The specific aims of the study were to determine (1) the mean condylar path inclination (CP) and Bennett angles (BA) in occlusally healthy dentate subjects and (2) whether there was right-left asymmetry of CP and BA. Eccentric movements of three mm and five mm from reference positions were recorded for 45 subjects using a Cadiax system. The mean right CP angles: 48.8 +/- 8 degrees (three mm) and 48.2 +/- 7 degrees (five mm); the mean left CP angles: 48.8 +/- 8 degrees (three mm) and 49.5 +/- 70 (5mm) were steeper than suggested means for setting articulators. The mean right BA: 7.7 +/- 3 degrees (3mm) and 7.9 +/- 4 degrees (five mm); and the mean left BA: 8.1 +/- 4 degrees (three mm) and 8.5 +/- 4 degrees (five mm) were lower than suggested means for setting articulators. Paired-t-tests showed no significant differences between right-left CP and right-left BA. These results suggest that current recommended average settings for semi-adjustable articulators for dentate individuals need to be reassessed.
Purpose
To determine the fracture resistance of chairside computer‐aided design and computer‐assisted manufacturing (CAD/CAM) lithium disilicate full coverage crowns and two different designs of overlay restorations for premolars.
Materials and Methods
CAD/CAM lithium disilicate (IPS e.max CAD for CEREC/HT A1 C14, Ivoclar Vivadent) restorations (15 specimens/group) with 1.5 mm occlusal thickness and 1.0 mm chamfer were designed and fabricated with a chairside CAD/CAM system (CEREC, Dentsply Sirona). The restorations were prepared in three different designs: (1) full coverage crowns, (2) overlays with the margin located 2 mm above the gingiva, and (3) overlays with the margin located 4 mm above the gingiva. Restorations were cemented using conventional resin luting cement (Multilink, Ivoclar Vivadent) with primer system (Monobond Plus, Ivoclar Vivadent) to resin printed dies, load cycled (2,000,000 load cycles at 1 Hz with 275 N force), and then finally loaded with a steel indenter until failure. Scanning electron microscopy observations of fractured surfaces were also conducted. Group results were analyzed with one‐way analysis of variance, and the medians were evaluated independently with Kruskal‐Wallis.
Results
The fracture force of CAD/CAM lithium disilicate restorations was significantly different (p < 0.001) depending on the design of the restoration. Full coverage crowns showed significantly higher force to fracture (1018.8 N) than both types of overlays (p = 0.002 for overlay 2.0 mm and p < 0.001 for overlay 4.0 mm above gingiva). Among the two overlays, the restoration with the margin located 2 mm above the gingiva showed significantly higher fracture force (813.8 N) than the overlay with margin at 4 mm above the gingiva (436.1 N; p < 0.001). The fracture appearance of the crowns was much more complex than that of the overlay restorations.
Conclusions
Full coverage chairside CAD/CAM lithium disilicate premolar crown showed higher fracture resistance than overlay restorations. Overlays with the margin located 2 mm above the margin demonstrated higher resistance than those with the margin located 4 mm above the gingiva.
Dental trauma is a common reason for tissue loss. Rehabilitation options for fractured incisors depends on the injuries' characteristics. Restoring teeth in the esthetic area may represent a challenge; however, adhesive materials and ceramic restorations may present a healthful solution, because they offer minimally invasive properties and excellent esthetic appearances.
CAD/CAM complete dentures have shown to improve the fit and material strength than conventionally fabricated dentures, however there are no clinical protocols described for extreme residual ridge resorption. This report describes a combined workflow of conventional and novel techniques for CAD/CAM complete dentures fabrication for atrophic alveolar ridges. Key Clinical Message Extreme residual ridge resorption is a challenging clinical situation for the fabrication of complete dental prostheses and this clinical report demonstrates a CAD/CAM workflow solving this complicated situation.
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