1
|
Revilla-León M, Gómez-Polo M, Sailer I, Kois JC, Rokhshad R. An overview of artificial intelligence based applications for assisting digital data acquisition and implant planning procedures. J ESTHET RESTOR DENT 2024. [PMID: 38757761 DOI: 10.1111/jerd.13249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES To provide an overview of the current artificial intelligence (AI) based applications for assisting digital data acquisition and implant planning procedures. OVERVIEW A review of the main AI-based applications integrated into digital data acquisitions technologies (facial scanners (FS), intraoral scanners (IOSs), cone beam computed tomography (CBCT) devices, and jaw trackers) and computer-aided static implant planning programs are provided. CONCLUSIONS The main AI-based application integrated in some FS's programs involves the automatic alignment of facial and intraoral scans for virtual patient integration. The AI-based applications integrated into IOSs programs include scan cleaning, assist scanning, and automatic alignment between the implant scan body with its corresponding CAD object while scanning. The more frequently AI-based applications integrated into the programs of CBCT units involve positioning assistant, noise and artifacts reduction, structures identification and segmentation, airway analysis, and alignment of facial, intraoral, and CBCT scans. Some computer-aided static implant planning programs include patient's digital files, identification, labeling, and segmentation of anatomical structures, mandibular nerve tracing, automatic implant placement, and surgical implant guide design.
Collapse
Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Research and Digital Dentistry, Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, Complutense University of Madrid, Madrid, Spain
- Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - Irena Sailer
- Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - John C Kois
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - Rata Rokhshad
- Topic Group Dental Diagnostics and Digital Dentistry, ITU/WHO Focus Group AI on Health, Berlin, Germany
| |
Collapse
|
2
|
Al Mortadi NA, Khasawneh L, Alzoubi KH. Manufacturing of PEEK orthodontic baseplate and 3D-printed alloy components from an intraoral scan. Medicine (Baltimore) 2024; 103:e38004. [PMID: 38669369 PMCID: PMC11049687 DOI: 10.1097/md.0000000000038004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
This paper demonstrates a digital manufacturing technique of a removable orthodontic appliance from an intraoral scan. An intraoral scan was made for the maxillary and mandibular arches. 3Shape Orthodontics Appliance Designer produced the virtual Hawley retainer, consisting of alloy components (Adam Clasps and Fitted Labial bow) and a base plate. The base plate design was modified to adapt to inserting the alloy components, which were combined using cold-cured acrylic. The finished Hawley retainer was assessed intraorally. The described technique emphasizes the design specifications of digitally designed and manufactured removable orthodontic appliances. A combination of additive and subtractive techniques was successfully employed to manufacture the alloy components and base plate. This novel method provides an alternative approach to manufacturing removable appliances with computer-aided design (CAD)/computer-aided manufacturing (CAM) technologies. The described process offers a precursor to digital manufacturing of other developed designs of dental appliances.
Collapse
Affiliation(s)
- Noor A. Al Mortadi
- Department of Applied Dental Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Lina Khasawneh
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H. Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
3
|
Schmalzl J, Keskeny GÁ, Hermann P, Pál A, Géczi Z, Borbély J, Róth I. Evaluating the influence of palate scanning on the accuracy of complete-arch digital impressions - an in vitro study. J Dent 2024; 145:105014. [PMID: 38648874 DOI: 10.1016/j.jdent.2024.105014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/12/2024] [Accepted: 04/19/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVES To assess the impact of including the palate and the number of images recorded during intraoral digital scanning procedure on the accuracy of complete arch scans. METHODS An experienced operator conducted 40 digital scans of a 3D printed maxillary model and divided them into two groups: 20 with inclusion of the palate (PAL) and 20 without (NPAL). Each set of scans was performed using an intraoral scanner (IOS) (Trios 5; 3Shape A/S; Copenhagen, Denmark). The resulting STL files were imported into the Geomagic Control X software (3D Systems, Rock Hill, SC, USA) for accuracy comparison. A reference STL file was created using a 3Shape E3 laboratory scanner (3Shape Scanlt Dental 2.2.1.0; Copenhagen, Denmark). The number of images captured was recorded during the scanning procedure. RESULTS In the case of the right side no statistically significant difference in trueness was detected (84 µm ± 45.6 for PAL and 80.4 ± 40.4 µm for NPAL). In the case of the left side no significant difference in trueness was observed (215.1 ± 70.2 µm for PAL and 233.9 ± 70.7 µm for NPAL). In the case of the arch distortion a statistically significant difference in trueness was seen between the two types of scans (135.3 ±71.9 µm for PAL and 380.4 ± 255.1 µm for NPAL). The average number of images was 831.25, and 593.8 for PAL and NPAL, respectively. CONCLUSIONS Scanning of the palatal area can significantly improve the accuracy of dental scans in cases of complete arches. In terms of the number of images, based on the current results, obvious conclusions could not be drawn, and further investigation is required. CLINICAL SIGNIFICANCE Scanning the palate may be beneficial for improving the accuracy of intraoral scans in dentate patients. Consequently, this should be linked to an appropriate scanning strategy that predicts palatal scanning.
Collapse
Affiliation(s)
- Judit Schmalzl
- Department of Prosthodontics, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary; Semmelweis University's School of Ph.D. Studies, Üllői u. 26, Budapest, 1085, Hungary.
| | - György Árpád Keskeny
- Semmelweis University's School of Ph.D. Studies, Üllői u. 26, Budapest, 1085, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary
| | - Adrienn Pál
- Department of Prosthodontics, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary; Semmelweis University's School of Ph.D. Studies, Üllői u. 26, Budapest, 1085, Hungary
| | - Zoltán Géczi
- Department of Prosthodontics, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary
| | - Ivett Róth
- Department of Prosthodontics, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary
| |
Collapse
|
4
|
Rosmaninho A, Vedovato E, Kois JC, Revilla-León M. Altered reverse impression method involving extraoral digitalization of a verification jig for the fabrication of implant-supported prosthesis by using a complete-digital workflow. J ESTHET RESTOR DENT 2024; 36:566-572. [PMID: 37882153 DOI: 10.1111/jerd.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
Abstract
The reverse impression method involves the extraoral digitalization of the interim implant-supported prostheses and intraoral digitalization of antagonist arch and maxillomandibular relationship. This technique allows the fabrication of implant-supported prostheses by using a complete-digital workflow. The scan analogs make the reverse impression method feasible. However, this method may not be recommended if the interim polymethyl methacrylate prosthesis does not have passive fit. The present manuscript describes an altered reverse impression technique that involves the extraoral digitalization of a conventional verification jig, which has attached scan analogs. With this technique modification, the implant positions captured using the verification jig are used to obtain the virtual definitive implant cast and fabricate the definitive implant-supported prosthesis.
Collapse
Affiliation(s)
| | | | - John C Kois
- Founder and Director Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Faculty & Director of Research and Digital Dentistry, Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| |
Collapse
|
5
|
El Osta N, Drancourt N, Auduc C, Veyrune JL, Nicolas E. Accuracy of conventional impressions and digital scans for implant-supported fixed prostheses in maxillary free-ended partial edentulism: An in vitro study. J Dent 2024; 143:104892. [PMID: 38367825 DOI: 10.1016/j.jdent.2024.104892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/13/2024] [Accepted: 02/15/2024] [Indexed: 02/19/2024] Open
Abstract
OBJECTIVES To evaluate the accuracy of conventional polyether impressions and digital scans produced by five intra-oral scanners (IOSs) in maxillary free-ended partial edentulism for long-span implant-supported prostheses. METHODS This in vitro study involved the impression of a maxillary model with free-end partial edentulism, in which six implants were placed before digitization using a desktop scanner to generate a digital reference model. Conventional impressions (Impregum Penta Soft, 3M) and digital scans with five IOSs (Trios 3 and 4, 3Shape; Primescan, Dentsply-Sirona; CS 3600, Carestream Dental; and i-500, Medit) were obtained. Conventional impressions were digitized using the same desktop scanner. Each digital STL file of conventional or digital impressions was superimposed over the reference STL file to enable comparison. Trueness was assessed by calculating angles and distance deviations. For precision, dispersions of values around their means were also measured. RESULTS The mean distance deviation was significantly higher for conventional impressions (454.24 ± 334.70 µm) than for IOSs (ranging from 160.98 ± 204.48 µm to 255.56 ± 395.89 µm) (p < 0.001). The mean angular deviation was high with conventional impressions (1.82 ± 1.51°), intermediate with CS 3600 (1.38 ± 1.42°), Primescan (1.37 ± 2.54°) and Trios 4 (1.30 ± 0.64°) scanners, and lower with I500 (0.97 ± 0.75°) and Trios 3 (1.01 ± 0.85°) scanners (p < 0.001). The dispersion of distance values around their means was lowest with Trios 3 and i-500, followed by CS3600, Primescan, and Trios 4, respectively, and higher for conventional impressions (p < 0.001). The dispersion of angular values was smallest with i-500, Trios 3, and Trios 4 compared with other groups and was highest with Primescan (p < 0.001). CONCLUSIONS Within the limits of the current study, Trios 3 scanner exhibited the highest accuracy, followed by i-500, Trios 4, CS 3600, Primescan, and conventional impressions respectively. IOSs might be reliable for the fabrication of an implant-supported prosthesis. In vivo studies are required to confirm these findings. CLINICAL SIGNIFICANCE Passive adaptation of the implant-supported framework is a challenge when rehabilitating patients with maxillary free-end partial edentulism. While Conventional impressions remain a reliable and validated technique, but IOSs demonstrated higher accuracy, suitable for the fabrication of long-span implant-supported prostheses in partially edentulous arch.
Collapse
Affiliation(s)
- Nada El Osta
- Department of Prosthodontics, UFR d'Odontologie, Centre de Recherche en Odontologie Clinique (CROC), University of Clermont Auvergne, Clermont-Ferrand, France.
| | - Noémie Drancourt
- Department of Prosthodontics, UFR d'Odontologie, Centre de Recherche en Odontologie Clinique (CROC), University of Clermont Auvergne, Clermont-Ferrand, France; CHU Clermont-Ferrand, Odontology Department, Clermont-Ferrand, France
| | - Chantal Auduc
- Department of Prosthodontics, UFR d'Odontologie, Centre de Recherche en Odontologie Clinique (CROC), University of Clermont Auvergne, Clermont-Ferrand, France; CHU Clermont-Ferrand, Odontology Department, Clermont-Ferrand, France
| | - Jean-Luc Veyrune
- Department of Prosthodontics, UFR d'Odontologie, Centre de Recherche en Odontologie Clinique (CROC), University of Clermont Auvergne, Clermont-Ferrand, France; CHU Clermont-Ferrand, Odontology Department, Clermont-Ferrand, France
| | - Emmanuel Nicolas
- Department of Prosthodontics, UFR d'Odontologie, Centre de Recherche en Odontologie Clinique (CROC), University of Clermont Auvergne, Clermont-Ferrand, France; CHU Clermont-Ferrand, Odontology Department, Clermont-Ferrand, France
| |
Collapse
|
6
|
Limones A, Molinero-Mourelle P, Çakmak G, Abou-Ayash S, Delgado S, Martínez Vázquez de Parga JA, Celemín A. Impact of the superimposition methods and the designated comparison area on accuracy analyses in dentate models. J Dent 2024; 145:104939. [PMID: 38521237 DOI: 10.1016/j.jdent.2024.104939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/25/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVES To measure the impact of superimposition methods and the designated comparison area on accuracy analyses of dentate models using an ISO-recommended 3-dimensional (3D) metrology-grade inspection software (Geomagic Control X; 3D Systems; Rock Hill, South Carolina; USA). MATERIALS AND METHODS A dentate maxillary typodont scanned with a desktop scanner (E4; 3 Shape; Copenhagen; Denmark) and an intraoral scanner (Trios 4; 3 Shape; Copenhagen; Denmark) was used as reference. Eight groups were created based on the core features of each superimposition method: landmark-based alignment (G1); partial area-based alignment (G2); entire tooth area-based alignment (G3); double alignment combining landmark-based alignment with entire tooth area-based alignment (G4); double alignment combining partial area-based alignment with entire tooth area-based alignment (G5); initial automated quick pre-alignment (G6); initial automated precise pre-alignment (G7); and entire model area-based alignment (G8). Diverse variations of each alignment and two regions for accuracy analyses (teeth surface or full model surface) were tested, resulting in a total of thirty-two subgroups (n = 18). The alignment accuracy between experimental and reference meshes was quantified using root mean square (RMS) error as trueness and its repeatability as precision. The descriptive statistics, a factorial repeated measures analysis of variance (ANOVA) and a post hoc Tuckey multiple comparison tests were used to analyze the trueness, and precision (α = 0.05). RESULTS A total of 576 superimpositions were performed. The unique partial area-based superimposition method demonstrated the least precise alignment and was the sole group to exhibit a significant difference (p<.001). Automated initial pre-alignments demonstrated similar accuracy to other superimposition methods (p>.05). Double alignments did not result in accuracy improvement (p>.05). The designated comparison area displayed differences in both trueness (p<.001) and precision (p<.001), leading to an overall discrepancy of 8 ± 4 μm between selecting the teeth surface or full model surface. CONCLUSIONS The superimposition method choice within the tested software did not impact accuracy analyses, except when the alignment relies on a unique and reduced area, such as the palatal rugae, a single tooth, or three adjacent teeth on one side. CLINICAL SIGNIFICANCE The superimposition method choice within the tested ISO-recommended 3D inspection software did not impact accuracy analyses.
Collapse
Affiliation(s)
- Alvaro Limones
- Department of Conservative Dentistry and Prosthodontics, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.
| | - Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Prosthodontics, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain; Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland.
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, University of Bern, Bern, Switzerland
| | - Silvia Delgado
- Department of Conservative Dentistry and Prosthodontics, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | | | - Alicia Celemín
- Department of Conservative Dentistry and Prosthodontics, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| |
Collapse
|
7
|
Etxaniz O, Amezua X, Jauregi M, Solaberrieta E. Obtaining more accurate complete arch implant digital scans with the aid of a geometric pattern: A dental technique. J Prosthet Dent 2024:S0022-3913(24)00137-9. [PMID: 38462435 DOI: 10.1016/j.prosdent.2024.01.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 03/12/2024]
Abstract
A technique to obtain more accurate complete arch implant digital scans and virtual casts is described. In order to obtain complete arch implant digital scans with greater accuracy, short-span intraoral digital scans are superimposed with the aid of a geometric pattern. Therefore, the technique takes advantage of the accuracy of intraoral scanners to obtain digital scans of reduced spans. Two virtual designs of the geometric pattern have been made available online: one for maxillary arches and one for mandibular arches. From these virtual designs, new virtual designs of geometric patterns of different sizes and shapes can be created to better fit different arch forms and implant positions.
Collapse
Affiliation(s)
- Olatz Etxaniz
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Xabier Amezua
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Mikel Jauregi
- Associate Professor, Department of Mechanical Engineering, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Eneko Solaberrieta
- Associate Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain.
| |
Collapse
|
8
|
Etxaniz O, Amezua X, Jauregi M, Solaberrieta E. Improving the accuracy of complete arch implant digital scans by using auxiliary clips for intraoral scan bodies: A dental technique. J Prosthet Dent 2024:S0022-3913(24)00066-0. [PMID: 38418305 DOI: 10.1016/j.prosdent.2024.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 03/01/2024]
Abstract
A technique to improve the accuracy of complete arch implant intraoral digital scans and the accuracy of their virtual casts is described. Obtaining accurate complete arch implant intraoral digital scans with an intraoral scanner is challenging because of the smooth and movable tissues of edentulous areas. The described technique uses auxiliary clips attached to intraoral scan bodies to cover interimplant edentulous spans with immobile tooth-like geometric references that are more favorable for intraoral scanning. The technique is designed to be user friendly and compatible with any intraoral scanner.
Collapse
Affiliation(s)
- Olatz Etxaniz
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Xabier Amezua
- Assistant Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Bilbao, University of the Basque Country (UPV/EHU), Bilbao, Spain
| | - Mikel Jauregi
- Associate Professor, Department of Mechanical Engineering, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Eneko Solaberrieta
- Associate Professor, Department of Graphic Design and Engineering Projects, Faculty of Engineering Gipuzkoa, University of the Basque Country (UPV/EHU), San Sebastian, Spain.
| |
Collapse
|
9
|
Campana V, Papa A, Silvetti MA, Del Fabbro M, Testori T. Use of the universal scan template to achieve a predictable optical impression: Preliminary data of a case series study in complete edentulous patients. Clin Implant Dent Relat Res 2024; 26:237-244. [PMID: 37965745 DOI: 10.1111/cid.13292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 09/26/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Full-arch IOS scan of edentulous areas rehabilitated with dental implants is nowadays still described as an unpredictable procedure. To improve the accuracy, a universal scan template (UST®) is proposed in this article. The clinician can easily assemble the template with a mechanical coupling, by matching the scan bodies with objects of known dimension characterized by specific markers. The UST® facilitates the scanning of an entire arch on scan bodies, reducing the learning curve, simplifying acquisition movements, shortening the scanning time, and drastically reducing the risk of distortions and aberrations of the scans. MATERIALS AND METHODS In a case series study on 12 patients, the improvement in the accuracy of the scans with UST® was validated by comparing the STL files derived from scans with and without the guide in place. A titanium bar was produced from each optical impression. RESULTS The bars obtained from the optical impressions taken without UST® were found to be nonpassive in the mouth in the majority of the cases. On the contrary with the use of UST® we obtained 12 passive prosthetic rehabilitations. CONCLUSIONS The proposed solution may represent a valid method to improve the predictability of full arch optical impressions on implants.
Collapse
Affiliation(s)
- Veronica Campana
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | | | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Tiziano Testori
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milano, Italy
- Department of Implantology and Oral Rehabilitation, Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milano, Italy
- Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, Michigan, USA
- Department of Oral Medicine, Infection and Immunity, Harvard University, School of Dental Medicine, Cambridge, Massachusetts, USA
| |
Collapse
|
10
|
Vag J, Romanszky L, Sersli G, DeFee M, Renne W, Mangano F, Borbola D. Application of the virtual-fit method for fixed complete denture cases designed on intraoral scans: Effect of cement spacing. J Dent 2024; 141:104780. [PMID: 37981046 DOI: 10.1016/j.jdent.2023.104780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 11/04/2023] [Accepted: 11/16/2023] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVES To validate the virtual-fit alignment, analyze the impact of cement spacing on internal/marginal gaps, and correlate results with conventional trueness measures. METHODS Four dental abutment models were scanned using an industrial reference scanner (one time each), Emerald S (three times each), and Medit i700 (three times each) intraoral scanners (IOS). On each IOS scan (n = 24), three complete-arch fixed frameworks were designed with 70 or 140 µm cement space with no marginal space (groups 70 and 140) and 70 µm with an additional 20 µm space, including the margin (group 70+20). Two types of alignment were performed by GOM Inspect software. The reference and IOS scans were aligned through a conventional iterative closest point algorithm (ICP) where the penetration of the two scans was permitted into each other (conventional trueness method). Second, the computer-aided designs were superimposed with the reference scan also using an ICP, but preventing the design from virtual penetration into the model (virtual-fit method). The virtual-fit algorithm was validated by non-penetration alignment of the designs with the IOS scans. Internal and marginal gap was measured between the design and the abutments. The difference between spacing groups was compared by Friedman's test. A statistical correlation (Spearman's Rho Test) was computed between the measured gaps and the conventional trueness method. A significant difference was accepted at p<0.05 after the Bonferroni correction. RESULTS The gaps deviated from the set cement space by 3-13 µm on IOS scans (validation of virtual-fit algorithm). The internal gap of the design on the reference scan was not affected by cement spacing (Emerald S, p = 0.779; Medit i700, p = 0.205). The marginal gap in groups 70 and 70+20 was significantly lower than in group 140 in Emerald S (p<0.05). In Medit i700, it was lower in the 70+20 group than in the group 70 (p<0.01) and in the group 140 (p<0.05). Some Medit i700 scans exhibited high marginal gaps within group 70 but not in groups 70 and 140. The measured gaps correlated significantly (r = 0.51-0.81, p<0.05-0.001) with the conventional trueness but were 2.6-4.6 times higher (p<0.001). CONCLUSION Virtual-fit alignment can simulate restoration seating. A 20 µm marginal and 90 µm internal spacing could compensate for scan errors up to several hundred micrometers. However, 140 µm internal spacing is counterproductive. The conventional trueness method could only partially predict framework misfit. CLINICAL SIGNIFICANCE The virtual-fit method can provide clinically interpretable data for intraoral scanners. Emerald S and Medit i700 intraoral scanners are suitable for fabricating complete-arch fixed tooth-supported prostheses. In addition, a slight elevation of spacing at the margin could compensate for moderate inaccuracies in a scan.
Collapse
Affiliation(s)
- Janos Vag
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest H-1088, Hungary.
| | - Laszlo Romanszky
- Dental Technicians, Artifex Dentis Kft., Révay utca 12, Budapest H-1065, Hungary
| | - Gyorgy Sersli
- Dental Technicians, Artifex Dentis Kft., Révay utca 12, Budapest H-1065, Hungary
| | - Michael DeFee
- Modern Optimized Dentistry Institute, 320 Broad St. #210 Charleston, SC 29401, United States
| | - Walter Renne
- Modern Optimized Dentistry Institute, 320 Broad St. #210 Charleston, SC 29401, United States
| | - Francesco Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, 8-2 Trubetskaya Street, Moscow 119991, Russian Federation
| | - Daniel Borbola
- Department of Restorative Dentistry and Endodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi utca 47, Budapest H-1088, Hungary
| |
Collapse
|
11
|
Mangano FG, Cianci D, Pranno N, Lerner H, Zarone F, Admakin O. Trueness, precision, time-efficiency and cost analysis of chairside additive and subtractive versus lab-based workflows for manufacturing single crowns: An in vitro study. J Dent 2024; 141:104792. [PMID: 38013004 DOI: 10.1016/j.jdent.2023.104792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE To evaluate the trueness, precision, time efficiency, and cost of three different workflows for manufacturing single crowns (SCs). METHODS A plaster model with a prepared tooth (#15) was scanned with an industrial scanner, and an SC was designed in computer-assisted-design (CAD) software. Ten SCs were printed with a hybrid composite (additive chairside) and a stereolithographic (SLA) printer (Dfab®), 10 SCs were milled in lithium disilicate (subtractive chairside) using a chairside milling unit (inLab MC XL®), and 10 SCs were milled in zirconia (lab-based) using a five-axis laboratory machine (DWX-52D®). All SCs were scanned with the same scanner after polymerization/sinterization. Each scan was superimposed to the marginal area of the original CAD file to evaluate trueness: absolute average (ABS AVG), root mean square (RMS), and (90˚-10˚)/2 percentile were calculated for each group. Marginal adaptation and quality of the occlusal and interproximal contact points were also investigated by two prosthodontists on 3D printed and plaster models. Finally, the three workflows' time efficiency and costs were evaluated. RESULTS Additive chairside and subtractive lab-based SCs had significantly better marginal trueness than subtractive chairside SCs in all three parameters (ABS AVG, p < 0.01; RMS, p < 0.01; [90˚-10˚]/2, p < 0.01). However, the two prosthodontists found no significant differences between the three manufacturing procedures in the quality of the marginal closure (p = 0.186), interproximal (p = 0.319), and occlusal contacts (p = 0.218). Both time efficiency and cost show a trend favoring the chairside additive workflow. CONCLUSIONS Chairside additive technology seems to represent a valid alternative for manufacturing definitive SCs, given the high marginal trueness, precision, workflow efficiency and low costs. STATEMENT OF CLINICAL RELEVANCE Additive chairside manufacturing of definitive hybrid composite SCs is now possible and shows high accuracy, time efficiency, and competitive cost.
Collapse
Affiliation(s)
- Francesco Guido Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
| | | | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Henriette Lerner
- Department of Oral, Maxillofacial and Plastic Surgery, Goethe University, Frankfurt, Germany
| | - Fernando Zarone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Oleg Admakin
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia
| |
Collapse
|
12
|
Revilla-León M, Gómez-Polo M, Kois JC. A guide for selecting the intraoral scan extension when fabricating tooth- and implant-supported fixed dental prostheses. J ESTHET RESTOR DENT 2024; 36:85-93. [PMID: 37789708 DOI: 10.1111/jerd.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 09/19/2023] [Indexed: 10/05/2023]
Abstract
OBJECTIVES To describe a new classification for intraoral scans based on the scan extension and to introduce a decision guideline to choose the scan extension for fabricating tooth- and implant-supported fixed dental prostheses (FDPs). OVERVIEW Multiple operator- and patient-related factors have been identified that can decrease the scanning accuracy of intraoral scanners (IOSs), including scan extension. However, the decision criteria for selecting scan extension for fabricating tooth- and implant-supported restorations is unclear. Based on the extension of the intraoral digital scans, three types of scans can be defined: half-arch (anterior or posterior), extended half-arch, and complete-arch scan. Variables to consider when choosing the scan extension include the number and location of units being restored, as well as the extension and location of edentulous areas. Additionally, the accuracy of the virtual definitive cast and the accuracy of the maxillomandibular relationship captured by using IOSs should be differentiated. CONCLUSIONS A decision tree for selecting the scan extension is presented. The decision is based on the number and location of units being restored, and the extension and location of edentulous areas. Intraoral scans with reduced scan extension are indicated when fabricating tooth- and implant-supported crowns or short-span fixed prostheses, when the patient does not have more than one missing tooth in the area of the dental arch included in the scan. For the remaining clinical conditions, complete-arch intraoral scans are recommended. CLINICAL SIGNIFICANCE Scan extension is a clinician's decision that should be based on the number and location of units being restored and the extension and location of edentulous areas. Intraoral scans with a reduced scan extension is recommended, when possible.
Collapse
Affiliation(s)
- Marta Revilla-León
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | - John C Kois
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Kois Center, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| |
Collapse
|
13
|
Vag J, Stevens CD, Badahman MH, Ludlow M, Sharp M, Brenes C, Mennito A, Renne W. Trueness and precision of complete arch dentate digital models produced by intraoral and desktop scanners: An ex-vivo study. J Dent 2023; 139:104764. [PMID: 37898433 DOI: 10.1016/j.jdent.2023.104764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/21/2023] [Accepted: 10/25/2023] [Indexed: 10/30/2023] Open
Abstract
OBJECTIVES The study aimed to compare the trueness and precision of five intraoral scanners (Emerald S, iTero Element 5D, Medit i700, Primescan, and Trios 4) and two indirect digitization techniques for both teeth and soft tissues on fresh mandibular and maxillary cadaver jaws. METHODS The maxilla and mandible of a fully dentate cadaver were scanned by the ATOS industrial scanner to create a master model. Then, the specimens were scanned eight times by each intraoral scanner (IOS). In addition, 8 polyvinylsiloxane (PVS) impressions were made and digitized with a Medit T710 desktop scanner. Stone models were then poured and again scanned with the desktop scanner. All IOS, PVS, and stone models were compared to the master model to calculate the mean absolute surface deviation for mandibular teeth, maxillary teeth, and palate. RESULTS For mandibular teeth, the PVS trueness was only significantly better than the Medit i700 (p < 0.001) and Primescan (p < 0.05). In maxillary teeth, the PVS trueness was significantly better than all IOSs (p < 0.05-0.001); the stone trueness was significantly better than Emerald S (p < 0.01), Medit i700 (p < 0.001) and Primescan (p < 0.01). In the palate, PVS and stone trueness were significantly lower than the iTero Element 5D (p < 0.01) and Trios 4 (p < p < 0.01). Stone trueness was significantly lower than the Medit i700 (p < 0.05). The precision in the palate was significantly lower for PVS and stone than for Emerald S (p < 0.01, p < 0.05), iTero Element 5D (p < 0.01, p < 0.01), Primescan (p < 0.001, p < 0.001), and Trios 4 (p < 0.001, p < 0.01). Significant differences in trueness between the IOSs were observed only in the mandibular teeth. The Medit i700 performed worse than Emerald S (p < 0.01) and iTero Element 5D (p < 0.01). For mandibular teeth, the Medit i700 was significantly more precise than Primescan (p < 0.01) and the Emerald S (p < 0.05). The Trios 4 was significantly less precise than Emerald S (p < 0.05). The precision of Medit i700 was significantly worse than iTero Element 5D (p < 0.01) for maxillary teeth, as well as the Primescan (p < 0.01) and Trios 4 (p < 0.05) for the palate. CONCLUSIONS In general, indirectly digitized models from PVS impressions had higher trueness than IOS for maxillary teeth; precision between the two methods was similar. IOS was more accurate for palatal tissues. The differences in trueness and precision for mandibular teeth between the various techniques were negligible. CLINICAL SIGNIFICANCE All investigated IOSs and indirect digitization could be used for complete arch scanning in mandibular and maxillary dentate arches. However, direct optical digitization is preferable for the palate due to the low accuracy of physical impression techniques for soft tissues.
Collapse
Affiliation(s)
- Janos Vag
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Szentkirályi Street 47, Budapest 1088, Hungary.
| | | | - Mohammed H Badahman
- Digital Dentistry Masters Program, Medical University of South Carolina, Charleston, SC, USA
| | - Mark Ludlow
- Section Head of Implant Dentistry, Digital Dentistry, And Removable Prosthodontics at the University of Utah School of Dentistry, UT, USA
| | - Madison Sharp
- Senior Dental Student, Medical University of South Carolina, Charleston, SC, USA
| | - Christian Brenes
- Director of Digital Dentistry Masters Program, Medical University of South Carolina, Charleston, SC, USA
| | | | - Walter Renne
- Modern Optimized Dentistry Institute, Charleston, SC, USA
| |
Collapse
|
14
|
Schwärzler A, Nemec M, Lettner S, Rank C, Schedle A, Jonke E. 3D printed indirect bonding trays: Transfer accuracy of hard versus soft resin material in a prospective, randomized, single-blinded clinical study. Dent Mater 2023; 39:1058-1065. [PMID: 37806794 DOI: 10.1016/j.dental.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES This prospective clinical study aimed to compare transfer accuracy and immediate loss rate of hard versus soft transfer trays utilizing a CAD/CAM workflow. METHODS We performed virtual bracket placement on intraoral scans of adolescent patients to create individual indirect bonding trays. Orthodontic software (Appliance Designer, 3Shape, Copenhagen, Denmark) was used to design the trays, which were then produced using 3D printing technology. Patients were randomly assigned to the hard or soft resin groups with a 1:1 allocation. Subgroups were determined based on the Little's Irregularity Index and distributed equally. RESULTS 552 brackets were bonded onto adolescent patients using 46 CAD/CAM indirect bonding trays. The linear mean transfer errors ranged from -0.011 mm (soft) to -0.162 mm (hard) and angularly -0.255° (hard) and -0.243° (soft). No statistically significant differences were found between the subgroups or soft and hard resin groups. However, the transfer accuracy of molar brackets was significantly lower in the transversal and horizontal directions. All mean transfer errors were within the limits of clinical acceptability. The loss rate was 2.4 % in the hard resin group and 2.3 % in the soft resin group. The Intra Observer Correlation was excellent. SIGNIFICANCE CAD/CAM technology for indirect bracket bonding has been proven reliable in a randomized clinical trial. Both hard and soft resin showed a low rate of immediate loss compared to the current literature. Soft resin was more favorable than hard resin in terms of accuracy and usability. However, the indirect bonding of molar brackets is significantly less accurate than incisor brackets.
Collapse
Affiliation(s)
- Alexander Schwärzler
- Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Michael Nemec
- Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Stefan Lettner
- Core Facility Hard Tissue and Biomaterials Research, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Christiane Rank
- Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Andreas Schedle
- Competence Center for Dental Materials, University Clinic of Dentistry, Medical University of Vienna, Austria.
| | - Erwin Jonke
- Department of Orthodontics, University Clinic of Dentistry, Medical University of Vienna, Austria
| |
Collapse
|
15
|
Nagy Z, Mikolicz A, Vag J. In-vitro accuracy of a novel jaw-tracking technology. J Dent 2023; 138:104730. [PMID: 37777084 DOI: 10.1016/j.jdent.2023.104730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 09/22/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023] Open
Abstract
OBJECTIVES As jaw-tracking systems integrate into digital prosthetic workflows, their accuracy remains underexplored. This study aimed to evaluate the in vitro accuracy of a novel digital jaw-tracking system (Modjaw, Villeurbanne, France) by comparing its precision and trueness to that of an industrial scanner. METHODS Upper and lower typodont models were scanned with an industrial-grade optical scanner (ATOS Q, Carl Zeiss GOM Metrology GmbH, Germany) to produce master scans. The models were placed in a phantom head with artificial joints to replicate five different intermaxillary relationships (IMRs). The 1, 2, 3, 4, and 5 mm IMR distances were stabilized by five silicone bites. The silicone bites were repositioned after each measurement. ATOS scanned the whole artificial joint with the models three times in each IMR to assess the precision of the repositioning (i.e., bite precision). The master scans were uploaded to Modjaw. Modjaw recorded the five IMR positions three times each to assess the precision of the Modjaw. Precision was calculated by aligning the scans within the same group, whereas Modjaw trueness was evaluated by aligning ATOS and Modjaw scans. The mean absolute distance (MAD) between aligned surfaces was calculated. The effect of IMR on the MAD was evaluated using a linear mixed model. RESULTS The mean bite precision across the IMRs was 7.6 ± 0.53 µm. Modjaw precision over the IMRS was 9.7 ± 1.76 µm, and the trueness was 10.8 ± 1.40 µm. Increased IMRs up to 4 mm significantly increased the MAD from 6.5 to 8.5 µm for the bite precision, 4.8 to 15.7 µm Modjaw precision, and 7.1 to 14.9 µm for trueness. CONCLUSIONS Modjaw excelled in accuracy, comparable to industrial scanners and superior to traditional methods. IMR elevation marginally deteriorates the accuracy. Future studies should extend to varied movements beyond centric relations and encompass the influence of intraoral scanners.
Collapse
Affiliation(s)
- Zsolt Nagy
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Szentkirályi street 47, Budapest 1088, Hungary
| | - Akos Mikolicz
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Szentkirályi street 47, Budapest 1088, Hungary
| | - Janos Vag
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Szentkirályi street 47, Budapest 1088, Hungary.
| |
Collapse
|