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Purpose Some crowns returned from the laboratory are clinically unacceptable, and dentists must remake them. The objectives of this study were to: (1) quantify the remake rate of single‐unit crowns; and (2) identify factors significantly associated with crown remakes and intraoral fit. Materials and Methods Dentists participating in the National Dental Practice‐Based Research Network recruited patients needing crowns and documented fabrication techniques, patient characteristics, and outcomes. Crowns were considered clinically acceptable or rejected. Also, various aspects of the clinical fit of the crown were graded and categorized as ‘Goodness of Fit (GOF).’ Dentist and patient characteristics were tested statistically for associations with crown acceptability and GOF. Results More than 200 dentists participated in this study (N = 205) and evaluated 3750 single‐unit crowns. The mean age (years) of patients receiving a crown was 55. The remake rate for crowns was 3.8%. The range of rejection rates among individual practitioners was 0% to 42%. Most clinicians (118, or 58%) did not reject any crowns; all rejections came from 42% of the clinicians (n = 87). The most common reasons for rejections were proximal misfit, marginal errors, and esthetic failures. Fewer years in practice was significantly associated with lower crown success rates and lower fit scores. GOF was also associated with practice busyness and patient insurance status, patient gender (dentists reported better fit for female patients), and patient ethnicity. Conclusions The crown remake rate in this study was about 4%. Remakes and crown GOF were associated with certain dentist and practice characteristics.
Purpose Some crowns returned from the laboratory are clinically unacceptable, and dentists must remake them. The objectives of this study were to: (1) quantify the remake rate of single‐unit crowns; and (2) identify factors significantly associated with crown remakes and intraoral fit. Materials and Methods Dentists participating in the National Dental Practice‐Based Research Network recruited patients needing crowns and documented fabrication techniques, patient characteristics, and outcomes. Crowns were considered clinically acceptable or rejected. Also, various aspects of the clinical fit of the crown were graded and categorized as ‘Goodness of Fit (GOF).’ Dentist and patient characteristics were tested statistically for associations with crown acceptability and GOF. Results More than 200 dentists participated in this study (N = 205) and evaluated 3750 single‐unit crowns. The mean age (years) of patients receiving a crown was 55. The remake rate for crowns was 3.8%. The range of rejection rates among individual practitioners was 0% to 42%. Most clinicians (118, or 58%) did not reject any crowns; all rejections came from 42% of the clinicians (n = 87). The most common reasons for rejections were proximal misfit, marginal errors, and esthetic failures. Fewer years in practice was significantly associated with lower crown success rates and lower fit scores. GOF was also associated with practice busyness and patient insurance status, patient gender (dentists reported better fit for female patients), and patient ethnicity. Conclusions The crown remake rate in this study was about 4%. Remakes and crown GOF were associated with certain dentist and practice characteristics.
Statement of the problem:The wide use of digital dentistry in fixed prosthodontics using 3D printers and CAD/CAM in fabricating crowns and partial fixed dental prosthesis created a need for more information about their marginal gap and internal fit.Purpose: This study aimed to evaluate the effect of fabrication technique using CAD/CAM manufactured and heat pressed lithium dislicate crowns made from milled wax and 3D printed resin patterns on their marginal gap and internal fit. Material & Methods:A total of 50 prepared mandibular first molar resin models were used and divided into two main groups according to their fabrication phase: Patterns group and fully fabricated crowns group. Patterns group was subdivided into milled wax patterns (W) (n=10) and 3D printed resin patterns (P) (n=10). Fully fabricated crowns group was subdivided according to fabrication technique of lithium disilicate crowns into: Machinable ceramics (M), using IPS e-max CAD blocks (n=10), Pressable ceramics (Pw), using IPS e-max press ingots following wax milling (n=10) and Pressable ceramics (Pp), using IPS e-max press ingots following 3D resin printing (n=10). All patterns and ceramic crowns were cemented with Rely-X self-adhesive resin cement. Marginal and internal adaptations were measured using SEM at 300 × magnification. Kruskal-Wallis and Wilcoxon signed-rank tests were applied to compare between the groups. Data were presented as median and range values. The significance level was set at P ≤ 0.05.Results: P group showed a significant higher median total marginal gap of 111.4 μm (80.8-139.7) than W group of 51.3 μm (45.1-57.8) before heat pressing. While M group showed the significant highest median marginal gap of 138.4 μm (83.4-191.8) and no significant difference between heat pressed groups (Pw and Pp) (P ≤ .05). Regarding changes after heat pressing, Pw group showed no significant decrease, while Pp group showed a significant decrease in median total marginal gap. For internal fit, there was no significant difference between the pattern groups (2780)
Resin bonding to zirconia ceramic cannot be established by standard methods that are utilized for conventional silicabased dental ceramics. This study was aimed to examine the tensile bond strength of resin cement to zirconia ceramic using a new laboratory technique. Sixty-four zirconia ceramic specimens were air-abraded using Al 2 O 3 particles and divided into two groups; the control group with no pretreatment (Control), and the group pretreated using the internal coating technique (INT), in which the surface of the zirconia specimens were thinly coated by fusing silica-based ceramic and air-abraded in the same manner. The specimens in each group were further divided into two subgroups according to the silane coupling agents applied; a mixture of dentin primer/silane coupling agent (Clearfil SE Bond Primer/Porcelain Bond Activator) or a newly developed single-component silane coupling agent (Clearfil Ceramic Primer). After bonding with dual-cured resin cement (Panavia F 2.0), they were stored in water for 24 h and half of them were additionally subjected to thermal cycling. The tensile bond strengths were tested using a universal testing machine. ANOVAs revealed significant influence of ceramic surface pretreatment (p < 0.001), silane coupling agent (p < 0.001) and thermal cycling (p < 0.001); the INT coating technique significantly increased the bond strengths of resin cement to zirconia ceramic, whereas thermal cycling significantly decreased the bond strengths. The use of a single-component silane coupling agent demonstrated significantly higher bond strengths than that of a mixture of dentin primer/silane coupling agent. The internal coating of zirconia dental restorations with silica-based ceramic followed by silanization may be indicated in order to achieve better bonding for the clinical success.
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