Comparison between Additive and Subtractive CAD-CAM Technique to Produce Orthognathic Surgical Splints: A Personalized Approach

Accuracy and clinical fit of milled versus rapid prototyped orthognathic surgical splints

Three-dimensional (3D) printing has become an integral part of orthognathic surgery. However, there is a lack of studies evaluating accuracy of orthognathic surgical splints fabricated from subtractive milling versus additive 3D printing. The primary aim of this in-vitro study was to compare the differences in trueness between milled and 3D-printed splints, while the secondary aim was to compare the differences in clinical fit of these splints. A sample of eight patients was selected, and STL files of the final orthognathic surgical splint were used to fabricate three splints for each of the eight cases. The first splint was fabricated by subtractive milling (SM), whereas the second and third splints were 3D printed with Digital Light Processing (DLP) and Laser Stereolithography (SLA), respectively. Paired superimposition of scans was performed using a reference model. The clinical fit of the splints to the printed models was also assessed. The mean root mean square (RMS) deviations for the SM, SLA, and DLP were 0.11 ± 0.02, 0.16 ± 0.02 and 0.14 ± 0.02 respectively. The post-hoc analysis showed that the SM splints had the highest accuracy (p < 0.01). However, DLP splints showed the best clinical fit, followed by SM and SLA. In conclusion, splints fabricated by SM were more accurate than those fabricated by 3D printing, although this difference may not be clinically significant. The site, rather than the magnitude of the errors, may have a greater effect on the clinical usability of splints. In general, SM and DLP splints demonstrated a good clinical fit and were suitable for the fabrication of surgical splints.

Assessing Artificial Intelligence in Oral Cancer Diagnosis: A Systematic Review

BACKGROUND

With the use of machine learning algorithms, artificial intelligence (AI) has become a viable diagnostic and treatment tool for oral cancer. AI can assess a variety of information, including histopathology slides and intraoral pictures.

AIM

The purpose of this systematic review is to evaluate the efficacy and accuracy of AI technology in the detection and diagnosis of oral cancer between 2020 and 2024.

METHODOLOGY

With an emphasis on AI applications in oral cancer diagnostics, a thorough search approach was used to find pertinent publications published between 2020 and 2024. Using particular keywords associated with AI, oral cancer, and diagnostic imaging, databases such as PubMed, Scopus, and Web of Science were searched. Among the selection criteria were actual English-language research papers that assessed the effectiveness of AI models in diagnosing oral cancer. Three impartial reviewers extracted data, evaluated quality, and compiled the findings using a narrative synthesis technique.

RESULTS

Twelve papers that demonstrated a range of AI applications in the diagnosis of oral cancer satisfied the inclusion criteria. This study showed encouraging results in lesion identification and prognostic prediction using machine learning and deep learning algorithms to evaluate oral pictures and histopathology slides. The results demonstrated how AI-driven technologies might enhance diagnostic precision and enable early intervention in cases of oral cancer.

CONCLUSION

Unprecedented prospects to transform oral cancer diagnosis and detection are provided by artificial intelligence. More resilient AI systems in oral oncology can be achieved by joint research and innovation efforts, even in the face of constraints like data set variability and regulatory concerns.

Stem Cells: Present Understanding and Prospects for Regenerative Dentistry

Regenerative medicine in dentistry focuses on repairing damaged oral tissues using advanced tools like stem cells, biomaterials, and tissue engineering (TE). Mesenchymal stem cells (MSCs) from dental sources, such as dental pulp and periodontal ligament, show significant potential for tissue regeneration due to their proliferative and differentiative abilities. This systematic review, following PRISMA guidelines, evaluated fifteen studies and identified effective strategies for improving dental, periodontal, and bone tissue regeneration through scaffolds, secretomes, and bioengineering methods. Key advancements include the use of dental pulp stem cells (DPSCs) and periodontal ligament stem cells (PDLSCs) to boost cell viability and manage inflammation. Additionally, pharmacological agents like matrine and surface modifications on biomaterials improve stem cell adhesion and promote osteogenic differentiation. By integrating these approaches, regenerative medicine and TE can optimize dental therapies and enhance patient outcomes. This review highlights the potential and challenges in this field, providing a critical assessment of current research and future directions.

Therapeutic Strategies and Genetic Implications for Periodontal Disease Management: A Systematic Review

The objective of this review is to identify the microbiological alterations caused by various therapy modalities by critically analyzing the current findings. We limited our search to English-language papers published between 1 January 2004 and 7 May 2024 in PubMed, Scopus, and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "microbio*" AND "periodontitis" were used. A total of 5152 papers were obtained from the databases Web of Science (2205), PubMed (1793), and Scopus (1154). This resulted in 3266 articles after eliminating duplicates (1886), and 1411 entries were eliminated after their titles and abstracts were examined. The qualitative analysis of the 22 final articles is included in this study. Research on periodontal disease shows that periodontitis alters the oral microbiome and increases antibiotic resistance. Treatments like scaling and root planing (SRP), especially when combined with minocycline, improve clinical outcomes by reducing harmful bacteria. Comprehensive mechanical debridement with antibiotics, probiotics, EMD with bone grafts, and other adjunctive therapies enhances periodontal health. Personalized treatment strategies and advanced microbial analyses are crucial for effective periodontal management and antibiotic resistance control.

From Reverse Engineering Software to CAD-CAM Systems: How Digital Environment Has Influenced the Clinical Applications in Modern Dentistry and Orthodontics

Background: Reverse engineering (RE) or back engineering is a process that analyzes a physical object to obtain the primary data of the same project. RE technologies have different applications in industrial settings and productive chains; however, with the advent of digital technologies in dentistry and orthodontic fields, they are involved in the new diagnostic and clinical digital workflow. For example, 3D model scanning, 3D facial scanning, models superimposition, digital orthodontic setup, anatomical volumetric assessment, soft tissue analysis, orthodontic digital guided systems, and prototyped orthodontic appliances represent a few examples of the application of RE in orthodontics. Moreover, clinicians can manipulate the data derived from original digital file to enhance diagnosis and communication with other clinicians and dental technicians; however, RE and digital technologies systems are not exempt from shortcomings, including costs and knowledge curve. In this regard, the aim of the present manuscript was to describe the use of reverse engineering technologies in modern digital orthodontics and provide helpful information for those specialists who are at the beginning of the transition from analogic to digital orthodontic workflow.

Main Applications and Recent Research Progresses of Additive Manufacturing in Dentistry

In recent ten years, with the fast development of digital and engineering manufacturing technology, additive manufacturing has already been more and more widely used in the field of dentistry, from the first personalized surgical guides to the latest personalized restoration crowns and root implants. In particular, the bioprinting of teeth and tissue is of great potential to realize organ regeneration and finally improve the life quality. In this review paper, we firstly presented the workflow of additive manufacturing technology. Then, we summarized the main applications and recent research progresses of additive manufacturing in dentistry. Lastly, we sketched out some challenges and future directions of additive manufacturing technology in dentistry.