Innovation by Computer-Aided Design/Computer-Aided Manufacturing Technology: A Look at Infection Prevention in Dental Settings. Biomed Res Int. 2019;2019:6092018. [PMID: 31467901 PMCID: PMC6699473 DOI: 10.1155/2019/6092018]

Mechanical shock test simulation analysis of butterfly valves developed for the naval defense industry and evaluation of real test and production data

The main purpose of this study is to investigate the mechanical shock behavior and develop the shock resistance of widely preferred butterfly valves for navy defense industries by handling the real test results with computer aided design and simulation programs. The 2D and 3D drawings were realized by using solid modeling and design programs. Mechanical analyzes to determine the mechanical strength of the specimens were carried out with the finite element analysis method by using structural simulation program. Mechanical shock test simulations were carried out by with shock response spectrum analysis. Solidification, filling-time-temperature analyzes, and simulation studies of inner stresses caused by micro and macro shrinkages were performed by using the casting simulation program. Comparisons of virtual tests simulated in computer environment with real tests were done in shock test setup. Products made of bronze were preferred due to the high corrosion resistance and the desire to be a useful research article that can respond to common applications in the defense industry. Virtual shock test simulation and real shock tests were performed according to the MIL STD 810 standard. The shock test results observations showed that by revising the design with a safety factor of 18% on the specimen, it was ensured that the product could pass the mechanical shock test even at an acceleration of 4000 m/s2. Then material become safe to use. With the use of a three-way feeder in the production of the reinforced design the difference in net weight from 19% has been reduced to 12%, while the production time has been improved by 22%.

Knowledge, Attitude, and Practices toward the Novel Coronavirus Infection in Dental Laboratories in the Kingdom of Saudi Arabia: Cross-Sectional Study

This study aimed to assess dental technologists/technicians knowledge, attitudes, and practice during the COVID-19 pandemic in Saudi Arabia. This cross-sectional study was conducted among workers in dental laboratories in Saudi Arabia. A validated questionnaire was developed based on previous literature and distributed online. The questionnaire assessed the study population's knowledge, attitude, and practice regarding infection control protocol for COVID-19. Descriptive statistics of categorical variables were conducted. The response rate was 58.3%, where most respondents are male at a rate of 97%. Most of the participants (82%) were aware of the various infection control measures for COVID-19 in a dental laboratory. Forty-eight participants showed a level of knowledge range between 80 and 100%, while 27 and 30 participants reported moderate and low level of knowledge, respectively. Only 67% of the participants strongly agree that dental cast and fabricated/repaired restorations should be transferred in a very close and protective package to control infection. About 70% of participants indicated they always wear protective gear/goggles and should be warned while working in the dental laboratory. As the pumice slurry was utilized frequently to clean and polish the prostheses, 66% of participants agreed that pumice slurry should be always changed regularly. Regarding COVID-19 infection control procedures, dental technologists/technicians showed good knowledge, attitude, and practice; however, considering how infectious the virus is, more measures should be taken into consideration. Effective communication and collaboration between the laboratory and the dental clinic are essential for infection control.

Comparative analysis of dimensional changes in autoclavable polyvinyl siloxane (PVS) impressions under various Sterilization/Disinfection Protocols: A randomized controlled trial

Background

Impressions that maintain their dimensional stability after autoclaving effectively control cross-infection and contamination resulting from a patient's oral secretions.

Purpose

The study aimed to assess the dimensional stability of autoclavable polyvinyl siloxanes after disinfection and sterilization.

Methods

A stainless steel metal model containing three full veneer crown preparations was fabricated according to ANSI/ADA specification No. 19. Reference grooves were established on the occlusal and axial surfaces of the abutments for accurate measurements. Forty impressions were created from the master model using single-step impression technique monophase polyvinyl siloxane material (AFFINIS, Coltene/Whaledent, Altstatten, Switzerland). The impressions were categorized into four groups: Group A (control, ten untreated impressions), Group B (ten disinfected impressions with 5.25 % sodium hypochlorite [NaOCl]), Group C (ten disinfected impressions with 2 % glutaraldehyde), and Group D (ten autoclaved impressions at 134 °C for 18 min). Subsequently, stone casts were produced using type IV gypsum products (Gelstone R, BK Giulini Chemie, Ludwigshafen/Rh., Germany). The dimensional accuracy of the obtained casts was assessed by measuring the inter-abutment measurements (between the abutments) and the intra-abutment measurements (diameter and height of the abutments). These measurements were performed using a universal measuring microscope (Olympus stereomicroscope B061 Imaging Corp. Tokyo, Japan) with a precision of 0.001 mm. The dimensions of the stone casts from the study groups were then compared to those of the control group. Data analysis was performed using a one-way ANOVA with a significance level of α = 0.05.

Results

AFFINIS impressions subjected to chemical disinfection in 5.25 % NaOCl and 2 % glutaraldehyde with different immersion times showed slight expansion in the intra- and inter-abutment measurements. The impressions autoclaved at 134 °C for 18 min showed slight shrinkage in the intra- and inter-abutment measurements. The dimensional change was statistically non-significant, and the percent of dimensional changes within the experimental groups was within the clinically accepted limit (α < 0.5).

Conclusion

AFFINIS polyvinyl siloxanes retain dimensional stability suitable for clinical use when subjected to chemical disinfection and steam autoclaving.

Antimicrobial effect and the mechanical and surface properties of a self-disinfecting and a chlorhexidine-incorporated Type IV dental stone

STATEMENT OF PROBLEM

Stone casts are subject to contamination, but whether disinfectants incorporated into the stone are effective is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the antimicrobial activity and the mechanical and surface properties of self-disinfecting gypsum (SDG) and gypsum mixed with 2% chlorhexidine (GCHX).

MATERIAL AND METHODS

Antimicrobial action was evaluated using the diffusion-disk technique on Streptococcus aureus and Candida albicans 1 hour and 24 hours after pouring the gypsum. The groups were SDG, GCHX, a positive control (PC) of gypsum mixed with distilled water, and a negative control (NC) of filter paper disk soaked with 2% chlorhexidine; n=8. Inhibition halos were measured using the ImageJ software program and statistically analyzed using the repeated measures mixed ANOVA with time×group interaction. Compressive strength (CS) in MPa and surface roughness (SR) in μm (parameters: Ra - roughness average; and Sa - 3-dimensional (3D) arithmetic mean of the surface profile) tests were performed to characterize the specimens (evaluated groups: SDG, GCHX, and PC; n=10). CS data were analyzed by a 2-way ANOVA with time×group interaction, and SR data by a 1-way ANOVA (α=.05).

RESULTS

For S aureus, there were differences between GCHX and SDG at 1 hour and 24 hours (P<.05), but no significant differences were found for C albicans (P>.05). GCHX was better than PC, except for C albicans, and showed a reduction in CS when compared with PC and SDG (P<.05) at all time intervals. The SR of GCHX increased (Ra:1.76, Sa:2.08) when compared with PC (Ra:0.89, Sa:1.12) and SDG (Ra:1.03, Sa:1.35) (Ra: P<.004 and Sa: P<.001).

CONCLUSIONS

The antimicrobial activity of GCHX against S aureus was better than that of SDG, but neither had an effect against C albicans. As for CS and SR, GCHX presented a decrease in properties when compared with PC and SDG but was within the American Dental Association #25 specification values.

Clothing Style Recognition and Design by Using Feature Representation and Collaboration Learning

In order to recognize the clothing style, this paper establishes a standard clothing style library. The images of clothing style are provided and annotated by fashion design experts. The clothing style image is represented as a set of line segments that is obtained by detecting the lines and corners consisting of the edge feature points in the image. Then, the authors extract the features of the line segment set and use the extracted features to establish clothing style matching rules to make the system automatically produce the matching and recognizing criteria for the clothing style images. When inputting an image of a person wearing clothes, they first find the position of the person through skin color detection and then locate the clothing. The clothing region is segmented by seed growth algorithm. The features of the segmentation are compared with clothing style matching rules to determine the style. The experimental results show that the recognition rate of clothing style can reach more than 92% for the standard clothing images and more than 91% for real clothing images.

A Review on Risk Management of Coronavirus Disease 19 (COVID-19) Infection in Dental Practice: Focus on Prosthodontics and All-Ceramic Materials

Background: A novel β-coronavirus infection (COVID-19) was first detected in Wuhan city, spreading rapidly to other countries and leading to a pandemic. Dental professionals and patients are exposed to a high risk of COVID-19 infection, particularly in the prosthodontic practice, because of the bio-aerosol produced during teeth preparation with dental handpieces and the strict contact with oral fluids during impression making. This paper aimed to provide an overview to limit the risk of transmission of COVID-19 infections during prosthetic procedures in dental offices. Methods: An electronic search was conducted on the electronic databases of PubMed/Medline, Google Scholar, Embase, Scopus, Dynamed, and Open Grey with the following queries: (COVID-19) AND/OR (SARS-CoV-2) AND/OR (Coronavirus) AND/OR (contaminated surface) AND/OR (cross-infection) AND/OR (Prosthodontics) AND/OR (dental ceramic) AND/OR (glass-ceramic). A manual search was performed as well. Results: From the 1023 collected records, 32 papers were included. Conclusions: Dental offices are at high risk of spreading SARS-CoV-2 infection due to the close contact with patients and continuous exposure to saliva during dental procedures. Therefore, pre-check triages via telephone, decontamination, the disinfection of impressions, the sterilization of scanner tips, and the use of specific personal protective equipment, dental high-speed handpieces with dedicated anti-retraction valves, and effective mouthwashes are strongly recommended.

Mechanical Properties of 3D Printed Orthodontic Retainers

Orthodontic retention is the final important stage of orthodontic treatment, the aim of which is to consolidate the functional and aesthetic position of teeth. Among adults, fixed retainers made of different types of wires are the most common. The aim of this study was to analyse the mechanical properties of a new generation of fixed orthodontic retainers-printed by 3D printers.

MATERIALS AND METHODS

The study was conducted using samples made of Nextdent MFH C&B N1 resin in the form of cuboid bars with nominal dimensions of width b = 3 mm, thickness d = 0.8 mm; 1 mm; 1.2 mm, length l = 30 mm for each type. The influence of the thickness of the retainers on their strength under loaded conditions was evaluated. Flexural strength, elastic properties, deflection, and creep were compared. The samples were aged in an artificial saliva bath at 37 ± 1 °C during the strength tests.

RESULTS

It was shown that differences in the thickness of the samples affected their elastic and strength properties. The highest average flexural modulus, the highest deflection, creep, and strength was characteristic of the samples with the highest thickness (1.2 mm). Samples with an average thickness of 1 mm had the lowest modulus of elasticity.

CONCLUSIONS

The mechanical properties of 3D printed retainers show that they can be an alternative to metal retainers and the procedure of making new retainers, especially when patients have aesthetic requirements or allergies to metals.

Pros and Cons of CAD/CAM Technology for Infection Prevention in Dental Settings during COVID-19 Outbreak

The purpose of this commentary is to update the evidence reported in our previous review on the advantages and limitations of computer-aided design/computer-aided manufacturing technology in the promotion of dental business, as well as to guarantee patient and occupational safety. The COVID-19 pandemic led to an unprecedented focus on infection prevention; however, waves of COVID-19 follow one another, asymptomatic cases are nearly impossible to identify by triage in a dental setting, and the effectiveness of long-lasting immune protection through vaccination remains largely unknown. Different national laws and international guidelines (mainly USA-CDC, ECDC) have often brought about dissimilar awareness and operational choices, and in general, there has been very limited attention to this technology. Here, we discuss its advantages and limitations in light of: (a) presence of SARS-CoV-2 in the oral cavity, saliva, and dental biofilm and activation of dormant microbial infections; (b) the prevention of SARS-CoV-2 transmission by aerosol and fomite contamination; (c) the detection of various oral manifestations of COVID-19; (d) specific information for the reprocessing of the scanner tip and the ward from the manufacturers.

Intraoral scanning reduces procedure time and improves patient comfort in fixed prosthodontics and implant dentistry: a systematic review

OBJECTIVES

The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes.

MATERIALS AND METHODS

Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available.

RESULTS

Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS.

CONCLUSIONS

Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes.

CLINICAL RELEVANCE

Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions.

Remote Management of Prosthodontic Emergencies in the Geriatric Population During the Pandemic Outbreak of COVID-19

The global pandemic outbreak of coronavirus disease 2019 (COVID-19) has put the world in a panic situation. It has been evident that the geriatric population is more susceptible to acquire this infection. Thus, due to this ongoing crisis, geriatric individuals cannot visit a dental operatory, and there is the possibility of their dental needs and emergencies to remain unattended. Partial or complete edentulism is very prevalent among the geriatric population, and prosthodontic management of these patients is essential for their well-being. However, the prosthesis can lead to various emergencies of the oral and its supporting structures. There are currently no available recommendations to address these prosthodontic emergencies in geriatric individuals during this pandemic period. Hence, the aims of this minireview were to discuss the common prosthodontic emergencies in the geriatric population and provide recommendations to manage these issues during the COVID-19 pandemic outbreak.

Fixed lingual orthodontic retainer with bilateral missing lateral incisors produced in PEEK material using CAD/CAM technology

Background

The aim of this investigation is to evaluate the feasibility of digital workflow for lingual fixed retainer based on digital intraoral scan and appliance production from Polyetheretherketone (PEEK) material for clinical consideration.

Material and Methods

Fully virtual lingual retainer with bilateral missing lateral incisors was designed using inlab software (Dentsply Sirona, Pennsylvania, USA). The designed retainer was produced in PEEK material and clinically adhered to lingual surfaces of the lower front teeth.

Results

Lingual retainer was successfully fabricated by full digital workflow and produced from PEEK material for clinical usage.

Conclusions

Although full digital workflow can be clinically used for production of prefabricated lingual retainer, however further software adaptions are required for improvement of the orthodontic workflow. Key words:PEEK, CAD/CAM, digital orthodontics, lingual retainer.

COVID-19 and Orthodontics: An Approach for Monitoring Patients at Home

Aim:

The aim of this study was to test an experimental approach involving the remote monitoring of orthodontic patients through the use of their smartphones.

Background:

Due to the COVID-19 emergency, dental offices were asked to stop elective treatments; suddenly orthodontic patients found themselves isolated at home, without the possibility of monitoring by their orthodontists. The use of telemonitoring via smartphones can be a quick way to recover the orthodontist-patient relationship, monitor and continue the treatment.

Objective:

The purpose of this study was to propose an innovative, simple and reliable approach for the remote management of orthodontic patients.

Methods:

137 patients were contacted verbally by phone and via WhatsApp®; they were asked to send a set of photographs taken with their smartphone. They were asked to complete a questionnaire to evaluate the effectiveness of the approach. Descriptive statistics (frequency with percent) of questionnaire results and the presence of procedural errors while taking pictures were calculated. Correlations between different questionnaire answers were analyzed with the Chi-Square test. Variables with p < 0:05 were declared as significant.

Results:

The majority of patients considered that this approach was positive and they did not feel abandoned. Difficulties emerged from a technical point of view, that is, in terms of photoshoot, and part of the patients expressed perplexity regarding the fact that telemonitoring can replace completely an outpatient visit.

Conclusion:

The use of telemonitoring managed to recreate a relationship with the orthodontist, especially in emergency periods.

Prosthodontic practice during the COVID-19 pandemic: prevention and implications

The objective of this review is to identify preventive measures for COVID-19 to safeguard dental professionals providing prosthodontic dental care. Electronic searches were performed in PubMed, Scopus, and Cochrane databases using the following descriptors and/or words: "COVID-19," "SARS-CoV-2," "Dental practice," "Prosthodontics," and "Dental infection control." Prosthodontists are at high risk for exposure to the novel coronavirus through aerosols and possibly contaminated surfaces and indirect contact with dental laboratories and dental technicians through impressions, dental stone casts, and fixed and removable prosthetic appliances. Therefore, preventive measures should be implemented, including performing emergency treatments only, rescheduling patients with suspected disease, disinfecting surfaces and prosthodontic materials with biocidal substances, and using protective equipment such as N95 masks, disposable gowns, and face-shields.

Complete-Arch Accuracy of Four Intraoral Scanners: An In Vitro Study

The purpose of this study is to define the accuracy of four intraoral scanners (IOS) through the analysis of digital impressions of a complete dental arch model. Eight metal inserts were placed on the model as reference points and then it was scanned with a laboratory scanner in order to obtain the reference model. Subsequently, the reference model was scanned with four IOS (Carestream 3600, CEREC Omnicam, True Definition Scanner, Trios 3Shape). Linear measurements were traced on an STL file between the chosen reference points and divided into four categories: three-element mesiodistal, five-element mesiodistal, diagonal, and contralateral measurements. The digital reference values for the measurements were then compared with the values obtained from the scans to analyze the accuracy of the IOS using ANOVA. There were no statistically significant differences between the measurements of the digital scans obtained with the four IOS systems for any of the measurement groups tested.

Digital versus conventional workflow for the fabrication of physical casts for fixed prosthodontics: A systematic review of accuracy

STATEMENT OF PROBLEM

A consensus on the accuracy of additively manufactured casts in comparison with those fabricated by using conventional techniques for fixed dental prostheses is lacking.

PURPOSE

The purpose of this systematic review was to determine the accuracy of additively manufactured casts for tooth- or implant-supported fixed dental prostheses in comparison with that of gypsum casts.

MATERIAL AND METHODS

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the International Prospective Register of Systematic Reviews (PROSPERO) database (CDR42020161006). Eight databases were searched in December 2019 and updated in September 2020. Studies evaluating the dimensional accuracy of additively manufactured casts for fixed dental prostheses in comparison with that of gypsum casts were included. An adapted checklist for reporting in vitro studies (Checklist for Reporting In vitro Studies guidelines) was used to assess the risk of bias.

RESULTS

Eight studies evaluating tooth-supported fixed dental prosthesis casts and 7 studies evaluating implant-supported fixed dental prosthesis casts were eligible for this review. Gypsum casts showed greater accuracy (trueness and precision) in most studies, although additively manufactured casts also yielded highly precise data. One study was associated with a low risk of bias, 9 with a moderate risk of bias, and 5 with a high risk of bias.

CONCLUSIONS

In vitro studies showed that additively manufactured casts and gypsum casts share similar accuracy within the acceptable range for the fabrication of casts. The quality of scanned data, additive manufacture technology, printing settings, and postprocessing procedures plays an essential role in the accuracy of additively manufactured casts. Clinical studies are required to confirm these findings.

Restorative CAD/CAM materials in dentistry: analysis of their fluorescence properties and the applicability of the fluorescence-aided identification technique (FIT)

OBJECTIVES

This study investigated the fluorescence properties of the most commonly used fluorescent CAD/CAM materials for monolithic dental restorations and their suitability to perform the fluorescence-aided identification technique (FIT).

MATERIALS AND METHODS

A total of 175 different color shades (n = 1) from 13 CAD/CAM material brands were analyzed with a monochromator-based microplate reader. Additionally, dentin, enamel, and combined dentin-enamel specimens (respectively, n = 11) were analyzed for comparison purposes. The maximum fluorescence intensity, the corresponding excitation and emission wavelength, and the total fluorescence for the wavelength spectrum λ_ex = 395 nm - 415 nm used for FIT were determined.

RESULTS

All assessed CAD/CAM ceramics showed virtually no total fluorescence for the wavelength spectrum λ_ex = 395 nm - 415 nm used for FIT. CERASMART^TM, KZR-CAD HD 2, and LuxaCam Composite displayed total fluorescence values similar to that of the tooth hard substances. All other resin-based CAD/CAM materials showed a significantly higher total fluorescence than the tooth hard substances.

CONCLUSIONS

Apart from the mentioned exceptions, all CAD/CAM materials assessed could be suitable for the FIT, either because they are more fluorescent than hard tooth substances or because they do not fluoresce at all at the respective wavelength of λ_ex = 395 nm - 415 nm.

CLINICAL RELEVANCE

This study provides insight into the not yet well-known fluorescent properties of dental CAD/CAM materials. This knowledge is not only necessary to reproduce the fluorescence properties of natural teeth but also for the applicability of diagnostic fluorescence inducing techniques.

Coronavirus Disease 2019 Coexistence in the Daily Practice

The purpose of the present narrative review was to evaluate and discuss the actual available information regarding coronavirus disease 2019 and dental practice, and to share recommendations with the intent to help dentists in providing a safe and healthful workplace during pandemic. A step-by-step workflow is presented including prevention and measures to reduce risk for cross infections before, during, and after the dental treatments. Individualization of different risk-level zones and the establishment of a team-based chain control is also presented. The present manuscript may offer deeper knowledge and discussion regarding recommended procedures aimed to reduce risk for dental health care workers contamination and cross infections. Within these, infection prevention in dental settings, respect of general rules, containment measures, proper use of the personal protective equipments (PPE), and well-organized chain control of all the staff, with definition of risk zones and specific responsibility could be an adjunctive but important step to control the spread of the disease.

Influence of Scanner Precision and Analysis Software in Quantifying Three-Dimensional Intraoral Changes: Two-Factor Factorial Experimental Design

BACKGROUND

Three-dimensional scans are increasingly used to quantify biological topographical changes and clinical health outcomes. Traditionally, the use of 3D scans has been limited to specialized centers owing to the high cost of the scanning equipment and the necessity for complex analysis software. Technological advances have made cheaper, more accessible methods of data capture and analysis available in the field of dentistry, potentially facilitating a primary care system to quantify disease progression. However, this system has yet to be compared with previous high-precision methods in university hospital settings.

OBJECTIVE

The aim of this study was to compare a dental primary care method of data capture (intraoral scanner) with a precision hospital-based method (laser profilometer) in addition to comparing open source and commercial software available for data analysis.

METHODS

Longitudinal dental wear data from 30 patients were analyzed using a two-factor factorial experimental design. Bimaxillary intraoral digital scans (TrueDefinition, 3M, UK) and conventional silicone impressions, poured in type-4 dental stone, were made at both baseline and follow-up appointments (mean 36 months, SD 10.9). Stone models were scanned using precision laser profilometry (Taicaan, Southampton, UK). Three-dimensional changes in both forms of digital scans of the first molars (n=76) were quantitatively analyzed using the engineering software Geomagic Control (3D Systems, Germany) and freeware WearCompare (Leeds Digital Dentistry, UK). Volume change (mm³) was the primary measurement outcome. The maximum point loss (μm) and the average profile loss (μm) were also recorded. Data were paired and skewed, and were therefore compared using Wilcoxon signed-rank tests with Bonferroni correction.

RESULTS

The median (IQR) volume change for Geomagic using profilometry and using the intraoral scan was -0.37 mm³ (-3.75-2.30) and +0.51 mm³ (-2.17-4.26), respectively (P<.001). Using WearCompare, the median (IQR) volume change for profilometry and intraoral scanning was -1.21 mm³ (-3.48-0.56) and -0.39 mm³ (-3.96-2.76), respectively (P=.04). WearCompare detected significantly greater volume loss than Geomagic regardless of scanner type. No differences were observed between groups with respect to the maximum point loss or average profile loss.

CONCLUSIONS

As expected, the method of data capture, software used, and measurement metric all significantly influenced the measurement outcome. However, when appropriate analysis was used, the primary care system was able to quantify the degree of change and can be recommended depending on the accuracy needed to diagnose a condition. Lower-resolution scanners may underestimate complex changes when measuring at the micron level.

Orthodontic Treatment and Healthcare Goals: Evaluation of Multibrackets Treatment Results Using PAR Index (Peer Assessment Rating)

Background: The evaluation of orthodontic treatment outcomes using an objective method is important in order to maintain high treatment quality and final healthcare of patients. It allows professionals and university students to raise the level of the therapy. The aim of this study was to assess the orthodontic treatment outcomes in an Italian postgraduate School of Orthodontics using Peer Assessment Rating (PAR) Index. Methods: A sample of 50 patients treated in a postgraduate program was randomly selected. PAR index was used to assess pre-treatment and post-treatment study casts by two different examiners. The influence of different variables such as gender, treatment method, and need for extraction was statistically analyzed. Results: The average numerical reduction of PAR between the beginning and the end of the treatment was 18.74 (CI 95% 16.53–20.95), while the percentage reduction was 94.8% (CI 95% 91.91–97.68). All cases improved: 8% of patients resulted in the improved category, while 92% of them were in the greatly improved group. Conclusions: According to PAR index, the results showed that patients received a high-standard therapy. None of the factors studied influenced significantly the treatment outcomes.

State of the Art on Biomaterials for Soft Tissue Augmentation in the Oral Cavity. Part II: Synthetic Polymers-Based Biomaterials

Most of the polymers used as biomaterials for scaffolds are naturally occurring, synthetic biodegradable, and synthetic non-biodegradable polymers. Since synthetic polymers can be adapted for obtaining singular desired characteristics by applying various fabrication techniques, their use has increased in the biomedical field, in dentistry in particular. The manufacturing methods of these new structures include many processes, such as electrospinning, 3D printing, or the use of computer-aided design/computer-aided manufacturing (CAD/CAM). Synthetic polymers show several drawbacks that can limit their use in clinical applications, such as the lack of cellular recognition, biodegradability, and biocompatibility. Moreover, concerning biodegradable polymers, the time for matrix resorption is not predictable, and non-resorbable matrices are preferred for soft tissue augmentation in the oral cavity. This review aimed to determine a new biomaterial to offset the present shortcomings in the oral environment. Researchers have recently proposed a novel non-resorbable composite membrane manufactured via electrospinning that has allowed obtaining remarkable in vivo outcomes concerning angiogenesis and immunomodulation throughout the polarization of macrophages. A prototype of the protocol for in vitro and in vivo experimentation with hydrogels is explained in order to encourage innovation into the development of promising biomaterials for soft tissue augmentation in the near future.

Treating severe periodontitis with staged load applied implant restoration: A case report

BACKGROUND

Because immediate implant surgery is not recommended for patients who have been diagnosed with periodontitis, researchers have treated these patients with a variety of methods, including combining orthodontic and periodontal surgeries as well as implantation. However, these treatments cost time and money for the patient. Although it has been reported that temporary implants released a severe gag reflex in 1 case, only a few studies have documented using temporary implants to treat patients diagnosed with severe periodontitis.

CASE SUMMARY

The patient was a 49-year-old female who was missing the majority of her teeth and had gingival atrophy and severe alveolar bone atrophy. After being diagnosed with severe periodontitis, the patient underwent staged load applied implant restoration therapy. The first load-bearing stage was carried out immediately by inserting temporary Osstem mini implants. Maxillary teeth were extracted by using the guided bone regeneration technique, and lateral maxillary sinus lifting was conducted on both sides. During the second load-bearing stage, temporary implants were removed, and permanent implants were placed. The resin bridge was segmented during the third load-bearing stage. During the fourth load-bearing stage, the permanent prosthesis was positioned in the patient’s mouth.

CONCLUSION

By conducting the load-bearing treatment in stages, the patient’s mouth contained restorations throughout the procedure, thus guaranteeing basic function and appearance.