Performance of high-translucent zirconia CAD/CAM fixed dental prostheses using a digital workflow: A clinical study up to 6 years (original) (raw)
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10.58240/1829006X-2022.18.1-56, 2022
Purpose: To evaluate the survival of implants, the success of prosthetics of implant-supported reconstructions based on monolithic zirconium dioxide, functioning up to 5 years. Materials and Methods: In this study 87 patients were participated referred in need of full arch implant-supported reconstructions in maxilla, mandible or both. All patients underwent a thorough clinical examination according to a generally accepted scheme. After the diagnostic workup was completed, a treatment plan was developed by using a cone beam computed tomography and software system. Using surgical guides 46 patients' dental implants were installed. Postoperative clinical and radiological monitoring was regularly conducted, and criteria for thesuccess of implantation and success of prosthetics of implant-supported reconstructions were evaluated 642 implants (6 to 8 dental implants in the edentulous arches) were installed for monolithic zirconia full arch reconstructions.prosthodontic treatment was performed 3 to 6 months after implants healing time. Digitaltechnologies were included in the work flow with the laboratory scanning of the master casts andCAD/CAM manufacturing software. The monolithic zirconia block were milled using CAD/CAM software according to the manufacturer's specifications and then a monolithic zirconia restorations sintering. Outcome measures were: Implant success; prosthesis success; complications and marginal bone levels. Results: No intra-operative or immediate post-operative complications were noted. During a 3-year observation fracture of the monolithic zirconia or any other mechanical complications of prostheses, no registered, screws fractured in 3 prosthesis was observed over the 3-year study period. Conclusion: Our studies have shown good aesthetic, functional and mechanical properties of monolithic zirconia restorations and fewer complications.
Journal of Prosthodontic Research
The purpose of this systematic review was to evaluate the survival rate, biological complications, technical complications, and clinical behavior of single crowns supported by teeth made up in monolithic zirconia with CAD/CAM technology. Study selection: An extensive electronic search was conducted through Medline/PubMed, Embase, and Cochrane Library databases. Additional manual search was performed on the references of included articles to identify relevant publications. Two reviewers independently performed the selection and electronic and manual search. Results: From nine articles included, there was a total of 594 participants and 1657 single-tooth restorations with a mean exposure time of 1.07 years, and follow-up period between 0.3 and 2.1 years. All studies showed a moderate level of quality, with a consequent moderate possibility of associated bias, using the Newcastle-Ottawa Scale (NOS), with survival rate (SR) ranging between 91% to 100%. Bleeding on probing (BOP) were reported with an average value of 29.12%. Marginal integrity showed high success rate values for the observation periods, except for one that included patients with bruxism which obtained a SR of 31.60%. Failures and/or fractures, mostly total and requiring replacement, were observed in three studies. Linear regression showed that there was no statistical correlation between survival rate and type of cementation and the average years of follow-up (p=0.730 e p=0.454). There was high heterogeneity between studies (I2 = 93.74% and Q = 79.672). Conclusions: Within the limitation of this study, monolithic zirconia might be considered as a possible option for restoring single crowns, especially in the posterior zone.
CAD/CAM System Vs. Laser Milling Zirconia For Fixed Restoration Construction; Narrative Review
SciDoc Publishers, 2021
The aim of This review article compares the use of a computer-aided design (CAD) system, and laser milling in fabricating dental prostheses made of zirconia ceramics (TZP).Since Land made the first all-ceramic crown with low-strength feldspar porcelain in 1903 [1], dental all-ceramic restoration materials' mechanical and aesthetic properties have been significantly evolved. Therefore, In dental clinics, these are commonly utilized. Many ways for fabricating all-ceramic dental restorations have recently been developed [2]. All-ceramic materials, on the other hand, are fragile and difficult to work with due to their high hardness and low fracture toughness. Zirconia ceramics are utilized in dental restorations because of their strong mechanical qualities, which allow them to be employed as entire ceramic restorations for long-span bridges. Milling fully sintered Zirconia might be difficult because of its extreme hardness. Instead, a CAD/CAM system is used to grind a partially sintered zirconia block, which is then sintered in a furnace. Sintering results in a linear shrinkage of 15% to 30%. [3]. For the softer partially sintered stone, milling efficiency is improved. To avoid restorative unfitnesscaused by sintering shrinkage, scanning operation, and milling [4]., laser machining of high-hardness Zirconia is employed. In dentistry, a variety of lasers are now operational.
10-year randomized trial (RCT) of zirconia-ceramic and metal-ceramic fixed dental prostheses
Journal of Dentistry
OBJECTIVES To monitor zirconia-ceramic and metal-ceramic posterior FDPs with respect to survival and technical/biological complication rates. MATERIALS AND METHODS Fifty-eight patients received 76 3-to 5-unit posterior FDPs. The sites were randomly assigned to 40 zirconia-based (ZC) and 36 metal-based (MC) FDPs. FDPs were examined at baseline (cementation), at 6 months, at 1 year and then yearly up to 10 years. Technical outcomes were assessed using modified United States Public Health Service (USPHS) criteria. Biologic outcomes included probing depth, plaque, bleeding on probing and tooth vitality. Statistical analysis was performed applying Kaplan-Meier (KM) estimation, log-rank, Mann-Whitney and Fisher exact test. RESULTS During the 10-year follow-up thirteen patients (17 FDPs) dropped out and 6 FDPs in 6 patients (5 ZC,1 MC) were considered catastrophic failures for technical and/or biological reasons. Forty-four patients with 53 FDPs (29 ZC, 24 MC) were available for examination. The median observation period was 10.3 years (ZC) and 10.0 years (MC). The 10-year KM survival estimate of ZC FDPs was 91.3% (95%CI:69.5;97.8) and 100% of MC FDPs. Minor chipping of the veneering ceramic and occlusal wear were found to a similar extent at ZC and MC FDPs. ZC FDPs demonstrated a significantly higher rate of framework fracture, de-bonding, major fractures of the veneering ceramic and poor marginal adaption. Biological outcomes were similar in both groups and between abutment and control teeth. CONCLUSION At 10 years, ZC and MC posterior FDPs resulted in similar outcomes for the majority of the outcome measures (p > 0.05).
BMC Oral Health, 2023
Background The accuracy of impression techniques determines the marginal fit of fixed prostheses. Marginal accuracy plays a main role in the success and failure of treatments. This in-vivo study evaluated the marginal fit of anterior three-unit monolithic zirconia fixed partial dentures (FPDs) using conventional and scannable polyvinyl siloxane impression materials. Methods Ten patients were selected to replace the lateral teeth with a three-unit monolithic zirconia bridge. For each patient, in the first group, an impression was made with a two-step putty-wash technique using scannable polyvinyl siloxane material (BONASCAN; DMP, Greece). In the identical session, as the second group, an impression of conventional putty-wash polyvinyl siloxane was taken (BONASIL A + Putty; DMP, Greece). The marginal discrepancy was measured through the replicas, which were cut perpendicularly within the buccolingual and mesiodistal directions. An Independent t-test was employed for data analyses (P < 0.05). Results The marginal discrepancy in a conventional method for central abutment in mid-buccal, mid-lingual, midmesial, and mid-distal was higher than in the scannable method but it was not significant (P > 0.05). Also, the marginal discrepancy for canine abutment in the conventional method was higher than in the scannable method, but it was not significant, either (P > 0.05). Conclusions FPDs fabricated from both scannable and conventional impression materials were not superior to each other in marginal fit for both central and canine abutments by evaluation using the replica technique.
Advantages and limitations of monolithic zirconia restorations
International Journal Of Community Medicine And Public Health
Due to their biocompatible nature and advantageous mechanical characteristics, zirconia treatments have been utilized effectively in by dentists for many decades. A zirconia core is typically veneered with porcelain as they are not translucent, which renders treatments poorer since the bonding between the two substances fails. All-ceramic zirconia treatments have recently been made available in the dentistry market in an effort to address this issue. In addition to the absence of chipping, monolithic zirconia (MZ) fillings appear to have the benefit of requiring less occlusal room. To advocate this comparatively recent approach for restorative therapy, however, requires scientific proof. MZ could be the optimum material for rear fixed partial prostheses in the case of powerful occlusal pressures and little occlusal restorative room, according to the findings of in vitro investigations. To come to a clear consensus, the findings should be validated by many more in vivo and especially...
Investigation of Fracture Resistance of Zirconia Restorations After Different Surface Treatments
Clinical and Experimental Health Sciences, 2021
Objective: The purpose of this study was to investigate the effects of the different surface treatments on fracture strength of the zirconia-based ceramic restorations. Methods: Each of 120 dental implant abutments and analogs were used in the present study. Zirconia core materials were manufactured on dental implants by using CAD/CAM device and they were randomly divided into 6 groups (n=20) according to surface pretreatments; control group (Group C), airborne-particle abrasion (Group AA), silica-coating (Group SC), Nd:YAG laser (Group N), bur-cut from cervical region (Group BC), and bur-cut on the functional tubercule (Group BT). Cementation was succeeded with two different types of cements including a dualcure resin-cement and a glass ionomer cement. The obtained data were evaluated statistically using one-way ANOVA and Tukey tests (p=0.05). Results: No statistically significant difference was found between the groups (p>0.05). Similarly, no statistically significant difference was found between the resin cement and glass ionomer groups with respect to fracture strength values (p>0.05). Conclusion: Within the limitations of the present study, surface treatments and cement have no effect on the flexural strength of zirconia ceramic crowns.
Acta Medica Transilvanica
With the help of dental implants, an oral rehabilitation can be performed not only very complex, but also very complete of various types of edentulous spaces. After insertion of the dental implants, they can be subsequently prosthetically restored through a wide range of implant-supported prosthetic restorations. In this material, we tried to highlight some particular aspects from the point of view of the laboratory stages of dental technique, which intervene in the technological flow of making implant-supported prosthetic restorations from ceramic masses on Zirconia structure.