Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2024, Vol. 56 ›› Issue (1): 81-87. doi: 10.19723/j.issn.1671-167X.2024.01.013

Previous Articles     Next Articles

Trueness of different digital design methods for incisal guidance of maxillary anterior implant-supported single crowns

Sui LI1,Wenjie MA1,Shimin WANG2,Qian DING1,*(),Yao SUN1,Lei ZHANG1,*()   

  1. 1. Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
    2. Center of Dental Laboratory, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2023-10-10 Online:2024-02-18 Published:2024-02-06
  • Contact: Qian DING,Lei ZHANG E-mail:dingqian@hsc.pku.edu.cn;drzhanglei@yeah.net
  • Supported by:
    the Clinical Research Foundation of Peking University School and Hospital of Stomatology(PKUSS-2023CRF503);the National Program for Multidisciplinary Cooperative Treatment on Major Diseases(PKUSSNMP-202004)

RICH HTML

   

PDF (PC)

Abstract:

Objective: To compare the trueness of incisal guidance of implant-supported single crowns designed by patient-specific motion (PSM) with that designed by average-value virtual articulator (AVA). Methods: The study had recruited 12 participants with complete dentition and stable incisal guidance. An intraoral scanner was used to scan digital casts and record two types of patient-specific motion (data only including protrusive movement, and data including protrusive movement and lateral protrusive movement). The lingual surfaces of the maxillary incisors which guided the protrusive movement was selected and elevated to create a reference cast. A maxillary central incisor of original casts was vir-tually extracted and implanted to generate a working cast. The Dental system software program was used to design implant-supported single crowns with the anatomical coping design method. The incisal guidance was designed by different methods. The incisal guidance in control group was designed by the average-value virtual articulator. The incisal guidance in experiment groups was designed by the patient-specific motion only including protrusive movement (PSM1) and with the patient-specific motion including protrusive movement and lateral protrusive movement (PSM2). The incisal guidance of prosthesis designed by these 3 methods were compared with the original incisal guidance in Geomagic Control 2015 (3DSystem, America). The measurements included: Average of positive values, ratio of positive area and maximum value reflecting supra-occlusion; average of negative values, ratio of negative area and minimum value reflecting over-correction; and root mean square reflecting overall deviation. Results: Statistical data were collected using the median (interquartile range) method. The average of positive values, ratio of positive area and average of negative values of the PSM2 group were smaller than those of the control group [8.0 (18.8) μm vs. 37.5 (47.5) μm; 0 vs. 7.2% (38.1%); -109.0 (63.8) μm vs.-66.5 (64.5) μm], and the ratio of negative area of PSM2 group was larger than those of the control group [52.9% (47.8%) vs. 17.3% (45.3%)], with significant differences (P all < 0.05). The ratio of positive area [0.1% (7.0%)] and average of negative values [-97.0 (61.5) μm] of PSM1 group, were smaller than those of the control group, and the ratio of negative area [40.7% (39.2%)] of the PSM1 group was larger than that of the control group, with significant differences (P < 0.05). The average of positive values [20.0 (42.0) μm] and ratio of positive area of PSM1 group was larger than that of the PSM2 group with significant differences (P < 0.05). Conclusion: To establish the incisor guidance of implant-supported single crowns, compared with the average-value virtual articulator and the patient-specific motion only including protrusive movement, the patient-specific motion including protrusive movement and lateral protrusive movement is more conducive to reducing the protrusive interference of prosthesis and improving the occlusal fit.

Key words: Dental implant, Dental prosthesis design, Computer-aided design, Maxillary anterior teeth, Incisal guidance

CLC Number: 

  • R782.1

Figure 1

Two different patient-specific motion A, patient-specific motion with protrusive movement; B, patient-specific motion with protrusive movement and lateral protrusive movement."

Figure 2

Preprocessing of digital maxillary casts A, the original cast; B, the lingual surfaces of maxillary incisors that guided the protrusive movement was selected; C, the selected surfaces elevated by 300 μm to create a reference cast; D, the copied original cast; E, right maxillary central incisor was virtually extracted and a scan body was inserted to generate a working cast; F, left maxillary central incisor was virtually extracted and a scan body was inserted to generate another working cast."

Figure 3

Design the incisal guidance of implant-supported single crowns in 3 groups AVA, average-value virtual articulator; PSM1, patient-specific motion only including protrusive movement; PSM2, patient-specific motion including protrusive movement and lateral protrusive movement. The red and yellow area in the lingual surface of the designed crowns indicated protrusive inter-ference detected by the virtual articulator or patient-specific motion in the Dental System software program."

Figure 4

Comparison results between the incisal guidance of prosthesis and the original incisal guidance Representative images of the color-coded maps showing the deviations between the incisal guidance designed by different methods (AVA, PSM1, PSM2) and the original incisal guidance. The green-coded areas indicated the deviation within tolerance range (-100 to 50 μm). The red-coded areas (positive deviation out of the tolerance range) indicated supra-occlusion. The blue-coded areas (negative deviation out of the tolerance range) indicated over-correction. Abbreviations as in Figure 3."

Table 1

Deviation analysis results of designed prosthesis with original tooth morphology (n = 24)"

Group Measurements indicating supra-occlusion Measurements indicating over-correction RMS/μm
MAX/μm +AVG/μm +S/% MIN/μm -AVG/μm -S/%
AVA 97.0 (128.8) 37.5 (47.5) 7.2 (38.1) -201.5 (136.8) -66.5 (64.5) 17.3 (45.3) 90.0 (55.5)
PSM1 46.0 (117.3) 20.0 (42.0) 0.1 (7.0) -234.5 (162.0) -97.0 (61.5) 40.7 (39.2) 104.5 (67.0)
PSM2 14.0 (47.5) 8.0 (18.8) 0 (0) -252.5 (105.5) -109.0 (63.8) 52.9 (47.8) 118.5 (62.5)

Table 2

Pairwise comparison of deviation analysis results (Wilcoxon signed rank test)"

Group 1 Group 2 Measurements Z P
PSM2 PSM1 MAX -2.949 0.003
+AVG -2.876 0.004
+S -2.271 0.023
MIN -0.486 0.627
-AVG -1.263 0.207
-S 1.943 0.052
RMS 0.786 0.432
PSM2 AVA MAX -3.467 0.001
+AVG -3.391 0.001
+S -3.173 0.002
MIN -2.000 0.045
-AVG -2.615 0.009
-S 3.200 0.001
RMS 1.986 0.047
PSM1 AVA MAX -1.886 0.059
+AVG -1.506 0.132
+S -1.964 0.050
MIN -1.743 0.081
-AVG -2.429 0.015
-S 2.986 0.003
RMS 2.458 0.014
1 谢秋菲. 临床牙合学:成功修复指导[M]. 2版.北京: 科学出版社, 2014: 33- 34.
2 韩科, 张豪. 牙合学理论与临床实践[M]. 北京: 人民军医出版社, 2008: 45.
3 塔兰托, 张富强. 修复与牙合重建临床病例解析[M]. 沈阳: 辽宁科学技术出版社, 2013: 46.
4 Stoichkov B , Kirov D . Analysis of the causes of dental implant fracture: A retrospective clinical study[J]. Quintessence Int, 2018, 49 (4): 279- 286.
5 Yuan JC , Sukotjo C . Occlusion for implant-supported fixed dental prostheses in partially edentulous patients: A literature review and current concepts[J]. J Periodontal Implant Sci, 2013, 43 (2): 51- 57.
doi: 10.5051/jpis.2013.43.2.51
6 Klineberg I , Kingston D , Murray G . The bases for using a particular occlusal design in tooth and implant-borne reconstructions and complete dentures[J]. Clin Oral Implants Res, 2008, 19 (3): 326- 328.
doi: 10.1111/j.1600-0501.2007.01549.x
7 Gross MD . Occlusion in implant dentistry: A review of the literature of prosthetic determinants and current concepts[J]. Aust Dent J, 2008, 53 (1): S60- S68.
8 Taylor TD , Wiens J , Carr A . Evidence-based considerations for removable prosthodontic and dental implant occlusion: A literature review[J]. J Prosthet Dent, 2005, 94 (6): 555- 560.
doi: 10.1016/j.prosdent.2005.10.012
9 Lepidi L , Suriano C , Wang HL , et al. Digital fixed complete-arch rehabilitation: From virtual articulator mounting to clinical delivery[J]. J Prosthet Dent, 2022, 127 (3): 398- 403.
doi: 10.1016/j.prosdent.2020.08.049
10 Valenti M , Schmitz JH . A reverse digital workflow by using an interim prosthesis scan and patient-specific motion with an intraoral scanner[J]. J Prosthet Dent, 2021, 126 (1): 19- 23.
doi: 10.1016/j.prosdent.2020.05.011
11 Lee YC , Lee CN , Shim JS , et al. Comparison between occlusal errors of single posterior crowns adjusted using patient-specific motion or conventional methods[J]. Applied Sciences, 2020, 10 (24): 9140.
doi: 10.3390/app10249140
12 Li L , Chen H , Li W , et al. Design of wear facets of mandibular first molar crowns by using patient-specific motion with an intraoral scanner: A clinical study[J]. J Prosthet Dent, 2023, 129 (5): 710- 717.
doi: 10.1016/j.prosdent.2021.06.048
13 Ke Y , Zhang Y , Wang Y , et al. Comparing the accuracy of full-arch implant impressions using the conventional technique and digital scans with and without prefabricated landmarks in the mandible: An in vitro study[J]. J Dent, 2023, 135, 104561.
doi: 10.1016/j.jdent.2023.104561
14 Kanjanasavitree P , Thammajaruk P , Guazzato M . Comparison of different artificial landmarks and scanning patterns on the complete-arch implant intraoral digital scans[J]. J Dent, 2022, 125, 104266.
doi: 10.1016/j.jdent.2022.104266
15 Tao C , Zhao YJ , Sun YC , et al. Accuracy of intraoral scanning of edentulous jaws with and without resin markers[J]. Chin J Dent Res, 2020, 23 (4): 265- 271.
16 Richert R , Goujat A , Venet L , et al. Intraoral scanner technologies: A review to make a successful impression[J]. J Healthc Eng, 2017, 2017, 8427595.
17 Ireland AJ , McNamara C , Clover MJ , et al. 3D surface imaging in dentistry: What we are looking at[J]. Br Dent J, 2008, 205 (7): 387- 392.
doi: 10.1038/sj.bdj.2008.845
18 Aubreton O , Bajard A , Verney B , et al. Infrared system for 3D scanning of metallic surfaces[J]. Mach Vision Appl, 2013, 24 (7): 1513- 1524.
doi: 10.1007/s00138-013-0487-z
19 Parl HS , Shah C . Development of high speed and high accuracy 3D dental intraoral scanner[J]. Procedia Eng, 2015, 100, 1174- 1181.
doi: 10.1016/j.proeng.2015.01.481
20 Li L , Chen H , Li W , et al. The effect of residual dentition on the dynamic adjustment of wear facet morphology on a mandibular first molar crown[J]. J Prosthodont, 2021, 30 (4): 351- 355.
doi: 10.1111/jopr.13290
21 Li L , Chen H , Zhao Y , et al. Design of occlusal wear facets of fixed dental prostheses driven by personalized mandibular movement[J]. J Prosthet Dent, 2022, 128 (1): 33- 41.
doi: 10.1016/j.prosdent.2020.09.055
22 Chen H , Yang X , Li L , et al. Morphological design of occlusal wear facets for the mandibular first molar crown using different bite registration methods[J]. J Prosthodont, 2023, 32 (5): 439- 444.
doi: 10.1111/jopr.13574
23 朱家奕, 王俊杰, 王宇轩, 等. 轻咬合和重咬合状态对下颌运动轨迹及虚拟预调牙合的影响[J]. 中华口腔医学杂志, 2023, 58 (1): 50- 56.
24 Li R , Zhang R , Zhou Y , et al. Accuracy of two best-fit alignment strategies with different reference areas for wear measurement with an intraoral scanner: An in vitro study[J]. Int J Comput Dent, 2023, 26 (4): 331- 337.
[1] Han ZHANG,Yixuan QIN,Diyuan WEI,Jie HAN. A preliminary study on compliance of supportive treatment of patients with periodontitis after implant restoration therapy [J]. Journal of Peking University (Health Sciences), 2024, 56(1): 39-44.
[2] Xinyu XU,Ling WU,Fengqi SONG,Zili LI,Yi ZHANG,Xiaojing LIU. Mandibular condyle localization in orthognathic surgery based on mandibular movement trajectory and its preliminary accuracy verification [J]. Journal of Peking University (Health Sciences), 2024, 56(1): 57-65.
[3] Congwei WANG,Min GAO,Yao YU,Wenbo ZHANG,Xin PENG. Clinical analysis of denture rehabilitation after mandibular fibula free-flap reconstruction [J]. Journal of Peking University (Health Sciences), 2024, 56(1): 66-73.
[4] Xiaoqiang LIU,Yin ZHOU. Risk factors of perioperative hypertension in dental implant surgeries with bone augmentation [J]. Journal of Peking University (Health Sciences), 2024, 56(1): 93-98.
[5] Qian DING,Wen-jin LI,Feng-bo SUN,Jing-hua GU,Yuan-hua LIN,Lei ZHANG. Effects of surface treatment on the phase and fracture strength of yttria- and magnesia-stabilized zirconia implants [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 721-728.
[6] Meng-en OU,Yun DING,Wei-feng TANG,Yong-sheng ZHOU. Three-dimensional finite element analysis of cement flow in abutment margin-crown platform switching [J]. Journal of Peking University (Health Sciences), 2023, 55(3): 548-552.
[7] Fei SUN,Jian LIU,Si-qi LI,Yi-ping WEI,Wen-jie HU,Cui WANG. Profiles and differences of submucosal microbial in peri-implantitis and health implants: A cross-sectional study [J]. Journal of Peking University (Health Sciences), 2023, 55(1): 30-37.
[8] FENG Sha-wei,GUO Hui,WANG Yong,ZHAO Yi-jiao,LIU He. Initial establishment of digital reference standardized crown models of the primary teeth [J]. Journal of Peking University (Health Sciences), 2022, 54(2): 327-334.
[9] LI Yi,YU Hua-jie,QIU Li-xin. Clinical classification and treatment decision of implant fracture [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 126-133.
[10] LI Yi,WONG Lai U,LIU Xiao-qiang,ZHOU Ti,LYU Ji-zhe,TAN Jian-guo. Marginal features of CAD/CAM laminate veneers with different materials and thicknesses [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 140-145.
[11] WANG Juan,YU Hua-jie,SUN Jing-de,QIU Li-xin. Application evaluation of prefabricated rigid connecting bar in implants immediate impression preparation of edentulous jaw [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 187-192.
[12] QIU Shu-ting,ZHU Yu-jia,WANG Shi-min,WANG Fei-long,YE Hong-qiang,ZHAO Yi-jiao,LIU Yun-song,WANG Yong,ZHOU Yong-sheng. Preliminary clinical application verification of complete digital workflow of design lips symmetry reference plane based on posed smile [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 193-199.
[13] Feng LIANG,Min-jie WU,Li-dong ZOU. Clinical observation of the curative effect after 5-year follow-up of single tooth implant-supported restorations in the posterior region [J]. Journal of Peking University (Health Sciences), 2021, 53(5): 970-976.
[14] LIU Xiao-qiang,YANG Yang,ZHOU Jian-feng,LIU Jian-zhang,TAN Jian-guo. Blood pressure and heart rate changes of 640 single dental implant surgeries [J]. Journal of Peking University (Health Sciences), 2021, 53(2): 390-395.
[15] XU Xiao-xiang,CAO Ye,ZHAO Yi-jiao,JIA Lu,XIE Qiu-fei. In vitro evaluation of the application of digital individual tooth tray in the impression making of mandibular full-arch crown abutments [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 54-61.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd