Esthetic Considerations for Reconstructing Implant Emergence Profile Using Titanium and Zirconia Custom Implant Abutments: Fifty Case Series Report

2015 ◽  
Vol 41 (5) ◽  
pp. 554-561 ◽  
Author(s):  
Ahmad Kutkut ◽  
Osama Abu-Hammad ◽  
Richard Mitchell
Keyword(s):  
Computer Aided Design ◽  
Case Series ◽  
Casting Technique ◽  
Custom Implant ◽  
Implant Abutments ◽  
Computer Aided ◽  
Case Series Report ◽  
Cad Cam ◽  
Implant Dentistry ◽  
Implant Restoration

Titanium and zirconia custom implant abutments are now commonly used for esthetic implant dentistry. Custom implant abutments allow the clinician to improve an implant's emergence profile, to customize cervical margins in accordance with the anatomy of the natural root, and to compensate for poor implant angulation. All of these are essential for optimum esthetic outcomes. Computer-aided design/computer-aided machining (CAD/CAM) technology allows the clinician to design custom implant abutment configurations and create natural-looking superstructures that are in harmony with the adjacent dentition and soft tissue. The CAD/CAM technique provides precise fit, reduces the cost of the procedure, and eliminates dimensional inaccuracies inherent in the conventional waxing and casting technique. The aim of this report is to describe a simplified technique for reconstructing emergence profiles during implant restoration using milled titanium and zirconia custom implant abutments. The results of 50 consecutive cases are reported.

scholarly journals Anatomical Shaping for Zirconia Custom Implant Abutment to Enhance Anterior Esthetic: A Clinical Technique

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mohammed Alshehri ◽  
Mohammed Alghamdi ◽  
Abdullah S. Alayad
Keyword(s):  
Computer Aided Design ◽  
Innovative Technology ◽  
Dental Crowns ◽  
Incisal Edge ◽  
Custom Implant ◽  
Optical Effects ◽  
Computer Aided ◽  
Cad Cam ◽  
The One ◽  
Aided Design

Abutments are used in dentistry to attach dental crowns to dental implant. Currently, zirconia custom abutment is the one which is mostly used in restorations, since it offers several advantages, especially better esthetics and prevention from infection. Several innovations are done in the implant designs and procedures to achieve better esthetics. Computer-aided design & computer-aided manufacturing (CAD/CAM) system is widely used innovative technology in dentistry. This technology offers custom implants that help to achieve better esthetics and good internal fit. This procedure used a novel technique of anatomical modification of the final abutment incisal edge from straight anatomical edge to irregular one with a mamelon-incisal effect to enhance esthetic, shade matching, and anatomical replication of incisal structure that resembles the natural incisor. Usually, dental technicians will perform facial and incisal cut-back and apply porcelain layers to the crown in order to reproduce the translucency and the other optical effects that most closely match that of natural dentin and enamel, especially at the incisal edge. These optical effects will make the prosthetic crown look more natural and esthetically pleasant. By this presented technique will help the dental technician to achieve highly esthetic crown with completely digital workflow without the need for porcelain layering. The procedure was also followed up to 3, 6, and 12 months after the surgery and found no complications or complaints from the patient and esthetically satisfied.

scholarly journals Two Years after Loading Performance of Implant-Supported Overdenture with Metal Bar and Low-Profile Attachments: A Prospective Case Series Multicenter Clinical Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Marco Montanari ◽  
Marco Tallarico ◽  
Gabriele Vaccaro ◽  
Emiliano Ferrari ◽  
Roberto Scrascia ◽  
...  
Keyword(s):  
Survival Rate ◽  
Oral Health ◽  
Bone Loss ◽  
Computer Aided Design ◽  
Case Series ◽  
Chromium Alloy ◽  
Technical Complications ◽  
Low Profile ◽  
Computer Aided ◽  
Cad Cam

Background. Prosthetic rehabilitation of patients with atrophic arches can be very challenging. Purpose. The aim of the present prospective multicenter study was to report the two-year preliminary data on clinical and radiographic performance of implant-supported overdentures with a metal bar and low-profile attachments. Material and Methods. A computer-aided design/computer-aided manufacturing (CAD/CAM) titanium bar or a conventional cast metal bar was fabricated according to the anatomy of the ridge, prosthetic contours (teeth setup), and implant position. Three to six threadable OT Equator attachments (Rhein 83, Bologna, Italy) were placed along the implant bar. A cobalt-chromium alloy metal framework was fabricated and fitted onto the metal bar as a counterpart. Prosthetic survival rate, biologic and technical complications, peri-implant bone loss, changes in oral health impact profile index, bleeding on probing, and plaque index were reported. Results. Overall, 177 implants were placed (range three to six) to support 43 metal bars with 170 OT Equators (Rhein 83, range three to six). Eleven metal bars were fabricated using CAD/CAM technology, while the other 32 were conventionally produced using cast technique. All the participants were followed up for at least two years (mean 42.2 months, range 24–88 months) after prosthesis delivery. Two maxillary implants failed in one nonsmoking patient (1.1%). The 2-year prosthesis survival rate was 97.7%. Only three minor technical complications were reported. Two years after loading, the mean marginal bone loss was 0.22 ± 0.09 mm (95% CI: 0.16 to 0.26). Two years after loading, OHIP was 22.3 ± 7.1 (95% CI from 17.4 to 24.6). Compared to the baseline, the difference was statistically significant ( P ≤ 0.001 ). At the two-year follow-up session, successful periodontal parameters were experienced. Conclusions. Implant overdenture supported by a CAD/CAM titanium bar may be a reliable option for the treatment of the edentulous arch over a 2-year period. Oral health-related quality of life significantly improved in all treated participants.

scholarly journals Fractography of clinically fractured, implant-supported dental computer-aided design and computer-aided manufacturing crowns

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774101 ◽  
Author(s):  
Ulrich Lohbauer ◽  
Renan Belli ◽  
Marco S Cune ◽  
Ulf Schepke
Keyword(s):  
Clinical Trial ◽  
Water Absorption ◽  
Computer Aided Design ◽  
Interfacial Stress ◽  
Computer Aided Manufacturing ◽  
Implant Abutments ◽  
Computer Aided ◽  
Cad Cam ◽  
Aided Design ◽  
Zirconia Implant

Today, a substantial part of the dental crown production uses computer-aided design and computer-aided manufacturing (CAD/CAM) technology. A recent step in restorative dentistry is the replacement of natural tooth structure with pre-polymerized and machined resin-based methacrylic polymers. Recently, a new CAD/CAM composite was launched for the crown indication in the load-bearing area, but the clinical reality forced the manufacturer to withdraw this specific indication. In parallel, a randomized clinical trial of CAD/CAM composite crowns luted on zirconia implant abutments revealed a high incidence of failure within the first year of service. Fractured crowns of this clinical trial were retrieved and submitted to a fractographic examination. The aim of the case series presented in this article was to identify failure reasons for a new type of CAD/CAM composite crown material (Lava Ultimate; 3M Oral Care, St. Paul, Minnesota, USA) via fractographic examinations and analytical assessment of luting surfaces and water absorption behavior. As a result, the debonding of the composite crowns from the zirconia implant abutments was identified as the central reason for failure. The adhesive interface was found the weakest link. A lack of silica at the zirconia surface certainly has compromised the bonding potential of the adhesive system from the beginning. Additionally, the hydrolytic stress released from swelling of the resin-based crown (water absorption) and transfer to the luting interface further added to the interfacial stress and most probably contributed to a great extend to the debonding failure.

Fit of CAD/CAM Implant Frameworks: A Comprehensive Review

2014 ◽  
Vol 40 (6) ◽  
pp. 758-766 ◽  
Author(s):  
Jaafar Abduo
Keyword(s):  
Computer Aided Design ◽  
Fabrication Method ◽  
Computer Aided Manufacturing ◽  
Comprehensive Review ◽  
Electronic Search ◽  
Computer Aided ◽  
Cad Cam ◽  
Implant Dentistry ◽  
Aided Design

Computer-aided design and computer-aided manufacturing (CAD/CAM) is a strongly emerging prosthesis fabrication method for implant dentistry. Currently, CAD/CAM allows the construction of implant frameworks from different materials. This review evaluates the literature pertaining to the precision fit of fixed implant frameworks fabricated by CAD/CAM. Following a comprehensive electronic search through PubMed (MEDLINE), 14 relevant articles were identified. The results indicate that the precision fit of CAD/CAM frameworks exceeded the fit of the 1-piece cast frameworks and laser-welded frameworks. A similar fit was observed for CAD/CAM frameworks and bonding of the framework body to prefabricated cylinders. The influence of CAD/CAM materials on the fit of a framework is minimal.

scholarly journals Rationale for the Use of CAD/CAM Technology in Implant Prosthodontics

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Jaafar Abduo ◽  
Karl Lyons
Keyword(s):  
Computer Aided Design ◽  
Laboratory Experiments ◽  
Clinical Evidence ◽  
Ceramic Materials ◽  
Main Stream ◽  
Implant Abutments ◽  
Computer Aided ◽  
Cad Cam ◽  
Aided Design ◽  
Further Development

Despite the predictable longevity of implant prosthesis, there is an ongoing interest to continue to improve implant prosthodontic treatment and outcomes. One of the developments is the application of computer-aided design and computer-aided manufacturing (CAD/CAM) to produce implant abutments and frameworks from metal or ceramic materials. The aim of this narrative review is to critically evaluate the rationale of CAD/CAM utilization for implant prosthodontics. To date, CAD/CAM allows simplified production of precise and durable implant components. The precision of fit has been proven in several laboratory experiments and has been attributed to the design of implants. Milling also facilitates component fabrication from durable and aesthetic materials. With further development, it is expected that the CAD/CAM protocol will be further simplified. Although compelling clinical evidence supporting the superiority of CAD/CAM implant restorations is still lacking, it is envisioned that CAD/CAM may become the main stream for implant component fabrication.

Structural Analysis of Product and Computer-Aided Assembly Planning in AssemBL Software Package

2018 ◽  
pp. 11-33
Author(s):  
A. N. Bozhko
Keyword(s):  
Computer Aided Design ◽  
State Of The Art ◽  
Graph Model ◽  
Design System ◽  
Assembly Planning ◽  
Complex Products ◽  
Assembly Sequences ◽  
Computer Aided ◽  
Cad Cam ◽  
Aided Design

Computer-aided design of assembly processes (Computer aided assembly planning, CAAP) of complex products is an important and urgent problem of state-of-the-art information technologies. Intensive research on CAAP has been underway since the 1980s. Meanwhile, specialized design systems were created to provide synthesis of assembly plans and product decompositions into assembly units. Such systems as ASPE, RAPID, XAP / 1, FLAPS, Archimedes, PRELEIDES, HAP, etc. can be given, as an example. These experimental developments did not get widespread use in industry, since they are based on the models of products with limited adequacy and require an expert’s active involvement in preparing initial information. The design tools for the state-of-the-art full-featured CAD/CAM systems (Siemens NX, Dassault CATIA and PTC Creo Elements / Pro), which are designed to provide CAAP, mainly take into account the geometric constraints that the design imposes on design solutions. These systems often synthesize technologically incorrect assembly sequences in which known technological heuristics are violated, for example orderliness in accuracy, consistency with the system of dimension chains, etc.An AssemBL software application package has been developed for a structured analysis of products and a synthesis of assembly plans and decompositions. The AssemBL uses a hyper-graph model of a product that correctly describes coherent and sequential assembly operations and processes. In terms of the hyper-graph model, an assembly operation is described as shrinkage of edge, an assembly plan is a sequence of shrinkages that converts a hyper-graph into the point, and a decomposition of product into assembly units is a hyper-graph partition into sub-graphs.The AssemBL solves the problem of minimizing the number of direct checks for geometric solvability when assembling complex products. This task is posed as a plus-sum two-person game of bicoloured brushing of an ordered set. In the paradigm of this model, the brushing operation is to check a certain structured fragment for solvability by collision detection methods. A rational brushing strategy minimizes the number of such checks.The package is integrated into the Siemens NX 10.0 computer-aided design system. This solution allowed us to combine specialized AssemBL tools with a developed toolkit of one of the most powerful and popular integrated CAD/CAM /CAE systems.

scholarly journals Fracture Load of Metal, Zirconia and Polyetheretherketone Posterior CAD-CAM Milled Fixed Partial Denture Frameworks

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 959
Author(s):  
Verónica Rodríguez ◽  
Celia Tobar ◽  
Carlos López-Suárez ◽  
Jesús Peláez ◽  
María J. Suárez
Keyword(s):  
Computer Aided Design ◽  
Testing Machine ◽  
Fracture Load ◽  
Fracture Pattern ◽  
Bending Test ◽  
Weibull Statistics ◽  
Promising Alternative ◽  
Computer Aided ◽  
Cad Cam ◽  
Group 2

The aim of this study was to investigate the load to fracture and fracture pattern of prosthetic frameworks for tooth-supported fixed partial dentures (FPDs) fabricated with different subtractive computer-aided design and computer-aided manufacturing (CAD-CAM) materials. Materials and Methods: Thirty standardized specimens with two abutments were fabricated to receive three-unit posterior FDP frameworks with an intermediate pontic. Specimens were randomly divided into three groups (n = 10 each) according to the material: group 1 (MM)—milled metal; group 2 (L)—zirconia; and group 3 (P)—Polyetheretherketone (PEEK). The specimens were thermo-cycled and subjected to a three-point bending test until fracture using a universal testing machine (cross-head speed: 1 mm/min). Axial compressive loads were applied at the central fossa of the pontics. Data analysis was made using one-way analysis of variance, Tamhane post hoc test, and Weibull statistics (α = 0.05). Results: Significant differences were observed among the groups for the fracture load (p < 0.0001). MM frameworks showed the highest fracture load values. The PEEK group registered higher fracture load values than zirconia samples. The Weibull statistics corroborated these results. The fracture pattern was different among the groups. Conclusions: Milled metal provided the highest fracture load values, followed by PEEK, and zirconia. However, all tested groups demonstrated clinically acceptable fracture load values higher than 1000 N. PEEK might be considered a promising alternative for posterior FPDs.

scholarly journals Evaluation of the Feasibility of NaCaPO4-Blended Zirconia as a New CAD/CAM Material for Dental Restoration

Materials ◽  
2021 ◽  
Vol 14 (14) ◽  
pp. 3819
Author(s):  
Ting-Hsun Lan ◽  
Yu-Feng Chen ◽  
Yen-Yun Wang ◽  
Mitch M. C. Chou
Keyword(s):  
Computer Aided Design ◽  
Optical Microscope ◽  
Dental Restoration ◽  
Numerical Control ◽  
Test Results ◽  
Cnc Machine ◽  
Computer Aided ◽  
Cad Cam ◽  
Aided Design ◽  
Better Than

The computer-aided design/computer-aided manufacturing (CAD/CAM) fabrication technique has become one of the hottest topics in the dental field. This technology can be applied to fixed partial dentures, removable dentures, and implant prostheses. This study aimed to evaluate the feasibility of NaCaPO4-blended zirconia as a new CAD/CAM material. Eleven different proportional samples of zirconia and NaCaPO4 (xZyN) were prepared and characterized by X-ray diffractometry (XRD) and Vickers microhardness, and the milling property of these new samples was tested via a digital optical microscope. After calcination at 950 °C for 4 h, XRD results showed that the intensity of tetragonal ZrO2 gradually decreased with an increase in the content of NaCaPO4. Furthermore, with the increase in NaCaPO4 content, the sintering became more obvious, which improved the densification of the sintered body and reduced its porosity. Specimens went through milling by a computer numerical control (CNC) machine, and the marginal integrity revealed that being sintered at 1350 °C was better than being sintered at 950 °C. Moreover, 7Z3N showed better marginal fit than that of 6Z4N among thirty-six samples when sintered at 1350 °C (p < 0.05). The milling test results revealed that 7Z3N could be a new CAD/CAM material for dental restoration use in the future.

scholarly journals Characterisation of the Filler Fraction in CAD/CAM Resin-Based Composites

Materials ◽  
2021 ◽  
Vol 14 (8) ◽  
pp. 1986
Author(s):  
Andreas Koenig ◽  
Julius Schmidtke ◽  
Leonie Schmohl ◽  
Sibylle Schneider-Feyrer ◽  
Martin Rosentritt ◽  
...  
Keyword(s):  
Computer Aided Design ◽  
Point Of View ◽  
Specific Information ◽  
Dental Resin ◽  
X Ray ◽  
Computer Aided ◽  
Cad Cam ◽  
Filler Fraction ◽  
The Individual ◽  
Aided Design

The performance of dental resin-based composites (RBCs) heavily depends on the characteristic properties of the individual filler fraction. As specific information regarding the properties of the filler fraction is often missing, the current study aims to characterize the filler fractions of several contemporary computer-aided design/computer-aided manufacturing (CAD/CAM) RBCs from a material science point of view. The filler fractions of seven commercially available CAD/CAM RBCs featuring different translucency variants were analysed using Scanning Electron Microscopy (SEM) with Energy Dispersive X-ray Spectroscopy (EDS), Micro-X-ray Computed Tomography (µXCT), Thermogravimetric Analysis (TG) and X-ray Diffractometry (XRD). All CAD/CAM RBCs investigated included midifill hybrid type filler fractions, and the size of the individual particles was clearly larger than the individual specifications of the manufacturer. The fillers in Shofu Block HC featured a sphericity of ≈0.8, while it was <0.7 in all other RBCs. All RBCs featured only X-ray amorphous phases. However, in Lava Ultimate, zircon crystals with low crystallinity were detected. In some CAD/CAM RBCs, inhomogeneities (X-ray opaque fillers or pores) with a size <80 µm were identified, but the effects were minor in relation to the total volume (<0.01 vol.%). The characteristic parameters of the filler fraction in RBCs are essential for the interpretation of the individual material’s mechanical and optical properties.

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