Purpose: The purpose of this study was to assess the marginal and internal fit of interim crowns fabricated by two different manu-facturing method (subtractive manufacturing technology and additive manufacturing technology). Materials and Methods: Forty study models were fabricated with plasters by making an impression of a master model of the maxillary right first molar for ceramic crown. On each study model, interim crowns (n = 40) were fabricated using three types of 3D printers (Meg-printer 2; Megagen, Zenith U; Dentis, and Zenith D; Dentis) and one type milling machine (imes-icore 450i; imes-icore GmbH). The internal of the interim crowns were filled with silicon and fitted to the study model. Internal scan data was obtained using an intraoral scanner. The fit of in-terim crowns were evaluated in the margin, absolute margin, axial, cusp, and occlusal area by using the superimposition of 3D scan data (Geomagic control X; 3D Systems). The Kruskal-wallis test, Mann-Whitney U test and Bonferroni correction method were used to compare the results among groups (α = 0.05). Results: There was no significant difference in the absolute marginal discrepancy of the temporary crown manufactured by three 3D printers and one milling machine (P = 0.812). There was a significant difference between the milling machine and the 3D printer in the axial and occlusal area (P < 0.001). The temporary crown with the milling machine showed smaller axial gap and higher occlusal gap than 3D printer. Conclusion Since the marginal fit of the temporary crown produced by three types of 3D printers were all with in clinically acceptable range (< 120 µm), it can be sufficiently used for the fab-rication of the temporary crown.

PURPOSE: To measure axial displacement of different implant-abutment connection types and materials during screw tightening at the recommended torque by using a contact scanner for two-dimensional (2D) and three-dimensional (3D) analyses. MATERIALS AND METHODS: Twenty models of missing mandibular left second premolars were 3D-printed and implant fixtures were placed at the same position by using a surgical guide. External and internal fixtures were used. Three implant-abutment internal connection (INT) types and one implant-abutment external connection (EXT) type were prepared. Two of the INT types used titanium abutment and zirconia abutment; the other INT type was a customized abutment, fabricated by using a computer-controlled milling machine. The EXT type used titanium abutment. Screws were tightened at 10 N·cm, simulating hand tightening, and then at the manufacturers' recommended torque (30 N·cm) 10 min later. Abutments and adjacent teeth were subsequently scanned with a contact scanner for 2D and 3D analyses using a 3D inspection software. RESULTS: Significant differences were observed in axial displacement according to the type of implant-abutment connection (P < .001). Vertical displacement of abutments was greater than overall displacement, and significant differences in vertical and overall displacement were observed among the four connection types (P < .05). CONCLUSION: Displacement according to connection type and material should be considered in choosing an implant abutment. When adjusting a prosthesis, tightening the screw at the manufacturers' recommended torque is advisable, rather than the level of hand tightening.
Bicuspid ; Dental Implant-Abutment Design ; Dental Implants ; Hand ; In Vitro Techniques ; Prostheses and Implants ; Titanium ; Tooth ; Torque

PURPOSE: The purpose of this study was to evaluate the occurrence of displacement while tightening the screw of scan bodies, which were compared according to the material type. MATERIALS AND METHODS: Three types of scan bodies whose base regions were made up of polyether ether ketone (PEEK) material [Straumann Group, Dentium Group, and Myfit (PEEK) Group] and another scan body whose base region was made up of titanium material [Myfit (Metal) Group] were used (15 per group). The reference model was fabricated by aligning the scan body library on the central axis of the implant, and moving this position by the resin model. The screws of the scan bodies were tightened to the implant fixture with torques of 5 Ncm, 10 Ncm, and a hand tightening torque. After the application of the torque, the scan bodies were scanned using a laboratory scanner. To evaluate the vertical, horizontal, and 3-dimensional (3D) displacements, a 3D inspection software program was used. To examine the difference among groups, one-way analysis of variance and Tukey’s HSD post hoc test were used (α=.05). RESULTS: There were significant differences in 3D, vertical, and horizontal displacements among the different types of scan bodies (P<.001). There was a significantly lower displacement in the Straumann group than in the Myfit (PEEK) and Dentium groups (P<.05). CONCLUSION The horizontal displacement in all groups was less than 10 µm. With the hand tightening torque, a high vertical displacement of over 100 µm occurred in PEEK scan bodies (Myfit and Dentium). Therefore, it is recommended to apply a tightening torque of 5 Ncm instead of a hand tightening torque.

Purpose: The purpose of this study was to evaluate the machining precision and the marginal and internal fit of single restorations fabricated with three types of lithium disilicate ceramic blocks and to evaluate the correlation. Materials and methods: Single restorations were designed using a CAD software program. The crown designed model file was extracted from the CAD software program. Three types of lithium disilicate blocks (Rosetta; HASS, IPS e.max CAD; Ivoclar vivadent, VITA Suprinity; VITA) were milled using a milling machine. For the fabrication of the crown scanned model file, the intaglio surface of the restoration was digitized using a contact scanner. Then, using the three-dimensional inspection software (Geomagic control X; 3D Systems), the process of the overlap of the crown designed model and the scanned model and 3-dimensional analysis was conducted. In addition, the marginal and internal fit of the crowns was evaluated by a silicone replication method. The difference among three types of single ceramic crown was analyzed using a Kruskal-Wallis H test, and Spearman correlation analysis was performed to analyze the correlation between machining precision and fitness (α=.05) Results: There was a significant difference in the machining precision and the marginal and internal fit according to the type of ceramic block (P<.001). In addition, the machining precision and the marginal and internal fit were positively correlated (P<.001). Conclusion The marginal fit of crowns fabricated according to the types of ceramic blocks was within the clinically acceptable range (< 120 µm), so it can be regarded as appropriate machining precision applicable to all clinical as aspects in terms of the marginal fit.

Purpose: The technique introduced in this study describes a technique for surface treatment that applies a photocuring resin to the surface of an interim crown fabricated by three-dimensional (3D) printing without a conventional polishing method. The purpose of this study was to evaluate marginal and internal fit and the intaglio surface trueness of interim crowns after surface treatment of 3D-printed crowns for clinical application. Materials and Methods: An interim crown was fabricated using a 3D printer with digital light-processing technology, and the surface support was removed. After the posttreatment process, the resin was thinly applied to the surface of the interim crown and polymerized to solve the esthetic problem of the surface without the conventional polishing process. In addition, the marginal and internal fits were measured to verify the clinical use of this technique, and the trueness was evaluated to confirm the deformation of the inner surface according to the technical application of the outer surface of the interim crown. The difference before and after the evaluation by a statistical method was verified using an independent t-test (α=0.05).Result: There was no significant difference in the marginal and internal fit before and after the application of this technique (P>0.05). There was no significant difference in intaglio surface trueness before and after the application of this technique (P=0.963). Conclusion There was no change in the marginal and internal fit or in intaglio surface trueness of the interim crowns to which this technology was applied. This surface treatment technique is a more convenient method for interim crowns fabricated using 3D-printing technology without the conventional polishing process.

PURPOSE: The purpose of this study was to compare the degree of tooth preparation abilities of students according to three self-assessment methods. MATERIALS AND METHODS: forty-eight sophomores in Kyungpook National University College of Dentistry were divided into three experimental groups. Students performed tooth preparation of the left mandibular first molar for full gold crown. They performed self-assessment using the three methods (visual, digital, and putty index self-assessment group), and reperformed tooth preparation. An intraoral scanner was used to scan each tooth model (prepared tooth and unprepared tooth), and data were acquired in standard tessellation language (STL) file format. The STL files of prepared tooth and unprepared tooth were superimposed using the 3-dimensional analysis software (Geomagic control X). And the reduction amount was measured. In the statistical analysis, all values of reduction amount were analyzed with the Wilcoxon signed rank test and Kruskal-Wallis test (α = 0.05). RESULTS: The three self-assessment methods showed statistically significant differences (P < 0.001). The putty index self-assessment group showed the highest reduction in error than the digital self-assessment method. CONCLUSION Within limitations of this study, students showed significant differences in improvement of tooth preparation ability according to the three self-evaluation methods.

Purpose: Using two types of electronic apex locators, this study aimed to investigate the differences in accuracy according to the evaluator and equipment. Materials and Methods: Artificial teeth of the lower first premolars and two mandibular acrylic models (A and B) were used in this study. In the artificial teeth, the pulp chamber was opened and the access cavity was prepared.Using calibrated digital Vernier calipers, the distance from the top of the cavity and the root apex was measured to assess the actual distance between two artificial teeth. The evaluation was conducted by 20 dentists, and each evaluator repeated measurements for each electronic apex locator five times. The difference between the actual distance from the top of the cavity to the root apex and the distance measured using electronic measuring equipment was compared. For statistical analysis, the Friedman test the Mann–Whitney U-test were conducted and the differences between groups were analyzed (α=0.05).Result: As for the accuracy of measurement according to the two types of electronic apex locators, the value of the measurement error was 0.4753 mm in Dentaport ZX and 0.3321 mm in E-Cube Plus. Moreover, electronic apex locators Dentaport ZX and E-Cube Plus showed statistically significant differences (P<0.05). As for the difference in the accuracy of the two types of electronic apex locators according to the evaluator, the resulting values differed depending on the evaluator and showed a statistically significant difference (P<0.001). Conclusion Electronic apex locator E-Cube Plus showed higher accuracy than did Dentaport ZX. Nevertheless, both types of electronic apex locators showed 100% accuracy in finding the region within root apex ±0.5 mm zone. Fur-thermore, according to the evaluator, the two electronic apex locators showed different resulting values.

PURPOSE: The purpose of this study is to assess the relationship between the time spent designing custom abutments and repeated learning using dental implant computer aided design (CAD) software. MATERIALS AND METHODS: The design of customized abutments was performed four stages using the 3DS CAD software and the EXO CAD software, and measured repeatedly three times by each stage. Learning effect by repetition was presented with the learning curve, and the significance of the reduction in the total time and the time at each stage spent on designing was evaluated using the Friedman test and the Wilcoxon signed rank test. The difference in the design time between groups was analyzed using the repeated measure two-way ANOVA. Statistical analysis was performed using the SPSS statistics software (P < 0.05). RESULTS: Repeated learning of the customized abutment design displayed a significant difference according to the number of repetition and the stage (P < 0.001). The difference in the time spent designing was found to be significant (P < 0.001), and that between the CAD software programs was also significant (P = 0.006). CONCLUSION: Repeated learning of CAD software shortened the time spent designing. While less design time on average was spent with the 3DS CAD than with the EXO CAD, the EXO CAD showed better results in terms of learning rate according to learning effect.
Computer-Aided Design ; Dental Implants ; Learning Curve ; Learning*

PURPOSE: Cement-retained implant prostheses can lack proper retrievability during repair, and residual cement can cause peri-implantitis. The purpose of this in vitro study was to evaluate the influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with lingual slots, known as retrievable cement-type slots (RCS). MATERIALS AND METHODS: We fabricated six types of titanium abutments (10 of each type) with two different heights (4 mm and 6 mm), three different convergence angles (8°, 10°, and 12°), a sloped shoulder margin (0.6 mm depth), a rectangular shape (6 mm × 6.5 mm) with rounded edges, and a rectangular ledge (2 mm × 1 mm) for the RCS. One monolithic zirconia crown was fabricated for each abutment using a dental computer-aided design/computer-aided manufacturing system. The abutments and crowns were permanently cemented together with dual-curing resin cement, followed by 24 hours in demineralized water at room temperature. Using a custom-made device with a slot driver and torque gauge, we recorded the torque (N·cm) required to remove the crowns. Statistical analysis was conducted using multiple regression analysis and Mann-Whitney U tests (α=.05). RESULTS: Removal torques significantly decreased as convergence angles increased. Multiple regression analysis showed no significant interaction between the abutment height and the convergence angle (Durbin-Watson ratio: 2.186). CONCLUSION: Within the limitations of this in vitro study, we suggest that the retrievability of cement-retained implant prostheses with RCS can be maintained by adjusting the abutment height and convergence angle, even when they are permanently cemented together.
Crowns ; In Vitro Techniques ; Peri-Implantitis ; Prostheses and Implants ; Resin Cements ; Shoulder ; Titanium ; Torque ; Water

PURPOSE: The purpose of this study was to evaluate the accuracy of three types of intraoral scanners and the accuracy of the single abutment and bridge abutment model. MATERIALS AND METHODS: In this study, a single abutment, and a bridge abutment with missing first molar was fabricated and set as the reference model. The reference model was scanned with an industrial three-dimensional scanner and set as reference scan data. The reference model was scanned five times using the three intraoral scanners (CS3600, CS3500, and EZIS PO). This was set as the evaluation scan data. In the three-dimensional analysis (Geomagic control X), the divided abutment region was selected and analyzed to verify the scan accuracy of the abutment. Statistical analysis was performed using SPSS software (α = .05). The accuracy of intraoral scanners was compared using the Kruskal-Wallis test and post-test was performed using the Pairwise test. The accuracy difference between the single abutment model and the bridge abutment model was analyzed by the Mann-Whitney U test. RESULTS: The accuracy according to the intraoral scanner was significantly different (P < .05). The trueness of the single abutment model and the bridge abutment model showed a statistically significant difference and showed better trueness in the single abutment (P < .05). There was no significant difference in the precision (P = .616). CONCLUSION: As a result of comparing the accuracy of single and bridge abutments, the error of abutment scan increased with increasing scan area, and the accuracy of bridge abutment model was clinically acceptable in three types of intraoral scanners.
In Vitro Techniques ; Molar