The computer-aided design (CAD) and computer-aided manufacturing (CAM) process chain for dental restorations starts with taking an impression of the clinical situation. For this purpose, either extraoral digitization of gypsum models or intraoral digitization can be used. Despite the increasing use of dental digitizing systems, there are only few studies on their accuracy. Objective This study compared the accuracy of various intraoral and extraoral digitizing systems for dental CAD/CAM technology.Material and Methods An experimental setup for three-dimensional analysis based on 2 prepared ceramic master dies and their corresponding virtual CAD-models was used to assess the accuracy of 10 extraoral and 4 intraoral optical non-contact dental digitizing systems. Depending on the clinical procedure, 10 optical measurements of either 10 duplicate gypsum dies (extraoral digitizing) or directly of the ceramic master dies (intraoral digitizing) were made and compared with the corresponding CAD-models.Results The digitizing systems showed differences in accuracy. However, all topical systems were well within the benchmark of ±20 µm. These results apply to single tooth measurements.Conclusions Study results are limited, since only single teeth were used for comparison. The different preparations represent various angles and steep and parallel opposing tooth surfaces (incisors). For most digitizing systems, the latter are generally the most difficult to capture. Using CAD/CAM technologies, the preparation angles should not be too steep to reduce digitizing errors. Older systems might be limited to a certain height or taper of the prepared tooth, whereas newer systems (extraoral as well as intraoral digitization) do not have these limitations.
Within the limitations of this in vitro study, we conclude that laser activation of NaOCl at 200 mW output power leads to effective soft tissue dissolution. This finding can be of use to endodontists pursuing effective soft tissue dissolution from their irrigants.
This randomized clinical study examined the influence of the gingival condition—healthy versus mild inflammation—on sulcus representation and possible gingival recession for two gingival displacement procedures prior to conventional impression making. The interventions double cord technique or a kaolin paste containing aluminum chloride were applied to 40 probands. The opposite quadrant served as intrapersonal reference (split-mouth design). Precision impressions were then made. Extraoral digitization of the plaster models resulting from the reference impression prior to gingival displacement, the intervention impression and control impressions were the basis for the computer-aided three-dimensional analysis. After six months, a mild artificial gingivitis was induced, and the contralateral quadrant (cross-over design) was examined for the intervention. The gingivitis deteriorated the sulcus representation for the double cord technique group but did not affect the paste technique group. The gingival condition had no influence on the marginal gingiva height changes. The minor extent of those changes, which were measured up to six months after intervention at the palatal study site, were not considered to be in the clinically relevant range for gingival recession. For healthy gingiva, the cord technique showed superior sulcus representation compared to the paste technique. This advantage was lost to a great extent under the conditions of mild gingivitis.
Among other factors, the precision of dental impressions is an important and determining factor for the fit of dental restorations. The aim of this study was to examine the three-dimensional (3D) precision of gypsum dies made using a range of impression techniques and materials. Ten impressions of a steel canine were fabricated for each of the 24 material-method-combinations and poured with type 4 die stone. The dies were optically digitized, aligned to the CAD model of the steel canine, and 3D differences were calculated. The results were statistically analyzed using one-way analysis of variance. Depending on material and impression technique, the mean values had a range between +10.9/−10.0 µm (SD 2.8/2.3) and +16.5/−23.5 µm (SD 11.8/18.8). Qualitative analysis using colorcoded graphs showed a characteristic location of deviations for different impression techniques. Three-dimensional analysis provided a comprehensive picture of the achievable precision. Processing aspects and impression technique were of significant influence.
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