An In Vitro Study of the Reproducibility of the Drilling Access of Digitalized Surgical Guides Generated via Three Different Implant Planning Software Programs

Several implant planning software programs are widely use in implant treatments, but there has been no evidence of how different software programs affect the accuracy of static surgical guides used for implant placement. Thus, in this in vitro study, we aimed to compare the accuracy of static surgical guides that were prefabricated from three different software programs, including Implant Studio (Program A) (3Shape®, Copenhagen, Denmark), coDiagnostiX® (Program B) (Straumann®, Basal, Switzerland), and Blue Sky Plan (Program C) (Blue Sky Bio®, LLC, Libertyville, IL, USA). A total of 90 drillable polyurethane models were used as samples in this in vitro study; 30 study models were used to plan the same implant positions and design the surgical guides by each software program (n = 30) and then 90 implants were placed in the models using the surgical guides. The outcomes of the surgical guide accuracy were autonomically measured by the evaluation tool in the coDiagnostiX® (Straumann®, Basal, Switzerland) software program. The deviations between the planned and placed implants were automatically evaluated as three-dimensional and angular deviations. The mean three-dimensional implant position deviations from the implant platform of Program A, Program B, and Program C were 0.55 ± 0.25 mm, 0.52 ± 0.31 mm, and 0.56 ± 0.22 mm, respectively. The mean three-dimensional implant position deviations from the implant apex of Program A, Program B, and Program C were 0.72 ± 0.37 mm, 0.73 ± 0.4 mm, and 0.9 ± 0.46 mm, respectively. The mean depth deviations of Program A, Program B, and Program C were 0.19 ± 0.13 mm, 0.31 ± 0.32 mm, and 0.31 ± 0.22 mm, respectively. The mean angulation deviations of Program A, Program B, and Program C were 1.72 ± 0.88 degrees, 2.05 ± 1.24 degrees, and 2.74 ± 1.81 degrees, respectively. The results indicated that there were no significant differences among the three-dimensional positions at the implant platform, the three-dimensional positions at the implant apex, and the depth deviations between all three groups. However, it was found that there was a significant difference in the angular deviation of the implant position between the three groups (p = 0.02). The mean angular deviation of Program C was significantly greater than the Program A group (p = 0.001). In terms of the deviation directions of the implant platform and implant apex for the three groups, most of the deviations of a larger magnitude were toward the mesio-buccal direction. No matter which program was used to plan the implant position, deviations between the placed implant position and the planned position still occurred. Therefore, when planning implant positions with any implant planning software program, one must take into account an implant position deviation

Reliability of Polyetherketoneketone as Definitive Implant-Supported Bridges in the Posterior Region—An In Vitro Study of the Ultimate Fracture Load and Vertical Marginal Discrepancy after Artificial Aging

Purpose: This study aims to investigate the ultimate fractural strength and marginal integrity of a three-unit implant-supported fixed partial denture (FPD) framework fabricated of polyetherketoneketone (PEKK) after simulated five-year clinical aging. Materials and Methods: Twelve FPD frameworks were milled (n = 6 per group). All experimental frameworks were cemented on identical stainless-steel abutment models and subjected to five years of clinically simulated thermomechanical aging. The vertical marginal gap values were analyzed using a scanning electron microscope before and after being subjected to each aging condition. A universal testing machine was used to evaluate the ultimate fracture load. Results: A significant increase in marginal gap values of the PEKK group was observed after five years of simulation aging (p < 0.001), while no significant difference was seen in the titanium group (p = 0.071). After thermocycling, the PEKK group showed a higher statistically significant mean marginal gap value (84.99 + 44.28 μm) than before (81.75 + 44.53 μm). The titanium group exhibited superior mechanical strength, with a fracture load significantly higher than that of the PEKK group (3050 + 385.30 and 1359.14 + 205.49 N, respectively). Conclusions: Thermocycling affects the marginal gap discrepancy of PEKK restoration. However, the mean vertical marginal gap values in PEKK and titanium groups after a five-year clinical aging simulation were clinically acceptable. The ultimate fracture load values were higher than the maximum bite force reported in the posterior region. Thus, PEKK could serve as a suitable alternative material to metal in the framework of fixed dental prostheses

Reliability of Polyetherketoneketone as Definitive Implant-Supported Bridges in the Posterior Region—An In Vitro Study of the Ultimate Fracture Load and Vertical Marginal Discrepancy after Artificial Aging

Purpose: This study aims to investigate the ultimate fractural strength and marginal integrity of a three-unit implant-supported fixed partial denture (FPD) framework fabricated of polyetherketoneketone (PEKK) after simulated five-year clinical aging. Materials and Methods: Twelve FPD frameworks were milled (n = 6 per group). All experimental frameworks were cemented on identical stainless-steel abutment models and subjected to five years of clinically simulated thermomechanical aging. The vertical marginal gap values were analyzed using a scanning electron microscope before and after being subjected to each aging condition. A universal testing machine was used to evaluate the ultimate fracture load. Results: A significant increase in marginal gap values of the PEKK group was observed after five years of simulation aging (p p = 0.071). After thermocycling, the PEKK group showed a higher statistically significant mean marginal gap value (84.99 + 44.28 μm) than before (81.75 + 44.53 μm). The titanium group exhibited superior mechanical strength, with a fracture load significantly higher than that of the PEKK group (3050 + 385.30 and 1359.14 + 205.49 N, respectively). Conclusions: Thermocycling affects the marginal gap discrepancy of PEKK restoration. However, the mean vertical marginal gap values in PEKK and titanium groups after a five-year clinical aging simulation were clinically acceptable. The ultimate fracture load values were higher than the maximum bite force reported in the posterior region. Thus, PEKK could serve as a suitable alternative material to metal in the framework of fixed dental prostheses