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Análisis comparativo de las mallas digitales entre dos tipos de sistemas de escaneado y sus sistemas operativos
(2020) Moreno Galvez, Marcela Domenica; Abad Coronel, Cristian Gustavo
In this pilot study, meshes were compared obtained in different resolution from two systems of acquisition and their respective software. Clearly, PrimeScan and CEREC SW 5.0 Software showed higher quantity and higher quality of triangles exported as well as a better distribution within the mesh, with more regular vertices and faces, compatible between the graphic and quantitative findings analyzed. The quality of digital printing is defined by two independent factors that are the truth or fidelity and precision. truth is obtained when comparing original geometry, i.e. the model reference master with the digitized model, while the precision is obtained by a intragroup comparison of digitized models.
Analysis of the mesh resolution of an .STL exported from an intraoral scanner file
(2022) Abad Coronel, Cristian Gustavo; Pendola, Martin; Mena Cordova, Nancy Cecilia; Cornejo, Julián; Romero Muñoz, Carla Estefania; Atria, Pablo J; Blatz, Markus
Objectives: This study aimed to provide information on the accuracy of exported digital files with the different resolutions available in the CEREC 4.6.2 software obtained by means of an intraoral scanner (IOS), in addition to establishing differences between materialized models with different exported resolutions, and how these different exported files can influence finite element analysis (FEA) simulations. Materials and Methods: The upper complete arch of 10 patients was scanned through an IOS (CEREC Omnicam 1.0/Dentsply Sirona). Files of three resolution meshes digitalized by a CAD software (Cerec SW, 4.6.2) high, medium and low (IOSH, IOSM, and IOSL) were exported. Each file was evaluated by a software (NETFABB) about the number of triangles obtained and compared with the number announced by the manufacturer. Also, with a superimposition with a specialized software (GEOMAGIC X), the digital models were compared. The files of each resolution were printed (Sprintray 3D Printer), and the printed models were scanned with IOS (Omnicam 1.0) and compared with the control group (intraoral scanned high-resolution file, IOSH). FEA simulations were imported into COMSOL and analyzed under different loading conditions. Results: The number of exported triangles coincided with that reported by the manufacturer. The digital models from files of different resolution did not show significant differences (less than 1.5 um) between each other. Models printed (H, M, L) from files of the same resolution mesh (H, M, L) did not show significant differences between them either in partial measures of the arch and neither in the complete arch. FEA showed significant differences in stress concentration between different exported models. Clinical Significance: Digital models can be exported and printed in three resolutions of the mesh, without differences clinically significative. On the other hand, for future FEA applications further research should be performed in order to determine the optimal number of triangles.
Anterior fiber-reinforced fixed partial dentures revisited
(DENTISTRY TODAY, 2016-01-01) Abad Coronel, Cristian Gustavo
BOPT, una filosofía que nace analógica pero que debe transformarse en digital
(2022) Abad Coronel, Cristian Gustavo
Actualmente, las nuevas tecnologías son de gran utilidad para ejecutar tratamientos restauradores más precisos utilizando diversos equipamientos de adquisición de imágenes, diseño y fabricación, utilizando modernos materiales. El concepto BOPT es una terapia que tiene como objetivo conseguir una adecuada relación entre el tejido dentario, los tejidos blandos circundantes y la restauración protética. Utilizar la digitalización dentro del desarrollo del concepto BOPT es un reto importante que requiere de un adecuado entendimiento del protocolo clínico y de laboratorio. Este artículo pretende mostrar, mediante la presentación de un caso clínico, un protocolo de tratamiento que incluye la digitalización del protocolo tanto clínico como de laboratorio desde una impresión de la preparación vertical hasta lograr una restauración coronaria con un perfil de adaptación protética individualizado a través de un caso clínico con un periodo de seguimiento de 2 años.
Carillas cerámicas y BOPT: una relación con pronóstico favorable
(2021) Abad Coronel, Cristian Gustavo; Vischia, Ferruccio; Roncoroni, Fabio
Clinical outcomes of the biologically oriented preparation technique (BOPT) in fixed dental prostheses: A systematic review
(2022) Abad Coronel, Cristian Gustavo; Palacio Sarmiento, Stefany Carolina; Villacis Manosalvas, Jeniffer Adriana; Pradíes, Guillermo; Loi, Ignazio; Esquivel, Jonathan
Statement of problem: The biologically oriented preparation technique is a concept with a vertical tooth preparation, gingitage, an immediate interim restoration preserving the clot, and a specific laboratory technique aiming to adapt the marginal periodontal tissue to a remodeled emergence profile of the crown. However, the published scientific evidence on this subject is limited. Purpose: The purpose of this systematic review was to analyze whether using the biologically oriented preparation technique leads to improved clinical outcomes in terms of probing depth, gingival inflammation index, gingival marginal stability, and fewer mechanical and biological complications. Material and methods: Recommendations from the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines were used in this systematic review. An electronic search of the MEDLINE/PubMed, EMBASE, Science Direct, Wiley Online Library, Cochrane, and ProQuest databases was made for articles published between March 2010 and July 2021 using keywords. Three reviewers selected and analyzed all articles that mentioned the biologically oriented preparation technique and met the inclusion criteria. Results: A total of 6 articles met the inclusion criteria: 1 prospective randomized clinical study, 1 randomized clinical study, 1 prospective clinical study, and 3 case series. According to these studies, of all the teeth treated with the biologically oriented preparation technique, probing depth (greater than 3 mm) increased in only 2.3%, gingival inflammation was present in 22.8%, gingival recession occurred in 1.7% (decreased gingival stability), and mechanical and biological failures occurred in 4.4% of the teeth. Conclusions: Fixed dental prosthesis treatments performed following the concept of the biologically oriented preparation technique did not increase probing depth and showed a moderate rate of gingival inflammation, lower recession rates, and lower mechanical and biological failures at the 5-year follow-up. The biologically oriented preparation technique appears to be a viable alternative technique for obtaining satisfactory and stable clinical results up to 5 years. Long-term randomized clinical trials are recommended to reach more conclusions about this protocol.
Comparative Analysis between 3D-Printed Models Designed with Generic and Dental-Specific Software
(2023) Larriva Loyola, Jaime Alejandro; Abad Coronel, Cristian Gustavo; Pazan Morales, Domenica Patricia; Hidalgo Tamayo, Maria Lorena
With the great demand in the market for new dental software, the need has been seen to carry out a precision study for applications in digital dentistry, for which there is no comparative study, and there is a general ignorance regarding their applications. The purpose of this study was to investigate the accuracy differences between digital impressions obtained using generic G-CAD (general CAD) and D-CAD (CAD dental) software. Today, there is a difference between the design software used in dentistry and these in common use. Thus, it is necessary to make a comparison of precision software for specific and generic dental use. We hypothesized that there is no significant difference between the software for specific and general dental use. Methods: A typodont was digitized with an intraoral scanner and the models obtained were exported in STL format to four different softwares (Autodesk MeshMixer 3.5, Exocad Dental, Blender for dental, and InLAB). The STL files obtained by each software were materialized using a 3D printer. The printed models were scanned and exported in STL files, with which six pairs of groups were formed. The groups were compared using analysis software (3D Geomagic Control X) by superimposing them in the initial alignment order and using the best fit method. Results: There were no significant differences between the four analyzed software types; however, group 4, composed of the combination of D-CAD (Blender– InLAB), obtained the highest average (􀀀0.0324 SD = 0.0456), with a higher accuracy compared to the group with the lowest average (group 5, composed of the combination of the Meshmixer and Blender models), a generic software and a specific software (0.1024 SD = 0.0819). Conclusion: Although no evidence of significant difference was found regarding the accuracy of 3D models produced by G-CAD and D-CAD, combinations of groups where specific dental design software was present showed higher accuracy (precision and trueness). The comparison of the 3D graphics obtained with the superimposition of the digital meshes of the printed models performed with the help of the analysis software using the best fit method, replicating the same five reference points for the six groups formed, evidenced a greater tolerance in the groups using D-CAD.
Comparative analysis of fracture resistance between CAD/CAM materials for interim fixed prosthesis
(2021) Abad Coronel, Cristian Gustavo; Carrera Calahorrano, Elena Alejandra; Mena Cordova, Nancy Cecilia; Fajardo Seminario, Jorge Isaac; Aliaga Sancho, Jenny Paulina
The aim of this study was to evaluate and compare the resistance to fracture of interim restorations obtained through additive techniques (3D impressions) and subtractive techniques (milling) using a computer-aided design and manufacture (CAD/CAM) system of a three-unit fixed dental prosthesis (FDP) to ascertain its clinical importance. (1) Materials and methods: In total, 40 samples were manufactured and divided into two groups (n = 20) using: (1) light-curing micro hybrid resin for temporary crowns and bridges (PriZma 3D Bio Prov, MarketechLabs, São Paulo, Brazil) for the rapid prototyping group (RP) and (2) a polymethylmethacrylate (PMMA) CAD/CAM disc (Vipiblock Trilux, VIPI, São Paulo, Brazil) for the computer-assisted milling (CC). The resistance to fracture was determined with a universal testing machine. (2) Results: The strength and the standard deviation for the computer-assisted milling group were higher (1663.57 ± 130.25 N) than the rapid prototyping (RP) group, which had lower values of (1437.74 ± 73.41 N). (3) Conclusions: The provisional restorations from the computer-assisted milling group showed a greater resistance to fracture than the provisional restorations obtained from the rapid prototyping group.
Comparative Analysis of the Structural Weights of Fixed Prostheses of Zirconium Dioxide, Metal Ceramic, PMMA and 3DPP Printing Resin—Mechanical Implications
(2023) Abad Coronel, Cristian Gustavo; Pacurucu Mendieta, Miguel David; Lupu Flores, Billy Darlin; Velez Chimbo, David Alejandro
The aim of this study was to determine the mechanical implications of four-unit fixed dental prostheses (FDPs) made of (1) monolithic zirconium dioxide (ZR O2), (2) polymethylmethacrylate (PMMA), (3) metal ceramic (PFM) and (4) impression resin (3DPP). Methods: Four groups were studied with eight samples for each material (n: 32). Each structure was weighed, subjected to compressive tests and analyzed using 3D FEA. Results: PMMA presented the lowest structural weight (1.33 g), followed by 3DPP (1.98 g), ZR O2 (6.34 g) and PFM (6.44 g). In fracture tests, PMMA presented a compressive strength of 2104.73 N and a tension of 351.752 MPa; followed by PFM, with a strength of 1361.48 N and a tension of 227.521 MPa; ZR O2, with a strength of 1107.63 N and a tension of 185.098 MPa; and 3DPP, with a strength of 1000.88 N and a tension of 143.916 MPa. According to 3D FEA, 3DPP presented the lowest degree of deformation (0.001 mm), followed by PFM (0.011 mm), ZR O2 (0.168 mm) and PMMA (1.035 mm). Conclusions: The weights of the materials did not have a direct influence on the mean values obtained for strength, stress or strain. Since the performance was related to the tension and forces supported by the structures in critical zones, the importance of considering design factors is clear. In vitro and 3D FEA assays allowed us to simulate different scenarios for the mechanical properties of certain materials before evaluating them clinically. Thus, they can generate predictions that would allow for the design of a better research methodology in future clinical trials.
Comparative Fracture Resistance Analysis of Translucent Monolithic Zirconia Dioxide Milled in a CAD/CAM System
(2023) Ulloa Wilches, Ana Liz; Fajardo Seminario, Jorge Isaac; Abad Coronel, Cristian Gustavo; Paladines Diaz, Maria De los angeles; Paltán Zhingre, César Antonio
The aim of this study was to evaluate and compare the fracture resistance of definitive zirconia dioxide restorations obtained using a computer-aided design and manufacturing (CAD/CAM) system. Methods: Two groups of ten samples were analyzed for each material (n: 20); the first group was Zolid Gen X Amann Girrbach (ZGX) and the second group was Cercon HT Dentsply Sirona (CDS). The restorations were designed with identical parameters and milled with a CAD/CAM system. Each specimen was load tested at a speed of 0.5 mm/min, with a direction parallel to the major axis of the tooth and with an initial preload of 10 N until fracture using a universal testing machine (Universal/Tensile Testing Machine, Autograph AGS-X Series) equipped with a 20 kN load cell. The results obtained were recorded in Newtons (N), using software connected to the testing machine. Results: Statistically significant differences were found, and the fracture resistance of the monolithic zirconia crowns was lower in the CDS group (1744.84 172.8 N) compared to the ZGX group (2387.41 516 N). Conclusions: The monolithic zirconia CAD-CAM zirconia crowns showed sufficient fracture resistance when used in posterior molar and premolar zones with either material, as they withstood fracture loads greater than the maximum masticatory force.
Computer-aided design in restorative dentistry
(Springer, Cham, 2019) Abad Coronel, Cristian Gustavo; Tamimi, Faleh; Pradies Ramiro, Guillermo Jesús; Hassan, Bassam; Ferreiroa Navarro, Alberto
As 3D printing, computer-aided machining, and optical scanners keep improving and are becoming more accessible, design software is rapidly becoming the next frontier in digital dentistry. Rapid prototyping technologies in dentistry were initially operated with generic software that was not specifically designed for dental applications. This was very inefficient and a limiting factor for digitalization of dentistry. The arrival of specialized software for different dental applications has made digital dentistry a reality by making it efficient and bringing it to its full potential. This chapter addresses the different types of software that has been developed for restorative dentistry. This includes software for fixed, removable, and implant prosthodontics as well as software for treatment planning
Desmitificando la evidencia científica, hacia su aplicación clínica.
(2018) Abad Coronel, Cristian Gustavo; Reyes Arevalo, Giuseppe Antonio; Bravo Calderón, Manuel Estuardo
Digital Volumetric Analysis of CAD/CAM Ceramic Materials after Tooth Brushing
(2023) Abad Coronel, Cristian Gustavo; Espinosa Guerrero, Jimmy Kelvin; Mena Cordova, Nancy Cecilia; Aliaga Sancho, Jenny Paulina
Objective: The objective of this in vitro study was to evaluate the volumetric wear of three CAD/CAM (computer-aided design/computer-aided manufacturing) ceramic materials. Materials and Methods: The materials evaluated were CEREC Blocs (Dentsply Sirona), Initial LRF (GC) and Amber Mill (HASS Corp). All the samples (n=30) were subjected to simulated brushing (100,000 cycles). The wear was assessed by superimposing pre- and post-brushing scans obtained with an intraoral optical scanner (CEREC Primescan; Dentsply Sirona, Germany), which was then imported into the OraCheck 5.0 software (Dentsply Sirona, Germany). Results: The CAD/CAM ceramic materials tested showed no statistically significant differences in terms of the average volumetric wear (p-= 0.455). Conclusion: Therefore, it can be concluded that the ceramic materials have a good behavior under simulated brushing, without significant volumetric alterations.
Digital Volumetric Analysis of CAD/CAM Polymeric Materials after Tooth Brushing
(2022) Aliaga Sancho, Jenny Paulina; Abad Coronel, Cristian Gustavo; Palomeque, Andrea; Mena Cordova, Nancy Cecilia
The objective of the study was to evaluate the volumetric wear of four composite materials for CAD/CAM (computer-aided design/computer-aided manufacturing) systems. The materials evaluated were: Cerasmart (CER), Shofu Block HC (SBH), Tetric CAD (TEC) and Brava (BRA). All the samples (n = 40) were subjected to simulated brushing (100,000 cycles). Wear was evaluated by superimposing pre-and post-brushing scans obtained with an intraoral optical scanner (CEREC Primescan; Dentsply Sirona, Germany), which were subsequently imported into the OraCheck software 5.0 (Dentsply Sirona, Germany). The data were analyzed by ANOVA test and Tukey’s HSD test was used for multiple comparisons. Cerasmart showed the least wear after brushing. All the tested materials exhibited mass loss.
Evaluation of resin composites for dental restorations
(Elsevier, 2019) Abad Coronel, Cristian Gustavo; Pradíes Ramiro, Guillermo; Ja Y, Pastor; Palacios García, Teresa
In the production of dental restorations, there are, currently, two main types of materials: ceramics and resin composites. These latter kinds are typically suggested because of their quick fabrication, easy reparation and increased crossed link density compared with conventional light-cured materials. However, it is not clear for the specialist what is the best option among the many commercially available materials for each precise clinical case. For that reason, this work aims to clarify the real mechanical performance of resin-based composites for indirect dental restorations obtained by material removal processes and their most suitable application. Two kinds of resin CAD/CAM blocks were selected: LavaTM Ultimate and CerasmartTM, which were tested under two conditions: in the as received by the manufacturer state and after storage in artificial saliva during 30 days. The mechanical properties of both materials were analysed (density, hardness, flexural strength, fracture toughness) but also the influence on the degradation of the mechanical performance due to the contact with the saliva. Results indicate a better mechanical performance of the Lava Ultimate material in the as-received condition, despite its coarser microstructure. However, Cerasmart shows a stabilised microstructure with a smaller degradation of the mechanical properties in contact with the artificial saliva; in other words, improved durability inside the mouth
Flujos digitales en beneficio de una atención integral y complementaria del paciente con necesidades estéticas y funcionales
(2021) Abad Coronel, Cristian Gustavo; Villacís Manosalvas, Jeniffer Adriana; Abad Coronel, Cristian Gustavo
Fracture Resistance Analysis of CAD/CAM Interim Fixed Prosthodontic Materials: PMMA, Graphene, Acetal Resin and Polysulfone
(2023) Abad Coronel, Cristian Gustavo; Calle Cabrera, Viviana Carolina; Abril Orellana, Gabriela Alexandra; Paltán Zhingre, César Antonio; Fajardo Seminario, Jorge Isaac
The aim of this study was to evaluate and compare the fracture resistance of temporary restorations made of polymethylmethacrylate (PMMA), graphene-modified PMMA (GRA), acetal resin (AR) and polysulfone (PS) obtained by a subtractive technique (milling) using a computer-aided design and manufacturing (CAD/CAM) system of a three-unit fixed dental prosthesis (FDP). Methods: Four groups of ten samples were fabricated for each material. Each specimen was characterized by a compression test on a universal testing machine, all specimens were loaded to fracture and the value in Newtons (N) was recorded by software connected to the testing machine. The fracture mode was evaluated on all samples using a stereomicroscope. Results: There were statistically significant differences (p value < 0.005) between PMMA and the other three materials (PMMA: 1302.71 N; GRA: 1990.02 N; RA: 1796.20 N; PS: 2234.97). PMMA presented a significantly lower value than the other materials, and PS showed the highest value. GRA and RA presented a similar range of values but they were still higher than those of PMMA. Conclusions: GRA, RA and PS are presented as valid options within the range of interim milled restorative materials and as alternatives to PMMA.
Fracture Resistance Comparative Analysis of Milled-Derived vs. 3D-Printed CAD/CAM Materials for Single-Unit Restorations
(2023) Abad Coronel, Cristian Gustavo; Bravo, Manuel Estuardo; Tello López, Salome; Cornejo Alava, Ana Emilia
The aim of this study was to evaluate and compare the fracture resistance of a singleunit fixed prosthesis, using a CAD/CAM PMMA material and two printed materials (3DPPa and 3DPPb). A typodont with a specific preparation for a full crown was used; a digital impression was made with a state-of-the-art scanner (PrimeScanTM, Dentsply-SironaTM, New York, NY, USA), and a full coverage restoration was designed using a biogeneric design proposal by means of specific software (InLAB 22.1, Dentsply-Sirona, NY, USA). Sixty crowns were prepared, divided into three groups according to the material: 3DPPa (n = 20), 3DPPb (n = 20), both 3D-printed from the .STL file with a resolution of 50 m, and PMMA (n = 20) milled-derived, which were subjected to a thermocycling process. A universal testing machine (Universal/Tensile Testing Machine, Autograph AGS-X Series) with integrated software (TRAPEZIUM LITE X) equipped with a 20 kN load cell was used to determine the fracture resistance. Significant differences were found by Kruskal–Wallis test and multiple comparisons (p < 0.05) in fracture resistance between materials. The fracture resistance for the PMMA material was higher, and the standard deviation was lower (x = 1427.9; sd = 36.9 N) compared to the 3DPPa (x = 1231; sd = 380.1 N) and 3DPPb (x = 1029.9; sd = 166.46 N) prints. The restorations from the milled-derived group showed higher average fracture resistance than the provisional restorations obtained from the printed groups. However, the results demonstrated that all three materials analyzed in single-unit restorations are capable of withstanding the average masticatory forces.
Fracture resistance of sintered monolithic zirconia dioxide in different thermal units
(2022) Ordoñez Balladares, Andrea Dolores; Martín Biedma, Benjamín José; Ramos, Joao Carlos; Abad Coronel, Cristian Gustavo
The purpose of this study was to compare the fracture strength of monolithic zirconium dioxide subjected to a sintering process in two different furnaces: InFire HTC Speed and CEREC SpeedFire. Methods: Forty restorations were designed and machined using a computer aided design / computer aidded machine (CAD/CAM) system. The restorations were randomly assigned to two groups of 20 samples each, Group 1 for the SpeedFire furnace (fast sintering) and Group 2 for the InFire furnace (slow sintering). Each of the crowns was subjected to a maximum compression load recorded in Newtons (N) and a displacement control with a speed of 1 mm/min. Results: Group 1 presented an average of 1222.8 N and a standard deviation of 136.91 N. Group 2 obtained a mean of 1068.5 N and a standard deviation of 316.39 N. Conclusions: There were no significant differences between the two groups, and the mechanical strength of the material was not affected, which would imply a saving of clinical and laboratory time when performing rapid sintering on monolithic translucent zirconium dioxide restorations. However, rapidly sintered restorations have limited reliability.
Impresiones digitales intraorales como parte del protocolo BOPT. A propósito de un caso clínico
(2020) Salido Rodríguez-Manzaneque, María Paz; Pradíes Ramiro, Guillermo; Abad Coronel, Cristian Gustavo

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