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Scan-layered reconstructions: A pilot study of a nondestructive dental histoanatomical analysis method and digital workflow to create restorations driven by natural dentin and enamel morphology
Abstract
Objective:
This work aims to present a pilot study of a non-destructive dental histo-anatomical analysis technique as well as to push the boundaries of the presently available restorative workflows for the fabrication of highly customized ceramic restorations.
Materials and methods:
An extracted human maxillary central incisor was subject to a micro computed tomography scan and the acquired data was transferred into a workstation, reconstructed, segmented, evaluated and later imported into a Computer-Aided Design/Computer-Aided Manufacturing software for the fabrication of a ceramic resin-bonded prosthesis.
Results:
The obtained prosthesis presented an encouraging optical behavior and was used clinically as final restoration.
Conclusion:
The digitally layered restorative replication of natural tooth morphology presents today as a clear possibility. New clinical and laboratory-fabricated, biologically inspired digital restorative protocols are to be expected in the near future.
Clinical significance:
The digitally layered restorative replication of natural tooth morphology presents today as a clear possibility. This pilot study may represent a stimulus for future research and applications of digital imaging as well as digital restorative workflows in service of esthetic dentistry.
... This may represent a stimulus for future research and applications of digital imaging as well as digital restorative workflows in the service of esthetic dentistry. 14 μCT technology has been used in various fields of dental and orthopedic research. Some of the dental applications described thus far are qualitative and quantitative evaluation of caries, 14,15 analysis of root canal morphology and root canal preparation, 9,15,[17][18][19] and archeological analysis of enamel thickness in different populations. ...
... 14 μCT technology has been used in various fields of dental and orthopedic research. Some of the dental applications described thus far are qualitative and quantitative evaluation of caries, 14,15 analysis of root canal morphology and root canal preparation, 9,15,[17][18][19] and archeological analysis of enamel thickness in different populations. 15,[20][21][22][23] The introduction of 3D data-acquisition technologies and techniques presents the potential to overcome the more traditional and invasive techniques previously described in dental and biomaterials research. ...
... This information may be useful not only for research purposes, but also for clinical applications. 14 With the advent of CAD/CAM and digital additive manufacturing in the dental field, the reconversion of data acquired and processed digitally into a physical format presents today as a clear and accurate option. 38 The μCT technique allows for a more direct application of the obtained files in a prosthesis manufacturing workflow, with reduced labor and more controlled quality and cost-effectiveness procedures. ...
... Micro-CT represents also a methodology for automatic segmentations [130,131] and elaborations of accurate 3D models [132], even if some limitations in spatial resolutions and missing information have to be considered [133,134]. The possibility to create 3D micro-CT models based on reconstructed images has relevance in implementing numerical studies aimed to determine the more realistic operative conditions. ...
Micro-computed tomography (micro-CT) is a consolidated imaging technology allowing non-destructive three-dimensional (3D) qualitative and quantitative analysis by the observation of microstructures with high resolution. This paper aims at delivering a structured overview of literature about studies performed using micro-CT in dentistry and maxillofacial surgery (MFS) by analyzing the entire set of articles to portray the state of the art of the last ten years of scientific publications on the topic. It draws the scenario focusing on biomaterials, in vitro and in/ex vivo applications, bone structure analysis, and tissue engineering. It confirms the relevance of the micro-CT analysis for traditional research applications and mainly in dentistry with respect to MFS. Possible developments are discussed in relation to the use of the micro-CT combined with other, traditional, and not, techniques and technologies, as the elaboration of 3D models based on micro-CT images and emerging numerical methods. Micro-CT results contribute effectively with whose ones obtained from other techniques in an integrated multimethod approach and for multidisciplinary studies, opening new possibilities and potential opportunities for the next decades of developments.
... The reference-imaging tool for dental research and anthropological and forensic data on the dental organ remains micro-CT. [8][9][10][11][12][13] Segmentation is interesting because it can provide a variety of information to the dentist. For example, the root canal anatomy is easier to apprehend after segmentation. ...
Objectives:
Tooth 3D automatic segmentation (AS) is being actively developed in research and clinical fields. Here, we assess the effect of automatic segmentation using a watershed-based method on the accuracy and reproducibility of 3D reconstructions in volumetric measurements by comparing it with a semi-automatic (SAS) method that has already been validated.
Methods:
The study sample comprised 52 teeth, scanned with micro computed tomography (micro CT) (41µm voxel size) and cone beam computed tomography (CBCT) (76 ; 200 and 300 µm voxel size). Each tooth was segmented by AS based on a watershed method and by SAS. For all surface reconstructions, volumetric measurements were obtained and analysed statistically. Surfaces were then aligned using the SAS surfaces as the reference. The topography of the geometric discrepancies was displayed by using a colour map allowing the maximum differences to be located.
Results:
AS reconstructions showed similar tooth volumes when compared with SAS for the 41 µm voxel size. A difference in volumes was observed, and increased with the voxel size for CBCT data. The maximum differences were mainly found at the cervical margins and incisal edges but the general form was preserved.
Conclusions:
Micro CT, a modality used in dental research, provides data that can be segmented automatically, which is time-saving. Automatic segmentation with CBCT data enables the general form of the region of interest to be displayed. However, our automatic segmentation method can still be used for metrically reliable measurements in the field of clinical dentistry if some manual refinements are applied.
To use the Kubelka-Munk theory to evaluate the scattering (S), absorption (K) and transmittance (T) of non-colored and colored dental zirconia systems and human (HD) and bovine (BD) dentins.
Two zirconia systems were used: ZC- ZirCAD (Ivoclar Vivadent) and LV-LAVA (3M ESPE). Specimens from each ceramic system were divided into 3 groups (n=5): ZC1 and LV1 (non-colored); ZC2 and LV2 colored to shade A1, and ZC3 and LV3 colored to shade A3. Five human and bovine anterior teeth were flattened and polished through 1200 grit SiC paper to expose the superficial buccal dentin. All samples were prepared to a final thickness of 0.5mm. Diffuse reflectance was measured against white and black backgrounds, using a spectroradiometer in a viewing booth with D65 illuminant and d/0° geometry. S and K coefficients and T were calculated using Kubelka-Munk's equations. Data was statistically analyzed using Kruskal-Wallis, Mann-Whitney tests, and VAF coefficient.
Spectral distributions of S, K and T were wavelength dependent. The spectral behavior of S and T was similar to HD (VAF≥96.80), even though they were statistically different (p≤0.05). The spectral behavior of K was also similar to HD, except for LV1 (VAF=38.62), yet all ceramics were statistically different from HD (p≤0.05). HD and BD showed similar values of S and T (p>0.05).
The dental professional should consider the optical behavior differences between the zirconia systems evaluated and the human dentin to achieve optimal esthetics in restorative dentistry.
Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT) in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB) root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072, SkyScan bvba, Aartselaar, Belgium). A specific software ResolveRT Amira (Visage Imaging) was used for the 3D analysis and imaging. The authors obtained three-dimensional images from 15 teeth. It was possible to precisely visualize and analyze external and internal anatomy of teeth, showing the finest details. Among the 5 upper molars analyzed, in three cases, the MB canals joined into one canal, while in the other two molars the two mesial canals were separate. Among the lower molars two of the five samples exhibited a single canal in the mesial root, which had a broad, flat appearance in a mesiodistal dimension. In the five premolar teeth, the canals were independent; however, the apical delta and ramifications of the root canals were quite complex. Micro-CT offers a simple and reproducible technique for 3D noninvasive assessment of the anatomy of root canal systems.
This review highlights the recent advances in X-ray microcomputed tomography (Micro-CT) applied in dental research. It summarizes Micro-CT applications in measurement of enamel thickness, root canal morphology, evaluation of root canal preparation, craniofacial skeletal structure, micro finite element modeling, dental tissue engineering, mineral density of dental hard tissues and about dental implants. Details of studies in each of these areas are highlighted along with the advantages of Micro-CT, and finally a summary of the future applications of Micro-CT in dental research is given.
Biomimetics, a name coined by Otto Schmitt in the 1950s for the transfer of ideas and analogues from biology to technology, has produced some significant and successful devices and concepts in the past 50 years, but is still empirical. We show that TRIZ, the Russian system of problem solving, can be adapted to illuminate and manipulate this process of transfer. Analysis using TRIZ shows that there is only 12% similarity between biology and technology in the principles which solutions to problems illustrate, and while technology solves problems largely by manipulating usage of energy, biology uses information and structure, two factors largely ignored by technology.
Although resin-bonded fixed dental prostheses (RBFDPs) were developed almost 40 years ago, their implementation in clinical practice did not achieve success due to biomechanical failures of the restorative materials. Nowadays, the evolution of ceramic materials and bonding procedures has allowed for the revival of the dental prosthesis. Zirconia is the dental ceramic with the highest flexural strength under compression. However, there are still some concerns regarding the bonding strength of zirconia to enamel that require further research. In this article, through the presentation of three clinical cases, the authors show how modifying the surface of zirconia frameworks by applying a feldspathic veneering on the retainer's buccal surface allows for a bonding procedure to dental structures. The goal of this treatment method is to simultaneously improve structural strength, esthetic integration, and bonding optimization to enamel. In a 3-year prospective evaluation, this framework modification shows promising results, with a survival rate of 100% and no biological or mechanical complications.
Objectives:
The objective of this systematic review was to assess the 5-year and 10-year survival of resin-bonded fixed dental prostheses (RBBs) and to describe the incidence of technical and biological complications.
Materials and methods:
An electronic MEDLINE search complemented by manual searching was conducted to identify prospective and retrospective cohort studies and case series on RBBs with a mean follow-up time of at least 5 years. Patients had to have been examined clinically at the follow-up visit. Assessment of the identified studies and data extraction were performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson regression models to obtain summary estimates of 5- and 10-year proportions.
Results:
The search provided 367 titles and 87 abstracts. Full-text analysis was performed for 22 articles resulting in seven studies that met the inclusion criteria. Five articles were found through manual search, and 17 studies were provided from (Pjetursson et al. 2008, Clinical Oral Implants Research, 19, 131), resulting in an overall number of included studies of 29. Meta-analysis of these studies reporting on 2300 RBBs indicated an estimated survival of resin-bonded bridges of 91.4% (95 percent confidence interval [95% CI]: 86.7-94.4%) after 5 years and 82.9% (95% CI: 73.2-89.3%) after 10 years. A significantly higher survival rate was reported for RBBs with zirconia framework compared with RBBs from other materials. RBBs with one retainer had a significantly higher survival rate (P < 0.0001) and a lower de-bonding rate (P = 0.001) compared with RBBs retained by two or more retainers. Moreover, the survival rate was higher for RBBs inserted in the anterior area of the oral cavity compared with posterior RBBs. The most frequent complications were de-bonding (loss of retention), which occurred in 15% (95% CI: 10.9-20.6%) and chipping of the veneering material that was reported for 4.1% (95% CI: 1.8-9.5%) of the RBBs over an observation period of 5 years.
Conclusion:
Despite the high survival rate of RBBs after 5 and 10 years, technical complications like de-bonding and minor chipping were frequent. RBBs with zirconia framework and RBBs with one retainer tooth showed the highest survival rate.
A thorough understanding of the spatial distribution pertaining to the histo-anatomic coronal structures and dynamic light interaction of the natural dentition provides the dental team with the ultimate strategic advantage with regards to optical integration of the final restoration. The second part of this two-part article will attempt to provide insight on the illumination interactivity and the spatial arrangement of the coronal elements of natural teeth through the utilization of this knowledge in the clinical and technical restorative approach. The main goals for this article are to cognize histo-anatomic visualization by introducing: (1) Dynamic light interaction, (2) the 9 elements of visual synthesis, (3) dynamic infinite optical thickness, and (4) amplified visual perception effect of the hard dental tissues. Furthermore, a diversification of photographic illumination techniques will be illustrated in order to juxtapose optical associations between the enamel/dentinoenamel complex/dentin nexus.
Objectives:
To evaluate the effect of framework design modification and veneering techniques in fatigue reliability and failure modes of veneered Yttria-Stabilized Tetragonal Zirconia Polycrystals (Y-TZP) crowns.
Methods:
A CAD-based mandibular molar crown preparation served as a master die. Y-TZP crown cores (VITA-In-Ceram-YZ, Vita-Zahnfabrik, Bad Säckingen, Germany) in conventional (0.5mm uniform thickness) or anatomically designed fashion (cusp support) were porcelain veneered with either hand-layer (VM9) or pressed (PM9) techniques. Crowns (n=84) were cemented on 30 days aged dentin-like composite dies with resin cement. Crowns were subjected to single load to fracture (n=3 each group) and mouth-motion step-stress fatigue (n=18) by sliding a WC indenter (r=3.18 mm) 0.7 mm buccally on the inner incline surface of the mesio-lingual cusp. Stress-level curves (use level probability lognormal) and reliability (with 2-sided 90% confidence bounds, CB) for completion of a mission of 50.000 cycles at 200 N load were calculated. Fractographic analyses were performed under light-polarized and scanning electron microscopes.
Results:
Higher reliability for hand-layer veneered conventional core (0.99, CB 0.98-1) was found compared to its counterpart press-veneered (0.50 CB 0.33-65). Framework design modification significantly increased reliability for both veneering techniques (PM9 [0.98 CB 0.87-0.99], VM9 [1.00 CB 0.99-1]) and resulted in reduced veneer porcelain fracture sizes. Main fracture mode observed was veneer porcelain chipping, regardless of framework design and veneering technique.
Significance:
Hand-layer porcelain veneered on conventional core designs presented higher reliability than press-veneered with similar core designs. Anatomic core design modification significantly increased the reliability and resulted in reduced chip size of either veneering techniques.
Objective:
To compare "survival" and "success" of implant-supported crowns (ISC) and tooth-supported 2-unit cantilevered resin-bonded bridges (cRBB) in the rehabilitation of a bounded single tooth space (BSTS), after an observation period of ≥5 years.
Methods:
A case-control study among subjects who received ISC or cRBB rehabilitation at a teaching hospital. The (i) survival (retention in mouth) and (ii) success (absence of complications requiring intervention) for the ISCs and cRBBs were compared (overall, supporting structures and that of the prostheses). Rates of survival and success were compared using log-rank statistics. Prevalence of survival and success (categories) were compared by chi-square/Fisher's exact test.
Results:
Seventy eight subjects participated in this study (39 ISC and 39 cRBB cases). Both had a mean observation time exceeding 100 months, P > 0.05. ISCs and cRBBs had similar survival rates: overall (P = 0.96), supporting structures (P = 0.14) and prostheses (P = 0.44) There was a significant difference in the rate of overall success between ISCs and cRBBs (P = 0.03), specifically with respect to the success rate of the supporting structures (P = 0.03). There was also a significant difference in the prevalence of supporting structures categorized as a "success": ISCs (69.2%) and cRBBs (89.7%), P = 0.03. Biological complications of supporting structures were more common among ISCs (25.6%) compared with cRBBs (7.7%), P = 0.03.
Conclusion:
Implant-supported crowns and cRBBs in the rehabilitation of a BSTS survive similarly after at least 5 years. However, cRBBs had a higher success rate and were more frequently categorized as successful than ISCs. Notably, there were fewer biological complications of cRBBs supporting structures than ISCs.
Objectives:
Pulpal response to tooth preparation is a major concern in fixed prosthodontics. Research has suggested that 2mm or more of remaining dentine is critical in protecting the pulp following tooth preparation. However, clinicians have no means of knowing dentine thickness either before or after preparation and therefore lack feedback about this important aspect of preparation quality. The aim of this project was to develop a method for measuring local dentine thickness following tooth preparation for metal ceramic crowns, in vitro, which could be used as a tool to evaluate preparation technique and instrumentation.
Methods:
Microtomography (XMT or micro-CT) scans were taken of extracted teeth before and after crown preparation. Local dentine thickness was defined for every voxel within the 3D tooth image as the sum of distances from that voxel to the pulp and to the anatomical surface. The method also allows the thickness of material removed to be quantified. Three-dimensional colour-coded maps of dentine thickness were generated, and the distributions of dentine thickness throughout the teeth were analysed. This was tested by a single operator on sixteen extracted upper central incisors.
Results:
This method enabled clear visualisation and analysis of residual dentine thickness. In the trial, it revealed consistent over-prepared regions along the labial proximal line angles which, in a clinical case, could affect subsequent tooth and restoration longevity. All but one of the prepared teeth had regions with a residual dentine thickness of less than 1.5mm, in 6 it was less than 1.0mm and in 3 of these it was less than 0.5mm.
Conclusion:
Although ex vivo, this method can be used as a research tool to look for patterns of over- or under-preparation, leading to possible modification of technique, instrumentation and, or crown design.
Clinical significance:
It is not currently possible for clinicians to know the thickness of residual dentine following crown preparation, a key factor in long term outcome. The described method of quantifying and visualising this thickness allows preparation techniques and instrumentation to be evaluated in vitro, leading to prospective improvements in clinical procedures.
To compare the crystalline phases present, quantify the adhesion to zirconia and measure the mechanical properties of four commercially available pressed ceramics suitable for zirconia substructures.
This study compares the X-ray diffraction response and the mechanical properties of four different pressed ceramics (Noritake CZR Press, Vita PM9, Wieland PressXzr and IPS e.max ZirPress) to Vita In-Ceram YZ zirconia substrate. The adhesion was determined using the interfacial strain energy release rate fracture mechanics approach; in addition biaxial flexural strength values of each material was determined.
X-ray diffraction analysis revealed that Noritake CZR Press and Vita PM9 contain leucite whereas IPS e.max ZirPress and Wieland PressXzr are non-leucite amorphous materials. The strain energy release rate results revealed that the pressed ceramics with leucite have better adhesion than non-leucite ceramics to zirconia. Differences were observed between biaxial strength results for the pressed ceramics from bilayer compared with monolayer specimens.
Pressed ceramics compatible with zirconia tested in this study were of two types; leucite containing and non-leucite containing essentially glass ceramics. Leucite containing pressable ceramics appears to have better adhesion to zirconia.
The aim of this study was to evaluate the fracture toughness and surface residual stresses present in various pressable ceramics to zirconia resulting from cooling induced temperature gradients.
Indentation fracture toughness was used to evaluate the residual stress present in various pressable ceramics (Noritake CZR Press, Vita PM9, Wieland PressXzr and IPS e.max ZirPress) to zirconia when subjected to different cooling regimen. The cooling responses of two ceramics were evaluated by thermocouples embedded in the surface of the porcelains and at the porcelain-zirconia interface.
The effective K(c) results obtained by indentation tests confirmed the presence of surface residual compressive stress for all-ceramic systems subjected to different cooling procedures. The residual stresses were quantified from the change in the radial crack size and the values compared for each ceramic before pressing, pressed ceramic only and pressed ceramic veneered on zirconia, from fast to slow cooling rates. A significant level of residual stress was found in the materials before pressing. Slow cooling significantly reduced the formation of residual stress for all pressed ceramics. From data produced by the thermocouples it was found that 'slow cooling' generated the least temperature difference between inner and outer surfaces of porcelain. A direct relationship was found for the cooling induced temperature difference between the surfaces, and interface thermocouples, and magnitude of the surface residual stresses.
Leucite containing porcelains have higher intrinsic fracture toughness, and for all porcelains fast cooling generated significant residual stress within the veneering porcelain. To reduce development of residual stress, slow cool is recommended on the last heating cycle (e.g. glazing cycle).
The aim of this study was to test whether the load bearing capacity of anterior zirconia crowns veneered with overpressed or layered, is similar and to evaluate the failure types.
Standardized zirconia frameworks were fabricated and randomly divided into 8 groups (N=120, n=15 per test group). Four groups were veneered with one of the layered veneering porcelains: Zirox, GC Initial ZR, VITA VM9 or IPS e.max Ceram and the other four groups were veneered with overpressed veneering porcelains: PressX Zr, GC Initial LF, VITA PM9 or IPS e.max ZirPress. The crowns were cemented on their corresponding CoCr abutment and the specimens were loaded at an angle of 45° in a Universal Testing Machine to determine the fracture load. Data were analyzed using one-way and two-way ANOVA, followed by a post hoc Scheffé test, t-test and Weibull analysis (alpha=0.05).
Within three manufacturers of veneering porcelain, fracture load values were not statistically significant between overpressed and layered porcelain systems. Within one manufacturer of veneering porcelain, the overpressed crowns (IPS e.max ZirPress: 1519 ± 334 N) demonstrated significantly higher (p<0.05) fracture load than that of the layered one (IPS e.max Ceram: 894 ± 160 N). Except with IPS e.max ZirPress, where exclusively only chipping of the veneering porcelain was observed, all other porcelain systems showed predominantly framework fractures together with fracture of the veneering porcelain.
Overpressed veneering porcelains for zirconia frameworks exhibited similar or better fracture load compared with layered ones.
A thorough understanding of the histoanatomic structures and dynamic light interaction of the natural dentition provides dental practitioners with the ultimate strategic advantage with regard to optical integration of the final restoration. The first part of this article will attempt to provide insight on the threedimensional coronal configuration of natural teeth and on the utilization of this knowledge in the clinical and technical restorative approach. The main goals for this article are to identify and reveal previously unreported histo-anatomic interrelationships and to explain existing ones: the sigmoid curve distribution (convex enamel/concave dentin), the distinction between dentinoenamel "junction" (DEJ, visual interface) and dentinoenamel "complex" (DEC, functional interphase), and the structural significance of DEC preservation.
In scanning microradiography (SMR), a thin section is stepped across a 15-μm diameter X-ray beam and the transmitted intensity measured at each point. This technique has permitted more accurate measurements of the spatial variation of the mineral concentration in sections of dentin and enamel than conventional photographic microradiography. Moreover, because the section is not in close contact with an emulsion, SMR allows continuous study while the specimen is bathed in a reaction solution. The present studies have been particularly directed to gaining an understanding of the formation and repair of carious lesions in teeth: one particular puzzle is subsurface demineralization, in which the initial loss of mineral appears to take place some 20 to 50 μm below the tooth surface. SMR studies are reported here on the demineralization in dilute acids and the subsequent partial remineralization in supersaturated calcium phosphate solutions in model systems for dental caries. In order to develop a theoretical model for de- and remineralization of carious lesions, it is necessary to quantify transport processes within the tooth. To this end, we are developing a method of measuring effective diffusion coefficients of strongly X-ray-absorbing ions in water within permeable solids in which the diffusion coefficient varies with position. The method uses sequential concentration/distance profiles determined by SMR. As a test, diffusion coefficients of potassium iodide in water within a permeable glass frit have been measured. X-ray microtomography (XMT) can be carried out by adding an axis of rotation to the SMR apparatus. Using this method, linear absorption coefficients, and hence mineral concentrations, can be measured in 15 X 15 X 15-μm3 voxels. This has advantages over SMR in that superposition within the depth of the section and errors in determining its thickness are avoided. XMT studies of de- and remineralization similar to those described above for SMR, and also XMT studies of the variation in mineral concentration in the cortical bone of a rat femur along its length, are reported.
A dark-colored prepared abutment tooth may negatively affect the esthetic outcome of a ceramic restoration if the tooth is restored using translucent enamel-like ceramic materials.
The purpose of this study was to evaluate the cumulative effect that the tooth abutment color, cement color, and ceramic thickness have on the resulting optical color of a CAD/CAM glass-ceramic lithium disilicate-reinforced crown.
A CAD/CAM glass-ceramic lithium disilicate-reinforced monolithic crown (IPS e.max CAD LT) was fabricated. Three possible crown restoration variables were tested in vitro. The procedure examined 4 prepared abutment tooth colors (light, medium light, medium dark, and dark), 2 cement (Variolink II) colors (translucent and opaque), and 4 ceramic thickness values (1.0 mm, 1.5 mm, 2.0 mm, and 2.5 mm). The color of each combination was measured using a spectrophotometer, and the average values of the color difference (ΔE) were calculated. The data were analyzed with a 3-way ANOVA (tooth abutment color, ceramic thickness, and luting agent) and Tukey's HSD test (α=.05), which evaluated within-group effects of the tooth abutment color to the ΔE at each ceramic thickness.
The ΔE values of a CAD/CAM glass-ceramic lithium disilicate-reinforced crown were significantly influenced by the tooth abutment color (P<.001), cement color (P<.001), and ceramic thickness (P<.001). Significant interactions were present among these 3 variables (P<.001). A dark-colored abutment tooth demonstrated the greatest ΔE values relative to other variables tested. An increase in ceramic thickness resulted in a significant decrease in ΔE values (P<.01). The ΔE values were slightly decreased when the crowns were cemented using the opaque cement.
This study demonstrated that underlying tooth abutment color, cement color, and ceramic thickness all influence the resulting optical color of CAD/CAM glass-ceramic lithium disilicate-reinforced restorations.
The aim was to describe a sequential software processing of mu-XCT molar-images for 3D-FE tooth/restoration model geometries based on a representative molar tooth, giving attention on each step of data-processing. This paper first gives an overview of a sequential processing and then applies the resulting model to the particular case.
An intact mandibular molar was scanned using a micro-XCT instrument (1072, SkyScan, Belgium) in which 960 slices were obtained. Sixty-three non-adjacent bitmap slices were then optimally selected for model-creation. Enamel/dentin boundaries were clarified, for each slice, using image control-system software (ScanIP, Simpleware), generated a file which was sequentially converted into a mesh in a reconstruction software (ScanFE, Simpleware) and posteriorly converted into a STL-file (triangulated-2D-stereolithography). This was imported into a FE-software package (Patran, MSC.Software, USA) and all elements were re-meshed. From these elements, surfaces were created and exported to another FE-software (Hypermesh, Altair Hyperworks) to build the dental-cavities. Finally, the volumetric-mesh was created and the model was imported back to FE-software to apply the boundary-conditions, material-properties and initiate post-processing (using Patran and Marc, MSC Software). To demonstrate the use of the resulting model, this was applied to the particular case of a Class I restoration subjected to distributed loading. The analysis was performed as linear and structural and outputs of maximum principal (MP) and maximum shear (MS) stresses were then evaluated.
A 3D-model of a mandibular molar was processed without generating errors in the FE-package used. The maximum deviation between the tooth and the model was less than 0.1%. Stress concentrations were found at the surface where the load was applied and in the vicinity of the tooth-composite interface.
The described procedure is a successful method able to produce a highly detailed 3D finite element model of restored molar teeth with any cavity configuration and combination of restorative materials and this method can also be used for other biological or biomaterials applications.
Laboratory micro-CT systems, although limited by beam hardening effect and instability of the source, have been utilized to measure mineral density in combination with specific image processing methods. However, few attempts have been made to accurately determine mineral density profiles in dentine due to the lack of suitable calibration standards. The aim of this study was to develop a calibration method to evaluate mineral density profiles in dentine including changes associated with dentinal caries. A series of K(2)HPO(4) solution phantoms in a concentration range between 0 and 0.9 g cm(-3)--coupled to a set of water infiltrated porous solid hydroxyapatite (HA) phantoms, with mineral densities ranging from 1.52 to 2.08 g cm(-3), was used in this investigation. First we evaluated the micrometer-scale homogeneity and noise in the HA phantoms using a commercial laboratory micro-CT system. Then an experimental validation was performed of the linearity over the entire density range of these two different calibration materials. The results show the HA phantoms extended the calibration curve obtained from K(2)HPO(4) solution phantoms to densities as high as 2.08 g cm(-3); the linearity remains stable at different energy levels. Finally, compared to the reference micro-CT calibration methods, the advantages of this new method are discussed. We conclude that this calibration method allows a more rational assessment of mineral density of dentine by micro-CT and has a promising potential for future studies.
X-ray microtomography is a miniaturized version of computerized axial tomography with a resolution of the order of micrometres. In the biomedical field it is particularly useful in the study of hard tissue because of its ability to accurately measure the linear attenuation coefficient. From this, the mineral concentration can be computed, which is one measure of bone quality. Using microtomography it is also possible to form three-dimensional images of bone from which structural parameters can be derived which could not be measured using conventional histomorphometry. Various types of microtomography scanner have been used, including simple translate - rotate systems which are capable of measuring x-ray attenuation at multiple energies simultaneously, and `cone-beam' systems which can acquire the necessary data for three-dimensional reconstructions in a relatively short time. Both laboratory x-ray sources and synchrotrons have been used in the study of hard tissue using microtomography. Most studies of bone have been concerned primarily with either the mineral concentration in cortical bone or the structure in cancellous bone. The mineral concentration in teeth has also been studied, in particular the loss of mineral in enamel during in vitro demineralization and the gain during subsequent remineralization. Although there are currently relatively few centres carrying out this work, interest in the technique is rapidly growing and it is likely to find a useful place both in research and ultimately in clinical practice.
Keywords: cancellous bone structure, microtomography, 3D visualization, biological mineral concentration, osteoporosis
This article describes a procedure to achieve natural-looking morphology and surface textures in anterior ceramic restorations. The natural dentition serves as an atlas to interpret and mimic the orientation and location of dental anatomic structures. Transition angles and ridges; proximal slopes; labial grooves; the cervical, middle, and incisal thirds of the buccal surface; the lingual central concavity; and the lingual transition ridges should all be mimicked by the prosthetic work to achieve esthetic integration. The position of buccal transition ridges directly influences the buccal mesiodistal dimension-the so-called "visual width." Once the desired morphology is obtained, a gold powder is used to outline its surface texture. This uniform golden appearance allows for precise identification of specific surface features such as ridges, grooves, and sulci for their consequent mimicking onto the ceramic surface. Specific surface texture characteristics reflect light and thus enhance visual dimensions of the rehabilitation and its final esthetic integration.
The study of dental morphology is essential in terms of phylogeny. Advances in three-dimensional (3D) measurement devices have enabled us to make 3D images of teeth without destruction of samples. However, raw fundamental data on tooth shape requires complex equipment and techniques. An online database of 3D teeth models is therefore indispensable. We aimed to explore the basic methodology for constructing 3D teeth models, with application for data sharing. Geometric information on the human permanent upper left incisor was obtained using micro-computed tomography (micro-CT). Enamel, dentine, and pulp were segmented by thresholding of different gray-scale intensities. Segmented data were separately exported in STereo-Lithography Interface Format (STL). STL data were converted to Wavefront OBJ (OBJect), as many 3D computer graphics programs support the Wavefront OBJ format. Data were also applied to Quick Time Virtual Reality (QTVR) format, which allows the image to be viewed from any direction. In addition to Wavefront OBJ and QTVR data, the original CT series were provided as 16-bit Tag Image File Format (TIFF) images on the website. In conclusion, 3D teeth models were constructed in general-purpose data formats, using micro-CT and commercially available programs. Teeth models that can be used widely would benefit all those who study dental morphology.
Application of scaning microradiography and x-ray microtomography to studies of bones and teeth
- Elliot
Longevity of implant crowns and 2-unit cantilevered resin-bonded bridges
- Wyh Lam
- M G Botelho
- Cpj Mcgrath
Lam WYH, Botelho MG, McGrath CPJ. Longevity of implant crowns
and 2-unit cantilevered resin-bonded bridges. Clin Oral Impl Res.
2013;24:1369-1374.
Achieving natural-looking morphology and surface textures in anterior ceramic fixed rehabilitations
- G O Galucci
- P Guex
- D Vinci
- U C Belser
Galucci GO, Guex P, Vinci D, Belser UC. Achieving natural-looking
morphology and surface textures in anterior ceramic fixed rehabilitations. Int J Periodontics Restorative Dent. 2007;27(2):117-125.
Achieving natural-looking morphology and surface textures in anterior ceramic fixed rehabilitations
- Galucci