Evaluation of the fitness of dental prosthesis produced by traditional, Subtractive, and additive manufacturing method
전통적인 가공방식과 절삭가공방식 및 적층가공방식으로 제작된 치과보철물의 적합도에 관한 연구
- 주제(키워드) Traditional manufacturing , Subtractive manufacturing , Additive manufacturing , Silicone replicas , Interim restoration , Implant , Marginal and internal gap
- 발행기관 고려대학교 대학원
- 지도교수 김웅철
- 발행년도 2016
- 학위수여년월 2016. 8
- 학위구분 박사
- 학과 대학원 보건과학과
- 세부전공 치의기공전공
- 원문페이지 109 p
- 실제URI http://www.dcollection.net/handler/korea/000000068152
- 본문언어 영어
- 제출원본 000045884596
초록/요약
Abstract The fit of an interim implant restoration (IIR) is important for the effective treatment of patients with partial edentulism. However, no clinical trials have evaluated the marginal and internal fits achieved with various fabrication methods. The purpose of this in vitro study was to evaluate and compare the marginal and internal gaps in IIRs produced with 3 different methods. Materials and methods were as follows. Partially edentulous maxillary and mandibular casts from a TS-transfer abutment were used. The prostheses were prepared by applying wax to the implant abutment. The shapes were copied using putty. IIRs were fabricated from polymethyl methacrylate for a conventional system with thermoplastic resin (CTR, n=40), a 4-axial milling machine with a crown-designed standard template library for a subtractive manufacturing system with Pekkton milling (SPM, n=40), and a 3-dimensional printer for an additive manufacturing system with digital light processing (ADL, n=40). The marginal and internal gaps were evaluated in each group using the silicone replica technique. The space between the abutment and the intaglio surface of the prosthesis was evaluated with a digital microscope (×160). The results were analyzed with nonparametric 2-way analysis of variance using rank-transformed values and the Tukey post hoc test (α=.05). The results of the first study showed for the fabricated IIRs were significantly different at all points (P<.001). Moreover, ADL was superior to CTR and SPM. The IIRs were significantly different only at the intermarginal gap (the vertical discrepancy between the crown and the point where the margin becomes round and changes to the axial wall), the axiogingival gap (the vertical discrepancy between the internal surface and the axial wall adjacent to the gingival wall of the abutment), and the occlusal gap (the vertical discrepancy between the occlusal wall of the abutment and the internal surface; this gap comprises the internal gap; P<.001). No significant differences were found among the IIRs at the marginal gap (the vertical discrepancy between the abutment margin and the crown; P>.111) and the axio-occlusal gap (the vertical discrepancy between the axial wall adjacent to the occlusal wall of the abutment and the internal surface; this gap comprises the internal gap; P>.257). The purpose of the second study was to verify the clinical-feasibility of additive manufacturing by comparing the accuracy of four different manufacturing methods for metal coping: the conventional lost wax technique (CLWT); subtractive methods with wax blank milling (WBM); and two additive methods, multi jet modeling (MJM), and micro-stereolithography (Micro-SLA). Materials and methods were as follows. The thirty study models were created with the Acrylic model (AG-3 ZPVK 13, 14, 16, Frasaco GmbH, Tettnang, Germany). The scanned files of the 30 study models by a non-contact blue light scanner (Identica; Medit Co. Ltd., Seoul, Korea) were used to design the thirty frameworks and create the Standard template library (STL) files. And based on the files, each thirty frameworks were produced in the WBM, MJM, and Micro-SLA way respectively. And based on the thirty study models, the thirty frame works were produced by applying the CLWT method, and consequently, the total 120 frameworks were produced. To measure the Marginal and Internal gap, the Silicone replicas method was adopted, and the obtained silicone image was measured by the Digital microscope (KH-7700; Hirox, Tokyo, Japan) at 140Ⅹmagnification. Then, it was analyzed through the Two-way analysis of variance (ANOVA) and Tukey HSD post hoc test (α=.05). The results of the second study showed for MG, a significant difference according to tooth type (p<0.001) and manufacturing method (p<0.037). Also RC, AW, IA or OA showed a significant difference according to tooth type (p<0.001) and manufacturing method (p<0.001). Meanwhile, MSLA didn’t show any significant difference in CLW as well as Marginal gap, and it had lower fitness value than WBM and MJM methods. Therefore, the conclusion of these study showed the mean values of gaps resulting from the different manufacturing methods were within a clinically allowable range, and, thus, the clinical use of additive manufacturing methods is acceptable as an alternative to the traditional lost wax-technique and subtractive manufacturing. Thus, Subtractive manufacturing method and Additive manufacturing method will be applied to manufacture dental prosthesis rather than conventional method.
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Contents
Abstract ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙Ⅰ
Contents ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙Ⅵ
List of Figures and Tables∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙Ⅷ
Figures∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙Ⅷ
Tables∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙Ⅹ
Chapter 1. Introduction∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙1
Chapter 2. Theoretical Background ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙5
2-1. Traditional manufacturing ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙5
2-2. Subtractive manufacturing∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙8
2-3. Additive manufacturing ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙11
2-4. Interim implant restorations ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙14
2-5. Fitness of marginal and internal gap ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙15
2-6. Research objective and scope ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙17
Chapter 3. Research Ⅰ ………………∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙…………∙∙∙∙18
3.1 Introduction ………………………………∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙…∙∙∙∙…∙∙∙∙19
3.2 Materials and Methods ………………………∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙…∙∙∙25
3.3 Results...…………………………………………∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙35
3.4 Discussion…………………………………∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙………37
3.5. Summary ………………………………………∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙…44
Chapter 4. Research Ⅱ……………………∙∙∙……∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙……45
4.1 Introduction∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙…∙∙∙46
4.2 Materials and Methods∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙……∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙50
4.3 Results∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙58
4.4 Discussion∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙65
4.5. Summary∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙70
Chapter 5. Conclusion∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙71
Reference ∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙∙72
Abstract (Korean)………………………………∙∙∙∙∙∙∙∙∙∙∙∙∙∙……∙∙∙∙∙∙82
Acknowledgement ………………………………∙∙∙∙∙∙∙∙∙∙∙∙∙∙…∙∙∙…88
