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Assessing a method of optimizing digital dental crown design with antagonist tooth-wear facets: A prospective
Xiaohan Chai1, Jingwen Yang2, Yong Wang3
1Postgraduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, PR China.
Statement Of Problem:
Artificial intelligence (AI) has been applied to crown design and can produce acceptable morphology. However, occlusal morphology and contact area distribution generated by AI may differ from natural teeth. Whether they can approach ideal static and dynamic occlusion remains unknown.
Purpose:
The purpose of this prospective clinical study was to assess whether using a technique based on the wear facets of antagonist teeth improved the performance of occlusal morphology and contact area distribution of AI generated crowns.
Material And Methods:
In the study, 23 participants were enrolled. Four types of crowns for maxillary first molars were analyzed: natural tooth (NA), technician designed crown (TE), AI generated crown (AT), and the Facets Align technique adjusted AT crown (FA). Occlusal morphology was evaluated by cusp inclination and root mean square (RMS). Occlusal contact area distribution was evaluated by area, F1-score, and occlusal contact separation distance. Finite element analysis (FEA) was used to analyze the stress distribution of the crowns. Statistical analysis was performed using the Friedman 2-way rank nonparametric test and Bonferroni post hoc tests (α=.05).
Results:
The cusp inclination of AT was lower than that of NA (P<.01) on the distobuccal and distopalatal cusps. The occlusal contact area of AT was smaller than that of NA (P<.01). The occlusal contact separation distance of AT was the shortest during protrusive, working side, and nonworking side lateral movements (P<.01). FA did not differ significantly from NA and AT in cusp inclination. FA had smaller RMS (P<.01) and larger occlusal contact area (P<.001) than AT in several regions. FA improved the occlusal contact separation distance of AT during lateral movement on the working side (P<.05), while no significant difference was observed during protrusive and nonworking side lateral movement. The mean F1-score was 0.60 for FA, and the difference was significant between FA and AT (P<.001). As for finite element analysis (FEA), FA tended to exhibit higher stress and deformation values than AT but remained lower than NA.
Conclusions:
The Facets Align technique optimized AI generated crowns in both static and dynamic occlusion when there were wear facets on the antagonist tooth.
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