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Othman B, Tash Niyazi AA, Alhusayni M. Utilization of Digital Periodontal and Restorative Dentistry in Full Mouth Reconstruction: A Case Report. Cureus 2024; 16:e62469. [PMID: 38887748 PMCID: PMC11181237 DOI: 10.7759/cureus.62469] [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: 06/16/2024] [Indexed: 06/20/2024] Open
Abstract
CT-guided surgery has demonstrated superior accuracy over traditional methods in the dental literature. However, inherent errors such as discrepancies between jaw dimensions in scans and reality can challenge the fabrication of screw-retained provisional restorations. These discrepancies can impede final restoration fabrication. Traditional immediate loading of edentulous jaws using temporary cylinders in existing dentures often requires time-consuming abutment positioning and drilling. Many articles addressed these issues through minimally invasive implant placement with immediate loading, achieved through careful preoperative planning and exact prosthetic techniques. CT-guided surgery facilitates minimally invasive procedures and immediate restoration of edentulous jaws, resulting in reduced morbidity and quicker, more precise outcomes. This case report illustrates how digital dentistry enhances implant placement precision and reliability. It involves using a lock object system between the surgical guide and provisional restoration, streamlining the process. A 59-year-old male with significant periodontal issues and non-restorable teeth was treated with implant-supported fixed prostheses using digital planning and computer-fabricated surgical guides. The plan included immediate loading with mechanical and magnetic locks for optimal outcomes. The patient received complete fixed provisional restorations on both arches through minimally invasive procedures. Digital dentistry facilitated precise implant placement and restoration, improving function, esthetics, and patient satisfaction. Digital technologies streamlined the process, reducing time and enhancing predictability and reproducibility. In conclusion, integrating digital dentistry into implant treatment planning and execution offers enhanced accuracy, efficiency, and patient outcomes. By utilizing digital technologies and innovative methods, clinicians can attain consistent and reliable outcomes, thereby enhancing the quality of care for patients undergoing implant therapy.
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Affiliation(s)
- Badr Othman
- Periodontology Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | | | - Mohammed Alhusayni
- Prosthodontics Department, King Fahad Hospital - Dental Speciality Center, Medina, SAU
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Bai X, Wu T, Zhu Y, Yang C, Cheng T, Liu Y, Zhou Y. Cone-wedge anchored surgical templates for stackable metal guide: a novel technique. Int J Implant Dent 2024; 10:27. [PMID: 38819712 PMCID: PMC11143131 DOI: 10.1186/s40729-024-00539-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/16/2024] [Indexed: 06/01/2024] Open
Abstract
OBJECTIVE To address the instability in implant surgical guides, this technique proposes an alternative anchoring mechanism in the stackable metal surgical guides utilizing cone-wedge anchors for improved stability. METHODS Postoperative implant position superimposed onto the preoperatively planned design using Mimics Medical 21.0 and Materialise Magics 24.0 to assess 3D coronal implant deviation, 3D apical implant deviation, and implant angular deviation. RESULTS Postoperative cone-beam computed tomography (CBCT) revealed a high level of precision in the implant placement, with an average 0.97 mm deviation at implant coronal region, 1.56 mm at implant apexes, and 2.95° angular deviation. CONCLUSION This technique introduces a novel cone-wedge anchoring mechanism to enhance the stability of stackable metal surgical guide templates, addressing inherent instability issues. The utilization of this approach significantly improves the accuracy of implant placement procedures.
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Affiliation(s)
- Xueying Bai
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Tao Wu
- Center for Prosthodontics and Implant Dentistry, Optics Valley Branch, School and Hospital of Stomatology; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology , Wuhan University, Wuhan University, Wuhan, PR China
| | - Yuxi Zhu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Chengyu Yang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Tiange Cheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China
| | - Yi Liu
- Department of Stomatology, Edong Healthcare Group, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Huangshi, PR China
| | - Yi Zhou
- Center for Prosthodontics and Implant Dentistry, Optics Valley Branch, School and Hospital of Stomatology; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology , Wuhan University, Wuhan, 430000, PR China.
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Lan R, Marteau C, Mense C, Silvestri F. Current knowledge about stackable guides: a scoping review. Int J Implant Dent 2024; 10:28. [PMID: 38819752 PMCID: PMC11143148 DOI: 10.1186/s40729-024-00547-w] [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: 02/02/2024] [Accepted: 05/21/2024] [Indexed: 06/01/2024] Open
Abstract
PURPOSE The rise of stereolithographic surgical guides and digital workflow, combined with a better knowledge of materials and loading principle, has enabled the placement of the temporary prosthesis at the time of implant placement. This scoping review aimed to assess the current knowledge available on stackable guides. METHODS The review focused on fully edentulous or requiring total edentulism patients. The procedure studied was the use of stackable guides for edentulous patients in order to place immediate temporary prostheses. The clinical endpoint was immediate placement of the provisional prosthesis after surgery combined with a prior bone reduction using a stackable guide. RESULTS 12 case reports or case series articles met inclusion criteria, which did not allow an analysis by a systematic review. The included studies were case reports or case series. Most of the articles showed a base stabilized by 3 or 4 bone-pins, anchored in buccal or lingual part. Regarding the accuracy of bone reduction (ranged from 0.0248 mm to 1.98 mm) and implant placement when compared to planned, only 4 articles reported quantitative data. 11 articles showed an immediate loading with the transitional prosthesis after implant placement. CONCLUSIONS There are as yet no prospective or comparative studies on the efficiency of this technique. In a reliable way, stackable guides seem to be able to guide the practitioner from the flap elevation to the placement of the temporary screw-retained implant supported prosthesis. Given the lack of studies in this specific field of guided surgery, further studies are needed to confirm the clinical relevance of this technique.
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Affiliation(s)
- Romain Lan
- Faculté des Sciences Médicales et Paramédicales, École de Médecine dentaire, ADES, CNRS, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille Cedex 5, 13555, France
| | | | - Chloë Mense
- Faculté des Sciences Médicales et Paramédicales, École de Médecine dentaire, ADES, CNRS, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille Cedex 5, 13555, France
| | - Frédéric Silvestri
- Faculté des Sciences Médicales et Paramédicales, École de Médecine dentaire, ADES, CNRS, Aix-Marseille University, 27 Boulevard Jean Moulin, Marseille Cedex 5, 13555, France.
- Department of Oral Rehabilitation, Karolinska Institute, Huddinge, Sweden.
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Alruhailie L, Zaidan A, Alasmari A, Raffa O. A Fully Guided Sequential Template Immediate Loading Protocol for Dual-Arch Implant Surgery. Clin Cosmet Investig Dent 2024; 16:167-177. [PMID: 38827119 PMCID: PMC11141767 DOI: 10.2147/ccide.s468780] [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: 04/11/2024] [Accepted: 05/21/2024] [Indexed: 06/04/2024] Open
Abstract
A method is described for designing, fabricating and implementing sequential template immediate loading protocols for dual arch implant therapy. A 41-year-old medically-free patient with terminal dentition was treated following stackable guide loading protocols for maxillary and mandibular arches. Implants were placed following extractions and immediately loaded with full arch fixed prostheses. Healing was uneventful and all implants integrated successfully. Special consideration was given to the design and clinical challenges when implementing stackable guide protocols for dual arch implant therapy.
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Affiliation(s)
- Lamia Alruhailie
- Department of Prosthodontics, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Aliyaa Zaidan
- Department of Periodontics, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Abeer Alasmari
- Department of Periodontics, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Ossama Raffa
- Department of Prosthodontics, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Martins J, Rangel J, de Araújo Nobre M, Ferro A, Nunes M, Almeida R, Moura Guedes C. A New Full Digital Workflow for Fixed Prosthetic Rehabilitation of Full-Arch Edentulism Using the All-on-4 Concept. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:720. [PMID: 38792903 PMCID: PMC11123051 DOI: 10.3390/medicina60050720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
(1) Background: Recent digital workflows are being developed for full-arch rehabilitations supported by implants with immediate function. The purpose of this case series is to describe a new digital workflow for the All-on-4 concept. (2) Methods: The patients were rehabilitated using the All-on-4 concept with a digital workflow including computerized tomography scanning, intra-oral scanning, and CAD-CAM production of the temporary prosthesis, with the 3D printing of stackable guides (base guide, implant guide, and prosthetic guide). The passive fit of the prostheses and the time to perform the rehabilitations were evaluated. (3) Results: The digital workflow allowed for predictable bone reduction, the insertion of implants with immediate function, and the connection of an implant-supported prosthesis with immediate loading. The time registered to perform the full-arch rehabilitations (implant insertion, abutment connection, prosthesis connection) was below 2 hours and 30 min. No passive fit issues were noted. (4) Conclusions: within the limitation of this case series, the digital workflow applied to the All-on-4 concept using stackable base-, implant-, and prosthetic guides constitutes a potential alternative with decreased time for the procedure without prejudice of the outcome.
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Affiliation(s)
- João Martins
- Prosthodontic Department, Malo Clinic, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisbon, Portugal; (J.M.); (J.R.); (R.A.); (C.M.G.)
| | - João Rangel
- Prosthodontic Department, Malo Clinic, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisbon, Portugal; (J.M.); (J.R.); (R.A.); (C.M.G.)
| | - Miguel de Araújo Nobre
- Research, Development and Education Department, Malo Clinic, Avenida dos Combatentes, 43, Level 11, 1600-042 Lisbon, Portugal
| | - Ana Ferro
- Oral Surgery Department, Malo Clinic, Avenida dos Combatentes, 43, Level 9, 1600-042 Lisbon, Portugal; (A.F.); (M.N.)
| | - Mariana Nunes
- Oral Surgery Department, Malo Clinic, Avenida dos Combatentes, 43, Level 9, 1600-042 Lisbon, Portugal; (A.F.); (M.N.)
| | - Ricardo Almeida
- Prosthodontic Department, Malo Clinic, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisbon, Portugal; (J.M.); (J.R.); (R.A.); (C.M.G.)
| | - Carlos Moura Guedes
- Prosthodontic Department, Malo Clinic, Avenida dos Combatentes, 43, Level 10, 1600-042 Lisbon, Portugal; (J.M.); (J.R.); (R.A.); (C.M.G.)
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Geng N, Ren J, Zhang C, Zhou T, Feng C, Chen S. Immediate implant placement in the posterior mandibular region was assisted by dynamic real-time navigation: a retrospective study. BMC Oral Health 2024; 24:208. [PMID: 38336661 PMCID: PMC10858590 DOI: 10.1186/s12903-024-03947-x] [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: 11/12/2023] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Efficient utilization of residual bone volume and the prevention of inferior alveolar nerve injury are critical considerations in immediate implant placement (IIP) within the posterior mandibular region. Addressing these challenges, this study focuses on the clinical efficacy and implant accuracy of dynamic real-time navigation, an emerging technology designed to enhance precision in implantation procedures. METHODS This study included 84 patients with 130 implants undergoing immediate placement in the posterior mandibular region. Stratified into dynamic navigation, static guide plate, and freehand implant groups, clinical indicators, including initial stability, distance to the inferior alveolar nerve canal, depth of implant placement, and various deviations, were systematically recorded. Statistical analysis, employing 1- or 2-way ANOVA and Student's t-test, allowed for a comprehensive evaluation of the efficacy of each technique. RESULTS All 130 implants were successfully placed with an average torque of 22.53 ± 5.93 N.cm. In the navigation group, the distance to the inferior alveolar nerve and the depth of implant placement were significantly greater compared to the guide plate and freehand groups (P < 0.05). Implant deviation was significantly smaller in both the navigation and guide plate groups compared to the freehand group(P < 0.05). Additionally, the navigation group exhibited significantly reduced root and angle deviations compared to the guide plate group(P < 0.05), highlighting the superior precision of navigation-assisted immediate implant placement. CONCLUSIONS It is more advantageous to use dynamic navigation rather than a static guide plate and free-hand implant insertion for immediate posterior mandibular implant implantation.
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Affiliation(s)
- Ningbo Geng
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
| | - Jing Ren
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Chi Zhang
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Tianren Zhou
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Chongjin Feng
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Songling Chen
- Department of Stomatology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China.
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Sun X, Feng Y, Jiao Y, Liu W. Fully digital workflow for the fabrication of occlusal stabilization splints based on individual mandibular movement. J Dent 2024; 141:104826. [PMID: 38157975 DOI: 10.1016/j.jdent.2023.104826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE This study was conducted to present a completely digital workflow for the fabrication of occlusal stabilization splints using CAD/CAM systems and a digital face bow based on optical sensor technology. METHODS Digital scans of the maxillary and mandibular arches of 20 volunteers were obtained using an intraoral scanner. Jaw relation and mandibular movements were recorded with a digital face bow via optical sensors. The virtual increase of the vertical dimension of occlusion (VDO) was then performed, after which computer-aided design (CAD) of the occlusal stabilization splints was carried out. The corresponding splints were then manufactured using digitally controlled technology. RESULTS A completely digital workflow for the manufacturing of occlusal stabilization splints was found to be clinically feasible. The corresponding data analysis revealed high congruence between virtual and physical occlusal contacts on the occlusal splint. Moreover, the appropriate guidance of the anterior teeth area was easily obtainable, and the time for adjusting the occlusion was less. CONCLUSIONS This study demonstrated that the fabrication of occlusal stabilization splints using a fully digital workflow is feasible. Compared to traditional impression-based manufacturing, several advantages of digital manufacturing include easy accessibility, time-efficient manufacturing, high-level accuracy in splint quality, and potential to manufacture duplicate splints. CLINICAL SIGNIFICANCE The proposed fully digital approach may help young dentists fabricating stable occlusal splints with beneficial curative effects. Meanwhile, it could also improve the production efficiency of stable occlusal splints, saving time for both doctors and patients while reducing labor costs.
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Affiliation(s)
- Xinrong Sun
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Yue Feng
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Yi Jiao
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Weicai Liu
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China.
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8
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Manfredini M, Poli PP, Maiorana C, Salina FE, Tandurella M, Beretta M. Computer Aided Full Arch Restoration by Means of One-Piece Implants and Stackable Guide: A Technical Note. Dent J (Basel) 2023; 11:256. [PMID: 37999020 PMCID: PMC10670089 DOI: 10.3390/dj11110256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/22/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023] Open
Abstract
This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans of the removable denture and upper and lower arches were performed. On this basis, a prototype with ideal esthetic and functional outcomes was realized and replicated into a custom-made radiological stent with markers. The superimposition of STL and DICOM files allowed virtual planning of one-piece implants in the ideal prosthetically driven position. The stackable guides, composed of a fixed base template and additional removable components, were then realized. The fixed template, initially secured with anchor pins to the bone, was no longer removed. The removable components, which were screwed to the base template, were used to perform implant surgery and immediate prosthetic loading. No surgical complications occurred, the implants achieved a minimum insertion torque of 35 Ncm, and immediate prosthetic loading was performed. The base template allowed for the maintenance of a fixed reference during the entire workflow, improving the transition between the digital project, the surgical procedure, and the prosthetic rehabilitation.
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Affiliation(s)
- Mattia Manfredini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Pier Paolo Poli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Federica Eugenia Salina
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Marco Tandurella
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (M.M.); (C.M.); (F.E.S.); (M.T.); (M.B.)
- Implant Center for Edentulism and Jawbone Atrophies, Maxillofacial Surgery and Dental Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Jurado CA, Villalobos-Tinoco J, Mekled S, Sanchez R, Afrashtehfar KI. Printed Digital Wax-up Model as a Blueprint for Layered Pressed-ceramic Laminate Veneers: Technique Description and Case Report. Oper Dent 2023; 48:618-626. [PMID: 37881104 DOI: 10.2341/22-144-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 10/27/2023]
Abstract
This article presents a clinical technique for transferring Digital Smile Design (DSD) information and a digital wax-up to fabricate highly personalized ceramic laminate veneers. The hybrid workflow of digitally designed wax-up and conventional hand-crafted veneers is showcased in a female adult who sought to improve her smile due to maxillary anterior incisal wear. The ceramic veneers, layered by feldspathic porcelain, followed the contours and shade blueprint planned with the digital wax-up. The DSD improved the harmony of the facial-and-smile relationship, and the ceramic restorations fulfilled the patient's esthetic and functional demands. Guides based on the printed model with the digitally designed wax-up can provide a reference for pressed lithium disilicate veneers layered with feldspathic porcelain.
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Affiliation(s)
- C A Jurado
- Carlos Alberto Jurado, DDS, MS, associate professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, visiting faculty, Specialty Program in Periodontics, National University of Rosario School of Dentistry, Rosario, Argentina
| | - S Mekled
- Salwa Mekled, DDS, MBA, associate professor, Department of Restorative Dentistry, Temple University Kornberg School of Dentistry, Philadelphia, PA, USA
| | - R Sanchez
- Ramon Sanchez, MDT, dental technician, private practice, San Felipe, BC, Mexico
| | - K I Afrashtehfar
- *Kelvin I. Afrashtehfar, DDS, MSc, Dr, FDS RCS, FRCDC, assistant professor, Division of Restorative Dental Sciences, Clinical Sciences Department, College of Dentistry, Ajman University, AE, UAE; adjunct research associate professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, BE, Switzerland
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10
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Tang W, Zhang H, Wang H, Li L. A digital technique of bone reduction for a maxillary full-arch implant-supported fixed dental prosthesis. J Prosthodont 2023. [PMID: 37811545 DOI: 10.1111/jopr.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/14/2023] [Accepted: 09/23/2023] [Indexed: 10/10/2023] Open
Abstract
When fabricating a maxillary full-arch implant-supported fixed dental prosthesis, it is often challenging to systematically reduce alveolar bone to create prosthetic space and hide the prosthesis-tissue junction. This article presents a digital technique that allows for precise bone reduction while simultaneously placing implants and interim prostheses. By using this technique, clinicians can perform surgical procedures in a systematic manner without compromising the functional or esthetic outcomes.
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Affiliation(s)
- Weimao Tang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Hai Zhang
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
| | - Haozhe Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lei Li
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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11
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Lin WS. Complications related to digital technologies in treating edentulous patients with dental implants-Part II. Computer-guided surgery and prosthetic stages. J Prosthet Dent 2023; 129:817-818. [PMID: 37270261 DOI: 10.1016/j.prosdent.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 06/05/2023]
Abstract
This is the second part of a JPD Digital presentation focusing on commonly seen complications and solutions related to using digital technologies in treating edentulous patients during the surgical and prosthetic stages. The proper usage of the computer-aided design and computer-aided manufacturing surgical templates and immediate loading prosthesis during computer-guided surgery and accurate translation of digital planning into clinical execution are discussed. In addition, design concepts of implant-supported complete fixed dental prostheses are presented to minimize subsequent issues in their long-term clinical service. In concert with these topics, this presentation will allow clinicians to deepen their understanding of the advantages and limitations of utilizing digital technologies in implant dentistry.
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Affiliation(s)
- Wei-Shao Lin
- Professor, Program Director, and Chair, Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Department of Prosthodontics, Indianapolis, Ind.
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12
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Lin WS. Complications related to digital technologies in treating edentulous patients with implant-supported prostheses. Part 1: Digital data collection and surgical planning stages. J Prosthet Dent 2023; 129:674-675. [PMID: 37121623 DOI: 10.1016/j.prosdent.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 05/02/2023]
Abstract
The treatment of complete or single arch edentulism remains a significant priority for dental clinicians. Patients often request immediate loading for complex complete arch treatments with shorter treatment times and fewer appointments, and digital technologies can be leveraged to provide more effective treatments. This part 1 presentation focuses on the discussion of commonly seen complications related to using digital technologies in treating edentulous patients during the data collection and surgical planning stages. Complications related to digital technologies can be prevented or corrected during these stages, preventing future complications in the clinical (surgical and prosthetic) stages.
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Affiliation(s)
- Wei-Shao Lin
- Professor, Program Director, and Chair, Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Department of Prosthodontics, Indianapolis, Ind.
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Zhang S, Chen W, Lin Y, Chen J. A digital technique for transferring the maxillomandibular relationship for complete arch implant rehabilitation in edentulous jaws. J Prosthet Dent 2023:S0022-3913(22)00494-2. [PMID: 36932022 DOI: 10.1016/j.prosdent.2022.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 03/17/2023]
Abstract
A digital technique for transferring the maxillomandibular relationship using photogrammetry, an intraoral scanner, and a computer-aided design software program is described in a treatment involving immediate loading in a patient with mandibular edentulism. The edentulous mandible was located preoperatively in a centric occlusal relationship with a denture, and preoperative and postoperative cone beam computed tomography (CBCT) data were aligned and merged based on bone markers. This technique, which allows the transfer of the presurgical maxillomandibular relationship during the immediate loading procedure, is more objective, more straightforward, and faster than the conventional method.
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Affiliation(s)
- Sihui Zhang
- Attending dentist, Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fujian, PR China
| | - Weiyi Chen
- Postgraduate student, Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fujian, PR China
| | - Yuxuan Lin
- Postgraduate student, Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fujian, PR China
| | - Jiang Chen
- Professor, Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fujian, PR China.
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Chen Y, Su B. Investigation on the application of digital guide templates guided dental implantation in China. BMC Oral Health 2023; 23:36. [PMID: 36683029 PMCID: PMC9869612 DOI: 10.1186/s12903-023-02750-4] [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: 10/29/2022] [Accepted: 01/16/2023] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of this survey is to investigate the application of digital guide templates (DGTs) across China, and the views and attitudes of oral health professionals toward them. METHODS This survey was prepared, distributed, and collected by WJX. Chinese oral health professionals were invited to participate in it. The basic information of respondents, the application of DGTs, and the views and attitudes toward their status quo and development were statistically described. Chi-square test was used to evaluate the correlation between the basic information of respondents and the application of DGTs as well as the views and attitudes toward them. RESULTS A total of 276 questionnaires were collected, of which 273 were identified as valid. 269 (98.5%) respondents were dental clinical workers, 204 (74.7%) were dental clinical implant workers, and 152 (55.7%) had been engaged in the implant industry for more than five years. The chi-square test showed that working years were significantly correlated with the half-guided, tooth-supported, and mucosa-supported DGTs (P < 0.05); and professional backgrounds and working years presented significant differences in the views and attitudes toward the status quo and development of DGTs (P < 0.05). The questionnaires also made a preliminary investigation and evaluation on the factors influencing accuracy, indications, doctors' recommendations and relevant training. CONCLUSION Most respondents held a positive attitude toward the accuracy and development of DGTs. This survey can point out the direction for the improvement of DGTs, and provide a reference for the study of factors affecting implant accuracy, the establishment of a training system, and the understanding of clinicians' current views on DGTs. Trial registration This survey was approved by the Ethics Review Committee of Chenghuaxinguanghua Dental Clinic (Approval NO. CDCIRB-D-2021-201).
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Affiliation(s)
- Yunli Chen
- College of Biomedical Engineering, Sichuan University, Chengdu, 610065, Sichuan Province, China
| | - Baohui Su
- College of Biomedical Engineering, Sichuan University, Chengdu, 610065, Sichuan Province, China.
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Alfallaj HA, Afrashtehfar KI, Asiri AK, Almasoud FS, Alnaqa GH, Al-Angari NS. The Status of Digital Dental Technology Implementation in the Saudi Dental Schools' Curriculum: A National Cross-Sectional Survey for Healthcare Digitization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:321. [PMID: 36612639 PMCID: PMC9819993 DOI: 10.3390/ijerph20010321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
Objective: The primary objective of this cross-sectional national study was to investigate the status of digital dental technology (DDT) adoption in Saudi Arabian undergraduate dental education. A secondary objective was to explore the impact of dental schools' funding sources to incorporate digital technologies. Methods: A self-administered questionnaire was distributed to the chairpersons of prosthetic sciences departments of the 27 dental schools in Saudi Arabia. If any department chairman failed to respond to the survey, a designated full-time faculty member was contacted to fill out the form. The participants were asked about the school's sector, DDT implementation in the curriculum, implemented level, their perceptions of the facilitators and challenges for incorporating DDT. Results: Of the 27 dental schools (18 public and 8 private), 26 responded to the questionnaire (response rate: 96.3%). The geographic distribution of the respondent schools was as follows: 12 schools in the central region, 6 in the western region, and 8 in other regions. Seventeen schools secure and preserve patients' records using electronic software, whereas nine schools use paper charts. Seventeen schools (64,4%) implemented DDT in their curricula. The schools that did not incorporate DDT into their undergraduate curricula were due to not being included in the curriculum (78%), lack of expertise (66%), untrained faculty and staff (44%), and cost (33%). Conclusions: This national study showed that digital components still need to be integrated into Saudi Arabian dental schools' curricula and patient care treatment. Additionally, there was no association between funding sources and the DDT implementation into the current curricula. Consequently, Saudi dental schools must emphasize the implementation and utilization of DDT to align with Saudi Vision 2030 for healthcare digitization and to graduate competent dentists in digital dental care.
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Affiliation(s)
- Hayam A. Alfallaj
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh P.O. Box 3660, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh P.O. Box 3660, Saudi Arabia
| | - Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Ali K. Asiri
- King Abdullah International Medical Research Center, Riyadh P.O. Box 3660, Saudi Arabia
- Dental Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh P.O. Box 22490, Saudi Arabia
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh P.O. Box 3660, Saudi Arabia
| | - Farah S. Almasoud
- King Abdullah International Medical Research Center, Riyadh P.O. Box 3660, Saudi Arabia
- Dental Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh P.O. Box 22490, Saudi Arabia
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh P.O. Box 3660, Saudi Arabia
| | - Ghaida H. Alnaqa
- King Abdullah International Medical Research Center, Riyadh P.O. Box 3660, Saudi Arabia
- Dental Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh P.O. Box 22490, Saudi Arabia
- College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh P.O. Box 3660, Saudi Arabia
| | - Nadia S. Al-Angari
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh P.O. Box 3660, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh P.O. Box 3660, Saudi Arabia
- Dental Department, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh P.O. Box 22490, Saudi Arabia
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16
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Hashemi AM, Hashemi HM, Siadat H, Shamshiri A, Afrashtehfar KI, Alikhasi M. Fully Digital versus Conventional Workflows for Fabricating Posterior Three-Unit Implant-Supported Reconstructions: A Prospective Crossover Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811456. [PMID: 36141729 PMCID: PMC9517085 DOI: 10.3390/ijerph191811456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 05/14/2023]
Abstract
This study assessed the clinical variables influencing the success of three-unit implant-supported fixed dental prostheses (ISFDPs) fabricated using either fully digital or conventional workflows. The clinical trial evaluated 10 patients requiring three-unit ISFDPs in the posterior mandible. Maxillomandibular relation records, and digital and conventional impressions were obtained from each patient using an intraoral scanner (IoS) and polyvinylsiloxane (PVS), and the frameworks were fabricated using zirconia and cobalt-chromium, respectively. A 2 µm accuracy scanner scanned the conventional master casts and standard reference models. The stereolithography (STL) files of the digital and conventional impressions were superimposed on the standard model file, and the accuracy was calculated with the best-fit algorithm. The framework adaptation and passivity were assessed using the one-screw and screw resistance tests. The time required for occlusal adjustment of both types of reconstructions, including the duration of the whole treatment, was recorded. The aesthetic appearance of ISFDPs was rated by each patient and clinician using a self-administered visual analogue scale questionnaire and the FDI World Dental Federation aesthetic parameters, respectively. The sample size was based on the power calculation, and alpha was set at 0.05 for the statistical analyses. The impression accuracy, framework adaptation and passivity, and reconstructions aesthetics did not significantly differ between the digital and conventional approaches. The total fabrication time was significantly shorter using the digital workflow. Within the limitations of this clinical study, the fully digital workflow can be used for the fabrication of ISFDPs with a clinical outcome comparable to that of the conventional workflow.
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Affiliation(s)
- Ali Mahmoud Hashemi
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Hamid Mahmoud Hashemi
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - Hakimeh Siadat
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
- Department of Prosthodontics, Tehran University of Medical Sciences, Tehran 1411713135, Iran
| | - Ahmadreza Shamshiri
- Department of Epidemiology and Biostatistics, School of Public Health and Institute of Public Health Research, Tehran University of Medical Sciences, Tehran 1417614411, Iran
| | - Kelvin Ian Afrashtehfar
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, 3010 Berne, Switzerland
- Division of Restorative Dental Sciences, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
- Correspondence: (K.I.A.); (M.A.)
| | - Marzieh Alikhasi
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1417614411, Iran
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran 1411713135, Iran
- Correspondence: (K.I.A.); (M.A.)
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Jurado CA, Amarillas-Gastelum C, Afrashtehfar KI, Argueta-Figueroa L, Fischer NG, Alshabib A. Ceramic and Composite Polishing Systems for Milled Lithium Disilicate Restorative Materials: A 2D and 3D Comparative In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15155402. [PMID: 35955341 PMCID: PMC9369544 DOI: 10.3390/ma15155402] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/30/2022] [Accepted: 08/01/2022] [Indexed: 05/20/2023]
Abstract
Purpose: This study aims to evaluate the effectiveness of two ceramic and two composite polishing systems for a novel chairside computer-aided design/computer-aided manufacturing (CAD/CAM) lithium disilicate ceramic with three-dimensional and two-dimensional microscopy images. This ceramic material can be used for implant-supported or tooth-borne single-unit prostheses. Materials and Methods: Sixty flat samples of novel chairside CAD/CAM reinforced lithium disilicate ceramic (Amber Mill, Hass Bio) were divided into five groups (n = 15/group) and treated as follows: Group 1 (NoP), no polished treatment; group 2 (CeDi), polished with ceramic Dialite LD (Brasseler USA); group 3, (CeOp) polished with ceramic OptraFine (Ivoclar Vivadent); group 4, (CoDi) polished with composite DiaComp (Brasseler USA), and group 5 (CoAs), polished with composite Astropol (Ivoclar Vivadent). The polished ceramic surface topography was observed and measured with three-dimensional and two-dimensional images. Results: All polishing systems significantly reduced the surface roughness compared with the non-polished control group (Sa 1.15 μm). Group 2 (CeDi) provided the smoothest surface arithmetical mean eight with 0.32 μm, followed by group 3 (CeOp) with 0.34 μm. Group 5 (CoAs) with 0.52 μm provided the smoothest surface among the composite polishing kits. Group 4 (CoDi) with 0.66 μm provided the least smooth surface among all polishing systems tested. Conclusions: Despite the effectiveness of ceramic polishing systems being superior to composite polishing systems of the CAD/CAM lithium disilicate restorative material, both polishing systems significantly improved the smoothness.
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Affiliation(s)
- Carlos A. Jurado
- Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center, El Paso, TX 79905, USA
| | | | - Kelvin I. Afrashtehfar
- Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City P.O. Box 346, United Arab Emirates
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010 Berne, Switzerland
| | | | - Nicholas G. Fischer
- Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA
| | - Abdulrahman Alshabib
- Department of Restorative Dentistry, King Saud University College of Dentistry, Riyadh 12372, Saudi Arabia
- Engineer Abdullah Bugshan Research Chair for Dental and Oral Rehabilitation, King Saud University, Riyadh 11545, Saudi Arabia
- Correspondence:
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Bone Tissue Engineering through 3D Bioprinting of Bioceramic Scaffolds: A Review and Update. LIFE (BASEL, SWITZERLAND) 2022; 12:life12060903. [PMID: 35743934 PMCID: PMC9225502 DOI: 10.3390/life12060903] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 12/11/2022]
Abstract
Trauma and bone loss from infections, tumors, and congenital diseases make bone repair and regeneration the greatest challenges in orthopedic, craniofacial, and plastic surgeries. The shortage of donors, intrinsic limitations, and complications in transplantation have led to more focus and interest in regenerative medicine. Structures that closely mimic bone tissue can be produced by this unique technology. The steady development of three-dimensional (3D)-printed bone tissue engineering scaffold therapy has played an important role in achieving the desired goal. Bioceramic scaffolds are widely studied and appear to be the most promising solution. In addition, 3D printing technology can simulate mechanical and biological surface properties and print with high precision complex internal and external structures to match their functional properties. Inkjet, extrusion, and light-based 3D printing are among the rapidly advancing bone bioprinting technologies. Furthermore, stem cell therapy has recently shown an important role in this field, although large tissue defects are difficult to fill by injection alone. The combination of 3D-printed bone tissue engineering scaffolds with stem cells has shown very promising results. Therefore, biocompatible artificial tissue engineering with living cells is the key element required for clinical applications where there is a high demand for bone defect repair. Furthermore, the emergence of various advanced manufacturing technologies has made the form of biomaterials and their functions, composition, and structure more diversified, and manifold. The importance of this article lies in that it aims to briefly review the main principles and characteristics of the currently available methods in orthopedic bioprinting technology to prepare bioceramic scaffolds, and finally discuss the challenges and prospects for applications in this promising and vital field.
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Afrashtehfar KI, Moawad RA, F.-Eddin AW, Wang HL. Mandibular full-arch fixed prostheses supported by three-dental-implants: A protocol of an overview of reviews. PLoS One 2022; 17:e0265491. [PMID: 35377903 PMCID: PMC8979460 DOI: 10.1371/journal.pone.0265491] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 02/16/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION To minimize trauma and cost of treatment, oral health practitioners have successfully rehabilitated full arches by supporting the prostheses on four implants. However, there is no consensus whether less than four implants supporting full mandibular arches would provide similar clinical outcomes to other well-established all-on-four alternative. OBJECTIVE To identify, summarize, appraise, and compare the clinical outcomes evidence of three-implant fixed full-arch prostheses in completely edentulous mandibular patients. MATERIALS AND METHODS This overview of systematic reviews (OoSRs) will include secondary synthesis studies (i.e., systematic reviews with or without a meta-analysis). A three-step search strategy will be conducted in MEDLINE (Ovid), EMBASE (Ovid), Cochrane Database of Systematic Reviews, Scopus, Web of Science (WoS Core Collection), and Google Scholar. Grey literature and a manual search in 12 specialized journals will also be conducted. Three independent reviewers will screen all retrieved articles for eligibility, extract data and assess the methodological quality of the included studies. The results will be presented as tables or narrative synthesis. The studies will be evaluated for risk of bias by ROBIS and methodology quality by the AMSTAR-2 tool. If new primary studies are identified, a meta-analysis will be conducted. Certainty of the evidence will be assessed to answer the following focused research question: In edentulous mandibular patients, what are the implant and prostheses clinical outcomes of three-implant fixed full-arch prostheses compared to other all-on-x solutions? DISCUSSION There are some systematic reviews about the use of fixed complete dental prostheses supported by three implants; however, their clinical outcomes related to the other all-on-four plus solutions are conflicting. So, an overview on this topic is required to provide recommendations. REVIEW REGISTRATION NUMBER International prospective register of systematic reviews (PROSPERO) ID#: CRD42021262175. National Institute for Health Research (NIHR) and Centre for Reviews and Dissemination, University of York, York, United Kingdom.
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Affiliation(s)
- Kelvin I. Afrashtehfar
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, Faculty of Medicine, University of Bern, Bern, Switzerland
- Centre of Medical and Bio-allied Health Sciences Research (CMBHSR), Ajman University, Dubai, City of Gold, UAE
- * E-mail:
| | - Rosalin A. Moawad
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
| | - Afaf W. F.-Eddin
- Evidence-Based Practice Unit, Clinical Sciences Department, College of Dentistry, Ajman University, Ajman City, Ajman Emirate, UAE
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, United States of America
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Afrashtehfar KI, Ghanem H, Calvo J. Dental Curriculum's Continuing Improvement in the North American and Gulf Cooperation Council (GCC) Education Systems. Open Dent J 2021. [DOI: 10.2174/1874210602115010601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Dynamic oral health care needs, alongside a diverse demographic of patients, presents a challenge to dental clinicians as they strive to resolve the ever-increasing demand for quality oral care service. Claims have arisen that the most appropriate way of speeding up the slow change in adopting innovations within the dental practice is by updating dentists' knowledge and skills through improving the undergraduate students' curriculum.
Objective:
This review compares the dental curriculum's continuing improvement processes between the North American and Gulf Cooperation Council (GCC) countries.
Methods:
The process of analysis consisted of identifying, examining, and interpreting patterns and themes within textual data, and then determining how each of these help answer the research questions.
Results:
Efforts to implement the dental curriculum's continuous improvement processes in the North American and GCC countries are evident, but the significant barriers for the dental curriculum's continuing improvement among the North American countries include the consequences of a compressed four-year curriculum, reliance on professional regulations, insufficient focus on patient perceptions, and the lack of a more theoretically robust approach to self-reflection. Conversely, amongst the GCC countries, the available literature states that the most significant factors hindering the dental curriculum's continuing improvement include deficient leadership attributes and low research productivity.
Conclusion:
The North American and GCC regions will benefit from the new dental curriculum and result in producing more competent dental practitioners, with improved leadership and patient-centered care. However, it has been observed that the dental curriculum’s continuous improvement processes are adopted slowly, particularly among the GCC countries.
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