Use of an ultrahigh-speed laser scanner for constructing three-dimensional shapes of dentition and occlusion

Maxillary arch dimensions in bilateral cleft lip and palate in the age 0-5 months

INTRODUCTION

The complete bilateral cleft lip and palate (BCLP) divides the maxillary arch into three segments, separated from each other, resulting in abnormal growth of the alveolar arch. This study evaluated the maxillary arch dimensions in BCLP and compared them with neonates without craniofacial anomalies.

METHODS

This retrospective study was conducted in a tertiary cleft centre. Sixty-six neonates aged 0-5 months were divided into two groups: cleft group-children with BCLP (23 boys and 18 girls) and control group-children without craniofacial deformities (15 boys and 10 girls). The dental models were processed by a 3D scanner. Landmarks were marked to achieve inter-canine distance, inter-tuberosity distance and arch length measurements. t-Tests were used for intergroup comparisons (p < .05).

RESULTS

The maxillary cleft arch was demonstrated to be wider and longer in the posterior region compared to the control group. The inter-canine distance did not present differences between the cleft and controls. The inter-canine distance of the control group was the only measurement influenced by the variable sex.

CONCLUSIONS

The cleft significantly interfered with the arch posterior width and arch sagittal length, making them larger. There was no statistical difference in the measurements between sex in the cleft group.

Assessment of curve of spee in different malocclusions

Purpose

The aim of this study was to compare the depth of curve of Spee (COS) in Angle Class I, Angle Class II and Angle Class III malocclusions.

Materials and methods

The Samples were chosen among the diagnostic materials in İstanbul Medipol University Department of Orthodontics. Ninety plaster models were chosen, and were divided into 3 groups (n=30) according to Angle dental malocclusion classification. The depth of curve of Spee was measured on left and right sides of mandibular dental models and mean values were used as depth of curve of Spee. ANOVA test was used to evaluate normally distributed data. Comparison of the sides were performed by using paired sample t test. Significance level was set to p<0.05.

Results

The depth of COS was found as deepest in Class II malocclusion (2.9±0.8 mm) and was relative flat in Class III malocclusion (2.1±0.9 mm) and the difference was statistically significant (p<0.05). No significant difference was found between Angle Class I and Class III malocclusions.

Conclusion

Since the depth of curve of Spee is increased in Class II malocclusions, this factor should be considered in treatment planning.

Technical Report on the Modification of 3-Dimensional Non-contact Human Body Laser Scanner for the Measurement of Anthropometric Dimensions: Verification of its Accuracy and Precision

Introduction: Three-dimensional (3D) scanners are widely used in medicine. One of the applications of 3D scanners is the acquisition of anthropometric dimensions for ergonomics and the creation of an anthropometry data bank. The aim of this study was to evaluate the precision and accuracy of a modified 3D scanner fabricated in this study. Methods: In this work, a 3D scan of the human body was obtained using DAVID Laser Scanner software and its calibration background, a linear low-power laser, and one advanced webcam. After the 3D scans were imported to the Geomagic software, 10 anthropometric dimensions of 10 subjects were obtained. The measurements of the 3D scanner were compared to the measurements of the same dimensions by a direct anthropometric method. The precision and accuracy of the measurements of the 3D scanner were then evaluated. The obtained data were analyzed using an independent sample t test with the SPSS software. Results: The minimum and maximum measurement differences from three consecutive scans by the 3D scanner were 0.03 mm and 18 mm, respectively. The differences between the measurements by the direct anthropometry method and the 3D scanner were not statistically significant. Therefore, the accuracy of the 3D scanner is acceptable. Conclusion: Future studies will need to focus on the improvement of the scanning speed and the quality of the scanned image.

Investigation of the effects of storage time on the dimensional accuracy of impression materials using cone beam computed tomography

PURPOSE

The storage conditions of impressions affect the dimensional accuracy of the impression materials. The aim of the study was to assess the effects of storage time on dimensional accuracy of five different impression materials by cone beam computed tomography (CBCT).

MATERIALS AND METHODS

Polyether (Impregum), hydrocolloid (Hydrogum and Alginoplast), and silicone (Zetaflow and Honigum) impression materials were used for impressions taken from an acrylic master model. The impressions were poured and subjected to four different storage times: immediate use, and 1, 3, and 5 days of storage. Line 1 (between right and left first molar mesiobuccal cusp tips) and Line 2 (between right and left canine tips) were measured on a CBCT scanned model, and time dependent mean differences were analyzed by two-way univariate and Duncan's test (α=.05).

RESULTS

For Line 1, the total mean difference of Impregum and Hydrogum were statistically different from Alginoplast (P<.05), while Zetaflow and Honigum had smaller discrepancies. Alginoplast resulted in more difference than the other impressions (P<.05). For Line 2, the total mean difference of Impregum was statistically different from the other impressions. Significant differences were observed in Line 1 and Line 2 for the different storage periods (P<.05).

CONCLUSION

The dimensional accuracy of impression material is clinically acceptable if the impression material is stored in suitable conditions.

Development of the curve of Spee in Class II subdivision malocclusion: a longitudinal study

OBJECTIVE

To compare the depth of curve of Spee (COS) in Class I and II sides of Class II subdivision malocclusion longitudinally and to describe the changes in the COS in relation to dental arch over time.

MATERIALS AND METHOD

The study group comprised 17 subjects exhibiting Class II subdivision malocclusion. The depth of COS, intermolar width, distances from mesial anatomic contact points of the first permanent molars to the contact point of the central incisors in Class I and II sides and arch length in mandible were analysed on digital models in three different time points based on cervical vertebral maturation (T1; mean age: 12.4 years, T2; mean age: 15.1 years, and T3: mean age: 19.1 years). Pearson's correlation coefficients were calculated and linear multiple regression analysis with enter method was carried out.

RESULTS

No significant differences were found in the depth of COS between Class I and II sides in all time periods. The mesiobuccal cusp of the first molar was the deepest part of COS in both sides and in all time periods, with a maximum depth of 2.37±0.83mm in T1 and a minimum depth of 1.91±0.66mm in T3. Between baseline and final follow-up; the depth of COS, ach length, and distance in Class I side decreased significantly. Arch length had a significant correlation with the depth of COS (r = 0.471) in T3.

CONCLUSIONS

As the depth of COS did not differ between either the Class II or I sides, the same mechanics can be used to level the COS in either sides of the mandibular arch.

Comparison of linear measurements and analyses taken from plaster models and three-dimensional images

Digital models are an alternative for carrying out analyses and devising treatment plans in orthodontics. The objective of this study was to evaluate the accuracy and the reproducibility of measurements of tooth sizes, interdental distances and analyses of occlusion using plaster models and their digital images. Thirty pairs of plaster models were chosen at random, and the digital images of each plaster model were obtained using a laser scanner (3Shape R-700, 3Shape A/S). With the plaster models, the measurements were taken using a caliper (Mitutoyo Digimatic(®), Mitutoyo (UK) Ltd) and the MicroScribe (MS) 3DX (Immersion, San Jose, Calif). For the digital images, the measurement tools used were those from the O3d software (Widialabs, Brazil). The data obtained were compared statistically using the Dahlberg formula, analysis of variance and the Tukey test (p < 0.05). The majority of the measurements, obtained using the caliper and O3d were identical, and both were significantly different from those obtained using the MS. Intra-examiner agreement was lowest when using the MS. The results demonstrated that the accuracy and reproducibility of the tooth measurements and analyses from the plaster models using the caliper and from the digital models using O3d software were identical.

Possibility of reconstruction of dental plaster cast from 3D digital study models

Objectives

To compare traditional plaster casts, digital models and 3D printed copies of dental plaster casts based on various criteria. To determine whether 3D printed copies obtained using open source system RepRap can replace traditional plaster casts in dental practice. To compare and contrast the qualities of two possible 3D printing options – open source system RepRap and commercially available 3D printing.

Design and settings

A method comparison study on 10 dental plaster casts from the Orthodontic department, Department of Stomatology, 2nd medical Faulty, Charles University Prague, Czech Republic.

Material and methods

Each of 10 plaster casts were scanned by inEos Blue scanner and the printed on 3D printer RepRap [10 models] and ProJet HD3000 3D printer [1 model]. Linear measurements between selected points on the dental arches of upper and lower jaws on plaster casts and its 3D copy were recorded and statistically analyzed.

Results

3D printed copies have many advantages over traditional plaster casts. The precision and accuracy of the RepRap 3D printed copies of plaster casts were confirmed based on the statistical analysis. Although the commercially available 3D printing enables to print more details than the RepRap system, it is expensive and for the purpose of clinical use can be replaced by the cheaper prints obtained from RepRap printed copies.

Conclusions

Scanning of the traditional plaster casts to obtain a digital model offers a pragmatic approach. The scans can subsequently be used as a template to print the plaster casts as required. Using 3D printers can replace traditional plaster casts primarily due to their accuracy and price.

Development of an RPD CAD system with finite element stress analysis

The structural design of removable partial dentures (RPDs) is critical for preventing distortion of the prosthesis, protecting abutment teeth and residual ridges as well as for high masticatory performance. The aim of this study was to clarify the feasibility and utility of a computer-aided designing (CAD) system with finite element analysis (FEA) for molar teeth arrangement in unilateral distal extension base RPDs. The shapes of artificial teeth and residual ridge were measured and converted into point group data. Solid models were created from surface-modelled point group data in a 3D surface CAD format. An occlusal rim was created on the residual ridge mucosa and the occlusal rim - residual ridge mucosa model with FEA function was created. Stress distribution on the residual ridge mucosa was compared by changing the loading point. The artificial teeth were then arranged in locations with the lowest amount of stress. After building an artificial teeth - saddle - residual ridge mucosa model, stress distribution in the residual ridge mucosa was re-evaluated by simulating occlusal force. On the occlusal rim - residual ridge mucosa model, stress was reduced when the loading point was located around the buccal shelf where functional cusps of artificial teeth were charted. It was confirmed that stress distribution in the residual ridge mucosa was equalized on the artificial teeth - saddle - residual ridge mucosa model. This system might be clinically useful tool for designing RPDs if FEA-guided designing of retainers and connectors can be added.

Direct 3-D morphological measurements of silicone rubber impression using micro-focus X-ray CT

Three-dimensional computer models of dental arches play a significant role in prosthetic dentistry. The microfocus X-ray CT scanner has the advantage of capturing precise 3D shapes of deep fossa, and we propose a new method of measuring the three-dimensional morphology of a dental impression directly, which will eliminate the conversion process to dental casts. Measurement precision and accuracy were evaluated using a standard gage comprised of steel balls which simulate the dental arch. Measurement accuracy, standard deviation of distance distribution of superimposed models, was determined as +/-0.050 mm in comparison with a CAD model. Impressions and casts of an actual dental arch were scanned by microfocus X-ray CT and three-dimensional models were compared. The impression model had finer morphology, especially around the cervical margins of teeth. Within the limitations of the current study, direct three-dimensional impression modeling was successfully demonstrated using microfocus X-ray CT.

Three-dimensional dental measurements: An alternative to plaster models

INTRODUCTION

The aim of this study was to compare the accuracy of dental measurements taken with calipers on plaster dental casts and those from computed tomography scans of the dentition with a dental measurement program.

METHODS

The sample consisted of plaster dental models of 34 orthodontic subjects. Dental arch measurements, including mesiodistal widths of teeth, arch widths, arch lengths, arch perimeters, and palatal depths were made with the calipers. The patients were also scanned with computed tomography, and measurements were made digitally with a 3-dimensional-based dental measurements program (3DD, Biodent, Cairo, Egypt).

RESULTS

The results showed strong agreement in most measurements between the conventional method and the 3DD in the 3 planes of space. The mesiodistal measurements of the maxillary right and left second premolars, left central incisor, and right first molar, and the mandibular left and right central incisors, right canine, and left first premolar had fair agreement.

CONCLUSIONS

Excellent agreement between the measurements with the conventional and 3DD methods in the 3 planes of space was found; 3DD can be an alternative to conventional stone dental models.

Measuring 3-dimensional tooth movement with a 3-dimensional surface laser scanner

INTRODUCTION

Our aims in this study were to (1) develop a method of measuring 3-dimensional (3D) tooth movement using a 3D surface laser scanner, (2) test the accuracy of this method, and (3) compare the measurements with those from cephalometric radiographs.

METHODS

A method of superimposing pretreatment and posttreatment models on the palatal rugae was developed, and an experimental model was prepared to evaluate the accuracy and reliability of the laser scanner. Records were obtained from a prospective longitudinal randomized clinical trial evaluating anchorage loss with headgears and midpalatal osseointegrated implants as a source of anchorage in Chesterfield, United Kingdom. The pretreatment and posttreatment study models were analyzed by using a 3D laser scanner to measure the 3D tooth movement.

RESULTS

The laser scanner was accurate to 0.0235 mm for anteroposterior measurements and 0.0071 mm for buccolingual movements for every 0.5 mm of movement. The study model analysis showed that mesial molar movements were 1.38 mm on the right side and 1.11 mm on the left side for the implant group, and 2.24 mm on right side and 1.63 mm on left side for the headgear group, with no statistically significant difference between the groups. The results for vertical movement of molars showed extrusion on both sides in both groups but no statistically significant difference between the groups. In the transverse plane, the results were not statistically significantly different between the groups. The results from superimposition of lateral cephalograms were similar to those obtained from the scanner.

CONCLUSIONS

The 3D laser scanner provides accurate and reliable measurements of tooth displacement and can be considered an alternative to cephalometric radiographs.

Three-dimensional computer-assisted study model analysis of long-term oral-appliance wear. Part 1: Methodology

INTRODUCTION

The aim of this study was to test a 3-dimensional (3D) computer-assisted dental model analysis system that uses selected landmarks to describe tooth movement during treatment with an oral appliance.

METHODS

Dental casts of 70 patients diagnosed with obstructive sleep apnea and treated with oral appliances for a mean time of 7 years 4 months were evaluated with a 3D digitizer (MicroScribe-3DX, Immersion, San Jose, Calif) compatible with the Rhinoceros modeling program (version 3.0 SR3c, Robert McNeel & Associates, Seattle, Wash). A total of 86 landmarks on each model were digitized, and 156 variables were calculated as either the linear distance between points or the distance from points to reference planes. Four study models for each patient (maxillary baseline, mandibular baseline, maxillary follow-up, and mandibular follow-up) were superimposed on 2 sets of reference points: 3 points on the palatal rugae for maxillary model superimposition, and 3 occlusal contact points for the same set of maxillary and mandibular model superimpositions. The patients were divided into 3 evaluation groups by 5 orthodontists based on the changes between baseline and follow-up study models.

RESULTS

Digital dental measurements could be analyzed, including arch width, arch length, curve of Spee, overbite, overjet, and the anteroposterior relationship between the maxillary and mandibular arches. A method error within 0.23 mm in 14 selected variables was found for the 3D system. The statistical differences in the 3 evaluation groups verified the division criteria determined by the orthodontists.

CONCLUSIONS

The system provides a method to record 3D measurements of study models that permits computer visualization of tooth position and movement from various perspectives.

Towards an integrated system for planning and assisting maxillofacial orthognathic surgery

Computer-assisted maxillofacial orthognathic surgery is an emerging and interdisciplinary field linking orthognathic surgery, remote signal engineering and three-dimensional (3D) medical imaging. Most of the computational solutions already developed make use of different specialized systems which introduce difficulties both in the information transfer from one stage to the others and in the use of such systems by surgeons. Trying to address such issue, in this work we present a common computer-based system that integrates proposed modules for planning and assisting the maxillofacial surgery. With that we propose to replace the current standard orthognathic preoperative planning, and to bring information from a virtual planning to the real operative field. The system prototype, including three-dimensional cephalometric analysis, static and dynamic virtual orthognathic planning, and mixed reality transfer of information to the operation room, is described and the first results obtained are presented.

A three-dimensional analysis method for edentulous mandibular ridge shape

The aim of this study was to develop a three-dimensional method to analyze edentulous ridge shapes. A laser projection method was used to record the shape of edentulous plaster models. Contour of residual ridge on the reconstructed image was then subdivided into small triangles, and a 'normal line' representing the center of gravity of each triangle was determined buccolingually and anteroposteriorly. Angle between the normal line on the residual ridge and the tentative occlusal plane was calculated for each triangle. These angles were then used to analyze the ridge shape. This method was used to analyze the ridges of 20 edentulous patients with excessive bone resorption. The results suggested that this method was useful for analyzing edentulous ridges regardless of ridge shape and degree of resorption.

Variations in orthodontic treatment planning decisions of Class II patients between virtual 3-dimensional models and traditional plaster study models

INTRODUCTION

Study models provide invaluable information in treatment planning. Digital models have proved to be an effective measurement tool, but their use in treatment planning has not been studied.

METHODS

Ten sets of records of Class II malocclusion subjects (dental study models, lateral cephalograms/tracings, panoramic radiographs, intraoral and extraoral photographs) were used for treatment planning by 20 orthodontists on 2 separate occasions. Digital models were used to evaluate the patients at 1 session and plaster models were used at the other session. Treatment recommendations were scored and compared for agreement. Eleven orthodontists served as the control group, looking at the records on 2 occasions with plaster models for agreement.

RESULTS

Good agreement was noted for surgery (P = 1.00, kappa = 0.549), extractions (P = .360, kappa = 0.570), and auxiliary appliances (P = 1.00, kappa = 0.539) for the digital/plaster group. Agreement in the plaster/plaster group for surgery (P = 1.00, kappa = 0.671), extractions (P = 1.00, kappa = 0.626), and auxiliary appliances (P = .791, kappa = 0.672) was also good. Overall proportions of agreement ranged between 0.777 and 0.870 for digital/plaster and 0.818 and 0.873 for plaster/plaster.

CONCLUSIONS

There was no statistical difference in intrarater treatment-planning agreement for Class II malocclusions based on the use of digital models in place of traditional plaster models. Digital orthodontic study models (e-models) are a valid alternative to traditional plaster study models in treatment planning for Class II malocclusion patients.

Validity, reliability, and reproducibility of plaster vs digital study models: Comparison of peer assessment rating and Bolton analysis and their constituent measurements

INTRODUCTION

The objective of this validation study was to compare standard plaster models (the current gold standard for cast measurements) with their digital counterparts made with emodel software (version 6.0, GeoDigm, Chanhassen, Minn) for the analysis of tooth sizes and occlusal relationships--specifically the Bolton analysis and the peer assessment rating (PAR) index and their components.

METHODS

Dental casts were poured from 24 subjects with 8 malocclusion types grouped according to American Board of Orthodontics categories. Measurements were made with a digital caliper to the nearest 0.01 mm from plaster models and with the software from the digital models. A paired samples t test was used to compare reliability and validity of measurements between plaster and digital methods.

RESULTS

Reproducibility of digital models via the concordance correlation coefficient was excellent in most cases and good in some. Although statistically significant differences in some measurements were found for the reliability and validity of the digital models via the average mean of the absolute differences of repeated measurements, none was clinically significant. Grouping of the measurements according to the 8 American Board of Orthodontics categories produced no significant difference (Kruskal-Wallis test). No measurement associated with Bolton analysis or PAR index made on plaster vs digital models showed a clinically significant difference. The PAR analysis and its constituent measurements were not significantly different clinically between plaster and emodel media.

CONCLUSIONS

Preliminary results did not indicate that digital models would cause an orthodontist to make a different diagnosis of malocclusion compared with plaster models; digital models are not a compromised choice for treatment planning or diagnosis.

A new way of analyzing occlusion 3 dimensionally

This article introduces a new method for 3-dimensional dental cast analysis, by using a mechanical 3-dimensional digitizer, MicroScribe 3DX (Immersion, San Jose, Calif), and TIGARO software (not yet released, but available from the author at hayasaki@dent.kyushu-u.ac.jp ). By digitizing points on the model, multiple measurements can be made, including tooth dimensions; arch length, width, and perimeter; curve of Spee; overjet and overbite; and anteroposterior discrepancy. The bias of the system can be evaluated by comparing the distance between 2 points as determined by the new system and as measured with digital calipers. Fifteen pairs of models were measured digitally and manually, and the bias was evaluated by comparing the variances of both methods and checking for the type of error obtained by each method. No systematic errors were found. The results showed that the method is accurate, and it can be applied to both clinical practice and research.

High-resolution 3-D shape integration of dentition and face measured by new laser scanner

Face and dentition were measured using a high-resolution three-dimensional laser scanner to circumvent problems of radiation exposure and metal-streak artifacts associated with X-ray computed tomography. The resulting range data were integrated in order to visualize the dentition relative to the face. The acquisition interval for dentition by laser scanner was 0.18 mm, and complicated morphologies of the occlusal surface could be sufficiently reproduced. Reproduction of occlusal condition of upper and lower dentitions was conducted by matching the surface of the occlusal impression record with upper dentition data. To integrate dentition and face, a marker plate interface was devised and adopted on the lower dental cast or by the subject directly. Integration was performed by matching both sets of interface data. Reproduction of the occlusal condition and integration of the dentition and face were accomplished and visualized satisfactorily by computer graphics. The integration accuracy was examined by changing the attachment angle of the marker plate, and the marker plate attached at 45 degrees showed the smallest error of 0.2 mm. The current noninvasive method is applicable to clinical examination, diagnosis and explanation to the patient when dealing with the physical relationship between face and dentition.

A technique for fabricating patterns for removable partial denture frameworks using digitized casts and electronic surveying

Although computer-aided design and manufacture techniques have shown some promising applications in the fabrication of crowns, inlays, and maxillofacial and oral surgery, the field of removable prosthodontics has not embraced these technologies so far. This article describes the development and investigation of computer-aided techniques that may eventually enable prosthodontic procedures such as surveying and the production of sacrificial patterns to be performed digitally. A 3-dimensional computer model of a conventional cast from a patient was obtained using an optical surface capture device (a scanner). The shape of a number of components of a removable partial denture framework was modeled on the 3-dimensional scan electronically, using computer-aided design software. A physical plastic shape of the components was produced using a Rapid Prototyping machine and used as a sacrificial pattern. Techniques to allow digital cast surveying before the production of sacrificial patterns were also developed. The results show that digital dental surveying and machine-produced sacrificial patterns can be accomplished. This article forms a basis for further developments leading to a fully integrated approach to the computer-aided design and fabrication of removable partial denture frameworks.

A preliminary report on a computer-assisted dental cast analysis system used for the prosthodontic treatment

To accomplish computerized 3D morphological analyses of maxillary and mandibular casts with malocclusions on the same co-ordinate system, a new reference co-ordinate located on soft tissue has been proposed consisting of the top of maxillary bilateral tubercles and incisive papilla on the maxillary cast. To test the validity of this co-ordinate system, the angles of the occlusal plane in this system were examined on 10 subjects with normal occlusion. In addition, to analyse maxillary and mandibular casts on the same co-ordinate system, a bite block was made under the intercuspal position. The maxillary cast was measured by 3D measuring system, then, the bite block was placed on maxillary casts, and measured similarly. To examine the position reproducibility of this method, 3D co-ordinates of the apex of the buccal cusp of the mandibular pre-molar in five bite blocks were determined. The angles formed of the occlusal plane were 1.3 +/- 1.3 degrees and 0.2 +/- 1.1 degrees on the sagittal and frontal base plane, respectively. This co-ordinate system had enough stability to replace the occlusal plane. By the measurement of bite blocks, the co-ordinates of the mandibular cusp tips were determined within the deviation of 0.2 mm.