Search Results (7)

Recently, due to the high demand for dental implants, the use of dental implant stock abutments has increased significantly, especially dental custom CAD/CAM implant abutments milled by dental technicians in their laboratories. The purpose of this study is to analyze the surface quality of the emergence profile of dental custom CAD/CAM implant abutments made by a non-industrial milling machine, compared to original and compatible dental implant stock abutments made by industrial machines. Thirty dental implant abutments were divided into six study lots. Lot 1 (control group): original dental implant stock abutments—industrial machined; lot 2 (study group): compatible dental implant stock abutments—industrial machined; lots 3, 4, 5, and 6 (study groups): compatible custom CAD/CAM dental implant abutments—non-industrial milled with hyperDENT CAM software and Paragon Tools. The Nikon SMZ745T stereomicroscope was used to analyze the emergence profile surface of each dental implant abutment. The structure of the analyzed surfaces did not show significant differences between original and compatible abutments that were industrially machined. As for the customized dental implant abutments, the greatest similarity with the original was obtained for lot 6, and a significant statistical difference was obtained for lot 4. Stepover and Feed Rate parameters of the milling process influenced the surface roughness of the emergence profile for the customized dental implant abutments. The digital technology of non-industrial milling compatible custom CAD/CAM dental implant abutments is reliable and within the correct milling parameters. Full article

Implant abutment selection is an important step in implant treatment to restore one or more lost teeth. The aim of this study was to compare stock and individual CAD/CAM full-form abutments after one year in function. A total of 64 subjects with one missing tooth were divided into two groups according to the type of abutment: 34 patients were given a stock abutment, and 30 an individual CAD/CAM abutment. Patients were scheduled for check-ups seven days after functional loading and after four, eight, and twelve months. Peri-implant soft tissue status was checked at every check-up by monitoring parameters traditionally used in similar studies: plaque index; bleeding on probing; and probing depth. To assess the stability of the bone tissue, radiological methods of measuring the amount of bone level compared to the implant shoulder were used. When needed, data were analysed by χ² test or by Fisher’s exact test. The normality of the distribution of quantitative measurements (properties) was tested by the Shapiro–Wilk test. Differences in the distribution of quantitative variables frequencies were analysed by Student’s t-test. Student’s t-test was used for repeated measurements, Mann–Whitney’s U test and ANOVA test for repeated measurements, and Friedmann’s two-way analysis of variance for repeated measurements. The predictive values of the chosen variables on the ABI index were assessed by the logistic regression model (Enter method). The results of this study showed that the impact of the abutment type (individual CAD/CAM or stock) on the average bleeding on probing was significant, especially after eight or twelve months. However, the abutment type did not show a significant correlation with the total crestal bone loss. The level of oral hygiene showed a significant correlation with the average bleeding on probing. The influence of smoking cigarettes on the total crestal bone loss evaluation was also significant. Overall, from a clinical perspective, custom CAD/CAM abutment performed slightly better than stock abutments during the one-year follow-up. Full article

The guardrail is an indispensable part of ballasted track structures on bridges. In order to reveal its influence on the track–bridge interaction of continuous welded rail (CWR), the longitudinal resistance model of the guardrail fastener and its influential factors are established through tests. By taking a continuous girder bridge (CGB) for railways as an example, a stock rail-guardrail-sleeper-bridge-pier integrated simulation model is developed. The effects of the guardrails, installation torque of the guardrail fastener, and joint resistance of the guardrail under typical conditions are carefully examined. The research results indicate that the nominal longitudinal resistance of the guardrail fastener and the elastic longitudinal displacement of the rail prior to sliding approximately grow linearly with the growth of the installation torque. The presence of a guardrail can alleviate the track–bridge interaction in the range of the CGB, but exacerbate the interaction near the abutment with moveable bearings. This fact enables the abutment position to be considered as a new control point for the design of CWR on bridges. Considering the changing rules of the rail longitudinal force and rail gap, it is recommended that the installation torques of the guardrail fastener and guardrail joint are 40–60 N·m and 700–800 N·m, respectively. The recommended maximum longitudinal stiffness of piers for CGBs is evaluated. When the longitudinal stiffness of the pier for a CGB is lower than the recommended value, the influence of the guardrail can be neglected in the design of the CWR. Full article

The implementation of CAD-CAM systems in dentistry has significantly influenced the evolution of dental implantology and implant-supported prosthetics within the past three decades. Implant-supported prostheses are comfortable and aesthetic. The prosthetic abutment has also faced a rapid design evolution, from the individualization of standard stock abutments offered by various manufacturers to a modern customization process using CAD-CAM technology. This paper presents a comparative study between 20 dental custom CAD-CAM implant abutments and 20 dental implant stock abutments, based on a set of measurements performed on the digital casts obtained from 24 cases of prosthetic rehabilitation on implants. The statistical analysis (Mann–Whitney U test) revealed significant differences between these two types of abutments: the incisal margin line diameter dimensions for custom abutments were significantly improved compared to standard abutments at the cervical level (U = 343.00, z = 3.868, p < 0.0005) and the incisal/occlusal level (U = 352.00, z = 4.112, p < 0.0005), while the inclination angle of the custom abutments relative to the 0-axis was significantly smaller than that of standard abutments (U = 115.50, z = −2.286, p = 0.022). The use of custom abutments leads to an increase in the final size of the abutment, an improvement in the retention of the prosthetic work, and reduces the angulation of the abutment in relation to the implant axis, thus decreasing the risk of unscrewing or fracturing the dental screw. Full article

With the evolution of CAD/CAM technology, custom titanium and/or zirconia abutments are increasingly being used, leading to several comparisons in the literature, both mechanical and aesthetic, to evaluate performance differences between these two types of abutments. Therefore, the aim of this comprehensive review is to present the most recent data on the latest comparisons between CAD/CAM and stock abutment applications. The PICO model was used to perform this review, through a literature search of the PubMed (MEDLINE) and Scopus electronic databases. CAD/CAM abutments allow individualization of abutment parameters with respect to soft tissue, allow increased fracture toughness, predict the failure mode, show no change in the fracture toughness over time, reduce the prosthetic steps, and reduce the functional implant prosthesis score and pain perceived by patients in the early stages. The advantages associated with the use of stock abutments mainly concern the risk of corrosion, time spent, cost, and fit, evaluated in vitro, in the implant–abutment connection. Equal conditions are present regarding the mechanical characteristics during dynamic cycles, screw loss, radiographic fit, and degree of micromotion. Further randomized controlled clinical trials should be conducted to evaluate the advantages reported to date, following in vitro studies about titanium and/or zirconia stock abutments. Full article

Background: The maintenance of marginal bone levels around dental implants is an important criterion for evaluating the success of implants. Although computer-aided design/computer-aided manufacturing (CAD/CAM) customized abutments (CAs) provide more flexible solutions, compared with the original preformed stock abutments (PAs), there are dimensional tolerances and underlying drawbacks in the production of CAD/CAM CAs, which may change the tightness and seamless connection between fixtures and abutments set by the manufacturer and then affect the long-term stability of the abutments. This study aimed to examine the change in both mesial and distal bone levels using digital periapical radiographs to evaluate the difference between CAD/CAM CAs and original PAs.Material and methods: Radiographs were taken before delivery; after functional loading for 1 month; and after 3, 6, and 12 months; and the vertical marginal bone levels (vMBLs) of both the mesial and distal surrounding implant bones were measured. All data are presented as means ± standard errors and were analyzed using Student’s t-test. A p-value < 0.05 was judged to represent a significant difference. Results: A total of 57 implants in 50 patients were divided into 22 CAD/CAM CAs and 35 original stock abutments. The PAs appeared to have a more stable bone level. By contrast, the amount of bone level change in the CAs was higher than that in the PAs. The change in the vMBL of the CAs was significantly more than that of the PAs after functional loading for 1 month (p = 0.006), 3 months (p = 0.013), 6 months (p = 0.014), and 12 months (p = 0.002). In contrast, the distal marginal bone level was lower than the mesial marginal bone level in any period. Nevertheless, the bone levels of the CAs and PAs in any period were comparable with no significant difference. Conclusions: Significant differences were found between the mesial and distal bone levels in the PAs. The CAD/CAM CAs showed a significantly greater bone level change than the original stock abutments after functional loading. Full article