CAD-CAM

CAD - CAM
  • 文章类型: Journal Article
    近年来,CAD-CAM(计算机辅助设计和计算机辅助制造)技术在牙科中的应用越来越普遍。通过提高精度和效率,使用CAD-CAM设计和创建牙科修复体。定制牙齿假体,如牙冠,贴面,嵌体,高架和桥梁是可能的CAD-CAM。
    The application of CAD-CAM (Computer-Aided Design and Computer-Aided Manufacturing) technology has become increasingly prevalent in dentistry in recent years. Dental restorations are designed and created using CAD-CAM by enhancing the precision and efficiency. Customization of dental prostheses such as crowns, veneers, inlays, onlays and bridges is possible with CAD-CAM.
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  • 文章类型: Journal Article
    目的:研究有关完整足弓植入物支持框架的常规和数字工作流程准确性的可用证据。材料和方法:本范围审查是根据Arksey和O\'Malley的5阶段框架进行的。根据PRISMA指南进行了系统的文献检索,以通过直接比较常规和数字方法来确定研究,以制造完整的足弓植入物支持的框架。包括58项体外研究,重点是2000年至2024年间发表的至少四种植入物的无牙弓。检查报告的结果以确定将单个错误加到工作流的累积错误的统计分析的值。结果:可以获得完整的足弓植入物支持框架的数字和常规工作流程准确性评估的证据。然而,同样,使用相同评估方法和结果单元的研究似乎过于异质,无法对误差累积进行统计分析.虽然在印象和铸造制造阶段没有达成共识,与传统铸造相比,数字技术显示出完整的足弓植入物支撑框架的制造具有更高的精度。结论:缺乏评估整个工作流程的准确性并根据临床相关性对其结果进行分类的体外研究。
    Purpose: To investigate the available evidence on the accuracy of conventional and digital workflows for complete arch implant supported frameworks. Materials and methods: This scoping review was conducted according to the 5-stage framework of Arksey and O\'Malley. A systematic literature search was performed adhering to the PRISMA guidelines to identify studies with a direct comparison of conventional and digital methods for the fabrication of complete arch implant supported frameworks. 58 in-vitro studies with the focus on edentulous arches with at least four implants published between 2000 and 2024 were included. The reported outcomes were examined to determine the value of a statistical analysis for adding up the individual errors to a cumulative error of the workflow. Results: Evidence on the accuracy assessment of digital and conventional workflows for complete arch implant supported frameworks is available. However, also studies with the same assessment methods and outcome units appear to be too heterogeneous to perform a statistical analysis of error accumulation. While there is no consensus in the impression and cast fabrication stage, digital techniques show a superior accuracy for the fabrication of complete arch implant supported frameworks compared to conventional casting. Conclusion: In-vitro studies assessing the accuracy of entire workflows and classifying their outcomes regarding the clinical relevance are lacking.
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  • 文章类型: Journal Article
    目的:本研究通过虚拟拟合方法比较了七种口内扫描仪(IOS)的准确性。
    方法:用工业参考扫描仪(n=1)和Aoralscan3,EmeraldS,Helios600,Lumina,Mediti700Primescan,和Trios5IOS(每个n=12)。在每次IOS扫描上设计了两个完整的拱形固定框架,其厚度为70µm(组70)和90µm的内部水泥空间(组7020,边缘处另外20µm)。虚拟拟合方法包括使用模拟临床尝试的非穿透算法将框架设计叠加到参考扫描上。测量了内部和边际差距。精度由平均绝对误差(MAE)估计。
    结果:在第70组中,Mediti700(43µm),Primescan(42µm),EmeraldS处于边际差距的最佳同质子集,其次是Lumina(67µm),Aoralscan3(70µm),和Trios5(70µm),而Helios600(118µm)在第三个子集。根据利润率的MAE,Mediti700、Trios5和EmeraldS属于第一好的同质子集,其次是Primescan。Lumina和Helios600属于第三个子集,Aoralscan3在第四子集。在第7020组中,Lumina和Aoralscan3的边缘间隙显着减小,而EmeraldS和Aoralscan3的MAE显着降低。IOS的等级与内部差距相似。
    结论:翡翠,Mediti700Primescan,和Trios5满足固定牙载完整牙弓修复的边缘和内部配合标准。在设计过程中增加水泥空间可以增强修复配合。
    结论:虚拟配合对准方法可有效评估不同口内扫描仪的准确性,为区分它们提供有价值的临床指导。长期IOS制造商的最新软件和硬件版本适用于制造完整的拱形修复。
    OBJECTIVE: This study compared the accuracy of seven intraoral scanners (IOS) by the virtual-fit method.
    METHODS: Four maxillary arches with tooth abutments were scanned with an industrial reference scanner (n=1) and by Aoralscan3, EmeraldS, Helios600, Lumina, Mediti700, Primescan, and Trios5 IOSs (each n=12). Two complete-arch fixed frameworks were designed on each IOS scan with a 70 µm (group 70) and a 90 µm internal cement space (group 70+20, additional 20 µm at the margin). The virtual-fit method was comprised of superimposing the framework designs onto the reference scan using a non-penetrating algorithm simulating the clinical try-in. Internal and marginal gaps were measured. Precision was estimated by the mean absolute errors (MAE).
    RESULTS: In group 70, Mediti700 (43 µm), Primescan (42 µm), and EmeraldS were in the best homogenous subset for the marginal gap, followed by the Lumina (67 µm), Aoralscan3 (70 µm), and Trios5 (70 µm), whereas Helios600 (118 µm) was in the third subset. Based on the MAE at the margin, Mediti700, Trios5, and EmeraldS were in the first-best homogenous subset, followed by Primescan. Lumina and Helios600 were in the third subset, and Aoralscan3 was in the fourth subset. In group 70+20, the marginal gap was significantly decreased for Lumina and Aoralscan3, whereas MAE significantly decreased for EmeraldS and Aoralscan3. The rank of IOSs was similar for the internal gap.
    CONCLUSIONS: EmeraldS, Mediti700, Primescan, and Trios5 meet the marginal and internal fit criteria for fixed tooth-borne complete arch restorations. Increasing the cement space during design could enhance restoration fit.
    CONCLUSIONS: The virtual-fit alignment method can effectively evaluate the accuracy of different intraoral scanners, offering valuable clinical guidance for distinguishing among them. Recent software and hardware versions of long-standing IOS manufacturers are suitable for fabricating complete arch restoration.
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  • 文章类型: Journal Article
    背景:这项初步体外研究的目的是评估灭菌对植入物内轴的影响,种植体间轴,通过使用实验室扫描仪(LBS)与具有口腔内扫描体(ISB)的口腔内扫描仪(IOS),在一条直线上的三个植入物的植入物内距离和植入物间距离。
    方法:打印的3D模型,在位置15#中具有三个内部十六进制类似物,16#,17#被使用Zirkonzhan(ZZ)口腔内扫描体(ISB),使用两件式钛。ZZISB通过7系列牙翼(LBS)扫描,Primescan(IOS)在灭菌前扫描30次,灭菌后扫描30次。对于每个扫描(前和后),创建立体光刻(STL)文件,并且通过使用3D分析软件将灭菌前和灭菌后的所有扫描之间的比较叠加在实验室扫描上。进行Kolmogorov-Smirnov测试,然后进行Wilcoxon签名等级测试。(p<0.05)结果:ZZISB灭菌后,植入物间距的平均误差显着增加(p<0.0005),植入物内距离1,2,3(p<0.0005),植入物内轴1,3(p<0.0005)和植入物内轴13,23(p<0.05)。相比之下,植入物内轴2(p<0.0005)和植入物内轴12(p<0.0005)的平均误差显著降低.
    结论:ZZISB在灭菌后显示所有四个参数的变化。关于所有四个参数,中间ISB的平均误差变化最大。灭菌过程可在三个循环后影响ZZISB的三维(3D)结构。该领域的文献缺乏,需要进一步研究以探索灭菌(多个循环)对不同ISB的影响,并制定有关行业中每种ISB灭菌量的批准指南。
    BACKGROUND: The purpose of this pilot in-vitro study was to assess the effect of sterilization on the intra-implant axis, inter-implant axis, intra-implant distance and inter-implant distance of three implants in a straight line by using laboratory scanner (LBS) versus intra-oral scanner (IOS) with intra-oral scan bodies (ISB).
    METHODS: A printed 3D model with three internal hex analogs in the positions 15#,16#,17# was used. Zirkonzhan (ZZ) intra-oral scan body (ISB), two-piece titanium was used. The ZZ ISBs were scanned by 7 Series dental wings (LBS) and 30 times by Primescan (IOS) pre sterilization and 30 times post sterilization. For each scan (pre and post) stereolithography (STL) file was created and a comparison between all the scans pre sterilization and post sterilization were superimposed on the laboratory scan by using a 3D analyzing software. A Kolmogorov-Smirnov test performed followed by Wilcoxon Signed Ranks tests. (p < 0.05) Results: Post sterilization of the ZZ ISB, the mean errors were significantly increased for the inter-implant distances (p < 0.0005), intra-implant distances 1,2,3 (p < 0.0005), intra-implant axis 1,3 (p < 0.0005) and inter-implant axes 13,23 (p < 0.05). In contrast, the mean errors for intra-implant axis 2 (p < 0.0005) and inter-implant axis 12 (p < 0.0005) were significantly reduced.
    CONCLUSIONS: ZZ ISB showed changes in all four parameters after sterilization. The middle ISB had the largest changes in mean error regarding all four parameters. Sterilization process may affect the three-dimensional (3D) structure of the ZZ ISB after three cycles. There is a lack in the literature in this field and there is a need for further studies to explore the effect of sterilization (multiple cycles) on different ISBs and for creating an approved guidelines regarding the amount of sterilization for each ISB in the industry.
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  • 文章类型: Case Reports
    数字工作流程的出现彻底改变了口腔康复,提供优秀的假体和修复适应,同时减少工作时间。此病例报告旨在通过数字工作流程描述使用粘膜支持的假体的全弓康复方案。该技术从扫描上颌并对下颌进行印模开始,然后扫描以创建数字演员表。接下来,使用闭口技术进行边界成型和两个拱门的最终印象,在此期间,患者被引导进行横向和突出运动。随后,进行咬合和两种印象的口内扫描,导致最终假牙的设计与建立咬合。最后,假牙是用Formlabs树脂印刷的,专门为假牙设计。数字工作流程有助于有效地制造粘膜支撑的全足弓假体。此方法允许调整遮挡的垂直尺寸,确保假体对软组织的良好适应性,并为患者提供审美满意度。此外,它减少了安装最终假体所需的会议次数。
    The advent of digital workflows has revolutionized oral rehabilitation, offering excellent prosthesis and restoration adaptation while reducing work time. This case report aims to describe a full-arch rehabilitation protocol using mucosa-supported prostheses through a digital workflow. The technique begins with scanning the upper jaw and taking an impression of the lower jaw, followed by scanning to create a digital cast. Next, border molding and the final impression of both arches are performed using a closed-mouth technique, during which the patient is guided to perform lateral and protrusive movements. Subsequently, intraoral scanning of the occlusion and both impressions is conducted, leading to the design of the final dentures with the established occlusion. Finally, the dentures are printed in Formlabs resin specifically designed for dentures. The digital workflow facilitates the manufacturing of mucosa-supported full-arch prostheses effectively. This method allows for the adjustment of the vertical dimension of occlusion, ensures excellent adaptation of the prosthesis to the soft tissues, and provides aesthetic satisfaction for the patient. Additionally, it reduces the number of sessions required to install the definitive prosthesis.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    目的:本研究旨在评估在有限的无牙空间中使用带有3D打印手术指南的计算机引导植入物手术的变形量。
    方法:使用完全数字化方案和3D打印的手术指南,将25个骨水平的自攻植入物(Straumann®BL和BLT)随机插入下颌后段或椎间后段。在叠加虚拟计划和最终植入图像的3个坐标后,评估了不准确性的程度。使用口腔内扫描和扫描身体获得。考虑了四个评估参数:原始位移,误差深度,计划和放置的植入物之间的根尖位移和角度。
    结果:原始位移的平均变形为0.71mm,误差深度为0.36mm,0.52毫米的水平位移和3.34º的误差角度。
    结论:排除的主要原因是CBCT伪影。这项研究的结果与先前有关部分无牙空间的研究结果一致。CAD/CAM制造过程没有导致明显的变形,而变形的最大部分源于手术过程。计算机引导的植入物手术中的学习曲线提出了不准确的重要原因。
    OBJECTIVE: This study aims to evaluate the amount of distortion using computer-guided implant surgery with 3D printed surgical guides in limited edentulous spaces.
    METHODS: 25 bone level self-tapping implants (Straumann® BL and BLT) were randomly inserted in either distal or intercalary posterior mandibular edentulism using a fully digital protocol and 3D printed surgical guides. Amount of inaccuracy was evaluated after superimposing the 3 coordinates of virtually planned and final implant images, which were obtained using intra-oral scans and scan bodies. Four evaluation parameters were considered: origo-displacement, error depth, apical displacement and angle between the planned and the placed implant.
    RESULTS: The average of distortion was 0.71 mm for the origo-displacement, 0.36 mm for the error depth, 0.52 mm for the horizontal displacement and 3.34º for the error angle.
    CONCLUSIONS: The major reason of exclusion was CBCT artifacts. Results of this study were aligned with the results of previous studies concerning partially edentulous spaces. CAD/CAM manufacturing process did not result in significant distortion whilst the biggest part of distortions originated from the surgical process. The learning curve in computer-guided implant surgery presented an important source of inaccuracy.
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  • 文章类型: Journal Article
    大多数关于重复假牙的报告都是介绍制造方法或临床病例报告。只有少数研究证实了它们的临床有效性;因此,缺乏为重复义齿使用构建有用的临床指南的证据。本综述旨在全面调查有关重复假牙的报道,以积累有助于临床实践指南制定的证据。制作新假牙时,重复假牙可有效用于印模制作和咬合配准,从而减少就诊次数和治疗时间。重复义齿也可以用作临时或新的假牙。各种适应能力下降的老年人,可能会发现很难适应新的假牙和经历压力,即使形状合适。重复假牙,它再现了它们习惯的旧假牙的形状,具有对老年人更熟悉且压力较小的优势。制造重复假牙时,在工作时间和成本方面,诸如铣削和三维打印之类的数字方法优于常规方法。数字方法的一个显著优点是义齿形状可以保存为数字数据,如果丢失,义齿很容易被复制。
    Most reports on duplicate dentures are introduction to fabrication methods or clinical case reports. Only a few studies have verified their clinical effectiveness; hence, evidence to construct useful clinical guidelines for duplicate denture use is lacking. This review aimed to comprehensively investigate reports on duplicate dentures to accumulate evidences that will contribute to the formulation of clinical practice guidelines. Duplicate dentures are effectively used for impression making and bite registration when fabricating new dentures, thereby reducing the number of clinic visits and treatment time. Duplicate denture can also be used as temporary or new dentures. Older people in whom various adaptive abilities have declined, may find it difficult to adjust to new dentures and experience stress, even if the shape is appropriate. Duplicate dentures, which reproduces the shape of old dentures that they are used to, have the advantage of being more familiar to older people and less stressful. When manufacturing duplicate dentures, digital methods such as milling and three-dimensional printing are superior to conventional methods regarding working time and cost. A notable advantage of the digital method is that the denture shape can be saved as digital data, and the denture can be easily duplicated if lost.
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    文章类型: Journal Article
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  • 文章类型: Case Reports
    牙髓手术的结果决定了所治疗牙齿的临床成功。牙髓修复后将恢复牙齿的形状,函数,和美学,同时保留和保护其现有的牙齿结构。为了用最好的组织保存来恢复经牙髓治疗的牙齿,最小侵入性的准备是目标。全覆盖冠仍然比部分覆盖冠更受欢迎。保守的牙科程序,如镶嵌,覆盖,和内冠部使完整的牙齿结构的量最大化,同时使去除的牙齿结构的量最小化。与帖子相比,核心,和皇冠,内冠子在易于制备方面提供了几个优点,应用程序,减少临床就诊次数和时间。Endocrown是一个简单的,通常在边缘位于牙龈上时给予微创准备,这使得它可以自我清洁并保持自然的牙齿接触,防止干扰牙周组织。此病例报告着重于使用计算机辅助设计(CAD)和计算机辅助制造(CAM)技术通过内冠制造来管理经牙髓治疗的牙齿。
    The outcome of an endodontic procedure determines the clinical success of the treated tooth. A post-endodontic restoration will restore the tooth\'s form, function, and aesthetics while preserving and safeguarding its existing tooth structure. To restore endodontically treated teeth with the best possible tissue preservation, the least invasive preparation is the aim. Full-coverage crowns are still more popular than partial-coverage crowns. Conservative dental procedures such as inlays, overlays, and endocrowns maximize the amount of tooth structure that is intact while minimizing the amount of tooth structure that is removed. Compared to posts, cores, and crowns, endocrowns offer several advantages in terms of ease of preparation, application, and reduced clinical visits and time. Endocrown is a simple, minimally invasive preparation usually given when margins are supragingival, which makes it self-cleansable and maintains natural tooth contact, preventing interference with periodontal tissue. This case report focuses on managing endodontically treated teeth with the fabrication of endocrown using computer-aided design (CAD) and computer-assisted manufacturing (CAM) techniques.
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