Diş Hekimliği Fakültesi / Faculty of Dentistry
Permanent URI for this collectionhttps://hdl.handle.net/11727/2120
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Item Prosthetic Complications with Mandibular Bar-Retained Implant Overdentures Having Distal Attachments and Metal Frameworks: A 2-To 12-Year Retrospective Analysis(2023) Ciftci, Gozde; Somay, Suphi Deniz; Ozcan, Isil; Ozcelik, Tuncer Burak; Yilmaz, Burak; 0000-0001-5685-4409; 34998584; JJF-5618-2023Statement of problem. Long-term reports on 2-implant-retained overdentures having metal frameworks and bars containing distal attachments are scarce.Purpose. The purpose of this retrospective study was to evaluate prosthetic complications with 2-implant-retained mandibular overdentures with metal frameworks having either screw-or cement-retained cantilevered bars with distal attachments.Material and methods. Seventy-three edentulous study participants who had been treated with mandibular overdentures with 2 implants were included. The parameters assessed were acrylic resin fractures (base fracture, fracture at midline), debonding of teeth, opposing prosthesis fracture, need for relining or rebasing, abutment and bar screw loosening and fracture, ball or bar attachment or clip wear, fracture or detachment, bar fracture, and implant loss. Statistical analysis was performed by using the Mann-Whitney U test as the data were not normally distributed. The categorical variables between the groups were analyzed by using the Fisher exact test (alpha=.05).Results. Twenty-seven prostheses had a cement-retained bar, and 46 bars were screw-retained. Of 73 overdentures, 68 were metal-reinforced. The mean observation time was 5.9 years with a range between 2 and 12 years. The most common complication was wear of the Rhein 83 polymer attachment followed by bar screw loosening. The cumulative survival rate for overdentures was 91.9% at 6.8 years. The service life of cement-retained prostheses was significantly longer (P<.05). Bar, resin base, and mid-line fractures were only seen with cement-retained prostheses. The number of times an attachment change was required did not differ between cement-and screw-retained bars. Of 191 implants, 3 were lost, and the cumulative survival rate was 93.5% at 7.5 years. No significant difference was found between retention types in terms of implant loss (P>.05).Conclusions. Based on the participant population observed, the survival rates of 2-implant-retained mandibular overdentures and their implants in the medium term were high. Wear of the polymer attachment was commonly seen. Overdentures with cement-retained bars had bar or acrylic resin fractures. Mandibular 2-implant-retained overdentures with a screw-retained bar containing bilateral distal attachments had fewer prosthetic complications and high implant survival in the medium term.Item Marginal fit of CAD-CAM monolithic zirconia crowns fabricated by using cone beam computed tomography scans(2020) Kale, Ediz; Cilli, Mesutcan; Ozcelik, Tuncer Burak; Yilmaz, Burak; 31653403Statement of problem: Information regarding the precision of monolithic zirconia crowns fabricated by using a standard computer-aided design and computer-aided manufacturing (CAD-CAM) workflow is available. However, information on the effect of a modified workflow using 3D laboratory scanning and/or cone beam computed tomography (CBCT) for monolithic zirconia crown fabrication is lacking. Purpose: The purpose of this in vitro study was to evaluate the effect of different scans on the marginal fit of CAD-CAM monolithic zirconia crowns fabricated by 3D laboratory scanning and CBCT. Material and methods: An extracted maxillary left first molar was prepared and digitized by using a 3D laboratory scanner (D900; 3Shape A/S) (control group). The tooth was also scanned by CBCT (i-CAT; Imaging Sciences) to generate a second virtual 3D model (CBCTscan group). A tooth cast out of polyurethane (PU) (Zenotec Model; Wieland) was reproduced from the CBCT data by using a CAD software program (Dental System 2.6; 3Shape A/S) and milling machine (CORiTEC 550i; imes-icore) and further scanned by using the 3D laboratory scanner to generate a third virtual 3D model to represent a clinical scenario where a patient's cast is needed (PU3DLab group). A monolithic zirconia crown design (cement space: margin 40 mu m, 1 mm above 70 mu m) was used on the virtual models, and crowns were fabricated out of presintered zirconia blocks (ZenostarT4; Wieland) by using a 5-axis milling machine (CORiTEC 550i; imes-icore). The crowns were sintered (Sinterofen HT-S Speed; Mihm-Vogt), and the vertical marginal discrepancy (VMD) was measured by x100-magnification microscopy. Measurements were made at 384 points in 3 groups of 16 specimens. The measurements for each specimen were averaged, and VMD mean values were calculated. The Kruskal-Wallis test was used for the statistical analysis (alpha=.05). The Mann-Whitney U test and Bonferroni adjustment were further used to compare the pairs (alpha=.017). Results: The mean VMD value was 41 mu m (median: 38 mu m) for the control group, 44 mu m (median: 42 mu m) for the CBCTscan, and 60 mu m (median: 58 mu m) for the PU3DLab. No significant difference was found between control and CBCTscan groups (P=.274). However, there was a significant difference between control and PU3DLab and CBCTscan and PU3DLab groups (P<.001). Conclusions: Marginal fit of the crowns fabricated by using the 3D laboratory scanner and through the direct use of CBCT was better than that of the crowns fabricated by using the workflow that combined the use of CBCT, PU cast, and 3D laboratory scanner. All tested protocols enabled the fabrication of monolithic zirconia crowns with a marginal discrepancy smaller than 120 mu m.