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Kondakji E, Lawand G, Yaacoub W, Tohme H. Effect of different surface locking patterns on the trueness of complete arch digital implant scans: An in vitro study. J Prosthet Dent 2024; 132:601.e1-601.e9. [PMID: 38918157 DOI: 10.1016/j.prosdent.2024.05.019] [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: 01/11/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/27/2024]
Abstract
STATEMENT OF PROBLEM The effect of different surface locking patterns on the trueness of a digital implant scan of a completely edentulous arch remains uncertain. PURPOSE The purpose of this in vitro study was to evaluate whether locking surfaces with different patterns affected the trueness of complete arch implant digital scans. MATERIAL AND METHODS An edentulous maxillary cast with 4 implants (2 anterior implants parallel and 2 posterior implants tilted at 17 degrees) was fabricated. Four implant-level scan bodies were fixed onto the implants, and the cast was scanned with a desktop scanner to create the reference file. Four groups (L0, L1, L2, and L3) were formed, each with a distinct locking surface configuration, and all scans were made using the same intraoral scanner. L0 kept all 4 implant-level scan bodies during scanning. L1 involved removing the right first premolar (RPM) scan body, scanning the other 3 implant scan bodies, then reattaching the RPM's scan body, and continuing scanning. In L2, the RPM and right lateral incisor (RIC) scan bodies were removed, followed by scanning the left implants to create a locking surface, and scanning the right implants. In L3, only the left posterior molar's (LPM) scan body was retained and scanned; then a locking surface was generated, and then the remaining implants were scanned. A metrology software program (Geomagic Control X) was used for comparison. Statistical analyses were performed using the Kruskal-Wallis, the 1-way ANOVA, the Welch ANOVA, the Friedman test, the repeated-measures ANOVA, the Bonferroni post hoc test, and the Games-Howell post hoc test (α=.05). RESULTS Significant 3D surface deviations were observed in the coronal bevel (CB) region and in the entire scan bodies when assessing trueness in the L0, L1, L2, and L3 groups (P<.001). L2 exhibited the highest discrepancies in 3D surface deviation for CB (0.030 ±0.002 mm) and implant scan bodies (0.357 ±0.052 mm) and distance deviation, while the highest mean angular deviation values were found in L0 (0.924 ±0.131 degrees). CONCLUSIONS Locking half of the arch showed the highest trueness discrepancies when performing digital scans for complete arch implant-supported prostheses.
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Affiliation(s)
- Elissa Kondakji
- Resident, Department of Prosthodontics and Esthetic Dentistry, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Ghida Lawand
- Clinical Instructor, Department of Removable and Fixed Prosthodontics, Beirut Arab University, Beirut, Lebanon
| | - Wassim Yaacoub
- Resident, Department of Prosthodontics and Esthetic Dentistry, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Hani Tohme
- Founder and Head, Department of Digital Dentistry, Artificial Intelligence, and Evolving Technologies, Saint Joseph University of Beirut, Beirut, Lebanon; and Postgraduate Program Director, Department of Removable Prosthodontics, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Bischof FM, Mathey AA, Stähli A, Salvi GE, Brägger U. Survival and complication rates of tooth- and implant-supported restorations after an observation period up to 36 years. Clin Oral Implants Res 2024. [PMID: 39177417 DOI: 10.1111/clr.14351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/02/2024] [Accepted: 07/29/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Tooth- and implant-supported fixed dental prostheses are well-documented and aesthetic treatment alternatives, and after a comprehensive periodontal treatment, a protocol with a good long-term prognosis if the maintenance program is strictly followed. AIM To reexamine a pre-existing patient cohort in order to obtain estimated long-term survival and complication outcomes of fixed dental prostheses. MATERIALS AND METHODS For this study, patients treated with fixed dental prostheses between 1978 and 2002 were reexamined between 2019 and 2020. The restorations were divided in single crowns and fixed dental prostheses supported by teeth (TSC, FPTDP) and implants (ISC, FPIDP). Survival and complication rates were obtained. Kaplan-Meier functions were used to model complication probabilities, and average hazard ratios of different strata were compared using weighted Cox regression. RESULTS The mean observation time of 40 patients and 223 reconstructions was 20.3 (±9.7, 1.2-36.2) years. The estimated survival rates were 84% (CI: 77%-92%) for TSC, 63% (CI: 51%-79%) for FPTDP, 87% (CI: 71%-100%) for ISC, and 64% (CI: 34%-100%) for FPIDP after 25 years. Biological complications included carious lesions (10.6%), periodontitis (7.9%), and peri-implantitis (6.8%). Technical complications included chipping (20.2%) and loss of retention (10.8%). CONCLUSION Biological complications lead to abutment loss in more than two-thirds of cases, regardless of the type of abutment (tooth or implant). Technical complications are less associated with abutment loss than biological complications.
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Affiliation(s)
- Frank M Bischof
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Ayse A Mathey
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Strauss FJ, Gil A, Smirani R, Rodriguez A, Jung R, Thoma D. The use of digital technologies in peri-implant soft tissue augmentation - A narrative review on planning, measurements, monitoring and aesthetics. Clin Oral Implants Res 2024; 35:922-938. [PMID: 38308466 DOI: 10.1111/clr.14238] [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: 09/03/2023] [Revised: 11/21/2023] [Accepted: 01/11/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To identify the different uses and modalities of digital technologies to diagnose, plan and monitor peri-implant soft tissue conditions and aesthetics. METHODS A comprehensive narrative review of pertinent literature was conducted, critically appraising key digital technologies that may assist peri-implant soft tissue augmentation and assessment. An electronic search on four databases including studies published prior to 1st July 2023 was performed and supplemented by a manual search. RESULTS Predominantly, tools such as cone beam computed tomography (CBCT), intraoral scanning (iOS), intraoral ultrasonography and digital spectrophotometry were commonly to assess and monitor peri-implant soft tissues. The main clinical and research applications included: (i) initial assessment of mucosal thickness, supra-crestal tissue height and keratinized mucosa width, (ii) evaluation of peri-implant soft tissue health and inflammation, (iii) monitoring profilometric changes and midfacial mucosal margin stability over time and (iv) aesthetic evaluation through colour assessment. While evidence for some digital tools may be limited, the integration of digital technologies into peri-implant soft tissue management holds great promise. These technologies offer improved precision, comfort and speed in assessment, benefiting both patients and clinicians. CONCLUSION As digital technologies progress, their full potential in peri-implant soft tissue augmentation and their value will become more evident with ongoing research. Embracing these innovations and their potential benefits is recommended to ensure that during progress in implant dentistry, patient care is not hindered.
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Affiliation(s)
- Franz Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Alfonso Gil
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Rawen Smirani
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Univ. Bordeaux, INSERM, BioTis, U1026, Bordeaux, France
- CHU de Bordeaux, Service de Médecine Bucco-Dentaire, Bordeaux, France
| | - Amanda Rodriguez
- Department of Periodontics and Oral Medicine, Dental School, University of Michigan, Ann Arbor, Michigan, USA
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Bessadet M, Auduc C, Drancourt N, Nicolas E, El Osta N. Comparative analyses of time efficiency and cost in fabricating fixed implant-supported prostheses in digital, hybrid, and conventional workflows: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(24)00456-6. [PMID: 39069390 DOI: 10.1016/j.prosdent.2024.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/30/2024]
Abstract
STATEMENT OF PROBLEM Economic considerations affect whether new technologies are adopted in dental practice. Limited evidence exists regarding the time and cost efficiency of different workflows for fabricating implant-supported restorations. PURPOSE The purpose of this systematic review and meta-analysis was to compare the time and cost involved in fabricating fixed implant-supported prostheses using digital, hybrid, and conventional methods throughout the entire prosthetic treatment by analyzing both clinical and laboratory steps. MATERIAL AND METHODS A systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA)-P 2015 guidelines. The methods and inclusion criteria were specified in a protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO) (registration number CRD42023458734). The databases PubMed, Cochrane, and PROSPERO were searched using keywords: (Prosthodontic OR restorative dentistry OR denture) AND (CAD CAM OR Digital workflow OR Computer Dentistry OR Digital Design) AND (Economic OR cost OR Financial OR time efficiency). Two investigators selected articles independently. RESULTS A qualitative synthesis of 12 articles published from 2010 to 2023 showed that digital scans took less time than conventional impressions (P<.05) in 7 out of 9 articles. Additionally, 8 articles revealed significant reductions in laboratory working time with digital workflows, intermediate times with hybrid workflows, and longer times with conventional workflows (P<.001). Meta-analysis confirmed the time efficiency of digital scanning over conventional impressions (Hedges g=1.65, 95% CI [0.33, 2.98]) and a substantial reduction in laboratory time with digital workflows compared with other workflows (Hedges g=6.55, 95% CI [2.69; 10.42]). However, no significant difference was found in adjustment time between digital and other workflows (Hedges g=0.91, 95% CI [-0.72; 2.55]). Direct laboratory costs were observed to be higher in conventional workflows compared with hybrid or digital workflows, with hybrid workflows also showing elevated costs compared with digital workflows (P<.05). CONCLUSIONS The digital workflow demonstrates potential benefits in reducing scan time, laboratory processing time, and direct laboratory costs for implant-supported restorations in partial edentulism. Further research is needed to validate these findings, particularly for long-span implant-supported fixed partial prostheses.
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Affiliation(s)
- Marion Bessadet
- Vice Dean and Senior Lecturer, Department of Prosthodontics, UFR d'Odontologie, Clinical Odontology Research Center (CROC), University of Clermont Auvergne, Clermont-Ferrand, France; and Hospital Practitioner, CHU Clermont-Ferrand, Odontology Department, Clermont-Ferrand, France
| | - Chantal Auduc
- Hospital Practitioner, CHU Clermont-Ferrand, Odontology Department, Clermont-Ferrand, France
| | - Noémie Drancourt
- Lecturer, Department of Prosthodontics, UFR d'Odontologie, Clinical Odontology Research Center (CROC), University of Clermont Auvergne, Clermont-Ferrand, France; and Hospital Practitioner, CHU Clermont-Ferrand, Odontology Department, Clermont-Ferrand, France
| | - Emmanuel Nicolas
- Dean and Professor, Department of Prosthodontics, UFR d'Odontologie, Clinical Odontology Research Center, University of Clermont Auvergne, Clermont-Ferrand, France; and Hospital Practitioner, CHU Clermont-Ferrand, Odontology Department, Clermont-Ferrand, France
| | - Nada El Osta
- Professor, Department of Prosthodontics, UFR d'Odontologie, Clinical Odontology Research Center (CROC), University of Clermont Auvergne, Clermont-Ferrand, France.
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Elashry WY, Elsheikh MM, Elsheikh AM. Evaluation of the accuracy of conventional and digital implant impression techniques in bilateral distal extension cases: a randomized clinical trial. BMC Oral Health 2024; 24:764. [PMID: 38970004 PMCID: PMC11227137 DOI: 10.1186/s12903-024-04495-0] [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: 01/29/2024] [Accepted: 06/17/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND This clinical study aims to evaluate the accuracy of the conventional implant impression techniques compared to the digital impression ones in bilateral distal extension cases. METHODS A total of 32 implants were placed in eight patients missing all mandibular posterior teeth except the first premolars. Each patient received a total of four implants, with two implants placed on each side, in order to provide support for three units of screw-retained zirconia restorations. Following osteointegration, the same patient underwent two implant-level impression techniques: Conventional open-tray impressions CII (splinted pick-up) and digital implant impressions DII with TRIOS 3 Shape intraoral scanner. The accuracy of impressions was evaluated utilizing a three-dimensional superimposition analysis of standard tessellation language (STL) files. Subsequently, the scan bodies were segmented using Gom inspect software to measure three-dimensional deviations in a color-coding map. Data were statistically analyzed using the Kruskal Wallis test and then a post-hoc test to determine the significance level (P < 0.05). RESULTS The study revealed that higher angular and positional deviations were shown toward distal scan bodies compared to mesial ones for both impression techniques. However, this difference was not statistically significant (P > 0.05). CONCLUSION Splinted open-tray conventional impression and intraoral scanning implant impression techniques have demonstrated comparable accuracy. TRIAL REGISTRATION Clinical Trials.gov Registration ID NCT05912725. Registered 22/06/ 2023- Retrospectively registered, https://register. CLINICALTRIALS gov .
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Affiliation(s)
- Wafaa Youssef Elashry
- Assistant lecturer, Prosthodontic department, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | | | - Ali Mohamed Elsheikh
- Professor, Prosthodontic department, Faculty of Dentistry, Tanta University, Tanta, Egypt
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Miftah ur Rahman M, Gundala R, Gupta K, Rami DS, Bhanawat N, Dewan H, Patel V, Kommuri S. Evaluation of Different Materials used in Prosthetic of Dental Implants: A Comparitive Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S2397-S2399. [PMID: 39346305 PMCID: PMC11426703 DOI: 10.4103/jpbs.jpbs_272_24] [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: 03/24/2024] [Revised: 04/02/2024] [Accepted: 04/27/2024] [Indexed: 10/01/2024] Open
Abstract
Background Implant-supported prostheses have become a cornerstone of restorative dentistry, offering patients an effective solution for missing teeth. However, the choice of material for these prostheses can significantly impact their maintenance requirements and long-term success. Methods Patient records of individuals who received implant-supported prostheses over a 2-year period were reviewed. Data on maintenance interventions, including adjustments, repairs, and replacements were collected and analyzed for metal alloys, ceramics, and composites. Results Metal alloys exhibited slightly higher average numbers of adjustments compared to ceramics and composites. Ceramics required a higher mean number of repairs and replacements compared to other materials. Statistical analysis revealed significant differences in adjustment frequency between metal alloys and ceramics (P = 0.047), but no significant differences were observed for repairs or replacements. Conclusion The outcomes imply that material choice plays a significant role in the maintenance requirements of implant dental prostheses. While metal alloys may require more frequent adjustments, ceramics and composites may necessitate more repairs and replacements over time. Clinicians should consider these factors when selecting materials for implant prostheses and develop tailored maintenance protocols to optimize treatment outcomes.
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Affiliation(s)
- Md Miftah ur Rahman
- Prosthodontics and Implantologist, Neodent Dental Hospital Hyderabad, Telangana, India
| | - Rupasree Gundala
- Assistant Professor, Department of Periodontics, Government Dental College and Hospital, Vijayawada, Andhra Pradesh, India
| | - Kavita Gupta
- Department of Prosthodontics, Government Dental College, Jamnagar, Gujarat, India
| | - Diptesh S. Rami
- Department of Prosthodontics, Crown and Bridge, AMC Dental College and Hospital, Ahmedabad, Gujarat, India
| | - Nilesh Bhanawat
- Department of Dentistry, Government Medical College, Khandwa, Madhya Pradesh, India
| | - Harisha Dewan
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, KSA
| | - Vilas Patel
- Department of Prosthodontics, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
| | - Sirisha Kommuri
- Department of Prosthodontics, Narsinhbhai Patel Dental College and Hospital, Sankalchand Patel University, Visnagar, Gujarat, India
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Raja SR, Dutta A, Jain SK, Dewan H, Thomas V, Jose AT. In Vitro Comparative Analysis of Digital Versus Conventional Impressions in Fixed Prosthodontics. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S2700-S2702. [PMID: 39346325 PMCID: PMC11426723 DOI: 10.4103/jpbs.jpbs_406_24] [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: 04/07/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 10/01/2024] Open
Abstract
Background In the realm of fixed prosthodontics, the transition from conventional to digital impressions has been a subject of ongoing debate. This study aims to provide a comparative analysis of digital versus conventional impressions in terms of accuracy and efficiency. Materials and Methods Twenty patients requiring fixed prosthodontic treatment were selected for this study. Each patient received both digital and conventional impressions. The digital impressions were obtained using an intraoral scanner, while conventional impressions were taken using polyvinyl siloxane material. The impressions were then used to fabricate fixed prostheses for each patient. Accuracy was assessed through measurement of marginal fit using a standardized technique, and efficiency was evaluated based on time taken for impression procedures. Results The mean marginal discrepancy for digital impressions was found to be 38 micrometers (±5), whereas for conventional impressions, it was 45 micrometers (±7). Additionally, the average time taken for digital impressions was 12 minutes, compared to 20 minutes for conventional impressions. Conclusion Digital impressions demonstrated superior accuracy and efficiency compared to conventional impressions in fixed prosthodontics.
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Affiliation(s)
- S Ramesh Raja
- Prosthodontics Rajas Dental College and Hospital Kavalkinaru, Tirunelveli, Tamil Nadu, India
| | - Arjita Dutta
- Prosthodontics, I.T.S Dental College, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Saket Kumar Jain
- Department of Dentistry, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, India
| | - Harisha Dewan
- Prosthetic Dental Sciences, College of Dentistry, Shawajra Campus, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Vishnu Thomas
- Department of Prosthodontics, Al-Azhar Dental College, Thodupuzha, Kerala, India
| | - Ajimol Theresa Jose
- Prosthodontics College, Porunnolil Pala Dental Clinic and Implants, Sangeo Complex, Puthenpallikunnu, Pala, Kerala, India
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Mahato M, Hota S, Jain A, Dutta D, Bhushan P, Raut A. Comparison of Conventional and Digital Workflows in the Fabrication of Fixed Prostheses: A Systematic Review. Cureus 2024; 16:e61764. [PMID: 38975453 PMCID: PMC11226733 DOI: 10.7759/cureus.61764] [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: 06/04/2024] [Indexed: 07/09/2024] Open
Abstract
When considering dental restorations, the use of fixed partial dentures is one of the most widely accepted treatment options. In the past, fabrication was done using traditional techniques and the conventional workflow was by far the popular method; however, nowadays digital workflows are being used as a means to produce the prosthesis. This systematic review aims to compare the workflows by considering their respective qualities, such as precision, efficiency, cost-effectiveness, and clinical performance. A complete search has been carried out to incorporate any relevant studies published between the years 2012 and 2023 in databases such as Scopus, Web of Science, PubMed, ScienceDirect, and Cochrane Library. Two independent reviewers screened articles for inclusion and assessed the studies' methodological quality rating via the NIH Tool. A total of 22 relevant articles were reviewed after a systematic search strategy. The main outcome of the review was digital workflows were found to reduce working time, eliminate the selection of trays, minimize material consumption, and enhance patient comfort and acceptance. The studies also showed that digital workflows resulted in greater patient satisfaction and higher success rates than conventional workflows. Workflows for digital dentistry demonstrated to be better than traditional ones due to the cost-effectiveness, accuracy, and time optimization for the fabrication of fixed prostheses.
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Affiliation(s)
- Mousumi Mahato
- Prosthodontics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Sadananda Hota
- Prosthodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Amulya Jain
- Prosthodontics and Crown and Bridge, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Debanwita Dutta
- Prosthodontics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Purnendu Bhushan
- Prosthodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Anjana Raut
- Prosthodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
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Haghi HR, Ghanbarzadeh J, Kiamanesh E. A randomized clinical trial comparing the clinical fit and chairside adjustment time for implant-supported crowns fabricated by fully digital and partially digital techniques. J Prosthet Dent 2024; 131:865-870. [PMID: 35525625 DOI: 10.1016/j.prosdent.2022.02.024] [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: 08/19/2021] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Implant-supported crowns made in both fully and partially digital workflows have been evaluated, but these studies have been mainly performed in vitro. Moreover, data on the comparison of clinical fitting and adjustment time for implant-supported crowns are limited. PURPOSE The purpose of this randomized clinical trial was to evaluate the clinical fit and adjustment time for implant-supported crowns produced by a partially and fully digital workflow in partially edentulous participants. MATERIAL AND METHODS Twenty-eight participants who had received 2 adjacent implants in posterior sites were enrolled, each receiving 2 custom titanium abutments and a splinted monolithic zirconia restoration. Restorations of the control group (n=14) were produced from a digital scan and a cast-free digital workflow, while the restorations of the test group (n=14) were from a conventional impression and a partially digital workflow. A blinded investigator delivered the restorations. The clinical adjustment was performed incrementally, and a digital chronometer recorded the time required for the evaluation and adjustment at each step. An independent t test, Mann-Whitney U test, and the Fisher exact test were used to evaluate the results (α=.05). RESULTS The total mean adjustment time in the control group (12.49 minutes) was significantly longer than that of the test group (11.27 minutes) (P<.001). For the occlusal contact points, significantly less clinical adjustment time was required with the cast-free digital workflow (5.31 minutes) than with the model-based partially digital workflow (6.06 minutes) (P=.001). On other surfaces, no significant difference was found between the 2 groups (P>.05). All crowns could be successfully delivered after 2 clinical appointments (impression and delivery). Remakes were not necessary for any restorations in the test or control group. CONCLUSIONS The parameters of occlusal adjustment time and total adjustment time of the fully digital workflow were significantly shorter than those of the partially digital workflow.
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Affiliation(s)
- Hamidreza Rajati Haghi
- Associate Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Jalil Ghanbarzadeh
- Associate Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Kiamanesh
- Assistant Professor, Department of Prosthodontics School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
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Rutkūnas V, Bilius V, Dirsė J, Revilla-León M, Rimašauskas M, Zadrożny Ł, Trumpaitė-Vanagienė R. Repositioning accuracy of the implant- and abutment-level prosthetic components used in conventional and digital workflows. J Dent 2024; 143:104835. [PMID: 38224850 DOI: 10.1016/j.jdent.2024.104835] [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: 07/05/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVES To evaluate the repositioning accuracy of the implant- and abutment-level impression components (impression abutments and implant scan bodies) and implant abutments (with and without anti-rotational hex index); also, to estimate the tightening torque influence on the positional stability of abutments. METHODS Seven types of prosthetic components (n = 7) [impression pick-up copings (PC), implant scan bodies (ISB), non‑hex and hex titanium base implant abutments (TB H and TB NH), multi-unit impression copings (MU PC), multi-unit implant scan bodies (MU ISB), and multi-unit caps (MU C) (Medentika GmbH)] were tested. For repositioning accuracy tests a coordinate measuring machine (CMM) was used. During assembly 15 Ncm torque for all components was applied. After measurement, only hex and non‑hex abutments were torqued to 25 Ncm and their coordinates were again recorded to assess torque influence. The procedure was repeated 7 times for each component. Linear and 3D deviations, angulation to the vertical axis, and axial rotation were calculated. The Kruskal-Wallis test was used to compare the measurements between the groups. A post-hoc test (Mann-Whitney U test) was used for pairwise comparison to determine the influence of the torque (α=0.05). RESULTS Implant- and abutment-level components used for digital scans showed different positional discrepancies compared to ones used for conventional impressions and ranged from 10 to 37 µm. Hex abutments demonstrated statistically significantly lower 3D deviations (4.4 ± 7.1 µm) compared to non‑hex abutments (8.7 ± 6.1 µm). Torque influence was significantly lower for hex abutments than for non‑hex abutments. CONCLUSIONS Repositioning inaccuracies were found in all implant- and abutment-level impression components (impression abutments and implant scan bodies) and all abutments (with and without anti-rotational hex index) tested. Final tightening of the components could cause further positional discrepancies. CLINICAL SIGNIFICANCE The misfit of the prosthetic components used in conventional and digital workflows stays in the clinically acceptable range. Even when multiple connections and disconnections on the track of the laboratory preparation is needed, it should not have a negative influence for single teeth reconstructions. However, in the complex cases with multiple implants, repetitive repositioning of the prosthetic components may lead to the accumulation of vertical, horizontal and rotational errors leading to the clinical problems with the passive fit of the final framework.
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Affiliation(s)
- Vygandas Rutkūnas
- Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, Lithuania
| | | | - Julius Dirsė
- Prosthodontist, Private practice, Vilnius, Lithuania
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA; Kois Center, Seattle, WA, USA; Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, MA, USA
| | - Marius Rimašauskas
- Department of Manufacturing Engineering, Kaunas University of Technology, Lithuania
| | - Łukasz Zadrożny
- Department of Dental Propaedeutics and Prophylaxis, Faculty of Dental Medicine, Medical University of Warsaw, 02-006 Warsaw, Poland.
| | - Rita Trumpaitė-Vanagienė
- Department of Prosthodontics, Institute of Odontology, Faculty of Medicine, Vilnius University, Lithuania
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Sabev B, Abazi S, Patcas R, Hertig G, Meyer S, Rommers N, Thieringer FM, Metzler P. Fully digital occlusion planning in orthognathic surgery - A crossover study. J Craniomaxillofac Surg 2024:S1010-5182(24)00090-8. [PMID: 39261246 DOI: 10.1016/j.jcms.2024.03.007] [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: 01/28/2024] [Accepted: 03/12/2024] [Indexed: 09/13/2024] Open
Abstract
Orthognathic surgery enables patients with severe jaw malocclusions to normalise their chewing function and, as such, to improve their quality of life. Over the last few years, digitalisation has been set in motion by intraoral scanners and the improvement of planning software in the field of oral and maxillofacial surgery. Previous studies based on plaster cast models showed that the virtual occlusion based on digitally scanned models can be comparable to conventional methods. This retrospective crossover study aimed to prove that the virtual occlusion finding with the IPS CaseDesigner® (version 2.3.5.2, KLS Martin, Tuttlingen, Germany) is accurate enough to use intraoral scans exclusively. MATERIALS AND METHODS A total of 23 orthognathic surgery patients receiving an intraoral scan for their treatment were included in this study. Two experienced maxillofacial surgeons haptically performed the occlusion finding on three-dimensional (3D) stereolithographic models using the fully digital pathway. One surgeon repeated the procedure a second time to evaluate intra-observer variability. The study aimed to show the difference between these two planning methods by upholding the surgical accuracy of less than 2 mm in translation and 2° in rotation. The conventional haptic occlusion was set as a reference throughout the whole study. The data were tested with a one-sample Wilcoxon test for the fit into the surgical accuracy. RESULTS The difference between the virtual and conventional groups was significantly smaller than the surgical accuracy (all p < 0.001). Both translational movements (anterior/posterior (median 0.51 mm [0.28, 0.88]), left/right (median 0.46 mm [0.20, 0.87]), cranial/caudal (median 0.37 mm [0.11, 0.69])) and rotations (Roll (median 0.71° [0.29, 1.35]), Pitch (median 0.72° [0.29, 1.44]), Yaw (median 1.09° [0.33, 1.60])) were in the range of surgical accuracy (2 mm/2°). The most significant differences were found in the anterior/posterior translation (median 0.51 mm [0.28, 0.88]) and the Yaw rotation (median 1.09° [0.33, 1.60]). CONCLUSION These results demonstrate that the entirely virtual workflow in orthognathic surgery, including intraoral scanning and the virtual semi-automatic occlusion finding, represents a reliable and state-of-the-art alternative to the conventional haptic method.
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Affiliation(s)
- Bogomil Sabev
- Oral- and Cranio-Maxillofacial Surgery, Cantonal Hospital Aarau, Tellstrasse, 5001 Aarau, Switzerland; Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zürich, Switzerland
| | - Sead Abazi
- Oral- and Cranio-Maxillofacial Surgery, University Hospital Basel, Klinikum 1, Spitalstrasse 21, 4031 Basel, Switzerland; Medical Additive Manufacturing Research Group (Swiss MAM), Hegenheimermattweg 167C/2nd floor, 4123 Allschwil, Switzerland
| | - Raphael Patcas
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zürich, Switzerland
| | - Gabriel Hertig
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zürich, Switzerland
| | - Simon Meyer
- Oral- and Cranio-Maxillofacial Surgery, University Hospital Basel, Klinikum 1, Spitalstrasse 21, 4031 Basel, Switzerland; Medical Additive Manufacturing Research Group (Swiss MAM), Hegenheimermattweg 167C/2nd floor, 4123 Allschwil, Switzerland
| | - Nikki Rommers
- Department of Clinical Research, University of Basel, University Hospital Basel, 4031 Basel, Switzerland
| | - Florian M Thieringer
- Oral- and Cranio-Maxillofacial Surgery, University Hospital Basel, Klinikum 1, Spitalstrasse 21, 4031 Basel, Switzerland; Medical Additive Manufacturing Research Group (Swiss MAM), Hegenheimermattweg 167C/2nd floor, 4123 Allschwil, Switzerland
| | - Philipp Metzler
- Oral- and Cranio-Maxillofacial Surgery, Cantonal Hospital Aarau, Tellstrasse, 5001 Aarau, Switzerland.
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Caussin É, Courson F, Dursun E, Brukarz Y, Dot D, Chaussain C, Attal J, François P. Interdisciplinary full mouth rehabilitation of a patient with amelogenesis imperfecta from childhood to young adult-hood: A 12-year case report. Clin Case Rep 2024; 12:e8704. [PMID: 38523819 PMCID: PMC10957491 DOI: 10.1002/ccr3.8704] [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: 01/22/2024] [Revised: 02/24/2024] [Accepted: 02/29/2024] [Indexed: 03/26/2024] Open
Abstract
Treatment of patients with amelogenesis imperfecta extends over many years, from childhood to early adulthood. Their management at any age is complex and has to be adapted in relation to therapies validated in the general population.
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Affiliation(s)
- Élisa Caussin
- Faculty of Dental SurgeryUniversity of Paris CitéMontrougeFrance
- Bretonneau Hospital, AP‐HPParisFrance
- URB2i, Université of Paris CitéMontrougeFrance
| | - Frédéric Courson
- Faculty of Dental SurgeryUniversity of Paris CitéMontrougeFrance
- Bretonneau Hospital, AP‐HPParisFrance
- URB2i, Université of Paris CitéMontrougeFrance
| | - Elisabeth Dursun
- Faculty of Dental SurgeryUniversity of Paris CitéMontrougeFrance
- URB2i, Université of Paris CitéMontrougeFrance
- Henri Mondor Hospital, AP‐HPCréteilFrance
| | | | - Daniel Dot
- Faculty of Dental SurgeryUniversity of Paris CitéMontrougeFrance
- Bretonneau Hospital, AP‐HPParisFrance
| | - Catherine Chaussain
- Faculty of Dental SurgeryUniversity of Paris CitéMontrougeFrance
- Bretonneau Hospital, AP‐HPParisFrance
- Laboratory Unité de Recherche 2496 Orofacial Pathologies, Imaging and Biotherapies, University of Paris CitéParisFrance
| | - Jean‐Pierre Attal
- Faculty of Dental SurgeryUniversity of Paris CitéMontrougeFrance
- URB2i, Université of Paris CitéMontrougeFrance
- Charles Foix Hospital, AP‐HPIvry‐Sur‐SeineFrance
| | - Philippe François
- Faculty of Dental SurgeryUniversity of Paris CitéMontrougeFrance
- Bretonneau Hospital, AP‐HPParisFrance
- URB2i, Université of Paris CitéMontrougeFrance
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Brandenburg LS, Georgii J, Schmelzeisen R, Spies BC, Burkhardt F, Fuessinger MA, Rothweiler RM, Gross C, Schlager S, Metzger MC. Reconstruction of dental roots for implant planning purposes: a retrospective computational and radiographic assessment of single-implant cases. Int J Comput Assist Radiol Surg 2024; 19:591-599. [PMID: 37523011 PMCID: PMC10881751 DOI: 10.1007/s11548-023-02996-x] [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: 03/07/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023]
Abstract
PURPOSE The aim of the study was to assess the deviation between clinical implant axes (CIA) determined by a surgeon during preoperative planning and reconstructed tooth axes (RTA) of missing teeth which were automatically computed by a previously introduced anatomical SSM. METHODS For this purpose all available planning datasets of single-implant cases of our clinic, which were planned with coDiagnostix Version 9.9 between 2018 and 2021, were collected for retrospective investigation. Informed consent was obtained. First, the intraoral scans of implant patients were annotated and subsequently analyzed using the SSM. The RTA, computed by the SSM, was then projected into the preoperative planning dataset. The amount and direction of spatial deviation between RTA and CIA were then measured. RESULTS Thirty-five patients were implemented. The mean distance between the occlusal entry point of anterior and posterior implants and the RTA was 0.99 mm ± 0.78 mm and 1.19 mm ± 0.55, respectively. The mean angular deviation between the CIA of anterior and posterior implants and the RTA was 12.4° ± 3.85° and 5.27° ± 2.97° respectively. The deviations in anterior implant cases were systematic and could be corrected by computing a modified RTA (mRTA) with decreased deviations (0.99 mm ± 0.84 and 4.62° ± 1.95°). The safety distances of implants set along the (m)RTA to neighboring teeth were maintained in 30 of 35 cases. CONCLUSION The RTA estimated by the SSM revealed to be a viable implant axis for most of the posterior implant cases. As there are natural differences between the anatomical tooth axis and a desirable implant axis, modifications were necessary to correct the deviations which occurred in anterior implant cases. However, the presented approach is not applicable for clinical use and always requires manual optimization by the planning surgeon.
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Affiliation(s)
- Leonard Simon Brandenburg
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
| | - Joachim Georgii
- Key Scientist Modeling and Simulation, Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Max-von-Laue-Str. 2, 28359, Bremen, Germany
| | - Rainer Schmelzeisen
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center -University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Felix Burkhardt
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center -University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Marc Anton Fuessinger
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - René Marcel Rothweiler
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Christian Gross
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Stefan Schlager
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - Marc Christian Metzger
- Department of Oral and Maxillofacial Surgery, Clinic, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany
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Seth C, Bawa A, Gotfredsen K. Digital versus conventional prosthetic workflow for dental students providing implant-supported single crowns: A randomized crossover study. J Prosthet Dent 2024; 131:450-456. [PMID: 37179154 DOI: 10.1016/j.prosdent.2023.03.031] [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: 01/06/2022] [Revised: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 05/15/2023]
Abstract
STATEMENT OF PROBLEM Digital scanning has become popular and has been reported to be more comfortable for patients and equally or more accurate than conventional impression techniques. However, clinical evidence to support the advantages of digital scanning is sparse. PURPOSE The purpose of this randomized crossover study was to examine and compare the patient and provider perceptions of digital scanning and conventional impression making for implant-supported single crowns (ISSCs) provided by dental students under supervision. Furthermore, the quality and patient-reported outcome of the definitive restorations were compared. MATERIAL AND METHODS Forty participants in need of a single tooth replacement were enrolled. Three months after initial implant placement, recordings were made for implant-supported crowns. The participants were randomized into a conventional or a digital group but underwent both procedures. Only the designated impression or scan was sent to the dental laboratory technician to be processed. All participants and students were asked questions concerning which technique they preferred. Furthermore, the participants filled out an oral health impact profile (OHIP-14) questionnaire before and after treatment. The restorations' esthetic and technical quality was evaluated using the Copenhagen Index Score (CIS). RESULTS The participants preferred the digital technique (80%) over the conventional technique (2%), while 18% of the participants had no preference. The participants were bothered significantly more (P<.001), experienced significantly more shortness of breath (P<.001), and were significantly more anxious during the conventional impression than during the digital scan (P<.001). Most students also preferred the digital technique (65%) over the conventional technique (22%), and 13% had no preference. The students found that the conventional impression procedure was less time-consuming but more uncertain in comparison with the digital technique. The digital technique was perceived as significantly more impractical than the conventional technique (P<.05). The results from CIS showed no significant difference in the quality of the restorations. Following treatment, the OHIP-14 scores showed a significant drop, suggesting an increase in oral health-related quality of life (P<.001). CONCLUSIONS The perceptions of the participants and students of the digital intraoral scanning were significantly better than those of the conventional technique. No significant differences in the quality of the restorations or OHIP scores were observed using the two recording techniques.
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Affiliation(s)
- Chahak Seth
- Research scholar student, Oral Rehabilitation Section, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Annika Bawa
- Research student, Oral Rehabilitation Section, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Gotfredsen
- Professor, Oral Rehabilitation Section, Department of Odontology, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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15
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Vavrickova L, Kapitan M, Schmidt J. Patient-reported outcome measures (PROMs) of digital and conventional impression methods for fixed dentures. Technol Health Care 2024; 32:885-896. [PMID: 37661898 DOI: 10.3233/thc-230277] [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] [Indexed: 09/05/2023]
Abstract
BACKGROUND Digital impression technique or computer-aided impression (CAI) has been recently concluded as a clinically acceptable alternative to conventional impression method (CIM) in the fabrication of crowns, short fixed partial dentures (FPDs), and implant-supported crowns. OBJECTIVE The purpose of this study was to investigate the patients' opinion and subjective perception of two different ways of impression - digital and conventional. METHODS A total of 45 patients were treated with CAI and CIM for the fabrication of tooth or implant-supported crowns. They fulfilled a questionnaire including 11 questions regarding the treatment time, gag reflex, discomfort related to manipulation, and other aspects of treatment. RESULTS CAI was considered the preferential method for future treatment in 53% of patients, whereas 28.9% of the respondents preferred CIM. The preference for the impression method was influenced by the total time spent with the procedure, discomfort during manipulation with the tray or scanning head, size of the tray or scanning head, maximal opening discomfort, and (the tendency towards) gag reflex. CONCLUSION CAI was considered a more comfortable and preferential method. Discomfort or difficulties during CAI negatively affected the patients' attitude to CAI, whereas the difficulties associated with CIM did not have any influence on the preferred method.
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Frąckiewicz W, Szymlet P, Jedliński M, Światłowska-Bajzert M, Sobolewska E. Mechanical characteristics of zirconia produced additively by 3D printing in dentistry - A systematic review with meta-analysis of novel reports. Dent Mater 2024; 40:124-138. [PMID: 37940500 DOI: 10.1016/j.dental.2023.10.020] [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: 05/17/2023] [Accepted: 10/20/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES This study was aimed at comparing the mechanical parameters of ceramics made using the addition and subtraction technique. METHODS A search was performed on four search engines on 5th April 2023. Quality assessment was performed using study type-specific scales. Where possible, a meta-analysis was performed. SOURCES Data were extracted from four search engines: PubMed, PubMed Central, Embase, Web of Science, Scopus. STUDY SELECTION The search strategy identified 686 potential articles. 19 papers were subject to qualitative analysis, and data from 11 papers were meta-analysed. The included studies were of high or medium quality. All included papers were in-vitro studies. No clinical trials were found in the literature. SIGNIFICANCE Ceramics made in the additive technology in terms of mechanical parameters can compete with ceramics made in the milling technology. There are no clinical studies yet that would indicate the use of this type of material for permanent restorations in patients. Studies presented in the literature vary greatly in terms of study design and reporting of results. The research did not receive external funding.
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Affiliation(s)
- Wojciech Frąckiewicz
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland.
| | - Paweł Szymlet
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Maciej Jedliński
- Department of Interdisciplinary Dentistry, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Małgorzata Światłowska-Bajzert
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Ewa Sobolewska
- Department of Dental Prosthetics, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
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Chen D, Zhao W, Ren L, Tao K, Li M, Su B, Liu Y, Ban C, Wu Q. Digital PBL-CBL teaching method improves students' performance in learning complex implant cases in atrophic anterior maxilla. PeerJ 2023; 11:e16496. [PMID: 38077445 PMCID: PMC10710131 DOI: 10.7717/peerj.16496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/30/2023] [Indexed: 12/18/2023] Open
Abstract
Background The clinical teaching of esthetic implant-supported restoration of the atrophic maxilla is challenging due to the complexity and unpredictability of bone and soft tissue augmentation. The traditional problem-based learning and case-based learning method (PBL-CBL method) with a full digital workflow (digital PBL-CBL method) provides the students a chance to view clinical cases in a more accurate and measurable way. The aim is to evaluate the effectiveness of the new digital PBL-CBL method in teaching complex implant cases in esthetic area. Materials & Methods A full digital workflow of dental implant therapy was established for patients with severely atrophic anterior maxilla. The digital data of cases done in the new workflow was used as teaching materials in digital PBL-CBL teaching. Fifty-four postgraduate students were randomly selected and divided into three groups, including traditional PBL-CBL group (students taught in a PBL-CBL method with no digital cases), digital PBL-CBL group (students taught in a PBL-CBL method with full digital cases) and control group (students taught in didactic teacher-centered method). After training for three months, a study of the students' opinions on the corresponding teaching method was carried out through a feedback questionnaire. A theory test was used to evaluate students' mastery of knowledge about tissue augmentation and esthetic implant restoration. A case analysis was used to determine whether students could apply the knowledge to problem solving. Results The digital PBL-CBL method resulted in a higher rate of satisfaction than the traditional PBL-CBL method and the didactic teacher-centered method in all items except for "This approach decreases extracurricular work". Case analysis scores of the digital PBL-CBL group were significantly higher than that of the traditional PBL-CBL group and the control group. For the theory test, the digital PBL-CBL group (61.00 ± 6.80) but not traditional PBL-CBL group (55.22 ± 9.86) obtained a significant higher score than the control group (45.11 ± 12.76), although no significant difference was found between the digital PBL-CBL group and the traditional PBL-CBL group. Conclusion Compared with other methods, students taught with the digital PBL-CBL method showed higher satisfaction and better performance in acquisition of academic knowledge and ability in solving practical clinical problems. The digital PBL-CBL method provided a promising alternative for teaching complex implant cases at the anterior maxilla.
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Affiliation(s)
- Dan Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Wenyan Zhao
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Li Ren
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Kunli Tao
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Miaomiao Li
- Dazhu Traditional Chinese Medicine Hospital, Chongqing, China
| | - Beiju Su
- Dazhu Traditional Chinese Medicine Hospital, Chongqing, China
| | - Yunfei Liu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chengzhe Ban
- Ruitai Stomatological Hospital, Chongqing, China
| | - Qingqing Wu
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
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18
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Xiang B, Yu J, Lu J, Yan Z. COMPARISONS BETWEEN DIGITAL-GUIDED AND NONDIGITAL PROTOCOL IN IMPLANT PLANNING, PLACEMENT, AND RESTORATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS. J Evid Based Dent Pract 2023; 23:101919. [PMID: 38035896 DOI: 10.1016/j.jebdp.2023.101919] [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: 03/11/2023] [Revised: 06/12/2023] [Accepted: 08/04/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVES The present study aimed to systematically review the current randomized clinical trials (RCTs) with respect to computer-aided design/computer-aided manufactured (CAD/CAM) techniques in the process of implant planning, placement, and rehabilitation. MATERIALS AND METHODS Four independent reviewers conducted an electronic and manual literature search using several databases, including the National Library of Medicine (MEDLINE-PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE. Articles were included if they were RCTs involving the interventions regarding the computer-guided impression, placement, and manufacturing process. The outcomes of interest include clinical and patient-reported outcomes and time efficiency. A meta-analysis was conducted to evaluate the time efficiency, pain severity, accuracy of implant placement, and postsurgery marginal bone level. RESULTS A total of 39 and 25 articles were included in the qualitative and quantitative analysis, respectively. The results of the meta-analysis showed that significantly less time was spent performing the digital impression procedure than the conventional impression (P = .002). In addition, the average adjustment time of the final prosthesis was significantly less than the nondigital fabricated prosthesis (P = .0005). Computer-guided groups reported significantly lower painkiller consumption compared to control groups (P = .03). CONCLUSIONS Digital impressions and CAD/CAM procedures are time-saving and provide stable and predictable outcomes. Moreover, computer-guided surgery can effectuate an accurate implant placement and less postsurgery discomfort.
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Affiliation(s)
- Bilu Xiang
- School of Dentistry, Shenzhen University, Shenzhen, China.
| | - Jiayi Yu
- Department of Stomatology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Jiayi Lu
- Department of Stomatology, Shenzhen University General Hospital, Shenzhen University, Shenzhen, China
| | - Zeping Yan
- Department of Artificial Intelligence, Guangdong Association of Thoracic Disease, Guangzhou, China
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Buddhikot CS, Garcha V, Shetty V, Ambildhok K, Vinay V, Deshpande U, Wahjuningrum DA, Luke AM, Karobari MI, Pawar AM. Bibliometric Analysis of Context, Trends, and Contents of Digital Health Technology Used in Dental Health. BIOMED RESEARCH INTERNATIONAL 2023; 2023:5539470. [PMID: 37920787 PMCID: PMC10620023 DOI: 10.1155/2023/5539470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/24/2023] [Accepted: 10/06/2023] [Indexed: 11/04/2023]
Abstract
Digital tools and apps are revolutionizing healthcare and provide creative answers to urgent problems. Through teamwork and the incorporation of digital technologies, dentistry has experienced a remarkable revolution. A large body of scholarly research backs up this trend. The context, trends, and content of digital health technology in oral and dental health are examined in our bibliometric analysis. Using targeted keywords and synonyms, an organized searching technique was used in the Scopus database, yielding 1942 articles that were extracted into a CSV file. To acquire insights into the content, trends, and context, visualization using VOSviewer 1.6.18 and a variety of analyses-including coauthorship, citation, cooccurrence of author keywords, bibliographic coupling, and cocitation-were executed. The analysis revealed that the USA and the UK contributed to a significant quantity of the literature, with newer contributions coming from nations like India. Cone Beam Computed Tomography, Dental Caries, and Artificial Intelligence were prominent keywords. It is important to note that BMC Oral Health was associated with a sizable number of the papers. This bibliometric analysis provides insightful information about the context, content, and trends of digital health in the field of oral and dental health. By implementing the right technology, policymakers can use this information to increase oral health, encourage dental literacy, and improve access to dental treatment. It is vital to take into account the wide variety of technologies and their classifications based on dental services and contextual variables.
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Affiliation(s)
- Chaitanya S Buddhikot
- Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Sinhgad Rd, Pune, Maharashtra 411041, India
| | - Vikram Garcha
- Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Sinhgad Rd, Pune, Maharashtra 411041, India
| | - Vittaldas Shetty
- Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Sinhgad Rd, Pune, Maharashtra 411041, India
| | - Kadambari Ambildhok
- Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Sinhgad Rd, Pune, Maharashtra 411041, India
| | - Vineet Vinay
- Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Sinhgad Rd, Pune, Maharashtra 411041, India
| | - Utkarsha Deshpande
- Department of Public Health Dentistry, Sinhgad Dental College and Hospital, Sinhgad Rd, Pune, Maharashtra 411041, India
| | - Dian Agustin Wahjuningrum
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya City, East Java 60132, Indonesia
| | - Alexander Maniangat Luke
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, UAE
- Center for Medical and Bio-Allied Health Sciences Research (CMBAHSR), Ajman University, Ajman, UAE
| | - Mohmed Isaqali Karobari
- Department of Conservative Dentistry, Faculty of Dental Medicine, Universitas Airlangga, Surabaya City, East Java 60132, Indonesia
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh 12211, Cambodia
- Department of Conservative Dentistry & Endodontics, Saveetha Institute of Medical and Technical Sciences University, Chennai, 600077 Tamil Nadu, India
| | - Ajinkya M Pawar
- Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, 400008 Maharashtra, India
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Mijiritsky E, Elad A, Krausz R, Ivanova V, Zlatev S. Clinical performance of full-arch implant-supported fixed restorations made of monolithic zirconia luted to a titanium bar: A retrospective study with a mean follow-up of 16 months. J Dent 2023; 137:104675. [PMID: 37607658 DOI: 10.1016/j.jdent.2023.104675] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 08/24/2023] Open
Abstract
OBJECTIVES This retrospective case series aimed to evaluate the short-term clinical advantages and limitations of full-arch implant-supported restorations made of monolithic zirconia suprastructures passively luted to titanium bar infrastructures and to report the rate of complications within a minimum of 1-year follow-up. MATERIALS AND METHODS This study included 31 patients (19 men and 12 women) requiring full-arch implant-supported prostheses in the upper or lower jaw. The patients were treated using an entirely digital approach from implant planning and guided implant placement to prosthetic construction planning, design, and fabrication. Full-arch implant-supported monolithic zirconia suprastructures luted to prism-shaped titanium bars were used in all the cases. All the restorations were evaluated for biological and technical complications during fixed control appointments. RESULTS No implant failures or serviceable prosthetic complications were reported, and the prosthetic survival rate was 100%, with a follow-up duration ranging from 12 months to 20 months. In two cases, a fracture line was observed in the zirconia suprastructures, although it did not require any intervention. CONCLUSIONS After a 16-month mean follow-up period, the monolithic zirconia implant-supported full-arch fixed dental prostheses demonstrated no biological or technical complications. Further clinical studies with long-term results are required to confirm these reported outcomes. CLINICAL SIGNIFICANCE CAD-/CAM-milled monolithic zirconia structures passively luted to titanium bar infrastructures are a viable treatment option for full-arch restorations over implants, demonstrating 100% survival and success rates in the present study. The outcomes of this short-term retrospective study indicated high success in function, aesthetics, phonetics, and the ability to maintain flawless hygiene. However, the long-term results of restorations produced using the proposed technique should be considered before recommending this approach for routine clinical use.
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Affiliation(s)
- Eitan Mijiritsky
- Department of Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, The Faculty of Medicine, Tel-Aviv University, Tel Aviv 6139001, Israel
| | | | | | - Vasilena Ivanova
- Oral Surgery Department, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv 4000, Bulgaria.
| | - Stefan Zlatev
- CAD/CAM Center of Dental Medicine at the Research Institute, Medical University-Plovdiv, Plovdiv 4000, Bulgaria
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21
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Shah N, Thakur M, Gill S, Shetty O, Alqahtani NM, Al-Qarni MA, Alqahtani SM, Elagib MFA, Chaturvedi S. Validation of Digital Impressions' Accuracy Obtained Using Intraoral and Extraoral Scanners: A Systematic Review. J Clin Med 2023; 12:5833. [PMID: 37762774 PMCID: PMC10532392 DOI: 10.3390/jcm12185833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND At present, the evidence regarding digital impressions' accuracy recorded by using digital scanners is lacking. This systematic review aimed to evaluate whether the type of scanning (intraoral/extraoral) affects the Accuracy of Digital Impressions. METHOD Two independent reviewers performed a systematic search in the database both electronically and manually (PubMed, Ebsco HOST, the Cochrane Library, and Google Scholar) for articles published from 1 January 2010 to 1 December 2022. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42020188765) and followed the PRISMA statement. The question in focus was as follows: Does the type of scanning (intraoral or extraoral) affect the accuracy of digital impression? RESULTS A total of 449 papers were obtained by searching electronically and manually. In total, 15 complete-text papers qualified for assessment based on eligibility criteria. After reading the full-text articles, five studies were excluded. Ten studies were selected for the qualitative analysis. The qualitative data reported that the accuracy of both types of scanners (intraoral and extraoral) lies within the range of clinical acceptability. Nevertheless, the intraoral scanners seem to be more accurate when compared to the extraoral scanners for a partial arch situation. CONCLUSIONS Scanning type affects the accuracy of the digital impression. Various factors influence the scanning ability. Intraoral scanners seem to be more accurate compared to extraoral scanners for a partial arch situation. More studies comparing the accuracy of the intraoral scanner and extraoral scanner for a complete arch scan and in an in vivo study setting are needed.
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Affiliation(s)
- Naisargi Shah
- Department of Prosthodontics, Terna Dental College, Navi Mumbai 400706, Maharashtra, India; (N.S.); (M.T.); (S.G.)
| | - Mrinmyaee Thakur
- Department of Prosthodontics, Terna Dental College, Navi Mumbai 400706, Maharashtra, India; (N.S.); (M.T.); (S.G.)
| | - Shruti Gill
- Department of Prosthodontics, Terna Dental College, Navi Mumbai 400706, Maharashtra, India; (N.S.); (M.T.); (S.G.)
| | - Omkar Shetty
- Department of Prosthodontics, SGT Dental College Gurugram, Gurgaon 122505, Haryana, India;
| | - Nasser M. Alqahtani
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia; (N.M.A.); (S.M.A.)
| | - Mohammed A. Al-Qarni
- Department of Restorative Dentistry, College of Dentistry, King Khalid University, P.O. Box 3263, Abha 61471, Saudi Arabia;
| | - Saeed M. Alqahtani
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia; (N.M.A.); (S.M.A.)
| | - Mohamed Fadul A. Elagib
- Division of Periodontics, Department of Periodontics and Community Dental Sciences (PCS), College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia;
| | - Saurabh Chaturvedi
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia; (N.M.A.); (S.M.A.)
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Cen Y, Huang X, Liu J, Qin Y, Wu X, Ye S, Du S, Liao W. Application of three-dimensional reconstruction technology in dentistry: a narrative review. BMC Oral Health 2023; 23:630. [PMID: 37667286 PMCID: PMC10476426 DOI: 10.1186/s12903-023-03142-4] [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: 04/24/2023] [Accepted: 06/16/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Three-dimensional(3D) reconstruction technology is a method of transforming real goals into mathematical models consistent with computer logic expressions and has been widely used in dentistry, but the lack of review and summary leads to confusion and misinterpretation of information. The purpose of this review is to provide the first comprehensive link and scientific analysis of 3D reconstruction technology and dentistry to bridge the information bias between these two disciplines. METHODS The IEEE Xplore and PubMed databases were used for rigorous searches based on specific inclusion and exclusion criteria, supplemented by Google Academic as a complementary tool to retrieve all literature up to February 2023. We conducted a narrative review focusing on the empirical findings of the application of 3D reconstruction technology to dentistry. RESULTS We classify the technologies applied to dentistry according to their principles and summarize the different characteristics of each category, as well as the different application scenarios determined by these characteristics of each technique. In addition, we indicate their development prospects and worthy research directions in the field of dentistry, from individual techniques to the overall discipline of 3D reconstruction technology, respectively. CONCLUSIONS Researchers and clinicians should make different decisions on the choice of 3D reconstruction technology based on different objectives. The main trend in the future development of 3D reconstruction technology is the joint application of technology.
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Affiliation(s)
- Yueyan Cen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Xinyue Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Jialing Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Yichun Qin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Xinrui Wu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Shiyang Ye
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China
| | - Shufang Du
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China.
| | - Wen Liao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No.14, 3Rd Section of Ren Min Nan Rd. Chengdu, Sichuan, 610041, China.
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23
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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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24
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Lee EH, Lim YJ, Kwon HB, Kim MJ. Improving wear resistance of acrylic resin denture teeth by using zirconia complete crowns fabricated with a CAD-CAM double-scanning method: A clinical report. J Prosthet Dent 2023; 130:273-277. [PMID: 35184883 DOI: 10.1016/j.prosdent.2022.01.013] [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: 10/26/2021] [Revised: 01/01/2022] [Accepted: 01/04/2022] [Indexed: 11/22/2022]
Abstract
Acrylic resin denture teeth can wear and chip when opposed by zirconia prostheses. This clinical report describes the use of zirconia complete crowns to prevent these problems. The predictability of treatment was improved by using the computer-aided design and computer-aided manufacturing (CAD-CAM) double-scanning method.
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Affiliation(s)
- Eun-Hyuk Lee
- Research Associate, Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Young-Jun Lim
- Professor, Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ho-Beom Kwon
- Professor, Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Myung-Joo Kim
- Professor, Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
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25
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Mohammed Alassiry A. Clinical aspects of digital three-dimensional intraoral scanning in orthodontics - A systematic review. Saudi Dent J 2023; 35:437-442. [PMID: 37520596 PMCID: PMC10373090 DOI: 10.1016/j.sdentj.2023.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 08/01/2023] Open
Abstract
Objective This systematic review aimed to investigate the accuracy, reproducibility, scanning time, patient comfort, and operator experience of various commercially available intraoral scanners (IOS) in orthodontics. Methods An elaborate and extensive search of literature in the PubMed, Scopus, Google Scholar, Embase, Web of Science, and Cochrane Central databases was performed using various relevant keywords. Results A total of 3256 articles were obtained from all the databases, 35 studies were included. The accuracy of IOS was controversial compared to that of conventional impression techniques. Digital scanning demonstrated satisfactory to excellent reproducibility, shorter scanning time, and improved patient comfort compared with conventional techniques. Conclusion IOS are time-efficient, comfortable for patients, and simple to use with a learning curve for the operator. These methods are sufficiently accurate for treatment planning and aligner fabrication in orthodontics.
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26
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Vieira SNV, Lourenço MF, Pereira RC, França EC, Vilaça ÊL, Silveira RR, Silva GC. Conventional and Digital Impressions for Fabrication of Complete Implant-Supported Bars: A Comparative In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16114176. [PMID: 37297310 DOI: 10.3390/ma16114176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
Obtaining accurate models and well-fitting prostheses during the fabrication of complete implant-supported prostheses has been a significant challenge. Conventional impression methods involve multiple clinical and laboratory steps that can lead to distortions, potentially resulting in inaccurate prostheses. In contrast, digital impressions may eliminate some of these steps, leading to better-fitting prostheses. Therefore, it is important to compare conventional and digital impressions for producing implant-supported prostheses. This study aimed to compare the quality of digital intraoral and conventional impressions by measuring the vertical misfit of implant-supported complete bars obtained using both types of techniques. Five digital impressions using an intraoral scanner and five impressions using elastomer were made in a four-implant master model. The plaster models produced with conventional impressions were scanned in a laboratory scanner to obtain virtual models. Screw-retained bars (n = five) were designed on the models and milled in zirconia. The bars fabricated using digital (DI) and conventional (CI) impressions were screwed to the master model, initially with one screw (DI1 and CI1) and later with four screws (DI4 and CI4), and were analyzed under a SEM to measure the misfit. ANOVA was used to compare the results (p < 0.05). There were no statistically significant differences in the misfit between the bars fabricated using digital and conventional impressions when screwed with one (DI1 = 94.45 µm vs. CI1 = 101.90 µm: F = 0.096; p = 0.761) or four screws (DI4 = 59.43 µm vs. CI4 = 75.62 µm: F = 2.655; p = 0.139). Further, there were no differences when the bars were compared within the same group screwed with one or four screws (DI1 = 94.45 µm vs. DI4 = 59.43 µm: F = 2.926; p = 0.123; CI1 = 101.90 µm vs. CI4 = 75.62 µm: F = 0.013; p = 0.907). It was concluded that both impression techniques produced bars with a satisfactory fit, regardless of whether they were screwed with one or four screws.
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Affiliation(s)
- Samanta N V Vieira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | | | - Esdras C França
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Ênio L Vilaça
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Rodrigo R Silveira
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Guilherme C Silva
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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27
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Lops D, Romeo E, Mensi M, Troiano G, Zhurakivska K, Del Fabbro M, Palazzolo A. CAD/CAM Abutments in the Esthetic Zone: A Systematic Review and Meta-Analysis of Soft Tissue Stability. J Clin Med 2023; 12:jcm12113847. [PMID: 37298041 DOI: 10.3390/jcm12113847] [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: 04/02/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
Computer-aided design and computer-aided manufacturing customized abutments are increasingly used in everyday clinical practice. Nevertheless, solid scientific evidence is currently lacking regarding their potential advantages in terms of soft tissue stability. The main aim of this systematic review and meta-analysis was to compare the soft tissue outcomes of prefabricated versus customized (CAD/CAM) abutments. The present review was registered with PROSPERO (CRD42020161875) and the protocol was developed according to the PRISMA statement. An electronic search was performed on three databases (PubMed, Embase and Cochrane Central) up to May 2023. Data extraction was followed by qualitative and quantitative analysis of the included studies. Three randomized controlled clinical trials and three controlled clinical trials (number of patients = 230; number of dental implants = 230) with a follow-up of between 12 and 36 months were included. No significant differences were observed between prefabricated versus customized (CAD/CAM) abutments regarding midfacial mucosal recession, interproximal papillae and pink aesthetic score (PES) after 12 months. Conclusion: The potential benefits of CAD/CAM abutments on soft tissues should be better clarified in future investigations. The usage of customized CAD/CAM abutments in everyday clinical practice should be based on a careful case-by-case evaluation (CRD42020161875).
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Affiliation(s)
- Diego Lops
- Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, School of Dentistry, University of Milan, 20122 Milan, Italy
| | - Eugenio Romeo
- Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, School of Dentistry, University of Milan, 20122 Milan, Italy
| | - Magda Mensi
- Department of Surgical Specialties, Radiological Science and Public Health, University of Brescia, 25123 Brescia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Khrystyna Zhurakivska
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Antonino Palazzolo
- Department of Biomedical, Surgical and Dental Sciences, Dental Clinic, School of Dentistry, University of Milan, 20122 Milan, Italy
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28
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Choukse V, Kunturkar A, Nirmal Aidasani A, Masih Gottlieb A, Agrawal R, Bumb PP. Survey of Indian Dental Professionals Regarding the Use of Computer-Aided Design/Computer-Aided Manufacture (CAD/CAM) Technology. Cureus 2023; 15:e40392. [PMID: 37456387 PMCID: PMC10345168 DOI: 10.7759/cureus.40392] [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] [Received: 04/18/2023] [Accepted: 06/04/2023] [Indexed: 07/18/2023] Open
Abstract
Objective In recent years, digital processes like computer-aided design/computer-aided manufacture (CAD/CAM) have been implemented in dentistry. On the use and reporting of this technology by dentists, there is no published information. The goal of this study was to determine whether CAD/CAM technology had infiltrated Indian dentistry practices and to look into the relationship between various demographic parameters and respondents' answers about using or not using this technology. Materials and methods A sample of Indian dentists, both users and non-users of CAD/CAM, were sent about 500 online surveys. It sought to shed light on the usage style, materials, advantages, and limitations of CAD/CAM dentistry, as well as their perceived advantages and access hurdles. Statistical analysis was conducted to determine the impact of numerous demographic factors, including country of employment, dentist experience, educational attainment, and the nature of the job. Results There were 132 total replies that were finished. The majority of respondents didn't use any aspect of a digital workflow, and the biggest obstacles to using CAD/CAM were the upfront expenses and a lack of perceived advantages over traditional techniques. The likelihood of using CAD/CAM technology was highest among dentists who primarily performed private practice (P<0.0001). A third of users thought that their training was insufficient, even though the majority of users were either self-taught or schooled by firms. The majority of respondents (60.6%) believed that CAD/CAM would have a significant future role. Conclusion Most respondents said they had never used any aspect of a digital process. Although most dentists who responded to the study thought CAD/CAM would play a significant role in the future, the majority were still interested in integrating it into their workflow. Dentists continue to have certain concerns regarding the chairside CAD/CAM restorations' quality.
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Affiliation(s)
- Vivek Choukse
- Department of Prosthodontics and Crown and Bridge, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Anuja Kunturkar
- Department of Prosthodontics and Crown and Bridge, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Ashwin Nirmal Aidasani
- Department of Prosthodontics and Crown and Bridge, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Abhilasha Masih Gottlieb
- Department of Prosthodontics and Crown and Bridge, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Ruchi Agrawal
- Department of Prosthodontics and Crown and Bridge, Dr. Hedgewar Smruti Rugna Seva Mandal's Dental College and Hospital, Hingoli, IND
| | - Pratik P Bumb
- Department of Prosthodontics and Crown and Bridge, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, IND
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29
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Róth I, Hermann P, Vitai V, Joós-Kovács GL, Géczi Z, Borbély J. Comparison of the learning curve of intraoral scanning with two different intraoral scanners based on scanning time. BMC Oral Health 2023; 23:267. [PMID: 37161444 PMCID: PMC10170701 DOI: 10.1186/s12903-023-02963-7] [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: 02/13/2023] [Accepted: 04/12/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The appearance of intraoral scanners (IOSs) in dental offices was an important milestones for the digital innovations in dentistry. Knowing the learning curve for intraoral scanning is crucial, because it can serve as a guideline for clinicians before buying a new IOS. The aim of the present in vivo study was to determine the learning curve required by dental students for intraoral scanning with the 3Shape Trios 4 IOS and the CEREC Primescan IOS, based on scanning time. METHODS A total of 20 dental students with no previous experience in intraoral scanning participated in the present study. 10 students scanned with Trios 4® IOS (TRI) and 10 students took digital impressions with Primescan® IOS (CER). Every student created 15 digital impressions from patients. Prior to taking the impressions, theoretical and practical education was provided. The total scanning time included the upper and lower arches as well as bite registration, for which average values were calculated. Statistical analysis was performed using the Stata package with a mixed-effects generalized least squares regression models. RESULTS The average total scanning times were the following: TRI - 205 s for the 1st impression, 133.6 s for the 15th, CER - 289.8 s for the 1st impression, 147 s for the 15th. The model-based estimate of the difference between the two in case of TRI was 57.5 s, and in CER was 144.2 s which is a highly significant improvement in both cases (P < 0.0001). The slope of the scanning time vs. learning phase curve gradually approached flatness, and maintained a plateau: TRI - from the 11th measurement and CER - from the 14th measurement onward. CONCLUSIONS Given the limitations of the present study, we found difference between the learning curve of scanner types which are operate various principle of imaging. In case of the TRI fewer digital impressions (11 repeating) were sufficient to reach the average scanning time of an experienced user than using CER (14 repeating). TRIAL REGISTRATION The permission for this study was given by the University Ethics Committee of Semmelweis University (SE RKEB number: 184/2022).
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Affiliation(s)
- Ivett Róth
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary.
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary
| | - Viktória Vitai
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary
| | | | - Zoltán Géczi
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary
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30
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Todaro C, Cerri M, Rodriguez Y Baena R, Lupi SM. Full-Arch Guided Restoration and Bone Regeneration: A Complete Digital Workflow Case Report. Healthcare (Basel) 2023; 11:healthcare11091301. [PMID: 37174843 PMCID: PMC10177883 DOI: 10.3390/healthcare11091301] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/19/2023] [Accepted: 04/23/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVE complex rehabilitations present multiple difficulties, regarding both the planification of the surgery and the design of the prothesis. A digital approach can support the workflow, as well as the degree of intraoperative precision, and improve the long-term prognosis. METHODS A surgical guide was designed for implant placement. An extensive regeneration of the upper jaw was performed with contextual implant insertion, and a delayed load rehabilitation was chosen. After four months, a second surgery and a simultaneous soft tissue augmentation was performed, and a 3D-printed temporary restoration was placed. After another two months, new dental and facial scans, smile design, and facial bite registrations were obtained. Upper and lower dentures were built using an exclusively digital workflow. Both metal substructures were passivated and cemented in one session; in the following appointment, the aesthetic and occlusal checks were carried out. During the third visit, both prostheses were delivered. RESULTS Careful case planning and the surgical guide made it possible to achieve primary stability and acceptable emergence profiles in an extremely reabsorbed upper jaw. Leukocyte-Platelet Rich Fibrin (L-PRF) made the extensive bone regeneration more approachable and lowered the post-operative pain and swelling, while speeding up the soft tissue healing process. During the re-entry surgery, the volumes of soft tissues were increased to improve aesthetics, and the amount of keratinized gingiva around the six implants was also increased. Smile design and facial scans have provided the means to create acceptable aesthetics and function in a few sessions with minimal patient discomfort. CONCLUSIONS Computer-assisted implantology is a safe and precise method of performing dental implant surgery. Preliminary studies have a high degree of accuracy, but further studies are needed to arrive at a fully digital clinical protocol at all stages.
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Affiliation(s)
- Claudia Todaro
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | | | - Ruggero Rodriguez Y Baena
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Saturnino Marco Lupi
- School of Dentistry, Department of Clinical Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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Prayongrat A, Kitpanit S, Lertbutsayanukul C, Saikaew P, Boonrueng T, Mekayarajjananonth T, Vacharaksa A. Digital fabrication of customized intraoral appliances for head and neck radiotherapy. Heliyon 2023; 9:e15374. [PMID: 37153386 PMCID: PMC10160696 DOI: 10.1016/j.heliyon.2023.e15374] [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: 07/23/2022] [Revised: 03/24/2023] [Accepted: 04/04/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction The radiotherapy received by head and neck cancer patients commonly has adverse effects on oral tissue and the muscles of mastication. This short communication describes the digital fabrication of intraoral appliances for radiotherapy and muscle exercises. Methods Three patients diagnosed with tongue squamous carcinoma were treatment-planned for radiotherapy using different radiation techniques. The patients were referred for oral scanning and digital bite records, and the appliance was collaboratively designed by a radiation oncologist, dentist, and laboratory technician. The appliance covered the occlusal surface of the remaining teeth with a 1-mm engagement. The lingual plate was 2-mm below the occlusal plane, and extended 4-mm distally, and the jaws were opened by 20-mm. The appliances were printed overnight using a rigid and biocompatible 3D printing material. Results Requiring minimal chair-time, the appliance was easily inserted and adjusted to comfortably fit in the mouth. The patients were trained to insert it themselves. The tongue was at a pre-determined position during daily radiotherapy, and the healthy tissues were separated from the radiation field. The patients had mild adverse effects on their oral mucosa. Additionally, the appliances were used for muscle exercises after the radiation courses to prevent trismus. Conclusions The interprofessional collaboration to fabricate customized intraoral appliances using digital workflow to maximize patients' benefits is feasible. Clinical significance The use of intraoral appliances is potentially increased when the fabrication process is facilitated. Using an intraoral appliance precisely targets the tumor are for better treatment outcomes, and the healthy adjacent tissues will be preserved to maintain the patient's quality of life.
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Affiliation(s)
- Anussara Prayongrat
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Sarin Kitpanit
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Chawalit Lertbutsayanukul
- Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Pipop Saikaew
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Thirayu Boonrueng
- Department of Dentistry, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | | | - Anjalee Vacharaksa
- Geriatric and Special Patients (International) Program, Bangkok, Thailand
- Research Unit on Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Corresponding author. Microbiology Department, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand. ,
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Accuracy of four recent intraoral scanners with respect to two different ceramic surfaces. J Dent 2023; 130:104414. [PMID: 36640842 DOI: 10.1016/j.jdent.2023.104414] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 12/09/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To investigate the complete arch accuracy of intraoral scanners (IOS) on two different ceramic surfaces. METHODS Two maxillary master cast samples were prepared. The bases of both the master casts were made from zirconium oxide. The difference between the two casts was that the teeth of the [ZR] cast were produced from zirconium oxide and that of the [LD] cast were made of lithium disilicate glass-ceramic. Unlike the zirconia teeth of the [ZR] cast, the lithium disilicate teeth of the [LD] cast were glazed. The two master casts were digitized using a high-resolution scanner (Atos Compact Scan 5 M, GOM GmbH, Braunschweig, Germany) to obtain digital reference casts. Subsequently, each master cast was scanned 15 times using four IOSs. The IOSs were the Cerec Omnicam [OM], Primescan [PR], Trios 4 [TR4], and VivaScan [VS]. On surface comparison, the absolute mean deviation values were obtained for trueness and precision. For multiple comparisons, statistically significant differences were analyzed using one-way ANOVA and the Kruskal-Wallis H test. The p-value was adjusted to control for the increased risk of type I error (p < 0.0083). To compare the two means, the t-test and Mann-Whitney U test were used (p < 0.05). RESULTS Trueness values for [ZR] ranged from 24.6 (±6.3) µm for [PR] and 77.1 (±8.3) µm for [OM]. Trueness values for [LD] were between 28.3 (±6.3) µm for [PR] and 72.8 (±15.6) µm for [OM]. Precision values for [ZR] ranged from 17.6 (±3.7) µm for [PR] to 37.3 (±9.9) µm for [OM]. Precision values for [LD] ranged from 17.5 (±3.6) µm for [PR] to 41.8 (±8.7) µm for [OM]. Statistically significant differences were found among all the IOSs (p < 0.0083). The trueness values of the four IOSs did not differ significantly (p < 0.05) with respect to either the [ZR] or [LD] cast. The precision values of [OM] and [VS] differed significantly with respect to the scanned surface. CONCLUSIONS Complete arch scans achieved with the four IOSs showed significantly different trueness and precision results. [VS] and [OM] were more sensitive in terms of the scanned material. CLINICAL SIGNIFICANCE The latest IOSs showed the required accuracy for complete arch digital impressions in-vitro investigations. These findings should be implemented under conditions relevant to complete arch deviations, such as the construction of occlusal splints, analysis of occlusal relationships, and long-span restorations. Clinicians should be aware that the clinically acceptable threshold varies depending on the purpose of the IOS.
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The Complete Digital Workflow in Fixed Prosthodontics Updated: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11050679. [PMID: 36900684 PMCID: PMC10001159 DOI: 10.3390/healthcare11050679] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Digital applications have changed therapy in prosthodontics. In 2017, a systematic review reported on complete digital workflows for treatment with tooth-borne or implant-supported fixed dental prostheses (FDPs). Here, we aim to update this work and summarize the recent scientific literature reporting complete digital workflows and to deduce clinical recommendations. A systematic search of PubMed/Embase using PICO criteria was performed. English-language literature consistent with the original review published between 16 September 2016 and 31 October 2022 was considered. Of the 394 titles retrieved by the search, 42 abstracts were identified, and subsequently, 16 studies were included for data extraction. A total of 440 patients with 658 restorations were analyzed. Almost two-thirds of the studies focused on implant therapy. Time efficiency was the most often defined outcome (n = 12/75%), followed by precision (n = 11/69%) and patient satisfaction (n = 5/31%). Though the amount of clinical research on digital workflows has increased within recent years, the absolute number of published trials remains low, particularly for multi-unit restorations. Current clinical evidence supports the use of complete digital workflows in implant therapy with monolithic crowns in posterior sites. Digitally fabricated implant-supported crowns can be considered at least comparable to conventional and hybrid workflows in terms of time efficiency, production costs, precision, and patient satisfaction.
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Zuercher AN, Ioannidis A, Hüsler J, Mehl A, Hämmerle CHF, Thoma DS. Randomized controlled pilot study assessing efficacy, efficiency, and patient-reported outcomes measures of chairside and labside single-tooth restorations. J ESTHET RESTOR DENT 2023; 35:74-83. [PMID: 35421283 DOI: 10.1111/jerd.12909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To test whether or not a chairside workflow (CHAIR) is similar to a labside workflow (LAB) in terms of efficacy (primary outcome) and efficiency (secondary outcome). MATERIAL AND METHODS Eighteen subjects in need of a single-tooth restoration in the posterior region of the maxilla or mandible were consecutively recruited and randomly assigned to the CHAIR or LAB workflow. Patient-reported outcome measures (PROMs; efficacy) were assessed using a questionnaire with visual analog scale. The white AEsthetic score (WES) was applied to evaluate the AEsthetic outcome objectively. The clinical and laboratory time (efficiency) were recorded. Nonparametric methods were applied for the group comparisons. RESULTS The overall median AEsthetic evaluation after treatment was 10 (interquartile range = IQR: 9.5-10) in group CHAIR and 10 (IQR: 9.5-10) in-group LAB (Mann-Whitney [MW] test p = 1.000). The WES amounted to 4 (IQR: 3-5) (CHAIR) and to 8 (IQR: 7-9) (LAB) (MW test p < 0.0001). The median total working time for the clinician in-group CHAIR was 49.9 min. (IQR: 40.9-63.7) and 41.4 min. (IQR: 37.2-58.2) in-group LAB (MW test p = 0.387). CONCLUSIONS Subjective PROMs of single-tooth supported restorations fabricated in a CHAIR or LAB workflow led to similar scores of patients' satisfaction and a moderate negative correlation for the objective evaluation of the clinician in the LAB workflow. CLINICAL SIGNIFICANCE PROMs can be considered a key element in the decision-making process for restoring single-tooth restorations. The patients' perception of AEsthetics was similar for the CHAIR or LAB workflows. The additional efforts undertaken with the LAB workflow did not result in a patient benefit when compared to a CHAIR workflow.
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Affiliation(s)
- Anina N Zuercher
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Alexis Ioannidis
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Institute of Mathematical Statistics and Actuarial Science, University of Bern, Bern, Switzerland
| | - Albert Mehl
- Department of Computerized Restorative Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Gintaute A, Zitzmann NU, Brägger U, Weber K, Joda T. Patient-reported outcome measures compared to professional dental assessments of monolithic ZrO 2 implant fixed dental prostheses in complete digital workflows: A double-blind crossover randomized controlled trial. J Prosthodont 2023; 32:18-25. [PMID: 35938349 PMCID: PMC10087166 DOI: 10.1111/jopr.13589] [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: 06/07/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This double-blind randomized controlled trial analyzed patient-reported outcome measures in terms of subjective patient satisfaction compared to objective dental evaluation of prosthetic treatment with 3-unit monolithic zirconium dioxide implant fixed dental prostheses (iFDPs) in 3 digital workflows. MATERIAL AND METHODS Twenty patients were restored with 3 iFDPs each on Straumann TL-implants with 2 completely digital workflows using different intraoral optical scanning systems with model-free fabrication of the restoration (Trios 3/3Shape [Test-1]; Virtuo Vivo/Straumann [Test-2]), and mixed analog-digital workflow with conventional impressions and digitized gypsum casts (Impregum/3M Espe [Control]). The order of impression-taking and the prosthetic try-in were randomly allocated. Sixty iFDPs were compared for patient satisfaction and dental evaluation using ANOVA. RESULTS For iFDP evaluation, patients generally provided more favorable ratings than dental experts, regardless of the workflow. ANOVA revealed no significant difference for overall satisfaction when comparing Test-1, Test-2, or Control, either for patients (f-ratio: 0.13; p = 0.876) or dentist (f-ratio: 1.55: p = 0.221). Secondary, patients clearly favored the digital impression workflows over the conventional approach (f-ratio: 14.57; p < 0.001). Overall, the 3Shape workflow (Test-1) received the highest scores for all analyses. CONCLUSIONS The different digital workflows demonstrated minor influence on the subjective and objective evaluation of the monolithic zirconium dioxide iFDPs in nonesthetic regions; however, the dentist may significantly increase patient satisfaction by choosing intraoral scanning instead of conventional impressions. The dentist has to consider individual patients' needs to fulfill their expectations for a personalized solution.
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Affiliation(s)
- Aiste Gintaute
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Karin Weber
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Karasan D, Sailer I, Lee H, Demir F, Zarauz C, Akca K. Occlusal adjustment of 3-unit tooth-supported fixed dental prostheses fabricated with complete-digital and -analog workflows: A crossover clinical trial. J Dent 2023; 128:104365. [PMID: 36403691 DOI: 10.1016/j.jdent.2022.104365] [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: 11/10/2021] [Revised: 10/31/2022] [Accepted: 11/11/2022] [Indexed: 11/19/2022] Open
Abstract
AIM This prospective crossover clinical trial aimed to compare the complete-digital and -analog workflows in terms of occlusal adjustment of 3-unit tooth-supported fixed dental prostheses, operator, and patient preferences. MATERIALS AND METHOD This study included twelve patients receiving fourteen 3-unit posterior FDPs. 2 FDPs were made for each restoration site: one fabricated in complete-digital workflow comprising intraoral scan with static bite registration (Trios 3) and a monolithic zirconia FDP (test); the other fabricated in complete-analog workflow comprising conventional impression/face-bow transfer and a porcelain-fused-to-metal FDP (control). The FDPs (n=28) were intraorally/provisionally fixed, and quadrant-like intraoral scans were taken for every FDP before & after their occlusal adjustments. Pre- and post-adjustment scans of each FDP were then superimposed using best-fit alignment (GOM Inspect) to measure the volumetric occlusal adjustment amount (mm3) (3Matic) (Mann Whitney U, α=0.05). The patient and operator experience for digital and analog workflows were evaluated using visual analog scales (Wilcoxon test, α=0.05). RESULTS Mean occlusal adjustments were 7.63 mm3 [±7.02] and 25.95 mm3 [±39.61] for test and control groups, respectively. The volumetric adjustment difference was clinically noticeable but not significant (P=0.12). The impression and digital workflow adjustment were perceived more favorably by both operator (P=0.003, P=0.046, respectively) and the patients (P=0.003, P=0.002, respectively). CONCLUSIONS Within the limitations of this clinical study, the complete digital workflow with digital static bite-registration provided high occlusal accuracy for short-span tooth-supported FDPs. In addition, the patient and operator preferences significantly favored the digital workflow. CLINICAL SIGNIFICANCE Complete-digital workflow employing intraoral scanning and model-free fabrication of monolithic-Zr short-span tooth-supported FDPs offers an effective treatment modality with sufficient occlusal accuracy. Therefore complete-digital workflow is a valid alternative for complete-analog workflow comprising conventional impression, face-bow transfer, and use of a semi-adjustable articulator.
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Affiliation(s)
- Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Hyeonjong Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Fatmanur Demir
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Cristina Zarauz
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Kivanc Akca
- Department of Prosthodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Lee SY, Lim JH, Kim D, Lee DH, Kim SG, Kim JE. Evaluation of the color stability of 3D printed resin according to the oxygen inhibition effect and temperature difference in the post-polymerization process. J Mech Behav Biomed Mater 2022; 136:105537. [PMID: 36327665 DOI: 10.1016/j.jmbbm.2022.105537] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
The aim of this study was to determine the color stability of 3D printed resin according to the post-curing conditions (polymerization conditions and temperature). Specimens were post-polymerized under different conditions of oxygen inhibition, such as on glycerin immersion (GLY), medium-low vacuum environment (VA), and oxygen contact (CON, the control group), and temperature (35 °C, 60 °C, and 80 °C). The degree of conversion (DC), water sorption (Wsp) and solubility (Wsl), surface roughness (Ra) were measured. Additionally, surface free energy (SFE), pH values of colorants were measured. Grape juice (grape), coffee, and curry were used as the colorants, and distilled water (DW) was used as a control. And the color value was measured before and after immersion using a spectrophotometer. Then, Calculated the color change. For statistical methods, The Shapiro-Wilk test performed to check for normality revealed that the data presented a normal distribution (p>0.05). ΔE values were analyzed using three-way ANOVA. DC, Wsp, Wsl, SFE, and Ra were analyzed using two-way ANOVA. To confirm the linear correlation, Pearson's correlation coefficient was determined. The threshold for significance (p) was set at 0.05 (95% confidence interval) for all tests. DC was the highest at 80 °C in the GLY group (95.08 ± 4.88%). And Wsl decreased with increasing temperature, and was lowest at 80 °C in the GLY group (0.46 ± 0.30 um/mm3). After the colorants were immersed for 30 days, as the temperature increased, ΔE decreased in the GLY group but not in the VA and CON groups, and was the lowest at 80 °C in the GLY group: (DW, 0.95 ± 0.45 [mean± SD]; grape, 6.45± 0.69; coffee, 4.50± 0.56; curry, 9.37± 1.40). There was also a significant inverse relation between DC and ΔE. A significant inverse relation was found between Wsl and DC, and a significant positive correlation was found between Wsl and ΔE. Wsp, SFE, and Ra did not affect color stability. In the post-polymerization process, increasing the temperature and GLY were effective in reducing ΔE, which was lowest at 80 °C in the GLY group. It was also observed that a complex mechanism between the DC, Wsl of 3D printed resin affects ΔE of the resin.
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Affiliation(s)
- Sang-Yub Lee
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea; Department of Prosthodontics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jung-Hwa Lim
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Dohyun Kim
- Department of Conservative Dentistry, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Dong-Hwan Lee
- Department of Prosthodontics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Seok Gyu Kim
- Department of Prosthodontics, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Ilwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea
| | - Jong-Eun Kim
- Department of Prosthodontics, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Benli M, Turkyilmaz I, Martinez JL, Schwartz S. Clinical performance of lithium disilicate and zirconia CAD/CAM crowns using digital impressions: A systematic review. Prim Dent J 2022; 11:71-76. [PMID: 36533368 DOI: 10.1177/20501684221132941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The purpose of this systematic review was to compare the clinical performance of lithium disilicate (LDS) and zirconia (Z) single crowns manufactured by computer-aided design/computer-aided manufacturing (CAD/CAM) systems using intraoral optical scanners (IOS). MATERIALS AND METHODS An electronic search for articles published between January 2012 and January 2022 in the English language was performed with the Medline/Pubmed database under the guidelines of Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA). The specific search terms used were "zirconia", "lithium disilicate", "CAD/CAM", "intraoral optical scanner", and "survival". RESULTS The initial electronic search resulted in 278 articles. Most of the resulting articles were excluded, six clinical studies addressing the clinical outcomes of Z and LDS crowns fitted the inclusion criteria and were selected for review. Of these six studies, three were randomised controlled trials, two were retrospective studies, and one was a prospective study. To quantify the clinical performance of the crowns several parameters were recorded, including fractures, endodontic complications, periodontal complications, technical complications, aesthetic complications, and biological complications. It was noted that the most common technical complication of Z and LDS crowns was chipping at a rate of 1.4% and 5% respectively. Regarding Z crowns, aesthetic concerns were the most frequently observed complication. CONCLUSION The outcomes of this systematic review indicate that Z and LDS crowns display a similar incidence of periodontal and endodontic complications when compared to metal-ceramic crowns, suggesting that these all-ceramic materials are viable alternatives. The incidence of chipping was higher in LDS crowns compared to other materials, while Z crowns were inferior in terms of aesthetics.
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Affiliation(s)
- Merve Benli
- Researcher, University of Pittsburgh, School of Dental Medicine, Department of Oral Biology, Pittsburgh, USA; Assistant Professor, Istanbul University, School of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | - Ilser Turkyilmaz
- Professor, New York University College of Dentistry, Department of Prosthodontics, New York, USA
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Time efficiency and efficacy of a centralized computer-aided-design/computer-aided-manufacturing workflow for implant crown fabrication: A prospective controlled clinical study. J Dent 2022; 127:104332. [PMID: 36252858 DOI: 10.1016/j.jdent.2022.104332] [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: 03/08/2022] [Revised: 09/29/2022] [Accepted: 10/13/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess time efficiency and the efficacy of the prosthetic manufacturing for implant crown fabrication in a centralized workflow applying computer aided design and computer aided manufacturing (CAD-CAM). MATERIAL AND METHODS Fifty-nine patients with one posterior implant each, were randomly allocated to either a centralized digital workflow (c-DW, test) or a laboratory digital workflow (l-DW, control). Patients were excluded from efficiency and efficacy analyses, if any additional restoration than this single implant crown had to be fabricated. A customized titanium abutment and a monolithic zirconia crown were fabricated in the c-DW. In the l-DW, models were digitalized for CAD-CAM fabrication of a monolithic zirconia crown using a standardized titanium base abutment. Time for impression, laboratory operating and delivery time were recorded. The efficacy of the prosthetic manufacturing was evaluated at try-in and at delivery. Data was analyzed descriptively. Statistical analyses using student's unpaired t- and paired Wilcoxon were performed (p < 0.05). RESULTS At impression taking, 12 patients (c-DW) and 19 patients (l-DW) were included. The impression time was 9.4±3.5 min (c-DW) and 15.1 ± 4.6 min (l-DW) (p < 0.05). The laboratory operating time was 130 ± 31 min (c-DW) and 218.0±8 min (l-DW) (p < 0.05). The delivery time was significantly longer in the c-DW (5.9 ± 3.5 1 days) as compared to the l-DW (0.5±0.05 days). At try-in and at delivery, efficacy of prosthetic manufacturing was similar high in both workflows. CLINICAL RELEVANCE The c-DW was more time efficient compared to the lab-DW and rendered a similar efficacy of prosthetic manufacturing.
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Matthisson L, Zitzmann NU, Zaugg LK, Joda T. Potential of intraoral optical scanning to evaluate motor skills' improvement for tooth preparation: A prospective cohort study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:669-675. [PMID: 34928540 DOI: 10.1111/eje.12745] [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: 05/02/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This prospective cohort study investigated the potential of digital assessment using intraoral scanning (IOS) combined with software analysis (prepCheck) to evaluate the outcome of repetitive tooth preparation and its influence on the acquisition of motor skills in dental students. MATERIALS AND METHODS Twenty-six students completed 177 full-crown preparations of the same tooth in six practice sessions followed by a final examination. Preparations were assessed digitally using prepCheck and conventionally by calibrated faculty instructors. In addition, students assessed their own performance and this was compared with the instructors' assessments. RESULTS Conventional assessment showed that students preparations improved over time, with 43.5% of students receiving score 2 (highest grade) at the fifth practice session. With the prepCheck assessment, statistically significant improvements indicated by an enlarged area within the tolerance range set at 0.2 mm were found between the first and the second practice session (7.5% improvement; 95% CI: 2.2%, 12.7%, p = 0.006), and between the first run and the final exam preparation (6.7%; 95% CI: 1.7%, 12.5%, p = 0.011). Agreement between instructor/student assessments was best immediately after students received visual feedback using prepCheck (76% agreement; Spearman's rho 0.78). CONCLUSION These data indicate that IOS technology was useful for student's self-evaluation by visual feedback.
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Affiliation(s)
- Lea Matthisson
- Department of Reconstructive Dentistry, UZB University Center for Dental Medicine Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, UZB University Center for Dental Medicine Basel, Basel, Switzerland
| | - Lucia K Zaugg
- Department of Reconstructive Dentistry, UZB University Center for Dental Medicine Basel, Basel, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry, UZB University Center for Dental Medicine Basel, Basel, Switzerland
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Abstract
Although the accuracy of direct digitization of oral structure has been improved, indirect digitization is still required in specific situations such as full-arch scanning. Once accurate images are imported, efficient designing can be achieved by CAD software. Although smile design using a 3-dimensional facial scan better predicts planned restorations, further improvement in virtual articulators is needed for complex cases. Computer-aided manufacturing can be offered in several formats such as chairside, laboratory, or centralized fabrications. The subtractive technique is mainly used for restorations, and many chairside CAM materials are available now, but the additive technique has the potential to save materials and an advantage in fabricating complex geometries. Limited evidence is available in applying CAD/CAM technologies in implant restorations. However, it is used to fabricate custom implant abutments and crowns from various materials such as titanium, zirconia, and PEEK and hybrid crowns using stock titanium base abutments.
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Affiliation(s)
- Hidehiko Watanabe
- Restorative Dentistry, Oregon Health & Science University, School of Dentistry, 2730 S Moody Avenue, Portland, OR 97201-5042, USA.
| | - Christopher Fellows
- Restorative Dentistry, Oregon Health & Science University, School of Dentistry, 2730 S Moody Avenue, Portland, OR 97201-5042, USA
| | - Hongseok An
- Restorative Dentistry, Oregon Health & Science University, School of Dentistry, 2730 S Moody Avenue, Portland, OR 97201-5042, USA
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Facial Scanning and Additive Manufacturing Used in Production Nasal Prosthesis. J Craniofac Surg 2022; 33:e762-e764. [PMID: 36100965 DOI: 10.1097/scs.0000000000008712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/17/2022] [Indexed: 11/26/2022] Open
Abstract
Maxillofacial prosthesis is an effective treatment for patients with facial sequelae, but it remains challenging for professionals due to its high esthetic complexity. This study describes a clinical case of successful nasal prosthetic rehabilitation using digital technology and additive manufacturing. Initially, the 76-year-old patient, with a facial defect in the nasal region, had her face scanned with 3-dimensional scanner for laboratory planning of the prototype of a nasal prosthesis. After approving the prototype image, working models in muffle shape were obtained in additive manufacture for the inclusion of the prosthesis. In the final session, the prosthesis was colored extrinsically and installed. The procedures digital in the manufacture of the facial prosthesis was applicable and agile, allowing the professional greater predictability regarding the shape of the rehabilitated organ, esthetic improvement in the mutilated area and patient satisfaction in relation to the speed, of the procedure and the quality of the prosthesis.
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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: 13] [Impact Index Per Article: 6.5] [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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Model-free digital workflow and immediate functional loading of implant-supported monolithic glass-ceramic crowns: A case series. J Dent 2022; 125:104270. [PMID: 36002118 DOI: 10.1016/j.jdent.2022.104270] [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: 10/10/2021] [Revised: 07/29/2022] [Accepted: 08/20/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES The aim of this study is to evaluate surgical and prosthetic outcomes of immediate functional loading of implants with glass-ceramic screw-retained single crowns. METHODS A total of 22 implants were placed. Within 24 hours, functional full-contour glass ceramic crowns were delivered to patients. The amount of attached gingiva, Simplified Oral Hygiene Index Score, bleeding on probing, time after extraction, bone type, implant size, soft tissue thickness, primary stability, a general fit of the restoration, occlusal and proximal contacts were recorded. Restorations were followed-up at 1, 3, and 6 months tracking marginal bone loss (MBL), noting changes in occlusal and interproximal contacts, checking other possible complications. RESULTS One implant failed and was removed after 4 weeks (95.5 % survival rate). The rest of the implants and crowns functioned with no complications during the follow-up period of 6 months. Factors such as time after extraction, bone type, implant size, soft tissue thickness, and primary stability recorded in Ncm and implant stability quotient (ISQ) values, were not associated with MBL (p<0.05). Mean MBL was found to be 0.3 mm (standard deviation = 0.42) mesially and 0.4 mm (standard deviation = 0.66) distally. One distal and one mesial proximal contact were found to be missing at the 6-month check-up appointment. CONCLUSIONS Within the limits of this study, fully digital workflow without a 3D printed model could be successfully employed for immediate functional loading with single-unit implant-supported crowns. Further studies are needed to obtain long-term results with a larger sample of patients. CLINICAL SIGNIFICANCE Model-free digital workflow and immediate functional loading of implant-supported monolithic glass-ceramic crown might be viable option to restore a single tooth defect.
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Tan YY, Ho TK, Goo CL. Effect of training on time efficiency and marginal adaptation of computer-aided design/computer-aided manufacturing crowns among dental students. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:468-474. [PMID: 34541757 DOI: 10.1111/eje.12722] [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: 05/17/2021] [Revised: 06/14/2021] [Accepted: 07/10/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION The computer-aided design/computer-aided manufacturing (CAD/CAM) technology has revolutionised dentistry at present. An operator's skills can affect the overall clinical duration and marginal accuracy of the prosthesis fabricated through this workflow. The aim of this study was to assess the effect of CAD/CAM hands-on training compared with that of a self-instructional video on the performance of dental students in digital impression and fabrication of a CAD/CAM crown. METHODS In this cross-sectional study, 30 undergraduate dental students were shown a CEREC demonstration video. Each operator then captured a digital impression using the intra-oral scanner, and a crown was subsequently milled. All participants underwent a training course before repeating the process. Marginal discrepancy for each crown on its abutment tooth was measured before and after training using a stereomicroscope and was evaluated using Wilcoxon signed rank test. The duration taken for the process was recorded before and after training and evaluated using paired t-test. RESULTS The overall mean ±standard deviation marginal adaptation for the CEREC crowns was 78.15 ± 42.83 μm before training and 52.41 ± 17.12 μm after training. The Wilcoxon signed rank test found significant difference (p < .05) in terms of marginal adaptation of crowns fabricated before and after training. Paired t-tests showed that the time efficiency after training significantly improved compared with that before training. CONCLUSIONS Training with guided feedback is crucial to improve the time efficiency of making a digital impression and marginal adaptation of fixed prosthesis using the CAD/CAM technology.
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Affiliation(s)
- Ying Yin Tan
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Ting Khee Ho
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Chui Ling Goo
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
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Carneiro Pereira AL, Medeiros VR, Campos MDFTP, de Medeiros AKB, Yilmaz B, Carreiro ADFP. Conventional and digital impressions for complete-arch implant-supported fixed prostheses: time, implant quantity effect and patient satisfaction. J Adv Prosthodont 2022; 14:212-222. [PMID: 36105876 PMCID: PMC9444484 DOI: 10.4047/jap.2022.14.4.212] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/13/2022] [Accepted: 08/22/2022] [Indexed: 12/04/2022] Open
Abstract
PURPOSE To evaluate and compare the effect of impression type (conventional vs digital) and the number of implants on the time from the impressions to the generation of working casts of mandibular implant-supported fixed complete-arch frameworks, as well as on patient satisfaction. MATERIALS AND METHODS 17 participants, 3 or 4 implants, received 2 types of digital impression methods (DI) and conventional (CI). In DI, two techniques were performed: scanning with the scan bodies (SC) and scanning with a device attached to the scan bodies (SD) (BR 10 2019 026265 6). In CI, the making of a solid index (SI) and open-tray impression (OT) were used. The outcomes were used to evaluate the time and the participant satisfaction with conventional and digital impressions. The time was evaluated through the timing of the time obtained in the workflow in the conventional and digital impression. The effect of the number of implants on time was also assessed. Satisfaction was assessed through a questionnaire based on seven. The Wilcoxon test used to identify the statistical difference between the groups in terms of time. The Mann-Whitney test was used to analyze the relationship between the time and the number of implants. Fisher's test was used to assess the patient satisfaction (P < .05). RESULTS The time with DI was shorter than with CI (DI, x̃=02:58; CI, x̃=31:48) (P < .0001). The arches rehabilitated with 3 implants required shorter digital impression time (3: x̃=05:36; 4: x̃=09:16) (P < .0001). Regarding satisfaction, the DI was more comfortable and pain-free than the CI (P < .005). CONCLUSION Digital impressions required shorter chair time and had higher patient acceptance than conventional impressions.
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Affiliation(s)
| | - Vitória Ramos Medeiros
- Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | | | | | - Burak Yilmaz
- Department of Gerodontology and Reconstructive Dentistry, University of Bern, School of Dentistry, Bern, Switzerland.,Department of Restorative, Preventive, and Pediatric Dentistry, University of Bern, School of Dentistry, Bern, Switzerland.,Division of Restorative and Prosthetic Dentistry, The Ohio State University, College of Dentistry, Columbus, OH, USA
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Abduo J, Lau D. Duration, deviation and operator's perception of static computer assisted implant placements by inexperienced clinicians. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2022; 26:477-487. [PMID: 34797018 DOI: 10.1111/eje.12724] [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: 01/28/2021] [Revised: 09/19/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION This study measured the duration, deviation and operator's perception of implant placement by fully guided (FG), pilot-guided (PG) and freehand (FH) protocols by postgraduate students with minimal implant experience. MATERIALS AND METHODS Twenty postgraduate students participated in the study. Half of them placed single anterior (S-Ant) and single posterior (S-Post) implants, and the other half placed anterior (B-Ant) and posterior (B-Post) implants in a wide edentulous area. The PG placement involved surgical guides that only controlled pilot drilling, whilst the FG placement controlled all the drilling steps and implant placement. The duration of implant placement and the operator's perception (ease of drilling, ease of implant placement and operator's preference) were measured. The deviations of placed implants were quantified by measuring the trueness and angulation deviations in relation to the planned implants. RESULTS The PG placement was the quickest for inserting implants, followed by FG and FH placements, respectively (p < .05). The location of the implant had influenced the duration of implant placement only for the PG placement. In relation to ease of drilling, ease of implant placement and operator's preference, there was no significant difference amongst the different placement protocols or implant locations. The FG placement was associated with least deviations, followed by PG and FH placements, respectively (p < .05). CONCLUSIONS In the hands of postgraduate students with minimal implant experience, FG and PG placements reduced the implant placement duration in comparison with FH placement. The FG placement was consistently more accurate followed by PG placement.
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Affiliation(s)
- Jaafar Abduo
- Melbourne Dental School, Melbourne University, Melbourne, Victoria, Australia
| | - Douglas Lau
- Private Practice, Melbourne Dental School, Melbourne University, Melbourne, Victoria, Australia
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48
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Costa V, Silva AS, Costa R, Barreiros P, Mendes J, Mendes JM. In Vitro Comparison of Three Intraoral Scanners for Implant-Supported Dental Prostheses. Dent J (Basel) 2022; 10:dj10060112. [PMID: 35735654 PMCID: PMC9221835 DOI: 10.3390/dj10060112] [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: 05/06/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 12/10/2022] Open
Abstract
With continuing technological developments, there have been advances in the field of fixed prosthetics, particularly in impression-taking techniques. These technological advances mean that a wide variety of diagnostic and/or rehabilitation possibilities can be explored without the need for physical models. The aim of this study was to evaluate the accuracy of three intraoral scanners used in oral implant rehabilitation using an extraoral scanner as a reference and varying the scanning area. Three models representing different clinical scenarios were scanned 15 times by each intraoral scanner and three times by the extraoral scanner. The readings were analyzed and overlaid using engineering software (Geomagic® Control X software (Artec Europe, Luxembourg)). Statistically significant differences in accuracy were found between the three intraoral scanners, iTero® (Align Technology Inc., San Jose, CA, USA), Medit® (Medit®: Seoul, Korea), and Planmeca® (Planmeca®: Helsinki, Finland). In all clinical scenarios, the iTero® scanner had the best trueness (24.4 μm), followed by the Medit® (26.4 μm) and Planmeca® (42.1 μm). The Medit® showed the best precision (18.00 μm) followed by the iTero® (19.20 μm) and Planmeca® (34.30 μm). We concluded that the iTero® scanner had the highest reproducibility and accuracy in the clinical setting.
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Affiliation(s)
- Vitória Costa
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (V.C.); (R.C.)
| | - António Sérgio Silva
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (P.B.); (J.M.); (J.M.M.)
- Correspondence:
| | - Rosana Costa
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (V.C.); (R.C.)
| | - Pedro Barreiros
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (P.B.); (J.M.); (J.M.M.)
| | - Joana Mendes
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (P.B.); (J.M.); (J.M.M.)
| | - José Manuel Mendes
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (P.B.); (J.M.); (J.M.M.)
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Yacob P, Peter D. Perceived Benefits of Sustainable Digital Technologies Adoption in Manufacturing SMEs. INTERNATIONAL JOURNAL OF INNOVATION AND TECHNOLOGY MANAGEMENT 2022. [DOI: 10.1142/s0219877022500122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study examines the perceived benefits of adopting sustainable digital technologies through the mediation effect of leaders’ attitudes in manufacturing small and medium-sized enterprises (SMEs) in Malaysia. Data were collected from an online survey of 389 respondents. The results exhibited that the perceived benefits, particularly perceived cost-effectiveness and perceived communication effectiveness, had a substantial positive influence on the adoption of sustainable digital technologies adoption compared to perceived usefulness and ease of use. The leader’s attitude fully mediates the association between perceived benefits and digital sustainable technologies adoption. This study has contributed to the rising body of knowledge relevant to adopting sustainable digital technologies in SMEs. It offers strategies to develop management skills and strong competencies in sustainable digital technologies solutions.
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Affiliation(s)
- Peter Yacob
- Faculty of Business & Finance, Universiti Tunku Abdul Rahman, Malaysia
| | - Darren Peter
- Faculty of Business & Finance, Universiti Tunku Abdul Rahman, Malaysia
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Sfondrini MF, Pascadopoli M, Dicorato S, Todaro C, Nardi MG, Gallo S, Gandini P, Scribante A. Bone Modifications Induced by Rapid Maxillary Expander: A Three-Dimensional Cephalometric Pilot Study Comparing Two Different Cephalometric Software Programs. APPLIED SCIENCES 2022; 12:4313. [DOI: 10.3390/app12094313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cone-beam computed tomography (CBCT) allows for more accurate 3D study of the craniofacial region and the development of a very precise treatment plan. The present pilot study aims to evaluate the skeletal outcomes of the rapid maxillary expander (RME) on the sagittal, transverse and vertical planes in growing patients subjected to CBCT at T0 and T1, and to compare the results from two different programs. The effects of the RME are monitored in 11 patients who were subjected to CBCT at T0, before the expansion, and at T1, 6 months after the end of the RME therapy. The results obtained are evaluated using two programs: Simplant and Delta-Dent. All of the analyses were performed by the same operator. Both programs reported statistically significant differences between the pre- and post-expansion values of the parameters on the transverse plane. On the vertical plane, only posterior facial height showed a statistically relevant variation. Both programs underlined a discrepancy between the pre- and post-expansion infraorbital and mental foramina distance values; however, this difference was considered statistically significant by Delta-Dent, and not by Simplant. CBCT is a reliable and effective tool for orthodontic diagnosis and treatment planning. Both of the evaluated programs are efficient in tridimensional cephalometric analysis.
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Affiliation(s)
- Maria Francesca Sfondrini
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maurizio Pascadopoli
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Serena Dicorato
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Claudia Todaro
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Maria Gloria Nardi
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Simone Gallo
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Paola Gandini
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
| | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
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