A Comparative Clinical Assessment of Adjunctive Hyaluronic Acid With 3D Printed Versus Milled CAD CAM Provisional Dental Restorations on Active Periodontal Status and Surface Roughness and Biocompatibility

Experimental: Intervention Study Group

Group (A and B): 3D Printed Dental Restoration with hyaluronic acid and Milled CAD CAM Dental Restoration with hyaluronic acid.

Procedimento: commonly used hyaluronic Acid with both procedures 3D Printed Versus Milled CAD CAM Provisional Dental Restorations

• Tooth preparation will be performed following standardized prosthodontic guidelines
• 1.5-2 mm occlusal reduction
• 1-1.2 mm axial reduction
• Chamfer finish line
• Digital impressions will be obtained using an intraoral scanner.
• CAD/CAM Milled and 3D printed Provisionals will be fabricated
• Once the study restorations were finished, the intraoral optical impression was made.

While control both procedures will be done but without using hyaluronic acid

Comparador Ativo: Control Group

Group (C and D): 3D Printed Dental Restoration without hyaluronic acid and Milled CAD CAM Dental Restoration without hyaluronic acid

Procedimento: commonly used hyaluronic Acid with both procedures 3D Printed Versus Milled CAD CAM Provisional Dental Restorations

• Tooth preparation will be performed following standardized prosthodontic guidelines
• 1.5-2 mm occlusal reduction
• 1-1.2 mm axial reduction
• Chamfer finish line
• Digital impressions will be obtained using an intraoral scanner.
• CAD/CAM Milled and 3D printed Provisionals will be fabricated
• Once the study restorations were finished, the intraoral optical impression was made.

While control both procedures will be done but without using hyaluronic acid

Clinical Attachment Loss (CAL)

• will be measured clinically using UNC periodontal probe from cemento enamel junction to depth of periodontal pocket

bleeding on probing (BOP)

will be measured clinically using UNC periodontal probe. Count the bleeding points and divided them by the total number of patients' teeth in the oral cavity and multiply by 100 to make the percent.

localized less than 30% and generalized greater than or equal 30%

Plaque index (PI)

plaque index

This clinical method assesses the thickness of plaque specifically at the cervical margin (gumline).

The Scoring Scale (0 to 3):

0: No plaque in the gingival area.

1. A film of plaque visible only by running a probe across the tooth surface or after using a disclosing solution.
2. Moderate accumulation of plaque visible to the naked eye along the gumline.
3. Abundance of soft matter within the pocket or along the gumline

biocompatibility

• will be calculated through measuring Bop, gingival index, and plaque index as mentioned before.

Surface roughness

will be measured using a surface roughness measuring instrument (or profilometer) is a precision device used to evaluate the texture of a material by measuring microscopic peaks and valleys. They are essential for quality control in manufacturing to ensure components meet strict friction, wear, and coating adhesion standards.