Intraoral devices retained by cementation in the maxillary molars were fabricated covering the posterior teeth and the hard palate. First, individual acrylic trays were made from a maxillary impression of a 90-day-old rat dry skull. With the individual trays, impressions of the palate were taken from each animal under anesthesia, using polyether (Impregum, 3M, Sao Paulo, Brazil) impression material. The impressions were poured with type IV dental stone (Herodent, Vigodent S.A., Rio De Janeiro, Brazil) to obtain the casts. Individual waxing of the palatal region covering the molar teeth was performed on the casts. Then, the devices were produced using thermo-polymerizing acrylic resin (Clássico®, São Paulo, Brazil) replacing the wax from a flasking procedure. Relief was performed on the molar teeth area of the device to be cemented with self-curing acrylic resin (Clássico®, São Paulo, Brazil). A perforation with a diameter of a 200-μL pipette tip was made in the center of the device to enable intermittent fungal inoculations without removing the device [38 (link)]. The devices were maintained in distilled water for two days. Afterwards, they were individually transferred to 200 mL of sterile distilled water and sterilized by microwave irradiation at 650 Watts for 3 min [39 (link)] before the biofilm formation.
Impregum
Manufactured by 3M
Sourced in Germany, United States
Impregum is a polyether-based impression material used in dental procedures. It is designed to provide accurate and detailed impressions of the oral cavity, which are essential for the fabrication of dental prosthetics and restorations. Impregum offers a balanced viscosity and hydrophilic properties to ensure optimal reproduction of the dental structures.
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14 protocols using impregum
1
Intraoral Device for Maxillary Molar Biofilm
2
Artificial Pocket Model for Biofilm
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An artificial pocket model was established using two forms of polyether (Impregum, 3M ESPE, Seefeld, Germany) resulting in an artificial pocket, which could be opened for specimen insertion and removal, thus not destroying the established biofilm (Fig 1C+1D ).
3
Pup Respiratory Dynamics Analysis
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Each pup was left with its mother for 15-20 min until the end of maternal care. The pup was then sexed, weighed and attached to the pneumotachometer inside a thermoregulated chamber (32°C). The snout was sealed into the facemask with polyether adhesive (Impregum, 3M, Saint Paul, MN, USA). Recordings were started within 100 min following delivery.
Breathing variables were recorded for 60 min (Figure 1E) and extended beyond this period in Phox2b 27Ala/+ pups until terminal apnea to analyze gasping.
Breathing variables were recorded for 60 min (Figure 1E) and extended beyond this period in Phox2b 27Ala/+ pups until terminal apnea to analyze gasping.
4
Endocrown and Crown Fabrication Protocols
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Impressions were taken with polyether impression material (Impregum, Penta H and L, Duosoft; 3M Espe, Neuss, Germany), using a double-mix dual-phase impression technique, and poured with type IV dental stone (Fujirock; GC Corporation, Alsip, USA).
The stone dies were scanned using a laboratory scanner (D900L scanner; 3 Shape, Copenhagen, Denmark) and the design of the endocrowns/crowns was manipulated with the dental digital designer (Dental Designer, version 17.2.1; 3 Shape, Copenhagen, Denmark). The endocrown height from the occlusal table was 6 mm and 5.5 mm to the buccal and palatal cusp tips, respectively. The occlusal and axial crown thickness for the PC group was 1.5 -2 mm and 1.2 -1.5 mm, respectively. The medial surfaces of the buccal and palatal cusps were modified to acquire 30° angle slopes to the horizontal axis of the teeth (Fig. 1).
Three subgroups (ZE1, ZE2, and ZE3) were milled out of presintered zirconia discs (Katana STML zirconia-based ceramic (4YSZ), Kuraray), using a dental milling machine (ZENOTEC Select hybrid; WIELAND Dental, Pforzheim, Germany). The other three subgroups (LE1, LE2, and LE3) and the crowns for post and core control group were milled out of lithium disilicate glass-ceramic blocks (IPS e.max CAD; Ivoclar Vivadent, Schaan, Liechtenstein).
The stone dies were scanned using a laboratory scanner (D900L scanner; 3 Shape, Copenhagen, Denmark) and the design of the endocrowns/crowns was manipulated with the dental digital designer (Dental Designer, version 17.2.1; 3 Shape, Copenhagen, Denmark). The endocrown height from the occlusal table was 6 mm and 5.5 mm to the buccal and palatal cusp tips, respectively. The occlusal and axial crown thickness for the PC group was 1.5 -2 mm and 1.2 -1.5 mm, respectively. The medial surfaces of the buccal and palatal cusps were modified to acquire 30° angle slopes to the horizontal axis of the teeth (Fig. 1).
Three subgroups (ZE1, ZE2, and ZE3) were milled out of presintered zirconia discs (Katana STML zirconia-based ceramic (4YSZ), Kuraray), using a dental milling machine (ZENOTEC Select hybrid; WIELAND Dental, Pforzheim, Germany). The other three subgroups (LE1, LE2, and LE3) and the crowns for post and core control group were milled out of lithium disilicate glass-ceramic blocks (IPS e.max CAD; Ivoclar Vivadent, Schaan, Liechtenstein).
5
Immediate Temporal Zirconia Crowns
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Information on the clinical and laboratory procedures was provided in detail in precedent publications reporting preliminary results after 12 months of observation [15, 16] . Key points were as follows. The implants were immediately temporized with prefabricated provisional reconstructions comprising slight occlusal contacts (shimstock foil of 8 µm thickness could be pulled through). After a healing period of at least 8 (mandible) or 16 weeks (maxilla), respectively, impressions were taken (Impregum; 3M Espe, Seefeld, Germany) and digitized (inEos scanner; Sirona, Bensheim, Germany). CAD/CAM-fabricated (Cerec inLab ® software, inLab ® MC XL 4-axis milling device; Sirona) zirconia frameworks (In-Ceram YZ, VITA Zahnfabrik) were hand-layered with a leucite-reinforced feldspathic ceramic (VM9, VITA Zahnfabrik) according to the manufacturer's instructions. All SCs were adhesively cemented using a dual-curing resin cement (RelyX Unicem Aplicap; 3M Espe). In case of a subgingival cementation line, retraction cords were placed to facilitate cement removal. Centric and dynamic occlusions were controlled (12 µm occlusion foil, 8 µm shimstock foil) both on the restoration and the residual dentition to avoid any excessive forces.
6
Simulating Root Dentin Aging and Mastication
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Thermal and mechanical cycling was performed to simulate aging and mastication of root dentin during function. Before the thermal and mechanical cycling, the teeth crowns were sectioned off at the cementoenamel junction (CEJ) under water cooling with a diamond disk. The teeth were embedded in cylindrical molds of polymethylmethacrylate (Palapress Vario, Heraeus-Kulzer, Germany) with a 200 μm thick layer of polyether material (Impregum, 3M Espe, Seefeld, Germany) surrounding the root surfaces to mimic periodontal ligament (PDL). The CEJ was positioned approximately 1.5 mm above the level of mold to simulate bone crest. All the teeth were then aged under thermal and mechanical load cycles in a chewing simulator (TCML, Chewing Simulator, EGO, Regensburg, Germany). The thermal cycling consisted of 6000 cycles × 5°/55°; each cycle was 2 min. The specimens were simultaneously subjected to mechanical load cycles of 1.2 × 106 cycles of 50 N at frequency of 1.6 Hz. This mechanical/thermal load cycles simulated 5 years of clinical function, based on the masticatory loads, speed of mandibular movements, and rate of chewing.[17 (link)18 (link)19 (link)] All specimens were kept hydrated in deionized water throughout the experiments. These thermomechanically cycled specimens were used to determine the load to fracture and subsequent fractographic analysis.
7
Implant Crown Fabrication Protocol
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Three months after implant placement, a final impression was taken at the abutment level using an impression cap. Polyether (3M™ Impregum™) was used as the impression material, and the crowns were made of either lithium disilicate or zirconia. All-ceramic crowns were cemented to the implant abutment using self-adhesive resin cement (RelyX™ U200; 3M ESPE, St. Paul Minnesota, USA) without any abutment adjustments.
8
Temporary Full-Arch Implant-Supported Bridge
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After the surgical procedure, a polyether impression (Impregum©, 3 M Deutschland GmbH, Neuss, Germany) was taken, and a plaster model for the dental technician was produced. The clinician chose the definitive abutments, which compensated for the tilted implant axis, and the dental technician then created a full arch resin bridge, which was screwed in directly after manufacturing (time range from 120 min for one to 150 min for both jaws). This temporary full-arch bridge provided sufficient fixed prosthodontic restoration during a healing period of at least 3 months. Postoperative follow-up visits were scheduled closely at day 2, 7, 14, and then at least monthly until definitive restoration.
9
Computer-Guided Implant Placement and Provisional Prosthesis
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CBCT radiographs were taken to collect detailed three-dimensional information on the patients’ maxillofacial hard tissues. Patients’ preliminary impressions (Impregum™, 3 M ESPE) and intraoral scans was collected and used to fabricate a diagnostic cast and create a radiographic template. Then, a computer-assisted implant design was performed in a prosthetically oriented way (Fig. 1 ). Surgical templates (for patients in both groups) and provisional restorations (for patients in Group A) were created using a 3D printer (Fig. 2 ).![]()
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Preoperative procedure in Group A.
Computer-aided manufacturing of the surgical templates and provisional prosthesis. (
10
Longitudinal Evaluation of Jaw Contour Changes
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Silicone impressions of the whole jaw (Impregum, 3M Espe, Neuss, Germany) were taken directly before surgery (T0), at suture removal (14 days post-surgery; T2), after 6 (T3) and 24 months (T4) of follow-up. At the end of surgery (T1) only clinical pictures were taken. The fixed prosthetic restoration was delivered 14 days after T2.
This article is protected by copyright. All rights reserved.
There was no standardization regarding the prosthetic protocol: each center was free to choose the most appropriate fixed prosthetic restoration for each patient. In order to measure tissue contour changes, master casts were fabricated from dental stone casts (GC Fujirock type 4, GC Corp., Tokyo, Japan) using the pre-surgery and followup impressions. The casts were then optically scanned with a CEREC scan utility (inEosX5, Sirona Dental Systems, Bensheim, Germany) resulting in digital STL files (Standard Tessellation Language). All study centers sent their impressions to Witten/Herdecke University, where all the scans were performed. One single expert evaluator (S.M.), unaware of the type of surgery performed, undertook all measurements.
This article is protected by copyright. All rights reserved.
There was no standardization regarding the prosthetic protocol: each center was free to choose the most appropriate fixed prosthetic restoration for each patient. In order to measure tissue contour changes, master casts were fabricated from dental stone casts (GC Fujirock type 4, GC Corp., Tokyo, Japan) using the pre-surgery and followup impressions. The casts were then optically scanned with a CEREC scan utility (inEosX5, Sirona Dental Systems, Bensheim, Germany) resulting in digital STL files (Standard Tessellation Language). All study centers sent their impressions to Witten/Herdecke University, where all the scans were performed. One single expert evaluator (S.M.), unaware of the type of surgery performed, undertook all measurements.
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