In this study, the hypothesis was tested that the marginal and internal fit of CAD/CAM fabricated all-ceramic three-unit fixed partial dentures (FPDs) can be as good as in metal-ceramic FPDs. Twenty-four all-ceramic FPDs were fabricated and randomly subdivided into three equally sized groups. Eight frameworks were fabricated using the Digident CAD/CAM system (DIGI), another eight frameworks using the Cerec Inlab system (INLA). Vita Inceram Zirkonia blanks were used for both groups. In a third group frameworks were milled from yttrium-stabilized Zirconium blanks using the Lava system (LAVA). All frameworks were layered with ceramic veneering material. In addition, six three-unit metal-ceramic FPDs served as control group. All FPDs were evaluated using a replica technique with a light body silicone stabilized with a heavy body material. The replica samples were examined under microscope. The medians of marginal gaps were 75 microm for DIGI, 65 microm for LAVA and INLA and 54 microm for the conventional FPDs. Only the DIGI data differed significantly from those of the conventional FPDs. Within the limits of this study, the results suggest that the accuracy of CAD/CAM generated three-unit FPDs is satisfactory for clinical use.

Estimation of chewing force from electromyograms (EMGs) calibrated in isometric biting yielded strikingly high force values. We tested the hypothesis that EMG-based force predictions are excessive because of differing activity/bite-force relations in mastication and isometric biting. In nine patients, unilateral bite forces and EMGs of 4 elevator muscles were recorded during chewing and isometric clenching on a bite-fork. We estimated chewing force by substituting chewing EMGs of each muscle into isometric activity/bite-force regressions. The estimates were compared with actual chewing forces recorded by intra-oral transducers. In all muscles except the balancing-side masseter, the activity/bite-force ratio was significantly higher in chewing than in isometric biting. The actual mean chewing force amounted to 220 N, while EMG-based estimates ranged from 273 to 475 N, depending on the muscle used for estimation. The results indicate that different activity/force characteristics in dynamic and isometric biting can cause overestimation when chewing force is predicted from masticatory EMGs.

No abstract

Elevator muscle activity per unit bite-force has been shown to be higher in chewing than in isometric biting. We tested the hypothesis that surplus elevator activity is evoked in response to a possible co-activation of jaw-opener muscles during the masticatory power stroke. In 32 subjects, digastric and bilateral masseter and temporalis activities were recorded during unilateral chewing of test foods, isometric biting on a force transducer, and during balancing of the jaw against maximum effort of depressor muscles. During elevator peak effort in chewing, the digastric activity was 113% higher than during peak effort in isometric biting. Comparison of balancing and chewing trials revealed that a 6% increase of elevator activity would suffice to compensate for this increased depressor action. Elevator activity in chewing, however, was up to 130% higher than in clenching. We conclude that depressor counteraction could have only a minor influence on the generation of surplus muscle activity in chewing.

No abstract