Journal of Clinical Medicine

Research

15 pages, 3703 KiB

Open AccessArticle

Fully Digital Workflow for Planning Static Guided Implant Surgery: A Prospective Accuracy Study

by Chia-Cheng Lin, Ching-Zong Wu, Mao-Suan Huang, Chiung-Fang Huang, Hsin-Chung Cheng and Dayen Peter Wang

J. Clin. Med. 2020, 9(4), 980; https://doi.org/10.3390/jcm9040980 - 1 Apr 2020

Cited by 43 | Viewed by 7069

Abstract

The accuracy of static guided implant surgery (sGIS) using conventional planning workflow has been extensively examined; however, more information is required to justify the application of fully digital planning protocol. The purpose of this study was to investigate the clinical accuracy of sGIS [...] Read more.

The accuracy of static guided implant surgery (sGIS) using conventional planning workflow has been extensively examined; however, more information is required to justify the application of fully digital planning protocol. The purpose of this study was to investigate the clinical accuracy of sGIS with a fully digital planning workflow. Twenty-one partially edentulous patients were enrolled in this prospective study. Cone-beam computed tomography (CBCT) and intraoral scans were taken and superimposed by matching the dental surface images directly (surface registration protocol) or by matching fiducial markers on a stereolithographic (SLA) radiographic template fabricated from the digital data of the intraoral scan (fiducial marker registration protocol). Virtual implant treatment plans were then determined, and tooth-supported SLA surgical guides were fabricated according to the plans. Twenty-six implant surgeries were performed via the surgical guide by one surgeon. Pre- and post-operative CBCT images were superimposed, and the positional and angular deviations between placed and planned implants were measured with metrology software. A total of 43 fully guided implants were placed, in which 25 implants were planned with the surface registration protocol. Implants planned based on the surface registration protocol had a larger mean angular deviation than the fiducial marker registration protocol. No significant differences were found for any deviations of the examined variables. Within the limits of this study, we concluded that the clinical accuracy of the sGIS planned with a fully digital workflow was consistent with the conventional workflow for partially edentulous patients. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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18 pages, 4215 KiB

Open AccessArticle

Evaluation of the Dimensional Accuracy of 3D-Printed Anatomical Mandibular Models Using FFF, SLA, SLS, MJ, and BJ Printing Technology

by Bilal Msallem, Neha Sharma, Shuaishuai Cao, Florian S. Halbeisen, Hans-Florian Zeilhofer and Florian M. Thieringer

J. Clin. Med. 2020, 9(3), 817; https://doi.org/10.3390/jcm9030817 - 17 Mar 2020

Cited by 150 | Viewed by 12191

Abstract

With the rapid progression of additive manufacturing and the emergence of new 3D printing technologies, accuracy assessment is mostly being performed on isosymmetric-shaped test bodies. However, the accuracy of anatomic models can vary. The dimensional accuracy of root mean square values in terms [...] Read more.

With the rapid progression of additive manufacturing and the emergence of new 3D printing technologies, accuracy assessment is mostly being performed on isosymmetric-shaped test bodies. However, the accuracy of anatomic models can vary. The dimensional accuracy of root mean square values in terms of trueness and precision of 50 mandibular replicas, printed with five common printing technologies, were evaluated. The highest trueness was found for the selective laser sintering printer (0.11 ± 0.016 mm), followed by a binder jetting printer (0.14 ± 0.02 mm), and a fused filament fabrication printer (0.16 ± 0.009 mm). However, highest precision was identified for the fused filament fabrication printer (0.05 ± 0.005 mm) whereas other printers had marginally lower values. Despite the statistically significance (p < 0.001), these differences can be considered clinically insignificant. These findings demonstrate that all 3D printing technologies create models with satisfactory dimensional accuracy for surgical use. Since satisfactory results in terms of accuracy can be reached with most technologies, the choice should be more strongly based on the printing materials, the intended use, and the overall budget. The simplest printing technology (fused filament fabrication) always scored high and thus is a reliable choice for most purposes. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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10 pages, 960 KiB

Open AccessArticle

Accuracy of Edentulous Computer-Aided Implant Surgery as Compared to Virtual Planning: A Retrospective Multicenter Study

by R. Vinci, M. Manacorda, R. Abundo, A.G. Lucchina, A. Scarano, C. Crocetta, L. Lo Muzio, E.F. Gherlone and F. Mastrangelo

J. Clin. Med. 2020, 9(3), 774; https://doi.org/10.3390/jcm9030774 - 12 Mar 2020

Cited by 37 | Viewed by 3685

Abstract

Purpose: To evaluate the accuracy of computer-aided dental implant positions obtained with mucosal-supported templates as compared to Three-Dimensional (3D) planning. Materials and methods: One-hundred implants were inserted into 14 edentulous patients using the All-on-4/6 protocol after surgical virtual planning with RealGUIDE, 3DIEMME, and [...] Read more.

Purpose: To evaluate the accuracy of computer-aided dental implant positions obtained with mucosal-supported templates as compared to Three-Dimensional (3D) planning. Materials and methods: One-hundred implants were inserted into 14 edentulous patients using the All-on-4/6 protocol after surgical virtual planning with RealGUIDE, 3DIEMME, and Geomagic software. After 6 months, three-dimensional neck (V) and apex (S) spatial coordinates of implants and angle inclination displacements as compared to virtual plans were evaluated. Results: The S maxilla coordinates revealed a significant discrepancy between clinical and virtual implant positions (p-value = 0.091). The V coordinates showed no significant differences (p-value = 0.71). The S (p-value = 0.017) and V (p-value = 0.038) mandible coordinates showed significant discrepancies between the clinical and virtual positions of the screws. Implant evaluation showed a 1-mm in average of the horizontal deviation in the V point and a 1.6-mm deviation in the S point. A mean 5° angular global deviation was detected. The multivariate permutation test of the S (p-value = 0.02) confirmed the difference. Greater errors in the mandible were detected as compared to the maxilla, and a higher S discrepancy was found in the posterior jaw compared to the anterior section of both the mandible and maxilla. Conclusions: Computer-aided surgery with mucosal-supported templates is a predictable procedure for implant placement. Data showed a discrepancy between the actual dental implant position as compared to the virtual plan, but this was not statistically significant. However, the horizontal and angle deviations detected indicated that flap surgery should be used to prevent implant positioning errors due to poor sensitivity and accuracy in cases of severe jaw atrophy. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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13 pages, 3362 KiB

Open AccessArticle

Stereolithographic Surgical Guide with a Combination of Tooth and Bone Support: Accuracy of Guided Implant Surgery in Distal Extension Situation

by Chia-Cheng Lin, Masahiro Ishikawa, Takeo Maida, Hsin-Chung Cheng, Keng-Liang Ou, Takashi Nezu and Kazuhiko Endo

J. Clin. Med. 2020, 9(3), 709; https://doi.org/10.3390/jcm9030709 - 5 Mar 2020

Cited by 16 | Viewed by 6305

Abstract

A distal free-end situation could result in insufficient stability of the surgical guide, and could reduce accuracy of the static guided implant surgery (sGIS). The purpose of this study was to investigate the accuracy of sGIS using a combination tooth-and-bone supported stereolithographic (SLA) [...] Read more.

A distal free-end situation could result in insufficient stability of the surgical guide, and could reduce accuracy of the static guided implant surgery (sGIS). The purpose of this study was to investigate the accuracy of sGIS using a combination tooth-and-bone supported stereolithographic (SLA) surgical guide in distal extension situation. Thirty dentists, each placed three implants at the Federal Dentaire Internationale (FDI) teeth positions #46, #47 (a distal extension situation), and #36 (a single tooth gap) via the surgical guide on a model fixed to a manikin. Pre- and post-operative computed tomography (CT) images of the models were superimposed, and the positional and angular deviations of the implants were measured with metrology software. An analysis of variance (ANOVA) test was performed to evaluate the intergroup differences. No significant differences were found for all the positional and angular deviations among the three implant sites, except the bucco-lingual deviation at the implant platform in the #47 position (0.43 ± 0.19 mm) that was significantly larger than the #46 (0.21 ± 0.14 mm) and #36 (0.24 ± 0.25 mm) positions (p < 0.0001). Within the limits of this study, we conclude that, in distal extension situation of missing mandibular molars, adding a bone-supported strut in the distal part of the surgical guide can be beneficial to the accuracy of the sGIS. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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9 pages, 1377 KiB

Open AccessArticle

Accuracy of Digital and Conventional Full-Arch Impressions in Patients: An Update

by Alexander Schmidt, Leona Klussmann, Bernd Wöstmann and Maximiliane Amelie Schlenz

J. Clin. Med. 2020, 9(3), 688; https://doi.org/10.3390/jcm9030688 - 4 Mar 2020

Cited by 79 | Viewed by 7533

Abstract

The aim of this clinical study was to update the available data in the literature regarding the transfer accuracy (trueness/precision) of four current intraoral scanners (IOS) equipped with the latest software versions and to compare these data with conventional impressions (CVI). A metallic [...] Read more.

The aim of this clinical study was to update the available data in the literature regarding the transfer accuracy (trueness/precision) of four current intraoral scanners (IOS) equipped with the latest software versions and to compare these data with conventional impressions (CVI). A metallic reference aid served as a reference dataset. Four digital impressions (Trios3Cart, Trios3Pod, Trios4Pod, and Primescan) and one CVI were investigated in five patients. Scan data were analyzed using three-dimensional analysis software and conventional models using a coordinate measurement machine. The transfer accuracy between the reference aid and the impression methods were compared. Differences with p < 0.05 were considered to be statistically significant. Overall, mean ± standard deviation (SD) transfer accuracy ranged from 24.6 ± 17.7 µm (CVI) to 204.5 ± 182.1 µm (Trios3Pod). The Primescan yielded the lowest deviation for digital impressions (33.8 ± 31.5 µm), followed by Trios4Pod (65.2 ± 52.9 µm), Trios3Cart (84.7 ± 120.3 µm), and Trios3Pod. Within the limitations of this study, current IOS equipped with the latest software versions demonstrated less deviation for short-span distances compared with the conventional impression technique. However, for long-span distances, the conventional impression technique provided the lowest deviation. Overall, currently available IOS systems demonstrated improvement regarding transfer accuracy of full-arch scans in patients. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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13 pages, 3205 KiB

Open AccessArticle

Factors Affecting Total Treatment Time in Patients Treated with Orthognathic Surgery Using the Surgery-First Approach: Multivariable Analysis Using 3D CT and Scanned Dental Casts

by Jun-Young Kim, Jin Hoo Park, Hwi-Dong Jung and Young-Soo Jung

J. Clin. Med. 2020, 9(3), 641; https://doi.org/10.3390/jcm9030641 - 28 Feb 2020

Cited by 9 | Viewed by 3272

Abstract

The aim of this study was to analyze factors affecting treatment times in patients treated with the surgery-first approach (SFA) for orthognathic surgery. Fifty skeletal class III patients who had undergone SFA bimaxillary orthognathic surgery were enrolled. Retrospective chart reviews and analysis of [...] Read more.

The aim of this study was to analyze factors affecting treatment times in patients treated with the surgery-first approach (SFA) for orthognathic surgery. Fifty skeletal class III patients who had undergone SFA bimaxillary orthognathic surgery were enrolled. Retrospective chart reviews and analysis of 3D CT and digitally scanned casts were conducted to assess the total treatment time. Statistical analysis was then performed with multiple study variables. Longer treatment times were required for patients with severe maxillary or mandibular teeth crowding (p = 0.009), a preoperative anterior open bite (p = 0.021), and those undergoing orthodontic extractions (p < 0.001). Longer treatment times were also observed when setting surgical occlusion in the postoperative anterior open bite (p = 0.007) and in patients with postoperative dental midline deviation (p < 0.001) and transverse maxillary deficiencies (p = 0.035). Treatment times were shorter when a class I molar key was formed in the surgical occlusion setup (p = 0.002) and in bilateral anterior and posterior occlusion with a minimum of four contact points (p < 0.001). The number of contact points, the number of extracted teeth, and postoperative midline deviation were identified as significant predictors. These results suggest that proper patient selection is important when considering SFA and that surgeons can reduce total treatment time with an appropriate surgical occlusion setup. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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20 pages, 7273 KiB

Open AccessArticle

Eighteen Months Follow-Up with Patient-Centered Outcomes Assessment of Complete Dentures Manufactured Using a Hybrid Nanocomposite and Additive CAD/CAM Protocol

by Corina Marilena Cristache, Eugenia Eftimie Totu, Gabriela Iorgulescu, Aida Pantazi, Dorel Dorobantu, Aurelia Cristina Nechifor, Ibrahim Isildak, Mihai Burlibasa, Gheorghe Nechifor and Marius Enachescu

J. Clin. Med. 2020, 9(2), 324; https://doi.org/10.3390/jcm9020324 - 23 Jan 2020

Cited by 53 | Viewed by 5192

Abstract

The present study aimed to assess the eighteen month follow-up patient-centered outcomes of a simple and predictable protocol for 3D-printed functional complete dentures manufactured using an improved poly(methyl methacrylate) (PMMA)–nanoTiO₂. A detailed morphological and structural characterization of the PMMA–TiO₂ nanocomposite, [...] Read more.

The present study aimed to assess the eighteen month follow-up patient-centered outcomes of a simple and predictable protocol for 3D-printed functional complete dentures manufactured using an improved poly(methyl methacrylate) (PMMA)–nanoTiO₂. A detailed morphological and structural characterization of the PMMA–TiO₂ nanocomposite, using SEM, EDX, XRD, and AFM, after 3D-printing procedure and post-wearing micro-CT, was also performed. Methods: A total of 35 fully edentulous patients were enrolled in this prospective study. A 0.4% TiO₂-nanoparticle-reinforced PMMA composite with improved mechanical strength, morphologically and structurally characterized, was used according to an additive computer-aided design and computer-aided manufacturing (CAD/CAM) protocol for complete denture fabrication. The protocol proposed involved a three-step appointment process. Before denture insertion, 1 week, 12 month, and 18-month follow up patients were evaluated via the Visual Analogue Scale (VAS, 0–10) and Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT), with a higher score meaning poor quality of life. Results: A total of 45 complete denture sets were inserted. OHIP-EDENT scored significantly better after 18 months of denture wearing, 20.43 (±4.42) compared to 52.57 (±8.16) before treatment; mean VAS was improved for all parameters assessed. Conclusions: Within the limitations of this study, we can state that the proposed workflow with the improved material used is a viable treatment option for patients diagnosed with complete edentulism. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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14 pages, 2976 KiB

Open AccessArticle

Comparison between Micro-Computed Tomography and Cone-Beam Computed Tomography in the Assessment of Bone Quality and a Long-Term Volumetric Study of the Augmented Sinus Grafted with an Albumin Impregnated Allograft

by Márton Kivovics, Bence Tamás Szabó, Orsolya Németh, Dóra Iványi, Bálint Trimmel, Ilona Szmirnova, Kaan Orhan, Eitan Mijiritsky, György Szabó and Csaba Dobó-Nagy

J. Clin. Med. 2020, 9(2), 303; https://doi.org/10.3390/jcm9020303 - 21 Jan 2020

Cited by 16 | Viewed by 3660

Abstract

The purpose of our study was to compare micromorphometric data obtained by cone-beam computed-tomography (CBCT) and microcomputed-tomography (micro-CT) of the augmented sinus and to evaluate the long-term stability of the bone gain achieved using BoneAlbumin. Sinus lifts, and after 6-months, healing bone-biopsy and [...] Read more.

The purpose of our study was to compare micromorphometric data obtained by cone-beam computed-tomography (CBCT) and microcomputed-tomography (micro-CT) of the augmented sinus and to evaluate the long-term stability of the bone gain achieved using BoneAlbumin. Sinus lifts, and after 6-months, healing bone-biopsy and implant placement were carried out. Specimens were analyzed by micro-CT. A total of 16 samples were collected from nine patients (mean age 54.7 ± 6.5 years). Pre-, postoperative, and 3-year control CBCT-data were registered to determine from where the biopsy samples were harvested. Micromorphometric variables were calculated from the micro-CT- and CBCT-data, and their correlation was determined by Spearman’s test. The volume of augmented bone was calculated at the time of implant placement and after 3 years. A positive correlation was found between bone-volume fraction, trabecular-separation, open-, and total-porosity, while a negative correlation was found between trabecular-thickness obtained from CBCT- and micro-CT-data (p < 0.05). Mean volumetric reduction of 39.28% (11.88–60.02%) was observed. Correlation of CBCT- and micro-CT-data suggested that micromorphometric analysis of CBCT reconstructions of the augmented sinuses provided reliable information on the microarchitecture of augmented bone. CBCT as a modality might be adequate in the analysis of bone quality in the augmented sinus. At the 3-year, control sinus grafts showed volumetric stability. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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7 pages, 2662 KiB

Open AccessArticle

Influence of the Digital Mock-Up and Experience on the Ability to Determine the Prosthetically Correct Dental Implant Position during Digital Planning: An In Vitro Study

by Miriam O’Connor Esteban, Elena Riad Deglow, Álvaro Zubizarreta-Macho and Sofía Hernández Montero

J. Clin. Med. 2020, 9(1), 48; https://doi.org/10.3390/jcm9010048 - 24 Dec 2019

Cited by 9 | Viewed by 3276

Abstract

The purpose of this study was to analyze the influence of the digital mock-up and operator experience on the dental implant planning position. A total of 200 dental implants were planned, which were distributed into two study groups: A. dental implant planning by [...] Read more.

The purpose of this study was to analyze the influence of the digital mock-up and operator experience on the dental implant planning position. A total of 200 dental implants were planned, which were distributed into two study groups: A. dental implant planning by dental surgeons with 5–10 years of experience (n = 80); and B. dental implant planning by dental surgery students without experience (n = 120). Operators were required to plan eight dental implants in the same maxillary edentulous case uploaded in 3D implant-planning software, before and after using the digital mock-up. Deviations between the dental implant planning positions before and after using the digital mock-up were analyzed at platform, apical and angular levels, and were analyzed using a 3D implant-planning software using Student’s t test. The paired t-test revealed statistically significant differences between the deviation levels of participants with 5–10 years’ experience and no experience at the platform, apical and angular levels. Digital mock-ups allow for more accurate dental implant planning regardless of the experience of the operator. Nevertheless, they are more useful for operators without dental surgery experience. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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22 pages, 3997 KiB

Open AccessArticle

Modern Surgery-First Approach Concept in Cleft-Orthognathic Surgery: A Comparative Cohort Study with 3D Quantitative Analysis of Surgical-Occlusion Setup

by Hyung Joon Seo, Rafael Denadai, Betty Chien-Jung Pai and Lun-Jou Lo

J. Clin. Med. 2019, 8(12), 2116; https://doi.org/10.3390/jcm8122116 - 2 Dec 2019

Cited by 21 | Viewed by 5691

Abstract

Despite the evident benefits of the modern surgery-first orthognathic surgery approach (reduced treatment time, efficient tooth decompensation, and early improvement in facial esthetics), the challenge of the surgical-occlusion setup acts as a hindering factor for the widespread and global adoption of this therapeutic [...] Read more.

Despite the evident benefits of the modern surgery-first orthognathic surgery approach (reduced treatment time, efficient tooth decompensation, and early improvement in facial esthetics), the challenge of the surgical-occlusion setup acts as a hindering factor for the widespread and global adoption of this therapeutic modality, especially for the management of cleft-skeletofacial deformity. This is the first study to assess three-dimensional (3D) quantitative data of the surgical-occlusion setup in surgery-first cleft-orthognathic surgery. This comparative retrospective study was performed on 3D image datasets from consecutive patients with skeletal Class III deformity who had a unilateral cleft lip/palate (cleft cohort, n = 44) or a noncleft dentofacial deformity (noncleft cohort, n = 22) and underwent 3D computer-assisted single-splint two-jaw surgery by a single multidisciplinary team between 2014 and 2018. They received conventional orthodontics-first or surgery-first approaches. 3D quantitative characterization (linear, angular, and positional measurements) of the final surgical-occlusion setup was performed and adopted for comparative analyses. In the cleft cohort, the occlusion setup in the surgery-first approach had a significantly (all p < 0.05) smaller number of anterior teeth contacts and larger incisor overjet compared to the conventional approach. Considering the surgery-first approach, the cleft cohort presented significantly (all p < 0.05) larger (canine lateral overjet parameter) and smaller (incisor overjet, maxillary intercanine distance, maxillary intermolar distance, ratio of intercanine distance, and ratio of intermolar distance parameters) values than the noncleft cohort. This study contributes to the literature by providing 3D quantitative data of the surgical-occlusion setup in surgery-first cleft-orthognathic surgery, and delivers information that may assist multidisciplinary teams to adopt the surgery-first concept to optimize cleft care. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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18 pages, 2594 KiB

Open AccessArticle

Computer-Aided Planning in Orthognathic Surgery: A Comparative Study with the Establishment of Burstone Analysis-Derived 3D Norms

by Cheng-Ting Ho, Rafael Denadai, Hsin-Chih Lai, Lun-Jou Lo and Hsiu-Hsia Lin

J. Clin. Med. 2019, 8(12), 2106; https://doi.org/10.3390/jcm8122106 - 2 Dec 2019

Cited by 10 | Viewed by 4952

Abstract

Three-dimensional (3D) computer-aided simulation has revolutionized orthognathic surgery treatment, but scarce 3D cephalometric norms have been defined to date. The purposes of this study were to (1) establish a normative database of 3D Burstone cephalometric measurements for adult male and female Chinese in [...] Read more.

Three-dimensional (3D) computer-aided simulation has revolutionized orthognathic surgery treatment, but scarce 3D cephalometric norms have been defined to date. The purposes of this study were to (1) establish a normative database of 3D Burstone cephalometric measurements for adult male and female Chinese in Taiwan, (2) compare this 3D norm dataset with the two-dimensional (2D) Burstone norms from Caucasian and Singaporean Chinese populations, and (3) apply these 3D norms to assess the outcome of a computer-aided simulation of orthognathic surgery. Three-dimensional Burstone cephalometric analysis was performed on 3D digital craniofacial image models generated from cone-beam computed tomography datasets of 60 adult Taiwanese Chinese individuals with normal occlusion and balanced facial profile. Three-dimensional Burstone analysis was performed on 3D image datasets from patients with skeletal Class III pattern (n = 30) with prior computer-aided simulation. Three-dimensional Burstone cephalometric measurements showed that Taiwanese Chinese males had significantly (p < 0.05) larger anterior and posterior facial heights, maxillary length, and mandibular ramus height than females, with no significant (p > 0.05) difference for facial soft-tissue parameters. The 3D norm dataset revealed Taiwanese Chinese-specific facial characteristics, with Taiwanese presenting (p < 0.05) a more convex profile, protrusive maxillary apical bases, protruding mandible, protruding upper and lower lips, and a shorter maxillary length and lower facial height than Caucasians. Taiwanese had significantly (p < 0.05) larger maxillary projection, vertical height ratio, lower face throat angle, nasolabial angle, and upper lip protrusion than Singaporean Chinese. No significant (p > 0.05) difference was observed between 3D norms and computer-aided simulation-derived 3D patient images for horizontal skeletal, vertical skeletal, and dental measurements, with the exception of two dental parameters (p < 0.05). This study contributes to literature by providing gender- and ethnic-specific 3D Burstone cephalometric norms, which can assist in the multidisciplinary-based delivery of orthodontic surgical care for Taiwanese Chinese individuals worldwide, including orthodontic management, computer-assisted simulation, and outcome assessment. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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11 pages, 1962 KiB

Open AccessArticle

Comparative Volume Analysis of Alveolar Defects by 3D Simulation

by Pang-Yun Chou, Rafael Denadai, Rami R. Hallac, Sarayuth Dumrongwongsiri, Wei-Chuan Hsieh, Betty CJ Pai and Lun-Jou Lo

J. Clin. Med. 2019, 8(9), 1401; https://doi.org/10.3390/jcm8091401 - 6 Sep 2019

Cited by 23 | Viewed by 3768

Abstract

A precise volumetric assessment of maxillary alveolar defects in patients with cleft lip and palate can reduce donor site morbidity or allow accurate preparation of bone substitutes in future applications. However, there is a lack of agreement regarding the optimal volumetric technique to [...] Read more.

A precise volumetric assessment of maxillary alveolar defects in patients with cleft lip and palate can reduce donor site morbidity or allow accurate preparation of bone substitutes in future applications. However, there is a lack of agreement regarding the optimal volumetric technique to adopt. This study measured the alveolar bone defects by using two cone-beam computed tomography (CBCT)-based surgical simulation methods. Presurgical CBCT scans from 32 patients with unilateral or bilateral clefts undergoing alveolar bone graft surgery were analyzed. Two hands-on CBCT-based volumetric measurement methods were compared: the 3D real-scale printed model-based surgical method and the virtual surgical method. Different densities of CBCT were compared. Intra- and inter-examiner reliability was assessed. For patients with unilateral clefts, the average alveolar defect volumes were 1.09 ± 0.24 and 1.09 ± 0.25 mL (p > 0.05) for 3D printing- and virtual-based models, respectively; for patients with bilateral clefts, they were 2.05 ± 0.22 and 2.02 ± 0.27 mL (p > 0.05), respectively. Bland–Altman analysis revealed that the methods were equivalent for unilateral and bilateral alveolar cleft defect assessment. No significant differences or linear relationships were observed between adjacent different densities of CBCT for model production to obtain the measured volumes. Intra- and inter-examiner reliability was moderate to good (intraclass correlation coefficient (ICC) > 0.6) for all measurements. This study revealed that the volume of unilateral and bilateral alveolar cleft defects can be equally quantified by 3D-printed and virtual surgical simulation methods and provides alveolar defect-specific volumes which can serve as a reference for planning and execution of alveolar bone graft surgery. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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9 pages, 2006 KiB

Open AccessArticle

Repeatability of Intraoral Scanners for Complete Arch Scan of Partially Edentulous Dentitions: An In Vitro Study

by Jae-Hyun Lee, Je-Hyeon Yun, Jung-Suk Han, In-Sung Luke Yeo and Hyung-In Yoon

J. Clin. Med. 2019, 8(8), 1187; https://doi.org/10.3390/jcm8081187 - 8 Aug 2019

Cited by 53 | Viewed by 10248

Abstract

Research on whether the number or location of missing teeth affects the accuracy of intraoral scanners in partial edentulous patients is scarce. This study aimed to evaluate the precision of complete-arch scan data of various partial edentulous arches acquired by intraoral scanners. Five [...] Read more.

Research on whether the number or location of missing teeth affects the accuracy of intraoral scanners in partial edentulous patients is scarce. This study aimed to evaluate the precision of complete-arch scan data of various partial edentulous arches acquired by intraoral scanners. Five different maxillary models were scanned using Carestream CS3600 and Medit i500 scanners. The models employed here were control: Fully dentate; Case 1: Missing a right second premolar and a first molar; Case 2: Missing a right second premolar, a first molar, both left premolars, and a left first molar; Case 3: Missing four incisors and a right canine; and Case 4: Missing four incisors, a left second premolar, and a first molar. Six scans per group were performed and the resulting two datasets were paired to analyze the precision of each group (n = 15). Two-way ANOVA was performed (α = 0.05). The root mean square (RMS) error values in Cases 2, 3, and 4 were significantly higher than those in Case 1 and control. The RMS values of the two intraoral scanners were not significantly different. Scanning precision was significantly lower for both devices when used for scanning dental arches with ≥5 missing teeth. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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17 pages, 4069 KiB

Open AccessArticle

A Comparison Study of Marginal and Internal Fit Assessment Methods for Fixed Dental Prostheses

by Keunbada Son, Sangbong Lee, Seok Hyon Kang, Jaeseok Park, Kyu-Bok Lee, Mansik Jeon and Byoung-Ju Yun

J. Clin. Med. 2019, 8(6), 785; https://doi.org/10.3390/jcm8060785 - 1 Jun 2019

Cited by 70 | Viewed by 6544

Abstract

Numerous studies have previously evaluated the marginal and internal fit of fixed prostheses; however, few reports have performed an objective comparison of the various methods used for their assessment. The purpose of this study was to compare five marginal and internal fit assessment [...] Read more.

Numerous studies have previously evaluated the marginal and internal fit of fixed prostheses; however, few reports have performed an objective comparison of the various methods used for their assessment. The purpose of this study was to compare five marginal and internal fit assessment methods for fixed prostheses. A specially designed sample was used to measure the marginal and internal fit of the prosthesis according to the cross-sectional method (CSM), silicone replica technique (SRT), triple scan method (TSM), micro-computed tomography (MCT), and optical coherence tomography (OCT). The five methods showed significant differences in the four regions that were assessed (p < 0.001). The marginal, axial, angle, and occlusal regions showed low mean values: CSM (23.2 µm), TSM (56.3 µm), MCT (84.3 µm), and MCT (102.6 µm), respectively. The marginal fit for each method was in the range of 23.2–83.4 µm and internal fit (axial, angle, and occlusal) ranged from 44.8–95.9 µm, 84.3–128.6 µm, and 102.6–140.5 µm, respectively. The marginal and internal fit showed significant differences depending on the method. Even if the assessment values of the marginal and internal fit are found to be in the allowable clinical range, the differences in the values according to the method should be considered. Full article

(This article belongs to the Special Issue Advances in Digital Dentistry: From Data Acquisition to Data Production)

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