Purpose: To evaluate the effect of different wax pattern fabrication techniques on the fit of customized pressed lithium disilicate implant abutments on titanium inserts before and after pressing. The marginal fit results of pressed lithium disilicate implant abutments were then compared with those of milled lithium disilicate abutments. Materials and Methods: After scanning the titanium inserts and designing an implant abutment, wax patterns were fabricated with three techniques (n = 15 each): computeraided design/computer-aided manufacturing (CAD/CAM) milling, 3D printing and conventional layering. The marginal fit (µm) was measured using a stereomicroscope for all the wax patterns before pressing them into the lithium disilicate abutments. The pressed implant abutments were measured again for marginal fit, and the results were compared to those of the milled lithium disilicate abutments. One-way analysis of variance (ANOVA) was used to assess different wax pattern fabrication techniques in each stage before and after pressing. One-way ANOVA was also used to compare the groups of pressed and milled lithium disilicate abutments. Multiple pairwise comparisons were performed using the Tukey post hoc test in each stage. Results: There were statistically significant differences between the marginal fit of the three wax patterns groups (p < 0.001; f = 123.33), wherein the mean marginal fit was the highest for conventionally layered wax patterns (30 ± 13.09) µm. Furthermore, after pressing, there were statistically significant differences between the marginal fit of the three pressed abutments groups (p < 0.001; f = 518.62), wherein the mean marginal fit was the highest for pressed e.max abutments fabricated from conventionally layered wax patterns (25.26 ± 3.9) µm. There was no statistically significant difference between the mean marginal fit of the pressed abutments fabricated from conventional layered wax patterns and that of the milled CAD/CAM abutments. However, the mean marginal fit of the milled CAD/CAM abutments was higher than that of the pressed abutments fabricated from both CAD/CAM wax and 3D printed wax. Conclusion: All the tested fabrication methods provided degrees of accuracy that lie well within accepted limits. The use of pressed lithium disilicate abutments fabricated from conventional layering wax pattern technique should provide a more consistent better marginal fit between the titanium insert and the abutment and may therefore be the preferable fabrication method.
Objective: to evaluate the effect of scaling procedures using different ultrasonic tips on the surface roughness, color stability and bacterial accumulation of lithium disilicate ceramic. Material and Methods: Scaling procedure was carried out using ultrasonic scaler (Satalec, Acteon, North America) with stainless-steel tip (US), titanium tip (UT) and plastic tip (UP), on disc shaped lithium disilicate samples cemented into a cavity prepared onto the labial surface of freshly extracted bovine teeth (10 samples per group). The samples were stored in coffee solution in an incubator at 37°C for 12 days, which is equivalent to 1 year of coffee consumption. The surface roughness was measured before and after the scaling procedure using a profilometer and atomic force microscopy. The color parameters were measured before and after scaling and staining procedures using VITA Easyshade Advance 4.0 according to the CIE L*a*b* color order system. The samples were then incubated with Streptococcus mutans (S. mutans) suspension. After incubation, the plates with 30 to 300 typical colonies of S. mutans were counted in a colony counter and mean values of colony forming units were obtained (CFU/mL). Results: The titanium scaling tip showed a statistically significant higher mean values of change in surface roughness Ra and bacterial count than the plastic scaling tip. Color changes (E) were not a statistically significant among the groups. The results showed a statistically significant positive (direct) correlation between surface roughness and color change (p = 0.012) and also between surface roughness and bacterial count (p = 0.00).
Conclusion: Within the limitations of this study, titanium scaling instruments cause irreversible surface alterations of lithium disilcate ceramics which was in direct correlation to the color changes and bacterial accumulation; therefore, dentists should proceed with caution when scaling lithium disilicate surfaces. The findings of the current study may indicate the need for instruments or equipment that can remove plaque and calculus without causing surface damage.
Keywords
Surface properties; Color; Bacterial adhesion; Ultrasonics; Dental scaling; Ceramics.
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