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Avaliação digital de coroas pré-formadas para molares temporários: estudo comparativo de três materiais
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O presente estudo avaliou, em modelos digitais de 100 crianças e em oito molares decíduos (54, 55, 64, 65, 74, 75, 84 e 85), a correspondência entre as dimensões dentárias reais e as dimensões de coroas pré-formadas de três fabricantes (3MTM — aço inoxidável; NuSmile® — zircónia; Bioflx Kids-e-Dental — polímero de resina). Foram medidas oito dimensões por dente, incluindo as alturas das cúspides e as larguras mesiodistais em quatro locais (vestibular, oclusal, gengival e palatino/lingual), tanto nos dentes naturais como nas coroas digitalizadas, e simulou-se a seleção do tamanho pelo princípio da mínima medida superior (escolher a coroa cuja dimensão é a menor, mas ainda assim superior, à medida do dente). Os resultados mostram que as marcas não partilham proporções semelhantes entre si: os incrementos entre tamanhos são irregulares e os tamanhos de marcas diferentes não são equivalentes, reduzindo a previsibilidade entre tamanhos e exigindo uma seleção dente-a-dente baseada em medições objetivas. A marca 3MTM destacou-se pela maior amplitude dimensional, oferecendo mais soluções restauradoras e maior probabilidade de corresponder às necessidades dos pacientes; a NuSmile® evidenciou maior correspondência em parâmetros mais específicos como a altura da cúspide mesiovestibular e a dimensão mesiodistal palatina/lingual; a Bioflx Kids-e-Dental, embora apresente a menor amplitude dimensional, mostrou utilidade em medidas específicas. Em várias situações, as medidas padronizadas das coroas não coincidiram com as medidas reais dos dentes, originando registos sem correspondência, o que confirma que nenhuma marca satisfaz, por si só, todo o espectro morfológico observado. Em termos clínicos, a adoção sistemática de medições prévias e da seleção guiada pelo princípio da mínima medida superior pode reduzir sobre-/sub-ajuste, diminuir tentativas sucessivas e melhorar o selamento marginal e a previsibilidade do tratamento. No futuro, recomenda-se validação clínica in vivo por marca e tamanho, o desenvolvimento de ferramentas digitais que proponham automaticamente a coroa cuja dimensão é a menor imediatamente superior à do dente e o alargamento das gamas com incrementos mais finos, de modo a oferecer mais soluções e a reduzir a percentagem de medidas sem correspondência com coroa.
This study evaluated, using STL models from 100 children and eight primary molars (54, 55, 64, 65, 74, 75, 84, and 85), the correspondence between real tooth dimensions and the ranges of preformed crowns from three manufacturers (3MTM — stainless steel; NuSmile® — zirconia; Bioflx Kids-e-Dental — resin polymer). Eight dimensions were measured per tooth, including cusp heights and mesiodistal widths at four sites (buccal, occlusal, gingival, and palatal/lingual), both on teeth and on digitized crowns, and size selection was simulated according to the principle of the minimum superior measure—that is, choosing the crown whose dimension is the smallest value that still exceeds the tooth measurement. The results show that brands do not share similar proportions: increments between adjacent sizes are irregular, and nominal sizes from different brands are not equivalent, which reduces predictability across sizes and requires tooth-by-tooth selection based on objective measurements. 3MTM stood out for its greater dimensional span, offering more restorative solutions and a higher likelihood of meeting patient’s needs; NuSmile® showed better correspondence for specific parameters such as the height of the mesiobuccal cusp and the palatal/lingual mesiodistal dimension; Bioflx Kids-e-Dental, while having the smallest dimensional span, proved useful for specific measurements. In several situations, standardized crown measurements did not match actual tooth dimensions, leading to no-match records, confirming that no single brand covers the full morphological spectrum on its own. Clinically, systematic premeasurement and selection guided by the principle of the minimum superior measure can reduce over-/undersizing, decrease trial-and-error attempts, and improve marginal seal and treatment predictability. Looking ahead, we recommend in-vivo clinical validation by brand and size, the development of digital tools that automatically suggest the crown whose dimension is the smallest value still exceeding the tooth measurement, and the expansion of commercial ranges with finer size increments to offer more solutions and reduce the proportion of no-match cases.
This study evaluated, using STL models from 100 children and eight primary molars (54, 55, 64, 65, 74, 75, 84, and 85), the correspondence between real tooth dimensions and the ranges of preformed crowns from three manufacturers (3MTM — stainless steel; NuSmile® — zirconia; Bioflx Kids-e-Dental — resin polymer). Eight dimensions were measured per tooth, including cusp heights and mesiodistal widths at four sites (buccal, occlusal, gingival, and palatal/lingual), both on teeth and on digitized crowns, and size selection was simulated according to the principle of the minimum superior measure—that is, choosing the crown whose dimension is the smallest value that still exceeds the tooth measurement. The results show that brands do not share similar proportions: increments between adjacent sizes are irregular, and nominal sizes from different brands are not equivalent, which reduces predictability across sizes and requires tooth-by-tooth selection based on objective measurements. 3MTM stood out for its greater dimensional span, offering more restorative solutions and a higher likelihood of meeting patient’s needs; NuSmile® showed better correspondence for specific parameters such as the height of the mesiobuccal cusp and the palatal/lingual mesiodistal dimension; Bioflx Kids-e-Dental, while having the smallest dimensional span, proved useful for specific measurements. In several situations, standardized crown measurements did not match actual tooth dimensions, leading to no-match records, confirming that no single brand covers the full morphological spectrum on its own. Clinically, systematic premeasurement and selection guided by the principle of the minimum superior measure can reduce over-/undersizing, decrease trial-and-error attempts, and improve marginal seal and treatment predictability. Looking ahead, we recommend in-vivo clinical validation by brand and size, the development of digital tools that automatically suggest the crown whose dimension is the smallest value still exceeding the tooth measurement, and the expansion of commercial ranges with finer size increments to offer more solutions and reduce the proportion of no-match cases.
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Palavras-chave
Coroas pré-formadas Coroas metálicas Coroas cerâmicas Molares temporários Dimensões dentárias Preformed crowns Stainless steel crowns Ceramic crowns Primary molars DENTAL dimensions