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Zaid W, Amin D, Carlson ER. Obturating the Maxillary Defect: Surgical and Prosthetic Considerations. Atlas Oral Maxillofac Surg Clin North Am 2024; 32:81-90. [PMID: 39059877 DOI: 10.1016/j.cxom.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Affiliation(s)
- Waleed Zaid
- Department of Oral and Maxillofacial Surgery, Louisiana State University, School of Dentistry, 7777 Hennessy Boulevard / Suite 306 Medical Plaza 1, Baton Rouge, LA 70808, USA
| | - Dina Amin
- Department of Oral and Maxillofacial Surgery, University of Rochester Schools of Medicine and Dentistry, 601 Elmwood Avenue, Suite 4.0241A, Rochester, NY 14642, USA
| | - Eric R Carlson
- Department of Oral and Maxillofacial Surgery, University of Tennessee Graduate School of Medicine, 1930 Alcoa Highway, Suite 335, Knoxville, TN 37920, USA.
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Yuan Z, Yuan J, Wang Z, Rong Q. Rehabilitation of Combined Hard and Soft Palate Defects with a Soft Relining Prosthesis: A Clinical Report. Cleft Palate Craniofac J 2024:10556656241272481. [PMID: 39105311 DOI: 10.1177/10556656241272481] [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: 08/07/2024] Open
Abstract
It remains a significant challenge in prosthetic rehabilitation for combined hard and soft palate defects on account of two primary reasons. At first, conventional impressions can hardly get an accurate analogue and usually bring about a terrible experience for the patients. Secondly, conventional hard denture base resins used in obturator prostheses exhibit limitations in marginal sealing, undercut retention, and elastic buffering when in contact with the soft palate. This article presents a case where combined hard and soft palate defects were successfully and rapidly reconstructed by using digital intraoral impression technology and denture soft reline material.
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Affiliation(s)
- Zhi Yuan
- Department of Stomatology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650032, China
| | - Jingman Yuan
- Department of Stomatology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650032, China
| | - Ziyuan Wang
- Department of Stomatology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650032, China
- Jinhe Dental Clinic, Chuxiong, Yunnan, 675000, China
| | - Qiong Rong
- Department of Stomatology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, Yunnan, 650032, China
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Srivastava G, Padhiary SK, Mohanty N, Patil PG, Panda S, Cobo-Vazquez C, Çakmak G, Molinero-Mourelle P. Digital workflow feasibility for the fabrication of intraoral maxillofacial prosthetics after surgical resection: a systematic literature review. Acta Odontol Scand 2024; 83:392-403. [PMID: 38895776 PMCID: PMC11302490 DOI: 10.2340/aos.v83.40870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES To evaluate the current evidence of digital workflow feasibility based on the data acquisition methods and the software tools used to fabricate intraoral prostheses for patients with partial or total maxillary and mandibular defects. MATERIALS AND METHODS An electronic search was performed in PubMed, SCOPUS, and Web of Science using a combination of relevant keywords: digital workflow, digital designing, computer-assisted design-computer aided manufacturing, 3D printing, maxillectomy, and mandibulectomy. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of evidence in the studies reviewed. RESULTS From a total of 542 references, 33 articles were selected, including 25 on maxillary prostheses and 8 on mandibular prostheses. The use of digital workflows was limited to one or two steps of the fabrication of the prostheses, and only four studies described a complete digital workflow. The most preferred method for data acquisition was intraoral scanning with or without a cone beam computed tomography combination. CONCLUSION Currently, the fabrication process of maxillofacial prostheses requires combining digital and conventional methods. Simplifying the data acquisition methods and providing user-friendly and affordable software may encourage clinicians to use the digital workflow more frequently for patients requiring maxillofacial prostheses.
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Affiliation(s)
- Gunjan Srivastava
- Department of Prosthodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India.
| | - Subrat Kumar Padhiary
- Department of Oral and Maxillofacial Surgery, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be Univesity, Bhubaneswar, India
| | - Neeta Mohanty
- Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Siksha 'O' Anusandhan Deemed to be University, Bhubaneswar, India
| | - Pravinkumar G Patil
- Department of Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
| | - Saurav Panda
- Department of Periodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan, University, Bhubaneswar, India
| | - Carlos Cobo-Vazquez
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Ali IE, Enomoto K, Sumita Y, Wakabayashi N. Combined digital-conventional workflow to fabricate a definitive obturator from an interim obturator for a patient with an anterior maxillectomy defect. J Prosthet Dent 2023:S0022-3913(23)00285-8. [PMID: 37277237 DOI: 10.1016/j.prosdent.2023.04.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 06/07/2023]
Abstract
An existing interim obturator can be reproduced as the definitive one using digital technology, with benefits for a patient with a maxillectomy. By digitally scanning the oral condition and the existing interim obturator, a definitive obturator, including a computer-aided designed and computer-aided manufactured metal framework, was fabricated and delivered to a patient with an anterior maxillectomy defect by following a combined digital and conventional workflow. This technique can hasten the adaptation of the patient to the new obturator and ensure a more comfortable and safer clinical procedure.
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Affiliation(s)
- Islam E Ali
- Doctoral student, Department of Advanced Prosthodontics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan; and Assistant Lecturer, Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Kouichi Enomoto
- Certified Dental Technician, Dental Laboratory, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuka Sumita
- Adjunct Lecturer, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Professor, Division of General Dentistry, The Nippon Dental University Hospital, Tokyo, Japan.
| | - Noriyuki Wakabayashi
- Professor, Department of Advanced Prosthodontics, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
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Jamayet NB, Farook TH, Al-Oulabi A, Johari Y, Patil PG. Digital workflow and virtual validation of a 3D-printed definitive hollow obturator for a large palatal defect. J Prosthet Dent 2021; 129:798-804. [PMID: 34635339 DOI: 10.1016/j.prosdent.2021.08.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/19/2022]
Abstract
This clinical report describes how a hollow obturator prosthesis was designed and fabricated for an 82-year-old partially edentulous patient with a large palatal defect. Computer-aided design (CAD) was used to design, articulate, and align the mandibular denture with the obturator prosthesis. The prosthesis was printed, adjusted chairside, rescanned, and made hollow by using a CAD software program. The prosthesis was printed in resin with a dental 3D printer. Quantitative evaluations of clinical (prosthesis dimensions, rest, and occlusal vertical dimensions) and virtual (surface area, volume, weight, interpoint mismatches, spatial overlap) parameters found that the 3D-printed prosthesis required an additional 5% chairside modification. The greatest differences in volume (24.7% less) and weight (22.2% less) were observed when the modified obturator bulb was made hollow via CAD. Hollowing the bulb, therefore, reduced the spatial overlap in volume by 16.8%.
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Affiliation(s)
- Nafij Bin Jamayet
- Senior Lecturer in Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.
| | - Taseef Hasan Farook
- Research Fellow, Maxillofacial Prosthetic Service, Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Ayman Al-Oulabi
- Clinical Fellow, Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Yanti Johari
- Senior Lecturer in Prosthodontics, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Pravinkumar G Patil
- Senior Lecturer in Prosthodontics, Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia
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AlRumaih HS. Clinical Applications of Intraoral Scanning in Removable Prosthodontics: A Literature Review. J Prosthodont 2021; 30:747-762. [PMID: 34043266 DOI: 10.1111/jopr.13395] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This review aimed to identify the reported intraoral scanning applications in fabricating different types of removable prostheses in the field of prosthodontics. METHODS A comprehensive electronic search was performed using the PubMed and MEDLINE databases. This review included in vitro studies and clinical reports published between January 2013 and March 2021. The main keywords were as follows: intraoral scanning, digital impression, computerized digital impression, removable prosthesis, chairside computer-aided design/computer-assisted manufacturing, digital complete denture, digital immediate complete denture, digital interim complete denture, digital removable partial denture, digital removable overdenture, digital obturator, digital occlusal splints, and digital maxillofacial prostheses. RESULTS In total, 33 papers (22 clinical reports, 8 papers focused on dental techniques, and 3 clinical studies) were included in the final analysis. CONCLUSIONS The efficiency of using intraoral scanning in the field of removable prosthodontics was documented. However, there is a need for more clinical studies to identify intraoral scanning-usage protocols and to yield reliable and valid data.
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Affiliation(s)
- Hamad S AlRumaih
- Substitutive Dental Science Department, College of Dentistry, Imam Abdulrahman Bin Fasial University, Dammam, Saudi Arabia
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Michelinakis G, Apostolakis D, Kamposiora P, Papavasiliou G, Özcan M. The direct digital workflow in fixed implant prosthodontics: a narrative review. BMC Oral Health 2021; 21:37. [PMID: 33478459 PMCID: PMC7819204 DOI: 10.1186/s12903-021-01398-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 01/13/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The purpose of this narrative review was to examine the applicability of IOS procedures regarding single and multiple fixed implant restorations. Clinical outcomes for monolithic zirconia and lithium disilicate restorations produced through a direct digital workflow were reported. METHODS A MEDLINE (Pubmed) search of the relevant English-language literature spanning from January 1st 2015 until March 31st 2020 was conducted. In vitro studies comparing digital implant impression accuracy by different IOS devices or in vitro studies examining differences in accuracy between digital and conventional impression procedures were included. Also, RCTs, clinical trials and case series on the success and/or survival of monolithic zirconia and lithium disilicate restorations on implants, manufactured completely digitally were included. In vitro and in vivo studies reporting on restorations produced through an indirect digital workflow, case reports and non-English language articles were excluded. The aim was to investigate the accuracy of IOS for single and multiple fixed implant restorations compared to the conventional impression methods and report on the variables that influence it. Finally, this study aimed to report on the survival and success of fixed implant-retained restorations fabricated using the direct digital workflow. RESULTS For the single and short-span implant sites, IOS accuracy was high and the deviations in the position of the virtual implant fell within the acceptable clinical limits. In the complete edentulous arch with multiple implants, no consensus regarding the superiority of the conventional, splinted, custom tray impression procedure compared to the IOS impression was identified. Moreover, complete-arch IOS impressions were more accurate than conventional, non-splinted, open or close tray impressions. Factors related to scanbody design as well as scanner generation, scanning range and interimplant distance were found to influence complete-arch scanning accuracy. Single implant-retained monolithic restorations exhibited high success and survival rates and minor complications for short to medium follow-up periods. CONCLUSIONS The vast majority of identified studies were in vitro and this limited their clinical significance. Nevertheless, intraoral scanning exhibited high accuracy both for single and multiple implant restorations. Available literature on single-implant monolithic restorations manufactured through a complete digital workflow shows promising results for a follow-up of 3-5 years.
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Affiliation(s)
| | | | - Phophi Kamposiora
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - George Papavasiliou
- Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Mutlu Özcan
- Division of Dental Biomaterials, Center for Dental and Oral Medicine, Clinic for Reconstructive Dentistry, University of Zürich, Zurich, Switzerland
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Digital Workflow in Maxillofacial Prosthodontics—An Update on Defect Data Acquisition, Editing and Design Using Open-Source and Commercial Available Software. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11030973] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore oral functions such as swallowing, speech and chewing, with the main goal being to improve the quality of life of the patients. The conventional procedures for maxillofacial prosthesis manufacturing involve several complex steps, are very traumatic for the patient and rely on the skills of the maxillofacial team. Computer-aided design and computer-aided manufacturing have opened a new approach to the fabrication of maxillofacial prostheses. Our review aimed to perform an update on the digital design of a maxillofacial prosthesis, emphasizing the available methods of data acquisition for the extraoral, intraoral and complex defects in the maxillofacial region and assessing the software used for data processing and part design. Methods: A search in the PubMed and Scopus databases was done using the predefined MeSH terms. Results: Partially and complete digital workflows were successfully applied for extraoral and intraoral prosthesis manufacturing. Conclusions: To date, the software and interface used to process and design maxillofacial prostheses are expensive, not typical for this purpose and accessible only to very skilled dental professionals or to computer-aided design (CAD) engineers. As the demand for a digital approach to maxillofacial rehabilitation increases, more support from the software designer or manufacturer will be necessary to create user-friendly and accessible modules similar to those used in dental laboratories.
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Moreno Soriano C, Castañeda Vega P, Estrugo Devesa A, Jané Salas E, López López J. Frequency and type of digital procedures used for the intraoral prosthetic rehabilitation of patients with head and neck cancer: A systematic review. J Prosthet Dent 2021; 127:811-815. [PMID: 33431172 DOI: 10.1016/j.prosdent.2020.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
STATEMENT OF PROBLEM In spite of a digital workflow playing an important role in the intraoral prosthetic rehabilitation of patients with head and neck cancer, information about how it has been implemented and its clinical implications is sparse. PURPOSE The purpose of this systematic review was to evaluate the use of a digital workflow in the intraoral prosthetic rehabilitation of patients with head and neck cancer by analyzing the frequency and type of the digital procedures used. MATERIAL AND METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The following terms were applied for the search conducted in the MEDLINE-PubMed, Cochrane, and SciELO databases: (prosthesis OR dental OR rehabilitation) AND (digital OR CAD-CAM OR intraoral scanner) AND (Cancer OR head neck). Articles that specified data on intraoral prosthetic treatment and analyzed the use of a digital workflow in the different prosthetic phases such as digital scanning and computer-aided design and computer-aided manufacturing (CAD-CAM) in patients with head and neck cancer were included. Data from the frequency and type of digital procedures were analyzed. RESULTS Thirteen articles were included, and all had incorporated CAD-CAM techniques in at least 1 of the prosthetic treatment stages (scanning, design, and/or fabrication). Only 1 patient was rehabilitated by using a completely digital workflow. The most frequent prosthetic treatment was an obturator (82.6%). Regarding the image capture method, the most used method was cone beam computed tomography (CBCT) (60.9%). CONCLUSIONS Most reports described the partial use of a digital workflow in the intraoral prosthetic rehabilitation of patients treated for head and neck cancer. A digital workflow is used for specific stages but not for the entire process. More studies are needed to evaluate digital systems, ideally comparing parameters with the conventional method, and to determine whether this technique has more relevant clinical implications.
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Affiliation(s)
- Carlos Moreno Soriano
- Professor of Master in Dentistry for Cancer and Immunocompromised Patients, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Paul Castañeda Vega
- Professor of Master in Dentistry for Cancer and Immunocompromised Patients, Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Albert Estrugo Devesa
- Professor of Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Researcher of Oral Health and Masticatory System Group, Institut d'Investigació Biomédica de Bellvitge (IDIBELL, Bellvitge Institute of Biomedical Research), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Enric Jané Salas
- Professor of Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Researcher of Oral Health and Masticatory System Group, Institut d'Investigació Biomédica de Bellvitge (IDIBELL, Bellvitge Institute of Biomedical Research), L'Hospitalet de Llobregat, Barcelona, Spain
| | - José López López
- Professor of Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Researcher of Oral Health and Masticatory System Group, Institut d'Investigació Biomédica de Bellvitge (IDIBELL, Bellvitge Institute of Biomedical Research), L'Hospitalet de Llobregat, Barcelona, Spain; Medical Manager and Head of the Medical-Surgical Area of Dentistry Hospital University of Barcelona, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
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Krämer Fernandez P, Kuscu E, Weise H, Engel EM, Spintzyk S. Rapid additive manufacturing of an obturator prosthesis with the use of an intraoral scanner: A dental technique. J Prosthet Dent 2020; 127:189-193. [PMID: 33276962 DOI: 10.1016/j.prosdent.2020.07.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/27/2022]
Abstract
A protocol for a completely digital manufacturing process for an obturator prosthesis is described. An intraoral scanner was used to capture the mandible and maxilla together with the sinus defect. The obturator base and the artificial teeth were created with a computer-aided design software program and manufactured by 3-dimensional printing. Stainless steel clasps provided the retention for the prosthesis.
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Affiliation(s)
- Pablo Krämer Fernandez
- Graduate student, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany.
| | - Ebru Kuscu
- Graduate student, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Hannes Weise
- Research Associate, Department of Oral and Maxillofacial Surgery, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tübingen, Germany
| | - Eva M Engel
- Head of the Department, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Sebastian Spintzyk
- Material Science Engineer, Section, Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
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Farook TH, Mousa MA, Jamayet NB. Method to control tongue position and open source image segmentation for cone-beam computed tomography of patients with large palatal defect to facilitate digital obturator design. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2020. [DOI: 10.1016/j.ajoms.2019.09.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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