| Objectives:The optical mode(reference optical mode)of final functional impression model,and the optical modes(test optical mode)of complete denture bases model fabricated by biofunctional prosthetic system or CAD-CAM technologies,and then,the anatomical impressions(test optical mode model)were acquired by an optical scanner..Thedenture base adaptation of complete dentures fabricated by biofunctional prosthetic system or CAD-CAM technologies,and the differences between functional impression and anatomical impression were analyzed by three-dimensional analysis.After the clinical trial of complete dentures fabricated by the two techniques,the clinial effects were evaluated,as the basis of the full denture fabrication.Methods:3 Edentulous patients were selected from the Department of Prosthodontics of Kunming Lanchie Dental Hospital from October to December,2017.Two impressions were taken from each patient.One was a pressure-free anatomical impression.The FCB tray and alginate were used to prepare impression,and then,the die stone model was made as the initial model numbered a.The other one was the closed pressure impression which made with silicone rubber and photosensitive resin individual trays,numbered b.The occlusal relationship was achieved using the biofunctional prosthetic system accessories and the gothic arch.The complete dentures were made by the biofunctional prosthetic system and CAD-CAM technology.Die stone model of complete denture tissue surface were made and numbered c and d respectively.And then optical models of the 4 models mentioned above were achieved by the 3-shape intraoral optical scanner.The optical impressions were imported into Geomagic Qualify 2012 software.By comparing the optical mode(a,b,c,d)on the corresponding area(In accordance with the traditional division method,the complete denture base is divided into the primary stress-bearing area,the secondary stress-bearing area,the border seal area,the post dam,and the relief area.),the adaptation comparison between biofunctional prosthetic system and CAD-CAM technologies of complete denture base were quantitativly analyzed.The morphological differences of the denture base tissue surface were compared between functional impression and anatomical impression techniques.Complete dentures made by biofunctional prosthetic system and CAD-CAM were adjusted and tried for two months to compare the clinical outcome of the two techniques.Results:1.Clinical outcome of complete dentures made by biofunctional prosthetic system and CAD-CAM technology.(1)After the 2 month' s trial,the chewing efficiency of the biofunctional repair system group was higher than that of the CAD/CAM group,and the difference was statistically significant(P<0.05).(2)After two month's trial,The retentive force of biofunctional prosthetic system group was higher than CAD-CAM group.The difference was statistically significant(P<0.05).(3)There was significant difference(P<0.01)in Maxillary average weight between biofunctional prosthetic system group and CAD-CAM group.There was no significant difference(P>0.05)in mandible average weight between biofunctional prosthetic system group and CAD-CAM group.CAD-CAM was lighter than biofunctional prosthetic system material.(4)The satisfaction rate in the biofunctional prosthetic system group was 100%,and the satisfaction rate in the CAD/CAM group was 33.33%.According to the score of the patients,the difference in satisfaction between the two groups was mainly reflected in the appearance and retention.2.Three dimensional analysis of complete denture adaptation made by biofunctional prosthetic system group and CAD-CAM.(1)The total three-dimensional gap of the maxillary and mandibular jaws in the biofunctional prosthetic system group was smaller than that in the CAD-CAM group,and the difference was statistically significant(P<0.05).The adaptation of complete denture made by biofunctional prosthetic system technology was better than CAD-CAM technology.(2)Differences within the two groups were compared by one-way ANOVA:There was no statistical difference between the five regions of maxillary biofunctional prosthetic system group(P>0.05).There was a statistically significant difference in the amount of three-dimensional gap between the secondary stress-bearing area and the border seal area of the maxillary CAD/CAM group(P<0.05).The three-dimensional gap in the border seal area was greater than that in the secondary stress-bearing area,and there was no statistical difference between the three-dimensional gap in the other areas(P>0.05).There was a statistically significant difference in the amount of three-dimensional gap between the primary stress-bearing area and the border seal area of the mandibular biofunctional prosthetic system group(P<0.05).The three-dimensional gap in the border seal area was greater than that in the primary stress-bearing area,and there was no statistical difference between the three-dimensional gaps in the other areas(P>0.05);There was a statistically significant difference in the amount of three-dimensional gap between the secondary stress-bearing area and the border seal area of the mandibular CAD/CAM group(P<0.05).The three-dimensional gap in the border seal area was greater than that in the secondary stress-bearing area,and there was no statistical difference between the three-dimensional gap in the other areas(P>0.05).(3)Paired t-tests were performed in the five regions of biofunctional prosthetic system group and the CAD/CAM group in the maxillary.The three-dimensional gap of the primary stress-bearing area and the border seal area in the biofunctional prosthetic system group was smaller than the CAD/CAM group,and the difference was statistically significant(P<0.05).Paired t-tests were performed in the three regions of two groups in the mandibular.The three-dimensional gap of the primary stress-bearing area and the secondary stress-bearing area in the biofunctional prosthetic system group was smaller than the CAD/CAM group,and the difference was statistically significant(P<0.05).3.Three-dimensional analysis of the morphology differences of functional and anatomical impression.(1)The maxillary functional impression group and the maxillary anatomical impression group were compared by one-way ANOVA in the five regions:The three-dimensional gap in the post dam was greater than in the primary stress-bearing area and the relief area;The three-dimensional gap in the border seal area was greater than the primary stress-bearing area and the relief area;The difference was statistically significant(P<0.05).In short,the three-dimensional gap in the five regions was arranged from large to small as:the border seal area;the post dam,the secondary stress-bearing area,the primary stress-bearing area,and the relief area.Approximately was(0.390±0.261)mm?(0.308±0.194)mm?(0.271 ±0.232)mm?(0.171±0.152)mm?(0.134±0.093)mm.There was no significant difference in the amount of three-dimensional gap between the primary stress-bearing area,the secondary stress-bearing area,and the border seal area,in mandible.The average three-dimensional gap was(0.382±0.518)mm.(2)In this study,flat alveolar ridge patients and well-rounded ridge patient were tested with a single sample t-test:In the maxillary,there was no significant difference in three-dimensional gap between flat alveolar ridge patients and well-rounded ridge patient(P>0.05).The three-dimensional gap of well-rounded ridge patient was(0.228±0.173)mm.The three-dimensional gap of flat alveolar ridge patients was(0.268±0.232)mm.In the mandible,the three-dimensional gap of well-rounded ridge patient was(0.094±0.070)mm,and the three-dimensional gap of flat alveolar ridge patients was(0.525±0.582)mm.The three-dimensional gap amount of flat alveolar ridge patients was greater than that of well-rounded ridge patient,and the difference was statistically significant(P<0.05).Conclusion:1.From the view of chewing,retention,and patient satisfaction,The biofunctional prosthetic system group was significantly better than the CAD/CAM group.2.Complete denture processing technology has a great influence on the retention of dentures.3.The adaptation of complete denture made by biofunctional prosthetic system technology was superior to CAD-CAM technology;The adaptation of the border seal area was inferior to that in the stress-bearing area.4.The three-dimensional gap of the five regions in the maxillary functional impression group and the maxillary anatomy impression group was ranked from large to small as the border seal area,the post dam,the primary stress-bearing area,the secondary stress-bearing area,the relief area.This reflected mucosal elasticity in different areas.5.Geomagic Qualify 2012 software could objectively measure the elasticity of mucosa under functional pressure impression,providing a new idea for analyzing mucosal elasticity.6.The elasticity of the maxillary mucosa was not related to the condition of the alveolar ridge.The mucousa elasticity of the severely resorbed edentulous mandibular ridge was inferior to that of fleshy alveolar ridge. |
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