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Revilla-León M, Gómez-Polo M, Sailer I, Kois JC, Rokhshad R. An overview of artificial intelligence based applications for assisting digital data acquisition and implant planning procedures. J ESTHET RESTOR DENT 2024. [PMID: 38757761 DOI: 10.1111/jerd.13249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES To provide an overview of the current artificial intelligence (AI) based applications for assisting digital data acquisition and implant planning procedures. OVERVIEW A review of the main AI-based applications integrated into digital data acquisitions technologies (facial scanners (FS), intraoral scanners (IOSs), cone beam computed tomography (CBCT) devices, and jaw trackers) and computer-aided static implant planning programs are provided. CONCLUSIONS The main AI-based application integrated in some FS's programs involves the automatic alignment of facial and intraoral scans for virtual patient integration. The AI-based applications integrated into IOSs programs include scan cleaning, assist scanning, and automatic alignment between the implant scan body with its corresponding CAD object while scanning. The more frequently AI-based applications integrated into the programs of CBCT units involve positioning assistant, noise and artifacts reduction, structures identification and segmentation, airway analysis, and alignment of facial, intraoral, and CBCT scans. Some computer-aided static implant planning programs include patient's digital files, identification, labeling, and segmentation of anatomical structures, mandibular nerve tracing, automatic implant placement, and surgical implant guide design.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Research and Digital Dentistry, Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, Complutense University of Madrid, Madrid, Spain
- Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Irena Sailer
- Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - John C Kois
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - Rata Rokhshad
- Topic Group Dental Diagnostics and Digital Dentistry, ITU/WHO Focus Group AI on Health, Berlin, Germany
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Pilecco RO, Machry RV, Baldi A, Tribst JPM, Sarkis-Onofre R, Valandro LF, Kleverlaan CJ, Scotti N, Pereira GKR. Influence of CAD-CAM milling strategies on the outcome of indirect restorations: A scoping review. J Prosthet Dent 2024; 131:811.e1-811.e10. [PMID: 38480018 DOI: 10.1016/j.prosdent.2024.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/19/2024] [Accepted: 02/20/2024] [Indexed: 05/13/2024]
Abstract
STATEMENT OF PROBLEM The influence of computer-aided manufacturing (CAM) parameters and settings on the outcomes of milled indirect restorations is poorly understood. PURPOSE The purpose of this scoping review was to summarize the current CAM systems, parameters, and setting changes, and their effects on different outcomes of milled indirect restorations and aspects related to their manufacture. MATERIAL AND METHODS The protocol of this review is available online (https://osf.io/x28ps/). Studies that used at least 2 different parameters (CAM units, number of axes, digital spacers, or protocols with different rotatory instruments, grit-sizes, milling speed, or others) for milling indirect restorations were included. A structured search up to July 2023 was performed by 2 independent reviewers for articles written in English in LILACS, MEDLINE via PubMed, EMBASE, Web of Science, and Scopus. RESULTS Of 1546 studies identified, 22 were included in the review. Discrepancies were found between the planned and actual measured cement space, with a decreasing linear relationship impacting restoration adaptation at different points. The CEREC MC XL milling machine was the most used system in the included studies, with variations in bur types, milling modes, and number of burs uses affecting internal fit and surface trueness. The results demonstrated the better adaptation of restorations made with 5-axis over 3-axis milling machines. Lithium disilicate and zirconia were the most commonly used materials, and crowns and inlays were popular designs. Marginal and internal adaptation were the primary outcomes assessed using the various techniques. CONCLUSIONS The study presented a comprehensive exploration of CAM systems and parameters, and their influence on indirect restorations. The planned cement space was not properly reproduced by the milling. Bur characteristics can affect restoration fit and trueness. The 5-axis units seem to result in better-adapted restorations compared with 3- and 4-axis units.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Postgraduate student, Postgraduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Renan Vaz Machry
- Postdoctoral student, Postgraduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Andrea Baldi
- Postdoctoral student, Department of Surgical Sciences, Dental School, Turin, Italy
| | - João Paulo Mendes Tribst
- Assistant Professor, Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands.
| | - Rafael Sarkis-Onofre
- Associate Professor, Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Brazil
| | - Luiz Felipe Valandro
- Full Professor, Postgraduate Program in Oral Sciences (Prosthodontics Unit), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - Cornelis Johannes Kleverlaan
- Full Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands
| | - Nicola Scotti
- Associate Professor, Department of Surgical Sciences, Dental School, Turin, Italy
| | - Gabriel Kalil Rocha Pereira
- Adjunct Professor, Postgraduate Program in Oral Sciences (Prosthodontics Unit), Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Revilla-León M, Fernández-Estevan L, Barmak AB, Kois JC, Alonso Pérez-Barquero J. Accuracy of maximum intercuspal position located by using four intraoral scanners and an artificial intelligence-based program. J Prosthet Dent 2024:S0022-3913(24)00193-8. [PMID: 38604907 DOI: 10.1016/j.prosdent.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
STATEMENT OF PROBLEM Maxillary and mandibular scans can be articulated in maximum intercuspal position (MIP) by using an artificial intelligence (AI) based program; however, the accuracy of the AI-based program locating the MIP relationship is unknown. PURPOSE The purpose of the present clinical study was to assess the accuracy of the MIP relationship located by using 4 intraoral scanners (IOSs) and an AI-based program. MATERIAL AND METHODS Conventional casts of a participant mounted on an articulator in MIP were digitized (T710). Four groups were created based on the IOS used to record a maxillary and mandibular scan of the participant: TRIOS4, iTero, i700, and PrimeScan. Each pair of nonarticulated scans were duplicated 20 times. Three subgroups were created: IOS, AI-articulated, and AI-IOS-corrected subgroups (n=10). In the IOS-subgroup, 10 duplicated scans were articulated in MIP by using a bilateral occlusal record. In the AI-articulated subgroup, the remaining 10 duplicated scans were articulated in MIP by using an AI-based program (BiteFinder). In the AI-IOS-corrected subgroup, the same AI-based program was used to correct the occlusal collisions of the articulated specimens obtained in the IOS-subgroup. A reverse engineering program (Geomagic Wrap) was used to calculate 36 interlandmark measurements on the digitized articulated casts (control) and each articulated specimen. Two-way ANOVA and pairwise multiple comparison Tukey tests were used to analyze trueness (α=.05). The Levene and pairwise multiple comparison Wilcoxon rank tests were used to analyze precision (α=.05). RESULTS Significant trueness discrepancies among the groups (P<.001) and subgroups (P<.001) were found, with a significant interaction group×subgroup (P<.001). The Levene test showed significant precision discrepancies among the groups (P<.001) and subgroups (P=.005). The TRIOS4 and iTero groups obtained better trueness and lower precision than the i700 and PrimeScan systems. Additionally, the AI-articulated subgroup showed worse trueness and precision than the IOS and AI-IOS-corrected subgroups. The AI-based program improved the MIP trueness of the scans articulated by using the iTero and PrimeScan systems but reduced the MIP trueness of the articulated scans obtained by using the TRIOS4 and i700. CONCLUSIONS The trueness and precision of the maxillomandibular relationship was impacted by the IOS system and program used to locate the MIP.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director, Research and Digital Dentistry, Kois Center, Seattle, Wash; and Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass.
| | - Lucía Fernández-Estevan
- Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Abdul B Barmak
- Associate Professor, Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - John C Kois
- Founder and Director, Kois Center, Seattle, Wash.; Affiliate Professor, Graduate in Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash.; and Private practice, Seattle, Wash
| | - Jorge Alonso Pérez-Barquero
- Associate Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Zhou Y, Fu L, Zhang Z, Tang X. Effect of tooth color on the accuracy of intraoral complete arch scanning under different light conditions using a zirconia restoration model. J Prosthet Dent 2024; 131:145.e1-145.e8. [PMID: 37923645 DOI: 10.1016/j.prosdent.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023]
Abstract
STATEMENT OF PROBLEM Information regarding the effect of tooth color under different light conditions on the accuracy of intraoral complete arch scanning is limited. PURPOSE The purpose of this in vitro study was to evaluate the effect of color and ambient light conditions on the accuracy of mandibular complete arch scanning with an intraoral scanner (IOS) using a zirconia restoration model with different shades. MATERIAL AND METHODS Five mandible dentition models with zirconia restorations of different shades were fabricated by computer-aided design and computer-aided manufacturing (CAD-CAM). The spectral reflectance and transmittance curves were collected with a spectrophotometer to determine color parameters (Rb, T, S+A, L*, a*, b*, C*, and h). Under 4 different lighting conditions: no light (ZL), natural light (NL), room light (RL), and chair light (CL), each model was scanned 10 times by using an IOS (TRIOS 3). Three-dimensional (3D) deviation analysis and a linear deviation analysis were performed for an accurate quantitative measurement of intraoral scanning. The multivariate test was used to determine significant differences in 3D deviation and linear deviation among groups. The multiple linear regression test was conducted to investigate the relevant independent factors of mean absolute 3D deviation. RESULTS The 3D deviation analysis showed that the mean absolute 3D deviation of 3M2 model scanning was the lowest (P<.001). Moreover, under CL and RL, the accuracy results from the 3M2 model scan were demonstrated as significantly better than the tested scans under other light conditions (P=.021). The result of the linear deviation analysis indicated that the variation in distance was only significant between the bilateral canines (P=.032). Ambient light conditions, C*, and h were factors influencing mean absolute 3D deviation (R2=0.593, P<.001). CONCLUSIONS Color change influenced the accuracy of intraoral mandibular complete arch scanning under different light conditions. This effect may be attributable to the interaction between the ambient light condition and color parameters such as C* and h.
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Affiliation(s)
- Yong Zhou
- Associate Professor, Department of Dental Implantology, College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research, Hefei, Anhui, PR China
| | - Lijuan Fu
- Graduate student, College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research, Hefei, Anhui, PR China
| | - Zhoujing Zhang
- Graduate student, College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research, Hefei, Anhui, PR China
| | - Xuyan Tang
- Associate Professor, Department of Prosthodontics, College & Hospital of Stomatology, Anhui Medical University, Key Laboratory of Oral Diseases Research, Hefei, Anhui, PR China..
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Liu CT, Chen JH, Du JK, Hung CC, Lan TH. Accuracy comparison of scan segmental sequential ranges with two intraoral scanners for maxilla and mandible. J Dent Sci 2024; 19:466-472. [PMID: 38303839 PMCID: PMC10829747 DOI: 10.1016/j.jds.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/04/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose The accuracy of a full-arch scan by using an intraoral scanner should be validated under clinical conditions. This study aimed to compare the accuracy of full-arch digital impressions in the maxilla and mandible using two intra oral scanners with three different scan segmental sequential ranges. Materials and methods A dental model with 28 teeth in their normal positions served as the reference. Sixty full-arch scans were performed using Trios 3 and Trios 4, employing scanning strategy O (manufacturer's original method), OH (segmental sequential ranges one half), and TQ (segmental sequential ranges third quarter). Trueness was evaluated by comparing digital impressions with a reference dataset using specialized software. One-way ANOVA and Tukey tests assessed differences between the groups. Results For Trios 3 on the maxilla, no significant difference was found among the groups of trueness; in the mandible, strategy O exhibited a significant difference (P = 0.008) with the highest deviation. For Trios 4 on the maxilla, strategy TQ demonstrated the lowest deviation with a significant difference (P = 0.006); in the mandible, no significant difference was found among the groups of trueness. Conclusion Strategy TQ exhibited the best trueness for Trios 3 and Trios 4, suggesting it may be preferred for higher accuracy. Clinicians should consider these findings when selecting scanning strategies and intraoral scanners for specific cases.
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Affiliation(s)
- Chih-Te Liu
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jen-Hao Chen
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Je-Kang Du
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Cheng Hung
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Ting-Hsun Lan
- Division of Prosthodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Revilla-León M, Gómez-Polo M, Kois JC. A guide for selecting the intraoral scan extension when fabricating tooth- and implant-supported fixed dental prostheses. J ESTHET RESTOR DENT 2024; 36:85-93. [PMID: 37789708 DOI: 10.1111/jerd.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVES To describe a new classification for intraoral scans based on the scan extension and to introduce a decision guideline to choose the scan extension for fabricating tooth- and implant-supported fixed dental prostheses (FDPs). OVERVIEW Multiple operator- and patient-related factors have been identified that can decrease the scanning accuracy of intraoral scanners (IOSs), including scan extension. However, the decision criteria for selecting scan extension for fabricating tooth- and implant-supported restorations is unclear. Based on the extension of the intraoral digital scans, three types of scans can be defined: half-arch (anterior or posterior), extended half-arch, and complete-arch scan. Variables to consider when choosing the scan extension include the number and location of units being restored, as well as the extension and location of edentulous areas. Additionally, the accuracy of the virtual definitive cast and the accuracy of the maxillomandibular relationship captured by using IOSs should be differentiated. CONCLUSIONS A decision tree for selecting the scan extension is presented. The decision is based on the number and location of units being restored, and the extension and location of edentulous areas. Intraoral scans with reduced scan extension are indicated when fabricating tooth- and implant-supported crowns or short-span fixed prostheses, when the patient does not have more than one missing tooth in the area of the dental arch included in the scan. For the remaining clinical conditions, complete-arch intraoral scans are recommended. CLINICAL SIGNIFICANCE Scan extension is a clinician's decision that should be based on the number and location of units being restored and the extension and location of edentulous areas. Intraoral scans with a reduced scan extension is recommended, when possible.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - John C Kois
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
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Bandiaky ON, Clouet R, Le Bars P, Soueidan A, Le Guehennec L. Marginal and internal fit of five-unit zirconia-based fixed dental prostheses fabricated with digital scans and conventional impressions: A comparative in vitro study. J Prosthodont 2023; 32:846-853. [PMID: 36627825 DOI: 10.1111/jopr.13639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/12/2022] [Accepted: 12/18/2022] [Indexed: 01/12/2023] Open
Abstract
PURPOSE This study aimed to compare the marginal and internal fit of five-unit zirconia-based fixed dental prostheses (FDPs) fabricated using digital scans and conventional impressions. MATERIALS AND METHODS Nine master models with three zirconia abutments were scanned with an intraoral scanner (test group), and nine conventional impressions (control group) of these same models were also made. The stone casts from these impressions were scanned with a laboratory extraoral scanner (D700, 3Shape, Copenhagen, Denmark). A total of 18 five-unit zirconia-based FDP frameworks (test group, n = 9; control group, n = 9) were manufactured. Marginal and internal fit (in μm) were evaluated using the replica method under micro-computed tomography. Analysis of variance (one-way ANOVA) and Kruskal-Wallis tests were used to compare continuous variables across two groups. A level of p < 0.05 was accepted as statistically significant. RESULTS The mean ± standard deviation of the marginal fit was 95.03 ± 12.74 μm in the test group and 106.02 ± 14.51 μm in the control group. The lowest marginal mean value was observed in the test group, with a statistically significant difference compared to the control group (F = 14.56, p < 0.05). The mean ± standard deviation of the internal fit was 103.61 ± 9.32 and 106.38 ± 7.64 μm, respectively, in the test and control groups, with no statistically significant difference (F = 1.56, p > 0.05). The mean values of both groups were clinically acceptable. CONCLUSIONS The five-unit zirconia-based FDPs fabricated with digital scans showed better fit than those in the conventional impression group. Within the limitations of this study, these results are encouraging, and continued progress in the digital field should allow for more accurate long-span restorations.
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Affiliation(s)
- Octave Nadile Bandiaky
- Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
| | - Roselyne Clouet
- Department of Prosthetic Dentistry, Nantes University, CHU Nantes, Nantes, France
| | - Pierre Le Bars
- Department of Prosthetic Dentistry, Nantes University, CHU Nantes, Nantes, France
| | - Assem Soueidan
- Department of Periodontology, Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
| | - Laurent Le Guehennec
- Department of Prosthodontics, Nantes University, Oniris, Univ Angers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, Nantes, France
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Akl MA, Daifallah K, Pérez-Barquero JA, Barmak AB, Wee AG, Revilla-León M. Influence of interdental spaces and the palate on the accuracy of maxillary scans acquired using different intraoral scanners. J Prosthodont 2023; 32:125-134. [PMID: 37591814 DOI: 10.1111/jopr.13748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 08/19/2023] Open
Abstract
PURPOSE To assess the influence of interdental spaces and scanning the palate on the accuracy of maxillary scans acquired using three intraoral scanners (IOSs). MATERIALS AND METHODS A virtual completely dentate maxillary cast without interdental spaces was obtained and modified to create 1, 2, and 3 mm of interdental spacing between the anterior teeth. These three files (reference standard tessellation language files) were used to print three reference casts. The reference casts were scanned using three IOSs: TRIOS4, iTero Element 5D, and Aoralscan2. Three groups were created based on the interdental spaces: 0, 1, 2, and 3 mm (n = 10). The groups were subdivided into two subgroups: no palate (NP subgroup) and palate (P subgroup). The reference STL files were used to measure the discrepancy with the experimental scans by calculating the root mean square (RMS) error. Three-way analysis of variance (ANOVA) and post hoc Tukey pairwise comparison tests were used to analyze trueness. The Levene test was used to analyze precision (α = 0.05). RESULTS Trueness ranged from 91 to 139 μm and precision ranged from 5 to 23 μm among the subgroups tested. A significant correlation was found between IOS*group (p<0.001) and IOS*subgroup ( p<0.001). Tukey test showed significant trueness differences among the interdental spaces tested (p<0.001). The 1- and 2-mm groups obtained better trueness than the 0- and 3-mm groups (p<0.001). An 11 μm mean trueness discrepancy was measured among the different interdental space groups tested. The P subgroups demonstrated significantly higher trueness when compared to the NP subgroups (p<0.001). The discrepancy between the maxillary scans with and without the palate was 4 μm. Significant precision discrepancies were found (p = 0.008), with the iTero group showing the lowest precision. CONCLUSION Interdental spaces and incorporation of the palate on maxillary intraoral scans influenced trueness and precision of the three IOSs tested. However, the scanning discrepancy measured may be of no clinical relevance.
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Affiliation(s)
- Mohammed A Akl
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States
| | - Khaled Daifallah
- Division of Prosthodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Abdul B Barmak
- Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Alvin G Wee
- Division of Prosthodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minnesota, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
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Fawaz P, Sayegh PE, Vannet BV. What is the current state of artificial intelligence applications in dentistry and orthodontics? JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101524. [PMID: 37270174 DOI: 10.1016/j.jormas.2023.101524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/08/2023] [Accepted: 05/31/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND The use of Artificial Intelligence (AI) in the medical field has the potential to bring about significant improvements in patient care and outcomes. AI is being used in dentistry and more specifically in orthodontics through the development of diagnostic imaging tools, the development of treatment planning tools, and the development of robotic surgery. The aim of this study is to present the latest emerging AI softwares and applications in dental field to benefit from. TYPES OF STUDIES REVIEWED Search strategies were conducted in three electronic databases, with no date limits in the following databases up to April 30, 2023: MEDLINE, PUBMED, and GOOGLE® SCHOLAR for articles related to AI in dentistry & orthodontics. No inclusion and exclusion criteria were used for the selection of the articles. Most of the articles included (n = 79) are reviews of the literature, retro/prospective studies, systematic reviews and meta-analyses, and observational studies. RESULTS The use of AI in dentistry and orthodontics is a rapidly growing area of research and development, with the potential to revolutionize the field and bring about significant improvements in patient care and outcomes; this can save clinicians' chair-time and push for more individualized treatment plans. Results from the various studies reported in this review are suggestive that the accuracy of AI-based systems is quite promising and reliable. PRACTICAL IMPLICATIONS AI application in the healthcare field has proven to be efficient and helpful for the dentist to be more precise in diagnosis and clinical decision-making. These systems can simplify the tasks and provide results in quick time which can save dentists time and help them perform their duties more efficiently. These systems can be of greater aid and can be used as auxiliary support for dentists with lesser experience.
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Affiliation(s)
- Paul Fawaz
- Academic Lecturer & Researcher at the Orthodontic department Université de Lorraine, Nancy, France.
| | | | - Bart Vande Vannet
- Clinical and Academical responsable of the Orthodontic department at Université de Lorraine, Nancy, France.
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Vitai V, Németh A, Sólyom E, Czumbel LM, Szabó B, Fazekas R, Gerber G, Hegyi P, Hermann P, Borbély J. Evaluation of the accuracy of intraoral scanners for complete-arch scanning: A systematic review and network meta-analysis. J Dent 2023; 137:104636. [PMID: 37516338 DOI: 10.1016/j.jdent.2023.104636] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 07/11/2023] [Accepted: 07/25/2023] [Indexed: 07/31/2023] Open
Abstract
OBJECTIVES This network meta-analysis (NMA) aimed to compare the complete-arch scanning accuracy of different intraoral scanners (IOSs) to that of reference standard tessellation language (STL) files. DATA Studies comparing the trueness and precision of IOS STL files with those of reference STL scans for different arch types (dentate, edentulous, completely edentulous with implants, and partially edentulous with implants) were included in this study. SOURCES An electronic search of five databases restricted to the English Language was conducted in October 2021. STUDY SELECTION A total of 3,815 studies were identified, of which 114 were eligible for inclusion. After study selection and data extraction, pair-wise comparison and NMA were performed to define the accuracy of scanning for four arch subgroups using four outcomes (trueness and precision expressed as mean absolute deviation and root mean square values). Cochrane guidelines and the QUADAS-2 tool were used to assess the risk of bias. GRADE was used for certainty assessment. RESULTS Fifty-three articles were included in this NMA. Altogether, 26 IOSs were compared directly and indirectly in 10 network systems. The accuracy of IOSs scans were not significantly different from the reference scans for dentate arches (three IOSs), edentulous arches (three IOSs), and completely edentulous arches with implants (one IOS). The accuracy of the IOSs was significantly different from the reference scans for partially edentulous arches with implants. Significant accuracy differences were found between the IOSs, regardless of clinical scenarios. CONCLUSIONS The accuracy of complete-arch scanning by IOSs differs based on clinical scenarios. CLINICAL SIGNIFICANCE Different IOSs should be used according to the complete arch type.
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Affiliation(s)
- Viktória Vitai
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Anna Németh
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Eleonóra Sólyom
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - László Márk Czumbel
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Réka Fazekas
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
| | - Gábor Gerber
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Section of Oral Morphology, Department of Anatomy Histology and Embryology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hermann
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Judit Borbély
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Budapest, Hungary.
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11
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Gómez-Polo M, Immorlano MG, Cascos-Sánchez R, Ortega R, Barmak AB, Kois JC, Revilla-León M. Influence of the dental arch and number of cutting-off and rescanning mesh holes on the accuracy of implant scans in partially edentulous situations. J Dent 2023; 137:104667. [PMID: 37595865 DOI: 10.1016/j.jdent.2023.104667] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 08/03/2023] [Accepted: 08/16/2023] [Indexed: 08/20/2023] Open
Abstract
OBJECTIVES To evaluate the influence of the dental arch and cutting-off and rescanning procedures on the accuracy of complete-arch implant scans in partially edentulous arches. MATERIAL AND METHODS A maxillary and a mandibular partially edentulous typodont with implant abutment analogs placed in the right and left first molar and right central incisor sites were digitized to create reference models by using an industrial optical scanner (7 Series Desktop Scanner; Dentalwings). Two experimental groups were scanned using an intraoral scanner (IOS) (TRIOS 4; 3Shape A/S): the Maxillary group (Mx) and the Mandibular group (Mb). Four subgroups were generated depending on the number of rescanned mesh holes: No holes (Mx-G0, Mb-G0), 1 hole (Mx-G1, Mb-G1), 2 holes (Mx-G2, Mb-G2) and 3 holes (Mx-G3, Mb-G3). A 3-dimensional metrology software (Geomagic Control X; 3D Systems) was used to measure the difference between the reference and the experimental scans computing the root mean square (RMS) error calculation. Two-way ANOVA and a post-hoc Tukey test were used to analyze the trueness data (α=0.05). Levene test was used to evaluate the prevision (α=0.05). RESULTS The Mx group obtained a trueness mean value of 54 ± 17 µm and a mean precision value of 54 ± 17 µm, while the Mb group presented a trueness mean value of 67 ± 23 µm and a mean precision value of 66 ± 22 µm. The Mx group demonstrated significantly better trueness than the Mb group (P<.001). The G0 and G1 subgroups had the highest trueness values among the subgroups tested. No significant difference was observed between G0 and G1, G1 and G2, and G2 and G3 subgroups in trueness and precision. However, the G0 had significantly better trueness and precision values compared to G2 and G3 subgroups. In addition, the G1 had significantly better trueness values than the G3 subgroup. However, the Levene test revealed no difference in the precision mean values among the subgroups tested. CONCLUSIONS Implant scanning trueness was affected by the dental arch and the number of rescanned mesh holes using the IOS tested. A higher number of rescanned mesh holes decreased the scanning trueness. The stitching algorithm of the IOS software tested after the mesh hole scan demonstrated a significant error, especially when multiples mesh holes are involved in the same arch. CLINICAL SIGNIFICANCE Given that cutting-off and rescanning techniques can reduce trueness, clinicians should consider whether these techniques are necessary in complete digital workflows. This is particularly important when fabricating multiple single implant-supported restorations in the same arch.
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Affiliation(s)
- Miguel Gómez-Polo
- Associate Professor Department of Conservative Dentistry and Prosthodontics, Director of postgraduate program of Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - Marina García Immorlano
- Postgraduate Specialist in Advanced-Prosthodontics. Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Cascos-Sánchez
- Postgraduate Specialist in Advanced in Implant-Prosthodontics, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Ortega
- Adjunct Professor Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
| | - Abdul B Barmak
- Assistant Professor Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY USA
| | - John C Kois
- Founder and Director Kois Center, Seattle, WA; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, WA; and Private Practice, Seattle, WA USA
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, WA; and Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, MA USA
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Mahat NS, Shetty NY, Kohli S, Jamayet NB, Patil P. Clinical outcomes of implant-supported and tooth-supported fixed prostheses fabricated from digital versus analogue impression: a systematic review and meta-analysis. Evid Based Dent 2023; 24:142. [PMID: 37369705 DOI: 10.1038/s41432-023-00904-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/15/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE To analyze the clinical outcomes of implant-supported prostheses and tooth-supported fixed prostheses, fabricated from digital and conventional impression. MATERIALS AND METHODS The literature search was carried out on two electronic databases (PubMed and Cochrane Library). Randomized controlled trials (RCT) published from January 2011 to September 2022 were included. The bias risk was evaluated using Cochrane Risk of Bias Tool 2.0. Further screening was done for meta-analysis according to modified Newcastle-Ottawa scoring criteria. Forest plot was generated using a statistical method of inverse variance of random effect with 95% confidence interval. RESULTS A total of 8 randomized controlled trials were included for systematic review out of which four studies were based on tooth-supported fixed prosthesis and remaining four were based on implant-supported prosthesis. Further screening was conducted and three studies were eligible for meta-analysis. Tooth-supported fixed prosthesis fabricated from digital impression showed no significant difference in the marginal fit in any region measured, except for occlusal region where conventional impression showed more favorable marginal fit. Implant-supported prosthesis fabricated from digital impression showed survival rates ranging from 97.3 to 100% and there was no statistically significant difference in marginal bone loss (p = 0.14). CONCLUSION Implant-supported prostheses fabricated from digital and conventional impressions show no significant differences in their clinical outcomes. Tooth-supported fixed prostheses fabricated from digital impression have shown favorable findings in terms of marginal fit. Despite that, there is still lack of clinical trials with larger sample size and longer follow-up periods. Future studies that fulfill these two criteria are deemed necessary.
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Affiliation(s)
- Nur Safiani Mahat
- School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Naresh Yedthare Shetty
- Associate Professor, Department of Clinical Sciences, Ajman University, Ajman, UAE
- Centre of Medical and Biomedical Allied Health Sciences Research, Deanship of Graduate Studies and Research, Ajman, UAE
| | - Shivani Kohli
- Senior Lecturer, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Nafij Bin Jamayet
- Senior Lecturer, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Pravinkumar Patil
- Associate Professor, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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Han JS, Yoon HI. Effect of translucency of CAD-CAM ceramic restorative materials and scanning aid conditions on the accuracy of intraoral scans. J Dent Sci 2023; 18:1212-1218. [PMID: 37404663 PMCID: PMC10316660 DOI: 10.1016/j.jds.2023.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 03/23/2023] [Indexed: 07/06/2023] Open
Abstract
Background/purpose Subsurface scattering from translucent material would affect the digital scans. This study aimed to evaluate the effect of translucency of ceramic restorative materials and scanning aid conditions on the accuracy of intraoral scans. Materials and methods Identical anatomic contour crowns with ten ceramic restorative materials were fabricated: five zirconia, three lithium disilicate glass-ceramic, and two leucite reinforced glass-ceramic. The models with ceramic crowns were digitized with an intraoral scanner (IOS) and analyzed for accuracy (n = 10) with and without a scanning aid. Scan time efficiency was recorded. Square-shaped specimens with 1.0-mm thickness were fabricated with the same materials, and translucency parameter (TP) values were measured. One-way ANOVA, Welch ANOVA, and a post-hoc pairwise comparison or independent t-test were used for trueness and time analysis, and the F-test was used to examine the precision (α = 0.05). Pearson correlation test was conducted. Results Significant differences were revealed for trueness with no scanning aid condition and for TP values (P < 0.05). In contrast, no statistically significant differences were observed for trueness with a scanning aid. A strong correlation (r = 0.854, P < 0.01) between TP value and trueness with no scanning aid was revealed. By applying a scanning aid, trueness was improved and scan time efficiency significantly increased (P < 0.05). Conclusion The translucency of ceramic restorative materials negatively affects the accuracy of IOS scan without a scanning aid; however, the scan accuracy and time efficiency of IOS scanning for ceramic restorations can be improved by applying scanning aid, and prostheses with high quality without unnecessary labor can be produced.
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Affiliation(s)
| | - Hyung-In Yoon
- Corresponding author. Department of Prosthodontics, Seoul National University School of Dentistry and Dental Research Institute, 101, Daehak-ro, Jongro-gu, Seoul, 03080, Republic of Korea.
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Zappi A, Papazoglou E, Anagnostou M. Is a Wiggling-Motion Modified Two-Step Impression Technique as Accurate as Conventional Techniques in Restorative Dentistry? Dent J (Basel) 2023; 11:dj11050139. [PMID: 37232790 DOI: 10.3390/dj11050139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/02/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND The purpose of this study was to evaluate dental impression accuracy of one-step and two-step techniques compared to a modified two-step technique. METHODS Four impression techniques were compared: (1) a one-step double mix (DM) technique, (2) a cut-out (CO) technique, in which space relief was created using a blade and a laboratory bur, (3) a membrane (ME) technique, in which space relief was created by placing a PVC membrane on top of the putty material during the primary impression, and (4) a wiggling motion (WI) technique, in which PVC membrane was placed and additional wiggling movements were performed during the first 20 s when the primary impression was seated upon the master model (MM). Impressions were poured with type IV stone. Casts were scanned with a laboratory scanner and measurements were made for each cast using three-dimensional analysis software. RESULTS All groups presented differences compared to MM group, in at least one intra-abutment distance. Groups DM and ME presented the most significant differences, in three and two distances, respectively, whereas CO and WI presented one significant different distance compared to MM. There were no differences between MM and the four techniques for inter-abutment distances. CONCLUSIONS WI yielded similar results with CO technique. Both performed better than the other groups.
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Affiliation(s)
- Anastasia Zappi
- Department of Operative Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Efstratios Papazoglou
- Department of Operative Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Anagnostou
- Department of Operative Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
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15
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Revilla-León M, Cascos-Sánchez R, Barmak AB, Kois JC, Gómez-Polo M. The effect of different tooth preparation finishing procedures and immediate dentin sealing on the scanning accuracy of different intraoral scanners. J Dent 2023; 130:104431. [PMID: 36682722 DOI: 10.1016/j.jdent.2023.104431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/08/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To measure the effect of different tooth preparation finishing procedures (super-coarse grit, fine grit, and air-particle abrasion) and immediate dentin sealing (IDS) on the scanning accuracy of 4 intraoral scanners (IOSs). MATERIAL AND METHODS A tooth preparation for a full-coverage restoration was performed on an extracted mandibular molar using super-coarse diamond burs. Four groups were created depending on the tooth preparation finishing procedure: super-coarse grit (bur with a grit size of 150 µm) (SCG group), fine grit (bur with a grit size of 30 µm) (FG), air-particle abrasion with 27-µm aluminum oxide particles (APA group), and IDS (IDS group). Each group was divided into 5 subgroups according to the scanning system used to digitize the tooth preparation: laboratory scanner (control subgroup) (T710; Medit), Trios 4 (Trios subgroup), CS 3800 (CS subgroup), i700 wireless (i700 subgroup), and iTero Element 5D Plus (iTero subgroup) (n=20). For each subgroup, the control file was aligned with each experimental scan using the best-fit algorithm and an engineering program (Geomagic Control X). The discrepancy between the control and experimental files of each subgroup was computed by measuring the root mean square (RMS) error. Two-way ANOVA and Tukey tests were used to analyze the data (α=.05). RESULTS Tooth preparation finishing procedures (P<.001) and the IOS assessed (P<.001) were significant predictors of the trueness and precision values obtained. The highest trueness and precision values were measured in the APA group, while the IDS group had the lowest trueness and precision. Additionally, the i700 subgroup obtained the highest trueness and precision values, while the CS and Trios subgroups had the lowest trueness and precision values. CONCLUSIONS The different tooth preparations finishing procedures tested influenced on the scanning accuracy of the 4 IOSs considered. The air-particle abrasion procedure obtained the best accuracy values. The trueness discrepancies measured among all the subgroups was 19µm and the precision discrepancies measured among all the subgroups was 4.69 µm. CLINICAL SIGNIFICANCE The tooth preparation finishing procedure used can reduce the intraoral scanning accuracy of any of the intraoral scanners tested. The air-particle abrasion finishing procedure might be recommended for maximizing the scanning accuracy of the IOSs tested.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA; Research and Digital Dentistry, Kois Center, Seattle, WA, USA; Department of Prosthodontics, Tufts University, Boston, MA, USA
| | - Rocío Cascos-Sánchez
- Department of Prosthodontics and Restorative Dentistry, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Abdul B Barmak
- Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - John C Kois
- Kois Center, Seattle, WA, USA; Department of Restorative Dentistry, University of Washington, Seattle, WA, USA; Private Practice, Seattle, WA, USA
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
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16
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Revilla-León M, Agustín-Panadero R, Zeitler JM, Barmak AB, Yilmaz B, Kois JC, Pérez-Barquero JA. Differences in maxillomandibular relationship recorded at centric relation when using a conventional method, four intraoral scanners, and a jaw tracking system: A clinical study. J Prosthet Dent 2023:S0022-3913(22)00795-8. [PMID: 36682896 DOI: 10.1016/j.prosdent.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 01/21/2023]
Abstract
STATEMENT OF PROBLEM Digital systems including intraoral scanners (IOSs) and optical jaw tracking systems can be used to acquire the maxillomandibular relationship at the centric relation (CR). However, the discrepancy of the maxillomandibular relationship recorded at the CR position when using digital methods remains uncertain. PURPOSE The purpose of this clinical study was to compare the accuracy of the maxillomandibular relationship recorded at the CR position using a conventional procedure, 4 different IOSs, and an optical jaw tracking system. MATERIAL AND METHODS A completely dentate volunteer was selected. A Kois deprogrammer (KD) was fabricated. Six groups were created based on the technique used to obtain diagnostic casts and record the maxillomandibular relationship at the CR position: conventional procedures (CNV group), 4 IOS groups: TRIOS4 (TRIOS4 group), iTero Element 5D (iTero group), i700 wireless (i700 group), Primescan (Primescan group), and a jaw tracking system (Modjaw) (Modjaw group) (n=10). In the CNV group, conventional diagnostic stone casts were obtained. A facebow record was used to mount the maxillary cast on an articulator (Panadent). The KD was used to obtain a CR record for mounting the mandibular cast, and the mounted casts were digitized by using a scanner (T710) to acquire the reference scans. In the TRIOS group, intraoral scans were obtained and duplicated 10 times. The KD was used to obtain a bilateral virtual occlusal record at the CR position. To acquire the specimens of the iTero, i700, and Primescan groups, the procedures in the TRIOS4 group were followed, but with the corresponding IOS. In the Modjaw group, the KD was used to record and export the maxillomandibular relationship at the CR position. Articulated virtual casts of each group were exported. Thirty-six interlandmark linear measurements were computed on both the reference and experimental scans. The distances obtained on the reference scan were used to calculate the discrepancies with the distances obtained on each experimental scan. The data were analyzed by using 1-way ANOVA followed by the pairwise comparison Tukey tests (α=.05). RESULTS The trueness and precision of the maxillomandibular relationship record were significantly affected by the technique used (P<.001). The maxillomandibular relationship trueness values from high to low were iTero (0.14 ±0.09 mm), followed by the Modjaw (0.20 ±0.04 mm) and the TRIOS4 (0.22 ±0.09 mm) groups. However, the iTero, Modjaw, and TRIOS4 groups were not significantly different from each other (P>.05). The i700 group obtained the lowest trueness and precision values (0.40 ±0.22 mm) of all groups tested, followed by the Primescan grop (0.26±0.13 mm); however, the i700 and Primescan groups had significantly lower trueness and precision than only the iTero group (P<.05). CONCLUSIONS The trueness and precision of the maxillomandibular relationship recorded at the CR position were influenced by the different digital techniques tested.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, Scool of Dental Medicine, Tufts University, Boston, MA.
| | - Rubén Agustín-Panadero
- Adjunct Professor, Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | | | - Abdul B Barmak
- Assistant Professor, Clinical Research and Biostatistics, Department of Dentistry, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| | - John C Kois
- Private practice, Kois Center, Seattle, Wash; Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash
| | - Jorge Alonso Pérez-Barquero
- Associate Professor, Department of Dental Medicine, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Petre AE, Pantea M, Drafta S, Imre M, Țâncu AMC, Liciu EM, Didilescu AC, Pițuru SM. Modular Digital and 3D-Printed Dental Models with Applicability in Dental Education. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010116. [PMID: 36676740 PMCID: PMC9861456 DOI: 10.3390/medicina59010116] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/20/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023]
Abstract
Background and Objectives: The ever more complex modern dental education requires permanent adaptation to expanding medical knowledge and new advancements in digital technologies as well as intensification of interdisciplinary collaboration. Our study presents a newly developed computerized method allowing virtual case simulation on modular digital dental models and 3D-printing of the obtained digital models; additionally, undergraduate dental students' opinion on the advanced method is investigated in this paper. Materials and Methods: Based on the digitalization of didactic dental models, the proposed method generates modular digital dental models that can be easily converted into different types of partial edentulism scenarios, thus allowing the development of a digital library. Three-dimensionally printed simulated dental models can subsequently be manufactured based on the previously obtained digital models. The opinion of a group of undergraduate dental students (n = 205) on the proposed method was assessed via a questionnaire, administered as a Google form, sent via email. Results: The modular digital models allow students to perform repeated virtual simulations of any possible partial edentulism cases, to project 3D virtual treatment plans and to observe the subtle differences between diverse teeth preparations; the resulting 3D-printed models could be used in students' practical training. The proposed method received positive feedback from the undergraduate students. Conclusions: The advanced method is adequate for dental students' training, enabling the gradual design of modular digital dental models with partial edentulism, from simple to complex cases, and the hands-on training on corresponding 3D-printed dental models.
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Affiliation(s)
- Alexandru Eugen Petre
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17–23 Calea Plevnei, 010221 Bucharest, Romania
| | - Mihaela Pantea
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17–23 Calea Plevnei, 010221 Bucharest, Romania
- Correspondence: (M.P.); (S.D.); Tel.: +40-722-387-969 (M.P.); +40-722-657-800 (S.D.)
| | - Sergiu Drafta
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17–23 Calea Plevnei, 010221 Bucharest, Romania
- Correspondence: (M.P.); (S.D.); Tel.: +40-722-387-969 (M.P.); +40-722-657-800 (S.D.)
| | - Marina Imre
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17–23 Calea Plevnei, 010221 Bucharest, Romania
| | - Ana Maria Cristina Țâncu
- Department of Prosthodontics, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 17–23 Calea Plevnei, 010221 Bucharest, Romania
| | - Eduard M. Liciu
- Coordinator of the 3D Printing Department, Center for Innovation and e-Health (CieH), “Carol Davila” University of Medicine and Pharmacy, 20 Pitar Mos Str., 010454 Bucharest, Romania
| | - Andreea Cristiana Didilescu
- Department of Embryology, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, 050474 Bucharest, Romania
| | - Silviu Mirel Pițuru
- Department of Professional Organization and Medical Legislation-Malpractice, Faculty of Dentistry, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Revilla-León M, Kois DE, Kois JC. A guide for maximizing the accuracy of intraoral digital scans. Part 1: Operator factors. J ESTHET RESTOR DENT 2023; 35:230-240. [PMID: 36479807 DOI: 10.1111/jerd.12985] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/30/2022] [Accepted: 10/31/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To describe the factors related to the operator skills and decisions that influence the scanning accuracy of intraoral scanners (IOSs). A new classification for these factors is proposed to facilitate dental professionals' decision making when using IOSs and maximize the accuracy and reliability of intraoral digital scans. OVERVIEW Each IOS system is limited by the hardware and software characteristics of the selected device. The operator decisions that can influence the accuracy of IOSs include the scanning technology and system selection, scanning head size, calibration, scanning distance, exposure of the IOS to ambient temperature changes, ambient humidity, ambient lighting conditions, operator experience, scanning pattern, extension of the scan, cutting off, rescanning, and overlapping procedures. CONCLUSIONS The knowledge and understanding of the operator factors that impact scanning accuracy of IOSs is a fundamental element for maximizing the accuracy of IOSs and for successfully integrating IOSs in daily practices. CLINICAL SIGNIFICANCE Operator skills and clinical decisions significantly impact intraoral scanning accuracy. Dental professionals must know and understand these influencing operator factors for maximizing the accuracy of IOSs.
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Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA.,Kois Center, Seattle, Washington, USA.,Department of Prosthodontics, Tufts University, Boston, Massachusetts, USA
| | - Dean E Kois
- Kois Center, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA
| | - John C Kois
- Kois Center, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA.,Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
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Arikan H, Muhtarogullari M, Uzel SM, Guncu MB, Aktas G, Marshall LS, Turkyilmaz I. Accuracy of digital impressions for implant-supported complete-arch prosthesis when using an auxiliary geometry device. J Dent Sci 2023; 18:808-813. [PMID: 37021239 PMCID: PMC10068489 DOI: 10.1016/j.jds.2023.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/12/2023] [Indexed: 01/25/2023] Open
Abstract
Background/purpose Digital impressions using intraoral scanners have recently gained popularity. The aim of the present study was to evaluate the fit of full-arch screw-retained cobalt-chromium frameworks fabricated via two different digital impression methods. Materials and methods An edentulous resin master model with four dental implants was fabricated. Forty cobalt-chromium superstructures were fabricated and evaluated according to four groups. In Group 1, the superstructures were evaluated using an intraoral scanner to generate digital impressions. Group 2 relied on the help of an auxiliary geometric appliance in generation of digital impressions via intraoral scanner. The traditional method of splinted open-tray conventional impressions was designated for Group 3. Finally, the control group (Group 4) relied on scanning of the master model directly with a laboratory scanner. Vertical marginal discrepancy was evaluated, and data obtained were statistically analyzed. Results The highest mean vertical marginal gap value (80.86 ± 50.06 μm) was observed for Group 1 and statistically higher than Group 2, 3, and 4 (P < 0.05). The lowest mean vertical marginal gap value (41.98 ± 26.33 μm) was measured from Group 4 and statistically similar to Group 2 and 3 (P > 0.05). Conclusion It has been suggested that the use of auxiliary geometric appliances yields increased scanning accuracy. Frameworks fabricated using the traditional splinted open-tray technique were more reliable compared to those frameworks from digital impressions.
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20
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Implementation of a Full Digital Workflow by 3D Printing Intraoral Splints Used in Dental Education: An Exploratory Observational Study with Respect to Students' Experiences. Dent J (Basel) 2022; 11:dj11010005. [PMID: 36661542 PMCID: PMC9858622 DOI: 10.3390/dj11010005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/11/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
Fully digital workflows gained acceptance in dental practice and thereby are of interest for undergraduate education. An exploratory clinical observation was designed to track the implementation of such a workflow with novice digital users in order to describe its feasibility, time investment, and pitfalls. METHODS Students were invited to provide feedback for their experiences with a training module that consisted of the following: intraoral scanning, computer-aided design (CAD), manual finishing, and insertion of a 3D-printed bite splint for the lower jaw. RESULTS A total of 82 fourth-year students participated in the module. The average time required to perform an intraoral scan was 17 m 5 s, and all students were able to design a splint with an average time of 2 h 38 m. Students who indicated prior experience with CAD seem to outperform inexperienced students in both CAD task completion and intraoral scanning. The initial fit was reported as clinically acceptable by 68.5% of the participants, while 79% rated the workflow as very good to satisfactory and indicated that the training was helpful for dental practice. CONCLUSIONS The implementation of a digital workflow in undergraduate dental education is feasible and has acceptable clinical results. However, CAD is time-intensive, and the experience can be challenging.
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Llansana F, Guirao S, Kois JC, Revilla-León M. Calibrated splinting framework for complete arch intraoral implant digital scans manufactured by combining milled and additively manufacturing technologies: A dental technique. J Prosthet Dent 2022:S0022-3913(22)00558-3. [PMID: 36535880 DOI: 10.1016/j.prosdent.2022.08.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 12/23/2022]
Abstract
Splinting frameworks are intended to increase the accuracy of complete arch intraoral digital implant scans. This article describes a technique that uses a calibrated splinting framework manufactured by combining milled and additively manufacturing technologies (IOSRing) for assisting with complete arch intraoral digital implant scanning. The splinting framework contains milled truncated cone-shape markers whose position in the metal framework is measured during the manufacturing process with a coordinate measurement machine. This framework splints the modified implant scan bodies and assists in the complete arch intraoral implant digital scanning. Computer-aided design procedures are then used to calculate the implant position on the virtual definitive implant cast by using the position of the calibrated markers as a reference.
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Affiliation(s)
| | - Sergi Guirao
- Chief Visionary Officer at iOSFIX, Aldosa, Andorra
| | - John C Kois
- Founder and Director Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash; Private practice, Seattle, Wash
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Adjunct Professor, Department of Prosthodontics, Tufts University, Boston, Mass.
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22
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Sarafidou K, Chatziparaskeva M, Chatzikamagiannis D, Mpotskaris V, Tortopidis D, Bakopoulou A, Kokoti M. Evaluation of marginal/internal fit of fixed dental prostheses after digital, conventional, and combination impression techniques: A systematic review. Eur J Oral Sci 2022; 130:e12902. [PMID: 36346664 DOI: 10.1111/eos.12902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022]
Abstract
Advances of digital technology are rapidly adopted in dental practice. This systematic review aimed to collect evidence on the accuracy of fit of different types of fixed dental prostheses (FDPs) fabricated through digital, conventional, or combination impression techniques. Data collection was based on the guidelines of the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Two databases (PubMed, Scopus) were searched for articles in English published between 2010 and 2021 resulting in 480 articles. Of those, 35 studies fulfilled the inclusion criteria. These articles referred to three groups of materials/techniques including all-ceramic (zirconia; lithium disilicate) and porcelain-fused-to-metal (PFM) restorations. Results showed clinically acceptable marginal fit (< 120 μm) for all materials and impression techniques. Α fully digital workflow appears more promising for the construction of short-span zirconia FDPs. Nevertheless, most articles evaluated marginal/internal fit of single crowns or short-span FDPs in vitro, while clinical data are limited for long-span FDPs. The necessity for gingival retraction remains a major drawback of all impression techniques, increasing procedural time and patient discomfort. Besides, factors related to the fabrication process, including milling and 3D printing of working models significantly influence the outcome. Overall, there still some way to go before digital technology can be incorporated in complex treatment plans in prosthodontics.
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Affiliation(s)
- Katia Sarafidou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Chatziparaskeva
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Chatzikamagiannis
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Mpotskaris
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Tortopidis
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athina Bakopoulou
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Kokoti
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Procedure Time and Students’ Perception Comparing Full Arch Digital Scans with Conventional Impressions: A Cross-Over Randomized Experimental Trial. Int J Dent 2022; 2022:6320251. [PMID: 36299404 PMCID: PMC9592231 DOI: 10.1155/2022/6320251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/14/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Abstract
Methods Ninety-six dental students each prepared tooth #36 for an all-ceramic crown on typodont models and were then randomly assigned into either group A: performed digital scan first, or Group B: performed conventional impression first. Procedure time was recorded for both. Immediately following each procedure, students indicated their perceived procedure difficulty. After exposure to both techniques, they selected their preferred one. Results There was a statistically significant difference between the mean procedure time of both techniques (P < 0.0001), where students spent 663.76 ± 442.50 seconds to complete the conventional impression and 293.32 ± 181.49 seconds to complete the digital scan. Females were significantly faster in completing the conventional impression compared to males. On the contrary, male students were faster in digital scanning than female students. There were no carryover effects in the duration and the initially performed procedure. 76% (73 of 96) of participants preferred digital scanning with no statistical significance shown between the preferred and initially performed procedure. Participants perceived conventional impressions to be more difficult than digital scans. There was a weak positive correlation between the VAS score and the procedure time for the digital technique (R = 0.25) and a moderate positive correlation for the conventional technique (R = 0.45). Conclusions The digital technique was preferred and perceived as easier than the conventional among undergraduate dental students with no impression-making experience, suggesting their readiness for new technology uptake. However, no significant correlation was found between the initially performed procedure and preference.
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Abduljawad DE, Rayyan MR. Marginal and internal fit of lithium disilicate endocrowns fabricated using conventional, digital, and combination techniques. J ESTHET RESTOR DENT 2022; 34:707-714. [PMID: 35294099 DOI: 10.1111/jerd.12902] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the marginal and internal adaptation of endocrowns produced using conventional technique, digital technique, and combination (cast digitization) techniques using microcomputed tomography (micro-CT). MATERIALS AND METHODS Ten freshly extracted human mandibular molar teeth were prepared for all-ceramic endocrowns. A total of 40 Lithium Disilicate (IPS e.max) endocrowns were fabricated and grouped according to the impression and production technique to four groups: Group (CO): Conventional impression/heat pressed endocrowns (n = 10), Group (CAD): Direct scanning of teeth/CAD-CAM endocrowns (n = 10), Group (COMIO): Combination; Cast digitization using Intraoral scanner/CAD-CAM endocrowns (n = 10), Group (COML): Combination; Cast digitization using laboratory scanner/CAD-CAM endocrowns (n = 10). Micro-computed tomography was used to measure the marginal and internal gaps in 11 predetermined sites. Mean marginal and internal gaps were compared using analysis of variance and Scheffe's post hoc test. RESULTS CO, CAD, COMIO, and COML groups showed significant differences in the mean marginal gap (150 ± 35 μm, 120 ± 27 μm, 110 ± 24 μm, 120 ± 29 μm, respectively p = 0.013), gap at line angle (280 ± 70 μm, 130 ± 37 μm, 140 ± 54 μm, 130 ± 33 μm, respectively, p < 0.001), gap at cavity wall (210 ± 76 μm, 140 ± 43 μm, 140 ± 52 μm, 150 ± 44 μm, respectively, p = 0.010) and gap at pulpal floor (500 ± 150 μm, 240 ± 58 μm, 260 ± 59 μm, 240 ± 64 μm, respectively, p < 0.001). CONCLUSION Digitally fabricated endocrowns showed superior marginal and internal fit compared to the conventionally fabricated endocrowns. CLINICAL SIGNIFICANCE Marginal and internal adaptation are detrimental factors for the success and survival of dental restorations including endocrowns. When compared with the conventional impressions and conventional production techniques, Digital workflow is more predictable and reliable as it reduces errors and improves the accuracy of fit.
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Affiliation(s)
- Danyh Emad Abduljawad
- Prosthdontic Department, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
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ACCURACY OF INTRAORAL SCANNERS VERSUS TRADITIONAL IMPRESSIONS: A RAPID UMBRELLA REVIEW. J Evid Based Dent Pract 2022; 22:101719. [DOI: 10.1016/j.jebdp.2022.101719] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/29/2022] [Accepted: 03/11/2022] [Indexed: 12/13/2022]
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Morsy N, El Kateb M, Azer A, Fathalla S. Fit of zirconia fixed partial dentures fabricated from conventional impressions and digital scans: A systematic review and meta-analysis. J Prosthet Dent 2021:S0022-3913(21)00496-0. [PMID: 34696907 DOI: 10.1016/j.prosdent.2021.08.025] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 08/20/2021] [Accepted: 08/23/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Available studies comparing fit accuracy of zirconia fixed partial dentures (FPDs) fabricated from conventional impressions and digital scans provide contradictory results. In addition, studies have been heterogeneous and of a limited number to provide conclusive evidence. PURPOSE The purpose of this systematic review and meta-analysis was to compare the marginal and intaglio fit of tooth-supported zirconia FPDs fabricated from conventional impressions and digital scans and to investigate the effect of different variables on the fit results. MATERIAL AND METHODS An electronic search was performed on the National Library of Medicine (NLM), Cochrane Central Register of Controlled Trials, and Scopus databases. In addition, a manual search was carried out. Studies comparing the fit of tooth-supported zirconia FPDs fabricated from conventional impressions and digital scans and reporting sufficient data for qualitative and quantitative analysis were included. Standard mean differences (SMDs) and 95% confidence intervals (CI) were calculated for meta-analysis. Subgroup analysis was performed to study the effect of variables including restoration form (monolithic or framework), units number, intraoral scanner (IOS) type, conventional impression material, spacer thickness, and abutments region. RESULTS The initial search resulted in a total of 608 articles. Nine articles were included in the analysis (1 clinical and 8 in vitro) evaluating 118 restorations. Digital scan displayed significantly better marginal fit (P<.001; SMD: -0.68; 95% CI: -0.92, -0.09) and intaglio fit (P=.020; SMD: -0.51; 95% CI: -0.94, -0.42). Test for subgroup difference showed a significant influence of only impression material type (P=.008) and units number (P=.030) on marginal fit. Digital scan showed significantly better marginal accuracy for 3-unit FPDs than 4-unit FPDs (P<.001; SMD: -1.02; 95% CI: -1.41, -0.63). In addition, digital scanning had significantly better marginal fit with polyvinyl siloxane than polyether (P<.001; SMD: -0.98; 95% CI: -1.32, -0.64). A cement spacer ≤50 μm improved both marginal and intaglio fit in the digital group. The TRIOS scanner resulted in the best performance in the digital group for marginal fit. CONCLUSIONS Digital scanning provides significantly better marginal and intaglio fit than conventional impression making for fabricating zirconia FPDs up to 4 units, either in monolithic form or frameworks and at any region of the arch. However, further clinical studies are recommended to obtain more substantial results.
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Affiliation(s)
- Noha Morsy
- Assistant Lecturer of Fixed Prosthodontics, Department of Conservative Dentistry, Alexandria University, Alexandria, Egypt.
| | - Mohammed El Kateb
- Professor of Fixed Prosthodontics, Department of Conservative Dentistry, Alexandria University, Alexandria, Egypt
| | - Amir Azer
- Associate Professor of Fixed Prosthodontics, Department of Conservative Dentistry, Alexandria University, Alexandria, Egypt
| | - Said Fathalla
- Senior Researcher, Department of Computer Science, University of Bonn, Bonn, Germany
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Li L, Chen H, Li W, Wang Y, Sun Y. Design of wear facets of mandibular first molar crowns by using patient-specific motion with an intraoral scanner: A clinical study. J Prosthet Dent 2021; 129:710-717. [PMID: 34426014 DOI: 10.1016/j.prosdent.2021.06.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/29/2021] [Accepted: 06/29/2021] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Although computer-aided design has become popular, restorations are typically designed from static occlusion and dynamically by using an average-value virtual articulator. Patient-specific motion recorded by using an intraoral scanner has rarely been used to design restorations, and its design ability has not been analyzed. PURPOSE The purpose of this clinical study was to record patient-specific motion by using an intraoral scanner and to analyze its ability to design the morphology of the wear facets on mandibular first molar crowns. MATERIAL AND METHODS An intraoral scanner was used to scan complete arch digital casts and to record patient-specific motion of 11 participants. Right and left mandibular first molars were selected as the target teeth. The complete crown preparations of the target teeth were virtually prepared on the digital mandibular casts by using the Geomagic Studio 2013 software program. High points were created by elevating the wear facets of the target teeth by 0.3 mm in the occlusal direction to generate digital wax patterns. The Dental System software program was used to design crowns with the anatomic coping design method. Occlusal adjustment with static occlusion (STA crown), with the average-value virtual articulator (DYN crown), and with patient-specific motion (FUN crown) was carried out. The crowns adjusted with these 3 methods were compared with the original wear facets. The mean value and root mean square (RMS) of 3D deviation were measured. One-way ANOVA was used to analyze the influence of the occlusal surface design methods on the morphology of the wear facets (α=.05). RESULTS The STA crowns had the poorest results with the mean ±standard deviation 3D deviation value of 0.15 ±0.05 mm and RMS value of 0.19 ±0.04 mm. The best results occurred in the FUN group, with the mean ±standard deviation 3D deviation value of 0.05 ±0.06 mm and RMS value of 0.13 ±0.03 mm. Significant differences were found among the 3 groups (P<.01). Except for the RMS value between the STA and DYN groups, significant differences were found between groups from the pairwise comparisons. CONCLUSIONS The occlusal surface of the crowns designed by using the patient-specific motion recorded with the intraoral scanner had the best coincidence with the morphology of the wear facets on the original teeth.
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Affiliation(s)
- Linlin Li
- Doctoral student, Faculty of Prosthodontics, Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health & Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, PR China
| | - Hu Chen
- Attending Doctor, Faculty of Prosthodontics, Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health & Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, PR China
| | - Weiwei Li
- Postdoctoral, Faculty of Prosthodontics, Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health & Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, PR China
| | - Yong Wang
- Professor, Faculty of Prosthodontics, Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health & Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, PR China
| | - Yuchun Sun
- Professor, Faculty of Prosthodontics, Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Engineering Laboratory for Digital and Material Technology of Stomatology & Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health & Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, PR China.
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Digital Approach for the Rehabilitation of the Edentulous Maxilla with Pterygoid and Standard Implants: The Static and Dynamic Computer-Aided Protocols. Methods Protoc 2020; 3:mps3040084. [PMID: 33371232 PMCID: PMC7768480 DOI: 10.3390/mps3040084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/16/2022] Open
Abstract
A full-arch rehabilitation of the edentulous upper jaw without grafting procedures exploits the residual alveolar or the basal bone, with the necessity of long implants placed with a particular orientation. The precision in planning and placing the fixtures is fundamental to avoid clinical problems and to allow an acceptable connection with the prosthesis. The computer-aided implantology resulted in more accuracy than the traditional one, with a high standard of correspondence between the virtual project and the real outcome. This paper reports about the two different digital protocols, static and dynamic, as support to implant-borne prosthetic rehabilitation of edentulous maxillae. Two pterygoid and two/four anterior standard implants were seated in both cases by two different operators, without flap raising, and immediately loaded. This approach avoided the posterior cantilever by-passing the maxillary sinus and was adequately planned and realized without any surgical or prosthetic error. The two digital flow-charts were described step by step, underlining each other’s advantages and drawbacks compared to a free-hand approach.
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