查看更多>>摘要：Abstract Objective This article describes a digital workflow using virtual enamel evaluation and a stereolithographic template for accurate tooth preparation for a complex exogenous dental erosion. Clinical Considerations A 22‐year‐old man with different degrees of defects on the labial surface in esthetic area was diagnosed as exogenous dental erosion. The residual undamaged enamel area and depth of defect were measured and analyzed accurately by creating a digital virtual patient based on the pretreatment data. According to the different conditions of residual enamel and tooth defect, the treatment plans of porcelain veneer, crown and composite resin were chosen for corresponding involved teeth. Based on the virtual wax‐up and the suggested material thickness, a template for tooth preparation was designed and three‐dimensional printed. This template together with a special bur indicating the reduction depth accurately guided the teeth preparation and achieved a long‐term effect. Conclusions The virtual enamel evaluation contributes to obtaining the appropriate corresponding treatment plan objectively. The stereolithographic template effectively meets the accuracy of tooth preparation, preserving the tooth hard tissue to the greatest extent. Clinical Significance The digital workflow described here may provide a quantifiable evaluation method and an accurate tooth preparation method for exogenous dental erosion.
查看更多>>摘要：Abstract To describe a digital workflow for creating a provisional restoration by using an extracted tooth rapidly, finally fixing the provisional restoration in the targeted position precisely and preserving the natural emergence profile from the time of provisional restoration to final restoration. Clinical considerations The use of extracted tooth as an immediate provisional restoration is an effective method for preserving the shape of the emergence profile. However, the existing methods for creating a provisional restoration by using natural tooth are time‐consuming and there is no reliable method to precisely attach tooth to temporary abutment. This case demonstrates a new method for using patient's natural tooth as an immediate provisional restoration under a sequence of guides, which significantly reduces the chair‐side time and inconvenience for clinicians and patients. Immediate provisional restoration contributes to preserving the soft tissue architecture after post‐extraction implant placement, especially when using the patient's tooth as a provisional restoration. Digital technology can help to improve the chair‐side clinical efficiency of dentist. Clinical significance Maintaining the natural soft tissue architecture is a huge challenge in dental implantology. Use of the extracted tooth as a provisional restoration is likely to achieve an optimal outcome. And digital technology is helpful to the efficiency and accuracy of treatment.
查看更多>>摘要：Abstract Objective The aim of this case report is to present a novel digital approach of guiding orthodontics and periodontal surgery by creating interim restorations that represent the final shape of the teeth before starting the treatment. Clinical considerations The patient presented with worn dentition, super‐erupted maxillary and mandibular anterior teeth, and altered passive eruption, all this creating a gummy smile. Following a digital wax‐up design, a digital orthodontic set‐up, and the digital bracket bonding, temporary restorations, and bracket indirect bonding trays were fabricated. Restorations' cementation, bracket bonding, and periodontal surgery were performed the same day. After 14?months of orthodontic treatment, teeth were restored with final ceramic restorations. One year and 6?months was the total treatment duration. Conclusion Prosthetically guided orthodontic concept allows the use of digital technology to simulate the final outcome of the patient treatment before starting dental therapy. This technique not only improves the communication between specialists, it also reduces treatment time and increases precision and predictability. Clinical significance The prosthetically guided orthodontics (PGO) concept has the goal to start interdisciplinary therapy with a simulation of the final outcome. Giving the worn teeth their proper size through interim restorations prior to orthodontic therapy will guide the orthodontist from the beginning of the treatment and will improve communications between all the specialists. Through a digital approach, a digital wax‐up and an orthodontic digital set‐up the objectives of treatment can be established early on.
查看更多>>摘要：Abstract Objective To provide a method of fabricating implant‐supported provisional restorations with orthodontic attachments by digital technique. Clinical consideration Polymethylmethacrylate (PMMA) provisional restorations are usually necessary when dental implants are serving as anchors for orthodontic treatments. For clear aligner treatment, it is possible to setup the teeth virtually and determine the final position of the implants, indicating that the provisional restorations can be also predetermined. However, attachments on PMMA restorations have a higher risk of debonding due to low bond strength. To fabricate provisional restorations with predetermined shape and position and no risk of attachment debonding immediately after implant placement, a digital workflow is introduced in this article. Conclusions By combining “pick‐up” technique and prefabricated monolithic PMMA provisional restorations, this technique is recommended for making implant‐supported provisional restorations with integrated orthodontic attachments based on the digitally designed positions of the teeth. Clinical significance The present protocol describes a digital workflow of designing and manufacturing implant‐supported PMMA provisional restorations with orthodontic attachments in the predetermined position of implants, which should lead to more reliable and predictable orthodontic treatment outcomes.
Julian ConejoTelmo SantosAbdullah TikreetiPablo J. Atria...
6页
查看更多>>摘要：Abstract Objective The aim of this case report is to present the CAD/Press technique; a workflow that combines digital design, milled, or 3D printed burnout molds, and a new pressable ceramic material for the treatment of extensive noncarious lesions with minimal invasive indirect ceramic restorations. Clinical Considerations Clinical decisions from material selection, preparation design, manufacturing techniques to adhesive protocols will be discussed, as they are important factors for achieving long‐term clinical success while preserving healthy tooth structure. Clinical Significance The presented workflow aims to ease clinical decisions when restoring extensive cases with indirect restorations and show clinicians a workflow combining several techniques.
查看更多>>摘要：Abstract Objective The conventional anterior esthetic treatment protocol is limited as it's time consuming and unreliable. A predictable digital workflow for minimally invasive anterior esthetic tooth rehabilitation with global diagnosis principle has been introduced in this report. Clinical Considerations A 23‐year‐old female patient with the chief complaint of unsatisfied shape and color of her anterior teeth visited our hospital for restorative consultation. Three‐dimensional Digital Smile Design was used to integrate into a virtual patient model to provide rehabilitative esthetic planning with global diagnostic principle. 3D printer was used for communication and guidance preparation. Digital impression and computer‐aided design/computer‐aided manufacturing technologies were adopted for making the morphology of designed restorations that can precisely transfer to definitive prostheses. The esthetics, functional occlusion, and gingival tissues remained stable for over a follow‐up period of 3?years. No signs of fractures within the restorations were observed. Conclusions Minimally invasive anterior esthetic tooth rehabilitation can be readily achieved using a predictable digital workflow with global diagnosis principle. Clinical Significance This digital approach might promote diagnosis, enhance communication, reduce processing time, and increase the predictability of final outcomes with high comfort and esthetic effect.
Carlos Rocha Gomes TorresAdrielle Caroline Moreira AndradeAna Paula Valente Pinho MafetanoFabrícia Stabile de Abreu...
13页
查看更多>>摘要：Abstract Objective This study compared the clinical performance of large indirect restorations (IRs) versus direct restorations (DRs) in posterior teeth. Methods Thirty subjects received two class II restorations (n?=?60), one fabricated from a precured composite block (Grandio Blocs, VOCO) for the indirect technique (IT) and the other with light‐cured composite (GrandioSO, VOCO) for the direct technique (DT). For IT, the restoration was created using the computer‐aided design and computer‐aided manufacturer (CAD/CAM) system. For DT, the material was applied light‐cured by using a layering technique. All restorations were evaluated by using the World Dental Federation criteria. Results Twenty‐three subjects attended the 2‐year recall, and 46 restorations were evaluated. No significant differences were detected between the techniques for most parameters analyzed (p?>?0.05). For “color match” at 7?days and 6?months, better results were observed for the DT. In relation to the overall scores, all restorations were esthetically acceptable after 2?years, while 93.3% of DT and 90% of IT showed acceptable function. For biological scores, 96.67% of DRs and 100% of IRs was acceptable after 24?months. Considering all properties, the success rates were 93.3% for DRs and 90% for IRs. Conclusions After 2?years, both restorations presented similar and good clinical behavior for all the properties analyzed. Clinical significance Light‐cured direct posterior composite restorations may perform similarly to indirect composite restorations made with precured CAD/CAM composite blocks up to 2?years.
Saif FaruqiKiran Kumar GanjiVinod BandelaAnil Kumar Nagarajappa...
7页
查看更多>>摘要：Abstract Aim To digitally evaluate the marginal adaptation of different types of all‐ceramic crowns on two different marginal configurations such as Shoulder and Chamfer of the prepared teeth. Methods The marginal fit of the crown specimens on the model of the prepared teeth were assessed using the dual scan replica technique. Two plastic teeth were prepared; one having a Shoulder finishing line (A), while the other with a Chamfer finish line (B). Three types of different all‐ceramic crowns, layered zirconia, monolithic zirconia, and pressed lithium disilicate, were fabricated for each prepared tooth (A) and (B). Measurements for assessing the marginal discrepancy were done on four designated points on the mesial, distal, buccal, and palatal surface of the superimposed image. Results The average marginal gap was the largest in the layered zirconia group, followed by monolithic zirconia, while pressed lithium disilicate crowns showed the least marginal gaps. Crowns with Chamfer finish lines were better fitting (less marginal gap) than the shoulder finish lines across all the groups. Conclusions Chamfer finish lines produced better fitting restorations, and heat‐pressed lithium disilicate crowns showed better adaptation at the margins than both layered zirconia and monolithic zirconia.
查看更多>>摘要：Abstract Objective The purpose of this study was to test a novel through‐the‐guide means of irrigation in an in‐vitro bovine bone model and to explore the method clinical applicability. Materials and Methods Surgical guides were designed to fit over five fresh bovine samples. Control osteotomy sites were compared to experimental sites irrigated through a 3D printed surgical guide with customized channels that direct the coolant toward the interface of the alveolar crest and drill. Temperature was measured during surgery with thermocouples located at 3 and 6?mm from the crestal height of the bone, and with an infrared thermal camera taking direct temperature readings from a window cut into axial wall at 9?mm from the crestal height of the ridge. Results Incorporation of routed irrigation significantly decreased heat generation, keeping temperature consistently below 47°C. A clinical case illustrates the method applicability using standard implant planning software, 3D printing technology, and regular implant armamentarium. Conclusions The in‐vitro analysis shows that this method mitigates temperature increase caused by static surgical guide irrigation blockade at the osteotomy site. This technique can be incorporated in the surgical guide design using commercially available software and 3D printing technology and has immediate applications in practice. Clinical Significance The in‐vitro analysis shows that this method can significantly mitigate the temperature increase caused by static surgical guide irrigation blockade at the osteotomy site. This technique also has the advantage that it can be incorporated in the digital surgical guide design using commercially available software and 3D printing technology. The method has immediate applications in practice, and especially in the treatment of edentulism in esthetic zone where use of guided surgery for implant placement is crucial in obtaining consistent results.
NSTL
Wiley