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Ren S, Jiang X, Di P. Auxiliary occlusal devices for IO scanning in a complete digital workflow of implant-supported crowns: a randomized controlled trial. BMC Oral Health 2024; 24:374. [PMID: 38519905 PMCID: PMC10958945 DOI: 10.1186/s12903-024-03986-4] [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: 12/10/2023] [Accepted: 02/05/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES To compare the crown accuracy and time efficiency of a complete digital workflow, utilizing an auxiliary occlusal device and IO scanning, with a conventional workflow, for multiple implant-supported single crowns. MATERIALS AND METHODS 24 patients with two adjacent posterior implants were included. 12 patients were randomly assigned to digital workflow group, involving intra-oral scanning with an auxiliary occlusal device and manufacture of customized abutments and zirconia single crowns (test group). The other 12 were assigned to the conventional workflow (control group), involving conventional impression and CAD-CAM crowns based on stone casts. Crown scanning was done before and after clinical adjustment using an intraoral scanner. Two 3D digital models were overlapped to assess dimension changes. Chair-side and laboratory times for the entire workflow were recorded and a linear mixed model and Independent-sample t tests were used for the statistical analysis. RESULTS The maximum occlusal deviation was 279.67 ± 112.17 μm and 479.59 ± 203.63 μm in the test and control group, respectively (p < 0.001). The sizes of the occlusion adjustment areas were 12.12 ± 10.51 mm2 and 25.12 ± 14.14 mm2 in the test and control groups, respectively (p = 0.013). The mean laboratory time was 46.08 ± 5.45 and 105.92 ± 6.10 min in the test and control groups, respectively (p < 0.001).The proximal contact adjustment and mean chair-side time showed no statistically significant difference between two groups. CONCLUSIONS A digital workflow for two implants-supported single crowns using an auxiliary device required fewer occlusal crown adjustments, and less laboratory time compared to conventional workflow. CLINICAL RELEVANCE The use of auxiliary occlusal devices in IOS enhances the accuracy of virtual maxillomandibular relationship in extended edentulous spans. Consequently, employing a digital workflow for multiple implants-supported crowns using IO scanning and an auxiliary occlusal device proves to be a feasible, accurate and efficient approach.
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Affiliation(s)
- Shuxin Ren
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 10081, PR China
| | - Xi Jiang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 10081, PR China.
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 10081, PR China
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Ma J, Zhang B, Song H, Wu D, Song T. Accuracy of digital implant impressions obtained using intraoral scanners: a systematic review and meta-analysis of in vivo studies. Int J Implant Dent 2023; 9:48. [PMID: 38055096 DOI: 10.1186/s40729-023-00517-8] [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: 10/01/2023] [Accepted: 11/28/2023] [Indexed: 12/07/2023] Open
Abstract
PURPOSE This systematic review aimed to investigate the accuracy of intraoral scan (IOS) impressions of implant-supported restorations in in vivo studies. METHODS A systematic electronic search and review of studies on the accuracy of IOS implant impressions were conducted to analyze the peer-reviewed literature published between 1989 and August 2023. The bias analysis was performed by two reviewers. Data on the study characteristics, accuracy outcomes, and related variables were extracted. A meta-analysis of randomized control trials was performed to investigate the impact of IOS on peri-implant crestal bone loss and the time involved in the impression procedure. RESULTS Ten in vivo studies were included in this systematic review for final analysis. Six studies investigated the trueness of IOS impressions, but did not reach the same conclusions. One study assessed the precision of IOS impressions for a single implant. Four clinical studies examined the accuracy of IOS implant impressions with a follow-up of 1-2 years. In full arches, IOS impression procedure needed significantly less time than conventional one (mean difference for procedure time was 8.59 min [6.78, 10.40 min], P < 0.001), prosthetic survival rate was 100%, and marginal bone levels of all participants could be stably maintained (mean difference in marginal bone loss at 12 months was 0.03 mm [-0.08, 0.14 mm], P = 0.55). CONCLUSIONS The accuracy of IOS impressions of implant-supported restorations varied greatly depending on the scanning strategy. The trueness and precision of IOS in the partial and complete arches remain unclear and require further assessment. Based on follow-up clinical studies, IOS impressions were accurate in clinical practice. However, these results should be interpreted with caution, as some evidences are obtained from the same research group.
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Affiliation(s)
- Jie Ma
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, No.500 Fenglin Road, Shanghai, 200032, China
| | - Binghua Zhang
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, No.500 Fenglin Road, Shanghai, 200032, China
| | - Hao Song
- Department of Oral Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Dongle Wu
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, No.500 Fenglin Road, Shanghai, 200032, China
| | - Tao Song
- Department of Implant Dentistry, Shanghai Xuhui District Dental Center, No.500 Fenglin Road, Shanghai, 200032, China.
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Yan Y, Lin X, Yue X, Geng W. Accuracy of 2 direct digital scanning techniques-intraoral scanning and stereophotogrammetry-for complete arch implant-supported fixed prostheses: A prospective study. J Prosthet Dent 2023; 130:564-572. [PMID: 35667889 DOI: 10.1016/j.prosdent.2022.03.033] [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: 11/16/2021] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Conventional impression techniques for complete arch implant-supported prostheses are technique-sensitive. Stereophotogrammetry (SPG) and intraoral scanning (IOS) may offer an alternative to conventional impression making. PURPOSE The purpose of this prospective study was to compare the accuracy of IOS and SPG for complete arch implant scans and to evaluate the passive fit of frameworks fabricated with SPG. MATERIAL AND METHODS Laboratory scanning of gypsum casts, SPG, and IOS were performed for all participants. The data regarding the abutment platform were superimposed to calculate the 3D deviation of SPG and IOS compared with that of laboratory scanning as an evaluation of accuracy. The effect of implant position and number on accuracy was analyzed. The more accurate technique between SPG and IOS was used to fabricate the titanium frameworks, as was laboratory scanning. The passive fit of the frameworks was assessed by clinical examination, the Sheffield test, and panoramic radiography. RESULTS Seventeen participants (21 arches, 120 implants) were included. The accuracy of SPG ranged from 2.70 μm to 92.80 μm, with a median (Q1, Q3) of 17.00 (11.68, 22.50) μm, which was significantly more accurate than that of IOS, ranging from 21.30 μm to 815.60 μm, with a median (Q1, Q3) of 48.95 (34.78, 75.88) μm. No significant correlation was found between position or number of implants and 3D deviation in the SPG group. A weak positive correlation was found between implant number and 3D deviation in the IOS group. SPG and laboratory scanning were used to fabricate titanium frameworks. The passive fit between the frameworks and abutment platforms was confirmed. CONCLUSIONS SPG, which was not affected by position or number of implants, was more accurate than IOS and comparable with laboratory scanning. The frameworks fabricated based on SPG and laboratory scanning were comparable in their passive fit. The SPG technique may be an alternative to laboratory scanning for complete arch implant scans.
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Affiliation(s)
- Yuwei Yan
- Graduate student, Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, PR China
| | - Xiao Lin
- Attending physician, Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, PR China
| | - Xinxin Yue
- Attending physician, Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, PR China
| | - Wei Geng
- Professor, Department of Dental Implant Center, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, PR China.
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Pullishery F, Huraib W, Alruhaymi AS, Alharandah WA, AlDara EW, Benten MM, Alassaf DM, Babatin WMA, Mohsen NMM. Intraoral Scan Accuracy and Time Efficiency in Implant-Supported Fixed Partial Dentures: A Systematic Review. Cureus 2023; 15:e48027. [PMID: 38034200 PMCID: PMC10688193 DOI: 10.7759/cureus.48027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
The digital implant impression technique (DIT) and conventional implant impression technique (CIT) workflows in implant-supported fixed partial dentures (FPDs) have not been extensively compared in prior studies. Moreover, there is no agreement on the more accurate method that entails less time in the laboratory and during the clinical phases of fabrication and delivery of the prosthesis, respectively. This review aimed to assess the precision of the imaging procedure and overall fabrication time of the DIT and CIT for the implant-supported FPDs. An electronic search was performed using PubMed, Scopus, EMBASE, Cochrane Oral Health Group, and Dentistry and Oral Science Source databases through EBSCO for relevant studies from January 2014 to April 2023. Following the preliminary screening, the studies that met the inclusion criteria underwent full-text review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Cochrane Collaboration risk of bias appraisal tool and Newcastle-Ottawa scale were applied to assess the quality of randomized controlled trials (RCTs) and non-randomized prospective clinical studies, respectively. The initial search yielded 332 studies, and after excluding duplicates, 241 papers were available for screening. Titles and abstracts were reviewed, and 97 articles were chosen for full-text review by two authors independently. Furthermore, 89 articles were excluded in compliance with the PICOS question, and eight studies were chosen for qualitative analysis. Hence, the review comprised two RCTs and six prospective clinical studies. The time efficiency of the implant-supported FPDs was examined in four investigations, three of which used the Trios 3 scanner and one used the Intero scanner. The three-dimensional accuracy of DIT and CIT was compared in six clinical comparative studies. One of the RCTs was rated to have a high risk of bias and the other with a moderate quality of evidence. The six prospective studies were rated to have high-quality of evidence. The findings of this review indicate the prospective applicability of future intraoral scanning systems. The DIT was reported to be outstanding in terms of patient preferences and total fabrication time efficiency. Additional in vivo studies are needed to establish the therapeutic usefulness and time efficiency of integrating DIT in more comprehensive settings.
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Affiliation(s)
- Fawaz Pullishery
- Community Dentistry and Research, Batterjee Medical College, Jeddah, SAU
| | - Wayel Huraib
- Fixed Prosthodontics, Dentistry Program, Batterjee Medical College, Jeddah, SAU
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Zhu N, Liu J, Ma T, Zhang Y, Lin Y. Fully digital versus conventional workflow for horizontal ridge augmentation with intraoral block bone: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:809-820. [PMID: 36068075 DOI: 10.1111/cid.13129] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/25/2022] [Accepted: 08/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To compare the outcome and efficiency of the computer-aided intraoral block bone grafting procedure with those of the conventional technique for the augmentation of horizontal ridge defects. MATERIALS AND METHODS A total of 28 patients with single missing tooth in esthetic zone with class IV horizontal alveolar bone defect in need of dental implant restoration were recruited. Computer-aided design of the implant restoration and intraoral block bone grafting was performed for all the participants. The patients were randomly and equally divided into guide and control groups. A fully guided bone harvesting, trimming, and grafting surgery was executed in the guide group. The control group patients underwent surgery without any guide. After 6 months, all the patients underwent implant placement. The primary outcomes were the root mean square estimate (RMSE) values between the outer contours of the actual implanted and planned bone block as well as the RMSE values between the inner surface of the implanted bone block and the original bone surface of the recipient site immediately after surgery. The secondary outcomes were the trimming time of bone block and the surgery-associated complications. The postoperative visual analog scale (VAS) of pain, swelling, and mouth opening difficulty was recorded. RESULTS All 28 patients underwent intraoral block bone grafting, followed by the placement of implant after 191.8 ± 19.69 days. The RMSE values between the outer contours of the implanted and planned bone blocks were significantly lower in the guide group (0.37 ± 0.16 mm) as compared to those in the control group (0.72 ± 0.29 mm) (p = 0.0007). The RMSE values between the inner contours of the graft block and original bone at the recipient site were lower in the guide group (0.35 ± 0.15 mm) as compared to those in the control group (0.48 ± 0.17 mm) (p = 0.043). The duration of bone block trimming was shorter in the guide group (401.51 ± 97.60 s) as compared to the control group (602.36 ± 160.57 s) (p = 0.0005). In the control group, two patients received secondary bone grafting, one patient experienced bleeding of donor site and temporary hypoesthesia of the lower lip and chin skin, and one patient developed temporary sensitivity of the adjacent tooth. CONCLUSIONS As compared to the conventional procedure, the fully digital workflow in the present study seemed to be a more accuracy and effective protocol for horizontal ridge augmentation with intraoral block bone. TRIAL REGISTRATION Chictr.org.cn (ChiCTR2000036390).
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Affiliation(s)
- Ning Zhu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jiayu Liu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ting Ma
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yu Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Hashemi AM, Hashemi HM, Siadat H, Shamshiri A, Afrashtehfar KI, Alikhasi M. Fully Digital versus Conventional Workflows for Fabricating Posterior Three-Unit Implant-Supported Reconstructions: A Prospective Crossover Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811456. [PMID: 36141729 PMCID: PMC9517085 DOI: 10.3390/ijerph191811456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 05/14/2023]
Abstract
This study assessed the clinical variables influencing the success of three-unit implant-supported fixed dental prostheses (ISFDPs) fabricated using either fully digital or conventional workflows. The clinical trial evaluated 10 patients requiring three-unit ISFDPs in the posterior mandible. Maxillomandibular relation records, and digital and conventional impressions were obtained from each patient using an intraoral scanner (IoS) and polyvinylsiloxane (PVS), and the frameworks were fabricated using zirconia and cobalt-chromium, respectively. A 2 µm accuracy scanner scanned the conventional master casts and standard reference models. The stereolithography (STL) files of the digital and conventional impressions were superimposed on the standard model file, and the accuracy was calculated with the best-fit algorithm. The framework adaptation and passivity were assessed using the one-screw and screw resistance tests. The time required for occlusal adjustment of both types of reconstructions, including the duration of the whole treatment, was recorded. The aesthetic appearance of ISFDPs was rated by each patient and clinician using a self-administered visual analogue scale questionnaire and the FDI World Dental Federation aesthetic parameters, respectively. The sample size was based on the power calculation, and alpha was set at 0.05 for the statistical analyses. The impression accuracy, framework adaptation and passivity, and reconstructions aesthetics did not significantly differ between the digital and conventional approaches. The total fabrication time was significantly shorter using the digital workflow. Within the limitations of this clinical study, the fully digital workflow can be used for the fabrication of ISFDPs with a clinical outcome comparable to that of the conventional workflow.
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Affiliation(s)
- Ali Mahmoud Hashemi
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Hamid Mahmoud Hashemi
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - Hakimeh Siadat
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
- Department of Prosthodontics, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - Ahmadreza Shamshiri
- Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Kelvin Ian Afrashtehfar
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Berne, Switzerland
- Division of Restorative Dental Sciences, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
- Correspondence: (K.I.A.); (M.A.)
| | - Marzieh Alikhasi
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran 1411713135, Iran
- Correspondence: (K.I.A.); (M.A.)
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Schmidt A, Wöstmann B, Schlenz MA. Accuracy of digital implant impressions in clinical studies: A systematic review. Clin Oral Implants Res 2022; 33:573-585. [PMID: 35527511 DOI: 10.1111/clr.13951] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/20/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The use of intraoral scanners (IOSs) for digital implant impressions in daily clinical practice is increasing. However, no structured literature review on the accuracy of digital implant impressions in clinical studies has been described to date. Therefore, this systematic review aimed to answer the PICO question: Which accuracy is described for digital implant impressions in clinical studies? MATERIAL AND METHODS An electronic database search was conducted in December 2021 using MeSH terms and free-text search. English-language studies addressing the accuracy of digital implant impressions in clinical studies involving at least 10 patients were included. All clinical indications were considered. RESULTS Eight publications between 2014 and 2021 matched the review criteria. However, the study designs showed considerable differences. The number of implants within the studies ranged from 1 to 6, and the number of patients ranged from 10 to 39. The oldest study (2014) revealed the highest deviation for linear distances at 1000±650 µm, whereas the other studies reported data in the range of 360±46 µm to 40±20 µm. In one study, no numerical data were reported and all studies compared digital and conventional implant impressions. CONCLUSIONS The number of clinical studies on the accuracy of digital implant impressions is low. Thus, the impact of different factors, such as the scanpath or scanbody, could not be identified. However, the accuracy of recent IOSs for digital implant impressions in patients was shown to be clinically acceptable. Nevertheless, the transfer error still needs to be considered when fabrication implant-supported restorations.
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Affiliation(s)
- Alexander Schmidt
- Department of Prosthodontics - School of Dental Medicine, Justus Liebig University, Giessen, Germany
| | - Bernd Wöstmann
- Department of Prosthodontics - School of Dental Medicine, Justus Liebig University, Giessen, Germany
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Accuracy of Additively Manufactured Dental Casts Compared with That of Virtual Scan Data Obtained with an Intraoral Scanner: An In Vitro Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The study aimed to evaluate the time-related accuracy of additively manufactured dental casts and to compare it with scan data obtained with an intraoral scanner in vitro. Twenty-eight markers were attached to a set of dentiforms as reference model, and the distances between the markers were measured using a digital caliper. An intraoral scanner was used to obtain the virtual scan data of the reference model with a total of 30 scans per arch. The distances between markers were measured using a three-dimensional inspection software for all scans (group IOS). Scan data were additively manufactured using a 3D printer, and the distances between markers were measured as in the reference model immediately after post-polymerization (group PPIA), 1 day (group PP1D), 7 days (group PP7D), and 30 days after post-polymerization (group PP30D). The linear deviation in group IOS was 199.74 ± 11.14 μm, PPIA was 242.88 ± 49 μm, PP1D was 259.9 ± 42.59 μm, PP7D was 289.82 ± 39.74 μm, and PP30D was 315.8 ± 33.28 μm, in comparison with the reference model, with significant differences among all groups (all p < 0.05). When additively manufacturing casts from scan data to verify the quality of dental prostheses designed virtually, the prostheses should be adapted to casts manufactured within one week.
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Ko KA, Song YW, Park JM, Park YB, Kim CS, Lee JS. Immediate loading protocols increase the risk of failure of implants placed by fully guided surgery in partially edentulous jaws: A randomized clinical trial. Clin Implant Dent Relat Res 2021; 23:735-744. [PMID: 34436812 DOI: 10.1111/cid.13042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 12/13/2022]
Abstract
AIM To compare the 1-year outcomes of immediate loading (IL) and delayed loading (DL) protocols for implants placed by fully guided surgery in partially edentulous jaws. MATERIALS AND METHODS This study included 72 patients who received implant surgery with either IL (93 implants, 36 patients) or DL (94 implants, 26 patients). A prefabricated provisional prosthesis was delivered immediately for the IL group (86 implants, 32 patients) with the exception of 4 subjects in whom an initial torque of >20 Ncm and an implant stability quotient of >65 were not achieved, while all DL-group implants were loaded after 3 months. The 1-year implant survival rate estimated by intention-to-treat (ITT) and per-protocol (PP) analyses, and the marginal bone loss (MBL) estimated by cone-beam computed tomography were statistically evaluated (p < 0.05). RESULTS The survival rate in the DL group was 100% at both patient and implant levels. With only 26 subjects with 78 implants surviving in the IL group, the survival rates were 69.4% and 83.4% at the patient and implant levels, respectively, in the ITT analysis, and 78.1% and 90.2% in the PP analysis. All intergroup differences in survival rates were statistically significant (p < 0.01). MBL was less than 0.1 mm in both groups (p > 0.05). CONCLUSIONS IL for implants placed by fully guided surgery in the partially edentulous jaws increased the probability of failure compared to 3-month DL. Regardless of when loading occurred, marginal bone levels remained stable.
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Affiliation(s)
- Kyung-A Ko
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Ji-Man Park
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, South Korea
| | - Young-Bum Park
- Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, South Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
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Han X, Qi C, Guo P, Zhang S, Xu Y, Lv G, Li Y, Li C. Whole-Process Digitalization-Assisted Immediate Implant Placement and Immediate Restoration in the Aesthetic Zone: A Prospective Study. Med Sci Monit 2021; 27:e931544. [PMID: 34428195 PMCID: PMC8400573 DOI: 10.12659/msm.931544] [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] [Indexed: 11/21/2022] Open
Abstract
Background This study explored the clinical effects of whole-process digitalization (WD)-assisted immediate implant placement (IIP) and immediate restoration (IR) in the aesthetic zone and clarified the clinical procedures. Material/Methods Patients who received maxillary aesthetic region IIP and IR treatment were randomly distributed into WD-assisted and conventional groups. Postoperative assessment included implant accuracy, marginal bone loss, aesthetic evaluation, and patient satisfaction evaluation. The aesthetic evaluation included visual analog score (VAS), pink aesthetic score (PES), and white aesthetic score (WES). Numerical data, measurement data, and grade data were analyzed by χ2 test, t test, and Mann-Whitney U test. Results The WD-assisted group exhibited decreased implant accuracy, including coronal deviation, apical deviation, angular deviation, and depth deviation, compared with the conventional group (P<0.05). The marginal bone loss in both the mesiodistal direction and the buccolingual direction were significantly lower in the WD-assisted group than in the conventional group (P<0.05). The VAS, PES, and WES were all significantly higher in the WD-assisted group than in the conventional group at 3, 6, and 12 months after surgery (P<0.05). Patients in the WD-assisted group also reported a higher satisfaction level than those in the conventional group (P<0.05). Conclusions WD-assisted IIP and IR treatment in the aesthetic zone increased implant accuracy, decreased marginal bone loss, improved aesthetic effect, and increased patient satisfaction compared with conventional treatment. Therefore, WD-assisted IIP and IR treatment constitutes a promising approach in clinical oral implantology.
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Affiliation(s)
- Xiaomei Han
- Stomatological Hospital, School of Dentistry, Tianjin Medical University, Tianjin, China (mainland).,Department of Oral Implantology, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia, China (mainland)
| | - Change Qi
- Department of Oral Implantology, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia, China (mainland)
| | - Pengnv Guo
- Department of Oral Implantology, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia, China (mainland)
| | - Shuying Zhang
- Department of Oral Implantology, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia, China (mainland)
| | - Yali Xu
- Department of Oral Implantology, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia, China (mainland)
| | - Guanghui Lv
- Department of Oral Implantology, Affiliated Hospital of Chifeng University, Chifeng, Inner Mongolia, China (mainland)
| | - Ying Li
- Stomatological Hospital, School of Dentistry, Tianjin Medical University, Tianjin, China (mainland)
| | - Changyi Li
- Stomatological Hospital, School of Dentistry, Tianjin Medical University, Tianjin, China (mainland)
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11
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Lyu M, Di P, Lin Y, Jiang X. Accuracy of impressions for multiple implants: A comparative study of digital and conventional techniques. J Prosthet Dent 2021; 128:1017-1023. [PMID: 33640093 DOI: 10.1016/j.prosdent.2021.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Intraoral scanning has benefits over conventional impression making, but whether scanning is sufficiently accurate for multiple implants is unclear. PURPOSE The purpose of this in vitro study was to compare the trueness of digital scans acquired by using intraoral scanners from a small range to a complete arch with the conventional impression technique and to determine the influence of 2 different evaluation methods (best-fit algorithm versus absolute linear deviation) on the outcomes of accuracy assessment. MATERIAL AND METHODS A mandibular model with 8 implants (A-H) around an edentulous arch was used as the master model. Open-format standard tessellation language (STL) data sets (1 reference file from a highly accurate dental laboratory scanner, 10 files from an intraoral scanner, and 10 files from digitized conventional impressions at room temperature) were imported to a metrology software program, and 5 groups of scanning ranges (AB, FGH, CDEF, BCDEFG, and ABCDEFGH) were identified simulating different clinical situations. Two evaluation methods-root mean square values calculated from the best-fit algorithm and average value of linear discrepancies from absolute linear deviation-were used to describe the trueness values. The impacts of different scanning or impression methods, ranges, and evaluation methods were tested by using a 3-way ANOVA. The effect of the scanning range on accuracy was further identified with 1-way ANOVA. The paired-sample t test was used to determine the differences of trueness values between the 2 methods in different groups. RESULTS The trueness values of the implant impressions were significantly affected by different scanning or impression methods (P<.001), evaluation methods (P<.001), and scanning ranges (P<.001) as independent variables. With use of the best-fit algorithm, deviations from the digital scans were significantly greater than those from the conventional impressions in cross-arch situations (groups CDEF, BCDEFG, and ABCDEFGH). With use of the absolute linear deviation method, statistically significant lower accuracy was found when larger areas were encountered (groups BCDEFG and ABCDEFGH). Use of the absolute linear deviation method resulted in a higher mean score of inaccuracy than that from the best-fit algorithm method in most situations. CONCLUSIONS Scanning or impression methods, ranges, and evaluation methods affected the dimensional accuracy (trueness) of scans or impressions with multiple implants. Digital scans had worse trueness values compared with those made with the conventional splinting open-tray technique when cross-arch implant impressions were acquired.
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Affiliation(s)
- Mingyue Lyu
- Resident Doctor, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ping Di
- Professor and Chairman, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Ye Lin
- Professor, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Xi Jiang
- Associated Doctor in Chief, Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, PR China.
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Banjar A, Chen YW, Kostagianni A, Finkelman M, Papathanasiou A, Chochlidakis K, Papaspyridakos P. Accuracy of 3D Printed Implant Casts Versus Stone Casts: A Comparative Study in the Anterior Maxilla. J Prosthodont 2021; 30:783-788. [PMID: 33474754 DOI: 10.1111/jopr.13335] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To conduct an in vitro comparison of the amount of three-dimensional (3D) deviation of 3D printed casts generated from digital implant impressions with an intraoral scanner (IOS) to stone casts made of conventional impressions. MATERIAL AND METHODS A maxillary master cast with partially edentulous anterior area was fabricated with two internal connection implants (Regular CrossFit, Straumann). Stone casts (n = 10) that served as a control were fabricated with the splinted open-tray impression technique. Twenty digital impressions were made using a white light IOS (TRIOS, 3shape) and the Standard Tesselation Language (STL) files obtained were saved. Based on the STL files, a digital light processing (DLP) and a stereolithographic (SLA) 3D printer (Varseo S and Form 2) were used to print casts (n = 10 from each 3D printer). The master cast and all casts generated from each group were digitized using the same IOS. The STL files obtained were superimposed on the master cast STL file (reference) to evaluate the amount of 3D deviation with inspection software using the root mean square value (RMS). The independent-samples Kruskal-Wallis test and Dunn's test with Bonferroni correction (for post hoc comparisons) were used for statistical analyses. RESULTS The Varseo S group had the lowest median RMS value [77.5 µm (IQR = 91.4-135.4)], followed closely by the Conventional group [77.7 µm (IQR = 61.5-93.4)]. The Form 2 had the highest mean value [98.8 µm (IQR = 57.6-87.9)]. The independent-samples Kruskal-Wallis test revealed a significant difference between the groups (p = 0.018). Post hoc testing revealed a significant difference between Varseo S and Form 2 (p = 0.009). CONCLUSION The casts generated from the Varseo S 3D printer had better 3D accuracy than did those from the Form 2 3D printer. Both the Varseo S group and the conventional stone casts groups had similar 3D accuracy.
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Affiliation(s)
- Ayman Banjar
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Yo-Wei Chen
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | | | - Matthew Finkelman
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA
| | | | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
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13
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Michelinakis G, Apostolakis D, Kamposiora P, Papavasiliou G, Özcan M. The direct digital workflow in fixed implant prosthodontics: a narrative review. BMC Oral Health 2021; 21:37. [PMID: 33478459 PMCID: PMC7819204 DOI: 10.1186/s12903-021-01398-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/13/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purpose of this narrative review was to examine the applicability of IOS procedures regarding single and multiple fixed implant restorations. Clinical outcomes for monolithic zirconia and lithium disilicate restorations produced through a direct digital workflow were reported. METHODS A MEDLINE (Pubmed) search of the relevant English-language literature spanning from January 1st 2015 until March 31st 2020 was conducted. In vitro studies comparing digital implant impression accuracy by different IOS devices or in vitro studies examining differences in accuracy between digital and conventional impression procedures were included. Also, RCTs, clinical trials and case series on the success and/or survival of monolithic zirconia and lithium disilicate restorations on implants, manufactured completely digitally were included. In vitro and in vivo studies reporting on restorations produced through an indirect digital workflow, case reports and non-English language articles were excluded. The aim was to investigate the accuracy of IOS for single and multiple fixed implant restorations compared to the conventional impression methods and report on the variables that influence it. Finally, this study aimed to report on the survival and success of fixed implant-retained restorations fabricated using the direct digital workflow. RESULTS For the single and short-span implant sites, IOS accuracy was high and the deviations in the position of the virtual implant fell within the acceptable clinical limits. In the complete edentulous arch with multiple implants, no consensus regarding the superiority of the conventional, splinted, custom tray impression procedure compared to the IOS impression was identified. Moreover, complete-arch IOS impressions were more accurate than conventional, non-splinted, open or close tray impressions. Factors related to scanbody design as well as scanner generation, scanning range and interimplant distance were found to influence complete-arch scanning accuracy. Single implant-retained monolithic restorations exhibited high success and survival rates and minor complications for short to medium follow-up periods. CONCLUSIONS The vast majority of identified studies were in vitro and this limited their clinical significance. Nevertheless, intraoral scanning exhibited high accuracy both for single and multiple implant restorations. Available literature on single-implant monolithic restorations manufactured through a complete digital workflow shows promising results for a follow-up of 3-5 years.
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Affiliation(s)
| | | | - Phophi Kamposiora
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - George Papavasiliou
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Mutlu Özcan
- Division of Dental Biomaterials, Center for Dental and Oral Medicine, Clinic for Reconstructive Dentistry, University of Zürich, Zurich, Switzerland
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14
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Papaspyridakos P, Vazouras K, Chen Y, Kotina E, Natto Z, Kang K, Chochlidakis K. Digital vs Conventional Implant Impressions: A Systematic Review and Meta‐Analysis. J Prosthodont 2020; 29:660-678. [DOI: 10.1111/jopr.13211] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
- Department of Prosthodontics, Eastman Institute for Oral Health University of Rochester Rochester NY
| | | | - Yo‐wei Chen
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | | | - Zuhair Natto
- Department of Dental Public Health King Abdulaziz University Jeddah Saudi Arabia
- Department of Periodontology Tufts University School of Dental Medicine Boston MA
| | - Kiho Kang
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health University of Rochester Rochester NY
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15
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Vandenberghe B. The crucial role of imaging in digital dentistry. Dent Mater 2020; 36:581-591. [PMID: 32299666 DOI: 10.1016/j.dental.2020.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
One of the recent trends in dentistry - and this in every field from the restorative to the orthodontic one- is the introduction of simplified completely digital workflows. Digital dentistry is supposed to allow dentists to work more efficiently, and this at higher precision, and with the possibility of all-in-one sessions using in-house computerized techniques. In this workflow, one of the major tools for simulating and transferring dental treatments is imaging. Both 3D low dose radiographic as well as optical imaging are playing crucial roles and have been overwhelming the market. Novel design platforms, compact and extremely fast milling and printing units are now also plentiful and rapidly being adopted in practice. Nevertheless, many of the steps in this digital dentistry process, no matter how simplified, present risks that can contribute to reduced precision and clinical difficulties. It is therefore the purpose of the article to briefly describe the role of imaging in this digital workflow, and where the pitfalls can be found that may lead to errors and imprecision.
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Affiliation(s)
- Bart Vandenberghe
- Advimago, Center for Advanced Oral Imaging, Emile Clausstraat 42, 1050 Brussels, Belgium.
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16
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Chochlidakis K, Papaspyridakos P, Tsigarida A, Romeo D, Chen Y, Natto Z, Ercoli C. Digital Versus Conventional Full‐Arch Implant Impressions: A Prospective Study on 16 Edentulous Maxillae. J Prosthodont 2020; 29:281-286. [DOI: 10.1111/jopr.13162] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
| | - Panos Papaspyridakos
- Department of ProsthodonticsEastman Institute for Oral Health, University of Rochester NY
- Department of ProsthodonticsSchool of Dental MedicineTufts University Boston MA
| | - Alexandra Tsigarida
- Department of PeriodonticsEastman Institute for Oral Health, University of Rochester NY
| | - Davide Romeo
- Department of ProsthodonticsEastman Institute for Oral Health, University of Rochester NY
- Advanced Oral Surgery UnitVita Salute University, San Raffaele Hospital Milan Italy
| | - Yo‐wei Chen
- Department of ProsthodonticsSchool of Dental MedicineTufts University Boston MA
| | - Zuhair Natto
- Department of Dental Public HealthKing Abdulaziz University Jeddah Saudi Arabia
- Department of PeriodontologySchool of Dental Medicine, Tufts University Boston MA
| | - Carlo Ercoli
- Department of ProsthodonticsEastman Institute for Oral Health, University of Rochester NY
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