Clinical Evaluation of Tooth-Supported Posterior Resin Nanoceramic Crowns Fabricated by Three-Dimensional (3D) Printing: A Short-Term Clinical Study

Project no. 32957 · Status: Kapanmış (Yayın bekleniyor) · 2025

Summary

<p>Additive&nbsp;manufacturing&nbsp;techniques&nbsp;in&nbsp;digital&nbsp;dentistry&nbsp;are&nbsp;increasingly&nbsp;being&nbsp;used&nbsp;as&nbsp;an&nbsp;alternative&nbsp;to&nbsp;conventional&nbsp;subtractive&nbsp;manufacturing&nbsp;techniques,&nbsp;and&nbsp;it&nbsp;is&nbsp;essential&nbsp;to&nbsp;scientifically&nbsp;evaluate&nbsp;the&nbsp;clinical&nbsp;performance&nbsp;of&nbsp;these&nbsp;materials.&nbsp;The&nbsp;aim&nbsp;of&nbsp;this&nbsp;thesis&nbsp;was&nbsp;to&nbsp;prospectively&nbsp;assess&nbsp;the&nbsp;clinical&nbsp;performance&nbsp;of&nbsp;ceramic-filled&nbsp;hybrid&nbsp;resin&nbsp;crowns&nbsp;fabricated&nbsp;using&nbsp;Digital&nbsp;Light&nbsp;Processing&nbsp;(DLP)-based&nbsp;three-dimensional&nbsp;(3D)&nbsp;printing&nbsp;technology&nbsp;in&nbsp;cases&nbsp;requiring&nbsp;single-unit&nbsp;crown&nbsp;restorations&nbsp;in&nbsp;the&nbsp;posterior&nbsp;region.</p><p>Premolar&nbsp;(PM)&nbsp;and&nbsp;molar&nbsp;(M)&nbsp;teeth&nbsp;requiring&nbsp;crown&nbsp;restorations&nbsp;in&nbsp;the&nbsp;posterior&nbsp;region&nbsp;were&nbsp;included&nbsp;in&nbsp;the&nbsp;study&nbsp;(44&nbsp;patients,&nbsp;52&nbsp;restorations).&nbsp;All&nbsp;restorations&nbsp;were&nbsp;fabricated&nbsp;using&nbsp;a&nbsp;fully&nbsp;digital&nbsp;workflow,&nbsp;including&nbsp;intraoral&nbsp;scanning&nbsp;(iTero&nbsp;Lumina,&nbsp;Align&nbsp;Technology&nbsp;Inc.,&nbsp;San&nbsp;Jose,&nbsp;CA,&nbsp;USA),&nbsp;computer-aided&nbsp;design&nbsp;(CAD)&nbsp;(Exocad&nbsp;DentalCAD,&nbsp;Exocad&nbsp;GmbH,&nbsp;Darmstadt,&nbsp;Germany),&nbsp;and&nbsp;DLP-based&nbsp;3D&nbsp;printing&nbsp;(Varseo&nbsp;XS,&nbsp;BEGO&nbsp;GmbH&nbsp;&amp;&nbsp;Co.&nbsp;KG,&nbsp;Bremen,&nbsp;Germany).&nbsp;The&nbsp;restorations&nbsp;were&nbsp;adhesively&nbsp;cemented,&nbsp;and&nbsp;clinical&nbsp;evaluations&nbsp;were&nbsp;performed&nbsp;at&nbsp;baseline&nbsp;(T0)&nbsp;and&nbsp;at&nbsp;the&nbsp;6-month&nbsp;follow-up&nbsp;(T1).&nbsp;Clinical&nbsp;success&nbsp;was&nbsp;assessed&nbsp;using&nbsp;the&nbsp;Modified&nbsp;USPHS&nbsp;criteria&nbsp;and&nbsp;the&nbsp;Revised&nbsp;FDI&nbsp;criteria.</p><p>No&nbsp;statistically&nbsp;significant&nbsp;difference&nbsp;was&nbsp;observed&nbsp;in&nbsp;the&nbsp;clinical&nbsp;performance&nbsp;of&nbsp;the&nbsp;restorations&nbsp;when&nbsp;comparing&nbsp;T0&nbsp;and&nbsp;T1&nbsp;evaluations&nbsp;(p&nbsp;&gt;&nbsp;0.05).&nbsp;The&nbsp;occlusal&nbsp;wear&nbsp;behavior&nbsp;of&nbsp;the&nbsp;restorations&nbsp;was&nbsp;evaluated&nbsp;both&nbsp;clinically&nbsp;and&nbsp;quantitatively&nbsp;using&nbsp;digital&nbsp;image&nbsp;superimposition&nbsp;(3D&nbsp;superimposition)&nbsp;with&nbsp;Geomagic&nbsp;Control&nbsp;X&nbsp;(3D&nbsp;Systems,&nbsp;Rock&nbsp;Hill,&nbsp;SC,&nbsp;USA),&nbsp;based&nbsp;on&nbsp;root&nbsp;mean&nbsp;square&nbsp;(RMS)&nbsp;values.&nbsp;According&nbsp;to&nbsp;the&nbsp;RMS&nbsp;results,&nbsp;no&nbsp;statistically&nbsp;significant&nbsp;difference&nbsp;in&nbsp;wear&nbsp;was&nbsp;found&nbsp;between&nbsp;premolar&nbsp;and&nbsp;molar&nbsp;groups&nbsp;(PM:&nbsp;20.82&nbsp;±&nbsp;9.35&nbsp;µm;&nbsp;M:&nbsp;26.14&nbsp;±&nbsp;28.41&nbsp;µm;&nbsp;p&nbsp;=&nbsp;0.380).</p><p>The&nbsp;short-term&nbsp;(6-month)&nbsp;follow-up&nbsp;results&nbsp;demonstrated&nbsp;that&nbsp;3D-printed&nbsp;hybrid&nbsp;resin&nbsp;crowns&nbsp;exhibited&nbsp;clinically&nbsp;satisfactory&nbsp;performance.&nbsp;However,&nbsp;fractures&nbsp;occurred&nbsp;in&nbsp;two&nbsp;restorations&nbsp;during&nbsp;the&nbsp;follow-up&nbsp;period;&nbsp;one&nbsp;was&nbsp;repaired&nbsp;intraorally&nbsp;and&nbsp;continued&nbsp;to&nbsp;function,&nbsp;while&nbsp;the&nbsp;other&nbsp;required&nbsp;replacement.&nbsp;Additionally,&nbsp;acute&nbsp;pulpitis&nbsp;developed&nbsp;in&nbsp;one&nbsp;case&nbsp;following&nbsp;adhesive&nbsp;cementation,&nbsp;and&nbsp;endodontic&nbsp;treatment&nbsp;was&nbsp;performed.</p><p>Although&nbsp;3D-printed&nbsp;hybrid&nbsp;resin&nbsp;crowns&nbsp;provide&nbsp;satisfactory&nbsp;clinical&nbsp;outcomes&nbsp;in&nbsp;the&nbsp;short&nbsp;term,&nbsp;they&nbsp;should&nbsp;be&nbsp;carefully&nbsp;evaluated&nbsp;regarding&nbsp;fracture&nbsp;risk,&nbsp;particularly&nbsp;under&nbsp;high&nbsp;occlusal&nbsp;stress.&nbsp;No&nbsp;statistically&nbsp;significant&nbsp;difference&nbsp;was&nbsp;found&nbsp;in&nbsp;time-dependent&nbsp;wear&nbsp;levels&nbsp;(p&nbsp;&gt;&nbsp;0.05).</p>

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