1
|
Blasi A, Henarejos-Domingo V, Palacios-Bañuelos R, Vidal-Ponsoda C, Aparicio C, Roig M. CAD-CAM and analog occlusal splints comparison based on the amount of occlusal adjustments. 3D analysis of the volumetric changes: A pilot study. J ESTHET RESTOR DENT 2023; 35:1271-1278. [PMID: 37395327 DOI: 10.1111/jerd.13080] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To evaluate the volumetric changes on occlusal surface of computer-aided design and computer-aided manufacturing (CAD-CAM) occlusal devices fabricated following a fully digital workflow after occlusal adjustment, compared to those fabricated with an analog workflow. MATERIALS AND METHODS Eight participants were included in this clinical pilot study, receiving two different occlusal devices fabricated with two different workflows, fully analog and fully digital. Every occlusal device was scanned before and after the occlusal adjustments to compare the volumetric changes using a reverse engineering software program. Moreover, three independent evaluators assessed a semi-quantitative and qualitative comparison using visual analog scale and dichotomous evaluation. The Shapiro-Wilk test was performed to validate normal distribution assumption, and a dependent t-Student test for paired variables was used to determine statistically significant differences (p-value < 0.05). RESULTS The root mean square value was extracted from the 3-Dimensional (3D) analysis of the occlusal devices. The average values of the root mean square were higher for the analogic technique (0.23 ± 0.10 mm) than the digital technique (0.14 ± 0.07 mm) but the differences were not statistically significant (paired t-Student test; p = 0.106) between the two fabrication techniques. The semiquantitative visual analog scale values between the impression for the digital (5.08 ± 2.4 cm) and analog (3.80 ± 3.3 cm) technique were significant (p < 0.001), and statistically significant differences values were assessed for evaluator 3 compared to the other evaluators (p < 0.05). However, the three evaluators agreed on the qualitative dichotomous evaluation in 62% of the cases, and at least two evaluators agreed in 100% of the evaluations. CONCLUSIONS Occlusal devices fabricated following a fully digital workflow resulted in fewer occlusal adjustments, as they could be a valid alternative to those fabricated following an analog workflow. CLINICAL SIGNIFICANCE Fabricated occlusal devices following a fully digital workflow could have some advantages over analog workflow such reduce occlusal adjustments at delivery appointment, which can result in reduced chair time and therefore increased comfort for the patient and clinician.
Collapse
Affiliation(s)
- Alvaro Blasi
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
- Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Georgia
| | - Víctor Henarejos-Domingo
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
| | - Ricardo Palacios-Bañuelos
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
| | - Carla Vidal-Ponsoda
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
| | - Conrado Aparicio
- Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Miguel Roig
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
- Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| |
Collapse
|
2
|
Blasi Á, Henarejos-Domingo V, Palacios-Bañuelos R, Aparicio C, Roig M. Comparison accuracy of digital and analog method using milled occlusal splints. J ESTHET RESTOR DENT 2023; 35:1103-1112. [PMID: 36942721 DOI: 10.1111/jerd.13039] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVE This clinical trial aims to compare the accuracy of interocclusal registration in centric relation taken with polyvinyl siloxane and intraoral scanner (IOS) with the fabrication of occlusal devices. METHODS Thirty-one participants were included in the trial registered at ClinicalTrials.gov (NCT05317182) receiving two different occlusal devices from two different workflows. One workflow was performed using polyvinyl siloxane impression material and the other with IOS. Every splint was scanned before and after the occlusal adjustments to compare the volumetric changes using the Root Mean Square deviation (RMS). Furthermore, three evaluators assessed the 3D comparison using color maps in a Visual Analog Scale (VAS). RESULTS The average values of RMS were higher for the analog approach (0.01 ± 0.067) than the digital approach (0.065 ± 0.035). However, the differences were not statistically significant (p < 0.063) between the two impression techniques. For the semiquantitative analysis performed by blinded evaluators, differences in VAS values between the impression for the digital (2.08 ± 2.4) and analog (3.80 ± 3.3) technique were statistically significant. The three evaluators agreed in more than 90% of the qualitative dichotomous evaluation. CONCLUSION Digital impressions did not show inferior accuracy compared to conventional impressions when assessed using quantitative measurements. CLINICAL SIGNIFICANCE This clinical trial provided evidence on registering interocclusal relationship at increased vertical dimension with fully digital workflow for complete arch prosthesis.
Collapse
Affiliation(s)
- Álvaro Blasi
- Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Georgia, USA
- Department of Restorative Dentistry, Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Víctor Henarejos-Domingo
- Department of Restorative Dentistry, Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Ricardo Palacios-Bañuelos
- Department of Restorative Dentistry, Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Conrado Aparicio
- Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Miguel Roig
- Department of Restorative Dentistry, Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| |
Collapse
|
3
|
Espona J, Vidal-Ponsoda C, Quintana P, Henarejos-Domingo V, Roig M. A fully digital protocol to provide a fixed interim complete denture for immediate loading for a completely edentulous patient: A dental technique. J Prosthet Dent 2023; 130:171-178. [PMID: 34711405 DOI: 10.1016/j.prosdent.2021.09.011] [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: 07/26/2021] [Revised: 09/20/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
Complete arch immediate-loading implant-supported prostheses can represent a major challenge for the patient and the dental team. Obtaining stable references and an accurate occlusal record after implant placement to provide an interim prosthesis is a difficult task and can deviate from the initial treatment plan. The described technique presents a fully digital protocol to provide an immediate complete arch implant-supported fixed interim prosthesis for edentulous patients by making postoperative cone beam computed tomography and intraoral digital scans that correlate with the previous plan.
Collapse
Affiliation(s)
- José Espona
- Associate Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Carla Vidal-Ponsoda
- Resident, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Pau Quintana
- Assistant Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Víctor Henarejos-Domingo
- Private practice, Barcelona, Spain; Associate Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain.
| | - Miguel Roig
- Chairman and Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| |
Collapse
|
4
|
Henarejos-Domingo V, de la Nuez González A, Lóbez Valverde R, Blasi A. A cost-effective technique for fabricating a dentoform by using a complete digital workflow. J Prosthet Dent 2023; 129:373-375. [PMID: 34373112 DOI: 10.1016/j.prosdent.2021.06.046] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Víctor Henarejos-Domingo
- Associate Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain; Private practice, Barcelona, Spain.
| | - Andrés de la Nuez González
- Resident, Máster en estética y rehabilitación oral, Barcelona Denal Institute by Padrós-Universitat Politècnica de Catalunya, Barcelona, Spain; Private practice, Barcelona, Spain
| | | | - Alvaro Blasi
- Adjunct Assistant Professor, Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Ga; Private practice, Barcelona, Spain
| |
Collapse
|
5
|
Henarejos-Domingo V, Clavijo V, Blasi Á, Madeira S, Roig M. Digital scanning under rubber dam: An innovative method for making definitive impressions in fixed prosthodontics. J ESTHET RESTOR DENT 2021; 33:976-981. [PMID: 34008328 DOI: 10.1111/jerd.12787] [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: 02/20/2021] [Accepted: 05/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To provide a comprehensive protocol for final impressions making under rubber dam isolation by using an intraoral scanner. CLINICAL CONSIDERATION Impression making after tooth preparation with rubber dam isolation are impossible with conventional physical impressions, which are not with intraoral scanners. Digital technologies have disrupted dentistry in the last decades, bringing new, straightforward, and more time-efficient protocols for dental practice. CONCLUSIONS Taking in consideration the beneficial properties of scanning under rubber dam this protocol can be highly recommended for everyday use for making definitive intraoral scans for tooth-supported restorations. CLINICAL SIGNIFICANCE The described protocol offers the possibility to make a final impression in a stress-free environment, without blood or saliva, to obtain a better visualization and scanning of the finish line, and the potential of save time on definitive impression making.
Collapse
Affiliation(s)
- Víctor Henarejos-Domingo
- Private practice, Barcelona, Spain; and Assistant Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Victor Clavijo
- Private practice, Indaiatuba, Brazil; and Visiting Professor, Advanced Program in Operative and Adhesive Dentistry, Division of Restorative Sciences, Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Álvaro Blasi
- Private practice, Barcelona, Spain; and Adjunct Assistant Professor, Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Sara Madeira
- Private practice, Barcelona, Spain; and Assistant Professor, Department of Integrated Dentistry Department, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Miguel Roig
- Private practice, Barcelona, Spain; and Chairman and Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| |
Collapse
|
6
|
Blasi A, Henarejos-Domingo V, Madeira S, Blasi G, Roig M. Stone verification device for verifying the definitive cast of an implant-supported restoration: A dental technique. J Prosthet Dent 2021; 128:858-863. [PMID: 33640084 DOI: 10.1016/j.prosdent.2021.01.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 01/16/2021] [Accepted: 01/19/2021] [Indexed: 11/28/2022]
Abstract
To reduce the risk of implant and prosthetic complications, implant-supported prostheses should be passive. A verification device is used to verify the abutment analog position on the definitive cast, and hence its accuracy. This article describes the fabrication of a Type IV stone implant verification device for verifying the accuracy of the definitive cast.
Collapse
Affiliation(s)
- Alvaro Blasi
- Private practice, Barcelona, Spain; Adjunct Assistant Professor, Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Ga
| | - Víctor Henarejos-Domingo
- Private practice, Barcelona, Spain; Assistant Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain.
| | - Sara Madeira
- Private practice, Barcelona, Spain; Assistant Professor, Department of Integrated Dentistry Department, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Gonzalo Blasi
- Private practice, Barcelona, Spain; Assistant Professor, Department of Periodontology, School of Dentistry, International University of Catalunya, Barcelona, Spain; Adjunct Assistant Professor, Division of periodontology, University of Maryland School of Dentistry, Baltimore, Md
| | - Miguel Roig
- Chairman and Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| |
Collapse
|
7
|
Henarejos-Domingo V, Madeira SN, Roig M, Blasi Á. The digital alveolar cast: A revised approach to an old concept. J Prosthet Dent 2020; 127:213-218. [PMID: 33288209 DOI: 10.1016/j.prosdent.2020.08.036] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
An alveolar cast is recommended for the fabrication of specific fixed dental prostheses. The analog workflow for such casts is labor-intensive, time-consuming, and highly skill dependent. Advancements in digital technologies are bringing new, efficient, and streamlined protocols for dental practice. This article presents a digital workflow for the fabrication of an alveolar cast by using computer-aided design and computer-aided manufacturing (CAD-CAM)technologies.
Collapse
Affiliation(s)
- Víctor Henarejos-Domingo
- Private practice, Barcelona, Spain; Assistant Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain.
| | - Sara Neves Madeira
- Private practice, Barcelona, Spain; Assistant Professor, Department of Integrated Dentistry Department, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Miguel Roig
- Chairman and Professor, Department of Restorative Dentistry, School of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Álvaro Blasi
- Private practice, Barcelona, Spain; Adjunct Assistant Professor, Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Ga
| |
Collapse
|