Journal of Prosthetic Dentistry最新文献

The use of a 3-dimensionally (3D) printed, stackable device to verify a complete arch implant digital scan and record the maxillomandibular relation (MMR) in a single appointment is described. The device consists of a base component serving as a verification device and a superstructure component functioning as a record base. The computer-aided design and computer-aided manufacturing (CAD-CAM) workflow minimizes the inaccuracies associated with conventional resin verification devices, eliminates the need for additional clinical appointments, and enhances efficiency when providing complete arch implant-supported prostheses.

Statement of problem: Effective screeners for temporomandibular disorders (TMDs) should be concise, inexpensive, straightforward to complete, diagnostically accurate, and ideally self-administered. Existing instruments have notable limitations, underscoring the need for a multidimensional screener that addresses these gaps.

Purpose: This study evaluated the reliability, diagnostic accuracy, and cut-point optimization of the multidimensional 6Ts-4D screener for identifying pain-related (PT) and intra-articular (IT) TMDs and assessed its clinical utility across specific TMD subtypes.

Material and methods: A case-control study was conducted with 344 adults recruited from a university-based dental hospital. Participants completed the 6Ts-4D screener, followed by standardized Diagnostic Criteria for TMD (DC/TMD) interviews and clinical examinations, supplemented with diagnostic imaging to establish reference standards. Reliability was assessed using the Cronbach alpha and intraclass correlation coefficients. Diagnostic performance was evaluated with area under the receiver operating characteristic curve (AUC) analysis and conventional accuracy metrics. Optimal cut-points were determined using the Youden Index.

Results: The 6Ts-4D demonstrated acceptable reliability (Cronbach alpha 0.67) and excellent diagnostic performance for all TMDs (AUC 0.97; sensitivity 86.8%; specificity 100%). Subscale analyses showed good accuracy for PT (AUC 0.83) and IT (AUC 0.81). Item-level screening yielded moderate-to-good AUCs for myalgia (0.80), arthralgia (0.82), disc displacement with reduction (0.77), disc displacement without reduction with limited opening (0.82), and TMJ subluxation (0.79).

Conclusions: The 6Ts-4D screener was found to be a brief, reliable, and subtype-sensitive tool for TMD triage, with robust diagnostic metrics supporting its use in clinical, telehealth, and research settings.

Implant scanning workflows for fabricating implant-supported restorations involve recording scans containing different information. Different reference landmarks can be used to guide the integration of the scans recorded in an implant scanning workflow, including anatomic structures. This manuscript describes a maxillary implant workflow guided by anatomic structures as predominant reference landmark for 3 scanning techniques: 1 noncalibrated method, 3 extraoral photogrammetry (PG) systems, and 1 intraoral PG technique. Understanding the data collection procedures and the protocol sequence for each implant workflow is essential to the successful implementation of digital data acquisition technologies.

Statement of problem: Binocular difference is the perception difference between the right eye and the left eye in the same individual. This disparity is crucial in clinical practice and should be accounted for. However, information regarding the effect of this phenomenon in the dental literature is lacking.

Purpose: The purpose of this study was to evaluate the impact of viewing condition (binocular versus monocular), ocular dominance, and sex on color discrimination accuracy using the Farnsworth-Munsell 100-Hue (FM-100) test in dental students with normal color vision.

Material and methods: A total of 102 dental students (51 women; 51 men; 21.4 ±1.2 years) with normal color vision and uncorrected (20/20) visual acuity were enrolled after Ishihara screening. Ocular dominance was identified with the Dolman hole-in-card method. Each participant completed the (FM-100) test under 3 viewing conditions: binocular (BN), dominant eye (DE), and nondominant eye (NDE). A 120-minute rest period was provided between conditions. Total error scores (TESs) were calculated using the Farnsworth-Munsell scoring software program, where lower TESs indicated better color discrimination performance. The Wilcoxon signed-rank tests, as well as the Mann-Whitney U tests and Holm-Bonferroni correction, were used to analyze data (α=.05). Test-retest reliability (n=30, retested after 14 days) was tested using the intraclass correlation coefficient (ICC).

Results: Right eye dominance was observed in 70.6% of participants, with no significant sex-based variation (P=.664). TESs differed significantly by viewing condition (P<.001). Binocular viewing yielded the lowest TES (29.8 ±16.5), followed by dominant (32.7 ±17.6) and nondominant eyes (44.6 ±22.7). TESs were significantly lower under binocular versus nondominant viewing (P<.001) and dominant versus nondominant viewing (P<.001); binocular versus dominant was statistically similar (P=.089). For BN, the mean of TESs was 26.0 ±15.0 in women and 33.6 ±17.4 in men (P=.006). For DE, TESs were 28.6 ±15.1 in women and 36.8 ±18.1 in men (P=.008). ICC values for test-retest reliability were good (ICC=0.88) for the nondominant eye, with excellent reliability for binocular and dominant eye conditions (ICC≥0.9).

Conclusions: No significant difference between binocular and dominant viewing was found. Color discrimination accuracy was significantly better with binocular and dominant eye viewing than with the nondominant eye. Women demonstrated better color perception under all conditions. Routine screening for ocular dominance and visual accuracy could improve shade matching.

Statement of problem: Additively manufactured occlusal devices typically require labor-intensive polishing to achieve clinically acceptable surfaces. However, limited evidence exists on whether newer resin tanks that are claimed to improve surface and optical properties can reduce this need or how polishing and aging interact to affect surface and optical outcomes.

Purpose: The purpose of this in vitro study was to investigate the effects of resin type, resin tank selection, polishing procedures, and aging on the surface roughness (R_a), gloss, and light transmittance of additively manufactured occlusal device resins.

Material and methods: Eighty disk-shaped specimens (Ø30×2 mm) were additively manufactured from 2 hard occlusal device resins (Freeprint Splint 2.0, FPS and KeySplint Hard, KSH) using 2 different resin tanks (Universal [conventional] and Ultragloss [modified]) of a digital light processing 3-dimensional printer (MAX UV). After fabrication, the specimens were divided into 2 subgroups (nonpolished and polished) (n=10). Specimens in the polished group were manually polished with a pumice-water slurry followed by a polishing paste. After initial R_a, gloss, and light transmittance measurements, all specimens were subjected to thermocycling (10 000 cycles, 5 °C and 55 °C), and these measurements were repeated. Generalized linear model analyses and Bonferroni-corrected post hoc tests were used for statistical analysis (α=.05).

Results: Polished specimens showed lower R_a than nonpolished specimens, and the modified tray led to lower R_a than the conventional tray for nonpolished specimens (P≤.005). FPS showed higher gloss than KSH when fabricated with the conventional tray and polished (P=.031). Nonpolished FPS and KSH specimens and polished KSH specimens had higher gloss when the modified tray was used (P<.001). Polishing increased the gloss of all specimens, while aging increased the gloss of polished specimens (P≤.026). The modified tray provided higher light transmittance irrespective of resin or polishing, while polishing increased transmittance for FPS with the modified tray and KSH with the conventional tray (P≤.012).

Conclusions: The modified tray improved the R_a, gloss, and light transmittance of nonpolished specimens; however, surface roughness remained clinically unacceptable, whereas polished specimens met acceptable thresholds. Polishing consistently increased gloss across all conditions and improved light transmittance in specific resin-tray combinations. The modified tray enhanced light transmittance regardless of polishing, and accelerated aging had no significant effect on R_a or light transmittance.

Statement of problem: Whether additive manufactured (AM) and subtractive manufactured (SM) resin-based restorations differ in optical properties after aging and staining is unclear.

Purpose: The purpose of this systematic review and meta-analysis was to evaluate whether AM and SM resin-based dental restoration materials differ in color change (ΔE), translucency (TP), and translucency change (ΔTP).

Material and methods: A systematic search was conducted in the PubMed, Embase, Scopus, Web of Science, and Cochrane Library databases up to January 2025. Eligible studies were English-language, peer-reviewed in vitro investigations comparing AM and SM resin-based fixed dental restorations for ΔE, TP, or ΔTP. Nonresin and noncomparative studies were excluded. Outcomes were synthesized as weighted mean differences (WMDs) using random-effects meta-analysis. Between-study heterogeneity was assessed using Cochrane Q and I² statistics and explored through subgroup and random-effects meta-regression analyses (α=.05). Publication bias was evaluated using funnel plots, Begg and Egger tests, and nonparametric trim-and-fill analysis. Risk of bias was assessed using the Quality Assessment Tool for In Vitro Studies (QUIN).

Results: Of 8169 records screened, 37 studies were included. AM resin-based materials showed greater ΔE compared with SM materials (WMD=1.40; 95% CI: 1.33 to 1.46; P<.001), with substantial heterogeneity (I²>99%). Evidence regarding TP differences between AM and SM materials was inconclusive because of high heterogeneity (I²>99%). ΔTP was greater in AM materials (WMD=-0.29; 95% CI: -0.43 to -0.15; P<.001), with high heterogeneity (I²≈98%).

Conclusions: AM resin-based materials tended to show greater ΔE and ΔTP after aging compared with SM materials, whereas evidence for TP differences was inconclusive.