Revolutionizing restorative dentistry: an overview

Understanding the Complexities of Cast Post Retention: A Comprehensive Review of Influential Factors

This comprehensive review delves into the intricate landscape of cast post retention in restorative dentistry, encompassing historical perspectives, contemporary techniques, and future directions. Examining factors ranging from tooth-related considerations to prosthesis-related dynamics, the review provides a detailed analysis of clinical techniques, including step-by-step procedures, common challenges, and innovative advancements. Technological breakthroughs, such as digital impressions, computer-aided design and computer-aided manufacturing (CAD/CAM) technology, three-dimensional (3D) printing, and finite element analysis, are explored for their transformative impact on precision and customization. The discussion extends to the promising future of cast post retention, emphasising emerging materials, the integration of artificial intelligence in treatment planning, and patient-specific approaches. Implications for clinical practice underscore the importance of individualised treatment planning and the adoption of advanced technologies. Recommendations for future research advocate for comprehensive long-term clinical studies, investigations into AI-driven treatment planning, and a focus on patient outcomes and satisfaction. This review consolidates existing knowledge and anticipates a future marked by enhanced precision, individualised care, and improved long-term success in cast post-retained restorations.

Students' perceptions and attitudes about digital dental technology is associated with their intention to use it

PURPOSE/OBJECTIVES

To investigate factors associated with predoctoral students' intention to use dental technology in future practice using the theory of planned behavior.

METHODS

A comprehensive survey was developed consisting of 29 questions grouped in three main domains: knowledge, perception, and suggestions. After students had completed their digital dentistry didactic courses in 2019, the University of Iowa-College of Dentistry and Dental Clinics D2, D3, and D4 classes completed the survey. The D1 class was excluded because they had not finished their digital dentistry didactic courses. The survey data were tabulated for each class separately to compare trends among classes. Each response was analyzed individually before creating scores for the various subdomains. A linear regression analysis was used to create the final model for the outcome variable (intention to use technology).

RESULTS

The response rate was 95% (n = 232). The mean age of participants was 25.7 years (SD = 2.7). There were significant differences between the classes in their knowledge (p < 0.0001), perceived quality of training (p < 0.0001), and all perceptions related to digital dentistry. Controlling for significant covariates among higher level students, there were significant associations between intention to use dental technology and greater knowledge scores (p = 0.05), attitude (p < 0.0001), subjective social norms (p = 0.02), and perceived control on the future use of technology (p < 0.0001).

CONCLUSIONS

Students may be motivated to use digital technology when they have good knowledge, feel that others are using it or endorsing its use, and perceive that they have control in their future practice.

Digital versus conventional workflow for the fabrication of physical casts for fixed prosthodontics: A systematic review of accuracy

STATEMENT OF PROBLEM

A consensus on the accuracy of additively manufactured casts in comparison with those fabricated by using conventional techniques for fixed dental prostheses is lacking.

PURPOSE

The purpose of this systematic review was to determine the accuracy of additively manufactured casts for tooth- or implant-supported fixed dental prostheses in comparison with that of gypsum casts.

MATERIAL AND METHODS

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (CDR42020161006). Eight databases were searched in December 2019 and updated in September 2020. Studies evaluating the dimensional accuracy of additively manufactured casts for fixed dental prostheses in comparison with that of gypsum casts were included. An adapted checklist for reporting in vitro studies (Checklist for Reporting In vitro Studies guidelines) was used to assess the risk of bias.

RESULTS

Eight studies evaluating tooth-supported fixed dental prosthesis casts and 7 studies evaluating implant-supported fixed dental prosthesis casts were eligible for this review. Gypsum casts showed greater accuracy (trueness and precision) in most studies, although additively manufactured casts also yielded highly precise data. One study was associated with a low risk of bias, 9 with a moderate risk of bias, and 5 with a high risk of bias.

CONCLUSIONS

In vitro studies showed that additively manufactured casts and gypsum casts share similar accuracy within the acceptable range for the fabrication of casts. The quality of scanned data, additive manufacture technology, printing settings, and postprocessing procedures plays an essential role in the accuracy of additively manufactured casts. Clinical studies are required to confirm these findings.

Prospects of nanodentistry for the diagnosis and treatment of maxillofacial pathologies and cancers

Despite the commendable milestones achieved in molecular maxillofacial pathology in the last decade, there remains a paucity of utilization of ancillary nanomolecular tools that complement the omics-based approaches. As the advent of omics science transforms our understanding of tumour biology from a phenomenological to a complex network (systems-oriented) paradigm, several ancillary tools have emerged to improve the scope of individualized medicine. Targeted nano drug delivery systems have significantly reduced toxicity of chemotherapeutic agents in a precise manner. Many conventional cancer therapies are limited in efficacy and this has led to the emergence of nanomedical innovations. Despite the success of nanomedicine, a major challenge that persists is tumour heterogeneity and biological complexity. A good understanding of the interaction between inorganic nanoparticles and the biological systems has led to the development of better tools for individualized medicine. Tools such as the composite organic-inorganic nanoparticles (COINs) and the quantum dots (QD) have significantly improved the identification and quantification of disease biomarkers, histopathological detection methods, as well as improving the clinical translation and utility of these nanomaterials. Nanomedicine has lent credence to several multipronged theranostic applications in medicine, and this has improved the medical practice tremendously. Despite the palpable influence of nanomedicine on the delivery of individualized medical therapies, the term "nanodentistry" remains in the background without much hype, albeit some progress has been made in this area. Hence, this review discusses the potential and challenges of nanodentistry in the diagnosis and treatment of maxillofacial pathologies, particularly cancer in resource-limited settings.

Additive manufacturing of dental polymers: An overview on processes, materials and applications

Additive manufacturing (AM) processes are increasingly used in dentistry. The underlying process is the joining of material layer by layer based on 3D data models. Four additive processes (laser stereolithography, polymer jetting, digital light processing, fused deposition modeling) are mainly used for processing dental polymers. The number of polymer materials that can be used for AM in dentistry is small compared to other areas. Applications in dentistry using AM are limited (e.g. study models, maxillo-facial prostheses, orthodontic appliances etc.). New and further developments of materials are currently taking place due to the increasing demand for safer and other applications. Biocompatibility and the possibility of using materials not only as temporarily but as definitive reconstructions under oral conditions, mechanically more stable materials where less or no post-processing is needed are current targets in AM technologies. Printing parameters are also open for further development where optical aspects are also important.

Use of Digital Technology to Improve Objective and Reliable Assessment in Dental Student Simulation Laboratories

The aim of this study was to assess inter-and intra-grader agreement with the use of digital scanning and a tooth preparation assessment software program in comparison to the current traditional visual grading method in a dental student simulation laboratory. Students' typodont teeth preparations from previous practical examinations were used (cast crown n=50; cast fixed partial denture abutments n=50). Five preclinical instructors received calibration training and evaluated each of the preparations by the traditional visual grading method using a rubric. The same preparations were assessed by the same instructors using a tooth preparation assessment software program (PrepCheck, Sirona). The results showed that intra-grader agreement was significantly higher when grades were determined by PrepCheck compared to the traditional visual grading method. The traditional method was associated with significantly greater inter-grader disagreement in comparison to grading using PrepCheck (p<0.05). When the average final grade for students' crown preparations by each grader was compared for the traditional method and PrepCheck, significant differences were found for all graders (p<0.001). In this study, the use of the PrepCheck software program greatly improved intra-and inter-grader agreement during grading in a student simulation laboratory. Digital technology may improve the objectivity and reliability of assessments by preclinical evaluators.

Evaluating the effectiveness of a preclinical practice of tooth preparation using digital training system: A randomised controlled trial

PURPOSE

This study aimed to evaluate the effectiveness of preclinical training on ceramic crown preparation using digital training system compared with traditional training method.

MATERIALS AND METHODS

A sample of 66 participating fourth-year undergraduate dental students were randomly assigned to one of two groups for ceramic crown preparation: experimental group as trained using digital method with Online Peer-Review System (OPRS) and Real-time Dental Training and Evaluation System (RDTES); control group as trained using traditional method with instructor demonstration and evaluation. At the completion of training periods, both groups performed the preparation of ceramic crown of upper left central incisor, which were blindly scored by the experienced instructors under the pre-defined assessment criteria. The results of both were compared using Student's t-test or Wilcoxon signed rank test. The level of significance was P < .05. The questionnaires regarding the benefits or drawbacks of digital training system were answered by the students of experimental group.

RESULTS

Five of 15 items in the assessment outcome of the digital group were significantly better than the traditional group. The questionnaire results from the students of the experimental group indicated 96.97% of the students agreed or strongly agreed that using digital training system could better improve the practical ability than traditional method. The total scores of practical results were significantly positively correlated with the points of the questionnaires.

CONCLUSION

The digital training system with OPRS and RDTES might be a good alternative to the traditional training method in the preclinical course of dental practice.

Management of Tooth Surface Loss of Varying Etiology with Full Mouth all Ceramic Computer-Aided Design/Computer-Aided Manufacture Restorations

The anatomical form of a tooth can undergo changes leading to loss of tooth form. The loss of tooth surface can be due to varying etiology. Dental caries, attrition, abrasion, erosion, involving any surface of the tooth can lead to loss of tooth structure. The rate of tooth destruction may proceed to such an extent that the esthetics, function and comfort may be lost. The role of a practioner lies in identification and screening of such case and motivate for oral rehabilitation that includes habit cessation. Computerized dentistry has raised the bar as far as esthetic restorations are concerned. Demanding esthetics has made zirconia crowns as the material of choice in full mouth rehabilitations. However, appropriate treatment planning with scientific evidence and a recommended treatment protocol with careful implementation results in successful restorations and satisfied patients.