Conventional Dental Impressions vs. Impressions Reinforced with Rigid Mouthguards

The impression materials utilized today in dental medicine offer a good reproducibility and are easily accepted by patients. However, because they are polymer-based, they have issues regarding their dimensional stability. In this respect, the present work proposes a new type of dental impression, which is reinforced with rigid mouthguards. The aim of the study is to test the performances of such new impressions by comparing them to conventional ones-from this critical point of view, of the dimensional stability. Three types of polymeric materials were considered for both types of impressions: alginate, condensation silicone, and addition silicone. In order to obtain the new type of impressions, a manufacturing technique was developed, comprising the following phases: (i) conventional impressions were made; (ii) a plaster model was duplicated, and 15 rigid mouthguards were obtained; (iii) they were inserted in the impression technique, with each mouthguard positioned on the cast before the high-consistency material was inserted in the tray and the practitioner took the impression; (iv) the mouthguard remained in the tray and the low-viscosity material was inserted over the mouthguard; (v) the impression was positioned on the model, and after the material hardened, the mouthguard-reinforced impression was analyzed. In the evaluation of the dimensional stability, rigorous statistical analysis was essential to discern the performance differences between conventional and mouthguard-reinforced dental impressions. Statistical analyses employed non-parametric Mann-Whitney U tests because of the non-normal distribution of the data. They indicated a statistically significant improvement in the dimensional stability of addition silicone impressions when reinforced with mouthguards (p < 0.05), showcasing superior performance over conventional methods. Conversely, alginate and condensation silicone reinforced impressions did not exhibit the same level of stability improvement, suggesting the need for further optimization of these materials. In conclusion, from the three considered elastomers, addition silicone was found to be the prime candidate for high-precision dental impressions, with the potential to improve their quality from conventional impressions by utilizing the proposed reinforcing technique.

The Influence of a Novel, Crenelated Design of CAD-CAM Ceramic Veneers on the Debonding Strength

(1) Background: Aesthetic dentistry has become one of the most dynamic fields in modern dental medicine. Ceramic veneers represent the most appropriate prosthetic restorations for smile enhancement, due to their minimal invasiveness and highly natural appearance. For long-term clinical success, accurate design of both tooth preparation and ceramic veneers is of paramount importance. The aims of this in vitro study were to assess the stress in anterior teeth restored with Computer-Aided Design (CAD) and Computer-Aided Manufacturing (CAM) ceramic veneers and compare the resistance to detachment and the fracture of ceramic veneers prepared using two different designs. (2) Methods: Sixteen lithium disilicate ceramic veneers were designed and milled using the CAD-CAM technology and divided into two groups according to the preparations (n = 8): Group 1, conventional (CO), with linear marginal contour and Group 2, crenelated (CR), the latter with our novel (patented) sinusoidal marginal design. All samples were bonded to anterior natural teeth. The mechanical resistance to detachment and fracture was investigated by applying bending forces on the incisal margin of the veneers in order to determine which type of preparation leads to better adhesion. An analytic method was employed, as well, and the results of the two approaches were compared. (3) Results: The mean values of the maximum force recorded at the veneer detachment were 78.82 ± 16.55 N for the CO group and 90.20 ± 29.81 N for the CR group. The relative increase, equal to 14.43%, demonstrated that the novel CR tooth preparation provided higher adhesive joints. In order to determine the stress distribution within the adhesive layer, a finite element analysis (FEA) was performed. The statistical t-test showed that the mean value of the maximum normal stresses is higher for the CR-type preparations. (4) Conclusions: The patented CR veneers represent a practical solution to augment the adhesion and mechanical properties of ceramic veneers. The obtained results demonstrated that CR adhesive joints triggered higher mechanical and adhesive forces, which subsequently led to a higher resistance to detachment and fracture.

Influence of the Text Neck Posture on the Static Dental Occlusion

Background and Objectives: The excessive use of smartphones for various tasks led to a new adverse postural phenomenon called text neck. The aim of this study was to investigate the effect of the text neck posture (TNP) on static occlusion by using the T-Scan III occlusal diagnostic system. Materials and Methods: Nineteen subjects (aged 20 to 24 years) were considered for this research. They had normal values for anterior overbite and overjet, Angle Class I occlusion, no posterior crossbite, and no signs or symptoms of cervical or temporo-mandibular disorders. Occlusal registrations were performed with the T-Scan III system in a normal, neutral head posture (NHP), as well as in the TNP. The investigated parameters were: occlusion time (OT), asymmetry index of the occlusal force (AOF), percent of the maximum movie force (%MMF), and the time elapsed from the last occlusal contact until the maximum intercuspation (MAT-OTB). The last three parameters were analyzed in the maximum area frame (MA) of the registrations. For the statistical analysis of the recorded data, the Wilcoxon Signed Ranks test and the Spearman’s correlation coefficient were used. Results: The following values were obtained in NHP and in TNP: for AOF, 14.88 ± 10.39% and 18.04 ± 12.83%, respectively; for OT, 1.34 ± 1.84 s and 1.32 ± 1.8 s, respectively; for the %MMF, 97.5 ± 2.83% and 96.31 ± 3.17%, respectively; for MAT-OTB, 2.08 ± 1.82 s and 1.45 ± 2.3 s, respectively. There were no statistically significant differences between the static occlusal parameters measured in NHP and those in TNP. However, the high values of the AOF and OT in NHP revealed an imbalance of the occlusal force distribution between the right and left side in maximum intercuspation (MI), as well as a lack of simultaneity of static occlusal contacts. Furthermore, there was a significant, direct, and strong correlation between OT and AOF in NHP. Conclusions: The NHP should not be used as the starting position in TNP simulations in T-Scan studies, so as to avoid statistically insignificant differences between static occlusion in NHP and TNP. The healthy standing subjects, with normal occlusal relationships from the clinical point of view, revealed an occlusal instability in NHP when examined with the T-Scan.

Ceramic Scaffolds for Bone Augmentation: Design and Characterization with SEM and Confocal Microscopy

Bone scaffolds must fulfil numerous and sometimes contradictory characteristics: biocompatibility, bioactivity, high porosity, and appropriate mechanical strength. To tackle some of these issues, this study has several aims for the development of such scaffolds for dentistry applications: (i) to utilize appropriate materials (ceramics and sponges) and to introduce a novel, potentially performant ceramic material; (ii) to characterize the obtained scaffolds by using a range of methods; (iii) to compare and to correlate the assessment results with the scope to validate them reciprocally. There are two commercially available dental ceramics (i.e., Ceramco iC Natural Enamel (E) and Ceramco iC Natural Dentine (D), (DeguDent GmbH, Hanau-Wolfgang, Deutschland)) that are considered, as well as a new-developed porcelain (ceramic C). To obtain porous structures of scaffolds, each ceramic is introduced in two different sponges: a denser one, green (G) and a less dense one, blue (B). A total of 60 samples are manufactured and divided in six study groups, obtained by combining the above materials: GE, BE, GD, BD, GC, and BC (where the first letter represents the sponge type and the second one the utilized ceramic). Several methods are applied to characterize their chemical composition, as well as their macro- and micro-porosity: X-ray Diffraction (XRD), apparent porosity measurements, scanning electronic microscopy (SEM), and confocal microscopy (CM). The latter two methods image the inner (porous) and the outer/cortical (denser) areas of the samples. The results show a good porosity (i.e., dimensions and uniformity of pores) of around 65% for the final group BC, with satisfactory values of around 51% for BD and GC. A certain correlation is made between SEM, CM, and the apparent porosity results. The biocompatibility of the new ceramic C is demonstrated. Finally, a necessary trade-off is made with the mechanical strength of the obtained scaffolds, which was also evaluated. From this point of view, Group BD has the highest compressive strength of around 4 MPa, while Group BC comes second, with around 2 MPa. This trade-off between porosity and mechanical strength suggests a choice between Groups BC and BD, which are the best with regard to the porosity and mechanical strength criterium, respectively.

Morphological aspects in remineralizing potential of Silver Diamine Fluoride

Objectives: The purpose of this study was to demonstrate the efficacy of Silver Diamine Fluoride (SDF) antibacterial solution in penetrating the demineralized areas of enamel. Materials and Methods: It was considered a group of four extracted teeth (with no color fading, fissures, decay, or demineralization). Each tooth was sectioned in two equal parts, in mesio-distal direction, using a dental handpiece and a special rounded, flat bur. Each specimen was demineralized, for one minute, with 45% orthophosphoric acid, on occlusal and proximal zones. The specimens were then washed and dried with water-air dental syringe. All the probes were inspected with an optical microscope and enamel thickness was digitally measured. Advantage Arrest (Elevate Oral Care, USA), which contains SDF, was applied on the previous demineralized zones. The penetration of the substance was visually inspected with the optical microscope and electronically measured. Results: It was observed an improvement in remineralizing the white spots on enamel surfaces, the optical microscope being able to detect both demineralization and the penetration of SDF through enamel. Conclusions: Based on our in vitro study, SDF (Advantage Arrest) was capable to induce/increase enamel remineralization, through SDF penetration.

Sinus Lift and Implant Insertion on 3D-Printed Polymeric Maxillary Models: Ex Vivo Training for In Vivo Surgical Procedures

Background and Objectives: The aim of this study is to demonstrate the increased efficiency achieved by dental practitioners when carrying out an ex vivo training process on 3D-printed maxillaries before performing in vivo surgery. Materials and Methods: This developed ex vivo procedure comprises the following phases: (i) scanning the area of interest for surgery; (ii) obtaining a 3D virtual model of this area using Cone Beam Computed Tomography (CBCT); (iii) obtaining a 3D-printed model (based on the virtual one), on which (iv) the dental practitioner simulates/rehearses ex vivo (most of) the surgery protocol; (v) assess with a new CBCT the 3D model after simulation. The technical steps of sinus augmentation and implant insertion could be performed on the corresponding 3D-printed hemi-maxillaries prior to the real in vivo surgery. Two study groups were considered, with forty patients divided as follows: Group 1 comprises twenty patients on which the developed simulation and rehearsal procedure was applied; Group 2 is a control one which comprises twenty patients on which similar surgery was performed without this procedure (considered in order to compare operative times without and with rehearsals). Results: Following the ex vivo training/rehearsal, an optimal surgery protocol was developed for each considered case. The results of the surgery on patients were compared with the results obtained after rehearsals on 3D-printed models. The performed quantitative assessment proved that, using the proposed training procedure, the results of the in vivo surgery are not significantly different (p = 0.089) with regard to the ex vivo simulation for both the mezio-distal position of the implant and the distance from the ridge margin to sinus window. On the contrary, the operative time of Group 1 was reduced significantly (p = 0.001), with an average of 20% with regard to in vivo procedures performed without rehearsals (on the control Group 2). Conclusions: The study demonstrated that the use of 3D-printed models can be beneficial to dental surgeon practitioners, as well as to students who must be trained before performing clinical treatments.

En-face optical coherence tomography analysis of gold and silver nanoparticles in endodontic irrigating solutions: An in vitro study

Optical coherence tomography (OCT) is a non-invasive, non-radioactive optical diagnostic method based on low-coherence interferometry, which achieves images with different orientation. In dentistry, its major advantage is represented by the localization and characterization of the smallest defects in hard dental tissues, dental materials and of the smallest details in dental anatomy (supplementary canals, recesses, isthmuses, or intra-radicular connections). The aim of the present in vitro study was to evaluate using c-scan en-face optical coherence tomography, the optical opacity, and the distribution inside the root canal lumen of several extracted human teeth of silver and gold nanoparticles from special irrigating solutions used in endodontic treatment. Twelve root canals from 5 human teeth were instrumented using the ProTaper Universal system after initial negotiation with hand K-files ISO no. 10 and rotary nickel-titanium PathFile instruments. An initial c-scan OCT analysis was performed for each sample to confirm that the root canal lumen was empty from radiopaque materials (Group 1). Teeth were first irrigated with NanoCare Plus (Group 2) and then with NanoCare Gold (Group 3) and C-scans were repeated after each irrigation method. The OCT investigation started at the tooth apex, at a depth of 1 mm from its tip. Subsequently, 100 slices of 10 microns were obtained from each root canal. Images were captured and then analyzed with ImageJ software to calculate the level of grey inside the root canal lumen. The highest values of grey were obtained in the samples irrigated with NanoCare Gold after NanoCare Plus (Group 3). The present study proved that both nanoparticles inserted in root canal irrigants were evidenced through OCT imagistic analysis due to their optical opacity, which allowed their highlighting in an empty root canal lumen, after the endodontic treatment was performed and the root canal was cleaned and shaped using specific protocols.

Cognitive dysfunction in young subjects with periodontal disease

Background

Periodontal disease is an inflammatory, dysbiotic condition. Studies have shown that in the elderly, periodontal disease was associated with cognitive dysfunction and Alzheimer’s disease.

Objective

To investigate whether young healthy subjects with periodontal disease have lower cognition compared to those without periodontal disease. The salivary cytokines (IL-1β, TNF-α) levels in relation to cognition were also tested.

Methods

In a monocenter, cross-sectional study, forty subjects [mean age (SD) = 34 (5) and 48% female] from western Romania were classified into periodontal disease conditions using radiographic assessment: 10 subjects had aggressive periodontitis (AGG_P), 20 chronic mild-moderate periodontitis (CR_P), and 10 no periodontitis (NL_P). Neuropsychological assessment performed by standardized neurologists and psychologist included Rey Auditory Verbal Learning Test (RAVLT), Montreal Cognitive Assessment test (MOCA), Mini-Mental State Examination (MMSE), and Prague tests. Salivary cytokines levels were determined by ELISA.

Results

RAVLT and MOCA delayed recall scores were lower in AGG_P group compared to NL_P and CR_P. The learning curve was also different with subjects with AGG_P showing reduced learning performance. Contrary to our hypothesis, salivary IL-1β associated with immediate but not delayed cognitive scores.

Conclusions

These results showed for the first time that subjects with AGG_P had cognitive dysfunction and IL-1β may play a role in this process.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10072-021-05115-3.

Complementarity of Photo-Biomodulation, Surgical Treatment, and Antibiotherapy for Medication-Related Osteonecrosis of the Jaws (MRONJ)

Background and Objectives: Antiresorptive or anti-angiogenic agents may induce medication-related osteonecrosis of the jaws (MRONJ), which represents a challenge for clinicians. The aim of this study is to design and apply a composed and stage-approach therapy combining antibiotherapy, surgical treatment, and photo-biomodulation (PBM) for the prevention or treatment of MRONJ lesions. Materials and Methods: The proposed treatment protocol was carried out in the Department of Oral & Maxillofacial Surgery of the “Victor Babes” University of Medicine and Farmacy of Timisoara, in 2018–2020. A total of 241 patients who were previously exposed to antiresorptive or anti-angiogenic therapy, as well as patients already diagnosed with MRONJ at different stages of the disease were treated. A preventive protocol was applied for patients in an “at risk” stage. Patients in more advanced stages received a complex treatment. Results: The healing proved to be complete, with spontaneous bone coverage in all the n = 84 cases placed in an “at risk” stage. For the n = 49 patients belonging to stage 0, pain reductions and decreases of mucosal inflammations were also obtained in all cases. For the n = 108 patients proposed for surgery (i.e., in stages 1, 2, or 3 of MRONJ), a total healing rate of 91.66% was obtained after the first surgery, while considering the downscaling to stage 1 as a treatment “success”, only one “failure” was reported. This brings the overall “success” rate to 96.68% for a complete healing, and to 99.59% when downscaling to stage 1 is included in the healing rate. Conclusions: Therefore, the clinical outcome of the present study indicates that patients with MRONJ in almost all stages of the disease can benefit from such a proposed association of methods, with superior clinical results compared to classical therapies.

A Custom-Made Orthodontic Mini-Implant-Effect of Insertion Angle and Cortical Bone Thickness on Stress Distribution with a Complex In Vitro and In Vivo Biosafety Profile

BACKGROUND

Orthodontic mini-implant failure is a debatable subject in clinical practice. However, the most important parameter to evaluate the success rate of mini-implant is the primary stability, which is mainly influenced by cortical bone thickness (CBT) and insertion angle.

MATERIALS AND METHODS

Three-dimensional finite element models of the maxilla were created and a custom-made, self-drilling, tapered mini-implant was designed. For the pull-out test, 12 simulations were performed, sequentially increasing the thickness of the cortical bone (1, 1.5 and 2 mm) and the insertion angle (30°, 60°, 90°, 120°). For the force analysis, 24 simulations were performed using an experimental orthodontic traction force of 2 N both in the horizontal and vertical axis.

RESULTS

Insertion angle and CBT have significant impact on force reaction values (p < 0.05). Cortical bone stress had the lowest value when the mini-implant had a 30° insertion angle and the highest value when the implant had a 120° insertion angle, while the CBT was 1 mm. Cortical bone stress had the lowest value with an insertion angle of 90° and the highest value when the implant was inserted at an angle of 30°, while the CBT was 2 mm independent of the force direction. Regarding the biosafety profile of the mini-implant alloy, the present results reveal that the custom-made mini-implant presents good biocompatibility.

CONCLUSIONS

When the CBT is reduced, we recommend inclined insertion while, when the CBT is appropriate, perpendicular insertion is advised.

Selective Laser Sintering versus Selective Laser Melting and Computer Aided Design - Computer Aided Manufacturing in Double Crowns Retention

Purpose This in vitro study aimed at ascertaining the retention forces for telescopic crowns fabricated with Selective Laser Manufacturing (SLM) and Selective Laser Sintering (SLS) additive technologies, and Computer Aided Design - Computer Aided Manufacturing (CAD-CAM) subtractive technology, by using suitable materials for each.Materials and Methods Full-factorial design was employed for experimental testing, considering the following three factors: (a) inner crown material ‒ technology (zirconia ‒ CAD-CAM; metal-alloy ‒ SLS; metal-alloy ‒ SLM); (b) tooth type (canine or molar); (c) wet vs. dry conditions (i.e. either with or without artificial saliva). The roughness of the inner crowns was analyzed through atomic force microscopy. Three-way analysis of variance (ANOVA) was applied for statistical analysis, followed by Tukey's post-hoc comparisons between the crown types.Results The retention force mean values were between 3.8 N (dry, SLM) and 14.8 N (artificial saliva, SLS), with statistically significant (p<0.001) differences between the three types of inner crowns and interaction with the tooth type. No significant interaction was found between crown or tooth types and the wet vs. dry testing conditions. The zirconia crowns' retention force was significantly (p<0.001) higher compared to similar SLM crowns, with 95% CI (3.62; 5.55) N for the differences. Zirconia was significantly (p<0.001) less retentive compared to similar SLS crowns, with 95% CI (-5.99; -4.06) N for the differences. The roughness decrease and subsequent loss of retention force was the largest in zirconia.Conclusions The SLS inner crowns showed the best retention, followed by zirconia and SLM inner crows.

The Challenges of OSCC Diagnosis: Salivary Cytokines as Potential Biomarkers

Fast, economic, and noninvasive, molecular analysis of saliva has the potential to become a diagnostic tool of reference for several local and systemic diseases, oral cancer included. The diagnosis of Oral Squamous Cell Carcinoma (OSCC) can be performed using high specificity and sensibility biomarkers that can be encountered in the biological fluids. Recent advances in salivary proteomics have underlined the potential use of salivary biomarkers as early diagnosis screening tools for oral neoplasia. In this respect, over 100 salivary molecules have been described and proposed as oral cancer biomarkers, out of which cytokines are among the most promising. Besides being directly involved in inflammation and immune response, the role of salivary cytokines in tumor growth and progression linked them to the incidence of oral malignant lesions. This review summarizes the existing studies based on the use of salivary cytokines as potential oral cancer biomarkers, their involvement in the malignant process based on their type, and ther influence upon prognostic and metastatic rates.

Dental Adhesive Interfaces Reinforced with Magnetic Nanoparticles: Evaluation and Modeling with Micro-CT versus Optical Microscopy

Dental adhesives are used in a wide range of applications, including to place direct composite restorations in frontal or posterior teeth. One of the most frequent causes for the failure of composite resin restorations is microleakages. The first aim of this work is to introduce a new type of self-etched dental adhesive doped with magnetic nanoparticles (MPs) synthetized in the laboratory. The scope is to produce adhesives with a minimized width/thickness to decrease the risk of microleakages. The second aim is to assess the width/thickness of the adhesive layer in all the characteristic areas of the teeth using both the less precise but most common optical microscopy and the more accurate and volumetric micro-Computed Tomography (CT) investigations. Twenty extracted teeth have been divided into four groups: Group 1 includes 'blank' samples with adhesives that are not doped with MPs; Group 2 includes samples with adhesives doped with MPs; Groups 3 and 4 include samples with adhesives doped with MPs that are subjected to an active magnetic field for 5 and 10 min, respectively. Microscopy investigations followed by micro-CT and EDAX are performed on the adhesive. While a rather good agreement is obtained between the microscopy and micro-CT results, the capability of the latter to offer a full volumetric reconstruction of the layer is exploited to analyze the adhesion of the four considered dental materials. Thus, from micro-CT results the graphs of the surface areas as functions of the adhesive layer width are modeled mathematically, as well as the volume of sealants, for each of the four groups. To our knowledge, it is the first time that such a methodology is used. Characteristic parameters are extracted and the ascertainment of the optimal parameter that should be utilized for such assessments is discussed. The study demonstrates the adhesion improvement produced for Groups 3 and 4, where MPs are used. It also concludes that the magnetic field should be applied to the adhesive material for the longest possible exposure time (with a trade-off with the clinical duration of the treatment).

Early Childhood Oral Health Impact Scale (ECOHIS): Literature review and Italian validation

OBJECTIVE

The Early Childhood Oral Health Impact Scale (ECOHIS) is a questionnaire to elucidate the relationship between parental perception of the quality of life of their preschool children and their oral health status. Aim of the present work was to validate an Italian ECOHIS version and review the literature.

METHODS

After adapting the original ECOHIS questionnaire from English to Italian (I-ECOHIS), I-ECOHIS was administered to parents of children afferent to the Dental Clinic of the University of Campania "Luigi Vanvitelli," regardless of age. Children under 6 years of age underwent anamnestic survey and physical examination, to correlate the dmft index with the ECOHIS score.

RESULTS

366 children have come to our observation. I-ECOHIS was administered to all parents to establish its comprehensibility. 87 children (44 females and 43 males) under 6 years (5.2 ± 1.4 years) underwent dmft evaluation to determine I-ECOHIS/oral health status correlation. Among the 87 children examined, the higher total score reached was 25/50. ANOVA analysis confirmed statistically significant correlations between ECOHIS score and dmft = 0 vs dmft equal/higher than 4.

CONCLUSION

The present pilot study validated the I-ECOHIS questionnaire and revealed to be a good tool to distinguish children without caries experience from those with a high dmft. However, it was not correlated with the intermediate dmft level, thus confirming the importance of screening for caries.

Do different dental conditions influence the static plantar pressure and stabilometry in young adults?

Background

Posture is influenced by many factors and dental occlusion seems to have its role on postural stabilization. Our rationale to perform the study was to find out if there are differences of static plantar pressure and stabilometric parameters depending on different dental conditions.

Methods

The observational study consisted in plantar pressure assessment and stabilometric analysis of 95 right-handed healthy volunteer subjects (mean age 22.94 ± 2.52 years) by using the PoData system. Each subject followed four measurements with open eyes: mandibular postural position, maximum intercuspation, biting on cotton rolls and maximum mouth opening. Plantar pressure was recorded on 1^st and 5^th metatarsal heads and heel, and was expressed as percentage of weight distribution on each foot. The recorded centre of pressure (CoP) parameters were: CoP path length, 90%confidence ellipse area and maximum CoP speed. Statistical analysis used repeated-measures ANOVA with Bonferroni posthoc analysis and Friedman test.

Results

Loading on the left 5^th metatarsal head was significantly higher in maximum mouth opening condition when compared to maximum intercuspation and to biting on cotton rolls. The left heel loading was significantly lower in the maximum mouth opening in comparison to maximum intercuspation. The CoP path length and maximum CoP speed were significantly higher in maximum mouth opening compared to the other three conditions. Confidence ellipse area had significantly lower values in maximum intercuspation and in the biting on cotton rolls conditions compared to the mandibular postural position, and in maximum intercuspation compared to maximum mouth opening.

Conclusion

In young adults with an optimum functional occlusion the static plantar pressure is influenced by the maximum mouth opening. An improved postural stability was recorded in maximum intercuspation (a condition used during swallowing) in comparison to mandibular postural position (a condition that allows relaxation of the masticatory muscles after functional moments).

In vitro Comparison of Accuracy of Two Scanners Used in Dental Medicine

This experimental study aims to highlight and compare the resolution and accuracy (trueness and fidelity) of an intraoral scanner and a laboratory scanner. In order to achieve the aim of this study, an experimental model consisting of a die with a standard preparation for a porcelain-fused to metal crown was manufactured from a physiognomic polymethylmethacrylate resin. The experimental model was scanned with an industrial CT to obtain the virtual reference model. Then, the die was scanned 15 times with each scanner. In order to asses trueness, comparisons were made with the virtual reference model, and for fidelity, the first scan in the series was compared with the following scans. In regards to the trueness of the scanners, the average deviation for the laboratory scanner is 4.31 and 17.34 mm for the intraoral scanner. When comparing the serial scannings� of the same die, the lowest recorded deviation is 6.4 mm for the laboratory scanner and 21.57mm for the intraoral scanner. For both fidelity and trueness, the F test demonstrates that there is a statistically significant difference between the scanners and the applied T-tests confirm the lower degree of error-rate generation by the laboratory scanner. The dimensional limitations imposed for the intraoral scanners have a direct consequence on their trueness and fidelity when compared to their laboratory counterparts.

MicroCT Analisys of Dental Adhesives Loaded with Nanoparticles

Dental decay is an infectious disease that affects more and more people. Dental Restoration Materials are not infallible, after filling a tooth with composite materials, and secondary caries may appear. One of the possible causes involved in the appearance of secondary caries is generated by the uneven thickness of the layer of adhesive that can be fractured by microinfiltration areas. The purpose of this study is to evaluate a new type of dental adhesive that has been loaded with ferric nanoparticles. The thickness of the adhesive layer used in the restoration of the various types of cavities on the surface of the teeth, which were coated with copolymerizable composite materials, was evaluated, making a comparison between the thickness of the uncoated adhesive layer and the thickness of the adhesive loaded with ferric nanoparticles.In this study, 20 extracted teeth were used which presented various carious lesions. The dental caries were removed resulting class I and II Black cavities. The restoration of the cavities was made using adhesive techniques and photopolymerizable fluid-type composites, the adhesive layer being analyzed by the microCT.

Periodontal disease in a young Romanian convenience sample: radiographic assessment

Background

The goal of this study was to determine the distribution of periodontal disease in a population seeking oral rehabilitation in a Romanian prosthodontics department and to identify the factors associated with each type of periodontal condition.

Methods

The study population consisted of patients presenting consecutively to the Prosthodontics Department of the Faculty of Dental Medicine, Victor Babeş University of Medicine and Pharmacy, Timisoara. The diagnosis and classification of periodontal conditions, as well as dental pathologies and conditions, were based on examination of panoramic radiographs. A standardized questionnaire was administered to obtain socio-demographic characteristics (age, gender, ethnicity, education, residency, marital status), medical history, dental/periodontal history (family history of periodontal disease), and behavior (smoking, brushing, flossing and regular cleaning).

Results

Among subjects presenting to the Prosthodontics department, only 34.2% were periodontal disease-free and 65.8% had periodontal disease, of which 11.4% had aggressive periodontitis. In univariate models, age, education, marital status, smoking, and tooth number were associated with chronic periodontitis. Age, education, family history, smoking, and tooth number were associated with aggressive periodontitis. However, in a multivariable model, only age, tooth number and family history were significant.

Conclusions

This study found a high prevalence of periodontal disease in patients seeking oral rehabilitation from the Prosthodontics department. Age, tooth number and family history of periodontal disease were associated with the type of periodontal disease. These results suggest the need for periodontal examination prior to prosthetic oral rehabilitation in this population.

Optical Coherence Tomography Investigations and Modeling of the Sintering of Ceramic Crowns

Dental prostheses are sintered in ovens that sometimes suffer from a loss of calibration. This can lead to variations of the sintering temperature outside the range recommended by the manufacturer. Stress and even fractures in dental ceramics may occur, and this leads to the necessity to rebuild the dental construct. The aim of this work is to monitor the quality of sintering processes using an established biomedical imaging technique-optical coherence tomography (OCT). Conventional current procedures imply the fabrication of supplemental samples that add to the expenses and are only evaluated visually. To our knowledge, we were the first to propose the use of OCT, a non-destructive method that brings objectivity for such assessments, focusing, in a previous study, on metal ceramic dental prostheses. Here, a different material, pressed ceramics, is considered, while we propose a quantitative assessment of the results-using reflectivity profiles of en-face (i.e., constant-depth) OCT images of sintered samples. The results for both the pressed ceramics and metal ceramics prostheses are discussed by obtaining the analytic functions of their reflectivity profiles. A multi-parametric analysis demonstrates the best parameter to characterize the loss of calibration of dental ovens. Rules-of-thumb are extracted; producing dental prostheses with defects can thus be avoided.

Flash-Free Orthodontic Adhesive System Compared with the Conventional Direct Bonding Method

The latest technology in the field of orthodontic materials is represented by the Flash-Free Orthodontic Adhesive System. In the present study this novel technique is compared with the conventional direct bonding method. Ten extracted human premolars were separated into two groups: in the Group 1, APC Flash-Free Adhesive Coated Appliance System (3M Unitek, Monrovia, CA, USA) was bonded, while in the control Group 2, Clarity Advanced braces (3M Unitek, Monrovia, CA, USA) were bonded using XT Adhesive Paste (3M Unitek, Monrovia, CA, USA) applied by the clinician on the bracket base. Bonding times were recorded for each sample. Shear bond strength (SBS) was recorded using Zwick Zoel Z005. After debonding, the adhesive remnant index (ARI) was established for both groups. Group 1 showed a mean bonding time of 21 s, while Group 2 needed about 45 s for each bracket bonding. Both groups had clinically accepted SBS values, but the difference between them was significant (10.97 MPa versus 8.23 MPa). ARI scores were equal to 1 for most samples. In conclusion, reducing the time for bracket placing, APC Flash-Free Coated Appliance System showed a brackets bonding time reduced to half compared to the conventional technique. This aspect, combined with significantly higher SBS values, makes this novel system better than the classical one. For both groups, more than half of the adhesive remained on the bracket base, which facilitates cleaning after debonding.

Implementation of Holographic Research in Periodontal Disease

In this paper were evaluated from a quantitative and qualitative point of view the retraction of the marginal periodontal tissues, using a holographic technique, subsequently validated through measurements accomplished with the help of acknowledged, consecrated soft wear.

Orthodontic Mini-Implants Hybrid Expanders in Palatal Expansion

The purpose of this case report is to evaluate the role of mini-implants hybrid expanders in the orthodontic treatment of narrow maxilla. A female patient with a skeletal asymmetry and unilateral posterior crossbitepresented for orthodontic treatment. Digital records were sent to the orthodontic laboratory. The orthodontic lab made the mini-implants hybrid expanders and a 3D surgical guide for an accurate insertion of the mini-implants. After two months, a successful expansion of the maxilla was obtained. Orthodontic mini-implants hybrid expanders could eliminate surgical treatemnt in many narrow maxilla cases.

Determining the Biological Sealing Quality of the Implant-abutment Interface Using Streptococcus mutans in Both, Conical and Internal Hex Connections A comparative study

Implants have been around for many years already, having a lot of advantages and high success rates, by some authors even higher than 90%. Nevertheless, throughout the years, problems and failures have occurred in practice which led to bone loss around the implants and even, in some cases, to losing the implant itself. The phenomenon behind this pathological process -peri-implantitis - is believed to be the microleakage which occurs at the implant-abutment interface.This happens due to the existence of a gap present between the implant and the prosthetic abutment. Moreover, the microleakage is amplified because of the, so called, pumo effect. The pump effect occurs when the crown-abutment complex is subjected to occlusal, vertical and oblique, forces. During these micro-movements of the abutment, the microleakage intensifies and the bacteria can easily enter inside the implant, where is impossible to reach and remove through oral hygiene, thus, creating the perfect conditions for peri-implantitis. There are two major types of implant-abutment connections widely used nowadays -internal hex and conical -which are believed to influence the phenomenon and, so, the outcome. In the present study, both types of connections are tested, using Streptococcus Mutans, a common bacteria found in the oral cavity.

A Ten-year Time Laps, Regarding Drug Consumption in the Western Part of Romania

The purpose of the research was to see the time-trends (2005/2006-2015/2016) of types and patterns of drug usage between the young adults from medical school in TimisCounty. The study is a comparison of two cross-sectional cohorts of student from Timis County, Romania (2005/2006: 365 females and 248 males; 2005/2016: 336 females and 123 males). In both investigations the same questionnairewas used. Through the investigation we measured the types and patterns of drugs used in relation with gender and cohort effect frequency. For the 2005/2006 evaluation 15% of boys and 4.9% of girls have tried at least one kind of drug. In the reevaluation study 2015/2016 the consumption of at least one kind of drug has risen 34.4% boys and 14.4% girls, which means meaning that the number of consumers has risen by 3 times in between investigations. The intervention to minimize the usage of any sort of drugs in a specific university environment or in the general population has to be done in very careful way in concordance with the specific patterns of usage and types of drugs.

Cytotoxicity Assessment of Metal and 3D Printed Resin Orthodontic Attachments An in vitro cell culture behavior study

Materials used in orthodontics are constantly changing and improving, but biocompatibility remains one of their most important characteristics.The purpose of this study is to evaluate the in vitro cellular behavior of dental MSC cells when put in contact with metal and 3D printed resin orthodontic attachments.Cell monolayers were seeded in wells and left to adhere. Polymer and metal orthodontic attachments were placed into the wells. The cells were analyzed on an inverted light microscope. The cellular viability was determined using Alamar Blue assay. Results showed that the morphology and the density of cells are not affected by the presence of either orthodontic material compared to the controls.The metabolic activity of the cells was not altered. Similar cellular reactions,were observed in contact with both materials used in our short term in vitro study.

Fluorescence influence on screening decisions for oral malignant lesions

OBJECTIVES

The aim of the present study was to assess the capability of the low-cost VELscope device to visualize the tissue auto-fluorescence of potentially malignant oral lesions and to establish the diagnostic accuracy, sensitivity, and specificity of this method when validating the retrieved data through the gold standard, i.e., histological examination.

PATIENTS, MATERIALS AND METHODS

Eighteen patients were evaluated by conventional oral examination (COE) followed by direct visual fluorescence evaluation (DVFE) using VELscope. Areas clinically suspicious detected by COE or with positive DVFE (visual fluorescence loss) were further investigated using surgical biopsy.

RESULTS

Eight positive biopsies for malignant lesions were detected by COE and DVFE. Only one positive biopsy for a premalignant lesion was not in accordance with COE and DVFE. One lesion identified on the VELscope and COE as a non-malignant lesion was confirmed by the biopsy. Therefore, the VELscope system had a sensitivity of 94.44% and a specificity of 100% in discriminating in situ normal mucosa from carcinoma or from invasive carcinoma, compared with histology. The predictive positive value was 100% and the negative predictive value was 50%, with a 95% confidence interval (CI).

CONCLUSIONS

DVFE allows for a simple and cost-effective margin determination, in order to perform the detection and screening of oral precancerous and early cancerous disorders. It was found that the VELscope system could not fully replace the histopathology procedure. Nonetheless, the study demonstrated its usefulness for clinical examination, monitoring oral lesions, and guiding the biopsy. Therefore, this method may add sensitivity to the oral tissue examination and be an effective adjunct for high-risk patients.

Low Viscosity Resin Penetration Degree in Incipient Caries Lesions

Resin infiltration is considered a treatment option for initial caries lesions. To prevent enamel lesion s from further demineralization a complete and homogeneous penetration of low-viscosity resins should be accomplished. The aim of this study was to compare the penetration abilities of 3 commercial products: Icon (DMG, Germany), Fluorodose (Centrix Inc. USA) and Tetric flow (IvoclarVivadent, Schaan, Liechtenstein).Artificial white spot lesions were produced in 60 orthodontic extracted human premolars. The samples were randomly divided into 3 groups: F - weeklyapplication of 5%fluoride gel; IC � resin infiltration (Icon1-DMG) and T - treatment with composite resins (Tetric flow). Specimens were studied using confocal microscopy and penetration depths were determined. A good correlation between PC and penetration depth was thereby observed (Pearson correlation coefficient, r=0.820).

Detecting the Implant in vitro Microleakage Using Spectrophotometry and Neutral Red Dye

Implants are one of the most innovative and less invasive prosthetic procedures available. Almost all types of edentations can, nowadays, be treated with an implant-retained prosthetic piece, either fixed or removable. But regardless of the development in the industry over the last decades and the high success rate - estimated at over 95% - there are still some problems concerning single or multi-unit restorations[1-3]. One of the main concerns about implant therapy today is the microleakage phenomenon. The microleakage appears between the implant and the abutment and, due to masticatory forces, it creates a pump effect which can carry the oral bacteria inside the implant, where it�s almost impossible to reach, thus, creating a local inflammation, called peri-implantitis[4-6] . Many authors have tried to identify and quantify the phenomenon by diverse means, but a consensus hasn�t been reached on how or when exactly it appears. In the present study, Neutral Red dye was used to determine the sealing of the implant-abutment interface in dynamic conditions, with the help of the spectrophotometry.

Evaluation of the Adhesion of a Novel Design of Veneers to Dental Materials

The aim of this in vitro study was to assess a new design that, to our knowledge, we have introduced (patent pending) for indirect dental veneers. Their effect on the retention and adhesive properties at their interfaces have been studied. Fourteen high performance polymeric (PEEK) dental veneers have been elaborated using a computer-aided-design (CAD) software and then milled using a computer-aided-machine (CAM). They were divided in two experimental groups: seven classical veneers with a liniar marginal contour and seven dental veneers with the novel proposed sinusoidal marginal design. All the samples have been bonded to polymeric blocks that had the vestibular face prepared in a specific way for each group. The values of the retention and adhesive forces were tested in vitro by applying bending forces on the incisal edge of the veneers, from the oral to the vestibular direction. A 50% increase of the values of these forces for the novel design with regard to the classical one has been demonstrated through the study.

Marginal Fit Evaluation Trough Micro-CT Technology of Pressed vs Milled Ceramic Inlays

The goal of the present study is to compare the marginal fit using microCT of ceramic inlays obtained using two different technologies: pressing technique (lithium disilicate) and milling technique (milled leucite glass-ceramic). After extraction of four caries-free mandibular first molars, first class inlay cavities were prepared. For each tooth two inlays were manufactured- one by using pressed lithium disilicate (Emax) (n=4) and one by using milled leucite glass-ceramic (n=4). The marginal gap was analyzed circumferentially at the occlusal margin using a table-top Bruker micro CT, by measuring the distance at the occlusal limit of the cavities, between the restoration and the tooth in several points for every surface of each tooth before cementing. Data were analyzed statistically using One �way ANOVA with Tukey�s Multiple Comparison Test performed using 5.00 for Windows (GraphPad Prism 5.00 Software, San Diego, California USA). When the marginal gaps of the inlays made out of different materials on the same tooth were compared, only one result had no statistical significance. The program expressed also results by comparing the gaps of pressed vs milled restorations on different teeth. 11 out of 16 results had statistical significance. Although statistical significance between the two studied materials, we can conclude that both used materials offer a good marginal adaptation within the acceptable limits. By summing up the gathered data we can conclude that the milled ceramic shows a better marginal fit than the pressed ceramic.

A Comparative Three- and Bi-dimensional Research of the Marginal Fit of Pressed Lithium Disilicate Inlays

The replacement of classical fillings, especially in the posterior area with different types of inlays has become a common solution used in order to improve all parameters which insure a long lasting treatment. Vrious ceramic materials and systems are available, but so far an ideal ceramic material suited for all clinical situations, has not been found. The range of ceramic materials as: lithium disilicate, aluminum oxide, zirconium oxide and hybrid ceramics enhance the possibilities of using ceramic inalys in various clinical situations. Marginal adaptation is one of the most important conditions for long-term success for any type of material. The marginal discrepancy of fixed restorations is one of the main factors which lead to failure of the prosthetic treatment.The purpose of the present study is to compare a 2D and 3D method for evaluating the marginal fit for pressed lithium dislicate inlays (Emax). The two used methods were: SEM- electronic microscopy and micro CT.

Three-dimensional Marginal Evaluation of Two Pressed Materials Using Micro-CT Technology

The main goal of the present study is to compare the marginal fit of two different kind of pressed materials: a partially crystalline thermoplastic resin reinforced with ceramic particles (BioHPP) and lithium disilicate (EMax), through the use of the microCT technique. After extraction of four caries-free mandibular first molars, first class inlay cavities were prepared. For each tooth two inlays were manufactured- one by using BioHPP thermoplastic resin (n=4) and one by using Emax Press lithium disilicate (n=4). The marginal gap was analyzed circumferentially at the occlusal margin using a Bruker micro CT, by measuring the distance at the occlusal limit of the cavities, between the restoration and the tooth in several points for every surface of each tooth before cementing. Data were analyzed statistically using the Mann-Whitney U test and the Pearson�s correlation coefficient (a=0.05). A significant statistical difference was found between the marginal gap size obtained for BioHPP and Emax inlays (p[0.001). For the Emax inlays the marginal gap had an average of 72mm, while for BioHPP the average was 94 �m. Both types of used materials offer a good marginal adaptation. By summing up the gathered data we can conclude that the pressed ceramics shows a better marginal fit than the pressed resin, probably because of the different processing methods: sintering versus polymerizing with different shrinkage values.

Interdisciplinary Treatment of an Adult Patient Using an Adjunctive Orthodontic Approach. Case Report

The aim of this case presentation is to outline some of the advantages that an adjunct orthodontic treatment can offer in a comprehensive oral rehabilitation of an adult patient. Adjunctive orthodontic treatment is usually limited to a dental arch or to a group of teeth within an arch. The purpose of dental movements in this case will be to position the teeth in a way that makes the restoration or replacement of damaged or missing teeth as easy as possible and with minimal dental tissue sacrifice. In addition, the improved position of the teeth will create a healthier periodontal environment that is easier to maintain over time.

Digital Dentistry — Digital Impression and CAD/CAM System Applications

Digital imprint and computer-aided design/computer-aided manufacture (CAD/CAM) systems offer several benefits compared to traditional techniques. The use of a CAD/CAM system to scan preparations and generate restorations in-office, removes a second appointment for the patient. The existence of precision benefits in using complete systems and chairside scanning systems, has been proven. CAD/CAM restorations have a good longevity and meet the accepted clinical parameters. New digital impression methods are presently accessible, and before long, the long-awaited goal of sparing patients of one the most unpleasant practices in clinical dentistry, acquiring dental impressions, will be exchanged by intraoral digital scanning. CAD/CAM systems existing nowadays, can feed data through accurate digital scans created from plaster models, straight to manufacturing systems that can shape ceramic or resin restorations with no requirement of a physical copy of the prepared, adjacent, and antagonist teeth.

Original Research. Photoacoustic Microscopy in Dental Medicine

Introduction: Photoacoustic microscopy, also known as optoacoustic imaging, is a comparatively new method of investigation in dental medicine, which uses a laser-generated ultrasound (short laser pulses) to achieve images for interpretation. Photoacoustic microscopy can be used in a broad spectrum, from detecting tooth decay at its earliest stages to dental anatomy analysis. Material and methods: The energy emitted by the photoacoustic pulse is moderately absorbed by the target and exchanged into heat, leading to a local transitory temperature upsurge. The tension propagates and grows as ultrasonic waves, distinguished by the ultrasonic transducers which are planted apart from the tissue. The photoacoustic microscope has a tunable dye laser which passes through a condensing lens, an objective and ultimately an ultrasonic transducer attached to an acoustic lens to capture and receive information about the scanned probe from a sample moved on the X, Y dimensions. Results: The precise anatomy of layered concentric structures can be clearly observed in photoacoustic microscopy. The image value of the inner layer can be higher, indicating strong optical absorption, while the image value of the outer layer is lower, indicating weaker optical absorption. Meanwhile, the inner layer has the exact same size as the dentin structure and the outer layer has the exact same size as the enamel structure in this cross-section. Conclusions: The photoacoustic microscope (all-optical) comes out to be a future and promising tool for detecting early-stage caries and lesions on the surface of the teeth, where micro-leakage occurs at the interface of tooth restoration, and also the anatomy of dental tissues.

Silver Nanotechnology — the Future in Caries Therapy? A Report of Two Cases

Introduction: Dental decays remain the most common and rampant biofilm-dependent oral disorders. Influencing the delicate dynamic between demineralization and remineralization is a big challenge in clinical practice, and nanotechnology is considered a viable solution. The therapeutic management of caries, which includes nanotechnology, has two big approaches, an antibacterial one and a remineralizing one. Silver is recognized to display a powerful toxicity to a large variety of micro-organisms, thus silver-based composites have been widely used in several bactericidal applications.

Case report: We present our attempts and results in using silver nanoparticle solutions on a 14-year-old and a 34-year-old patient with dental decays and no previous dental pain. One of the cases was treated with chlorhexidine 2% and the other with Nanocare Plus, as antimicrobial agents. In both cases we recorded decreased values of the bacterial burden in comparison with the initial values.

Conclusion: This two-case presentation compared the antibacterial effect of two antibacterial solutions, providing useful information regarding novel therapies for dental caries, but further research in this domain is needed.

Digital Dentistry — 3D Printing Applications

Three-dimensional (3D) printing is an additive manufacturing method in which a 3D item is formed by laying down successive layers of material. 3D printers are machines that produce representations of objects either planned with a CAD program or scanned with a 3D scanner. Printing is a method for replicating text and pictures, typically with ink on paper. We can print different dental pieces using different methods such as selective laser sintering (SLS), stereolithography, fused deposition modeling, and laminated object manufacturing. The materials are certified for printing individual impression trays, orthodontic models, gingiva mask, and different prosthetic objects. The material can reach a flexural strength of more than 80 MPa. 3D printing takes the effectiveness of digital projects to the production phase. Dental laboratories are able to produce crowns, bridges, stone models, and various orthodontic appliances by methods that combine oral scanning, 3D printing, and CAD/CAM design. Modern 3D printing has been used for the development of prototypes for several years, and it has begun to find its use in the world of manufacturing. Digital technology and 3D printing have significantly elevated the rate of success in dental implantology using custom surgical guides and improving the quality and accuracy of dental work.

Micro-CT and optical microscopy imagistic investigations of root canal morphology

Protecting the root's internal morphology is the first key toward the success of the endodontic treatment. Due to the vast diversity of endodontic space, it is difficult to visualize and to establish the shape and limits of the root canal, especially the morphology of apical area and lateral root canals. Optical microscopy is a classical imagistic investigation method, widely used along classical methods like radiographs that also offer limited information about root morphology and extension of decay. Micro-computed tomography (micro-CT), a modern imagistic investigation method can provide detailed three-dimensional reconstructions of root canal. Micro-CT is a non-invasive method that has the possibility to offer cross-sectional and axial images of the endodontic space. The success of root canal treatment is based on cleaning and shaping. Beyond these two procedures, sealing the endodontic space by respecting its limits is another prerequisite for long-term success of endodontic therapy. Micro-CT can perform three-dimensional reconstruction of the root canal, root canal filling and can provide accurate images of the endodontic space. The assessment of root morphology can be obtained through imagistic invasive optical microscopy and already mentioned non-invasive methods (micro-CT). The aim of this study is to illustrate and analyze the endodontic space, according to its diversity by using micro-CT, a non-invasive imagistic investigation method an also optical microscopy. The two techniques can also provide the extension of carries or demineralized substance on different levels of the root.

Design and testing of prototype handheld scanning probes for optical coherence tomography

Three simple and low-cost configurations of handheld scanning probes for optical coherence tomography have been developed. Their design and testing for dentistry applications are presented. The first two configurations were built exclusively from available off-the-shelf optomechanical components, which, to the best of our knowledge, are the first designs of this type. The third configuration includes these components in an optimized and ergonomic probe. All the designs are presented in detail to allow for their duplication in any laboratory with a minimum effort, for applications that range from educational to high-end clinical investigations. Requirements that have to be fulfilled to achieve configurations which are reliable, ergonomic-for clinical environments, and easy to build are presented. While a range of applications is possible for the prototypes developed, in this study the handheld probes are tested ex vivo with a spectral domain optical coherence tomography system built in-house, for dental constructs. A previous testing with a swept source optical coherence tomography system has also been performed both in vivo and ex vivo for ear, nose, and throat-in a medical environment. The applications use the capability of optical coherence tomography to achieve real-time, high-resolution, non-contact, and non-destructive interferometric investigations with micrometer resolutions and millimeter penetration depth inside the sample. In this study, testing the quality of the material of one of the most used types of dental prosthesis, metalo-ceramic is thus demonstrated.

Quantitative evaluation of dental abfraction and attrition using a swept-source optical coherence tomography system

A fast swept-source optical coherence tomography (SS-OCT) system is employed to acquire volumes of dental tissue, in order to monitor the temporal evolution of dental wear. An imaging method is developed to evaluate the volume of tissue lost in ex vivo artificially induced abfractions and attritions. The minimal volume (measured in air) that our system could measure is 2352 μm3. A volume of 25,000 A-scans is collected in 2.5 s. All these recommend the SS-OCT method as a valuable tool for dynamic evaluation of the abfraction and attrition with remarkable potential for clinical use.