Evaluation of Occlusal Adjustment Material Removal on Monolithic Zirconia Blocks: An In Vitro Study

NCT ID: NCT07280130

Last Updated: 2025-12-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Total Enrollment

120 participants

Study Classification

OBSERVATIONAL

Study Start Date

2026-02-01

Study Completion Date

2027-12-31

Brief Summary

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This study aims to improve understanding of the amount of tooth-replacement material removed during a single grinding "stroke" performed in the adjustment of a zirconia crown. Zirconia is a highly durable ceramic material commonly used for dental restorations, and accurate adjustment is essential for achieving proper occlusion. However, existing literature does not provide quantitative data regarding material removal per stroke during chairside adjustment, resulting in reliance on individual clinical experience.

In this study, standardized zirconia specimens will be prepared and assigned to three operator groups: dental students, dental interns, and experienced clinicians. Each participant will perform a controlled number of grinding strokes on the specimens using a commonly used dental grinding stone. Specimens will be scanned before and after grinding using a three-dimensional scanner to precisely quantify material removal.

Hypothesis

The hypotheses of this study are:

Each grinding stroke results in a measurable and relatively consistent amount of zirconia material removal.

Experienced clinicians demonstrate more controlled and predictable material removal per stroke compared with students and interns.

Detailed Description

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Clinical occlusal adjustment requires precision within tens of micrometers; however, current literature lacks objective data regarding per-stroke material removal during chairside adjustment of monolithic zirconia. As a result, clinical decision-making largely depends on subjective judgment.

Objective

The objective of this study is to quantify material removal per single reciprocating grinding stroke on monolithic zirconia blocks using a silicon carbide grinding stone and to compare performance among operators with different levels of clinical experience.

Methods

Monolithic zirconia specimens (VITA YZ ST; dimensions: 8 × 2 × 15 mm) will be milled, sintered, and embedded into standardized holders. Operators will include 40 fourth-year dental students, 40 sixth-year dental interns, and 40 experienced clinicians. Each participant will perform 100 grinding strokes along an 8-mm linear path at a frequency of 100 strokes per minute, guided by a metronome.

Grinding will be performed using a silicon carbide stone (Dura-Green Stone HP 0031/PC2, SHOFU, Japan) operated at 20,000 rpm. Pre- and post-grinding scans will be obtained using a 3Shape F8 scanner. Scan datasets will be superimposed using feature-based alignment to calculate volumetric loss and thickness reduction, expressed as mm³ per stroke and µm per stroke, respectively.

Statistical Analysis

Mixed-effects models will be applied to evaluate group-by-stroke interactions. Reference intervals for material removal will be established, and results will be translated into a clinically applicable occlusal adjustment guide.

Expected Results

The study is expected to define the magnitude and variability of zirconia material removal per grinding stroke, identify differences in performance between operator experience levels, and highlight areas requiring targeted educational training.

Conclusion

This in vitro investigation will provide the first stroke-level quantitative evidence for monolithic zirconia occlusal adjustment. The findings are expected to enhance the accuracy of clinical decision-making, improve training assessment, and support evidence-based guidelines for zirconia crown adjustment.

Conditions

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Dental Occlusion Occlusal Wear of Teeth Fixed Dental Prosthesis

Keywords

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occlusal adjustment Monolithic zirconia Material removal Silicon carbide stone 3D scan registration

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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A.fourth-year dental students

Forty fourth-year dental students who have completed preclinical courses in operative dentistry, complete denture prosthodontics, and fixed prosthodontics (Part I). They have little to no experience in adjusting zirconia.

perform material removal on monolithic zirconia

Intervention Type PROCEDURE

Each participant will perform 100 strokes along an 8-mm path at a rate of 100 strokes per minute, guided by a metronome on the monolithic zirconia

B.sixth-year interns

Forty sixth-year dental interns. Each participant will be tested twice-once before and once near the end of their clinical training. A questionnaire will also record their prosthodontic clinical experience within the past year.

perform material removal on monolithic zirconia

Intervention Type PROCEDURE

Each participant will perform 100 strokes along an 8-mm path at a rate of 100 strokes per minute, guided by a metronome on the monolithic zirconia

C.clinicians

Forty licensed clinicians with 0-5 years of post-graduation experience (with practical experience in zirconia adjustment). A questionnaire will also document their clinical experience in prosthodontics.

perform material removal on monolithic zirconia

Intervention Type PROCEDURE

Each participant will perform 100 strokes along an 8-mm path at a rate of 100 strokes per minute, guided by a metronome on the monolithic zirconia

Interventions

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perform material removal on monolithic zirconia

Each participant will perform 100 strokes along an 8-mm path at a rate of 100 strokes per minute, guided by a metronome on the monolithic zirconia

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

Group A: Forty fourth-year dental students who have completed preclinical courses in operative dentistry, complete denture prosthodontics, and fixed prosthodontics (Part I). They have little to no experience in adjusting zirconia.

Group B: Forty sixth-year dental interns. Each participant will be tested twice-once before and once near the end of their clinical training. A questionnaire will also record their prosthodontic clinical experience within the past year.

Group C: Forty licensed clinicians with 0-5 years of post-graduation experience (with practical experience in zirconia adjustment). A questionnaire will also document their clinical experience in prosthodontics.

Exclusion Criteria

* Acute upper-limb/hand injuries or postoperative recovery within the past 3 months that may affect grip strength or fine motor control.
* Neuromuscular disorders or tremor/postural control impairments (e.g., essential tremor, peripheral neuropathy, moderate to severe carpal tunnel syndrome) that prevent stable operation.
* Uncorrected or inadequately corrected vision that does not meet the requirements for close-range tasks (e.g., inability to clearly see fine markings at a distance of 30-40 cm even with correction).
* Inability to follow the metronome rhythm (100 beats per minute).
Minimum Eligible Age

20 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Yihao Lan, DDS, MSD

Role: STUDY_DIRECTOR

National Taiwan University Hospital

Central Contacts

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Yihao Lan, DDS, MSD

Role: CONTACT

Phone: 0922901103

Email: [email protected]

Other Identifiers

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202510051RINA

Identifier Type: -

Identifier Source: org_study_id