International Journal of Computerized Dentistry, Pre-Print
ScienceDOI: 10.3290/j.ijcd.b4451424, PubMed ID (PMID): 3782354112. Oct 2023,Pages 1-22, Language: EnglishPrause, Elisabeth / Schmidt, Franziska / Unkovskiy, Alexey / Beuer, Florian / Hey, Jeremias
Aim: The adjustment and transfer of a stable occlusion can be a major challenge in prosthetic rehabilitations. The aim of this study was to assess a non-invasive treatment option for complex prosthetic rehabilitations and occlusal analyses using 3D-printed restorations clinically.
Materials and Methods: Eleven patients received a partial or complete rehabilitation with the aid of 3D-printed restorations (n=171). After 12 months of clinical service, all restorations were analyzed using the United States Public Health Service (USPHS) criteria.
Results: The 12-month clinical data revealed that 3D-printed restorations showed a survival rate of 84.4%. Complications occurred mostly regarding the anatomical form (7%) or marginal integrity (6AC%) and were consequently rated “Charlie” or “Delta.” Color stability and color match of 3D-printed restorations were rated “Alpha” in 83% and 73%, respectively, of all restorations. Marginal inflammation was rated “Alpha” in 89% of all restorations. An excellent surface texture and no secondary caries or postoperative sensitivities (100%) were observed.
Conclusions: 3D-printed restorations might be an alternative treatment option for initiating complex prosthetic rehabilitations. Technical complications rarely occurred. Biological complications did not occur at all. The color stability showed promising results after 12 months of clinical service. However, the results should be interpreted with caution. Long-term results with a high number of restorations should be awaited.
Keywords: 3D-printing, additive manufacturing, CAD/CAM, color stability, in vivo, wear behavior
Deutsche Zahnärztliche Zeitschrift, 1/2024
BuchbesprechungPages 8, Language: GermanBeuer, Florian
von Stefan WolfartInternational Journal of Computerized Dentistry, 1/2024
EditorialDOI: 10.3290/j.ijcd.b5139819, PubMed ID (PMID): 38530271Pages 3-4, Language: English, GermanBeuer, Florian
International Journal of Computerized Dentistry, 1/2024
ScienceDOI: 10.3290/j.ijcd.b3916799, PubMed ID (PMID): 36811290Pages 89-97, Language: English, GermanHofmann, Paul / Kunz, Andreas / Schmidt, Franziska / Beuer, Florian / Duddeck, Dirk
Purpose: A reference method for quantifying contaminations on two-piece abutments manufactured using CAD/CAM has not yet been established. In the present in vitro study, a pixel-based machine learning (ML) method for detecting contamination on customized two-piece abutments was investigated and embedded in a semiautomated quantification pipeline.
Materials and methods: Forty-nine CAD/CAM zirconia abutments were fabricated and bonded to a prefabricated titanium base. All samples were analyzed for contamination by scanning electron microscopy (SEM) imaging followed by pixel-based ML and thresholding (SW) for contamination detection; quantification was performed in the postprocessing pipeline. Wilcoxon signed-rank test and Bland-Altmann plot were applied to compare both methods. The contaminated area fraction was recorded as a percentage.
Results: There was no statistically significant difference between the percentages of contamination areas (median = 0.004) measured with ML (median = 0.008) and with SW (median = 0.012), asymptotic Wilcoxon test: P = 0.22. The Bland-Altmann plot demonstrated a mean difference of -0.006% (95% confidence interval [CI] from -0.011% to 0.0001%) with increased values from a contamination area fraction of > 0.03% for ML.
Conclusion: Both segmentation methods showed comparable results in evaluating surface cleanliness; pixel-based ML is a promising assessment tool for detecting external contaminations on zirconia abutments. Further studies are required to investigate the clinical performance of this tool.
Keywords: computer-aided design, scanning electron microscopy, machine learning, ultrasonics, hygiene, dental implant abutments
QZ - Quintessenz Zahntechnik, 9/2023
BuchbesprechungPages 886-888, Language: GermanBeuer, Florian
Quintessence International, 9/2023
DOI: 10.3290/j.qi.b4366813, PubMed ID (PMID): 37724999Pages 746-749, Language: EnglishKohnen, Luisa Valentina / Beuer, Florian / Hey, Jeremias / Adali, Ufuk
Objectives: Addressing a single-tooth gap in the anterior region, resulting from aplasia or trauma, poses both esthetic and functional challenges. This case report presents the restoration of a young adult with a cleft, exhibiting anterior hypoplasia and aplasia in the canine and incisor regions, using all-ceramic cantilever resin-bonded fixed dental prostheses.
Method and materials: After verification of esthetic and functional considerations through a diagnostic wax-up and an intraoral mock-up, three anterior all-ceramic cantilever resin-bonded fixed dental prostheses made of veneered zirconium dioxide were planned in the region of the maxillary right lateral incisor and maxillary left canine. The impression was made with an intraoral scanner. The framework fit was evaluated. Glaze firing and full adhesive cementation under rubber dam followed.
Results: The final restoration met the patients’ expectations and restored facial esthetics and function.
Conclusions: All-ceramic cantilever resin-bonded fixed dental prostheses offer a promising minimally invasive therapeutic option for cleft patients.
Keywords: aplasia, cantilever, cleft of lip and palate, prosthodontics, resin-bonded fixed dental prosthesis (RBFDP), veneered zirconium dioxide
International Journal of Periodontics & Restorative Dentistry, 5/2023
DOI: 10.11607/prd.6155, PubMed ID (PMID): 37733468Pages 561-569, Language: EnglishBruhnke, Maria / Krastl, Gabriel / Neumeyer, Stefan / Beuer, Florian / Herklotz, Insa / Naumann, Michael
The purpose of this clinical study was to assess the feasibility of forced orthodontic extrusion with the Tissue Master Concept to retain subgingivally fractured teeth as abutments for which extraction and replacement would be equal treatment opportunities. Participants were recruited from a group of consecutive patients in need of prosthodontic rehabilitation. In total, 36 deeply destroyed teeth in 31 patients underwent forced orthodontic extrusion with forces exceeding 50 g to reestablish biologic width and ensure a 2-mm dentin-ferrule design prior to single-crown restoration. The primary endpoint was the success of the extrusion in terms of the ability to restore the respective abutment tooth. Information about overall treatment time, frequency, and reasons for failure were collected. Four patients dropped out of the treatment. For the remaining 27 participants, data were fully collected. The amount of extrusion ranged between 2 and 6 mm (3.5 ± 0.9 mm), and the mean duration until retention was 20 ± 12 days. On average, patients returned three (± 3) times for control visits after extrusion. Adhesive failure (n = 6) and orthodontic relapse (n = 2) were the most frequent complication types. Forced orthodontic extrusion may be a useful tool to restore teeth evaluated as nonrestorable.
Deutsche Zahnärztliche Zeitschrift, 5/2023
WissenschaftPages 320-328, Language: GermanPrause, Elisabeth / Nicic, Robert / Beuer, Florian / Hey, Jeremias
FallberichtEinführung: Die Rekonstruktion generalisierter Zahnhartsubstanzdefekte stellt eine therapeutische Herausforderung dar. Vor mehr als zehn Jahren wurden Konzepte auf der Basis von noninvasiven Vorgehensweisen veröffentlicht. Die aufwendige Vorgehensweise verhinderte einen flächendeckenden Einsatz. Die additive Fertigung eröffnet dafür neue Chancen. In einer klinischen Untersuchung wird die Bewährung gedruckter Aufbisse aus Hybridmaterial validiert. Exemplarisch für diese Studie wird im Folgenden ein Patientenfall erläutert.
Behandlungsmethode: Im dargestellten Patientenfall bestand die Problematik eines generalisierten, ausgeprägten Erosionsgebisses. Die Rekonstruktion basierte auf einem volldigitalen Workflow und führte zu 27 gedruckten Aufbissen im Non-prep-Design aus einem Hybridmaterial. Nach Eingliederung erfolgten eine Farbbestimmung mittels Spektralfotometers sowie ein Intraoralscan zur Beurteilung des Verschleißverhaltens. Beide Maßnahmen wurden nach sechs, zwölf, 24 und 36 Monaten wiederholt.
Ergebnisse: Nach zwölf Monaten Tragezeit wurden ein durchschnittlicher Materialverschleiß von 0,09 mm und eine Farbveränderung von ΔE = 6,3 ± 2,3 ermittelt. Zudem kam es zu drei Abplatzungen.
Schlussfolgerung: Das Patientenbeispiel zeigte die Verwendung gedruckter Hybridmaterialien als noninvasive Therapiemaßnahme. Eine schnelle Verbesserung der Ästhetik, verbunden mit einer Bisshebung, wurde ohne eine langwierige Vorbehandlung mittels Bisshebungsschiene erreicht. Zur weiteren Beurteilung der Behandlungsoption müssen die Ergebnisse einer größeren Kohorte über einen längeren Zeitraum abgewartet werden.
Keywords: 3D-Druck, Abrasion, additive Fertigung, Bisshebung, CAD/CAM, Erosion
International Journal of Computerized Dentistry, 4/2023
EditorialDOI: 10.3290/j.ijcd.b4702447, PubMed ID (PMID): 38014639Pages 279-280, Language: English, GermanBeuer, Florian
International Journal of Computerized Dentistry, 3/2023
ScienceDOI: 10.3290/j.ijcd.b3796761, PubMed ID (PMID): 36632987Pages 247-255, Language: English, GermanPrause, Elisabeth / Hey, Jeremias / Sterzenbach, Guido / Beuer, Florian / Adali, Ufuk
A 10-year follow-up studyAim: The aim of the present study was to evaluate the long-term clinical survival and success rate of veneered zirconia crowns with a modified anatomical framework design after 10 years in function.
Materials and methods: In total, 36 zirconia crowns were fabricated for 28 patients. An anatomically modified framework design was developed. Crowns were inserted between 2008 and 2009. A follow-up of 19 patients with 28 crowns was conducted in 2020 to document mechanical and biologic parameters. Additionally, a modified version of the pink esthetic score (PES) was documented. Patient satisfaction was assessed using United States Public Health Service (USPHS) criteria. The success and survival rates were calculated using the Kaplan-Meier analysis.
Results: After more than 10 years of clinical service, the survival rate of the zirconia crowns was 92.9%. Biologic complications occurred in 12% of the examined crowns, whereas technical complications occurred in 54%. Mostly, chippings (50%) and insufficient marginal gaps (50%) were observed. Most crowns were positively evaluated for more than one technical complication. Periodontal conditions with probing depths of up to 3 mm were comparable with measured values before crown delivery (73% to 75%). Most of the crowns had modified PES values of 10 or higher. Patient satisfaction was high.
Conclusions: The modified framework design led to a high survival rate of the crowns but a relatively low success rate. High patient satisfaction and inconspicuous periodontal conditions were demonstrated. Biologic complications occurred far less frequently than technical complications.
Keywords: all-ceramic crown, framework design, clinical study, chipping, complications