Level of evidence analysis of the Saudi Dental Journal: A bibliometric analysis of publications from 2012 to 2021

Objectives

The Level of Evidence (LOE) ranking system is used to measure the methodological quality of research. This study aimed to analyze and evaluate the trends of LOEs in articles published in the Saudi Dental Journal (SDJ) between 2012 and 2021.

Methodology

The bibliometric details of all articles published from 2012 to 2021 were extracted from the SDJ website. All articles, expect editorials, were included in the analysis. The articles were divided based on LOEs, dental specialties, number of authors, and centers. The citation metrics were obtained from Google Scholar, and the statistical analysis was performed using JMP Pro 15.2.0 software.

Results

Five hundred twenty-two articles were selected for analysis. They had an average of 21.19 citations per article, and a growing trend in the number of articles was observed. Authors from 40 countries contributed to the articles, with the most contributions from the Kingdom of Saudi Arabia. Most articles (n = 269; 51.53%) were LOE IV and V, while a low proportion (5.56%) were LOE I articles. Aside from miscellaneous articles, periodontics composed most of the LOE I studies, followed by endodontics, and oral and maxillofacial Surgery (OMFS). Orthodontics had the highest number of LOE II studies, pediatric dentistry had the most LOE IV, and prosthodontics had the most LOE V studies. No significant correlations were found between LOE and the number of authors or centers. However, a significant correlation was found in the distribution of LOE contributed by academic institutes.

Conclusion

The study results highlight that most articles were LOE IV and V, whereas nominal LOE I articles were found. Furthermore, there is a need to encourage dental scientists to carry out high-quality evidence studies. Professional dental societies can play a pivotal role in this regard.

Polytetrafluoroethylene tape spacer for direct splinted teeth-supported provisional restoration: A dental technique

Provisional restoration is essential for function, esthetics, occlusion, and tissue health. However, when multiple teeth are involved, making a direct splinted provisional restoration could be challenging due to the combined undercuts between the prepared teeth. This article describes a dental technique using polytetrafluoroethylene (PTFE) tape as a spacer to fabricate a splinted provisional restoration for multiple prepared teeth. The PTFE tape spacer will compensate for discrepancies in the path of insertion between prepared teeth, thus facilitating the removal of the direct splinted provisional restoration intact.

Impact of intraoral scanner, scanning strategy, and scanned arch on the scan accuracy of edentulous arches: An in vitro study

STATEMENT OF PROBLEM

The scanning strategy used when making complete arch digital scans affects the accuracy of the scan, and the accuracy of the strategy may be influenced by the scanner used. However, these effects have not been investigated thoroughly with complete arch edentulous scanning.

PURPOSE

The purpose of this in vitro study was to determine the effect of scanning strategies and the scanned arch on the accuracy of complete arch edentulous scans using 2 intraoral scanner (IOS) systems.

MATERIAL AND METHODS

Two IOSs were used (TRIOS 4 and Emerald S) to scan maxillary and mandibular typodonts using 6 scanning strategies (test scans), and conventional impressions of both arches were also made. By using a metrology software program, test scans were superimposed onto a reference scan, and the root mean square (RMS) of the absolute deviation values was calculated to express trueness. The sample with the best trueness was used as reference onto which the remaining samples from the same group were superimposed, and the RMS of the absolute deviation values was calculated to express precision. Statistical modeling was applied using the fixed effects models (α=.05).

RESULTS

The main effects of scanner and strategy significantly impacted the trueness RMS values (P<.001), with significant interactions between them (P=.012). The main effects of scanner, strategy, and arch significantly impacted the precision of RMS values (P=.004), (P=.033), and (P=.023). Conventional impressions and the TRIOS 4 scanner had comparable accuracy, while the Emerald S scanner was inferior to both. P-O-B had the highest overall accuracy and strategy ZZ had the worst. Better precision was found with the maxillary arch.

CONCLUSIONS

The scanner type and scanning strategy significantly impacted the accuracy of the digital scans of completely edentulous arches, with a significant interaction between scanner and strategy. The arch being scanned had a significant effect on scan precision but not on scan trueness.

Complete-Arch Implant Rehabilitation with the Aid of Computer-Assisted Implant Surgery and Transitional Implants: A New Digital Approach

This case report describes a new digital workflow for computer-assisted implant surgery in an edentulous patient using transitional implants to support a fixed surgical template and interim prosthesis. The accuracy of the final implant position using the described protocol was evaluated and compared to the outcomes obtained using other types of surgical templates. This novel digital approach appears to enhance the accuracy of implant positioning for edentulous patients and seems to be comparable to a tooth-supported surgical template.

The impact of cone beam computer tomography field of view on the precision of digital intra-oral scan registration for static computer-assisted implant surgery: A CBCT analysis

OBJECTIVES

Registration of intra-oral surface scans to cone beam computer tomography (CBCT) is critical in the digital workflow for static computer-aided implant surgery (sCAIS). This study aimed to assess the impact of CBCT field of view (FoV) on the precision of digital intra-oral scan registration.

MATERIALS AND METHODS

Cone beam computer tomography data and intra-oral scans from 20 patients were included. Small FoV CBCT's were created by digitally segmenting a large FoV into three sextants. Virtual implant planning was performed. Digital intra-oral scans were repeatedly registered onto their corresponding large and small FoV CBCT datasets. The distances and angulations between the matching implant positions of each repeated registration were used to determine the precision of the registration process. Wilcoxon Signed Rank Paired Tests were used to compare the differences between large FoV and small FoV. The threshold for statistical significance was set at p = .05.

RESULTS

Differences in 3D implant position based on the registration precision between small FoV and large FoV present at both the implant entry point (0.37 ± 0.25 mm vs 0.35 ± 0.23 mm, p = .482) and implant tip (0.49 ± 0.34 mm vs 0.37 ± 0.24 mm, p < .001). Differences in overall angular precision were observed between small FOV and large FoV (1.43 ± 1.36° vs 0.51 ± 0.38°, p < .001).

CONCLUSION

CBCT with a small FoV is accompanied by greater precision errors in intra-oral scan registration. However, when sufficient well-distributed teeth are visible in small FoV CBCT, the precision of digital intra-oral scan registration appears to be within clinically acceptable limits for sCAIS.

Tilted versus axial implant distribution in the posterior edentulous maxilla: A CBCT analysis

OBJECTIVES

This study aimed to determine whether distally angulating an implant is a successful strategy to avoid the maxillary sinus and the need for bone augmentation, while increasing the anterior-posterior (A-P) implant distribution in the edentulous maxilla.

MATERIALS AND METHODS

In 115 patients with edentulous maxillae, virtual implant planning was performed utilizing cone-beam computer tomographs. Axial (8 mm length) and tilted (12 mm length) dental implants with 30-degree and 45-degree angulation were virtually positioned to avoid entering the maxillary sinus, while maximizing A-P distribution. Measurements were made between the tilted and axial implants to assess the change in A-P distribution of implants at the implant and abutment levels.

RESULTS

Forty-seven sites (20.4%) were not able to have either treatment modality with insufficient bone for implant placement. Axial implants were placed more distally than 45-degree and 30-degree tilted implants in 24% and 42% of sites, respectively. The average change in A-P spread measured at the implant level, for 30- and 45-degree tilted implants was -0.25 mm (95% CI -0.76, 0.26) and 1.9 mm (95% CI 1.4, 2.3), respectively. When measured from the center of each multi-unit abutment the average increase in A-P distances for tilted implants appears larger in the 30-degree and 45-degree groups by 0.97 mm and 1.74 mm, respectively compared to measurements at the implant level.

CONCLUSIONS

Angulating 12 mm implants provides a limited increase in A-P distribution of implants in edentulous rehabilitation in most situations. In certain patients, the use of 8mm axial implants may provide a greater A-P spread.

Designing a complete-arch digital trial tooth arrangement for completely edentulous patients by using an open-source CAD software program: A dental technique

A method for creating a complete-arch digital trial tooth arrangement for completely edentulous patients is described. The technique demonstrates an effective way to reproduce the dental and gingival anatomies by using a free 3D modeling software program. This cost-effective, time-saving, and versatile method allows dental professionals to digitally plan challenging treatments for completely edentulous patients. The technique can also be used to fabricate diagnostic prostheses and implant-supported interim prostheses.

A Modified Implant Surgical Guide for the Administration of Maxillary Nerve Block Anesthesia Intraorally via the Greater Palatine Foramen: Case Report

Block anesthesia for the maxillary division (V2) of the trigeminal nerve is a suitable approach when an entire quadrant of teeth and/or associated structures are involved. The most effective approach to anesthetize the maxillary branch is intraorally via the greater palatine canal. This case report describes the use of a computer-aided design/computer-assisted manufacturing (CAD/CAM) implant surgical template designed with a guide channel to allow for the administration of maxillary nerve block through the greater palatine canal.

Impact of number of registration points on the positional accuracy of a prosthetic treatment plan incorporated into a cone beam computed tomography scan by surface scan registration: An in vitro study

OBJECTIVES

To evaluate the accuracy of a prosthetic treatment plan incorporation into a cone beam computed tomography (CBCT) scan using point-based registration with three registration points selected and to evaluate the impact of number of registration points on prosthetic plan accuracy.

MATERIAL AND METHODS

A CBCT scan of a completely dentate master model with removable teeth was exposed after removing the mandibular left first premolar, second premolar, and first molar. A digital scan of the master model with all teeth present was made by scanning a stone replica using a laboratory scanner. The digital model was registered onto the three-dimensional (3D) volume rendering of the CBCT scan using implant planning software. The point-based registration was repeated using three, four, five, six, seven, eight, nine, and 10 reference points. Metrology software was used to measure the 3D deviation of the registered models for each reference point group on standard tessellation language (STL) files obtained from the CBCT scans. An STL file of the master model with all teeth present obtained from another CBCT scan was used as reference.

RESULTS

Using three registration points, the registered prosthetic plan had a mean absolute deviation of 17.63 µm from the reference. Increasing the number of registration points failed to demonstrate statistically significant effects on the deviation (p > 0.05).

CONCLUSIONS

For this clinical scenario, three registration points provided adequate accuracy for prosthetic plan incorporation into CBCT scans. Increasing the number of registration points had no significant impact on the prosthetic plan accuracy in this study.

Modification of clinically short Locator abutments using laser welding

As dental implants continue to survive longer, managing and maintaining implant prostheses can be complicated by the lack of compatible parts or the discontinuation of implant systems. This report describes a laser welding procedure for the management of clinically short Locator abutments (Zest Anchors Inc) that lacked a commercially available, compatible alternative.

A technique for the removal of a wedged implant abutment fragment or debonded titanium base

A technique for the retrieval of wedged implant fragments is described. The technique is suitable for fractured zirconia and metal abutments and titanium bases left behind after fracture or debonding of the custom zirconia abutment from the titanium base of an implant-supported prosthesis. This straightforward, noninvasive, technique facilitates the removal of the fragments or titanium bases without risking damage to the implant, surrounding bone, or soft tissues.