Molar Crown Research Articles

In-vitro performance of subtractively and additively manufactured resin-based molar crowns

PurposeTo compare the in-vitro performance and wear behavior of additively or subtractively fabricated resin-based composite molar crowns for temporary and permanent application. Materials and methodsIdentical molar crowns (n = 8 per group) were manufactured from materials for temporary or permanent application (3x temporary additive fabrication, 3x additive permanent fabrication, 1x temporary subtractive fabrication, 1x permanent subtractive fabrication). All crowns were adhesively bonded (Calibra Universal, Dentsply Sirona, USA) on standardized resin-based composite molars (FDI 46, P Pro temporary Crown & Bridge). Thermal cycling and mechanical loading (2 × 3000 × 5°C/55 °C, 2min, H20 dist., 1.2 × 106 force 50N) were performed and fracture force was determined (v = 1 mm/min, Z010, Zwick, Germany). Mean wear, maximum wear, and roughness were investigated on polished (P1200) specimens (n = 8 per group, d = 8 mm) in a pin-on-block test (50N; 120000 cycles; 1.6Hz; H2O). Statistics were performed by using one-way ANOVA, Bonferroni post-hoc-tests, and Pearson-correlation (α = 0.05). ResultsAll crowns survived TCML without failures. Fracture forces ranged from 1362.4 ± 182.4N to 2354.1 ± 373.3N for the additive temporary crowns, from 1680.4.4 ± 525.1N to 2601.6 ± 403.7N for the additive permanent crowns, and reached values of 2988.5 ± 604.7N for subtractive temporary crowns and 3092.0 ± 307.6 N for subtractive permanent crowns. Significant (p < 0.001) differences were identified between the various additively manufactured systems, but not for the subtractively fabricated systems (p = 0.673). Mean wear of the additive temporary crowns ranged between 114.5 ± 25.8 μm and 163.8 ± 21.4 μm without significant differences (p = 0.061). Mean wear of the additive permanent crowns ranged between 120.0 ± 27.5 μm and 171.3 ± 31.8 μm with significant differences (p = 0.004). No statistically significant differences were identified between temporary and permanent subtractively manufactured specimens, with mean wear ranging between 140.5 ± 51.1 μm and 176.6 ± 26.8 μm (p = 0.673). Maximum wear of additive temporary specimens ranged between 221.4.5 ± 53.3 μm and 322.1 ± 50.6 μm; significant differences were identified between the groups (p = 0.016). Maximum wear of additive permanent specimens ranged between 246.3 ± 47.3 μm and 337.4 ± 61.4 μm, and significant differences were identified between the groups (p = 0.006). Mean wear of the subtractive group (permanent and temporary) showed no differences in maximum wear from 277.9 ± 79.7.1 μm to 316.4 ± 58.1 μm (p = 0.288). Ra roughness ranged from 0.7 ± 0.2 μm to 3.6 ± 1.3 μm with significant differences (p < 0.001) and Rz reference between 65.9 ± 26.2 μm and 16.8 ± 6.3 μm. ConclusionTemporary and permanent molar crowns provided at least acceptable in-vitro performance and fracture force for clinical mid-term application. Laboratory wear stability of the resin-based materials appeared sufficient, but should be verified under clinical conditions.

Evaluation of marginal and internal fit of single crowns manufactured with an analog workflow and three CAD-CAM systems: A prospective clinical study.

This prospective clinical study evaluated and compared the marginal and internal fit of crowns fabricated with an analog workflow and three different computer-aided design and computer-aided manufacturing (CAD-CAM) systems. Twenty-five participants in need of a single complete-coverage molar or premolar crown were recruited in the study. Twenty-two completed the study, and three participants dropped out. Teeth were prepared according to a standardized protocol by one operator. For each participant, one final impression was made with polyether material (PP) and three intraoral scanners: CEREC Omnicam (C), Planmeca Planscan (PM), and True Definition (TR). For the PP group, crowns were fabricated with a pressable lithium disilicate ceramic, whereas for the other three groups (C, PM, and TR), crowns were designed and milled with dedicated CAD-CAM systems and materials. Marginal (vertical and horizontal) and internal discrepancies between the crowns and tooth preparation were measured at various locations with digital superimposition software. Data was analyzed for normality with Kolmogorov-Smirnov and Shapiro-Wilk tests and then compared with one-way ANOVA and Kruskal-Wallis tests. Mean vertical marginal gap values were 92.18±141.41μm (PP), 150.12±138.06μm (C), 129.07±109.96μm (PM), and 135.09±112.03μm (TR). PP group had statistically significantly smaller vertical marginal discrepancy (p=0.001) than all other groups, whereas no significant difference was detected among the three CAD-CAM systems (C, PM, and TR). Horizontal marginal discrepancies were 104.93±111.96μm (PP), 89.49±119.66μm (C), 113.36±128.49μm (PM), and 136.39±142.52μm (TR). A significant difference was detected only between C and TR (p<0.0001). Values for the internal fit were 128.40±49.31μm (PP), 190.70±69.79μm (C), 146.30±57.70μm (PM), and 168.20±86.67μm (TR). The PP group had a statistically significant smaller internal discrepancy than C (p<0.0001) and TR groups (p=0.001), whereas no significant difference was found compared to the PM group. Posterior crowns fabricated with CAD-CAM systems showed vertical margin discrepancy greater than 120μm. Only crowns fabricated with the conventional methodology had vertical margins below 100μm. Horizontal marginal discrepancy was different among all groups, and only CEREC CAD-CAM was below 100μm. Internal discrepancy was less for crowns fabricated with an analog workflow.

Relationships between Dental Topography, Gross Wear, and Bang and Ramm/Liversidge and Molleson Age Estimates for a Sample of Human Premolar Teeth.

Molar crown wear is often used in bioarchaeological research as a proxy for age at death. However, a small number of researchers have used premolars or compared the application of different methods of relative age estimation. Using a sample of 197 previously extracted maxillary first premolars from US dental patients, we considered three protocols for estimating age: the Bang and Ramm/Liversidge and Molleson (BRLM) age estimate method, occlusal topographic analysis, and the Smith system of macrowear scoring. A previous study utilizing the Bang and Ramm method yielded an age estimate range of 9.4 to 10.8 years for the sample. Our analyses showed no associations between occlusal topography parameters (occlusal slope, relief, or faceting) and BRLM age estimates, but some concordance was found between Smith scoring and BRLM ages estimates and between Smith scoring and occlusal topography parameters. The results of the present study suggest that relationships between gross tooth wear, tooth shape, and dental age estimates are complex, and available methods should be considered together to gain a more comprehensive understanding of how teeth change their shape with wear throughout the lifecourse.

Which audio distraction technique is more effective for reduction the pain and anxiety of pediatric dental patients; “music” or “kids-story”? A randomized split-mouth crossover clinical trial

ObjectiveControl of pain, fear, and anxiety of children during dental procedures is a major challenge in pediatrics. This study aimed to compare the effect of audio distraction by music and audio-story on pain and anxiety of children during dental treatment. MethodsThis randomized crossover clinical trial evaluated 60 systemically healthy children between 4 and 8 years, who were candidates for pulpotomy and steel crown of bilateral primary maxillary first or second molars. The patients were randomly divided into two groups of music-story (M first), and story-music (S first) according to the sequence of receipt of the distraction techniques with a split-mouth design. The level of pain and anxiety of patients was measured using physiological scales such as pulse rate (PR), sound-eye-motor (SEM) and faces pain rating (FPR). The pkcross package in Stata software version 14 was used to assess the treatment effect, period effect, sequence effect and carryover effect. ResultsIn each group, 28 cases were included in the analysis. The difference in PR was not significant at the onset and termination of each treatment session between two distraction techniques and also, the mean FPR (P = 0.55) and SEM (P > 0.99) scores were not significantly different between the two groups. ConclusionsThe “audio-story” and “music” distraction techniques were not significantly different for pediatrics relieving during LA administration. Thus, considering the equal efficacy of the two techniques, dental clinicians can use any of the two to distract children. Registration informationThe study registered in the Iranian Registry of Clinical Trials (IRCT20190702044077N1).

Performance of Dental Cements Used for Bonding Zirconia Crowns with Titanium Implants Embedded in an Innovative Bi-Layered Artificial Bone

This study aimed to investigate four dental adhesive cements and develop a new method for constructing a bi-layered bone holder for implant testing. HahnTM Tapered Titanium Implants (Glidewell Laboratories) were embedded in mono- and bi-layered holders, and the implant components were assembled. First molar zirconia crowns and crowns for the tensile bond strength test were milled and sintered. Three self-adhesive resin cements (SARC) and one resin-modified glass ionomer (RMGI, Glidewell Laboratories) cement were used to cement the crowns on the abutment. Tensile bond strength, compressive load, and oblique load tests were performed on the implants. The Glidewell Experimental SARC (GES, Glidewell Laboratories) and RMGI cements had the highest tensile bond strength after thermocycling. The implant assemblies with these two cements had the highest mean compressive strength after thermocycling. Under oblique load, the implants with Denali (Glidewell Laboratories) and GES had the highest strength before thermocycling. However, after thermocycling, Dencem (Dentex) and RMGI had the highest strength under an oblique load. The GES cement and RMGI cement had a better overall performance with zirconia crowns and titanium abutments. In addition, a novel technique for constructing an artificial, bi-layered bone holder was successfully developed to mimic the natural structure of the jawbone.

Analysis of the impact of various finish line designs and occlusal morphologies on the accuracy of digital impressions

Background/purposeRecent advancements in dental technology has led clinicians to convert from traditional methods to digital workflows. The purpose of this study was to analyze the effect of various finish line designs and occlusal morphologies on the accuracy of digital impressions. Materials and methodsSix maxillary molar crown preparations were designed by using a digital sculpting software program. The samples differed in finish line design and occlusal surface morphology. Three different finish line designs (shoulder, chamfer, and shoulder with internal round angle) and two different occlusal morphologies (sharp and rounded) were used, giving six groups. Using three different intraoral scanners, each group was scanned and compared with a reference scan obtained from an industrial scanner. The accuracy of each scan was studied, and the data were statistically analyzed. ResultsA total of 180 scans were acquired by utilizing three different intraoral scanners. The reference scan was compared with the scans from each group and overall differences (marginal, axial, and occlusal) were assessed. A crown preparation with a chamfer finish line showed the lowest marginal discrepancy of 13.2 ± 4.18 μm while preparation with a shoulder finish line reported the highest discrepancy of 34.8 ± 7.9 μm (P < 0.05). Also, the occlusal discrepancies of the samples with rounded and sharp occlusal morphologies were 12.55 ± 3.09 μm and 19.13 ± 2.3 μm, respectively (P < 0.05). ConclusionIt has been suggested that chamfer finish line design and rounded occlusal anatomy may produce more accurate digital impression for single crown restorations.

REMOVED: Comparison between two different expansion protocols in early mixed dentition: Clear Aligners vs Rapid Maxillary Expansion

Aim to compare the effects of two different expansion protocols in terms of bi-dimensional linear, angular measurements, and three-dimensional analysis of palatal area on digital casts in patients with mixed dentition. Methods digital casts of 32 children treated with the RME (RG: 17 subjects), or with clear aligners (FG: 15 subjects) were collected. Linear and angular values were measured in both groups on the upper arch for each pre (T1) and post-treatment (T2) models, as well as palatal area. Unpaired t-test was used to test significant differences between groups (p<0.05). Results the comparison of T2-T1 changes for linear measurements between groups showed significant differences in the inter-canine width (+1.5mm in FG), in the first inter-deciduous molar width (+1.5mm in FG), in the first inter-molar distal width (-1.2mm in FG), in the inter-canine transpalatal width (+1.5mm in FG) and in the first inter-deciduous molar transpalatal width (+1.4mm in FG). The analysis of angular measurements showed a significant increase of the crown angulation for all the teeth in FG except for the second deciduous molars and for the first molars. First molars showed a reduction of this parameter. FG patients showed a greater increase of the palatal area. Conclusions the comparison between FG and RG groups pointed out that clear aligners system seems to be more efficient than RME in terms of expansion obtainable at the anterior segment of the arch with a better control of upper first molar crown angulation and a greater increase of the palatal area.

The relationship of tooth crown dimensions between first molar and central incisor in maxilla.

The purpose of this study was to investigate a correlation between the cusp dimensions of the first molar and mesiodistal crown diameters of the central incisors in the maxilla. The study materials were composed of dental casts from 29 modern Japanese female subjects with a mean age of 20years and 8months. The mesiodistal crown diameters of the maxillary central incisors were measured. The mesiodistal and bucco-lingual crown diameters and the cusp diameters of the maxillary first molars, such as the paracone, metacone, protocone, and hypocone, were also measured. The crown areas and indices of the first molars were calculated. The Spearman's single rank correlation coefficients between the mean values for the crown dimensions of the first molars and the mesiodistal crown diameters of the central incisors were calculated. The hypocone cusp diameter and the hypocone index were the largest compared to those of the paracone, protocone, and metacone cusps. The bucco-lingual diameter and hypocone cusp diameter of the first molars positively correlated with the mesiodistal crown diameters of the central incisors on the same sides. There were positive correlations between the hypocone index of the first molars and the mesiodistal crown diameters of the central incisors. Based on the results, if a large hypocone is observed in eruption of the maxillary first molars, it will be predictable that of the mesiodistal crown diameter of the maxillary central incisor large.

Variability in molar crown morphology and cusp wear in two Western chimpanzee populations.

Chimpanzees (Pan troglodytes) possess a relatively generalized molar morphology allowing them to access a wide range of foods. Comparisons of crown and cusp morphology among the four subspecies have suggested relatively large intraspecific variability. Here, we compare molar crown traits and cusp wear of two geographically close populations of Western chimpanzees, P. t. verus, to provide further information on intraspecific dental variability. Micro-CT reconstructions of high-resolution replicas of first and second molars of two Western chimpanzee populations from Ivory Coast (Taï National Park) and Liberia, respectively were used for this study. First, we analyzed projected tooth and cusp 2D areas as well as the occurrence of cusp six (C6) on lower molars. Second, we quantified the molar cusp wear three-dimensionally to infer how the individual cusps alter with advancing wear. Both populations are similar in their molar crown morphology, except for a higher appearance rate of a C6 in Taï chimpanzees. In Taï chimpanzees, lingual cusps of upper molars and buccal cusps of lower molars possess an advanced wear pattern compared to the remaining cusps, while in Liberian chimpanzees this wear gradient is less pronounced. The similar crown morphology between both populations fits with previous descriptions for Western chimpanzees and provides additional data on dental variation within this subspecies. The wear pattern of the Taï chimpanzees are in concordance with their observed tool rather than tooth use to open nuts/seeds, while the Liberian chimpanzees may have consumed hard food items crushed between their molars.

The Effect of a Digital Manufacturing Technique, Preparation Taper, and Finish Line Design on the Marginal Fit of Temporary Molar Crowns: An In-Vitro Study.

The aim of this study is to investigate the combined effect of a digital manufacturing technique (subtractive vs. additive), preparation taper (10° vs. 20° TOC), and finish line (chamfer vs. shoulder) on the marginal adaptation of temporary crowns following cementation with a compatible temporary cement. Four mandibular first molar typodont teeth were prepared for full coverage crowns with standard 4 mm preparation height as follows: 10° TOC with the chamfer finish line, 10° TOC with the shoulder finish line, 20° TOC with the chamfer finish line and 20° TOC with the shoulder finish line. Each of the four preparation designs were subdivided into two subgroups to receive CAD/CAM milled and 3D-printed crowns (n = 10). A total of 80 temporary crowns (40 CAD/CAM milled and 40 3D-printed) were cemented to their respective die using clear temporary recement in the standard cementation technique. The samples were examined under a stereomicroscope at ×100 magnification following calibration. Linear measurements were performed at seven equidistant points on each axial surface and five equidistant points on each proximal surface. One-way ANOVA analysis and Tukey HSD (Honestly Significance Difference) were performed. The best marginal fit was seen in group 8, while the poorest fit was noted in group 2. Shoulder finish lines and 10° TOC resulted in higher marginal gaps, especially in CAD/CAM milled group. The selection of 3D-printed crowns may provide a better marginal fit within the range of clinical acceptability. Marginal gaps were within clinical acceptability (50 and 120 µm) in all groups except group 2.

Wild boar versus domestic pig-Deciphering of crown growth in porcine second molars.

Based on the previously established periodicity of enamel growth marks, we reconstructed crown growth parameters of mandibular second molars from two wild boar and two domestic pigs of the Linderöd breed. Body weight gain and progression of dental development were markedly faster in the domestic pigs than the wild boar. While the final crown dimensions of the M2 did not differ between domestic pigs and wild boar, mean crown formation time (CFT) of this tooth was considerably shorter in the domestic pigs (162 days) than in the wild boar (205 days). The difference in CFT was mainly attributable to a higher enamel extension rate (EER) in the domestic pig. Generally, EER was highest in the cuspalmost deciles of the length of the enamel-dentine-junction and markedly dropped in cervical direction, with lowest values occurring in the cervicalmost decile. In consequence, the cuspal half of the M2 crown was formed about three times faster than the cervical half. In contrast to the EER, no marked difference in daily enamel secretion rate (DSR) was recorded between domestic pigs and wild boar. The duration of enamel matrix apposition as well as linear enamel thickness in corresponding crown portions was only slightly lower in the domestic pigs than the wild boar. Thus, the earlier completion of M2 crown growth in the domestic pig was mainly achieved by a higher EER and not by an increased DSR. The more rapid recruitment of secretory ameloblasts in the course of molar crown formation of domestic pigs compared to wild boar is considered a side-effect of the selection for rapid body growth during pig domestication.

Remineralization effects of Er,Cr:YSGG and/or bioactive glass on human enamel after radiotherapy-an in vitro study.

The aim was to evaluate the effects of Er,Cr:YSGG and/or bioactive glass 45S5 (BG) on the chemical and physical properties of enamel after radiotherapy. Third molar crowns were cut in half (buccal-lingually), and the mid part of the labial/oral surface was subjected to different protocols. All samples were treated with standard 70Gy. After radiotherapy, enamel was treated with either Er,Cr:YSGG (2780nm; pulse 60μs) and BG or only BG, and control samples were kept in deionized water. Vickers microhardness, scanning electron microscopy (SEM), and characteristic X-ray spectroscopy (EDS) were performed before, after radiotherapy, and after treatment. Analysis of variance (ANOVA) was used. A significant drop in enamel microhardness was observed after radiotherapy (p < 0.001). After Er,Cr:YSGG and BG or BG alone, there was a significant increase in microhardness (p < 0.001), which was on average significantly higher compared to the initial measurements for Er,Cr:YSGG with BG (p < 0.001), but not observed in BG alone (p = 0.331). After radiotherapy, SEM showed increased surface roughness with eroded prisms. Er,Cr:YSGG and BG or BG alone both showed disorderly packed glass particles on the enamel surface. Radiotherapy noticeably reduced the concentrations of calcium and phosphorus. Er,Cr:YSGG and BG treatment increased the concentrations of calcium, sodium, phosphorus, and silicate. BG treatment alone increased the concetration of calcium and phosphorus. Directly induced radiotherapy led to potential damage of enamel, but afterwards treatment with Er,Cr:YSGG laser and BG resulted in a higher increase of enamel microhardness compared to BG alone, reflecting in a possible better remineralization effect.

In Vitro Investigation of Material Combinations for Meso- and Suprastructures in a Biomimetic Approach to Restore One-Piece Zirconia Implants

The aim of this study was to find a suitable material combination to avoid cement excess in the marginal region of one-piece zirconia implant-supported restorations by means of a hybrid crown consisting of a meso- and a suprastructure. One-piece zirconia implants (n = 120) were embedded in epoxy resin. Microfilled resin composite mesostructures (n = 60), designed as caps, were bonded on the implant abutment with a primer only. A molar crown was constructed and cemented with a resin cement on top of the mesostructure as a suprastructure out of feldspar ceramic (n = 12), lithium-disilicate (n = 24), or zirconia (n = 24). Fracture load (n = 6) and retention force (n = 6) were measured immediately after storage in distilled water at 37 °C for 24 h, as well as after an additional exposure to artificial aging in a chewing simulator and simultaneous thermal cycling. For the measurement of the fracture load, monolithic crowns made of the employed restorative materials and identical in shape to the hybrid crowns served as controls (n = 6 each). Fracture load values for feldspar ceramic and lithium-disilicate hybrid crowns were slightly higher than those for the respective monolithic crowns at baseline and after aging, which was statistically significant only for feldspar crowns after aging. In contrast, fracture load values for zirconia monolithic crowns were higher than those for zirconia hybrid crowns, which was only statistically significant after aging. Artificial aging reduced the fracture load of feldspar and lithium-disilicate crowns both for hybrid and monolithic crowns. The effect was only statistically significant for lithium disilicate hybrid crowns. The fracture load for hybrid and monolithic zirconia crowns was increased by artificial aging without reaching statistical significance. The retention force of lithium-disilicate and zirconia hybrid crowns was not affected by artificial aging. Taking into account retention force and fracture load, lithium-disilicate hybrid crowns showed promising results.

Semi-supervised automatic dental age and sex estimation using a hybrid transformer model.

Teeth-based age and sex estimation is an important task in mass disasters, criminal scenes, and archeology. Although various methods have been proposed, most of them are subjective and influenced by observers' experiences. In this study, we aimed to develop a deep learning model for automatic dental age and sex estimation from orthopantomograms (OPGs) and compare to manual methods. A large dataset of 15,195 OPGs (age range, 16 ~ 50years; mean age, 29.65years ± 9.36 [SD]; 10,218 females) was used to train and test a hybrid deep learning model which is a combination of convolutional neural network and transformer model. The final performance of this model was evaluated on additional independent 100 OPGs and compared to the manual method for external validation. In the test of 1413 OPGs, the mean absolute error (MAE) of age estimation was 2.61years by this model. The accuracy and the area under the receiver operating characteristic curve (AUC) of sex estimation were 95.54% and 0.984. The heatmap indicated that the crown and pulp chamber of premolars and molars contain the most age-related information. In the additional independent 100 OPGs, this model achieved an MAE of 3.28years for males and 3.79years for females. The accuracy of this model was much higher than that of the manual models. Therefore, this model has the potential to assist radiologists in automated age and sex estimation.

Estimates of absolute crown strength and bite force in the lower postcanine dentition of Gigantopithecus blacki

Gigantopithecus blacki is hypothesized to have been capable of processing mechanically challenging foods, which likely required this species to have high dental resistance to fracture and/or large bite force. To test this hypothesis, we used two recently developed approaches to estimate absolute crown strength and bite force of the lower postcanine dentition. Sixteen Gigantopithecus mandibular permanent cheek teeth were scanned by micro-computed tomography. From virtual mesial cross-sections, we measured average enamel thickness and bi-cervical diameter to estimate absolute crown strength, and cuspal enamel thickness and dentine horn angle to estimate bite force. We compared G. blacki with a sample of extant great apes (Pan, Pongo, and Gorilla) and australopiths (Australopithecus anamensis, Australopithecus afarensis, Australopithecus africanus, Paranthropus robustus, and Paranthropus boisei). We also evaluated statistical differences in absolute crown strength and bite force between the premolars and molars for G. blacki. Results reveal that molar crown strength is absolutely greater, and molar bite force absolutely higher, in G. blacki than all other taxa except P. boisei, suggesting that G. blacki molars have exceptionally high resistance to fracture and the ability to generate exceptionally high bite force. In addition, G. blacki premolars have comparable absolute crown strength and larger bite force capabilities compared with its molars, implying possible functional specializations in premolars. The dental specialization of G. blacki could thus represent an adaptation to further facilitate the processing of mechanically challenging foods. While it is currently not possible to determine which types of foods were actually consumed by G. blacki through this study, direct evidence (e.g. dental chipping and microwear) left by the foods eaten by G. blacki could potentially lead to greater insights into its dietary ecology.

Marginal and Internal Fit of Monolithic Zirconia Crowns Fabricated by Using Two Different CAD-CAM Workflows: An In Vitro Study

Objectives: Few studies have evaluated the marginal fit of computer-aided design—computer-aided manufacturing (CAD-CAM) monolithic zirconia crowns fabricated through completely digital workflow; however, the internal fit of these restorations is not well known. The purpose of this in vitro study was to evaluate the marginal and internal fit of monolithic zirconia crowns fabricated by using digital workflow, including intraoral scanner (IOS) scans, and compare the results to those of a semi-digital workflow, which combined conventional impressions, poured casts, and extraoral scanner (EOS) scanning. Materials and methods: A typodont right mandibular first molar was prepared for a complete-coverage ceramic crown and scanned using an IOS. The conventional impressions of the preparation were also made, and stone casts were poured and scanned by using an EOS. Virtual models were generated for both workflows, and identical virtual anatomic contour crowns were designed using CAD software. Monolithic zirconia crowns were fabricated for both IOS (ZI; n = 10) and EOS (ZE; n = 10) groups. The silicon replica technique was used to evaluate the marginal and internal fit of the crowns. Measurements were made at 13 points on buccolingual and mesiodistal cross-sections per specimen with a ×6.5 to ×50 zoom stereo microscope. The results from both groups were statistically compared using the Independent Samples t-tests and the Mann–Whitney U test (α = 0.05). Results: Mean gap values at all measurement locations for ZE were significantly higher than those for ZI (p ≤ 0.002). Overall mean values ranged between 29 and 43 µm (median: 28–42 µm) for ZI and 42 and 75 µm (median: 43–77 µm) for ZE. Conclusion: Completely digital workflow through intraoral scans provided significantly better marginal and internal fit for CAD-CAM monolithic zirconia crowns compared with the semi-digital workflow, where stone casts obtained from conventional impressions were scanned with an EOS. Yet, both workflows provided an acceptable marginal and internal fit for CAD-CAM monolithic zirconia molar crowns (&lt;120 µm). Clinical Relevance: Completely digital workflow using IOS scans may be advantageous for the fabrication of CAD-CAM monolithic zirconia crowns as favorable results can be obtained with less material waste and potentially shortened overall treatment time as the impression files can be transferred to the production facility electronically. The results need to be corroborated with clinical studies.

Comparison of the morphology of the primary first molars and the forms of stainless steel crowns used in clinical practice.

This study aimed to assess the difference in the mesiodistal (MD) and buccolingual (BL) dimensions of primary first molars between Taiwanese boys and girls using a three-dimensional (3D) scanner (Microscribe G2 digitizer), record the coordinates in the 3D systems of Graph-R Project and reconstruct 3D images for subsequent analysis. We also determined whether the differences in these parameters between primary first molars and stainless steel crowns (SSC, 3M ESPE, No. 2-7) could be used as a reference for selecting a suitably-sized SSC and performing adjustments during restoration. The results indicated a statistically significant difference in the mesiodistal distance of lower primary first molar crowns between boys (7.75 ± 0.38 mm) and girls (7.41 ± 0.41 mm) (p < 0.05) but no differences in the mesiodistal distance of upper primary first molars between the two sexes. The mean mesiodistal distances of the upper and lower primary first molars of boys were close to SSC size 4 and 3, respectively, while those of girls were close to size 3 in both arches. Overall, the buccolingual distance between the first maxillary and mandibular molars of Taiwanese children was greater than the buccolingual distance between the 3M ESPE SSC. Reducing the buccolingual length of the abutment teeth might quickly help achieve a better fit, reduce chair time, and minimize patient discomfort. In addition, trimming the mesial and distal metal margins of SSCs might help reduce microleakage from the crown margins and improve its retention and survival rate. In conclusion, the 3D scanning and analysis method used in this study can serve as a reference for fabricating SSC to achieve better crown adaptation and improve dental procedures.

Clinical Outcomes of Posterior Implants with Surveyed Crowns for Implant-Assisted Removable Partial Dentures: A Retrospective Study.

Purpose: To evaluate the clinical outcomes of posterior implants with surveyed crowns in implant-assisted removable partial dentures (IARPDs). Materials and Methods: Internal-connection implants were inserted and restored with surveyed crowns at the most posterior molar regions of Kennedy class I or II in partially edentulous patients between 2007 and 2018. IARPDs were fabricated and functioned with or without clasps on the surveyed implant crowns. Clinical outcomes of biologic problems, mechanical problems, and marginal bone loss (MBL) through periapical and panoramic views were recorded and measured. The effects of sex, Kennedy classification, opposing dentition, and clasp existence on MBL were analyzed using Mann-Whitney test, and the implant length, crown-to-implant (C/I) ratio, and function period on MBL were analyzed using a multiple regression analysis at α = .05. Results: A total of 32 posterior implants were restored with a surveyed crown for IARPDs in 16 patients (7 men, 9 women; mean age: 69.3 ± 6.0 years). A total of 15 IARPDs were for the mandible (1 maxilla), and 13 were Kennedy class I (3 class II) before implant insertion. All internal-connection implants (15 bone-level and 17 tissue-level) with 7-mm (n = 12), 8.5-mm (n = 18), and 9-mm (n = 2) lengths were restored for 3 surveyed premolar crowns and 29 molar crowns (15 first molar and 14 second molar). The mean C/I ratio was 1.48. The mean function period of the implants was 60.9 ± 40.2 months (range: 14 to 155), and the mean MBL was 0.11 ± 0.36 mm. Only Kennedy class II showed significantly more MBL (P = .002). The implant survival and success rates were 96.9% and 90.6%, respectively. Conclusion: Within the limitations of this retrospective clinical study, mainly in mandibular IARPDs, implants with surveyed crowns showed high survival and success rates during short- to medium-term functions. Posterior implants with surveyed crowns appear to be a reliable alternative for free-end removable partial denture (RPD) patients.

Ceramic Crowns and Sleep Bruxism: First Results from a Randomized Trial.

Background: This randomized clinical trial was conducted to assess whether sleep bruxism (SB) is associated with an increased rate of technical complications (ceramic defects) in lithium disilicate (LiDi) or zirconia (Z) molar single crowns (SCs). Methods: Adult patients were classified as affected or unaffected by SB based on structured questionnaires, clinical signs, and overnight portable electromyography (BruxOff) and block randomized into four groups according to SB status and crown material (LiDi or Z): LiDi-SB (n = 29), LiDi-no SB (n = 24), Z-SB (n = 23), and Z-no SB (n = 27). Differences in technical complications (main outcome) and survival and success rates (secondary outcomes) one year after crown cementation were assessed using Fisher’s exact test with significance level α = 0.05. Results: No technical complications occurred. Restoration survival rates were 100% in the LiDi-SB and LiDi-no SB groups, 95.7% in the Z-SB group, and 96.3% in the Z-no SB group (p > 0.999). Success rates were 96.6% in the LiDi-SB group, 95.8% in the LiDi-no SB group (p > 0.999), 91.3% in the Z-SB group, and 96.3% in the Z-no SB group (p ≥ 0.588). Conclusions: With a limited observation time and sample size, no effect of SB on technical complication, survival, and success rates of molar LiDi and Z SCs was detected.

Distribution of Rodent Species (Mammalia: Rodentia) in Zonguldak Province, Turkey

To know rodent species in an area is important in wildlife management studies, forestry applications, conservation purposes, and public health studies because of some rodent-borne diseases. To determine rodent species and their distribution in Zonguldak was aimed to supply a detailed inventory data and distribution maps for further studies in future. Samples were collected mostly by Sherman traps, and rarely conventional cage-like traps, phototraps, or visually from 33 localities that represent different habitat types, between 2009 and 2016. A total of 427 specimens from 15 species were evaluated. These species are: Sciurus anomalus, Myodes glareolus, Microtus subterraneus, M. levis, Apodemus flavicollis, A. sylvaticus, A. uralensis, A. witherbyi, A. mystacinus, Rattus rattus, R. norvegicus, Mus domesticus, M. macedonicus, Glis glis and Muscardinus avellanarius. Of them S. anomalus, M. levis, A. uralensis, M. macedonicus and M. avellanarius were recorded by primary data for the first time from Zonguldak. According to the results, Sciurus anomalus, Apodemus flavicollis and Glis glis are the most common species by being recorded from 13, 12 and 9 localities, respectively. Among the 33 localities trapped, Kurtköy and Beldibi areas have highest number of rodent species by each having 7 species. Trap Night Index (TNI) was calculated to find the most caught rodent species, the overall trap success for rodents caught and the localities where the majority of rodent samples were caught. TNI was calculated as 21.43 for seven of the localities studied. Skull and pelage morphology (pectoral spot expressions, the posterior end of the palatal bone, pterygoid process, fronto-parietal suture and upper molar crown patterns) were used to identify Apodemus species. Morphological evaluations of Apodemus specimens verified the occurrence of A. sylvaticus in Asiatic Turkey.