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Corsalini M, Barile G, Ranieri F, Morea E, Corsalini T, Capodiferro S, Palumbo RR. Comparison between Conventional and Digital Workflow in Implant Prosthetic Rehabilitation: A Randomized Controlled Trial. J Funct Biomater 2024; 15:149. [PMID: 38921523 PMCID: PMC11204927 DOI: 10.3390/jfb15060149] [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: 05/08/2024] [Revised: 05/21/2024] [Accepted: 05/30/2024] [Indexed: 06/27/2024] Open
Abstract
The progress of digital technologies in dental prosthodontics is fast and increasingly accurate, allowing practitioners to simplify their daily work. These technologies aim to substitute conventional techniques progressively, but their real efficiency and predictability are still under debate. Many systematic reviews emphasize the lack of clinical RCTs that compare digital and traditional workflow. To address this evidence, we conducted a three-arm designed clinical RCT, which compares fully digital, combined digital, and analogic and fully analog workflows. We aimed to compare the clinical properties of each workflow regarding interproximal (IC) and occlusal contact (OC), marginal fit, impression time (IT), and patient satisfaction through a VAS scale. In total, 72 patients were included in the study. The IC and OC of the digital workflow were better than the others (p < 0.001), which obtained similar results. No difference between implant-abutment fit was observed (p = 0.5966). The IT was shorter in the digital workflow than the others (p < 0.001), which were similar. Patient satisfaction was higher in the digital workflow than in the conventional one. Despite the limitations, this study's results support better accuracy and patient tolerance of digital workflow than of conventional techniques, suggesting it as a viable alternative to the latter when performed by clinicians experienced in digital dentistry.
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Affiliation(s)
- Massimo Corsalini
- Department of Interdisciplinary Medicine, ‘Aldo Moro’, University of Bari, 70100 Bari, Italy; (M.C.); (S.C.)
| | - Giuseppe Barile
- Department of Interdisciplinary Medicine, ‘Aldo Moro’, University of Bari, 70100 Bari, Italy; (M.C.); (S.C.)
| | - Francesco Ranieri
- Department of Prosthodontics, Magna Graecia Institute, 74121 Taranto, Italy; (F.R.); (R.R.P.)
| | - Edvige Morea
- Department of Medicine and Aging Science, University ‘G. D’annunzio’, 66100 Chieti, Italy;
| | - Tommaso Corsalini
- Department of Interdisciplinary Medicine, ‘Aldo Moro’, University of Bari, 70100 Bari, Italy; (M.C.); (S.C.)
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, ‘Aldo Moro’, University of Bari, 70100 Bari, Italy; (M.C.); (S.C.)
| | - Rosario Roberto Palumbo
- Department of Prosthodontics, Magna Graecia Institute, 74121 Taranto, Italy; (F.R.); (R.R.P.)
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Thekiya TSA, Walia T, Shetty RM, Berdouses ED, Hashim R, Al Jaghsi A. Variation of OXIS contact areas in primary molars among 3-6-year-old children with intraoral digital scanning. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00902-w. [PMID: 38698225 DOI: 10.1007/s40368-024-00902-w] [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: 12/17/2023] [Accepted: 04/04/2024] [Indexed: 05/05/2024]
Abstract
PURPOSE To determine the variation of OXIS contact areas in primary molars using digital impressions generated from an intraoral scanner (IOS). METHODS A cross-sectional study was carried out on 214 caries-free posterior quadrants of 80 children (38 males and 42 females) aged 3-6 years. Calibration of taking digital impressions with the IOS procedure was performed initially through scanning of ten quadrants of children to provide a learning environment to the examiner. The digital impressions were then exported, and the type of interproximal contact areas present between the distal surface of the primary first molar and the mesial surface of the primary second molar were identified according to the OXIS classification. The prevalence of the types of OXIS contact areas was expressed in the form of numbers and percentages. The chi-square test was applied to investigate the variability among the arches and to understand the association of OXIS contact areas across age, gender, and arches. RESULTS The most common contact area type observed was I-type (59.8%), followed by S-type (15.4%), X-type (12.6%), and O-type (12.2%). The I-type contact area was most frequently seen in both males (51.6%) and females (65.5%), while the S-type contact area in males (14.7%) and X-type contact area in females (8.4% each) were the least frequent with no statistical significance between genders (p > 0.05). All three age groups studied showed the highest prevalence of the I-type contact area, which increased with an increase in age (p < 0.05). The inter-arch comparison showed a significant result in terms of the X-type contact area on the right side, and O-type, X-type, and I-type contact areas on the left side, while no statistical difference was seen in the intra-arch comparison for all contact types. CONCLUSION I-type contact areas were the most prevalent across the arches, age groups and genders.
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Affiliation(s)
- T S A Thekiya
- Pediatric Dentistry, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - T Walia
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates.
| | - R M Shetty
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research (Declared As Deemed-to-Be University), Wardha, Maharashtra, India
| | - E D Berdouses
- Department of Clinical Sciences, Dentistry, Ajman University, Ajman, United Arab Emirates
| | - R Hashim
- Department of Basic Medical and Dental Sciences, Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - A Al Jaghsi
- Clinical Sciences Department, College of Dentistry, Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- Department of Prosthodontics, Gerodontology and Dental Materials, Greifswald University Medicine, Greifswald, Germany
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Cheng J, Zhang H, Liu H, Li J, Wang HL, Tao X. Accuracy of edentulous full-arch implant impression: An in vitro comparison between conventional impression, intraoral scan with and without splinting, and photogrammetry. Clin Oral Implants Res 2024; 35:560-572. [PMID: 38421115 DOI: 10.1111/clr.14252] [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: 12/11/2023] [Revised: 01/25/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES The purpose of this in vitro study was to compare the trueness and precision of complete arch implant impressions using conventional impression, intraoral scanning with and without splinting, and stereophotogrammetry. MATERIALS AND METHODS An edentulous model with six implants was used in this study. Four implant impression techniques were compared: the conventional impression (CI), intraoral scanning (IOS) without splinting, intraoral scanning with splinting (MIOS), and stereophotogrammetry (SPG). An industrial blue light scanner was used to generate the baseline scan from the model. The CI was captured with a laboratory scanner. The reference best-fit method was then applied in the computer-aided design (CAD) software to compute the three-dimensional, angular, and linear discrepancies among the four impression techniques. The root mean square (RMS) 3D discrepancies in trueness and precision between the four impression groups were analyzed with a Kruskal-Wallis test. Trueness and precision between single analogs were assessed using generalized estimating equations. RESULTS Significant differences in the overall trueness (p = .017) and precision (p < .001) were observed across four impression groups. The SPG group exhibited significantly smaller RMS 3D deviations than the CI, IOS, and MIOS groups (p < .05), with no significant difference detected among the latter three groups (p > .05). CONCLUSIONS Stereophotogrammetry showed superior trueness and precision, meeting misfit thresholds for implant-supported complete arch prostheses. Intraoral scanning, while accurate like conventional impressions, exhibited cross-arch angular and linear deviations. Adding a splint to the scan body did not improve intraoral scanning accuracy.
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Affiliation(s)
- Jing Cheng
- Department of General Dentistry, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, China
| | - Haidong Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Hailin Liu
- Jingpin Medical Technology (Beijing) Company Limited, Beijing, China
| | - Junying Li
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Xian Tao
- Department of Prosthodontics, Stomatological Hospital of Xiamen Medical College, Xiamen Key Laboratory of Stomatological Disease Diagnosis and Treatment, Xiamen, China
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Ben-Izhack G, Rosner O, Zenziper E, Nissan J, Hosary R, Lugassy D, Shely A. Comparison between Conventional and Digital Impressions for Determining Axes and Distances of Three Implants in Straight and Curved Lines: An In Vitro Study. J Clin Med 2024; 13:2352. [PMID: 38673631 PMCID: PMC11051143 DOI: 10.3390/jcm13082352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Background: In this study, we aimed to compare the effects of conventional and digital impressions on several parameters (inter-implant distance, intra-implant distance, inter-implant axis, and intra-implant axis) of three implants in curved lines and straight lines by using a laboratory scanner (LBS) versus an intra-oral scanner (IOS). Methods: Two 3D models were fabricated using a printer, each model with three internal hex implants analogues at the positions of 15#,16#,17# (straight line) and 12#,13#,14# (curved line). Standard intra-oral scan bodies (ISBs) were used, and the two models were scanned using 7 Series dental wings (LBS, reference model), followed by ten scans with Primescan (digital method). Standard Tessellation Language (STL) files were created. Five polyether impressions were taken from each model (straight and curved), and gypsum type 4 models were poured; each model was scanned five times to create a total of 25 STL files for each group (conventional method). The comparison between all the STL files (conventional and digital) was made by superimposition of the STL files on the STL reference model laboratory file using a 3D analyzing software. A Kolmogorov-Smirnov test was performed, followed by Mann-Whitney tests and Wilcoxon signed-rank tests. (p < 0.05). Results: For the conventional method, the mean errors were significantly higher for the curved line model (12-14) compared to the straight line model (15-17) for most parameters (p < 0.05). For the digital method, the mean errors were significantly higher for the curved-line model (12-14) compared to the straight line model (15-17) in half of the parameters (p < 0.05). Within the curved line model (12-14) and the straight line model (15-17), the mean errors between the conventional method and the digital method were not significant for most variables. Conclusions: The difference between curved lines and straight lines has an impact on the mean error of the conventional method. Both methods are reliable for straight and curved lines in partially dentate situations.
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Affiliation(s)
- Gil Ben-Izhack
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel; (O.R.); (E.Z.); (J.N.); (R.H.); (A.S.)
| | - Ophir Rosner
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel; (O.R.); (E.Z.); (J.N.); (R.H.); (A.S.)
| | - Eran Zenziper
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel; (O.R.); (E.Z.); (J.N.); (R.H.); (A.S.)
| | - Joseph Nissan
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel; (O.R.); (E.Z.); (J.N.); (R.H.); (A.S.)
| | - Reema Hosary
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel; (O.R.); (E.Z.); (J.N.); (R.H.); (A.S.)
| | - Diva Lugassy
- Department of Orthodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Asaf Shely
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel; (O.R.); (E.Z.); (J.N.); (R.H.); (A.S.)
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Kropfeld J, Berger L, Adler W, Schulz KL, Motel C, Wichmann M, Matta RE. Impact of Scanbody Geometry and CAD Software on Determining 3D Implant Position. Dent J (Basel) 2024; 12:94. [PMID: 38668006 PMCID: PMC11049057 DOI: 10.3390/dj12040094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 03/28/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024] Open
Abstract
The implementation of CAD software in the digital production of implant prosthetics stands as a pivotal aspect of clinical dentistry, necessitating high precision in the alignment of implant scanbodies. This study investigates the influence of scanbody geometry and the method of superimposing in CAD software when determining 3D implant position. A standardized titanium model with three bone-level implants was digitized to create reference STL files, and 10 intraoral scans were performed on Medentika and NT-Trading scanbodies. To determine implant position, the generated STL files were imported into the Exocad CAD software and superimposed-automatically and manually-with the scanbody geometries stored within the software's shape library. Position accuracy was determined by a comparison of the 3D-defined scanbody points from the STL matching files with those from the reference STL files. The R statistical software was used for the evaluation of the data. In addition, mixed linear models and a significance level of 0.05 were applied to calculate the p-values. The manual overlay method was significantly more accurate than the automatic overlays for both scanbody types. The Medentika scanbodies showed slightly superior precision compared to the NT-Trading scanbodies. Both scanbody geometry and the type of alignment in the CAD software significantly affect digital workflow accuracy. Manual verification and adjustment of the automatic alignment process are essential for precise implant positioning.
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Affiliation(s)
- Judith Kropfeld
- Department of Prosthodontics, University Hospital Erlangen, Glückstrasse 11, 91054 Erlangen, Germany; (J.K.); (L.B.); (C.M.); (M.W.)
| | - Lara Berger
- Department of Prosthodontics, University Hospital Erlangen, Glückstrasse 11, 91054 Erlangen, Germany; (J.K.); (L.B.); (C.M.); (M.W.)
| | - Werner Adler
- Institute of Medical Informatics, Biometry and Epidemiology (IMBE) of the Friedrich-Alexander-University, Erlangen-Nuremberg, Waldstrasse 6, 91054 Erlangen, Germany;
| | - Katja Leonie Schulz
- Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Erlangen, Glückstrasse 11, 91054 Erlangen, Germany;
| | - Constantin Motel
- Department of Prosthodontics, University Hospital Erlangen, Glückstrasse 11, 91054 Erlangen, Germany; (J.K.); (L.B.); (C.M.); (M.W.)
| | - Manfred Wichmann
- Department of Prosthodontics, University Hospital Erlangen, Glückstrasse 11, 91054 Erlangen, Germany; (J.K.); (L.B.); (C.M.); (M.W.)
| | - Ragai Edward Matta
- Department of Prosthodontics, University Hospital Erlangen, Glückstrasse 11, 91054 Erlangen, Germany; (J.K.); (L.B.); (C.M.); (M.W.)
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Wang ZY, Gong Y, Liu F, Chen D, Zheng JW, Shen JF. Influence of intraoral scanning coverage on the accuracy of digital implant impressions - An in vitro study. J Dent 2024; 143:104929. [PMID: 38458380 DOI: 10.1016/j.jdent.2024.104929] [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: 01/04/2024] [Revised: 02/15/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES To evaluate the influence of intraoral scanning coverage (IOSC) on digital implant impression accuracy in various partially edentulous situations and predict the optimal IOSC. METHODS Five types of resin models were fabricated, each simulating single or multiple tooth loss scenarios with inserted implants and scan bodies. IOSC was subgrouped to cover two, four, six, eight, ten, and twelve teeth, as well as full arch. Each group underwent ten scans. A desktop scanner served as the reference. Accuracy was evaluated by measuring the Root mean square error (RMSE) values of scan bodies. A convolutional neural network (CNN) was trained to predict the optimal IOSC with different edentulous situations. Statistical analysis was performed using one-way ANOVA and Tukey's test. RESULTS For single-tooth-missing situations, in anterior sites, significantly better accuracy was observed in groups with IOSC ranging from four teeth to full arch (p < 0.05). In premolar sites, IOSC spanning four to six teeth were more accurate (p < 0.05), while in molar sites, groups with IOSC encompassing two to eight teeth exhibited better accuracy (p < 0.05). For multiple-teeth-missing situations, IOSC covering four, six, and eight teeth, as well as full arch showed better accuracy in anterior gaps (p < 0.05). In posterior gaps, IOSC of two, four, six or eight teeth were more accurate (p < 0.05). The CNN predicted distinct optimal IOSC for different edentulous scenarios. CONCLUSIONS Implant impression accuracy can be significantly impacted by IOSC in different partially edentulous situations. The selection of IOSC should be customized to the specific dentition defect condition. CLINICAL SIGNIFICANCE The number of teeth scanned can significantly affect digital implant impression accuracy. For missing single or four anterior teeth, scan at least four or six neighboring teeth is acceptable. In lateral cases, two neighboring teeth may suffice, but extending over ten teeth, including contralateral side, might deteriorate the scan.
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Affiliation(s)
- Zhen-Yu Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu Gong
- College of Computer Science, Sichuan University, Chengdu, Sichuan Province, China
| | - Fei Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China; West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Du Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Jia-Wen Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China
| | - Jie-Fei Shen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chengdu, Sichuan Province, China; West China School of Stomatology, Sichuan University, Chengdu, Sichuan Province, China; West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province, China.
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Mansoor MA, Sayed ME, Abdul HN, Zaidan MS, Hakami TM, Dighriri MA, Alqahtani SM, Alfaifi MA, Altoman MS, Jokhadar HF, AlResayes SS, AlWadei MH, Jundus AI, Komosany AM, Al-Najjar HZ. Comparative Accuracy of Intraoral and Extraoral Digital Workflows for Short Span Implant Supported Fixed Partial Denture Fabrication: An In Vitro Study. Med Sci Monit 2024; 30:e943706. [PMID: 38500254 PMCID: PMC10960501 DOI: 10.12659/msm.943706] [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: 01/04/2024] [Accepted: 02/02/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND The advent of digital impressions using computer-aided design and manufacturing technology (CAD/CAM) has simplified and improved the fabrication of implant prostheses in dentistry. The conventional impression has several drawbacks, including tray selection, material type, impression technique, impression disinfection, and cast model storage. The inaccuracies caused by distortion and contraction of impression material can be minimized with digital impressions. This study aimed to compare digital dental impressions of 10 working casts made using the Pindex laser removable die system to fabricate parallel drill channels vs 10 working casts made using the Di-Lok plastic tray removable die system. MATERIAL AND METHODS An implant master die with 2 dental implant analogs was fabricated. Ten working casts using the Pindex laser removable die system with parallel drill channels and 10 working casts using the Di-Lok plastic tray removable die system were fabricated. The working casts were scanned using an extra-oral laboratory scanner and the implant master model was scanned with an intra-oral scanner. RESULTS The properties of the casts made using the 2 systems were evaluated and analyzed with ANOVA and post hoc Tukey test. The mean horizontal linear distances between A1B1 (P<0.021), A2B2 (P<0.018), C1D1 (P<0.026), C2D2 (P<0.03), B1C1 (P<0.01), and mean vertical distances between B1A2 (P<0.015), C1D2 (P<0.001), B1B2 (P<0.028), and C1C2 (P<0.001) were significantly different between the Pindex system and Di-Lok tray system as compared to intra-oral scans. CONCLUSIONS Complete digital workflow with intra-oral scans were more than the partial digital workflow with extra-oral scans for the Pindex system and Di-Lok tray systems.
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Affiliation(s)
- Manawar Ahmad Mansoor
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Mohammed E. Sayed
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Hina Naim Abdul
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | | | | | - Saeed M. Alqahtani
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A. Alfaifi
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Majed S. Altoman
- Department of Prosthetic Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Hossam F. Jokhadar
- Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Saad Saleh AlResayes
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed H. AlWadei
- Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Etxaniz O, Amezua X, Jauregi M, Solaberrieta E. Obtaining more accurate complete arch implant digital scans with the aid of a geometric pattern: A dental technique. J Prosthet Dent 2024:S0022-3913(24)00137-9. [PMID: 38462435 DOI: 10.1016/j.prosdent.2024.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 03/12/2024]
Abstract
A technique to obtain more accurate complete arch implant digital scans and virtual casts is described. In order to obtain complete arch implant digital scans with greater accuracy, short-span intraoral digital scans are superimposed with the aid of a geometric pattern. Therefore, the technique takes advantage of the accuracy of intraoral scanners to obtain digital scans of reduced spans. Two virtual designs of the geometric pattern have been made available online: one for maxillary arches and one for mandibular arches. From these virtual designs, new virtual designs of geometric patterns of different sizes and shapes can be created to better fit different arch forms and implant positions.
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Affiliation(s)
- Olatz Etxaniz
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Xabier Amezua
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Mikel Jauregi
- Associate Professor, Department of Mechanical Engineering, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Eneko Solaberrieta
- Associate Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain.
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Han X, Wei D, Jiang X, Di P, Yi C, Lin Y. Digital registration versus cone-beam computed tomography for evaluating implant position: a prospective cohort study. BMC Oral Health 2024; 24:304. [PMID: 38438985 PMCID: PMC10913533 DOI: 10.1186/s12903-024-04088-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/29/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Postoperative cone-beam computed tomography (CBCT) examination is considered a reliable method for clinicians to assess the positions of implants. Nevertheless, CBCT has drawbacks involving radiation exposure and high costs. Moreover, the image quality can be affected by artifacts. Recently, some literature has mentioned a digital registration method (DRM) as an alternative to CBCT for evaluating implant positions. The aim of this clinical study was to verify the accuracy of the DRM compared to CBCT scans in postoperative implant positioning. MATERIALS AND METHODS A total of 36 patients who received anterior maxillary implants were included in this clinical study, involving a total of 48 implants. The study included 24 patients in the single implant group and 12 patients in the dual implant group. The postoperative three-dimensional (3D) positions of implants were obtained using both CBCT and DRM. The DRM included three main steps. Firstly, the postoperative 3D data of the dentition and intraoral scan body (ISB) was obtained through the intraoral scan (IOS). Secondly, a virtual model named registration unit which comprised an implant replica and a matching ISB was created with the help of a lab scanner and reverse engineering software. Thirdly, by superimposing the registration unit and IOS data, the postoperative position of the implant was determined. The accuracy of DRM was evaluated by calculating the Root Mean Square (RMS) values after superimposing the implant positions obtained from DRM with those from postoperative CBCT. The accuracy of DRM was compared between the single implant group and the dual implant group using independent sample t-tests. The superimposition deviations of CBCT and IOS were also evaluated. RESULTS The overall mean RMS was 0.29 ± 0.05 mm. The mean RMS was 0.30 ± 0.03 mm in the single implant group and 0.29 ± 0.06 mm in the dual implant group, with no significant difference (p = 0.27). The overall registration accuracy of the IOS and CBCT data ranged from 0.14 ± 0.05 mm to 0.21 ± 0.08 mm. CONCLUSION In comparison with the 3D implant positions obtained by CBCT, the implant positions located by the DRM showed clinically acceptable deviation ranges. This method can be used in single and dual implant treatments to assess the implant positions.
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Affiliation(s)
- Xinrui Han
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Donghao Wei
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Xi Jiang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China
| | - Chun Yi
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China.
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, PR China.
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10
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Risciotti E, Squadrito N, Montanari D, Iannello G, Macca U, Tallarico M, Cervino G, Fiorillo L. Digital Protocol to Record Occlusal Analysis in Prosthodontics: A Pilot Study. J Clin Med 2024; 13:1370. [PMID: 38592229 PMCID: PMC10931913 DOI: 10.3390/jcm13051370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/19/2024] [Accepted: 02/26/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Digital technologies enable the accurate replication of occlusion, which is pivotal for stability in maximum intercuspation and dynamic occlusion. CAD softwares generates standardized occlusal morphologies requiring significant adjustments. The consideration of individual mandibular movements during restoration leads to better functional integration. This pilot study evaluates the efficacy of a novel, fully digital protocol for occlusal analysis recording in prosthodontics. Methods: Patients needing single or multiple metal-free restorations were included. Teeth underwent horizontal finish line preparation, while restorations on implants were either directly screwed or used multi-unit abutments. A digital impression (Trios 3 Intraoral Scanner) captured the mouth's elements. Dynamic occlusion was recorded via Patient Specific Motion (PSM). After the placement and functionalization of temporary restorations, subsequent scans included various elements, and CAD software (Dental system) was used for the restoration design. Restorations were milled in monolithic zirconia, pressed from CAD/CAM-milled wax, and sintered. Results: An evaluation of 52 restorations in 37 patients indicated high accuracy in restorations manufactured via the fully digital workflow. Monolithic zirconia was predominantly used. Subtractive (17.3%) and additive (7.7%) occlusal adjustments were mainly chairside. Conclusion: This study underscores the efficacy of meticulous verification measures and a centric contact system in reducing the need for clinical occlusal refinements in prosthetic restorations.
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Affiliation(s)
| | | | | | | | - Ugo Macca
- Private Practice, 96100 Siracusa, Italy;
| | - Marco Tallarico
- School of Dentistry, University of Sassari, 07100 Sassari, Italy;
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy;
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy;
- Department of Dental Cell Research, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune 411018, India
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 80121 Naples, Italy
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11
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Etxaniz O, Amezua X, Jauregi M, Solaberrieta E. Improving the accuracy of complete arch implant digital scans by using auxiliary clips for intraoral scan bodies: A dental technique. J Prosthet Dent 2024:S0022-3913(24)00066-0. [PMID: 38418305 DOI: 10.1016/j.prosdent.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 03/01/2024]
Abstract
A technique to improve the accuracy of complete arch implant intraoral digital scans and the accuracy of their virtual casts is described. Obtaining accurate complete arch implant intraoral digital scans with an intraoral scanner is challenging because of the smooth and movable tissues of edentulous areas. The described technique uses auxiliary clips attached to intraoral scan bodies to cover interimplant edentulous spans with immobile tooth-like geometric references that are more favorable for intraoral scanning. The technique is designed to be user friendly and compatible with any intraoral scanner.
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Affiliation(s)
- Olatz Etxaniz
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Xabier Amezua
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Mikel Jauregi
- Associate Professor, Department of Mechanical Engineering, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Eneko Solaberrieta
- Associate Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain.
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12
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Ganta GK, Mosca RC, Varsani R, Murthy VR, Cheruvu K, Lu M, Arany PR. Automation in Dentistry with Mechanical Drills and Lasers for Implant Osteotomy: A Narrative-Scoping Review. Dent J (Basel) 2023; 12:8. [PMID: 38248216 PMCID: PMC10814723 DOI: 10.3390/dj12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/11/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
The popularity of implants is increasing with the aging population requiring oral-dental rehabilitation. There are several critical steps in the implant workflow, including case selection, implant design, surgical procedure, biological tissue responses, and functional restoration. Among these steps, surgical osteotomy procedures are a crucial determinant of clinical success. This brief review was aimed at outlining the current state of the field in automation-assisted implant surgical osteotomy technologies. A broad search of the literature was performed to identify current literature. The results are outlined in three broad categories: semi-automated static (image-guided) or dynamic (navigation-assisted) systems, and fully-automated robotic systems. As well as the current mechanical rotary approaches, the literature supporting the use of lasers in further refinement of these approaches is reviewed. The advantages and limitations of adopting autonomous technologies in practical clinical dental practices are discussed. In summary, advances in clinical technologies enable improved precision and efficacious clinical outcomes with implant dentistry. Hard-tissue lasers offer further advancements in precision, improved biological responses, and favorable clinical outcomes that require further investigation.
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Affiliation(s)
- Gopala Krishna Ganta
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
- Intercare Community Health Network, Bangor, MI 49013, USA
| | - Rodrigo Crespo Mosca
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Ridham Varsani
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Venkata Ramana Murthy
- Department of Maxillofacial Surgery, Anil Nirukonda Dental College, Visakhapatnam 531162, India
| | - Kamala Cheruvu
- Department of Orthodontics, Gandhi Institute of Technology and Management Dental College, Visakhapatnam 530045, India
| | - Michael Lu
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Praveen R. Arany
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
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13
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Önöral Ö, Kurtulmus-Yilmaz S, Toksoy D, Ozan O. Effect of angulation on the 3D trueness of conventional and digital implant impressions for multi-unit restorations. J Adv Prosthodont 2023; 15:290-301. [PMID: 38205122 PMCID: PMC10774637 DOI: 10.4047/jap.2023.15.6.290] [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: 08/28/2023] [Revised: 11/27/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE The study aimed to determine the influence of implant angulation on the trueness of multi-unit implant impressions taken through different techniques and strategies. MATERIALS AND METHODS As reference models, three partially edentulous mandibular models (Model 1: No angulation; Model 2: No angulation for #33, 15-degree distal angulation for #35 and #37; Model 3: No angulation for #33, 25-degree distal angulation for #35 and #37) were created by modifying the angulations of implant analogues. Using a lab scanner, these reference models were scanned. The obtained data were preserved and utilized as virtual references. Three intraoral scanning (IOS) strategies: IOS-Omnicam, ISO-Quadrant, and IOS-Consecutive, as well as two traaditional techniques: splinted open tray (OT) and closed tray (CT), were used to create impressions from each reference model. The best-fit alignment approach was used to sequentially superimpose the reference and test scan data. Computations and statistical analysis of angular (AD), linear (LD), and 3D deviations (RMS) were performed. RESULTS Model type, impression technique, as well as interaction factor, all demonstrated a significant influence on AD and LD values for all implant locations (P < .05). The Model 1 and SOT techniques displayed the lowest mean AD and LD values across all implant locations. When considering interaction factors, CT-Model 3 and SOT-Model 1 exhibited the highest and lowest mean AD and LD values, respectively. Model type, impression technique, and interaction factor all revealed significant effects on RMS values (P ≤ .001). CT-Model 3 and SOT-Model 1 presented the highest and lowest mean RMS values, respectively. CONCLUSION Splinted-OT and IOS-Omnicam are recommended for multi-unit implant impressions to enhance trueness, potentially benefiting subsequent manufacturing stages.
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Affiliation(s)
- Özay Önöral
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
| | | | - Dilem Toksoy
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
| | - Oguz Ozan
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin10, Turkey
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14
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Donmez MB, Güven ME, Yılmaz D, Abou-Ayash S, Çakmak G, Yilmaz B. Trueness and precision of combined healing abutment scan body system scans at different sites of maxilla after multiple repositioning of the scan body. J Dent 2023; 139:104716. [PMID: 37739057 DOI: 10.1016/j.jdent.2023.104716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/23/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVES To evaluate the accuracy of the scans of the combined healing abutment-scan body (CHA-SB) system located at different sites of the maxilla when SBs are replaced in between each scan. METHODS Three SBs were seated into HAs located at the central incisor, first premolar, and first molar sites of a maxillary model inside a phantom head, and the model was scanned extraorally (CEREC Primescan SW 5.2). This procedure was repeated with new SBs until a total of 10 scans were performed. Standard tessellation language files of CHA-SBs at each implant location were isolated, transferred into analysis software (Geomagic Control X), and superimposed over the proprietary library files to analyze surface (root mean square), linear, and angular deviations. Trueness and precision were evaluated with one-way analysis of variance and Tukey tests. The correlation between surface and angular deviations was analyzed with Pearson's correlation (α=0.05). RESULTS Molar implant scans had the highest surface and angular deviations (P≤.006), while central incisor implant scans had higher precision (surface deviations) than premolar implant scans (P=.041). Premolar implant scans had higher accuracy than central incisor implant scans on the y-axis (P≤.029). Central incisor implant scans had the highest accuracy on the z-axis (P≤.018). A strong positive correlation was observed between surface and angular deviations (r = 0.864, P<.001). CONCLUSION Central incisor implant scans mostly had high accuracy and molar implant scans mostly had lower trueness. SBs were mostly positioned apically; however, the effect of SB replacement can be considered small as measured deviations were similar to those in previous studies and the precision of scans was high. CLINICAL SIGNIFICANCE Repositioning of scan bodies into healing abutments would be expected to result in similar single crown positioning regardless of the location of the implant, considering high scan precision with the healing abutment-scan body system. The duration of the chairside adjustments of crowns in the posterior maxilla may be longer than those in the anterior region.
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Affiliation(s)
- Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Mehmet Esad Güven
- Department of Prosthodontics, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Deniz Yılmaz
- Department of Prosthodontics, Faculty of Dentistry, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Ohio, United States of America
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15
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Tarce M, Becker K, Lahoud P, Shujaat S, Jacobs R, Quirynen M. Non-invasive oral implant position assessment: An ex vivo study using a 3D industrial scan as the reference model to mimic the clinical situation. Clin Oral Implants Res 2023. [PMID: 37927146 DOI: 10.1111/clr.14206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/17/2023] [Accepted: 11/01/2023] [Indexed: 11/07/2023]
Abstract
AIM To introduce an objective method to evaluate the accuracy of implant position assessment in partially edentulous patients by comparing different techniques (conventional impression, intraoral scan, CBCT) to a reference 3D model obtained with an industrial scanner, the latter mimicking the clinical situation. MATERIALS AND METHODS Twenty-nine implants were placed in four human cadaver heads using a fully guided flapless protocol. Implant position was assessed using (a) a conventional impression, (b) an intraoral scan, and (c) CBCT and compared to an industrial scan. Three-dimensional models of intraoral scan body and implant were registered to the arch models and the deviation at implant shoulder, apex, and the angle of deviation were compared to each other as well as to the reference model. RESULTS The three assessment techniques showed statistically significant deviations (p < .01) from the industrial scan, for all measurements, with no difference between the techniques. The maximum deviation at the implant shoulder was 0.16 mm. At the implant apex this increased to 0.38 mm. The intraoral scan deviated significantly more than the CBCT (0.12 mm, p < .01) and the conventional impression (0.10 mm, p = .02). The maximum implant angle deviation was 1.0°. The intraoral scan deviated more than the conventional impression (0.3°, p = .02). CONCLUSION All assessment techniques deviated from the reference industrial scan, but the differences were relatively small. Intraoral scans were slightly less accurate than both conventional impressions and CBCT. Depending on the application, however, this inaccuracy may not be clinically relevant.
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Affiliation(s)
- Mihai Tarce
- Division of Periodontology & Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Kathrin Becker
- Charité- Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Orthodontics and Dentofacial Orthopedics, Berlin, Germany
| | - Pierre Lahoud
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Sohaib Shujaat
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
- King Abdullah International Medical Research Center, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Department of Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Marc Quirynen
- Periodontology and Oral Microbiology, Department of Oral Health Sciences, Faculty of Medicine, KU Leuven, Leuven, Belgium
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16
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Schmalzl J, Róth I, Borbély J, Hermann P, Vecsei B. The effect of generation change on the accuracy of full arch digital impressions. BMC Oral Health 2023; 23:766. [PMID: 37853398 PMCID: PMC10585882 DOI: 10.1186/s12903-023-03476-z] [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: 06/12/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023] Open
Abstract
PURPOSE This study is aimed to evaluate the effect of generation change on accuracy of IOSs on full-arch scans and the inter-operator reliability. METHODS In this study, 6 different IOS were tested: 3Shape Trios 3 (20.1.2.), 3Shape Trios 4 (20.1.1.), Medit i500 (2.3.6.), Medit i700 (2.4.6.), Planmeca Emerald (6.0.1.) and Planmeca Emerald S (6.0.1.). Eighteen dental students, inexperienced in scanning, took part in this study as operators. Each operator made 10 digital impressions; altogether, 30 impressions were made by each scanner. The 30 STL files were imported to the Geomagic Control X program, where they were compared to a reference STL file; the surface point's deviation of the full arch and the distance between the second molars' distobuccal cusps were measured, the inter-operator reliability was also investigated. RESULTS A significant increase in accuracy was found between Trios 3 and 4 in the case of both parameters and between Medit i500 and i700 in the case of full arch. There was no significant difference between Planmeca generations. In case of the inter-operator reliability no significant difference was detected. CONCLUSION Within this current study's limitation, it can be concluded that surface digitalization's accuracy can be modified with generation changes and that digital technology is less technique sensitive than traditional impression taking.
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Affiliation(s)
- Judit Schmalzl
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary.
| | - Ivett Róth
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary
| | - Bálint Vecsei
- Department of Prosthodontics, Semmelweis University, Szentkiralyi street 47, Budapest, 1088, Hungary
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17
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Gómez-Polo M, Immorlano MG, Cascos-Sánchez R, Ortega R, Barmak AB, Kois JC, Revilla-León M. Influence of the dental arch and number of cutting-off and rescanning mesh holes on the accuracy of implant scans in partially edentulous situations. J Dent 2023; 137:104667. [PMID: 37595865 DOI: 10.1016/j.jdent.2023.104667] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 08/03/2023] [Accepted: 08/16/2023] [Indexed: 08/20/2023] Open
Abstract
OBJECTIVES To evaluate the influence of the dental arch and cutting-off and rescanning procedures on the accuracy of complete-arch implant scans in partially edentulous arches. MATERIAL AND METHODS A maxillary and a mandibular partially edentulous typodont with implant abutment analogs placed in the right and left first molar and right central incisor sites were digitized to create reference models by using an industrial optical scanner (7 Series Desktop Scanner; Dentalwings). Two experimental groups were scanned using an intraoral scanner (IOS) (TRIOS 4; 3Shape A/S): the Maxillary group (Mx) and the Mandibular group (Mb). Four subgroups were generated depending on the number of rescanned mesh holes: No holes (Mx-G0, Mb-G0), 1 hole (Mx-G1, Mb-G1), 2 holes (Mx-G2, Mb-G2) and 3 holes (Mx-G3, Mb-G3). A 3-dimensional metrology software (Geomagic Control X; 3D Systems) was used to measure the difference between the reference and the experimental scans computing the root mean square (RMS) error calculation. Two-way ANOVA and a post-hoc Tukey test were used to analyze the trueness data (α=0.05). Levene test was used to evaluate the prevision (α=0.05). RESULTS The Mx group obtained a trueness mean value of 54 ± 17 µm and a mean precision value of 54 ± 17 µm, while the Mb group presented a trueness mean value of 67 ± 23 µm and a mean precision value of 66 ± 22 µm. The Mx group demonstrated significantly better trueness than the Mb group (P<.001). The G0 and G1 subgroups had the highest trueness values among the subgroups tested. No significant difference was observed between G0 and G1, G1 and G2, and G2 and G3 subgroups in trueness and precision. However, the G0 had significantly better trueness and precision values compared to G2 and G3 subgroups. In addition, the G1 had significantly better trueness values than the G3 subgroup. However, the Levene test revealed no difference in the precision mean values among the subgroups tested. CONCLUSIONS Implant scanning trueness was affected by the dental arch and the number of rescanned mesh holes using the IOS tested. A higher number of rescanned mesh holes decreased the scanning trueness. The stitching algorithm of the IOS software tested after the mesh hole scan demonstrated a significant error, especially when multiples mesh holes are involved in the same arch. CLINICAL SIGNIFICANCE Given that cutting-off and rescanning techniques can reduce trueness, clinicians should consider whether these techniques are necessary in complete digital workflows. This is particularly important when fabricating multiple single implant-supported restorations in the same arch.
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Affiliation(s)
- Miguel Gómez-Polo
- Associate Professor Department of Conservative Dentistry and Prosthodontics, Director of postgraduate program of Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
| | - Marina García Immorlano
- Postgraduate Specialist in Advanced-Prosthodontics. Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Cascos-Sánchez
- Postgraduate Specialist in Advanced in Implant-Prosthodontics, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Ortega
- Adjunct Professor Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
| | - Abdul B Barmak
- Assistant Professor Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY USA
| | - John C Kois
- Founder and Director Kois Center, Seattle, WA; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, WA; and Private Practice, Seattle, WA USA
| | - Marta Revilla-León
- Affiliate Assistant Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, WA; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, WA; and Adjunct Professor, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, MA USA
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18
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Li S, Yi C, Yu Z, Wu A, Zhang Y, Lin Y. Accuracy assessment of implant placement with versus without a CAD/CAM surgical guide by novices versus specialists via the digital registration method: an in vitro randomized crossover study. BMC Oral Health 2023; 23:426. [PMID: 37370027 PMCID: PMC10294323 DOI: 10.1186/s12903-023-03116-6] [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: 04/18/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Many studies demonstrated that surgical guides might reduce discrepancies compared with freehand implant placement. This randomized crossover study aimed to assess the effects of approaches, practitioners' experience and learning sequences on the accuracy of single tooth implantation via digital registration method. No similar study was found. METHODS This in vitro randomized crossover study enrolled 60 novice students (Group S) and 10 experienced instructors (Group I). Sixty students were randomly and evenly assigned to two groups (Group SA and SB). In Group SA, 30 students first performed single molar implant on a simulation model freehand (Group SAFH), and then with a CAD/CAM surgical guide (Group SASG). In Group SB, another 30 students first performed guided (Group SBSG) and then freehand (Group SBFH). Ten instructors were also divided into Group IAFH/IASG (n = 5) and IBSG/IBFH (n = 5) following the same rules. The accuracy of implant placement was assessed by the coronal and apical distance (mm) and angular (°) deviations using the digital registration method. T tests and nonparametric tests were used to compare the results among different groups of approaches, experience and sequences. RESULTS For students, the coronal and apical distance and the angular deviations were significantly lower in surgical guide group than freehand group in total and in learning freehand first subgroup, but for learning surgical guide first subgroup the apical distance deviation showed no significant difference between two approaches. For students, the angular deviation of freehand group was significantly lower in learning surgical guide first group than learning freehand first group. For instructors, the coronal and apical distance and angular deviations showed no significant difference between two approaches and two sequences. For freehand approach, the coronal and apical distance and the angular deviations were significantly higher in student group than instructor group, while not significantly different between two groups for surgical guide approach. CONCLUSIONS For novices, using a surgical guide for the first implant placement may reduce the potential deviations compared with freehand surgery, and may reach a comparable accuracy with that of specialists. For simple single molar implantation, the surgical guide may not be significantly helpful for experienced specialists.
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Affiliation(s)
- Sha Li
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, P. R. China
| | - Chun Yi
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, P. R. China
| | - Ziyang Yu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology Center of Digital, Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, P. R. China
| | - Aozhou Wu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yu Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, P. R. China.
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun South Avenue, Haidian District, 100081, Beijing, P. R. China.
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Çakmak G, Donmez MB, Akay C, de Paula MS, Mangano FG, Abou-Ayash S, Yilmaz B. Effect of measurement techniques and operators on measured deviations in digital implant scans. J Dent 2023; 130:104388. [PMID: 36502966 DOI: 10.1016/j.jdent.2022.104388] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/21/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To evaluate the effect of different measurement techniques and operators on measured deviations in vitro implant scans. METHODS A 2-piece system that comprises a healing abutment (HA) and a scan body (SB) was mounted onto an implant at right first molar site of a polymethylmethacrylate mandibular dentate model. Model was digitized by using an industrial scanner (reference model scan, n = 1) and an intraoral scanner (test scan, n = 20). All standard tessellation language files were imported into a 3-dimensional analysis software and superimposed. Three operators with similar experience performed circle-based and point-based deviation analyses (n = 20). Deviations measured with different techniques were compared with paired samples t-test within each operator, while the reliability of the operators was assessed by using F-tests for both technqiues (α = 0.05). RESULTS Point-based technique resulted in lower deviations than circle-based technique for all operators (P = .001) with to higher reliability among operators (ICC = 0.438, P = .001). The correlation among the operators was nonsignificant when circle-based technique was used (ICC = 0.114, P = .189). CONCLUSION Lower deviations were detected with the point-based technique. In addition, different operators' measurements had higher correlation when point-based technique was used compared with circle-based technique. CLINICAL SIGNIFICANCE Point-based technique may be preferred over circle-based technique for research studies on scan accuracy of implants, given its higher reliability. The accuracy of measured deviations may increase if the number of planes are increased, which can facilitate point generation at different surfaces of the scan body.
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Affiliation(s)
- Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mustafa Borga Donmez
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, Istinye University, Faculty of Dentistry, Istanbul, Turkey.
| | - Canan Akay
- Department of Prosthodontics, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey; Translational Medicine Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Marcella Silva de Paula
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Universidade Federal de Goiás, Department of Prevention and Oral Rehabilitation, Goiânia, GO, Brasil
| | - Francesco Guido Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, OH, USA
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20
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Zimmermann R, Seitz S. The Impact of Technological Innovation on Dentistry. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1406:79-102. [PMID: 37016112 DOI: 10.1007/978-3-031-26462-7_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Technology has revolutionized the way dentists are able to treat their patients. These technological advances have paved the way for the creation of virtual patient models utilizing these 3-dimensional intra-oral patient models, cone bean computer tomography (CBCT) radiograph scans, extraoral 3-dimensional scans, and jaw motion tracings to create a patient-specific model. These models are advantageous in planning surgical treatments by providing 3-dimensional views of vital anatomical structures to accurately identify the location, size, and shape of a structure or defect in order to plan accordingly. Virtual augmentation of either hard tissue (bone) and/or soft tissue (i.e., gingiva) can also be accomplished.Technology has allowed the capture of the dynamic motions of the jaw and combined them with the virtual patient to develop permanent restorations in harmony with the patient's orofacial complex. With the introduction of new technology in the realm of digital dentistry, patient care is being brought to a new and higher level. This creates a level of more optimal care that a dentist can deliver to patients.
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Affiliation(s)
- Richard Zimmermann
- Department of Comprehensive Dentistry, UT Health San Antonio, San Antonio, TX, USA
| | - Stefanie Seitz
- Department of Comprehensive Dentistry, UT Health San Antonio, San Antonio, TX, USA.
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21
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Gracis S, Appiani A, Noè G. Digital workflow in implant prosthodontics: The critical aspects for reliable accuracy. J ESTHET RESTOR DENT 2023; 35:250-261. [PMID: 36606714 DOI: 10.1111/jerd.13004] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION This paper is a comprehensive treaty about the variables that influence the transfer of the position of an implant to the laboratory when using a digital workflow. OBJECTIVE The aim is to provide operators and manufacturers with a guide on how to improve certain aspects of the digital workflow specific to the fabrication of implant-supported restorations. OVERVIEW It addresses intraoral scanning issues and CAD software issues. In the former, the variables that play a part in the quality of the scan file are investigated: the implant scan body, the IOS and the operator. For the latter, instead, the focus is on those aspects that still today may create inaccuracies in the workflow and in the final product being fabricated: the identification of the specific implant placed in the patient and the generation of a virtual model with the representation of that implant platform correctly positioned in the three dimensions of space. Suggestions and recommendations are given to improve the control on the quality of the digital workflow's output. CONCLUSION In a digital workflow for the fabrication of an implant-supported restoration, the selection and use of the implant scan body, the use of an effective scan strategy and the appropriateness of the best fit function in the CAD software, that is, the procedure of superimposing the library of geometric shapes of the ISB linked to the implant with the shape acquired intraorally, are variables that can influence the positional precision of the FDP. CLINICAL SIGNIFICANCE Fully understanding the importance of the information enclosed in the ISBs themselves can be crucial in the digital workflow. A proper ISB's selection, a correct scan of the ISB's shape and an accurate CAD superimposition of the ISB's library can lead the clinician to reduce the variables that affect the final result in daily practice.
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22
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Arikan H, Muhtarogullari M, Uzel SM, Guncu MB, Aktas G, Marshall LS, Turkyilmaz I. Accuracy of digital impressions for implant-supported complete-arch prosthesis when using an auxiliary geometry device. J Dent Sci 2023; 18:808-813. [PMID: 37021239 PMCID: PMC10068489 DOI: 10.1016/j.jds.2023.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 01/12/2023] [Indexed: 01/25/2023] Open
Abstract
Background/purpose Digital impressions using intraoral scanners have recently gained popularity. The aim of the present study was to evaluate the fit of full-arch screw-retained cobalt-chromium frameworks fabricated via two different digital impression methods. Materials and methods An edentulous resin master model with four dental implants was fabricated. Forty cobalt-chromium superstructures were fabricated and evaluated according to four groups. In Group 1, the superstructures were evaluated using an intraoral scanner to generate digital impressions. Group 2 relied on the help of an auxiliary geometric appliance in generation of digital impressions via intraoral scanner. The traditional method of splinted open-tray conventional impressions was designated for Group 3. Finally, the control group (Group 4) relied on scanning of the master model directly with a laboratory scanner. Vertical marginal discrepancy was evaluated, and data obtained were statistically analyzed. Results The highest mean vertical marginal gap value (80.86 ± 50.06 μm) was observed for Group 1 and statistically higher than Group 2, 3, and 4 (P < 0.05). The lowest mean vertical marginal gap value (41.98 ± 26.33 μm) was measured from Group 4 and statistically similar to Group 2 and 3 (P > 0.05). Conclusion It has been suggested that the use of auxiliary geometric appliances yields increased scanning accuracy. Frameworks fabricated using the traditional splinted open-tray technique were more reliable compared to those frameworks from digital impressions.
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23
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Alvarez C, Domínguez P, Jiménez-Castellanos E, Arroyo G, Orozco A. How the geometry of the scan body affects the accuracy of digital impressions in implant supported prosthesis. In vitro study. J Clin Exp Dent 2022; 14:e1008-e1014. [PMID: 36601246 PMCID: PMC9799989 DOI: 10.4317/jced.59948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 10/10/2022] [Indexed: 12/05/2022] Open
Abstract
Background To determine and compare how three-dimensionally accurate scan bodies of different geometric shapes are placed over 6 implants (platform or crestal module). Material and Methods A master plaster model was made with 6 INHEX STD implant analogs made by Mozo-Grau S.A and 4 scan body types were compared. Several groups were made: a control group using a DS101 85G20 contact scanner (Renishaw, Gavá, Spain) and 2 experimental groups using optical scanners: Cerec Omnicam (Sirona, Bensheim, Germany) and Trios 3 (3Shape, Copenhagen, Denmark). 3 parameters were measured on the implants: dis-tance between the axial axes, height difference and angulation difference. Two experienced op-erators scanned 10 times using each of the 2 scanners. The STL files were compared using the "Best-Fit" technique and the data was then extrapolated and processed statistically. Results The scan bodies PRMG (SB3) and TALL (SB4) lead to smaller errors in distance, projected height and angulation than ELOS (SB1) and MG (SB2). Conclusions Despite the results obtained in PRMG (SB3) and TALL (SB4), the scanning errors may still be too large to achieve a good fit in large rehabilitations over implants. Any marginal discrepancy may lead to the failure of the rehabilitation or the implant due to the associated biomechanical problems. Key words:IOS, CAD/CAM, SCAN Bodies.
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Affiliation(s)
- Carlos Alvarez
- DDS, PhD Student, Department of Prosthodontics, College of Dentistry, University of Seville, Seville, Spain
| | - Pablo Domínguez
- DDS, PhD. Clinical Associate Professor, Department of Prosthodontics, College of Dentistry, University of Seville, Seville, Spain
| | - Emilio Jiménez-Castellanos
- DDS, PhD. Professor and Head, Department of Prosthodontics, College of Dentistry, University of Seville, Seville, Spain
| | - Gema Arroyo
- DDS, PhD. Clinical Associate Professor, Department of Prosthodontics, College of Dentistry, University of Seville, Seville, Spain
| | - Ana Orozco
- DDS, PhD. Clinical Associate Professor, Department of Prosthodontics, College of Dentistry, University of Seville, Seville, Spain
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24
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Digital versus radiographic accuracy evaluation of guided implant surgery: an in vitro study. BMC Oral Health 2022; 22:540. [DOI: 10.1186/s12903-022-02585-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022] Open
Abstract
Abstract
Background
Cone-beam computed tomography (CBCT) is the most widely used method for postsurgical evaluation of the accuracy of guided implant surgery. However, the disadvantages of CBCT include radiation exposure, artifacts caused by metal implants, and high cost. Few studies have introduced a digital registration method to replace CBCT for evaluating the accuracy of guided surgery. The purpose of this study was to compare digital registration to conventional CBCT in terms of the capacity to evaluate the implant positioning accuracy of guided surgery.
Materials and methods
This in vitro study included 40 acrylic resin models with posterior single mandibular tooth loss. Guided surgery software was used to determine the optimal implant position; 40 tooth-supported fully guided drilling templates were designed and milled accordingly. After the guided surgery, the accuracies of the surgical templates were evaluated by conventional CBCT and digital registration. For evaluation by conventional CBCT, postsurgical CBCT scans of the resin models were performed. The CBCT data were reconstructed and superimposed on the implant planning data. For digital registration, we constructed a virtual registration unit that consisted of an implant replica and a scan body. Next, we obtained postsurgical optical scans of resin models with the scan body. The postsurgical implant position was identified by superimposition of the registration unit and optical scan data. The implant planning data and postsurgical implant position data were superimposed; deviations were reported in terms of distance for implant entry/apex point and in terms of angle for the implant axis. Interclass correlation coefficients (ICCs) and Bland–Altman plots were used to analyze the agreement between the two evaluation methods.
Results
The ICCs between the two methods were 0.986, 0.993, and 0.968 for the entry point, apex point, and angle, respectively; all were significantly greater than 0.75 (p < 0.001). Bland–Altman plots showed that the 95% limits of agreement of the differences were − 0.144 to + 0.081 mm, − 0.135 to + 0.147 mm, and − 0.451° to + 0.729° for the entry point, apex point, and angle, respectively; all values were within the maximum tolerated difference.
Conclusion
Conventional CBCT and digital registration showed good agreement in terms of evaluating the accuracy of implant positioning using tooth-supported surgical templates.
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Abstract
Although the accuracy of direct digitization of oral structure has been improved, indirect digitization is still required in specific situations such as full-arch scanning. Once accurate images are imported, efficient designing can be achieved by CAD software. Although smile design using a 3-dimensional facial scan better predicts planned restorations, further improvement in virtual articulators is needed for complex cases. Computer-aided manufacturing can be offered in several formats such as chairside, laboratory, or centralized fabrications. The subtractive technique is mainly used for restorations, and many chairside CAM materials are available now, but the additive technique has the potential to save materials and an advantage in fabricating complex geometries. Limited evidence is available in applying CAD/CAM technologies in implant restorations. However, it is used to fabricate custom implant abutments and crowns from various materials such as titanium, zirconia, and PEEK and hybrid crowns using stock titanium base abutments.
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Affiliation(s)
- Hidehiko Watanabe
- Restorative Dentistry, Oregon Health & Science University, School of Dentistry, 2730 S Moody Avenue, Portland, OR 97201-5042, USA.
| | - Christopher Fellows
- Restorative Dentistry, Oregon Health & Science University, School of Dentistry, 2730 S Moody Avenue, Portland, OR 97201-5042, USA
| | - Hongseok An
- Restorative Dentistry, Oregon Health & Science University, School of Dentistry, 2730 S Moody Avenue, Portland, OR 97201-5042, USA
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26
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Conejo J, Han S, Atria PJ, Stone-Hirsh L, Dubin J, Blatz MB. Full digital workflow to resolve angled adjacent dental implants: A dental technique. J Prosthet Dent 2022:S0022-3913(22)00496-6. [PMID: 36114017 DOI: 10.1016/j.prosdent.2022.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022]
Abstract
The digital acquisition, fabrication process, and delivery of computer-aided design and computer-aided manufacture (CAD-CAM) implant-supported restorations on angled adjacent implants are described. The proximal surface of a scan post was modified for correct adaptation, permitting an accurate digital scan of adjacent implants in 1 step. Definitive screw-retained splinted implant-supported restorations were designed and milled in a zirconia material and delivered with a combined extraoral and intraoral cementation protocol.
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Affiliation(s)
- Julian Conejo
- Assistant Professor, Clinical Restorative Dentistry, and Director, Chairside CAD/CAM Dentistry, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa.
| | - Sean Han
- Chief Executive Officer of Maters' Arch, Phoenix, Ariz
| | - Pablo J Atria
- Assistant Professor, College of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Leslie Stone-Hirsh
- Clinical Associate Professor, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | - Jay Dubin
- Clinical Associate, Department of Preventive and Restorative Dentistry, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
| | - Markus B Blatz
- Professor of Restorative Dentistry and Chairman, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa; Assistant Dean, Digital Innovation and Professional Development, Department of Preventive and Restorative Sciences, University of Pennsylvania School of Dental Medicine, Philadelphia, Pa
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27
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Costa V, Silva AS, Costa R, Barreiros P, Mendes J, Mendes JM. In Vitro Comparison of Three Intraoral Scanners for Implant-Supported Dental Prostheses. Dent J (Basel) 2022; 10:dj10060112. [PMID: 35735654 PMCID: PMC9221835 DOI: 10.3390/dj10060112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 12/10/2022] Open
Abstract
With continuing technological developments, there have been advances in the field of fixed prosthetics, particularly in impression-taking techniques. These technological advances mean that a wide variety of diagnostic and/or rehabilitation possibilities can be explored without the need for physical models. The aim of this study was to evaluate the accuracy of three intraoral scanners used in oral implant rehabilitation using an extraoral scanner as a reference and varying the scanning area. Three models representing different clinical scenarios were scanned 15 times by each intraoral scanner and three times by the extraoral scanner. The readings were analyzed and overlaid using engineering software (Geomagic® Control X software (Artec Europe, Luxembourg)). Statistically significant differences in accuracy were found between the three intraoral scanners, iTero® (Align Technology Inc., San Jose, CA, USA), Medit® (Medit®: Seoul, Korea), and Planmeca® (Planmeca®: Helsinki, Finland). In all clinical scenarios, the iTero® scanner had the best trueness (24.4 μm), followed by the Medit® (26.4 μm) and Planmeca® (42.1 μm). The Medit® showed the best precision (18.00 μm) followed by the iTero® (19.20 μm) and Planmeca® (34.30 μm). We concluded that the iTero® scanner had the highest reproducibility and accuracy in the clinical setting.
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Affiliation(s)
- Vitória Costa
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (V.C.); (R.C.)
| | - António Sérgio Silva
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (P.B.); (J.M.); (J.M.M.)
- Correspondence:
| | - Rosana Costa
- Department of Dental Sciences, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (V.C.); (R.C.)
| | - Pedro Barreiros
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (P.B.); (J.M.); (J.M.M.)
| | - Joana Mendes
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (P.B.); (J.M.); (J.M.M.)
| | - José Manuel Mendes
- UNIPRO—Oral Pathology and Rehabilitation Research Unit, University Institute of Health Sciences (IUCS), CESPU, 4585-116 Gandra, Portugal; (P.B.); (J.M.); (J.M.M.)
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28
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Cakmak G, Marques VR, Donmez MB, Lu WE, Abou-Ayash S, Yilmaz B. Comparison of measured deviations in digital implant scans depending on software and operato. J Dent 2022; 122:104154. [DOI: 10.1016/j.jdent.2022.104154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/29/2022] [Accepted: 05/04/2022] [Indexed: 11/26/2022] Open
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Wada M, Mameno T, Tsujioka Y, Yamashita M, Ikebe K. Effective utilization of digital technology in complete denture fabrication. J Oral Sci 2022; 64:172-174. [PMID: 35236812 DOI: 10.2334/josnusd.21-0381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Although digital technology is commonly used in various forms of dental treatment, its application to fabrication of removable dentures is still associated with limitations or challenges, such as the recording of occlusal vertical dimensions and determination of the occlusal plane. Here, a simple and inexpensive technique for fabrication of removable complete dentures, partly aided by digital technology, is proposed.
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Affiliation(s)
- Masahiro Wada
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
| | - Tomoaki Mameno
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
| | - Yoshitaka Tsujioka
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
| | | | - Kazunori Ikebe
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry
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30
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Shuturminskiy VH, Labunets VA, Kirichek AV. Influence of direct prostheses on the condition of the alveolar processes during dental implantation. Saudi Dent J 2022; 34:51-55. [PMID: 35079213 PMCID: PMC8767284 DOI: 10.1016/j.sdentj.2021.10.002] [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: 08/02/2021] [Revised: 09/27/2021] [Accepted: 10/06/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The purpose of this article is to study of the processes accompanying osseointegration of the dental implants using various plate prostheses as temporary constructions, as well as to compare the dynamics of changes in the state of the jaw alveolar processes. MATERIALS AND METHODS The effect of dentures on the condition of the alveolar processes was studied in all patients according to the technique developed by L. Chulak on the 7th, 14th, 30th day and in 3, 6 months. To verify the results, the degree of atrophy of the alveolar processes was also determined by the second method the authors have chosen at the same time as indicated above. RESULTS The measurement results confirm linear changes in the height of the alveolar processes of the jaws with a decrease in the tissues of the prosthetic area. Throughout the duration of the examination, atrophy of the tissues of the alveolar processes is observed. Judging by the results obtained during the patients' study, it can be concluded that when applied as a temporary prosthesis with a dental delayed implantation of a partial denture made of polypropylene, the results of the state of the hard tissues of the mandible alveolar process show a better adaptation of the mucous membrane and slowing of atrophy of the jaw alveolar processes with this type of prosthetics.
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Affiliation(s)
| | - Vasil A. Labunets
- Department of Orthopedic Dentistry, Institute of Dentistry and Maxillofacial Surgery of National Academy of Medical Sciences of Ukraine, Odesa, Ukraine
| | - Aleksej V. Kirichek
- Odessa Medical Institute, International Humanitarian University, Odesa, Ukraine
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31
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Gómez-Polo M, Revilla-León M, Limones Á, Cascos R, Gómez-Polo C, Ortega R. Intraoral Digital Scans for Fabricating Tooth-Supported Prostheses Using a Custom Intraoral Scan Body. J Prosthodont 2021; 31:356-361. [PMID: 34894032 DOI: 10.1111/jopr.13468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 11/30/2022] Open
Abstract
This article describes a technique to assist with intraoral digital scans for fabricating tooth-supported prostheses by using a custom intraoral scan body when the extension of the scan or the clinical characteristics might compromise the reliability of the intraoral digital scan. A preliminary intraoral scan of the tooth preparations is used to design a custom intraoral scan body which is manufactured using polymethylmethacrylate and a 5-axis milling machine. A low-viscosity polyvinyl siloxane impression of the tooth preparations is obtained using the custom intraoral scan body. Subsequently, the custom intraoral scan body is digitized using an intraoral scanner. A design software program is used to align the digitized custom intraoral scan body with the preliminary intraoral scan to obtain the definitive virtual cast. This technique aims to reduce manual conventional laboratory procedures such as pouring dental impression or die trimming which might minimize inaccuracies on the virtual definitive cast.
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Affiliation(s)
- Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Marta Revilla-León
- Restorative Dentistry Department, School of Dentistry, University of Washington, Seattle, WA.,Research and Digital Dentistry, Kois Center, Seattle, WA.,Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, MA
| | - Álvaro Limones
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Rocío Cascos
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Cristina Gómez-Polo
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Rocío Ortega
- Department of Prosthetic Dentistry, School of Dentistry, European University of Madrid, Madrid, Spain
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32
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Çakmak G, Yilmaz H, Treviño Santos A, Kökat AM, Yilmaz B. Effect of Scanner Type and Scan Body Location on the Accuracy of Mandibular Complete-Arch Digital Implant Scans: An In Vitro Study. J Prosthodont 2021; 31:419-426. [PMID: 34453466 PMCID: PMC9290536 DOI: 10.1111/jopr.13418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/24/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose To compare the accuracy (trueness and precision) of scans of a newly introduced intraoral scanner (IOS) (Virtuo Vivo) and a widely used IOS (Trios 3) to a laboratory scanner (LBS) (Cares 7 SERIES) for 6 implants placed in an edentulous mandible, and to investigate the effect of scan body location on trueness. Material and methods Scanbodies were tightened on 6 implants placed in an edentulous polymethylmethacrylate mandibular model. An industrial scanner was utilized to generate a master reference model STL file. Three different scanners were used to scan the model (2 IOSs and 1 LBS), and the scans (n = 10) were exported into STL files. Best‐fitting algorithm was used to superimpose test scans over the MRM‐STL (nominal). ANOVA and Tukey HSD tests were performed to analyze the data (α = 0.05). Results The distance deviations in Car7‐LBS scans were the highest (p < 0.001), whereas those in Tri‐IOS scans were the lowest (p < 0.001). Vir‐IOS had lower angular deviations than those of Tri‐IOS (p = 0.031). In Vir‐IOS scans, SB5 had higher distance deviations than SB2 (p = 0.029) and SB3 (p = 0.044). In Car7‐LBS scans, SB1 had higher distance deviations than SB3 (p = 0.015) and SB5 (p = 0.005). In Tri‐IOS scans, SB1 had higher mean distance deviations than SB2 and SB5 (p = 0.005). Vir‐IOS had lower precision than Car7‐LBS (distance deviation data) (p = 0.01). No difference was found among scanners for the precision of angular deviation data (p = 0.840). Conclusion When trueness and precision were considered, distance and angular deviations depended on the scanner type. None of the scanners outperformed others in accuracy considering all distance and angular deviations. Scan body location affected only the trueness (distance deviations).
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Affiliation(s)
- Gülce Çakmak
- Buser Foundation Scholar for Implant Dentistry, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Hakan Yilmaz
- Department of Orthodontics, Yeditepe University, Faculty of Dentistry, Istanbul, Turkey
| | - Alejandro Treviño Santos
- Postdoctoral and Research Division, Faculty of Dentistry, National Autonomous University of Mexico, Mexico City, Mexico
| | - Ali Murat Kökat
- Department of Prosthodontics, Istanbul Okan University, Faculty of Dentistry, Istanbul, Turkey
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, OH
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