Facial scanning technologies in the era of digital workflow: A systematic review and network meta-analysis

The influence of structured light scanning probe configuration on the 3D scanning accuracy of the maxillofacial region in a smiling state: An in vitro study

Currently, single-unit, dual-unit, and triple-unit structured light 3D scanning technologies have become the predominant facial scanning methods. However, the impact of different unit strategies on facial scanning accuracy remains unclear. A standardized 3D facial model in a smiling state was established. Key point reference coordinates and 3D data were obtained using a coordinate measurement instrument and an industrial-grade laser 3D scanner. Three structured light scanning techniques (single-, dual-, triple-unit) were utilized to capture the 3D information of the model. Linear distance deviations and 3D surface deviations (trueness and precision) of the three scanning strategies were compared. The triple-unit scanning strategy exhibited the lowest deviation among 20 trueness indicators and 22 precision indicators for linear distance measurements (P < 0.05). Furthermore, the accuracy of the triple-unit strategy (trueness: 0.1607 ± 0.0201 mm, precision: 0.0161 ± 0.0112 mm) for overall facial scanning was significantly lower than that of the single-unit and dual-unit strategies, particularly in critical regions for oral and maxillofacial aesthetic analysis, such as the orbital, nasal, and perioral regions. The triple-unit structured light scanning strategy significantly enhances the accuracy of facial 3D scanning, particularly when acquiring 3D facial information from the midline and perioral regions. This in vitro study demonstrates that the triple-unit structured light 3D scanning strategy effectively improves the accuracy of facial scanning, especially in the oral-maxillofacial aesthetic regions. This approach provides a foundation and support for both preoperative planning and postoperative evaluation of aesthetic restoration.

Positional accuracy of intraoral scan alignment to a facial scan using structured light scanning and trial denture base with occlusal rim markers in patients with complete maxillary edentulism

STATEMENT OF PROBLEM

Creating precise 3D virtual head models for patients with complete maxillary edentulism remains challenging owing to the lack of natural landmarks and limitations of current image-matching technologies.

PURPOSE

The purpose of this study was to evaluate the positional accuracy of intraoral scan alignment to structured light-based facial scans using varying sizes and positions of occlusal rim markers under maxillary edentulous conditions.

MATERIAL AND METHODS

Radiopaque artificial markers of 3 sizes (2, 4, and 6 mm) were made and attached to the maxillary occlusal rim of a completely edentulous patient at different positions (midline-canine [MC], midline [M], canine [C]). Facial scans were obtained of the patient by using a structured light facial scanner under 9 experimental conditions (size-location: 2MC, 2M, 2C, 4 MC, 4M, 4C, 6MC, 6M, and 6C; 5 scans under each condition). Intraoral scans were aligned to the facial scans using stepwise images matching the occlusal rim scan casts. The alignment accuracy was evaluated by comparing the intraoral scan with a reference position established using cone beam computed tomography data. Measured variables included anterior and posterior linear deviations and angular deviation of the arch plane. Statistical analysis was conducted using the Kruskal-Wallis test and Mann-Whitney U test with Bonferroni correction (α=.05).

RESULTS

The 4-mm and 6-mm marker groups exhibited significantly lower deviation in image registration than the groups without markers and those with 2-mm markers (P<.001). Regarding the marker position, the midline-canine group exhibited the lowest deviation value, followed by the midline and canine groups. Markers positioned in the midline exhibited less deformation compared with those in the canine region.

CONCLUSIONS

Occlusal rim markers can be used to align intraoral and facial scans in patients with complete maxillary edentulism when structured light face scanning is included. Markers with a clearly recognizable size in facial scans are less prone to deformation in the facial midline area.

Effects of Rapid Palate Expander on Facial Soft Tissues and Dental Arch: Study Conducted With Stereophotogrammetry and Intraoral Scans in Cleft Patients

INTRODUCTION

This pilot study explores the impact of rapid palatal expansion on facial soft tissues and dental arches, utilizing stereophotogrammetry and intraoral scanner in a cleft population.

MATERIALS AND METHODS

Forty-five patients with unilateral cleft lip-palate (27), bilateral cleft lip-palate (9), and cleft palate (9) were included and underwent rapid palatal expansion. Stereophotogrammetric scans were conducted using (VECTRA M3) and intraoral scans (CEREC Primescan) at T0 (expander application) and at T1 (end of activations). Superimpositions and variations in surface and volume within the right cheek, left cheek, upper lip, and lower third were executed using the VECTRA Analysis Module (VAM) to compare soft tissues at T0 and T1. Expansion of the dental arches was verified on Meshmixer.

RESULTS

In unilateral cleft lip and palate patients the increase in the cheek area was 0.88 mm2 and 2.06 cm3 on the cleft side, whereas on the cleft side was 0.92 mm2 and 2.18 cm3. In bilateral cleft lip and palate the increase was of 0.75 mm2 and 1.7 cm3 on the left side and 0.58 mm2 and 1.4 cm3 on the right and in cleft patients there is an increase of 0.79 mm2 and 2.05 cm3 on the left and 0.95 mm2 and 2.01 cm3 on the right. On upper lip area the increase was 1.19 mm2 and 1.7 cm3 in unilateral cleft lip and palate, 0.88 mm2 and 1.1 cm3 in bilateral cleft lip and palate and 0.85 mm2 and 1.2 cm3 in cleft patients. On lower third area the increase was 1.58 mm2 and 6.15 cm3 in unilateral cleft lip and palate, 1.62 mm2 and 5.34 cm3 in bilateral cleft lip and palate, 1.37 mm2 and 5.37 cm3 in cleft palate. On dental arches symmetric expansion was present in no patient with unilateral cleft lip and palate, 55.6% of bilateral cleft lip and palate patient and 88.9% of cleft palate.

DISCUSSION AND CONCLUSIONS

Palatal expansion influences soft tissues as well as dental arches in terms of surface and volumetric changes. It was not possible to identify a relationship between the expansion of the dental arches and effects on the soft tissues. In unilateral cleft lip and palate, there was a non-symmetrical expansion of the arch; however, the position of the cleft does not influence the expansion. A symmetric expansion was frequent in the isolated cleft palate. Volumetric changes are mostly evident in the lower facial third.

Trueness and precision of a handheld, a desktop and a mobile 3D face scanning system: An in vitro study

OBJECTIVE

This in vitro study investigated the trueness and precision of three different face scanning systems: a handheld, a desktop and a mobile 3D face scanning system.

MATERIAL AND METHODS

Fourteen landmarks were placed on a mannequin head, and sixteen inter-landmark distances were measured using a digital vernier caliper, repeated 20 times over 80 days. Three 3D face scanning systems were evaluated: a handheld (Metismile; Shining 3D Tech Co., Hangzhou, China), a desktop (RAYFace v2.0; Ray Co., Ltd., Gyeonggi-do, Korea), and a mobile application (Heges, Simon Marinek) on a smart device (iPad Pro X, Apple Inc., Cupertino, CA). Sixty facial scans were analyzed using metrology software (Geomagic Control X), and inter-landmark distances were compared to anthropometric measurements. Trueness was determined by absolute linear deviation and analyzed using one-way ANOVA, with Bonferroni and Tamhane tests for significant variance. Precision was compared to anthropometric measurements and analyzed using Kruskall-Wallis test.

RESULTS

3D analysis showed that the handheld scanner had the highest trueness (0.18 ± 0.15 mm) and precision (0.22 ± 0.04 mm). The desktop scanner had a trueness of 0.35 ± 0.26 mm and precision of 0.61 ± 0.18 mm, while the mobile scan application had a trueness of 0.54 ± 0.34 mm and precision of 0.47 ± 0.12 mm. All systems showed the highest trueness for vertical measurements compared to horizontal measurements. In the lower face, the precision was higher than anthropometric measurements for all 3D face scanning systems.

CONCLUSIONS

The handheld scanner demonstrated the highest trueness and its precision surpassed anthropometric measurements. The desktop scanner outperformed the mobile scan application in trueness but not in precision.

CLINICAL SIGNIFICANCE

The handheld, the desktop and the mobile face scanning system showed clinically acceptable trueness (< 0.6 mm) and could be used for virtual facebow transfer. All 3D face scanning systems in the present study demonstrated superior precision in the lower face compared to anthropometric measurements.

Facial Scans in Clinical Dentistry and Related Research: A Scoping Review

This scoping review examined the adoption of three-dimensional (3D) facial scanning technology in clinical dentistry, focusing on the range of scanning techniques, clinical applications, and related implementation trends. A systematic literature search of three major databases identified studies published between January 2020 and June 2024 that described 3D facial scanning of human participants in clinical dental settings. After screening 224 records, 48 from 19 countries met the inclusion criteria. Both clinical studies and case/technical reports showed that facial scanning was used in multiple specialties, including orthodontics, prosthodontics, and maxillofacial surgery, primarily for diagnosis, treatment planning, and outcome assessment. The technologies such as stereophotogrammetry, structured light scanning, laser scanning, and mobile device-based solutions vary in accuracy and ease of integration. Mobile scanning, in particular, is growing in importance due to lower cost, accessibility, and compatibility with digital workflows. Despite these advances, standardized protocols for integrating facial scans with other digital records, such as cone beam computed tomography and intraoral scans, remain underdeveloped. This review demonstrates the growing importance of 3D facial scanning in improving clinician-patient communication and identifies areas where further research is needed, including long-term validation, cost-effectiveness, and standardized data management.

Influence of Head Circumference on the Accuracy of Facial Scanning: An In vitro Study

OBJECTIVES

This study aimed to investigate the impact of head circumference on the accuracy of three-dimensional (3D) facial scans, focusing on trueness and precision across three mannequin heads of different sizes.

MATERIAL AND METHODS

Three 3D-printed mannequin heads with circumferences of 30, 50, and 65 cm were used. Ten facial landmarks were identified to measure seven interlandmark distances and two angles. Direct anthropometric measurement, serving as the reference value, was taken using a digital vernier calliper for linear distance, and angle was calculated using the law of cosines. Each head was scanned six times using two systems: a dual-structured light facial scanner (iTom) and a stereophotogrammetry system (3dMD). Digital measurements were analysed using Meshlab and Blender for distances and angles, respectively. Trueness values were determined by comparing measurements to reference measurements, while precision values were derived from the variability among the six scans. Statistical analysis was performed using the Kruskal-Wallis test due to nonhomogeneous variances, followed by Bonferroni correction for pairwise group comparisons.

RESULTS

For each scanning system, overall deviations in trueness and precision significantly increased with head circumference. Five of the seven distances and one angle showed significant compromises in trueness with larger head circumferences. Most measurements exhibited significant precision decreasing due to head circumference changes, except for N-Pn and Pn-Sn. Additionally, 3dMD displayed higher overall trueness compared to iTom, with five out of seven linear measurements and one angular measurement showing better results.

CONCLUSION

Head circumference significantly affects both trueness and precision of 3D facial scans for both technologies, suggesting that facial imaging should be used with caution for larger faces. Selecting an appropriate scanning system, such as 3dMD, can help mitigate the negative effects of scanning larger objects.

Periodontal, occlusal, and aesthetic outcomes of missing maxillary lateral incisor replacement: A systematic review and network meta-analysis

INTRODUCTION

The aim of this systematic review was to determine the best treatment alternatives for patients with maxillary lateral incisor agenesis (MLIA) by comparing orthodontic space closure, implant and tooth supported dental prostheses by assessing studies that evaluated their periodontal, occlusal (function) and aesthetic results.

METHODS

The present systematic review was reported according to the indications of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) incorporating network meta-analysis, and the protocol was registered with PROSPERO (CRD42023487245). The PRISMA systematic search, without restriction on language or initial date, was carried out using electronic databases: MEDLINE (PubMed), Scopus and central register of controlled trials. To assess the aesthetic effects of the different treatment methods, an arm-based network meta-analysis was carried out.

RESULTS

The systematic search initially produced 1177 studies. At the end 10 studies met the inclusion criteria. These studies used various methods of treatment for maxillary lateral incisor agenesis including orthodontic space closure, implant-supported and tooth-supported dental prostheses. Data were extracted from the articles selected, and a network meta-analysis was carried out.

CONCLUSIONS

Within the limits of this network meta-analysis, no significant difference was found regarding the aesthetic results between orthodontic space closure or dental implant. Tooth-supported dental prostheses for MLIA reported worse scores in the periodontal indexes than orthodontic space closure treatment but the impact of orthodontic and prosthetic treatment on periodontal health remained contentious. Furthermore, no signs of TMJ dysfunction were observed in patients treated with either orthodontic space closure or prosthetic replacement.

Evolution of Dental Occlusion: Integrating Digital Innovations

The landscape of dental occlusion is undergoing a transformative shift with the integration of digital technologies offering accuracy, efficiency, and improved patient outcomes. This article explores the advancements in digital innovations that have reshaped occlusal analysis and management. By examining tools such as three-dimensional (3D) scanning, virtual articulators, and occlusal diagnostic software, we highlight their impact on treatment planning and clinical workflows. These technologies enable dental professionals to analyse occlusal relationships with a level of detail previously unattainable, paving the way for more accurate and individualised treatment plans. The implementation of digital approaches also enhances patient engagement, as visual data aids in understanding treatment processes. This article also reviews the available research on the reliability of these innovations, providing an evidence-based perspective on their clinical application.

Comparing analog and 3D measurements of vertical dimension in edentulous subjects

OBJECTIVE

This study aimed to explore the feasibility and reliability of measuring the vertical dimension of occlusion/rest (OVD/RVD) on 3D facial scans of edentulous patients.

METHODS

Nineteen edentulous participants rehabilitated with complete removable dental prostheses (CDs) participated in this study. Analog measurements (control) were obtained directly on the face for each participant with the jaws positioned at the rest position (without CDs, RVD) and at centric occlusion (with dentures, OVD), between the facial landmarks: Glabella (G) and Soft Pogonion (SP), Pronasale (PN) and SP, and Subnasale (SN) and SP. Participants' faces were scanned twice, using a face-scanner (Class 1 LASER, Obiscanner). Scans were imported into a mesh-processing software, and the OVD/RVD were measured digitally. Two investigators performed all the measurements and were blinded. Data analysis included intra-class correlation coefficient (ICC) and pairwise comparison tests (p < 0.05).

RESULTS

Digital measurements were higher than analog measurements, and the mean paired difference ranged from -4.86±3.2 to 0.42±2.7 mm. All the differences were statistically significant, expect for SN-SP (p = 0.110). Magnitude of the differences for the RVD were large for G-SP and SN-SP (ES>0.80) and moderate for PN-SP (ES>0.50). There was a large effect for G-SP when measuring OVD (ES>0.50), and small effect for PN-SP and SN-SP (ES≤0.20).

CONCLUSION

Considering the limitations associated with the specific type of facial scanner used in this study, it can be concluded that registering the resting vertical dimension in edentulous patients through digital methods may not be currently recommended. This is due to the potential errors that may arise during the data acquisition process, which could compromise the accuracy and reliability of the measurements.

CLINICAL SIGNIFICANCE

Digital methods for registering the vertical dimension of rest (RVD) in edentulous patients can introduce errors, resulting in occlusal errors and discomfort. Clinicians must, for the moment, still use conventional analog methods to ensure accurate RVD measurement for a successful denture therapy.

Evaluation of Polymethyl Methacrylate as a Provisional Material in a Fully Digital Workflow for Immediate-Load Complete-Arch Implant-Supported Prostheses over Three Months

While complete-arch digital-implant-scanning protocols have been described, their clinical outcomes when using polymethyl methacrylate (PMMA) as a provisional material remain insufficiently substantiated. This clinical study aims to integrate digital solutions into implant dentistry and establish PMMA as a reliable material for immediate-loaded protocols. Fifty-six patients received 432 implants and 72 immediate fixed interim complete-arch prostheses, all fabricated using a fully digital workflow. Patients were followed up at 3 months to evaluate implant survival, prosthesis survival, and implant mean marginal bone loss using an interim PMMA prosthesis. Patients completed the Oral Health Impact Profile (OHIP) questionnaire to determine the implants' impact on quality of life. Statistical analyses included analysis of variance, Fisher's least significant difference (LSD) test, and the Wilcoxon signed-rank test. Of the 432 implants placed, only two failures were observed. Marginal bone loss (MBL) was significantly greater in male patients (p = 0.002) and older smokers (p = 0.016). Patient-reported outcomes, as measured by the OHIP questionnaire, demonstrated significant improvements in quality of life. PMMA is a reliable material for immediate-loading protocols in fixed interim complete-arch implant prostheses. Its combination of mechanical strength, biocompatibility, and esthetic properties, along with the accuracy of fully digital workflows, ensures predictable clinical outcomes.

Smartphone applications for facial scanning: A technical and scoping review

INTRODUCTION

Facial scanning through smartphone scanning applications (SSA) is increasingly being used for medical applications as cost-effective, chairside method. However, clinical validation is lacking. This review aims to address: (1) Which SSA could perform facial scanning? (2) Which SSA can be clinically used? (3) Which SSA have been reported and scientifically validated for medical applications?

METHODS

Technical search for SSA designed for face or object scanning was conducted on Google, Apple App Store, and Google Play Store from August 2022 to December 2023. Literature search was performed on PubMed, Cochrane, EMBASE, MEDLINE, Scopus, IEEE Xplore, ACM Digital Library, Clinicaltrials.gov, ICTRP (WHO) and preprints up to 2023. Eligibility criteria included English-written scientific articles incorporating at least one SSA for clinical purposes. SSA selection and data extraction were executed by one reviewer, validated by second, with third reviewer being consulted for discordances.

RESULTS

Sixty-three applications designed for three-dimensional object scanning were retrieved, with 52 currently offering facial scanning capabilities. Fifty-six scientific articles, comprising two case reports, 16 proof-of-concepts and 38 experimental studies were analysed. Thirteen applications (123D Catch, 3D Creator, Bellus 3D Dental Pro, Bellus 3D Face app, Bellus 3D Face Maker, Capture, Heges, Metascan, Polycam, Scandy Pro, Scaniverse, Tap tap tap and Trnio) were reported in literature for digital workflow integration, comparison or proof-of-concept studies.

CONCLUSION

Fifty-two SSA can perform facial scanning currently and can be used clinically, offering cost-effectiveness, portability and user-friendliness. Although clinical validation is crucial, only 13 SSA were scientifically validated, underlying awareness of potential pitfalls and limitations.

Accuracy of Smartphone-Based Three-Dimensional Facial Scanning System: A Systematic Review

BACKGROUND

Recently, the integration of 3D face scanning into smartphones has raised vast interest in plastic surgery. With the release of smartphones featuring 3D face scanning technology, users now can capture detailed 3D models of their faces using their smartphones. However, trueness and precision of this system is less well established.

METHODS

PubMed, Cochrane Library, Embase, ScienceDirect, Scopus, and Web of Science databases were searched for studies evaluating 3D scanning of smartphone devices and conventional 3D imaging systems from January 1, 2017, to June 1, 2023. A qualitative systematic review was conducted by two review authors after independently selecting studies, extracting data, and assessing the risk of bias of included studies.

RESULTS

A total of 11 studies were included, all focusing on the accuracy of smartphone 3D facial scanning. The results show that although smartphones perform poorly on deep and irregular surfaces, they are accurate enough for clinical applications and have the advantage of being economical and portable.

CONCLUSIONS

Smartphone-based 3D facial scanning has been basically validated for clinical application, showing broad clinical application prospects in plastic surgery.

LEVEL OF EVIDENCE II

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

Accuracy of the Conventional Facial Impression Method and Three-Dimensional Auricular Shape Data Obtained Using Extra- and Intraoral Optical Scanners

Background: Facial impression methods have been used to fabricate auricular prostheses; however, deformation due to the weight of the impression material remains. This study aimed to investigate the accuracy of auricular three-dimensional (3D) data obtained using a 3D optical extraoral scanner and an intraoral scanner compared with that of a conventional facial impression method. Methods: Six auricles were digitized using an extraoral scanner with and without a reference board around the auricle and an intraoral scanner. Auricle casts fabricated using auricle impressions were scanned using a laboratory scanner. All obtained data were superimposed, and the 3D deformations of the different methods were evaluated using measurement mapping and root mean square (RMS) values. The length, width, and height of the auricular casts and scanned data were measured and compared with the sizes of the original auricles measured using a caliper. Results: Large displacements of the back and margins of the ears were observed, and the RMS values ranged from 0.5-2.4 mm. Larger widths and smaller heights of the scanned and impression data were observed compared to the anthropometric ear data. Conclusions: The study concluded that the fabrication of auricular prostheses using optical scanning is clinically acceptable. All examined scanning techniques demonstrated discrepancies within acceptable limits when compared to the conventional facial impression method.

The Validity of a Smartphone-Based Method for Acquiring 3D Images of the Face

Objectives. To evaluate the accuracy and reproducibility of measurements obtained using the Bellus3D Face Application on a mobile smartphone by comparing them to direct measurements on pre-marked and blank face scans. Materials and Methods. Twenty-five healthy young adults (six males and nineteen females; age range 20-30 years) were included in this prospective cross-sectional study, with the only exclusion criterion being the presence of significant facial hair interfering with the placement and visualization of landmarks. Image acquisitions were performed using an iPhone XR with the Bellus3D FaceApp face scanning application, an iOS application for smartphones. Ten single midfacial and five paired bilateral landmarks were defined and marked. Two face scans were performed on each patient, both on blank and marked faces, and distances were measured directly with calipers and digitally. Results. The random error values were 1.0 mm and 0.4 mm for the manual point placement and measurements and virtual point placement on blank faces, respectively. The two methods used (the direct method and acquisition on faces with landmarks) demonstrate relatively similar reliability (ICC > 0.8); however, a paired t-test showed that the differences between several measurements were statistically significant (p < 0.05). Regardless of the method used, there was a systematic error for various values that included the nose and mouth (p < 0.05). The measurements demonstrating the most significant differences between the methods were those that included the tip of the nose, with the mean differences being -4.4-3.3 mm. The measurements of the distances that estimate face "depth" showed the greatest consistency irrespective of the tested method (p > 0.05 and ICC > 0.8). Conclusions. The use of the Bellus3D FaceApp is precise and reproducible for certain areas of the face, but digital reconstruction errors prohibit, for the time being, the use of this technology in everyday clinical practice. The noted discrepancies were consistent and more prevalent for specific areas such as the tip of the nose. Further investigations are required to determine other sources of error and for other smartphone-based applications released for 3D face image acquisitions.

Efficacy of topical agents in oral mucositis prevention: Systematic review and network meta-analysis

BACKGROUND

Oral mucositis (OM) is considered one of the most common side effects of patients undergoing cancer therapy. OM prevention plays a crucial role in the effectiveness of cancer treatment and the patient's quality of life. Different preventive treatments have been proposed in clinical trials, however with inconclusive results.

MATERIALS AND METHODS

A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: in cancer patients, do specific topical agents compared to standard treatments or placebo reduce the onset and severity of oral mucositis? The risk of bias was assessed, and a network meta-analysis was conducted.

RESULTS

Of 2913 results, 30 randomized clinical trials were considered suitable for inclusion. A total of 2564 patients were analyzed, of which 1284 belonged to the test group and 1280 belonged to the control group. Natural products were the most used, followed mainly by antimicrobial agents, coating agents, and basic oral care measures. Topical sucralfate resulted in the most powerful intervention for the OM prevention (OR = 0.04, 95%C.I. = 0.01-0.25, p-value = 0.001).

CONCLUSION

Due to its cytoprotective action, low cost, ease of administration, and safety, sucralfate could become a potential ally to prevent the onset of OM during cancer therapy.

Regeneration of periodontal intrabony defects using platelet-rich fibrin (PRF): a systematic review and network meta-analysis

One of the most promising approaches to correct periodontal bone defects and achieve periodontal regeneration is platelet-rich fibrin (PRF). This systematic review and meta-analysis aimed to evaluate the regeneration of periodontal bone defects using PRF compared to other regenerative treatments. The data search and retrieval process followed the PRISMA guidelines. An electronic search of MEDLINE, Cochrane, and PubMed databases was performed, selecting exclusively randomized clinical trials where the following were measured: probing depth reduction (PD), clinical attachment level gain (CAL), and radiographic bone fill (RBF). Out of 284 selected articles, 32 were chosen based on inclusion criteria. The use of platelet-rich fibrin (PRF) + open flap debridement (OFD), PRF + metformin, PRF + platelet-rich plasma (PRP), and PRF + OFD/bone graft (BG) significantly reduced PD and improved CAL and RBF. However, the combination of PRF + BG, PRF + metformin, and PRF + STATINS reduced CAL. The intervention of PRF combined with different treatments such as metformin, OFD, PRP, BG, and STATINS has a significant impact on improving PD and CAL. The use of PRF significantly improved the regeneration of periodontal bone defects compared to other treatments.

Two-dimensional facial photography for assessment of craniofacial morphology in sleep breathing disorders: a systematic review

PURPOSE

Craniofacial morphology is integral to Sleep Breathing Disorders (SBD), particularly Obstructive Sleep Apnea (OSA), informing treatment strategies. This review assesses the utility of two-dimensional (2D) photogrammetry in evaluating these metrics among OSA patients.

METHODS

Following PRISMA guidelines, a systematic review was conducted. PubMed, Embase, and Lilacs databases were systematically searched for studies utilizing 2D photography in SBD. Findings were narratively synthesized.

RESULTS

Thirteen studies involving 2,328 patients were included. Significant correlations were found between craniofacial measurements-specifically neck parameters and facial width-and OSA severity, even after BMI adjustment. Ethnic disparities in craniofacial morphology were observed, with photogrammetry effective in predicting OSA in Caucasians and Asians, though data for other ethnicities were limited. Pediatric studies suggest the potential of craniofacial measurements as predictors of childhood OSA, with certain caveats.

CONCLUSION

2D photogrammetry emerges as a practical and non-invasive tool correlating with OSA severity across diverse populations. However, further validation in various ethnic cohorts is essential to enhance the generalizability of these findings.

Reliability of a face scanner in measuring the vertical dimension of occlusion

OBJECTIVE

This study evaluated the reliability of a face scanner in measuring the vertical dimension of occlusion (VDO).

METHODS

Fully dentate volunteers (n = 20; mean-age = 30.0 ± 10.7 years) were recruited. Clinical facial measurements were obtained using a digital caliper and a face scanner (Obiscanner, Fifthingenium, Italy). The scans were imported into a mesh-processing software, and the distances were measured digitally. Measurements were obtained for each participant with the jaws positioned in maximal intercuspation (MI) and with increased vertical distances of 2, 4, and 6 mm. Vertical and horizontal measures were obtained using facial anatomical landmarks: Glabella (GL), Pronasale (PrN), Subnasale (SbN), inferior border of the right and left Alare, Labiale superius (Ls), right and left Cheilion (Ch), Soft Pogonion (SPg), right and left Tragus of the ear (Tr), for all selected vertical positions. Data analysis included intra-class correlation coefficient (ICC), pairwise comparison tests, Bland-Altman plots, and Passing-Bablok regression.

RESULTS

120 VDO measurements (clinical=60, digital=60) were recorded by two independent evaluators. Mean differences between digital and clinical measurements ranged from 0.054 ± 0.14 mm to 0.203 ± 0.13 mm. All parameters were strongly correlated (r > 0.93; p < 0.001). ICC estimates revealed excellent reliability, and the measuring procedure yielded the same results on repeated trials irrespective of the raters and measurement methods. Bland-Altman plots revealed a difference, between digital and clinical measurements, of 1.7 % for the vertical measurements. Regression analysis revealed no significant proportional difference between the two methods, so both can be used interchangeably.

CONCLUSIONS

The findings of this study demonstrate that VDO can be measured accurately from face scans using 3D mesh-processing software and that even small changes in the VDO could be detected using the digital methods.

CLINICAL SIGNIFICANCE

Findings provide evidence about the reliability of a digital method for jaw relation registrations and may be applied towards incorporating this method into clinical workflows for computer-aided-design/ computer-assisted-manufacturing (CAD-CAM) dentures.

Breakthroughs in Oral and Maxillofacial Surgery

In the field of oral and maxillofacial surgery, continuous advances have ushered in a new era of innovation, profoundly influencing this branch of medicine [...].

Longitudinal Three-Dimensional Stereophotogrammetric Growth Analysis in Infants with Unilateral Cleft Lip and Palate from 3 to 12 Months of Age

This longitudinal study aimed to evaluate facial growth and soft tissue changes in infants with complete unilateral cleft lip, alveolus, and palate (CUCLAP) at ages 3, 9, and 12 months. Using 3D images of 22 CUCLAP infants, average faces and distance maps for the entire face and specific regions were created. Color-coded maps highlighted more significant soft tissue changes from 3 to 9 months than from 9 to 12 months. The first interval showed substantial growth in the entire face, particularly in the forehead, eyes, lower lip, chin, and cheeks (p < 0.001), while the second interval exhibited no significant growth. This study provides insights into facial soft tissue growth in CUCLAP infants during critical developmental stages, emphasizing substantial improvements between 3 and 9 months, mainly in the chin, lower lip, and forehead. However, uneven growth occurred in the upper lip, philtrum, and nostrils throughout both intervals, with an overall decline in growth from 9 to 12 months. These findings underscore the dynamic nature of soft tissue growth in CUCLAP patients, highlighting the need to consider these patterns in treatment planning. Future research should explore the underlying factors and develop customized treatment interventions for enhanced facial aesthetics and function in this population.

Dental Materials Design and Innovative Treatment Approach

In recent years, technological innovation has had exponential growth, resulting in positive implications in dentistry [...].

Prevention of peri-implant disease in edentulous patients with fixed implant rehabilitations

OBJECTIVES

To provide an overview about the current approaches to prevent peri-implant diseases in edentulous patients with complete-arch implant-supported prostheses, and to review the clinical applications of the latest digital technologies for implant prosthodontics.

METHODS

A review of the guidelines to prevent peri-implant diseases in patient's receiving complete-arch implant-supported prostheses including facially driven treatment planning procedures using either conventional or digital methods, computer-aided implant planning procedures, and prosthodontic design variables including the optimal number and distribution of dental implants, implant to abutment connection type, implant or abutment level design, screw- or cement-retained alternatives, prostheses contours, and material selection is provided. Furthermore, an outline of the current therapeutic management approaches to address peri-implant diseases is reviewed.

CONCLUSIONS

Clinicians should understand and know different planning and design-related variables that can affect biological and mechanical complication rates of complete-arch implant-supported prostheses. Maintenance protocols are fundamental for minimizing biological and mechanical complications.

A digital workflow to predict facial aesthetics in patients with maxillofacial trauma with implant retained prostheses

PURPOSE

To introduce a digital workflow for the prediction of facial aesthetics, especially in patients with dentation deformity caused by maxillofacial trauma.

METHODS

Cone-beam computed tomography (CBCT) and three-dimensional facial scans of patients with radiographic prostheses were collected. The aforementioned data were uploaded to ProPlan CMF software and merged to generate a virtual patient with craniofacial hard tissue, realistic facial soft tissue, and remaining dentition. The radiographic prostheses were scanned to form a digital cast, which was fitted with its CBCT image to create the virtual prostheses. Postoperative facial soft tissue was simulated according to the movement of the virtual prostheses. An appropriate virtual diagnostic prosthesis plan was selected by the patient and dentist. Subsequently, prosthetically driven implant guide and restoration were designed and fabricated.

CONCLUSIONS

A virtual patient was successfully constructed. A 4-mm protrusion of the virtual prosthesis was chosen. Subsequently, implant surgery was performed, and dental prostheses were fabricated based on this location. The fusion of the postoperative facial scan and preoperative facial prediction was found to be coincident. This technique can effectively predict facial aesthetic features of patients with maxillofacial trauma, facilitate communication with patients, reduce chairside time, and guide the multidisciplinary design of implant placement and restoration fabrication.