In Vitro Investigation of Marginal & Internal Adaptation of Two Screw-Retained Implant Supported Crowns: A Comparative Analysis of Direct Optical & Subtractive Reverse Engineering Techniques.

Heba Ismail, M. Wahsh, A. Aboelfadl, Ingy Nouh
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Abstract

Objectives: The aim of this in-vitro study was to investigate the marginal and internal adaptation of two screw-retained crowns; lithium disilicate and BioHPP using direct optical and subtractive reverse engineering techniques and to calculate the degree of agreement between them. Materials & Methods: Twenty-eight implant analogs were embedded perpendicularly in an auto-polymerizing resin. Implant-supported restorations were designed then milled with CAD wax and divided into 2 groups according to material (n=14): Lithium disilicate and BioHPP. Each group was pressed according to the manufacturer’s instructions. The marginal and internal adaptation of the specimens were analyzed using DOT & subtractive RET. Data were explored for normality using Shapiro-Wilk’s and Levene’s tests and were analyzed using independent and paired t-test for inter and intragroup comparisons respectively with a significance level of p<0.05. Agreement analysis was done using intraclass correlation coefficient (ICC). Results: BioHPP screw-retained implant-supported crowns showed higher marginal gap than lithium disilicate, yet the difference was non-significant when measured using DOT, while it was significant when measured using sRET. Calculated agreement between the two techniques at the marginal level showed that there was a statistically significant moderate agreement between both methods. Regarding internal adpatation, BioHPP had a statistically significant higher internal gap than lithium disilicate group. Conclusions: Supra-structure material affected marginal and internal adaptation of implant-supported restorations. Pressed lithium disilicate crowns showed better marginal and internal adaptation than BioHPP crowns, however, both groups showed clinically acceptable results. DOT and RET were both relevant and showed moderate agreement between them.
两种螺钉固位种植牙冠边缘和内部适应性的体外研究:直接光学和减法逆向工程技术的对比分析
研究目的这项体外研究的目的是使用直接光学和减法逆向工程技术研究两种螺钉固位牙冠(二硅酸锂和 BioHPP)的边缘和内部适应性,并计算它们之间的一致程度。材料与方法:将 28 个种植体模拟体垂直嵌入自动聚合树脂中。设计种植体支持的修复体,然后用 CAD 蜡进行研磨,并根据材料分为两组(n=14):二硅酸锂和 BioHPP。每组均按照制造商的说明进行压制。使用 DOT 和减法 RET 分析试样的边缘和内部适应性。使用 Shapiro-Wilk 检验和 Levene 检验对数据进行正态性检验,并分别使用独立 t 检验和配对 t 检验对组间和组内比较进行分析,显著性水平为 p<0.05。采用类内相关系数(ICC)进行一致性分析。结果BioHPP螺钉固位种植体支持冠的边缘间隙高于二硅酸锂冠,但使用DOT测量时差异不显著,而使用sRET测量时差异显著。对两种技术在边缘水平上的一致性进行计算后发现,这两种方法在统计学上具有显著的中度一致性。在内部间隙方面,BioHPP 的内部间隙在统计学上明显高于二硅酸锂组。结论上部结构材料会影响种植体支持修复体的边缘和内部适应性。与 BioHPP 冠相比,压制二硅酸锂冠显示出更好的边缘和内部适应性,但两组都显示出临床可接受的结果。DOT 和 RET 都具有相关性,而且两者之间的一致性适中。
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