Marta Revilla Leon M.S.D.

Posted May 21st 2021

Prosthetically-Driven Full-Mouth Implant-Supported Prostheses Using Guided Surgical Implant Planning with Composite Resin Markers: A Case Report.

Marta Revilla-León, M.S.D.

Marta Revilla-León, M.S.D.

Cabanes-Gumbau, G., Agustín-Panadero, R., Revilla-León, M. and Zubizarreta-Macho, Á. (2021). “Prosthetically-Driven Full-Mouth Implant-Supported Prostheses Using Guided Surgical Implant Planning with Composite Resin Markers: A Case Report.” J Prosthodont April 17. [Epub ahead of print].

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This report describes a prosthetically-driven implant planning method, guided by the alignment procedures between the cone beam computed tomography, intraoral digital scans, and digitized maxillary and mandibular interim complete dentures using intraoral composite resin markers as a common reference. The markers were attached to the keratinized oral mucosa of the edentulous ridges using cyanoacrylate and kept in place during the digitizing procedures. The technique provides a simpler and more economical alternative to conventional prosthetically-driven static implant planning methods.


Posted April 20th 2021

Influence of postpolymerization methods and artificial aging procedures on the fracture resistance and flexural strength of a vat-polymerized interim dental material.

Marta Revilla-León, M.S.D.

Marta Revilla-León, M.S.D.

Scherer, M.D., Barmak, B.A., Özcan, M. and Revilla-León, M. (2021). “Influence of postpolymerization methods and artificial aging procedures on the fracture resistance and flexural strength of a vat-polymerized interim dental material.” J Prosthet Dent Mar 29;S0022-3913(21)00099-8. [Epub ahead of print].

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STATEMENT OF PROBLEM: The influence of postpolymerization methods and artificial aging procedures on the fracture resistance and flexural strength of additively manufactured interim polymers remains unclear. PURPOSE: The purpose of this in vitro study was to evaluate the effect of the conditions (dry and water- and glycerin-submerged) and time (25, 30, 35, 40, and 45 minutes) of postpolymerization methods with and without artificial aging procedures on the fracture resistance and flexural strength of an additively manufactured interim material. MATERIAL AND METHODS: Bar specimens (25×2×2 mm) were manufactured from an interim resin (NexDent C&B MFH N1) with a 3-dimensional printer (NexDent 5100) as per the manufacturer’s recommendations. Three groups were created based on the postpolymerization condition: dry (D group) and submerged in a container with water (W group) or glycerin (G group) inside the ultraviolet polymerization machine (LC-3DPrint Box). Each group was divided into 5 subgroups (D1 to D5, W1 to W5, and G1 to G5) depending on the polymerizing time (25, 30, 35, 40, and 45 minutes) (n=20). Each subgroup was divided into nonaged and aged subgroups. The aged groups were treated in a mastication simulator. Fracture strength was measured on a universal testing machine. The flexural strength was calculated as per International Organization for Standardization (ISO) 10477-2018. The Kolmogorov-Smirnov test demonstrated that data were normally distributed. The 3-way ANOVA test was used to analyze the data (α=.05). RESULTS: A significant main effect was found on the fracture strength analysis for each of the 3 factors: postpolymerization condition (F[2, 449]=81.00, P<.001), treatment duration (F[4, 449]=2.84, P=.024), and aging procedure (F [1, 449] =7.62, P=.006). The only significant 2-way interaction was between postpolymerization condition and treatment duration (F[8, 449]=3.12, P=.002). Furthermore, a significant main effect was found on the flexural strength for each of the 3 factors including postpolymerization condition (F[2, 449]=82.55, P<.001), treatment duration (F[4, 449]=2.85, P=.024), and artificial aging procedure (F[1, 449]=6.72, P=.010). The only significant 2-way interaction was between postpolymerization condition and treatment duration (F[8, 449]=3.33, P=.001). Dry postconditions at 25 minutes and nonaged procedures obtained the significantly highest fracture resistance and flexural strength values. CONCLUSIONS: Postpolymerization conditions and duration time affected the fracture resistance and flexural strength of the additively manufactured interim material assessed. Artificial aging procedures significantly decreased the fracture resistance and flexural strength of the additively manufactured interim dental material.


Posted April 20th 2021

Workflow of a fiber-reinforced composite fixed dental prosthesis by using a 4-piece additive manufactured silicone index: A dental technique.

Marta Revilla-León, M.S.D.

Marta Revilla-León, M.S.D.

Revilla-León, M., Fountain, J., Piedra-Cascón, W., Özcan, M. and Zandinejad, A. (2021). “Workflow of a fiber-reinforced composite fixed dental prosthesis by using a 4-piece additive manufactured silicone index: A dental technique.” J Prosthet Dent 125(4): 569-575.

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A digital workflow for fabricating a fiber-reinforced composite prosthesis is described. A facial scanner and an intraoral scanner were used to gather records, and dental and open-source software programs were used to elaborate a diagnostic waxing and design a 4-piece additively manufactured clear silicone index. Advantages of the index design included precise translation of the diagnostic waxing, optimal composite resin stratification, and minimal clinical time.


Posted April 20th 2021

Fabricating a dual-material, vat-polymerized, additively manufactured static implant surgical guide: A dental technique.

Marta Revilla-León, M.S.D.

Marta Revilla-León, M.S.D.

Piedra-Cascón, W., Mostafavi, D., Ruiz-de-Gopegui, J., Pérez-Pevida, E., Robles-Cantero, D. and Revilla-León, M. (2021). “Fabricating a dual-material, vat-polymerized, additively manufactured static implant surgical guide: A dental technique.” J Prosthet Dent Mar 11;S0022-3913(21)00078-0. [Epub ahead of print].

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Protocols with static computer-aided implant placement provide more tangible clinical advantages than conventional implant placement methods. A technique to manufacture a dual-material implant surgical guide by using a vat-polymerization printer is described. The implant surgical guide combined a resilient intaglio and hard exterior surface. The technique should minimize the clinical adjustments needed to ensure fit and improve patient comfort.


Posted March 16th 2021

Manufacturing accuracy and volumetric changes of stereolithography additively manufactured zirconia with different porosities.

Amarali Zandinejad, M.S.

Amarali Zandinejad, M.S.

Revilla-León, M., Mostafavi, D., Methani, M.M. and Zandinejad, A. (2021). “Manufacturing accuracy and volumetric changes of stereolithography additively manufactured zirconia with different porosities.” J Prosthet Dent Feb 8;S0022-3913(20)30504-7. [Epub ahead of print].

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STATEMENT OF PROBLEM: When compared with subtractive fabricating methods, additive manufacturing (AM) technologies are capable of fabricating complex geometries with different material porosities. However, the manufacturing accuracy and shrinkage of the stereolithography (SLA) AM zirconia with different porosities are unclear. PURPOSE: The purpose of this in vitro study was to measure the manufacturing accuracy and volumetric changes of AM zirconia specimens with porosities of 0%, 20%, and 40%. MATERIAL AND METHODS: A digital design of a bar (25×4×3 mm) was obtained by using an open-source software program (Blender, version 2.77a; The Blender Foundation). The standard tessellation language (STL) file was exported. Three groups were created based on the material porosity: 0% porosity (0% group), 20% porosity (20% group), and 40% porosity (40% group). The STL was used to manufacture all the specimens by using an SLA ceramic printer (CeraMaker 900; 3DCeram Co) and zirconia material (3DMix ZrO(2) paste; 3DCeram Co) (n=20). After manufacturing, the specimens were cleaned of the green parts by using a semiautomated cleaning station. Subsequently, debinding procedures was completed in a furnace at 600 °C. The sintering procedures varied among the groups to achieve different porosities. For the 0% group, the ZrO(2) was sintered in a furnace at 1450 °C, and for the 20% and 40% groups, the sintering temperature varied between 1450 °C and 1225 °C. The specimen dimensions (length, width, and height) were measured 3 times with digital calipers, and the mean value was determined. The manufacturing volume shrinkage (%) was calculated by using the digital design of the bar and the achieved AM dimensions of the specimens. The Shapiro-Wilk test revealed that the data were not normally distributed. Therefore, the data were analyzed by using the Kruskal-Wallis followed by pairwise Mann-Whitney U tests (α=.05). RESULTS: The Kruskal-Wallis test demonstrated significant differences among the groups in length, width, and height (P<.001). The Mann-Whitney U test indicated significant differences in pairwise comparisons of length, width, and height among the 3 groups (P<.001). The 0% group obtained a median ±interquartile range values of 20.92 ±0.14 mm in length, 3.43 ±0.07 mm in width, and 2.39 ±0.03 mm in height; the 20% group obtained 22.81 ±0.29 mm in length, 3.74 ±0.07 mm in width, and 2.62 ±0.05 mm in height; and the 40% group presented 25.11 ±0.13 mm in length, 4.14 ±0.08 mm in width, and 2.96 ±0.02 mm in height. Significant differences in manufacturing volumetric changes were encountered among the 3 groups (P<.001). In all groups, volumetric changes in the length, width, and height were not uniform, being higher in the z-axis direction compared with the x- and y-axis. The manufacturing volumetric changes varied from -20.33 ±1.00% to +3.5 ±2.00%. CONCLUSIONS: The 40%-porosity group obtained the highest manufacturing accuracy and the lowest manufacturing volume change, followed by the 20%-porosity and the 0%-porosity groups. An uneven manufacturing volume change in the x-, y-, and z-axis was observed. However, none of the groups tested were able to perfectly match the virtual design of the specimens.