Influence of interdental spaces and the palate on the accuracy of maxillary scans acquired using different intraoral scanners

PURPOSE

To assess the influence of interdental spaces and scanning the palate on the accuracy of maxillary scans acquired using three intraoral scanners (IOSs).

MATERIALS AND METHODS

A virtual completely dentate maxillary cast without interdental spaces was obtained and modified to create 1, 2, and 3 mm of interdental spacing between the anterior teeth. These three files (reference standard tessellation language files) were used to print three reference casts. The reference casts were scanned using three IOSs: TRIOS4, iTero Element 5D, and Aoralscan2. Three groups were created based on the interdental spaces: 0, 1, 2, and 3 mm (n = 10). The groups were subdivided into two subgroups: no palate (NP subgroup) and palate (P subgroup). The reference STL files were used to measure the discrepancy with the experimental scans by calculating the root mean square (RMS) error. Three-way analysis of variance (ANOVA) and post hoc Tukey pairwise comparison tests were used to analyze trueness. The Levene test was used to analyze precision (α = 0.05).

RESULTS

Trueness ranged from 91 to 139 μm and precision ranged from 5 to 23 μm among the subgroups tested. A significant correlation was found between IOS*group (p<0.001) and IOS*subgroup ( p<0.001). Tukey test showed significant trueness differences among the interdental spaces tested (p<0.001). The 1- and 2-mm groups obtained better trueness than the 0- and 3-mm groups (p<0.001). An 11 μm mean trueness discrepancy was measured among the different interdental space groups tested. The P subgroups demonstrated significantly higher trueness when compared to the NP subgroups (p<0.001). The discrepancy between the maxillary scans with and without the palate was 4 μm. Significant precision discrepancies were found (p = 0.008), with the iTero group showing the lowest precision.

CONCLUSION

Interdental spaces and incorporation of the palate on maxillary intraoral scans influenced trueness and precision of the three IOSs tested. However, the scanning discrepancy measured may be of no clinical relevance.

The Role of Intraoral Scanners in the Shade Matching Process: A Systematic Review

PURPOSE

The variation in findings with regards to the accuracy and precision of intraoral scanners for shade selection are no doubt confusing for clinicians who may find it difficult to make evidence-based decisions. The aim of this systematic review is to provide a comprehensive and in-depth assessment of available studies to determine the viability of using intraoral scanners for the purpose of shade matching. The PICO-guided research question is as follows: when shade matching, are intraoral scanners as valid as visual or other digital shade measuring devices in determining tooth colors.

METHODS

Electronic databases including PubMed/MEDLINE, SCOPUS, EBSCO, Cochrane, and ProQuest were systematically searched for articles published between January 1, 2011 and December 30, 2021 using the main search terms: "intraoral scanners," "scanners," "TRIOS," "CEREC," "Planmeca," "Medit," "digital dentistry" in concurrence with one of the following keywords: "EasyShade" OR "shade selection" OR "shade matching" OR "shade" OR "tooth color" OR "tooth shade" OR "digital shade matching." Bibliographies of included articles and the following journals were searched for relevant articles: Journal of Prosthetic Dentistry, Journal of Prosthodontics, Journal of Esthetic and Restorative Dentistry, Journal of Advanced Prosthodontics, and Journal of Dentistry. A total of 15 articles were included in the review.

RESULTS

Intraoral scanners are highly repeatable for shade matching, and outperformed visual shade matching. Accuracy varied significantly between studies, with the majority recommending the use of visual shade matching to confirm/verify the intraoral scanner results. Setting intraoral scanners to the Vita 3D Master shade guide improved both accuracy and precision. Shade matching with intraoral scanners may be influenced by external factors such as ambient light sources and incorrect use or manipulation.

CONCLUSION

Intraoral scanners set to the Vita 3D Master shade guide may be used for shade matching, but shade should be verified with visual shade matching. Further studies are required to address limitations of current studies.

Validation of Two Clinical Color Measuring Instruments for Use in Dental Research

OBJECTIVE

There are several shade matching instruments developed for clinical use, but the validity of their use in dental research has not been thoroughly investigated. The objective of this study is to evaluate the accuracy of using two clinical color measuring instruments, VitaEasyshade and Spectroshade, against a referent laboratory color measuring instrument (Spectroradiometer PR670).

METHODS AND MATERIALS

The validity and repeatability of the referent laboratory color measuring instrument was assessed using standard color patches with certified CIE L*a*b* values. 10% of the 240 color patches were randomly selected and measured ten times in a random order to test for repeatability. 16 metal ceramic specimens, fabricated from base metal alloy veneered with porcelain of different Vita Classic shades, were measured for L*a*b* values using the PR670, Vita EasyShade and the Spectroshade. The CIE L*a*b* values obtained from the three color measuring instruments were compared using repeated measures ANOVA and post hoc using the Bonferroni test. The color difference, CIEDE2000 (∆E₀₀), between the gold standard (PR670) and the two color measuring instruments were also determined and compared against the known perceptible color difference.

RESULTS

L*a*b* values varied significantly between the three instruments. When comparing the mean ΔE₀₀, the differences in values between PR670 and Spectroshade were not clinically significantly. However, the mean ΔE₀₀ values between PR670 and Vita Easyshade were both clinically and statistically significant.

CONCLUSION

The lack of clinical significance in values obtained from the SpectroShade when compared to those obtained by the PR670 suggests that the SpectroShade may be recommended for use in dental color research.

CLINICAL SIGNIFICANCE

The SpectroShade instrument and PR670 spectroradiometer provided values that lacked clinical significance, suggesting that its use may be highly beneficial for clinical shade matching as well as color research.

Mathematical Tooth Proportions: A Systematic Review

PURPOSE

The aim of this systematic review was to evaluate and compare three commonly used proportions that include the golden proportion, golden percentage, and Recurring Esthetic Dental (RED) proportion to identify which of the mathematical formulas, if any, can be used to provide predictable and repeatable esthetic clinical outcomes.

METHODS

A comprehensive search of electronic databases that included EBSCO, ProQuest, SCOPUS, Science Direct, Wiley, Google Scholar and PubMed was conducted using the terms: "golden proportion," "golden percentage," and "Recurring Esthetic Dental (RED) proportions" alone or in concurrence with one or both ensuing terms: "tooth proportions" and "esthetic tooth proportions." In addition, the following journals were hand searched for relevant articles: Journal of Prosthodontics, Journal of Prosthetic Dentistry and Journal of Esthetic and Restorative Dentistry. Related citations were also considered.

RESULTS

Tooth proportions varied substantially in the natural dentition. No studies revealed findings that supported the use of one mathematical formula to predict esthetic success. The golden proportion is present between the central to lateral incisor in some cases, but rarely between the lateral incisor and the canine. When compared to the other proportions, the golden percentage provided better starting points for tooth shape and size, but only when values were adjusted to consider other factors such as ethnicity and/or facial proportions.

CONCLUSION

Mathematical formulas did not provide consistent results that would allow for their use as a standardized guide for esthetically pleasing smiles. Although the golden percentage may be a good starting point if the percentages are adjusted on a case-by-case basis, generalized esthetic ideals cannot be determined by a mathematical formula and are open to interpretation by both the clinician and the patient.

Selective flotation-separation and spectrophotometric determination of cadmium using phenanthraquinone monophenythiosemicarbazone

A simple, selective and sensitive procedure is described for the preconcentration by flotation followed by spectrophotometric determination of trace amounts of Cd(II). Cadmium forms an intense red 1:2 complex with phenanthraquinone monophenylthiosemicarbazone (PPT) at pH > or = 6. The colored Cd-PPT complex was floated quantitatively with oleic acid (HOL) surfactant at pH 6.5, exhibiting maximum absorbance at 520 nm and having a molar absorptivity of 2.4 x 10(5) L mol(-1) cm(-1). The stability constant of the formed complex is 1.5 x 10(12); log K = 12.2. Beer's law was obeyed over the concentration range 0.01-0.34 mg/L. The Sandell sensitivity and relative standard deviation are 0.4 ng/cm2 and 2.6%, respectively. The results obtained spectrophotometrically were compared to those obtained by AAS analysis. The analytical parameters affecting flotation and hence determination have been thoroughly investigated. The proposed procedure was successfully applied to the determination of Cd(II) traces in certified and real human hair samples as well as in natural waters. The structure of the complex formed and the mechanism of flotation were proposed.

Selective flotation-spectrophotometric determination of trace copper(II) in natural waters, human blood and drug samples using phenanthraquinone monophenylthiosemicarbazone

Copper(II) forms 1:1 and 1:2 intense red complexes with phenanthraquinone monophenylthiosemicarbazone (PPT) at pH 3-3.5 and > or =6.5, respectively. These complexes exhibit maximal absorbance at 545 and 517 nm, the molar absorptivity being 2.3 x 10(4) and 4.8 x 10(4) l mol(-1) cm(-1), respectively. However, the 1:1 complex was quantitatively floated with oleic acid (HOL) surfactant in the pH range 4.5-5.5, providing a highly selective and sensitive procedure for the spectrophotometric determination of CuII. The molar absorptivity of the floated Cu-PPT complex was 1.5 x 10(5) l mol)(-1) cm(-1). Beer's law was obeyed over the range 3-400 ppb at 545 nm. The analytical parameters affecting the flotation process and hence the determination of copper traces were reported. Also, the structure of the isolated solid complex and the mechanism of flotation were suggested. Moreover, the procedure was successfully applied to the analysis of CuII in natural waters, serum blood and some drug samples.