Australian dental journal最新文献

The rapid advancement of scanning technologies, design software, and manufacturing techniques has led to the maturation of digital workflows in prosthodontics over the past few decades. Initially perceived as alternatives to analogue workflows, digital workflows now offer significant advantages in diagnosis, treatment planning, communication, and prosthesis design and fabrication. The growing demand for efficient, predictable, aesthetic, and outcome-driven prosthodontic treatments has led to increasing adoption of digital workflows. This integration has transformed each step of prosthodontic treatment, resulting in three digital workflows: laboratory, clinical, and combined clinical-laboratory workflows. Although most prosthodontic treatments can now be executed digitally, a universally applicable digital workflow is yet to be established. Contrary to analogue workflows, digital workflows continue to evolve rapidly, with significant improvements anticipated in the near future that may establish them as the mainstream approach in prosthodontics. This review article aims to: (1) illustrate the importance of digital workflows in modern prosthodontics, (2) discuss available digital workflows in relation to different areas of prosthodontics, and (3) explore how recent advancements in digital dentistry are likely to shape the future of prosthodontics.

This narrative review examines the application of photogrammetry (PG) in complete-arch implant fixed prosthodontics, as it offers an alternative to conventional and intraoral scanning (IOS) impression techniques. Evidence from in vitro and in vivo studies suggests that PG provides high trueness and precision. The technique supports both immediate and delayed loading workflows, potentially reducing prosthetic misfit and chairside adjustments. Limitations include the need for separate IOS scans to capture soft tissues and occlusion, the cost of the device, and the restricted scanning scope. Future improvements in integration and accessibility may broaden its role in implant dentistry.

Digital dental radiology has evolved significantly from traditional two-dimensional (2D) imaging to advanced three-dimensional (3D) modalities such as cone-beam computed tomography (CBCT). This progression has overcome many limitations of 2D imaging, including superimposition and distortion, enabling more accurate visualisation of complex anatomical structures. Despite CBCT's higher radiation dose compared to 2D imaging, ongoing advances in low-dose protocols and artefact reduction algorithms have expanded its clinical applications. Integration with digital tools such as intraoral scanners and CAD/CAM systems has further enhanced its utility in guided implant surgery, orthodontic appliance design, and forensic dentistry. Emerging artificial intelligence technologies promise to improve image analysis, diagnostic accuracy, and workflow efficiency. Emphasising radiation safety and careful imaging selection remains essential. Additionally, magnetic resonance imaging and ultrasound are gaining attention as non-ionising imaging alternatives, offering valuable soft tissue assessment complementary to CBCT's strengths in hard tissue evaluation. Together, these innovations reflect the crucial change in dental diagnostics from 2D to 3D imaging, advancing patient care through improved accuracy and comprehensive treatment planning.

Guided Endodontics has emerged as a digital treatment concept designed to overcome the challenges associated with conventional access cavity preparation in teeth with pulp canal calcification. Calcification of the pulp (also referred to as obliteration or mineralization), often caused by trauma or chronic irritative stimuli, presents a substantial clinical obstacle during endodontic treatment. The advent of computer-assisted technologies such as static and dynamic navigation systems has enabled highly precise and minimally invasive localization of root canal orifices, even in cases of severe calcification. This narrative review explores the clinical indications, technical workflows, and current evidence for both static and dynamic Guided Endodontics, including their limitations and future directions. Numerous in vitro and clinical studies have shown that guided access preparation results in higher precision, reduced dentine loss, and increased success rates compared to freehand techniques, even when performed by less experienced clinicians. While static navigation provides excellent accuracy for straight canals, its application in posterior teeth and curved canals remains limited. Dynamic navigation, in contrast, offers greater intraoperative flexibility but requires significant training and costly equipment. Future developments, including augmented reality integration and MRI-based workflows, may further expand the applicability of Guided Endodontics. However, the current techniques are limited by cost, planning time, and the necessity for advanced imaging. Despite these challenges, Guided Endodontics has the potential to transform the management of calcified canals and represents a significant step forward in minimally invasive endodontics.

This narrative review examines the clinical indication, practical advantages and limitations of dental digital impressions as compared to conventional impression techniques. Digital impressions are scientifically approved for their high accuracy for single tooth restorations while enhancing workflow efficiency through seamless integration with computer-aided design and computer-aided manufacturing (CAD/CAM) systems. They improve both patient and clinician experiences by reducing discomfort, shortening treatment times and facilitating more direct communication with dental laboratories. Furthermore, digital records offer long-term archiving benefits and enable direct comparisons with future scans, which can be valuable for monitoring treatment progress. Despite these advantages, digital impressions face challenges in specific clinical scenarios, including movable oral tissues, deep subgingival margins and long-span prostheses. These limitations currently restrict their universal application across all dental indications. Nonetheless, digital impressions are increasingly being adopted in clinical practice across all dental specialties. As technological advancements of intraoral scanners continue, particularly improvements in scanning accuracy and the integration of artificial intelligence, the clinical utility of digital impressions is expected to expand further.

Digital technologies are reshaping dental implantology, with dynamic navigation and robotic systems offering high implant placement accuracy within clinically acceptable error ranges, the latter often achieving slightly higher accuracy. These systems enhance surgical accuracy and minimise trauma; however, high costs, extended preparation time, steep learning curves and uncertain patient acceptance limit their widespread adoption. This review summarises current principles, applications, benefits and limitations of dynamic navigation and robotic computer-assisted implant surgery (d-CAIS and r-CAIS), highlighting the need for clinicians to refine system proficiency and adapt their roles for future implant treatment procedures.

Three-dimensional-printed resin-based composite (3D-RBC) materials for definitive restorations offer more cost-effectiveness and save more chair-side time compared to computer-aided design/computer-aided manufacturing (CAD/CAM) or milled restorations. While the filler/resin ratio of 3D-RBCs is kept low to allow for vat photopolymerization and 3D printing, this can significantly influence their material-inherent properties and the mechanical behavior of 3D-RBC restorations intraorally. This narrative review aimed to critically review the literature on the physicomechanical properties of 3D-RBC materials for definitive restorations. Three electronic bibliographic databases (Medline via PubMed, Scopus, and Web of Science) were searched to identify studies on 3D-RBCs for definitive restorations. Ninety-nine studies satisfied the inclusion criteria. With lower mechanical properties and high susceptibility to color change, 3D-RBCs are not yet valid alternatives to CAD/CAM (milled) composite or hybrid materials for definitive restorations. 3D-RBC definitive restorations presented excellent marginal and internal adaptation, comparable to or superior to milled restorations. Clinical evidence on these restorations is still insufficient to draw definitive conclusions. However, 3D-RBCs seem more suitable for cases with less challenging occlusal conditions and aesthetic needs.

Recent advancements in digital dentistry have facilitated the accurate recording of dynamic mandibular movements using optical tracking devices, thereby improving the clinical outcomes and the patient's ability to adapt to their oral rehabilitation. This narrative review provides an overview of the evolution, functionality, and clinical applications of the mandibular movement devices and the current status of optical tracking devices in dentistry. Unlike traditional mechanical or electronic approaches, optical tracking devices offer noninvasive, real-time monitoring with high spatial precision. By accurately capturing patient-specific mandibular movements, these systems substantially improve the understanding of occlusal function, condylar motion, and temporomandibular joint dynamics, which enables the optimal design of prostheses tailored to individual patient anatomy, function, and esthetics. Optical tracking technologies can integrate successfully with digital workflows, including intraoral scanning and cone-beam computed tomography, thus enhancing diagnostic accuracy and facilitating precise treatment planning in prosthodontics and occlusal rehabilitation. Despite the challenges of optical tracking devices, such as high costs, system complexity, and calibration requirements, the optical tracking devices present a significant advancement in delivering individualised and functionally driven dental care.