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Unkovskiy A, Spintzyk S, Kiemle T, Roehler A, Huettig F. Trueness and precision of skin surface reproduction in digital workflows for facial prosthesis fabrication. J Prosthet Dent 2023; 130:402-413. [PMID: 35256182 DOI: 10.1016/j.prosdent.2021.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM How much skin surface details of facial prostheses can be transferred throughout the digital production chain has not been quantified. PURPOSE The purpose of this in vitro study was to quantify the amount of skin surface details transferred from the prosthesis virtual design through the prototype printing with various additive manufacturing (AM) methods to the definitive silicone prosthesis with an indirect mold-making approach. MATERIAL AND METHODS Twelve test blocks with embossed wrinkles of 0.05 to 0.8 mm and 12 test blocks with applied earlobe skin structures were printed with stereolithography (SLA), direct light processing (DLP), and PolyJet methods (n=4). DLP and SLA prototype specimens were duplicated in wax. All specimens were then transferred into medical-grade silicone. Rz values of the wrinkle test blocks and the root mean square error (RMSE) of the earlobe test blocks were evaluated by laser topography to determine the trueness and precision of each stage. RESULTS For the earlobe test blocks, the PolyJet method had superior trueness and precision of the final skin surface reproduction. The SLA method showed the poorest trueness, and the DLP method, the lowest precision. For the wrinkle test blocks, the PolyJet method had the best wrinkle profile reproduction level, followed by DLP and SLA. CONCLUSIONS The indirect mold-making approach of facial prostheses manufacturing may be associated with 7% of skin surface profile loss with SLA, up to 20% with DLP, and no detail loss with PolyJet.
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Affiliation(s)
- Alexey Unkovskiy
- Research Associate, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Sebastian Spintzyk
- Research Associate, Section "Medical Materials and Science", Tuebingen University Hospital, Tuebingen, Germany
| | - Tobias Kiemle
- Research Associate, Department of Geosciences, University of Tuebingen, Tuebingen, Germany
| | - Ariadne Roehler
- Research Associate, Section "Medical Materials and Science", Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Acting Deputy Head, Priv.-Doz, Department of Prosthodontics, Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
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Borchers C, Eder TF, Richter J, Keutel C, Huettig F, Scheiter K. A time slice analysis of dentistry students' visual search strategies and pupil dilation during diagnosing radiographs. PLoS One 2023; 18:e0283376. [PMID: 37289785 PMCID: PMC10249848 DOI: 10.1371/journal.pone.0283376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 03/08/2023] [Indexed: 06/10/2023] Open
Abstract
Diagnosing orthopantomograms (OPTs: panoramic radiographs) is an essential skill dentistry students acquire during university training. While prior research described experts' visual search behavior in radiology as global-to-focal for chest radiographs and mammography, generalizability to a hybrid search task in OPTs (i.e., searching for multiple, diverse anomalies) remains unclear. Addressing this gap, this study investigated visual search of N = 107 dentistry students while they were diagnosing anomalies in OPTs. Following a global-to-focal expert model, we hypothesized that students would use many, short fixations representing global search in earlier stages, and few, long fixations representing focal search in later stages. Furthermore, pupil dilation and mean fixation duration served as cognitive load measures. We hypothesized that later stages would be characterized by elaboration and a reflective search strategy, leading to higher cognitive load being associated with higher diagnostic performance in late compared to earlier stages. In line with the first hypothesis, students' visual search comprised of a three-stage process that grew increasingly focal in terms of the number of fixations and anomalies fixated. Contrary to the second hypothesis, mean fixation duration during anomaly fixations was positively associated with diagnostic performance across all stages. As OPTs greatly varied in how difficult it was to identify the anomalies contained therein, OPTs with above-average difficulty were sampled for exploratory analysis. Pupil dilation predicted diagnostic performance for difficult OPTs, possibly capturing elaborative cognitive processes and cognitive load compared to mean fixation duration. A visual analysis of fine-grained time slices indicated large cognitive load differences towards the end of trials, showcasing a richness-resolution-trade-off in data sampling crucial for future studies using time-slicing of eye tracking data.
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Affiliation(s)
| | | | | | - Constanze Keutel
- Department of Oral- and Maxillofacial Radiology, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery at the University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery at the University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Katharina Scheiter
- Eberhard Karls University of Tübingen, Tübingen, Germany
- Leibniz-Institut für Wissensmedien, Tübingen, Germany
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Unkovskiy A, Spintzyk S, Beuer F, Huettig F, Röhler A, Kraemer-Fernandez P. Accuracy of capturing nasal, orbital, and auricular defects with extra- and intraoral optical scanners and smartphone: An in vitro study. J Dent 2021; 117:103916. [PMID: 34875273 DOI: 10.1016/j.jdent.2021.103916] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 11/29/2021] [Accepted: 12/02/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES This in vitro study compares the scanning accuracy of various stationary and portable as well as extra- and intraoral devices for capturing oncological defects. METHODS A 3D-printed model of a nasal, orbital, and auricular defect, as well as one of an intact auricle, were digitalized (n = 7 per device) with a stationary optical scanner (Pritiface), a portable extraoral optical scanner (Artec Space Spider), two intraoral scanners (Trios 4 and Primescan), and a smartphone (iPhone 11 Pro). For the reference data, the defect models were digitalized using a laboratory scanner (D2000). For quantitative analysis, the root mean square error value for trueness and precision and mean deviations in millimeters were obtained for each defect type. The data were statistically analyzed using two-way ANOVA and Tukey multiple comparison test. For qualitative analysis, a colorimetric map was generated to display the deviation within the defect area and adjacent tissue. RESULTS Statistically significant interactions were found in the trueness and precision for defect and scanner type. CONCLUSION The Primescan and Artec Space Spider scanners showed the highest accuracy for most defect types. Primescan and Trios 4 failed to capture the orbital defect. The iPhone 11 Pro showed clinically acceptable trueness but inferior precision. CLINICAL SIGNIFICANCE The scanning devices may demonstrate varying accuracy, depending on the defect type. A portable extraoral optical scanner is an universal tool for the digitization of oncological defects. Alternatively, an intraoral scanner may be employed in maxillofacial prosthetics with some restrictions. Utilizing a smartphone in maxillofacial rehabilitation should be considered with caution, because it provides inconsistent accuracy.
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Affiliation(s)
- Alexey Unkovskiy
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, 119146 Moscow, Russian Federation.
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany; ADMiRE Lab-Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, 9524 Villach
| | - Florian Beuer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, Tbingen 72076, Germany
| | - Ariadne Röhler
- Section Medical Materials Science and Technology, Tübingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Pablo Kraemer-Fernandez
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, Tbingen 72076, Germany
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Unkovskiy A, Huettig F, Kraemer-Fernandez P, Spintzyk S. Multi-Material 3D Printing of a Customized Sports Mouth Guard: Proof-of-Concept Clinical Case. Int J Environ Res Public Health 2021; 18:ijerph182312762. [PMID: 34886486 PMCID: PMC8657614 DOI: 10.3390/ijerph182312762] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/22/2021] [Accepted: 11/27/2021] [Indexed: 01/05/2023]
Abstract
A multilayer mouth guard is known to have the best protective performance. However, its manufacturing in a digital workflow may be challenging with regards to virtual design and materialization. The present case demonstrates a pathway to fabricate a multilayer individualized mouth guard in a fully digital workflow, which starts with intraoral scanning. A free-form CAD software was used for the virtual design. Two various CAM techniques were used, including Polyjet 3D printing of rubber-like soft material and silicone printing using Drop-on-Demand technique. For both methods the outer layer was manufactured from more rigid materials to facilitate its protective function; the inner layer was printed from a softer material to aid a better adaptation to mucosa and teeth. Both 3D printed multilayer mouth guards showed a clinically acceptable fit and were met with patient appraisal. Their protective capacities must be evaluated in further clinical studies.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, 14197 Berlin, Germany
- Department of Prosthodontics, Peoples’ Friendship University of Russia (RUDN University), 117198 Moscow, Russia
- Correspondence:
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, 72076 Tuebingen, Germany; (F.H.); (P.K.-F.)
| | - Pablo Kraemer-Fernandez
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, 72076 Tuebingen, Germany; (F.H.); (P.K.-F.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, 72076 Tuebingen, Germany;
- ADMiRE Lab—Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, 9800 Villach, Austria
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Spintzyk S, Brinkmeier S, Huettig F, Unkovskiy A. Bonding strength of 3D printed silicone and titanium retention magnets for maxillofacial prosthetics application. J Prosthodont Res 2021; 66:422-430. [PMID: 34545007 DOI: 10.2186/jpr.jpr_d_21_00019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To assess the bonding between conventional and additively manufactured silicone elastomers and cylindrical retention titanium magnets for anchorage of facial prostheses. METHODS The customized titanium retention magnets were embedded in conventional and additively produced silicone blocks without primer application (n = 20) and with two commercially available primers G611 (n = 20) and A304 (n = 20) applied onto the magnet surface. The pull out test was performed in the universal testing machine using 45° and 90° angulation and the pull out strength was measured for each group. Additionally the SEM images of the pulled out magnets' surface were obtained and the amount of residual silicone onto the magnet surface was quantified. RESULTS Significantly higher pull out strength values (p < 0.05) were revealed for 90° specimens (0.11 - 0.17 ± 0.01 N/mm2) compared to the 45° group (0.03 ± 0.02 N/mm2). The pull out test with primer revealed no significant differences between the G 611 and A 304 primers in the additive group. However, significantly (p < 0,05) higher values were observed for conventional specimens in the A304 group (1.10 ± 0.21 N/mm2) compared to the G611 group (0.59 ± 0.27 N/mm2). CONCLUSION The application of both used primers may be an acceptable technical option for the anchorage of retention titanium magnets in silicone facial prostheses, produced additively in a fully digital workflow.
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Affiliation(s)
- Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
| | - Sophia Brinkmeier
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriartric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt - Universität zu Berlin, Berlin, Germany.,Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia
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Eder TF, Richter J, Scheiter K, Keutel C, Castner N, Kasneci E, Huettig F. Correction to: How to support dental students in reading radiographs: effects of a gaze‑based compare‑and‑contrast intervention. Adv Health Sci Educ Theory Pract 2021; 26:1185-1186. [PMID: 34184147 PMCID: PMC8338840 DOI: 10.1007/s10459-021-10058-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Thérése F Eder
- Leibniz-Institut für Wissensmedien, Schleichstraße 6, 72076, Tübingen, Germany.
| | - Juliane Richter
- Leibniz-Institut für Wissensmedien, Schleichstraße 6, 72076, Tübingen, Germany
| | - Katharina Scheiter
- Leibniz-Institut für Wissensmedien, Schleichstraße 6, 72076, Tübingen, Germany
- University of Tübingen, Tübingen, Germany
| | - Constanze Keutel
- Department of Oral‑ and Maxillofacial Radiology, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Nora Castner
- Perception Engineering, Department of Computer Science, University of Tübingen, Tübingen, Germany
| | - Enkelejda Kasneci
- Perception Engineering, Department of Computer Science, University of Tübingen, Tübingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
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Kuscu E, Klink A, Spintzyk S, Kraemer Fernandez P, Huettig F. Bonding Interface and Repairability of 3D-Printed Intraoral Splints: Shear Bond Strength to Current Polymers, with and without Ageing. Materials (Basel) 2021; 14:ma14143935. [PMID: 34300854 PMCID: PMC8307865 DOI: 10.3390/ma14143935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/12/2022]
Abstract
This in-vitro study investigates the bonding interfaces reached by the conditioning of a splint material additively manufactured by digital light processing (AM base) as well as the shear bond strength (SBS) of resins bonded to these surfaces (repair material). Therefore, the AM base was either stored in dry for 12 h or wet environment for 14 days to simulate ageing by intraoral wear. The dry and wet group was bonded after physical and/or chemical conditioning to cylinders made from polymethylmethacrylate or four novel polymers allowing splint modifications. Blasted and methylmethacrylate (MMA)-conditioned Polymethylmethacrylate (PMMA) bonded to PMMA acted as the gold standard. The surface profiles revealed highest differences of Ra towards the gold standard in AM base conditioned with other than MMA after sandblasting. The adhesively bonded repair materials of the wet AM base were further aged in wet environment for 14 days. The SBS of the gold standard (25.2 MPa and 25.6 MPa) was only reached by PMMA bonded to blasted and MMA-conditioned AM base after dry (22.7 MPa) and non-conditioned after wet storage (23 MPa). Four repair materials failed to reach the threshold of 5 MPa after dry storage and three after wet storage, respectively. Non-conditioned AM base revealed the highest risk for adhesive fractures when using other resins than PMMA.
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Affiliation(s)
- Ebru Kuscu
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
- Correspondence:
| | - Andrea Klink
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany;
| | - Pablo Kraemer Fernandez
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
| | - Fabian Huettig
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
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Eder TF, Richter J, Scheiter K, Huettig F, Keutel C. Comparing radiographs with signaling improves anomaly detection of dental students: An eye‐tracking study. Appl Cognit Psychol 2021. [DOI: 10.1002/acp.3819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Thésése F. Eder
- non‐university research institute Leibniz‐Institut für Wissensmedien Tübingen Germany
| | - Juliane Richter
- non‐university research institute Leibniz‐Institut für Wissensmedien Tübingen Germany
| | - Katharina Scheiter
- non‐university research institute Leibniz‐Institut für Wissensmedien Tübingen Germany
- University of Tübingen Tübingen Germany
| | - Fabian Huettig
- Department of Prosthodontics, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tübingen University of Tübingen Tübingen Germany
| | - Constanze Keutel
- Department of Oral‐ and Maxillofacial Radiology, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tübingen University of Tübingen Tübingen Germany
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Eder TF, Richter J, Scheiter K, Keutel C, Castner N, Kasneci E, Huettig F. How to support dental students in reading radiographs: effects of a gaze-based compare-and-contrast intervention. Adv Health Sci Educ Theory Pract 2021; 26:159-181. [PMID: 32488458 PMCID: PMC8238744 DOI: 10.1007/s10459-020-09975-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 05/20/2020] [Indexed: 06/10/2023]
Abstract
In dental medicine, interpreting radiographs (i.e., orthopantomograms, OPTs) is an error-prone process, even in experts. Effective intervention methods are therefore needed to support students in improving their image reading skills for OPTs. To this end, we developed a compare-and-contrast intervention, which aimed at supporting students in achieving full coverage when visually inspecting OPTs and, consequently, obtaining a better diagnostic performance. The comparison entailed a static eye movement visualization (heat map) on an OPT showing full gaze coverage from a peer-model (other student) and another heat map showing a student's own gaze behavior. The intervention group (N = 38) compared five such heat map combinations, whereas the control group (N = 23) diagnosed five OPTs. Prior to the experimental variation (pre-test) and after it (post-test), students in both conditions searched for anomalies in OPTs while their gaze was recorded. Results showed that students in the intervention group covered more areas of the OPTs and looked less often and for a shorter amount of time at anomalies after the intervention. Furthermore, they fixated on low-prevalence anomalies earlier and high-prevalence anomalies later during the inspection. However, the students in the intervention group did not show any meaningful improvement in detection rate and made more false positive errors compared to the control group. Thus, the intervention guided visual attention but did not improve diagnostic performance substantially. Exploratory analyses indicated that further interventions should teach knowledge about anomalies rather than focusing on full coverage of radiographs.
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Affiliation(s)
- Thérése F Eder
- Leibniz-Institut für Wissensmedien, Schleichstraße 6, 72076, Tübingen, Germany.
| | - Juliane Richter
- Leibniz-Institut für Wissensmedien, Schleichstraße 6, 72076, Tübingen, Germany
| | - Katharina Scheiter
- Leibniz-Institut für Wissensmedien, Schleichstraße 6, 72076, Tübingen, Germany
- University of Tübingen, Tübingen, Germany
| | - Constanze Keutel
- Department of Oral- and Maxillofacial Radiology, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
| | - Nora Castner
- Perception Engineering, Department of Computer Science, University of Tübingen, Tübingen, Germany
| | - Enkelejda Kasneci
- Perception Engineering, Department of Computer Science, University of Tübingen, Tübingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tübingen, University of Tübingen, Tübingen, Germany
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Richter J, Scheiter K, Eder TF, Huettig F, Keutel C. How massed practice improves visual expertise in reading panoramic radiographs in dental students: An eye tracking study. PLoS One 2020; 15:e0243060. [PMID: 33270704 PMCID: PMC7714201 DOI: 10.1371/journal.pone.0243060] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 11/15/2020] [Indexed: 02/06/2023] Open
Abstract
The interpretation of medical images is an error-prone process that may yield severe consequences for patients. In dental medicine panoramic radiography (OPT) is a frequently used diagnostic procedure. OPTs typically contain multiple, diverse anomalies within one image making the diagnostic process very demanding, rendering students’ development of visual expertise a complex task. Radiograph interpretation is typically taught through massed practice; however, it is not known how effective this approach is nor how it changes students’ visual inspection of radiographs. Therefore, this study investigated how massed practice–an instructional method that entails massed learning of one type of material–affects processing of OPTs and the development of diagnostic performance. From 2017 to 2018, 47 dental students in their first clinical semester diagnosed 10 OPTs before and after their regular massed practice training, which is embedded in their curriculum. The OPTs contained between 3 to 26 to-be-identified anomalies. During massed practice they diagnosed 100 dental radiographs without receiving corrective feedback. The authors recorded students’ eye movements and assessed the number of correctly identified and falsely marked low- and high prevalence anomalies before and after massed practice. Massed practice had a positive effect on detecting anomalies especially with low prevalence (p < .001). After massed practice students covered a larger proportion of the OPTs (p < .001), which was positively related to the detection of low-prevalence anomalies (p = .04). Students also focused longer, more frequently, and earlier on low-prevalence anomalies after massed practice (ps < .001). While massed practice improved visual expertise in dental students with limited prior knowledge, there is still substantial room for improvement. The results suggest integrating massed practice with more deliberate practice, where, for example, corrective feedback is provided, and support is adapted to students’ needs.
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Affiliation(s)
- Juliane Richter
- Leibniz-Institut für Wissensmedien, Tübingen, Germany
- * E-mail:
| | - Katharina Scheiter
- Leibniz-Institut für Wissensmedien, Tübingen, Germany
- Eberhard Karls University of Tübingen, Tübingen, Germany
| | | | - Fabian Huettig
- Department of Prosthodontics, University Hospital for Dentistry, Oral Medicine, and Maxillofacial Surgery at the University Hospital Tübingen, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Constanze Keutel
- Radiology Department of the University Hospital for Dentistry, Oral Medicine, and Maxillofacial Surgery at the University Hospital Tübingen, Eberhard Karls University of Tübingen, Tübingen, Germany
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Almadani AM, Huettig F. Rehabilitation of a maxillary partial edentulous patient using an implant-supported overdenture retained with two bilateral milled bars. BMJ Case Rep 2020; 13:13/8/e235530. [PMID: 32843416 DOI: 10.1136/bcr-2020-235530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The use of implants has enabled more treatment options for prosthetic rehabilitation of partially and completely edentulous patients. This clinical report describes a treatment approach for an 80-year-old patient taking advantage of the remaining natural teeth for prosthetic rehabilitation. The final treatment plan included natural tooth-supported and implant-supported crowns combined with a milled bar partial overdenture retained by tilted dental implants. The overdentures supported by the milled bar implants provide the advantages of both fixed and removable restorations. In addition to patient satisfaction, the overdentures also minimise alveolar bone resorption, increase longevity and stability and improve masticatory efficiency.
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Affiliation(s)
- Atif Mohammed Almadani
- Department of Prosthodontics, University Clinic for Dentistry, Oral Medicine, and Maxillofacial Surgery, Tuebingen, Germany .,Ministry of Health, Jeddah, Saudi Arabia
| | - Fabian Huettig
- Department of Prosthodontics, University Clinic for Dentistry, Oral Medicine, and Maxillofacial Surgery, Tuebingen, Germany
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Unkovskiy A, Wahl E, Huettig F, Keutel C, Spintzyk S. Multimaterial 3D printing of a definitive silicone auricular prosthesis: An improved technique. J Prosthet Dent 2020; 125:946-950. [PMID: 32680736 DOI: 10.1016/j.prosdent.2020.02.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/19/2020] [Accepted: 02/19/2020] [Indexed: 12/01/2022]
Abstract
Direct silicone printing has been reported for the manufacture of interim facial prostheses. The recent advancements in printing hardware have allowed for multimaterial simultaneous silicone printing with 4 nozzles. With this technology, an auricular prosthesis was printed with various grades of Shore hardness. A few analog steps, including polishing, sealing, coloring, and relining, resulted in an individualized prosthesis with a thin frontal margin and smooth transition into the adjacent tissue. It was considered a definitive treatment option.
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Affiliation(s)
- Alexey Unkovskiy
- Research Associate, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Eugen Wahl
- Dental Technician, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Acting Deputy Head, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | - Constanze Keutel
- Assistant Medical Director and Head of Radiology Department at the Centre of Dentistry, Department of Oral and Maxillofacial Surgery, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tübingen, Germany
| | - Sebastian Spintzyk
- Material Science Engineer, Medical Materials Science and Technology, Tuebingen University Hospital, Tuebingen, Germany
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Schweitzer F, Spintzyk S, Geis-Gerstorfer J, Huettig F. Influence of minimal extended firing on dimensional, optical, and mechanical properties of crystalized zirconia-reinforced lithium silicate glass ceramic. J Mech Behav Biomed Mater 2020; 104:103644. [DOI: 10.1016/j.jmbbm.2020.103644] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 01/14/2020] [Accepted: 01/15/2020] [Indexed: 11/29/2022]
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Unkovskiy A, Wahl E, Zander AT, Huettig F, Spintzyk S. Intraoral scanning to fabricate complete dentures with functional borders: a proof-of-concept case report. BMC Oral Health 2019; 19:46. [PMID: 30866892 PMCID: PMC6417141 DOI: 10.1186/s12903-019-0733-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 02/25/2019] [Indexed: 11/24/2022] Open
Abstract
Background The utilization of intraoral scanning for manufacturing of complete dentures (CD) has been reported recently. However, functional border molding still cannot be supported digitally. A proof-of-concept trial shows two possible pathways to overcome this limitation by integrating a relining procedure into the digital workflow for CD manufacturing. Case presentation Intraoral scans and additional facial scans were performed with two various scanning systems for the rehabilitation of an edentulous male patient. The obtained raw data was aligned and used for the computer aided design (CAD) of the CD. The virtually constructed dentures were materialized in two various ways, considering rapid manufacturing and digital relining approaches in order to apply functionally molded borders. Conclusion The use of intraoral edentulous jaws scans in combination with the digital relining procedure may allow for fabrication of CD with functional borders within a fully digital workflow.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany. .,Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, 119146, Moscow, Russia.
| | - Eugen Wahl
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - Anne Teresa Zander
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tuebingen, Germany
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15
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Unkovskiy A, Roehler A, Huettig F, Geis-Gerstorfer J, Brom J, Keutel C, Spintzyk S. Simplifying the digital workflow of facial prostheses manufacturing using a three-dimensional (3D) database: setup, development, and aspects of virtual data validation for reproduction. J Prosthodont Res 2019; 63:313-320. [PMID: 30792148 DOI: 10.1016/j.jpor.2019.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 01/08/2019] [Accepted: 01/17/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To set up the digital database (DDB) of various anatomical parts, skin details and retention elements in order to simplify the digital workflow of facial prostheses manufacturing; and to quantify the reproduction of skin wrinkles on the prostheses prototypes with stereolithography (SLA) and direct light processing (DLP) methods. METHODS Two structured light scanners were used to obtain the nasal and auricle forms of 50 probands. Furthermore, the ala nasi and scapha areas were captured with the digital single lens reflex camera and saved in jpeg format. The four magnetic retention elements were remodeled in computer aided design (CAD) software. The 14 test blocks with embossed wrinkles of 0.05-0.8mm were printed with SLA and DLP methods and afterwards analyzed by means of profilometry and confocal microscopy. RESULTS The introduced DDB allows for production of customized facial prosthesis and makes it possible to consider the integration of concrete retention elements on the CAD stage, which makes the prosthesis modelling more predictable and efficient. The obtained skin structures can be applied onto the prosthesis surface for customization. The reproduction of wrinkles from 0.1 to 0.8mm in depth may be associated with the loss of 4.5%-11% of its profile with SLA or DLP respectively. Besides, the reproduction of 0.05mm wrinkles may be met with up to 40% profile increasement. CONCLUSIONS The utilization of DDB may simplify the digital workflow of facial prostheses manufacturing. The transfer of digitally applied skin wrinkles till the prostheses' prototypes may be associated with deviations from 11 to 40%.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Moscow, Russia.
| | - Ariadne Roehler
- Section Medical Materials and Science, Tuebingen University Hospital, Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tuebingen, Germany
| | | | | | - Constanze Keutel
- Department of Oral and Maxillofacial Surgery, and Head of Radiology Department at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Tübingen, Germany
| | - Sebastian Spintzyk
- Section Medical Materials and Science, Tuebingen University Hospital, Tuebingen, Germany
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Unkovskiy A, Bui PHB, Schille C, Geis-Gerstorfer J, Huettig F, Spintzyk S. Objects build orientation, positioning, and curing influence dimensional accuracy and flexural properties of stereolithographically printed resin. Dent Mater 2018; 34:e324-e333. [PMID: 30293688 DOI: 10.1016/j.dental.2018.09.011] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the influence of printing parameters on flexural properties and accuracy of SLA-printed standard objects. METHODS Thirty specimens were printed in 0°, 45° and 90° orientation. Fourth nine more specimens were printed evenly on the build platform. forty more specimens were printed and polymerized with three curing unit. Length, height and width was measured three times for each specimen and compared to the original dimensions. Afterwards all specimens underwent a three-point-bending test to assess their flexural properties. One way ANOVA and the Post-Hoc all pairs Tukey-Kramer HSD test were used for data evaluation. RESULTS The print orientation influences the printing accuracy. The parameters printed along the Z-axis are particularly prone to inaccuracies. Specimens with 45° orientation were found to be the most accurate. Object printed on the borders of build platform a rather prone to inaccuracies than those in the center. The 90° specimens with layer orientation parallel to the axial load showed the superior flexural strength and flexural modulus. The use of different curing unit is unlikely to affect the objects printing accuracy and flexural properties. SIGNIFICANCE The anisotropical behavior of printed specimens with regards to build orientation and positioning was revealed. The understanding of how the adjustable printing parameter influence the printing outcome is important for a precise fabrication of surgical guides. Inaccuracies up to 10% along the Z-axis, as revealed in the present study,may restrict an accurate implant placement.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tubingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, 8-2 Trubetskaya st., 119991 Moscow, Russia.
| | - Phan Hai-Binh Bui
- Section "Medical Materials, Science and Technology" Tuebingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Christine Schille
- Section "Medical Materials, Science and Technology" Tuebingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Juergen Geis-Gerstorfer
- Section "Medical Materials, Science and Technology" Tuebingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tubingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
| | - Sebastian Spintzyk
- Section "Medical Materials, Science and Technology" Tuebingen University Hospital, Osianderstr. 2-8, 72076 Tuebingen, Germany
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Huettig F, Chekhani U, Klink A, Said F, Rupp F. A modified shark-fin test simulating the single-step/double-mix technique: A comparison of three groups of elastomers. Dent Mater J 2018; 37:414-421. [PMID: 29491198 DOI: 10.4012/dmj.2017-013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The shark-fin test was modified to convey the clinical application of a single-step/double-mix technique assessing the behavior of two viscosities applied at one point in time. A medium and light body polyether (PE), a medium and light body polyvinylsiloxane (PVS), and a medium as well as heavy and light body vinyl polyether silicone (PVXE) impression material were analyzed solely, and in a layered mixture of 1:1 and 3:1 at working times of 50, 80, and 120 s. The fin heights were measured with a digital ruler. The wettability was measured 50 and 80 s after mixing by drop shape analysis. The results showed a synergistic effect of the medium and light body PE. This was not observed in PVXE and PVS. Interestingly, PVXE showed an antagonistic flow behavior in 3:1 mixture with medium body. PVXE was more hydrophilic than PE and PVS. Future rheological studies should clarify the detected flow effects.
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Affiliation(s)
- Fabian Huettig
- Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tuebingen
| | - Usama Chekhani
- Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tuebingen
| | - Andrea Klink
- Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tuebingen
| | - Fadi Said
- Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, University Hospital Tuebingen
| | - Frank Rupp
- Section Medical Materials Science and Technology, University Hospital Tuebingen
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Unkovskiy A, Spintzyk S, Brom J, Huettig F, Keutel C. Direct 3D printing of silicone facial prostheses: A preliminary experience in digital workflow. J Prosthet Dent 2018; 120:303-308. [PMID: 29429837 DOI: 10.1016/j.prosdent.2017.11.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 11/06/2017] [Accepted: 11/06/2017] [Indexed: 11/29/2022]
Abstract
Direct silicone printing may be applied to the fabrication of maxillofacial prostheses, although its clinical feasibility is unknown. The present clinical report shows an early application of a directly printed silicone prosthesis for the rehabilitation of a nasal defect. Two extraoral scanning systems were used to capture the face and the defect. The virtual construction of the nasal prosthesis was performed with free-form software. Two prostheses were printed in silicone and post-processed by manual sealing and coloring. The clinical outcome was acceptable for an interim prosthesis; however, the marginal adaptation and color match were not satisfactory without further individualization.
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Affiliation(s)
- Alexey Unkovskiy
- Dentist, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany.
| | - Sebastian Spintzyk
- Material Science Engineer, Section of Medical Materials and Science, Tübingen University Hospital, Tübingen, Germany
| | - Joern Brom
- Anaplastologist, Brom Epithetik, Heidelberg, Germany
| | - Fabian Huettig
- Assistant Medical Director, Department of Prosthodontics at the Centre of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany
| | - Constanze Keutel
- Senior Associate, Department of Oral and Maxillofacial Surgery, and Head of Radiology Department at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tübingen University Hospital, Tübingen, Germany
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19
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Klink A, Groten M, Huettig F. Complete rehabilitation of compromised full dentitions with adhesively bonded all-ceramic single-tooth restorations: Long-term outcome in patients with and without amelogenesis imperfecta. J Dent 2017; 70:51-58. [PMID: 29275170 DOI: 10.1016/j.jdent.2017.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 12/17/2017] [Accepted: 12/20/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES This clinical follow-up evaluated the long-term outcome of full-mouth rehabilitations with adhesively bonded all-ceramic restorations in patients suffering from amelogenesis imperfecta (AI) or affected by extensive tooth wear including a loss of the vertical dimension of occlusion. MATERIALS AND METHODS Included for evaluation were all patients treated with adhesively bonded monolithic single-tooth restorations made of silicate or lithium disilicate ceramics; allowing a maximum four missing teeth and a facial feldspathic veneering of LDS anterior crowns. After treatment, patients have been enrolled in a recall program for dental check-ups including quality assessment of the restorations. Patients answered the oral health impact profile (OHIP-14) at their last visit. RESULTS Seventeen patients (mean age = 35 ± 18 years) were observed up to 16.5 years (mean: 6.2 ± 3.8 years). 12 out of 450 restorations failed due to core fracture (n = 7), tooth fracture (n = 2), one secondary caries, one chip-off grade 3, and one fixed dental prosthesis due to discomfort. The overall mean survival rate of the single-tooth restorations was estimated 99.4% at 5 and 91.4% at 10 years. The overall mean success rate was estimated 92.6% at 5 and 81.4% at 10 years, mainly due to chip-offs and crack formation (27 out of 31 relative failures). The mean annual failure rates (AFR) range between 1.5 and 2% over the years, but non-AI patients were affected more frequently by early technical complications in the facial veneering of anteriors, resulting in an AFR ranging between 5.2 and 4%. Quality assessment revealed stable color, form and marginal integrity in all patients up to ten years. The distribution of OHIP values is comparable to the representative sample of healthy patients. CONCLUSION Adhesively bonded single-tooth restorations provided a high clinical quality in the long-run. However, while the survival and success were excellent in AI patients, restorations in non-AI patients were affected by a higher complication rate, likely related to a higher risk profile due to a history of bruxism and tooth wear.
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Affiliation(s)
- Andrea Klink
- Department of Prosthodontics, Center for Dentistry, Oral Medicine, and Maxillofacial Surgery, Tuebingen University Hospital, Tübingen, Germany
| | - Martin Groten
- Department of Prosthodontics, Center for Dentistry, Oral Medicine, and Maxillofacial Surgery, Tuebingen University Hospital, Tübingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics, Center for Dentistry, Oral Medicine, and Maxillofacial Surgery, Tuebingen University Hospital, Tübingen, Germany.
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Unkovskiy A, Brom J, Huettig F, Keutel C. Auricular Prostheses Produced by Means of Conventional and Digital Workflows: A Clinical Report on Esthetic Outcomes. INT J PROSTHODONT 2017; 31:63–66. [PMID: 29145528 DOI: 10.11607/ijp.5446] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The utilization of additive manufacturing (AM) technology for the production of auricular prostheses has been widely acknowledged. However, few studies and case history reports have evaluated the esthetic outcomes of AM prostheses compared to those of conventionally manufactured prostheses. In this case history report, three manufacturing approaches-conventional, indirect, and direct mold preparation-were assessed for their esthetic outcomes in the same patient.
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Unkovskiy A, Spintzyk S, Axmann D, Engel EM, Weber H, Huettig F. Additive Manufacturing: A Comparative Analysis of Dimensional Accuracy and Skin Texture Reproduction of Auricular Prostheses Replicas. J Prosthodont 2017; 28:e460-e468. [PMID: 29125215 DOI: 10.1111/jopr.12681] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2017] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The use of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing in maxillofacial prosthetics has been widely acknowledged. Rapid prototyping can be considered for manufacturing of auricular prostheses. Therefore, so-called prostheses replicas can be fabricated by digital means. The objective of this study was to identify a superior additive manufacturing method to fabricate auricular prosthesis replicas (APRs) within a digital workflow. MATERIALS AND METHODS Auricles of 23 healthy subjects (mean age of 37.8 years) were measured in vivo with respect to an anthropometrical protocol. Landmarks were volumized with fiducial balls for 3D scanning using a handheld structured light scanner. The 3D CAD dataset was postprocessed, and the same anthropometrical measurements were made in the CAD software with the digital lineal. Each CAD dataset was materialized using fused deposition modeling (FDM), selective laser sintering (SLS), and stereolithography (SL), constituting 53 APR samples. All distances between the landmarks were measured on the APRs. After the determination of the measurement error within the five data groups (in vivo, CAD, FDM, SLS, and SL), the mean values were compared using matched pairs method. To this, the in vivo and CAD dataset were set as references. Finally, the surface structure of the APRs was qualitatively evaluated with stereomicroscopy and profilometry to ascertain the level of skin detail reproduction. RESULTS The anthropometrical approach showed drawbacks in measuring the protrusion of the ear's helix. The measurement error within all groups of measurements was calculated between 0.20 and 0.28 mm, implying a high reproducibility. The lowest mean differences of 53 produced APRs were found in FDM (0.43%) followed by SLS (0.54%) and SL (0.59%)--compared to in vivo, and again in FDM (0.20%) followed by SL (0.36%) and SLS (0.39%)--compared to CAD. None of these values exceed the threshold of clinical relevance (1.5%); however, the qualitative evaluation revealed slight shortcomings in skin reproduction for all methods: reproduction of skin details exceeding 0.192 mm in depth was feasible. CONCLUSION FDM showed the superior dimensional accuracy and best skin surface reproduction. Moreover, digital acquisition and CAD postprocessing seem to play a more important role in the outcome than the additive manufacturing method used.
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Affiliation(s)
- Alexey Unkovskiy
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Sebastian Spintzyk
- Medical Material Science and Technology, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Detlef Axmann
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Eva-Maria Engel
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Heiner Weber
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
| | - Fabian Huettig
- Department of Prosthodontics, Tüebingen University Hospital, Tübingen, Baden-Württemberg, Germany
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Kruck S, Hennenlotter J, Amend B, Geiger M, Filipova E, Neumann T, Stühler V, Schubert T, Todenhöfer T, Rausch S, Huettig F, Stenzl A, Bedke J. Chronic Periodontitis Does Not Impact Serum Levels of Prostate-specific Antigen. Anticancer Res 2017; 37:3163-3167. [PMID: 28551659 DOI: 10.21873/anticanres.11675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 05/11/2017] [Accepted: 05/15/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Chronic periodontitis (CP) has already been associated with altered PSA values in men undergoing biopsy. This study addressed the impact of CP treatment on PSA screening. PATIENTS AND METHODS Fifty-two asymptomatic men presenting for CP treatment were prospectively enrolled. Total (t)PSA, free (f)PSA and %PSA were determined (n=47) before and after therapy. Pre- and post-therapy values were correlated pairwise regarding patients and dental characteristics. RESULTS Median age was 54 years (SD=±7.7 years) and mean tPSA was 1.3 ng/ml (±1.9 ng/ml). tPSA and fPSA correlated linearly and positively with age (p<0.002). After stratification by age, tPSA/fPSA remained significantly lower in smokers (p<0.05). No other patient or dental factor was associated with tPSA, fPSA, %PSA. CP therapy had no effect on PSA reduction and did not affect indication for biopsy. CONCLUSION The potential influence of CP on PSA testing seems to be excludable in asymptomatic men.
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Affiliation(s)
- Stephan Kruck
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Jörg Hennenlotter
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Bastian Amend
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Maya Geiger
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Elitsa Filipova
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Tim Neumann
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Viktoria Stühler
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Tina Schubert
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Tilman Todenhöfer
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Steffen Rausch
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Fabian Huettig
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany.,Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Eberhard-Karls-University, Tuebingen, Germany
| | - Arnulf Stenzl
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
| | - Jens Bedke
- Department of Urology, Eberhard-Karls-University, Tuebingen, Germany
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Sippli K, Rieger MA, Huettig F. GPs' and dentists' experiences and expectations of interprofessional collaboration: findings from a qualitative study in Germany. BMC Health Serv Res 2017; 17:179. [PMID: 28270205 PMCID: PMC5341464 DOI: 10.1186/s12913-017-2116-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/24/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Against the background of well-described associations between oral and general health, collaboration between dentists and general practitioners (GP) is crucial to provide therapeutic and preventive patient care. However, in the German health system, GPs and dentists are organizationally separated, implying that interprofessional collaboration can only occur informally and on a voluntary basis. Given the scarce evidence of interprofessional collaboration between dentists and GPs, an explorative study was conducted. This paper outlines the findings of this study with regard to GPs' and dentists' experiences and expectations of interprofessional collaboration. METHODS Semi-structured interviews were conducted with GPs (n = 15) and dentists (n = 13) from three structurally different regions in Baden-Wurttemberg, Germany. The interview guide included questions on occasions, expectations and experiences of interprofessional collaboration. The interviews were transcribed verbatim and analysed using qualitative content analysis according to Mayring. RESULTS Both GPs and dentists reported perceived knowledge deficits of the other profession with regard to medication, particularly anticoagulants and bisphosphonates, as well as systemic and general respectively dental diseases. Expectations regarding the scope of collaboration diverge: whereas dentists were interested in extending collaboration, most GPs saw no need for collaboration. CONCLUSIONS The perceived medical knowledge deficits of the other profession as well as divergent expectations concerning the scope of collaboration hinder profound and regular interprofessional collaboration between GPs and dentists. These perceived knowledge deficits may be rooted in the separate education of dentists and GPs in Germany. Fostering interprofessional education is a promising way to improve cooperation between GPs and dentists in the long term.
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Affiliation(s)
- Khira Sippli
- Department of Prosthodontics, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery at the University Hospital Tuebingen, Eberhard-Karls-University Tuebingen, Osianderstr. 2-8, D-72076 Tübingen, Germany
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tuebingen, Wilhelmstr. 27, D-72074 Tübingen, Germany
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tuebingen, Wilhelmstr. 27, D-72074 Tübingen, Germany
- CoreFacility/Coordinating Center Health Services Research, Faculty of Medicine, Eberhard Karls University Tuebingen, Wilhelmstr. 27, D-72074 Tübingen, Germany
| | - Fabian Huettig
- Department of Prosthodontics, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery at the University Hospital Tuebingen, Eberhard-Karls-University Tuebingen, Osianderstr. 2-8, D-72076 Tübingen, Germany
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Knops E, Kobbe G, Kaiser R, Luebke N, Dunay G, Fischer J, Huettig F, Wensing A, Haas R, Nijhuis M, Martinez-Picado J, Haeussinger D, Jensen B. Treatment of HIV and acute myeloid leukemia by allogeneic CCR5-d32 blood stem cell transplantation. J Clin Virol 2016. [DOI: 10.1016/j.jcv.2016.08.171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Huettig F, Gehrke UP. Early complications and performance of 327 heat-pressed lithium disilicate crowns up to five years. J Adv Prosthodont 2016; 8:194-200. [PMID: 27350853 PMCID: PMC4919489 DOI: 10.4047/jap.2016.8.3.194] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 02/03/2016] [Accepted: 04/26/2016] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The prospective follow-up aimed to assess the performance of lithium disilicate crowns and clinical reasons of adverse events compromising survival and quality. MATERIALS AND METHODS 58 patients were treated with 375 heat-pressed monolithic crowns, which were bonded with resin cement. Annual recalls up to five years included a complete dental examination as well as quality assessment using CDA-criteria. Any need for clinical intervention led to higher complication rate and any failure compromised the survival rate. Kaplan-Meier-method was applied to all crowns and a dataset containing one randomly selected crown from each patient. RESULTS Due to drop-outs, 45 patients (31 females, 14 males) with the average age of 43 years (range = 17-73) who had 327 crowns (176 anterior, 151 posterior; 203 upper jaw, 124 lower jaw) were observed and evaluated for between 4 and 51 months (median = 28). Observation revealed 4 chippings, 3 losses of retention, 3 fractures, 3 secondary caries, 1 endodontic problem, and 1 tooth fracture. Four crowns had to be removed. Survival and complication rate was estimated 98.2% and 5.4% at 24 months, and 96.8% and 7.1% at 48 months. The complication rate was significantly higher for root canal treated teeth (12%, P<.01) at 24 months. At the last observation, over 90% of all crowns showed excellent ratings (CDA-rating Alfa) for color, marginal fit, and caries. CONCLUSION Heat pressed lithium disilicate crowns showed an excellent performance. Besides a careful luting, dentists should be aware of patients' biological prerequisites (grade of caries, oral hygiene) to reach full success with these crowns.
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Affiliation(s)
- Fabian Huettig
- Department of Prosthodontics, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
| | - Ulf Peter Gehrke
- Department of Prosthodontics, Centre for Dentistry, Oral Medicine, and Maxillofacial Surgery, Eberhard-Karls-Universität Tübingen, Tübingen, Germany
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Huettig F, Said FM, Sippli K, Preiser C, Rieger MA. [What do General Practitioners and Dentists Report about their Cooperation? A Qualitative Exploration]. Gesundheitswesen 2016; 80:262-265. [PMID: 27280680 DOI: 10.1055/s-0042-108645] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Against the background of well-described associations between oral and general health, the cooperation between general practitioners (GPs) and dentists is crucial. Besides treatment, this includes prevention. Administrative referral between these two professions is not provided by statute. Thus, the study addresses the question: How do dentists and GPs integrate the associations between oral and systemic health in daily routine? METHODS A total of 28 semi-structured interviews were conducted with GPs and dentists from 3 structurally different regions in the Federal State of Baden-Wurttemberg. Participants were visited in their office. The interviews were recorded, transcribed and analysed by 2 dentists and sociologists using Mayrings' qualitative content analysis. RESULTS Associations between general and oral health are partially known to both practitioners. However, contact between them is limited. GPs send patients directly to dentists, without contacting them - mainly due to a desolate dental status, rarely due to therapy-resistant headache or facial pain. Dentists contact GPs to clarify mainly medication or anticoagulation medications taken by patients prior to invasive procedures. Preventive aspects play a minor part. Consultation essentially depends on acquaintanceship. CONCLUSION Separation by statute determines the cooperation. Oral cavity in daily care is demarcated. Holistic patient care is hindered by a lack of knowledge and daily routines.
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Affiliation(s)
- F Huettig
- Poliklinik für Zahnärztliche Prothetik, Universitätsklinikum Tübingen, Tübingen
| | - F M Said
- Poliklinik für Zahnärztliche Prothetik, Universitätsklinikum Tübingen, Tübingen
| | - K Sippli
- Poliklinik für Zahnärztliche Prothetik, Universitätsklinikum Tübingen, Tübingen
| | - C Preiser
- Institut für Arbeitsmedizin, Sozialmedizin und Versorgungsforschung, Universitätsklinikum Tübingen, Tübingen
| | - M A Rieger
- Institut für Arbeitsmedizin, Sozialmedizin und Versorgungsforschung, Universitätsklinikum Tübingen, Tübingen
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Huettig F, Behrend F. Clinical Teaching of Prosthodontics in Undergraduate Courses in a German Dental School: Patients, Visits, Efforts, and Incentives. J Dent Educ 2016; 80:40-50. [PMID: 26729683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
It is unknown what disadvantages are faced by patients deciding for a prosthodontic treatment by inexperienced students. Commonly, the related extra effort and time are compensated by cost reduction of treatment fees. Thereby, the dental schools subsidize treatments to teach clinical prosthodontics. The aim of this study was to clarify the benefits to patients as well as the efforts of the dental school. Data collected from three courses in a dental school in Germany were patient gender, age, occupation, zip code, number of visits, scope of treatment including costs, financial discount, and remaining copayment. Travel costs were calculated based on zip code. Balance of travel costs and treatment discount was defined as financial benefit. The results showed that 185 patients (95 male) aged 32 to 82 years (median=58) were treated with fixed restorations (FR, n=110), telescopic dentures (TD, n=87), complete dentures (CD, n=17), or other (RD, n=3). The mean number of visits was 11 for FR, 12 for TD, and 9 for CD. Single distance to the clinic ranged from 0.6 to 65 miles (median=12). Total costs of prosthodontics were reduced by 19% on average. The mean financial benefit was 429 USD (median=298, min=-482, max=4025). The financial benefits were found to differ widely, including additional expenditures of patients. Participation, travel burden, and copayment did not depend on age, gender, or occupation. The financial benefit was relativized because students needed at least twice the sessions of a dentist. As a result, the financial efforts of dental schools are significant and compromise a cost-covering education.
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Affiliation(s)
- Fabian Huettig
- Dr. Huettig is Assistant Medical Director, Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Tübingen, Germany; Mr. Behrend is a doctoral candidate, Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Tübingen, Germany.
| | - Florian Behrend
- Dr. Huettig is Assistant Medical Director, Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Tübingen, Germany; Mr. Behrend is a doctoral candidate, Department of Prosthodontics, Center of Dentistry, Oral Medicine, and Maxillofacial Surgery, Tübingen, Germany
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Affiliation(s)
- Fabian Huettig
- Department of Prosthodontics; Center of Dentistry; Oral Medicine, and Maxillofacial Surgery; Tübingen Germany
| | - Florian Behrend
- Department of Prosthodontics; Center of Dentistry; Oral Medicine, and Maxillofacial Surgery; Tübingen Germany
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Klink A, Huettig F. The challenge of erosion and minimally invasive rehabilitation of dentitions with BEWE grade 4. Quintessence Int 2016; 47:365-372. [PMID: 26665261 DOI: 10.3290/j.qi.a35262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Dental erosion is a challenging problem. In addition to dental erosion's dental effects, general health also has to be taken into account. In particular, consumption of newly marketed beverages as well as psychosomatic and gastroesophageal disorders contribute to decayed dentitions. Without a comprehensive method for implementing preventive concepts in daily practice, many young adults will require large-scale, long-term treatment in the near future. Thus, dentists should be aware of preventative methods, prerequisites for rehabilitation, and treatment concepts available for such cases. Clinical Considerations: Patients with severe dental erosions are often young adults who suffer from hypersensitivity and loss of vertical dimension and occlusal structure. Modern ceramics enable a minimally invasive, esthetic, and rugged approach for achieving a complete rehabilitation. In particular, monolithic restorations using lithium disilicate or zirconia-reinforced lithium silicate seem to be promising treatment strategies. In addition to the dentist, the dental technician needs to be educated and experienced with complex occlusal and functional rehabilitation. Currently, clinical longterm experiences have only been reported for adhesively bonded silicate and lithium disilicate restorations. CONCLUSION Heat-pressed and adhesively bonded monolithic lithium disilicate restoration fulfills all needs of complex treatment and long-term rehabilitation in young adults with dental erosion. Even if minimal tooth preparation is needed, in healthy teeth, adhesively bonded restorations require minimal thickness of the ceramic layer to obtain function, durability, and esthetics for this type of patient.
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Huettig F, Prutscher A, Goldammer C, Kreutzer CA, Weber H. First clinical experiences with CAD/CAM-fabricated PMMA-based fixed dental prostheses as long-term temporaries. Clin Oral Investig 2015; 20:161-8. [PMID: 25898895 DOI: 10.1007/s00784-015-1475-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 04/09/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The clinical performance of polymethylmethacrylate (PMMA)-based fixed dental prostheses (FDP) was evaluated in the indication of long-term temporaries. MATERIALS AND METHODS In the current indication of the applied machinable PMMA-based material (Vita CAD-Temp), i.e. temporary crowns and FDPs, 27 patients with compromised dentitions (uncertain dental prognosis or postponement of a removable treatment option) were recruited and 45 FDPs (3 or 4 units, 37 terminal-retained, 8 cantilevered) were inserted. Frameworks were computer-aided design (CAD)/computer-aided manufacturing (CAM)-manufactured after conventional impression taking and labside scanning of stone master casts. A resin-modified hybrid cement material (RelyX Unicem) was used for luting in a conventional protocol. Clinical follow-up was performed biannually. RESULTS Over an observation time from 2 to 26 months (median 13 months), 11 complications were found in 9 out of 45 PMMA restorations: 4 losses of retention, 5 complete fractures; two of these subsequent to a trepanation for endodontic treatment. Thereby, 3 out of 8 cantilevered FDPs had to be removed within 8 months. Thus, the statistical evaluation included FDPs with abutment at end, only. These standard design FDPs (n = 37) showed a 90.4 % survival rate with a complication-free rate of 88.3 % estimated for an observation time of 16 months. CONCLUSION Cantilevered FDPs and reconstructions on abutment teeth with markedly reduced biological prognosis or endodontic intervention yielded a high-failure rate. Terminal-retained FDPs performed clinically well in cases without compromised abutment teeth. CLINICAL RELEVANCE PMMA-based material might be used successfully for long-term temporization with 3- to 4-unit FDPs in a standard design over at least one year.
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Affiliation(s)
- Fabian Huettig
- Department of Prosthodontics with Section "Medical Materials and Technology" at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tübingen, Germany.
| | - Andreas Prutscher
- Department of Prosthodontics with Section "Medical Materials and Technology" at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Christoph Goldammer
- Department of Prosthodontics with Section "Medical Materials and Technology" at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Curt A Kreutzer
- Department of Prosthodontics with Section "Medical Materials and Technology" at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tübingen, Germany
| | - Heiner Weber
- Department of Prosthodontics with Section "Medical Materials and Technology" at the Centre of Dentistry, Oral Medicine and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2-8, 72076, Tübingen, Germany
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Huettig F, Axmann D. Reporting of dental status from full-arch radiographs: Descriptive analysis and methodological aspects. World J Clin Cases 2014; 2:552-564. [PMID: 25325067 PMCID: PMC4198409 DOI: 10.12998/wjcc.v2.i10.552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Revised: 07/11/2014] [Accepted: 08/31/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To identify standards, how entities of dental status are assessed and reported from full-arch radiographs of adults.
METHODS: A PubMed (Medline) search was performed in November 2011. Literature had to report at least one out of four defined entities using radiographs: number of teeth or implants; caries, fillings or restorations; root-canal fillings and apical health; alveolar bone level. Cohorts included to the study had to be of adult age. Methods of radiographic assessment were noted and checked for the later mode of report in text, tables or diagrams. For comparability, the encountered mode of report was operationalized to a logical expression.
RESULTS: Thirty-seven out of 199 articles were evaluated via full-text review. Only one article reported all four entities. Eight articles reported at the maximum 3 comparable entities. However, comparability is impeded because of the usage of absolute or relative frequency, mean or median values as well as grouping. Furthermore the methods of assessment were different or not described sufficiently. Consequently, established sum scores turned out to be highly questionable, too. The amount of missing data within all studies remained unclear. It is even so remissed to mention supernumerary and aplased teeth as well as the count of third molars.
CONCLUSION: Data about dental findings from radiographs is, if at all possible, only comparable with serious limitations. A standardization of both, assessing and reporting entities of dental status from radiographs is missing and has to be established within a report guideline.
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Abstract
A total of 163 monolithic restorations made from Vitablocs Mark II and luted adhesively or with resin cement were followed up for 3 to 70 months. Recall consisted of an evaluation of complete dental and hygiene status as well as quality assessment. Seven of 35 patients were lost to follow-up. Ninety-one percent of the 37 crowns, 23 partial crowns, and 89 inlays evaluated were in the posterior region. Combined survival estimate was 0.92 at the 48-month median observation time. Inlays and partial crowns performed well. Prevalence of complication and failure was highest for crowns (CP = 37.8%, FP = 21.6%). The results demonstrate that success relates to patient factors and restoration type, not luting protocol.
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Affiliation(s)
- Andrea Klink
- Department of Prosthodontics, Center of Dentistry, Oral Medicine and Maxillofacial Surgery, Tubingen, Germany
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