DISSERTATION –SYNOPSIS

DR. J. RISHIRAJ

POSTGRADUATE STUDENT

DEPARTMENT OF PROSTHODONTICS

BATCH 2011-2012

A.J. INSTITUTE OF DENTAL SCIENCES, KUNTIKANA

MANGALORE

Rajiv Gandhi University of Health Sciences, Karnataka

Bangalore
 ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECT FOR MDS DISSERTATION

1. Name of the candidate DR. J.RISHIRAJ

DEPARTMENT OF PROSTHODONTICS
A.J. INSTITUTE OF DENTAL SCIENCES
KUNTIKANA
MANGALORE-575 004

2. Name of the Institution A.J. INSTITUTE OF DENTAL SCIENCES

KUNTIKANA
MANGALORE -575004

3. Course of the study and subject MASTER OF DENTAL SURGERY

PROSTHODONTICS

4. Date of admission to course 20 /04/2011

5. Title of the topic “ACCURACY OF MARGINAL FIT OF

THE ZIRCONIA COPING FABRICATED
BY TWO DIFFERENT
MANUFACTURING SYSTEMS - A
COMPARATIVE IN VITRO STUDY.”

6. Brief resume of the intended work

6.1Need for the study

 1. Precise marginal fit is essential for successful zirconia restoration because
inaccurate marginal fit is responsible for intraoral degradation of cements can
result in loss of marginal seal and promote retention of plaque. Thus it leads
directly or indirectly to secondary dental caries, adverse pulpal reactions and
periodontal disease.

2. Marginal accuracy of the zirconia coping is dependant on the pattern which

may be made from wax or pattern resin.

3. Advances in computer-aided design/computer-assisted manufacturing

(CAD/CAM) technology purportedly enhance the marginal fit of dental
restorations. However, little information is available on the marginal accuracy
of copings manufactured from Copy milling and by the CAD/CAM system.

6.2Review of literature

1. Charlotte Grenade, Amélie Mainjot, and Alain Vanheusden, (2011)1

compared the fit of the single tooth zirconia copings with various manufacturing
 process and concluded that marginal fit of the procera copings was significantly
better than that of the ceramill copings .

2. Florian Beuer , Hans Aggstaller, Daniel Edelhoff , Wolfgang Gernet, John

Sorensen (2008) 2 compared the precision of the fit of zirconia substructure
materials for all ceramic fixed partial dentures from semi-sintered zirconia
blocks that were designed and machined with two CAD/CAM and one cam
system and concluded all the three system were considered clinically acceptable
and the CAD/CAM system were more precise than the CAM system.

3. Ovidiu Moldovan, Ralph G. Luthardt, Nicoleta Corcodel, Heike Rudolph

(2011)3 studied the three-dimensional fit of CAD/CAM made zirconia copings
still have to be improved regarding standardization, reproducibility and
efficiency.

4. Lang NP, Kiel RA and Andhalden K (1983)4 studied the clinical and
microbiological effects of subgingival restoration with overhanging or
clinically perfect margins and they found that overhanging subgingival
restoration leads to increase in the potential mechanism for initiation of
periodontal disease.

5. Holmes JR, Bayne SC, Holland GA, Sulik WD (1989)5 studied the
considerations in the measurement of marginal fit and they presented the
significance and difference in the magnitude of misfit at different location
between the tooth and a restoration and found that the absolute marginal
discrepancy would always be the largest measurement of error at the margin and
would reflect the total misfit at that point.

6.2Objectives of the study

To compare the accuracy of marginal fit of the zirconia copings fabricated by

copy milling technique (Ceramill system) and by CAD/CAM technique (3 Shape
dental system).
7 Materials and methods

7.1Source of data

1. Light hardening synthetic modeling resin.

2. CAD/CAM (3 Shape dental system ,Denmark).
3. Colour spacer (Han Dae Chemical Co. Ltd.).
4. Zirconia block (Aman Girbach ,Germany).
5. Instruments and materials required for the in-vitro study are to
be obtained from the Department of Prosthodontics, A.J.
Institute of Dental Sciences, Mangalore.
6. Translating toolmaker microscope.
7. Appropriate statistical analysis will be done using
Student Unpaired test.

7.2Method of collection of data

Test specimen preparation :

A custom-made stainless steel die will be prepared to simulate preparation for a

maxillary first molar with a uniform shoulder margin of 0.5mm width. It will be 9 mm
in cervical diameter and 5 mm in height. A tooth preparation convergence of 12 degrees
will be given. A cylindrical section of the die will be contiguous to tooth preparation
finish line measuring 5 mm in height and 9 mm in diameter. A counter die will be
prepared for the molar die with 0.5 mm gap on the preparation surface for standardizing
the operator fabricated coping thickness.

Methodology

30 samples of zirconia copings will be prepared from the following methods:

Group I: 15 samples will be prepared using Copy milling (Ceramill system)
Group II: 15 samples will be prepared using CAD/CAM (3 Shape dental system).

Prior to the fabrication of each sample from Group I, the stainless steel die will be
coated with Die spacer (Han Dae Chemical Co. Ltd.). One coat will be painted with
a paint brush. Die spacer will be applied on all tooth preparation surfaces, 1mm
short of the finish line. Resin pattern (light polymerized acrylic resin) will be made
and the pattern will be read by the technician-guided sensor and the copings will be
milled out of the Zirconia blocks. For group II, copings will be virtually designed
based on scanned die and the data regarding the virtually designed coping will be
transmitted to the decentralized manufacturing center of the CAD/CAM (3 Shape
dental system) where the zirconia copings will be manufactured.
The marginal discrepancy of the test specimens will be measured using an
translating toolmaker microscope and using software analysis for both group I and
group II.

Statistical analysis: The values of marginal discrepancy obtained will be

statistically analyzed using Student Unpaired Test

Investigation design
30 samples of zirconia copings
will be prepared using 2
systems
 Group I (15 SAMPLES) Group II (15 SAMPLES)

With copy milling With CAD/CAM.

Marginal accuracy using an translating toolmaker microscope

and using software analysis

Statistical analysis using Student Unpaired Test.

7.3Does the study require any investigation or interventions to be

made on patients or other humans or animals? If yes, please
describe briefly

NO
7.4Has ethical clearance been obtained from your institution, if yes for
7.3
 Not applicable.

8. List of references

1. Charlotte Grenade, Amélie Mainjot, and Alain Vanheusden. Fit of the

single tooth zirconia copings. J Prosthet Dent 2011; 105: 249-255.

2. Florian Beuer , Hans Aggstaller, Daniel Edelhoff , Wolfgang Gernet, John

Sorensen. Marginal and internal fits of fixed dental prostheses zirconia
retainers. Dental materials 2009; 25: 94-102.

3. Ovidiu Moldovan, Ralph G. Luthardt, Nicoleta Corcodel, Heike Rudolph.

Three-dimensional fit of CAD/CAM-made zirconia copings. Dental materials
2011.

4. Lang NP, Kiel RA and Andhalden K. Clinical and microbiological effects of

subgingival restorations with overhanging or clinically perfect margin. J Clin
periodontal 1983; 10: 563-78.

5. Holmes JR, Bayne SC, Holland GA, Sulik WD. Considerations in

measurement of marginal fit. J Prosthet dent 1989; 62: 405-8.

9 Signature of the candidate

10 Remarks of the guide

11. 11.1 Name and designation of Dr. Y. BHARATH SHETTY

Guide PROFESSOR AND HEAD,
DEPARTMENT OF
 PROSTHODONTICS,
A.J.INSTITUTE OF DENTAL
SCIENCES.
11.2 Signature of the guide

11.3 Co-guide (if any) Dr. RESHMA KARKERA

PROFESSOR ,
DEPARTMENT OF
PROSTHODONTICS,
A.J.INSTITUTE OF DENTAL
SCIENCES.

11.4 Signature

11.5 Head of the department Dr. Y. BHARATH SHETTY

DEPARTMENT OF
PROSTHODONTICS
A.J.INSTITUTE OF DENTAL
SCIENCES.
11.6 Signature

12. 12.1 Remarks of the chairman and

principal
12.2 Signature