the membranes allowed penetration, which was blocked by barriers. The DT group allowed a greater penetration of S. mutans to occur compared to A. actinomycetemcomitans b (p = 0.009), which showed a higher penetration into the DS membranes compared to S. mutans (p = 0.016). The penetration of A. actinomycetemcomitans b through DS was higher compared to its penetration through DT and LP (p < 0.01 for both). DT and DS allowed a greater penetration of S. mutans to occur compared to LP, which prevented both bacterial species from penetrating. Conclusion: The apparatus allowed for the settlement and complete sealing of the biomaterials, enabling standardization.

3D-printed CAD/CAM complete dentures – Case report

Dentures are used to restore missing teeth and are traditionally fabricated using the lostwax technique. The flasking process is arduous, time-consuming, error-prone, and requires a skilled technician. The development of 3D printing technology has made rapid prototyping of dentures more feasible. This case report describes the functional rehabilitation of a completely edentulous patient with complete dentures by a manufacturer-independent workflow with conventional clinical steps combined with computer-aided design, computer-aided manufacturing (CAD/CAM), and 3D printing technology. The result was 3D-printed complete dentures that were fully adapted, economical, and well-accepted by the patient.

Evaluating the accuracy of one-piece and three-piece 3D-printed indirect bonding transfer trays: An in vitro study.

Recent developments in computer-aided design/computer-aided manufacturing (CAD/CAM) and 3D printing have enabled the fabrication of digital indirect bonding (IDB) transfer trays. These modern products require thorough investigation. The aim of the study was to determine the accuracy of one-piece and three-piece IDB transfer trays in vitro. An initial dental scan (IDS) of a randomly selected patient with digitally positioned brackets served as the master scan (MS) for designing 16 IDB transfer trays of each type. They were 3D printed and used for bonding 448 brackets to the models. Subsequently, the models were scanned with a TRIOS® 3 Intraoral Scanner (3Shape A/S, Copenhagen, Denmark), producing actual scans (ASs). The accuracy of bracket positioning was measured digitally on both MSs and ASs. The measurements were compared to the Objective Grading System for dental casts provided by the American Board of Orthodontics (ABO). The 2 types of IDB transfer trays showed comparable accuracy. All linear errors were within the clinically acceptable range, whereas the angular measurements demonstrated significant variability, resulting in clinically unacceptable transfer errors that ranged from 3.3% to 90.3%. The study results cannot be unconditionally extrapolated to other types of IDB transfer trays due to the diversity of their properties and features. The study evaluated the in vitro accuracy of IDB transfer trays. The revealed number of errors may be even higher in vivo due to limitations in visibility, salivary flow, interference from the tongue, and difficulties in achieving a proper fit of the IDB transfer tray to the teeth.

Resistance of CAD/CAM composite resin and ceramic occlusal veneers to fatigue and fracture in worn posterior teeth: A systematic review.

Severe tooth wear is related to substantial loss of tooth structure, with dentin exposure and significant loss (≥1/3) of the clinical crown. The objective of this systematic review was to summarize and analyze the scientific evidence regarding the mechanical performance of computer-aided design/computer-aided manufacturing (CAD/CAM) composite resin and CAD/CAM lithium disilicate ceramic occlusal veneers, in terms of fatigue and fracture resistance, on severely worn posterior teeth. Currently, occlusal veneers are an alternative for treating worn posterior teeth. Although scientific evidence demonstrates the good performance of lithium disilicate occlusal veneers, there are less brittle materials with a modulus of elasticity more similar to dentin than ceramics, such as resin CAD/CAM blocks. Therefore, it is important to identify which type of material is best for restoring teeth with occlusal wear defects and which material can provide better clinical performance. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of the PubMed, Embase, Web of Science, Scopus, Cochrane, OpenGrey, Redalyc, DSpace, and Grey Literature Report databases was conducted and supplemented by a manual search, with no time or language limitations, until January 2022. We aimed to identify studies evaluating the fatigue and fracture resistance of CAD/CAM composite resin and ceramic occlusal veneers. The quality of the full-text articles was evaluated according to the modified Consolidated Standards of Reporting Trials (CONSORT) criteria for in vitro studies, and 400 articles were initially identified. After removing duplicates and applying the selection criteria, 6 studies were included in the review. The results demonstrated that the mechanical performance of CAD/CAM composite resin occlusal veneers is comparable to that of CAD/CAM lithium disilicate occlusal veneers in terms of fatigue and fracture resistance.