The International journal of prosthodontics最新文献

Purpose: The present study aimed to compare the performance of seven AI chatbots (ChatGPT 3.5, 4, 4o, Gemini, Claude 3, Copilot, and Llama) with that of U.S. prosthodontic residents on the National Prosthodontic Resident Examination (NPRE) from 2011 to 2023.

Materials and methods: NPRE exam files and answer keys were obtained from the American College of Prosthodontists (ACP). AI-generated responses were collected using standardized prompts that requested only letter answer choices. Each chatbot's first response was recorded and compared to the official exam key. Performance was evaluated as the percentage of correct responses, and results were compared with the average scores of human participants. Statistical analysis included repeated measures ANOVA and Bonferroni post-hoc comparisons.

Results: Statistically significant differences were found between the different groups (p<0.001). ChatGPT 3.5 achieved the highest scores, followed by Claude 3 and Llama, while Copilot performed significantly worse than residents. Other chatbots demonstrated performance levels comparable to human participants, but with notable variability across AI models.

Discussion: The findings suggest that AI chatbots, particularly ChatGPT 3.5, can perform at or above the level of prosthodontic residents on standardized examinations. However, differences in chatbot capabilities, training data, and inconsistencies in performance raise concerns about reliability. While AI has potential as a supplementary learning tool, its use should be guided by critical evaluation.

Conclusions: AI chatbots demonstrate adequate performance on specialized academic exams, but variability across models highlights the need for further assessment before integration into dental education and professional practice.

Purpose: This clinical report aims to highlight the complications associated with cocaine use, particularly focusing on oronasal perforations, and demonstrate the efficacy of using a maxil-lary obturator for rehabilitating palatal defects to restore oral functions. Material and Meth-ods: A 60-year-old male patient with a history of cocaine abuse presented with an oronasal perforation in the hard and soft palate after multiple surgical interventions. He reported issues with hypernasal speech and difficulties swallowing. A prosthodontic approach was employed; a removable obturator was fabricated using impression techniques with care to minimize weight and maximize functionality.

Results: Post-delivery, the obturator successfully restored the patient's ability to speak and swallow normally, with significant improvements reported in aesthetic outcomes. Regular follow-ups demonstrated the prosthesis's stability.

Conclusion: The findings suggest that prosthetic rehabilitation with an obturator is a viable and effective solution for managing palatal perforations resulting from cocaine use, significantly improving oral functions and quality of life. This approach highlights the need for comprehensive treatment plans that include both prosthetic management and encouragement toward substance abstinence, emphasizing the multifaceted public health implications of cocaine addiction and its complications.

Background: Tooth loss leads to functional and psychological issues such as difficulty in chewing, changes in diet, and impaired speech. Research indicates that edentulism has a significant impact on oral health-related quality of life (OHRQoL). Prosthodontic treatments, such as removable and fixed partial dentures, as well as implant-supported prosthesis, help restore function and enhance quality of life.

Objectives: To compare the oral health-related quality of life among fixed and removable prosthesis and identify associated factors.

Methods: The urdu version of the validated OHIP-14 questionnaire was administered to the patients visiting the Prosthodontic department of Dow University of Health Sciences (DUHS). R-Studio software was used to analyze the gathered data.

Results: Out of a total of 222 patients who were included in the study, there were 118(53%) males and 104(47%) females with a mean age of 49.3±14.5 years. Distribution of OHIP-14 scores along with mean and standard deviation reveals that the majority of participants scored "Never" or "Hardly Ever" as their experience with using dental prosthesis.

Conclusion: In light of the findings, there is no significant difference in OHRQoL between fixed and removable dental prosthesis. The continued use of conventional removable dentures remains a viable and appropriate option in resource-constrained settings like Pakistan. Given the widespread economic limitations and the large proportion of the population belonging to lower socio-economic groups, promoting the use of affordable prosthetic solutions can help improve access to oral rehabilitation without compromising perceived quality of life.

Purpose: To evaluate the trueness of implant analog positions in digital implant models (DIMs) printed via two different technologies: Direct Light Processing (DLP) and Liquid Crystal Display (LCD).

Materials & methods: Twenty-one replicate casts were reproduced from an educational implant model with six key-position implants; fourteen DIMs through the educational model (EM) scanning and 3D-printing by DLP and LCD 3D-printers (group DLP and group LCD; n=7/group); and seven stone models by pouring the EM open-tray impressions (group Stone). All casts were scanned to generate their standard tessellation language (STL) files. The STL of the EM laboratory scanning provided the reference data. Medit compare deviation analysis software was used to assess the positional trueness of implant analogs. ANOVA for repeated measures and he paired t-test were used for intragroup comparisons, and the three groups were compared using the one-way analysis of variance and Bonferroni's post hoc test (P≤0.05).

Results: Group DLP exhibited greater vertical deviations, and group Stone exhibited greater horizontal deviations (P≤0.05). The highest deviation recorded was for the vertical displacement in group DLP (0.488±0.090mm), and the least was for group Stone vertical displacements (0.032±0.008mm) (P=0.000). Comparing the mean difference of apex/shoulder vertical displacements between groups indicated greater tilting of the vertical axis in group DLP (0.504±0.096), followed by group LCD (-0.285±0.040), then group stone (-0.167±0.026) (P=0.000).

Conclusion: Regarding implant-analog positional trueness, the stone casts are more accurate than the 3D-printed models; however, 3D-printed DIMs generated via intraoral scanning, and printed using LCD technology showed close accuracy findings.

Background: Immediate implant placement with delayed loading and delayed/late implant placement in conjunction with immediate loading are established treatment concepts in the posterior maxilla/mandible. In contrast, immediate placement along with immediate loading in the posterior maxilla/mandible has not sufficiently been documented. Such a treatment concept relies on an implant design rendering a high primary stability and a relative wide prosthetic platform. Consequently, hybrid design implants or tissue level implants are thought to be suitable for such a treatment approach. The present proof of concept study aimed to utilize a hybrid/tissue level implant design for immediate placement and immediate loading in the posterior region applying a digital workflow.

Material & methods: Twelve patients with a single tooth in the posterior maxilla or mandible to be extracted were consecutively recruited. A CBCT examination and an intraoral scan were performed and the digital data was used to fabricate a surgical guide and a provisional restoration for immediate loading. A flapless extraction was performed and an implant with a hybrid design was inserted in the extraction socket applying a fully guided protocol. A prefabricated screw-retained provisional prosthesis was then inserted in full occlusion. After 2-3 months a final intra oral scan was performed and a definitive prosthesis inserted. Patient reported outcome measures (PROMs), marginal bone loss (MBL) and probing depth (PD) values was recorded over a period of 6 months. Statistical analyses were performed using Paired 't' test.

Results: Stable clinical (mean PD 2.8+0.5mm) and biological (mean PI 4.9% +5%) outcomes were observed for all implants rendering a 100% success and survival rate. PROMs were 9.5 ± 0.5 at baseline and 9.7 ± 0.4, at 6 months of follow-up.

Conclusion: The use of hybrid design implants placed immediately and subjected to immediate loading presents a viable treatment option in the posterior maxilla and mandible. Randomized controlled clinical trials should be performed with a larger sample size to further recommend such an approach for daily clinical use.

Purpose: This study aimed to evaluate the color and translucency changes of conventional, milled, and three-dimensional (3D)-printed provisional restorative materials (PRMs) after cigarette smoke exposure and brushing.

Materials and methods: A total of 120 disc-shaped (Ø6 mm × 2 mm) specimens were fabricated from conventional (CN; GC TempSmart), milled (ML; FusionCeram), and 3D-printed (PR; GC TempPRINT) PRMs (n=40 per material). Specimens were randomly divided into smoke-exposed (S) and control (C) groups (n=20). After 20 days of exposure (20 cigarettes/day, 2-second puffs, 60-second intervals) or artificial saliva storage, specimens underwent brushing simulation (15 strokes/day) to form S-BR and C-BR subgroups. Color and translucency were measured at baseline (T0), post-exposure (T1), and post-brushing (T2) using a spectrophotometer. Color change (∆E00), translucency change (∆TP00), and translucency parameter (TP00) were calculated. Data were analyzed using two-way robust ANOVA (5% trimmed means) and Tukey's post hoc test (α = .05).

Results: ML exhibited significantly lower ∆E00 values than CN and PR after cigarette smoke exposure (P < .001). Brushing reduced discoloration in all smoking groups, especially for ML (P < .05). PR showed the highest ∆TP00 values across groups, differing significantly only from ML (P = .008). ML consistently demonstrated the highest TP00 values across all groups (P < .001), indicating superior translucency retention.

Conclusions: Cigarette smoke adversely affected the optical properties of PRMs, particularly in conventional and 3D-printed resins. Milled materials exhibited superior resistance to discoloration and translucency change. Although brushing did not completely reverse staining, it effectively reduced discoloration, particularly in milled materials.

The passivity of screw-retained restorations is challenging to achieve yet difficult to measure and quantify. The purpose of this article is to describe a digital technique to construct an implant verification jig that allows quantifying the degree of framework misfit. A gear cylinder is designed and connected to the digital scan over each implant component. The gears are connected to form a verification bar design. The milled bar is used with a plastic pointer mounted on the screwdriver to calculate the degree of framework misfit. Key message/ clinical relevance: This method is a helpful clinical tool that would help clinicians make better decisions regarding framework passivity. Furthermore, it can be helpful for a researcher who needs to quantify the degree of misfit instead of using subjective nonparametric techniques.