Dental impression technique

牙科印象技术
  • DOI:
    文章类型: English Abstract
    目的:比较口腔内数字扫描和选择性压力印模技术在下颌牙列缺损远端延伸区的粘膜形态差异。
    方法:纳入17例KennedyI类和II类牙列缺损患者,包括22个远端延伸。每位患者均采用口内数字扫描和功能印模技术,分别。使用实验室铸模扫描仪扫描由选择性压力印模制成的石膏铸模,以获得三维数据。所有数据以STL格式存储。通过GeomagicControl2014软件比较了从同一患者的口腔内数字扫描和选择性压力印模收集的3D数据。在距末端牙齿5,10,15mm处计算2.5mm直径面积的均方根。采用Pearson相关检验,用SPSS20.0软件包分析距离与形态差异的相关性。
    结果:通过口腔内数字扫描和选择性压力印模技术获取的颌骨远端延伸无牙区的平均粘膜形态差异为(0.37±0.12)mm。距终牙距离与粘膜形态差异呈正相关(P<0.05).距终牙5、10、15mm的形态差异为(0.14±0.11)mm,(0.22±0.13)mm,(0.39±0.16)mm,分别。
    结论:在这项研究中,远端延伸缺牙区长度与粘膜形态差异呈正相关,而脊缺损的种类和粘膜厚度也可能影响形态差异的数量。
    OBJECTIVE: To compare the mucosal morphological difference in distal-extension area of mandibular dentition defect taken by intra-oral digital scanning and selective pressure impression techniques.
    METHODS: Seventeen patients with Kennedy Class I and Class II dentition defect in lower jaw were included, including twenty-two distal-extensions. Intraoral digital scanning and functional impression technique were taken in each patients, respectively. Laboratory cast scanner was used to scan the plaster casts made from the selective pressure impression to obtain the three-dimensional data. All the data were stored in STL format. The 3D data collecting from intra-oral digital scanning and selective pressure impression from the same patient were compared by Geomagic Control 2014 software. Root mean square of 2.5mm diameter area was calculated in 5,10,15 mm from terminal tooth. Pearson\'s correlation test was used to analyze the correlation of the distance and morphological difference with SPSS 20.0 software package.
    RESULTS: Mean mucosal morphological difference of jaw distal-extension edentulous area taken by intra-oral digital scanning and selective pressure impression techniques was (0.37±0.12) mm. There was positive correlation between distance from terminal tooth and mucosal morphological difference(P<0.05). Morphological differences in 5, 10, 15 mm from terminal tooth were (0.14±0.11) mm, (0.22±0.13) mm and (0.39±0.16) mm, respectively.
    CONCLUSIONS: In this study, there was positive correlation between the length of distal-extension edentulous area and mucosal morphological difference, while the kind of ridge defect and mucosal thickness may also affect the morphological difference quantity.
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  • DOI:
    文章类型: Journal Article
    数字技术在牙科领域逐渐普及。特别是,用口内扫描仪进行印象变得越来越常规;然而,即使在这之前也必须经常使用收缩绳。本文提出了一种创新的技术,可以使用印模材料代替收缩绳的临时修复物记录自然牙基牙的数字印象。在实验室里,使用计算机辅助设计,技术人员可以分割临时修复体的内表面,并用它来替换口内扫描的基台,从而获得准确的应对方法,从而获得有关制剂的牙龈上和血管内表面的更详细信息。
    Digital technologies are gradually gaining ground in dentistry. In particular, taking impressions with intraoral scanners is becoming routine; however, even this must often be preceded by the use of retraction cords. This article presents an innovative technique to record digital impressions of natural tooth abutments using interim restorations relined with impression material instead of retraction cords. In the laboratory, using computer-aided design, the technician can segment the internal surface of the interim restoration and use it to replace the abutment of the intraoral scan, thus obtaining an accurate coping that yields more detailed information about the supragingival and intrasulcular surface of the preparation.
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  • 文章类型: Journal Article
    目的:评估使用不同的三维(3D)打印机和打印方向制造的各种牙齿制剂的增材制造上颌定形铸模的制造真实性。
    方法:上颌类型,其牙齿准备用于后位3单元固定局部义齿,侧切牙冠,中门牙和犬科贴面,第一前磨牙和第二磨牙嵌体,第一个磨牙牙冠用工业扫描仪数字化。此扫描文件用于使用数字光处理(DLP)或立体光刻(SLA)3D打印机在不同方向(0度,30度,45度,和90度)(n=7)。所有的演员都用同一个扫描仪数字化,并对每个制备部位的偏差进行了评估。统计学分析采用广义线性模型(α=0.05)。
    结果:3D打印机和打印方向之间的相互作用影响了所有制剂中的测量偏差(P≤0.001),除了侧切牙牙冠和犬类贴面(P≥0.094),仅受到主要因素的影响(P<0.001)。DLP-90主要导致最高,而DLP-0主要导致后牙预备中的最低偏差(P≤0.014)。DLP-30导致第一前磨牙嵌体内的最小偏差,DLP-45导致中央门牙贴面准备内的最小偏差(P≤0.045)。
    结论:在DLP-0或DLP-30的情况下,受试铸型的后端制剂的真实性最高,而在DLP-45的情况下,中切牙贴面制剂的真实性最高。DLP-90导致大多数牙齿准备的真实性最低。
    结论:使用测试的DLP3D打印机制造的具有牙齿准备的最终铸型以及在牙齿准备时调整的打印方向可以实现良好的修复。然而,使用此3D打印机应避免90度打印方向,因为它导致了最低的制造真实性。
    OBJECTIVE: To evaluate the fabrication trueness of additively manufactured maxillary definitive casts with various tooth preparations fabricated with different 3-dimensional (3D) printers and print orientations.
    METHODS: A maxillary typodont with tooth preparations for a posterior 3-unit fixed partial denture, lateral incisor crown, central incisor and canine veneers, first premolar and second molar inlays, and a first molar crown was digitized with an industrial scanner. This scan file was used to fabricate definitive casts with a digital light processing (DLP) or stereolithography (SLA) 3D printer in different orientations (0-degree, 30-degree, 45-degree, and 90-degree) (n = 7). All casts were digitized with the same scanner, and the deviations within each preparation site were evaluated. Generalized linear model analysis was used for statistical analysis (α = 0.05).
    RESULTS: The interaction between the 3D printer and the print orientation affected measured deviations within all preparations (P ≤ 0.001) except for the lateral incisor crown and canine veneer (P ≥ 0.094), which were affected only by the main factors (P < 0.001). DLP-90 mostly led to the highest and DLP-0 mostly resulted in the lowest deviations within posterior tooth preparations (P ≤ 0.014). DLP-30 led to the lowest deviations within the first premolar inlay and DLP-45 led to the lowest deviations within the central incisor veneer preparation (P ≤ 0.045).
    CONCLUSIONS: Posterior preparations of tested casts had the highest trueness with DLP-0 or DLP-30, while central incisor veneer preparations had the highest trueness with DLP-45. DLP-90 led to the lowest trueness for most of the tooth preparations.
    CONCLUSIONS: Definitive casts with tooth preparations fabricated with the tested DLP 3D printer and the print orientation adjusted on tooth preparation may enable well-fitting restorations. However, 90-degree print orientation should be avoided with this 3D printer, as it led to the lowest fabrication trueness.
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  • 文章类型: Journal Article
    OBJECTIVE: This study aimed to evaluate the application of digital impression and resin model technology in removable partial dentures (RPD) for Kennedy classⅠandⅡdentition defects.
    METHODS: Patients with Kennedy classⅠorⅡdental defect were selected and grouped in accordance with the following denture production processes: digital impression/resin model/cast cobalt-chromium alloy framework group (group A), digital impression/resin model/laser printed titanium framework group (group B), alginate impression/plaster model/cast cobalt-chromium alloy framework group (group C), and alginate impression/plaster model/laser printed titanium framework group (group D), with 40 cases in each group. The final RPD was examined in place in the mouth, and the evaluation indicators included the retention force of clamp ring, the tightness of connector and base, and the accuracy of occlusion. The evaluation scores of each index were used for analysis on the Kruskal-Wallis rank-sum test.
    RESULTS: No statistically significant difference in the score of each index was found among the four groups in RPD.
    CONCLUSIONS: The cast cobalt-chromium alloy and laser-printed titanium framework RPD using digital impression and resin model can meet the clinical restoration requirements of patients with Kennedy classⅠandⅡdentition defects.
    目的: 评估肯氏Ⅰ、Ⅱ类牙列缺损数字化印模及树脂模型技术在可摘局部义齿(RPD)中的应用效果。方法: 选择肯氏Ⅰ、Ⅱ类牙列缺损患者,按照义齿制作流程分组:数字化印模/树脂模型/钴铬合金铸造支架组(A组)、数字化印模/树脂模型/激光打印钛支架组(B组)、藻酸盐印模/石膏模型/钴铬合金铸造支架组(C组)、藻酸盐印模/石膏模型/激光打印钛支架组(D组),每组40例。对最终完成的RPD在口内就位情况进行检查,评估指标包括卡环固位力、连接体和基托在口内的密合度、咬合准确度,各项指标评估分值使用Kruskal-Wallis秩和检验进行分析。结果: 4组RPD各项指标的评分值差异无统计学意义。结论: 利用数字化印模及树脂模型完成的铸造钴铬合金和激光打印钛支架式RPD能够满足肯氏Ⅰ、Ⅱ类牙列缺损患者的临床修复要求。.
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  • 文章类型: Journal Article
    目的:这项体外研究的目的是研究不同IAC设计中不同的旋转自由度方案是否以及在多大程度上影响三部分固定局部义齿(FPD)的垂直尺寸。同时,实验设置应尽可能准确地模拟实施此类FPD的所有临床和实验室步骤.
    方法:20对相同的钳口模型由铝制成,每个下颌模型持有两个带锥形或扁平IAC的植入物。每个模型的三个印象用于制造石模和三单元FPD。比较了三种装配方案为这些FPD提供的垂直位置稳定性,不同的是,顺序植入物组件(印模柱>实验室类似物>基台1>基台2)与IAC的位置索引对齐。这样,共制作了60个石模和FPD,并对垂直尺寸的变化进行了统计学分析(p<0.05)。
    结果:无论是否使用锥形/扁平IAC(p>0.05),垂直尺寸的平均变化在位置索引(0.286/0.350mm)的左、右限止点之间交替出现的“最坏情况”(所有比较p<0.0001)比在10名牙医和10名具有不同经验水平的技术人员自由选择对齐(0.003/0.014mm)的“随机情况”或在所有组件的“最佳情况停止点”(0.00.005mm-19
    结论:与IAC设计相比,在垂直尺寸方面正确整合上层建筑的可能性与装配策略相比差异更大。具体来说,我们的研究结果证明,我们建议所有植入物组件应与定位指数的右限止点对齐.
    OBJECTIVE: The aim of this in vitro study was to investigate whether and to what extent different scenarios of rotational freedom in different IAC designs affect the vertical dimension of a three-part fixed partial denture (FPD). At the same time, the experimental setup should simulate all clinical and laboratory steps of the implementation of such an FPD as accurately as possible.
    METHODS: Twenty identical pairs of jaw models were fabricated from aluminum, each lower-jaw model holding two implants with conical or flat IACs. Three impressions of each model were taken to fabricate stone casts and three-unit FPDs. Three assembly scenarios were compared for the vertical position stability they offered for these FPDs, differing by how the sequential implant components (impression posts > laboratory analogs > abutments 1 > abutments 2) were aligned with the positional index of the IAC. In this way, a total of 60 stone casts and FPDs were fabricated and statistically analyzed for changes in vertical dimension (p < 0.05).
    RESULTS: Regardless of whether a conical/flat IAC was used (p > 0.05), significantly greater mean changes in vertical dimension were consistently (all comparisons p < 0.0001) found in a \"worst-case scenario\" of component alignment alternating between the left- and right-limit stop of the positional index (0.286/0.350 mm) than in a \"random scenario\" of 10 dentists and 10 technicians with varying levels of experience freely selecting the alignment (0.003/0.014 mm) or in a \"best-case scenario\" of all components being aligned with the right-limit stop (-0.019/0.005 mm).
    CONCLUSIONS: The likelihood of integrating a superstructure correctly in terms of vertical dimension appears to vary considerably more with assembly strategies than with IAC designs. Specifically, our findings warrant a recommendation that all implant components should be aligned with the right-limit stop of the positioning index.
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  • 文章类型: Journal Article
    目的:制作两步腻子-轻体印模后,印模中可能会残留一些小缺陷。这项研究的目的是评估和比较2步和相关的2步(3步)腻子轻体印象的尺寸精度。材料和方法:在这项体外研究中,30个印象是用腻子做的,轻体,和使用2步和3步印模技术的超轻体添加有机硅材料(N=15)。制作了环氧树脂母模,复制了上颌字体,左第一前磨牙和第一磨牙的牙齿,并在the中和第三磨牙部位准备了肩终点线和截短的金字塔形指数。除了通过扫描主模型来创建参考数字模型之外,扫描了30个主模型以产生数字模型。使用线性测量将模型的前后(AP)和横截面(CS)尺寸精度与主模型进行了比较。此外,进行牙齿大小测量,并使用均方根(RMS)进行比较.数据采用双样本t检验(α=0.05)。结果:两组间AP和RMS平均值差异无统计学意义(P>0.05)。然而,两组之间的CS差异有统计学意义(P<0.001),与主模型相比,三步印象技术显示出更小的差异。结论:单单位和多单位制剂两种技术的准确性没有显着差异。3步印模技术具有较高的CS尺寸精度。
    Objectives: Some small defects may remain in the impression after making a two-step putty-light body impression. The aim of this study was to evaluate and compare the dimensional accuracy of 2-step and relined 2-step (3-step) putty-light body impressions. Materials and Methods: In this in vitro study, 30 impressions were made with putty, light body, and extra-light body addition silicone materials using the 2-step and 3-step impression techniques (N=15). An epoxy resin master model was made duplicating a maxillary typodont with left first premolar and first molar teeth prepared with a shoulder finish line and truncated pyramidal-shaped indices in the mid-palate and third molar sites. In addition to creating a reference digital model by scanning the master model, 30 master casts were scanned to produce digital models. The anteroposterior (AP) and cross-sectional (CS) dimensional accuracy of the models were compared with the master model using linear measurements. Moreover, tooth size measurements were made and compared using the root mean square (RMS). Two-sample t-test was applied to analyze the data (α=0.05). Results: The mean AP and RMS differences between the two study groups were not significant (P>0.05). However, the CS difference between the two groups was significant (P<0.001), and the 3-step impression technique showed smaller discrepancies in comparison to the master model. Conclusion: There was no significant difference in accuracy of the two techniques for single-unit and multiple-unit preparations. The 3-step impression technique had a higher CS dimensional accuracy.
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  • 文章类型: Journal Article
    背景:这项临床研究旨在评估常规植入物印模技术与数字印模技术在双侧远端延伸病例中的准确性。
    方法:对8例除第一前磨牙外所有下颌后牙缺失的患者共放置了32个植入物。每位患者总共接受了四个植入物,每侧放置两个植入物,以便为三个单位的螺钉保留氧化锆修复体提供支持。骨整合后,同一患者接受了两种植入物水平印模技术:传统开式印模CII(夹板拾取)和使用TRIOS3形口内扫描仪的数字植入物印模DII.使用标准镶嵌语言(STL)文件的三维叠加分析来评估印象的准确性。随后,使用Gom检查软件对扫描体进行分割,以测量颜色编码图中的三维偏差.使用KruskalWallis检验对数据进行统计学分析,然后进行事后检验以确定显著性水平(P<0.05)。
    结果:研究表明,与两种印模技术相比,远端扫描体的角度和位置偏差更大。然而,差异无统计学意义(P>0.05)。
    结论:Splintedopen-talet传统印模和口内扫描植入物印模技术已经证明了相当的准确性。
    背景:临床试验.gov注册IDNCT05912725。注册22/06/2023-回顾性注册,https://register。
    结果:政府。
    BACKGROUND: This clinical study aims to evaluate the accuracy of the conventional implant impression techniques compared to the digital impression ones in bilateral distal extension cases.
    METHODS: A total of 32 implants were placed in eight patients missing all mandibular posterior teeth except the first premolars. Each patient received a total of four implants, with two implants placed on each side, in order to provide support for three units of screw-retained zirconia restorations. Following osteointegration, the same patient underwent two implant-level impression techniques: Conventional open-tray impressions CII (splinted pick-up) and digital implant impressions DII with TRIOS 3 Shape intraoral scanner. The accuracy of impressions was evaluated utilizing a three-dimensional superimposition analysis of standard tessellation language (STL) files. Subsequently, the scan bodies were segmented using Gom inspect software to measure three-dimensional deviations in a color-coding map. Data were statistically analyzed using the Kruskal Wallis test and then a post-hoc test to determine the significance level (P < 0.05).
    RESULTS: The study revealed that higher angular and positional deviations were shown toward distal scan bodies compared to mesial ones for both impression techniques. However, this difference was not statistically significant (P > 0.05).
    CONCLUSIONS: Splinted open-tray conventional impression and intraoral scanning implant impression techniques have demonstrated comparable accuracy.
    BACKGROUND: Clinical Trials.gov Registration ID NCT05912725. Registered 22/06/ 2023- Retrospectively registered, https://register.
    RESULTS: gov .
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  • 文章类型: Journal Article
    目的:评估重复切断和重新扫描程序对三种口内扫描仪(IOS)的真实性的影响。
    方法:制备了具有标准II类腔的牙齿模型(#16),并且使用实验室扫描仪(D2000,3ShapeA/S)扫描完整牙弓以获得参考扫描。然后用三个IOS(3ShapeTRIOS3,CERECOmnicam,和Mediti500)在两种重新扫描策略(全切和部分切)下,具有不同数量的重复切断和重新扫描程序(0、1、3、5、7或10)。使用均方根(RMS)计算来估计参考数字扫描与实验数字扫描之间的真实性差异。选择了三个感兴趣的区域来代表重新扫描,identification,和非重新扫描区域。并使用线性混合模型(α=0.05)分析差异。
    结果:截止和重新扫描程序与参考相比,在所有测试条件下都显着降低了数字扫描的准确性。然而,在任何重新扫描条件下,均未观察到差异逐渐增加.根据使用的IOS,发现对真实性有重大影响,与3Shape系统表现出较低的RMS值。与全切策略相比,部分切策略显示出较低的RMS值,虽然没有统计学意义。
    结论:虽然反复的切断和重新扫描程序导致数字印象质量下降,它们没有导致重复重新扫描的差异积累。
    结论:为了确保牙科实践中的高扫描精度,当校正数字扫描中的缺陷时,建议最大限度地减少重新扫描区域。此外,选择合适的扫描仪可以帮助减轻重新扫描技术的负面影响。
    OBJECTIVE: To evaluate the effects of repeated cut-off and rescan procedures on the trueness of three intraoral scanners (IOS).
    METHODS: A tooth model (#16) with a standard class II cavity was prepared, and the complete-arch was scanned using a laboratory scanner (D2000, 3Shape A/S) to obtain a reference scan. Then the typodont was scanned with three IOSs (3Shape TRIOS 3, CEREC Omnicam, and Medit i500) under two rescanning strategies (full-cut and partial-cut), with varying numbers of repeated cut-off and rescanning procedures (0, 1, 3, 5, 7, or 10). The trueness discrepancy between the reference and experimental digital scan was estimated using root mean square (RMS) calculations. Three regions of interest were selected to represent the rescanning, identification, and non-rescan area. And the discrepancies were analyzed using a linear mixed model (α=.05).
    RESULTS: Cut-off and rescanning procedures significantly decreased the trueness of digital scans in all test conditions compared to the reference. However, no progressive increase in discrepancy was observed under any rescan conditions. Significant influences on trueness were found based on the IOS used, with the 3Shape system exhibiting lower RMS values. The partial-cut strategy showed lower RMS values compared to the full-cut strategy, albeit without statistical significance.
    CONCLUSIONS: While repeated cut-off and rescanning procedures led to a decline in the quality of digital impressions, they did not result in discrepancy accumulation with repeated rescanning.
    CONCLUSIONS: To ensure high scanning accuracy in dental practice, it is advisable to minimize the rescanning area when correcting imperfections in digital scans. Additionally, selecting an appropriate scanner can help mitigate the negative effects of the rescanning technique.
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  • 文章类型: Journal Article
    目的:回顾口腔内扫描仪(IOS)技术在种植修复中的应用,强调它们对数字印象准确性的影响,咬合注册,以及植入物支持的修复体的配合。
    方法:与种植修复相关的已发表的文章,数字印象的准确性,咬合注册,以及植入物支撑的固定修复体的配合。
    方法:选择了三个搜索引擎:Medline/PubMed,EBSCO,还有Cochrane.还进行了手动搜索。
    方法:文献检索筛选了相关数据库和期刊,以研究从2018年12月至2023年12月在数字种植体修复工作流程中的IOS应用。纳入标准包括随机对照试验,临床试验,案例系列,体外研究集中在IOS在数字种植修复中的应用。
    结论:数字牙科技术利用的增加导致数字种植修复工作流程显著融入临床医生的临床实践。几个变量会影响IOS生成的数字印象的准确性。一般来说,学术论文中的普遍观点是,数字工作流程适用于解决短跨度植入物支持的修复。然而,当涉及到大跨度缺陷时,数字工作流程的准确性仍然是一个有争议的问题。数字咬合注册是工作流程的组成部分。它主要取决于缺陷的大小和位置,扫描策略,解剖牙齿的变化,过度咬伤和其他因素。数字预制植入物修复体的整体配合包括近端,咬合接触以及修复体与植入物连接的准确性。研究方法需要标准化以进一步验证。
    结论:在临床实践中,必须对可能影响数字印象准确性和最终假体在种植修复中的适合性的各种因素进行全面和最新的理解。
    OBJECTIVE: To review the developments in intraoral scanner (IOS) technologies applied in implant prosthodontics, emphasizing their influence on the accuracy of digital impressions, occlusal registrations, and the fit of implant-supported restorations.
    METHODS: A collection of published articles related to implant prosthodontics, the accuracy of digital impressions, occlusal registration, and the fit of implant-supported fixed restorations.
    METHODS: Three search engines were selected: Medline/PubMed, EBSCO, and Cochrane. A manual search was also conducted.
    METHODS: A literature search screened relevant databases and journals for studies on IOS applications in digital implant prosthodontic workflows from Dec 2018 to Dec 2023. Inclusion criteria encompassed randomized control trials, clinical trials, case series, and in vitro research focused on the use of IOS in digital implant prosthodontics.
    CONCLUSIONS: The increased utilization of digital dental technologies has led to significant integration of digital implant prosthodontic workflows into clinicians\' clinical practice. Several variables affect the accuracy of digital impressions generated by IOS. Generally, the prevailing opinion in academic papers is that digital workflows are suitable for addressing short-span implant-supported restorations. However, when it comes to long-span defects, the accuracy of digital workflows is still a matter of debate. Digital bite registration is an integral part of the workflow. It depends mainly on the defect size and location, scan strategy, anatomical tooth variations, overbite and other factors. The overall fit of digitally prefabricated implant restorations comprises of proximal, occlusal contacts and how accurately the restoration connects with implants. Research methodologies need standardization for further validation.
    CONCLUSIONS: In clinical practice, it is essential to have a thorough and up-to-date comprehension of various factors that can affect the accuracy of digital impressions and the fit of the final prosthesis in implant prosthodontics.
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    文章类型: Journal Article
    病人总是在寻找保守的,审美,和持久的牙齿修复,使用的技术直接影响治疗的寿命。修复体在口腔中的位置和腐烂的程度影响治疗选择。腔体制备的尺寸越大,使用直接技术修复牙齿的难度越大。半直接技术,当指示时,能取得满意的效果。这是一个相对简单的过程,包括接受间接修复的牙齿准备,藻酸盐印模的制作,在柔性铸件上制造复合树脂修复体,胶结作用,清除多余的水泥,和咬合调整。本病例报告的目的是为广泛腐烂的后牙提供直接和间接修复的可行替代方法。本文介绍了用于制造复合树脂修复体的口外半直接技术,突出其适应症,讨论利弊。
    Patients are always looking for conservative, esthetic, and long-lasting dental restorations, and the technique used directly influences the longevity of the treatment. The location of the restoration in the mouth and the extent of the decay influence the treatment choice. The larger the dimensions of the cavity preparation, the greater the difficulties in restoring the tooth using direct techniques. The semidirect technique, when indicated, can achieve satisfactory results. It is a relatively easy procedure, consisting of tooth preparation to receive an indirect restoration, fabrication of an alginate impression, fabrication of the composite resin restoration on a flexible cast, cementation, removal of excess cement, and occlusal adjustment. The aim of this case report is to present a viable alternative to direct and indirect restorations for posterior teeth with extensive decay. The article describes the extraoral semidirect technique for fabricating a composite resin restoration, highlighting its indications and discussing advantages and disadvantages.
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