The Journal of Prosthetic Dentistry最新文献

Statement of problem

Oral rehabilitation with implants is an alternative to the provision of removable dentures in all patients for whom missing teeth require replacement. However, individuals with cognitive, mental health issues, and/or physical disabilities are often excluded from implant-supported prostheses because of the high perceived risk of failure linked to poor oral health, presence of parafunction, or systemic conditions.

Purpose

The purpose of this cohort study was to describe the protocols, outcomes, and survival rates of oral rehabilitation with implant-supported prostheses in patients with cognitive and physical disabilities treated under general anesthesia (GA) in a French unit of Special Care Dentistry.

Material and methods

A retrospective cohort study was conducted on patient files. Data collected included demographics and information about the surgical and prosthetic phases of rehabilitation. Clinical and radiological reports were retrieved to establish the survival, success, and failure rates of implant placement according to the Health Scale for Dental Implants (HDSI) classification.

Results

A total of 298 dental implants had been placed under GA in 57 patients between January 2007 and August 2021. The prevalence of technical and biological postoperative complications was found to be 14% and 13% respectively. Thirty implants were determined to be failures. The estimated survival time in the population studied for loaded implants was 144.7 months [138.0; 151.3]. The cumulative survival rate was estimated to be 86% at 157 months.

Conclusions

Implant-supported prostheses were found to be effective, and oral rehabilitation carried out under the conditions described was determined to be stable.

Statement of problem

Visual shade selection in dentistry may be influenced by factors that include the background color and the illuminant.

Purpose

The purpose of this clinical study was to evaluate the influence of using a gray background and a light-correcting device on visual shade selection.

Material and methods

Two experienced clinicians assessed the incisor color of 30 volunteers using the VITA 3D-MASTER shade guide. Visual analyses were carried out using or not (control) a gray background, with and without (control) a light-correcting device (Smile Lite). Furthermore, the use of a polarizing filter was evaluated. Data from a clinical spectrophotometer were defined as the standard instrumental analysis. The agreement and the similarity (based on the whitening indexes of tabs) were evaluated between instrumental and visual analyses. Statistical testing was conducted through ordinal logistic regression and repeated-measures ANOVA. The Shapiro-Wilk test was used to confirm the data distribution, and homogeneity of variance was assessed with the Levene test (α=.05)

Results

The use of Smile Lite resulted in lighter tabs than indicated by the instrumental analysis, and the opposite was observed in its absence. The polarizing filter did not affect the results (P>.05). For similarity, the illuminant improved the results (P<.001). The gray background reduced the differences between visual and instrumental analysis only in the absence of the Smile Lite (P<.001).

Conclusions

The color similarity between visual and instrumental analysis improved with the use of a light-correcting device with or without a polarization filter. A gray background was useful only without the light-correcting device.

Computer-aided design and computer-aided manufacturing technology has been applied to the fabrication of maxillary obturator frameworks, both directly and indirectly. However, with earlier techniques, it was not possible to accurately determine the position of the framework conforming to the palate, an issue that has been resolved in current fabrication methods. Using the patient’s existing denture, prosthodontists can determine where the framework should be positioned in the defect area. This allows the obturator bulb to be hollowed, thereby reducing weight and making adjustment easier. The most appropriate position for the finish line can be determined by accurately establishing the arrangement of the artificial teeth as well as the most appropriate polishing surface morphology. In maxillofacial prosthetics, restoring proper articulation and the swallowing function through rehabilitation is important, and determining the proper palatal morphology enables good tongue movement and facilitates the restoration of adequate function. The lighter weight contributes to protecting the remaining teeth and improves patient comfort.

Statement of problem

The process of removing ceramic veneers is difficult, time consuming, and invasive. However, although lasers should provide a straightforward method for the debonding of ceramic veneers, a systematic review is lacking.

Purpose

The purpose of this systematic review and meta-analysis was to investigate the efficacy of the laser-assisted debonding of ceramic veneers.

Material and methods

A systematic search was conducted in Medline/PubMed, Cochrane, Scopus, and Web of Science databases. Then, an analysis was performed using the meta-analysis approach to investigate the efficacy of the laser-assisted debonding of ceramic veneers. Quality assessment of the included articles was carried out using the Cochrane Collaboration tool. For the meta-analysis, the RevMan 5.4 software program was used to perform a random-effects model of standardized mean differences with 95% confidence intervals.

Results

A total of 1108 studies were identified, of which 627 studies were selected for title and abstract analysis. The qualitative analysis included 16 studies, of which 3 studies were used in the quantitative synthesis. In the meta-analysis, the shear bond strength of the laser groups was compared with that of the control group. A substantial level of heterogeneity was noted in the included studies (I²=67%, P<.001).

Conclusions

The findings suggest that erbium lasers have a significant immediate effect in decreasing the shear bond strength of ceramic veneers. Furthermore, with proper laser settings, veneers can be safely removed without damaging the underlying tooth structure.

Statement of problem

The congruence of surgical implant placement with the preplanned position is important for anatomic and prosthetic precision, minimal complications, and increased longevity. The influence of implant placement timing on the surgical deviations in single posterior implants is unclear.

Purpose

The purpose of this clinical study was to compare deviations between preplanned and single posterior immediate and delayed implants placed using computer-guided digital light processing (DLP) surgical guides fabricated using intraoral scanning and cone beam computed tomography (CBCT).

Material and methods

Implant surgery was performed on 24 participants requiring single immediate or delayed implants in the posterior maxillary and mandibular regions, for which the surgical site data were obtained from CBCT and intraoral scanning. Subsequently, virtual implant planning and DLP surgical guides were fabricated. Preimplant and postimplant placement CBCT scans were overlapped, and mean deviations for the immediate and delayed implant groups were calculated. The groups were compared with unpaired t tests (α=.05).

Results

A total of 24 implants were placed, 12 in each group. In participants who received immediate implant placement, the mean ±standard deviation angular deviation, linear deviation at shoulder, linear deviation at apex, and vertical deviation were 1.03 ±0.70 degrees, 0.26 ±0.30 mm, 0.23 ±0.24 mm, and 0.39 ± 0.34 mm, respectively. In participants who received delayed implant treatment, the deviations were 0.53 ±0.60 degrees, 0.15 ±0.18 mm, 0.25 ±0.33 mm, and 0.17 ±0.10 mm, respectively. Significant differences between the 2 groups were found in the vertical deviation (P<.05).

Conclusions

The timing of the single posterior placement was associated with different deviations in the vertical direction. All deviations obtained were below the recommended values. DLP surgical guides fabricated from intraoral and CBCT scans provided accurate implant placement in immediate and delayed single posterior implants.

Optical jaw tracking systems are designed to record the static maxillomandibular relationship and the mandibular motion of a patient, including excursive movements and mastication pattern. This digital data acquisition technology can be integrated into diagnostic and treatment planning procedures, as well as into designing dental prostheses. A step-by-step protocol to record a patient’s digital data, including the repeatable reference position of the jaw or centric relation, by using an intraoral scanner, Kois deprogrammer, and optical jaw tracking system is described. The data are then processed in the software program of the jaw tracking system to locate centric occlusion.

Extraction of a residual root tip and implant placement can be challenging because of the complexity and invasiveness of the procedure. Improvised application of a guided implant surgery may avoid such challenges. This clinical report presents an innovative technique combining a 3-dimensionally printed surgical guide with conventional instrumentation for a residual root tip extraction in a minimally invasive and predictable way.

Statement of problem

With the growing importance of implant brand detection in clinical practice, the accuracy of machine learning algorithms in implant brand detection has become a subject of research interest. Recent studies have shown promising results for the use of machine learning in implant brand detection. However, despite these promising findings, a comprehensive evaluation of the accuracy of machine learning in implant brand detection is needed.

Purpose

The purpose of this systematic review and meta-analysis was to assess the accuracy, sensitivity, and specificity of deep learning algorithms in implant brand detection using 2-dimensional images such as from periapical or panoramic radiographs.

Material and methods

Electronic searches were conducted in PubMed, Embase, Scopus, Scopus Secondary, and Web of Science databases. Studies that met the inclusion criteria were assessed for quality using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Meta-analyses were performed using the random-effects model to estimate the pooled performance measures and the 95% confidence intervals (CIs) using STATA v.17.

Results

Thirteen studies were selected for the systematic review, and 3 were used in the meta-analysis. The meta-analysis of the studies found that the overall accuracy of CNN algorithms in detecting dental implants in radiographic images was 95.63%, with a sensitivity of 94.55% and a specificity of 97.91%. The highest reported accuracy was 99.08% for CNN Multitask ResNet152 algorithm, and sensitivity and specificity were 100.00% and 98.70% respectively for the deep CNN (Neuro-T version 2.0.1) algorithm with the Straumann SLActive BLT implant brand. All studies had a low risk of bias.

Conclusions

The highest accuracy and sensitivity were reported in studies using CNN Multitask ResNet152 and deep CNN (Neuro-T version 2.0.1) algorithms.

Statement of problem

The evidence regarding the application of artificial intelligence (AI) in identifying dental implant systems is currently inconclusive. The available studies present varying results and methodologies, making it difficult to draw definitive conclusions.

Purpose

The purpose of this systematic review with meta-analysis was to comprehensively analyze and evaluate articles that investigate the application of AI in identifying and classifying dental implant systems.

Material and methods

An electronic systematic review was conducted across 3 databases: MEDLINE/PubMed, Cochrane, and Scopus. Additionally, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies investigating the accuracy of AI-based diagnostic tools on dental radiographs for identifying and classifying dental implant systems and comparing the results with those obtained by expert judges using manual techniques—the search strategy encompassed articles published until September 2023. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of included articles.

Results

Twenty-two eligible articles were included in this review. These articles described the use of AI in detecting dental implants through conventional radiographs. The pooled data showed that dental implant identification had an overall accuracy of 92.56% (range 90.49% to 94.63%). Eleven studies showed a low risk of bias, 6 demonstrated some concern risk, and 5 showed a high risk of bias.

Conclusions

AI models using panoramic and periapical radiographs can accurately identify and categorize dental implant systems. However, additional well-conducted research is recommended to identify the most common implant systems.

Statement of problem

Worn denture teeth are a common reason for replacing complete dentures. However, clinical studies on the amount of denture tooth wear are lacking.

Purpose

The purpose of this clinical study was to compare the clinical wear of denture teeth made from double cross-linked (DCL) versus highly cross-linked (HCL) materials after 1 year in service.

Material and methods

Fourteen participants received maxillary and mandibular removable complete dentures (RCDs). The participants randomly received either DCL or HCL teeth. Each RCD was scanned with an intraoral scanner 1 week after finishing any occlusal adjustment and after 1 year. Occlusal contact marks were recorded using articulating paper, and photographs were made in centric and eccentric movements. The generated 1-week and 1-year standard tessellation language (STL) files of the scans were obtained and trimmed using the Geomagic X software program. After merging the files, the depth of the wear facets was measured using the software program tool that measures the vertical gap distance in micrometers at 100 points distributed on the contact areas. These areas were identified by using the segment tools in the software program. Repeated measures ANOVA was used to analyze the differences between the collected data (α=.05).

Results

The DCL had higher mean ±standard deviation wear (62.7 ±40 µm) than the HCL (37 ±31 µm) after 1 year in service (P<.001).

Conclusions

Both DCL and HCL denture teeth showed acceptable clinical wear after 1 year of clinical use. HCL denture teeth showed more resistance to occlusal wear than DCL denture teeth.