Accuracy Comparison between Robot-Assisted Dental Implant Placement and Static/Dynamic Computer-Assisted Implant Surgery: A Systematic Review and Meta-Analysis of In Vitro Studies

Background and Objectives: The present systematic review and meta-analysis undertake a comparison of studies that examine the accuracy of robot-assisted dental implant placement in relation to static computer-assisted implant surgery (SCAIS), dynamic computer-assisted implant surgery (DCAIS), and freehand procedures. This study aims to provide a comprehensive understanding of the precision of robot-assisted dental implant placement and its comparative efficacy in relation to other placement techniques. Methods: The guidelines recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used to organize and compose this review. Four electronic databases (PubMed, Web of Science, Scopus, and Cochrane) were systematically searched for pertinent articles. Articles were selected following the inclusion and exclusion criteria. Qualitative and quantitative analyses of the selected articles were performed. Results: The initial electronic search resulted in 1087 hits. Based on the inclusion and exclusion criteria, five articles were selected for qualitative analysis, out of which three were considered for quantitative analysis. Three parameters were considered for accuracy evaluation (angular, coronal, and apical deviation). The mean angular deviation was -1.22 degrees (95% CI, -1.06--1.39), the mean coronal deviation was -0.15 mm (95% CI, -0.24--0.07), and the mean apical deviation was -0.19 mm (95% CI, -0.27--0.10). Conclusions: The robotic implant system was found to have significantly lower angular deviations and insignificantly lower coronal and apical deviations compared to DCAIS. Within the limitations of this review, it can be concluded that robot-assisted implant placement in resin models permits higher accuracy compared to DCAIS and SCAIS systems. However, due to the limited number of comparative studies with high heterogeneity, the findings of this review should be interpreted with caution. Further research is necessary to confirm the clinical application of robotics in implant surgery.

Radiographic Evaluation of the Gap between Cemented Post and Remaining Gutta-Percha in Endodontically Treated Teeth Performed by Undergraduate Students: A Retrospective Cross-Sectional Study

The coronal seal in root canal-treated teeth may be compromised depending on the accuracy of post space preparation and post cementation along with remaining gutta-percha. Root canal treatment can be compromised by endotoxins released by the coronal bacteria as a result of microleakage. The study was conducted by undergraduate students to measure the gap between the cemented post and residual gutta-percha. In total, 217 endodontically treated teeth were evaluated with intraoral peri-apical radiographs. Based on the intraoral periapical radiographic examination in the CS-R4 program, Group I had no gap, Group II had a gap of >0 to 2 mm, and Group III had a gap of more than 2 mm between the end of the cemented post and the remaining gutta-percha. In total, 40% (n = 87) of the teeth had no gap, 59% (127) had a gap of >0 to 2 mm, and 1% (n = 3) had a gap of more than 2 mm between the cemented post end and remaining gutta. Chi square test revealed a significant difference in the gap between the post and remaining gutta-percha between males and females students (p < 0.001). In terms of the gap between the cemented post end and the residual gutta-percha, the root canal treated teeth with post and core by undergraduates were clinically acceptable.

A Comparison in Patient Comfort Using Conventional Syringe and Needleless Jet Anesthesia Technique in Periodontal Surgery—A Split-Mouth Randomized Clinical Trial

Background and Objectives: Periodontal surgery requires local anesthetic coverage to alleviate patient discomfort. Needles and injections can engender feelings of fear and anxiety in individuals. This study aimed to assess the level of comfort and anxiety in patients during the administration of local anesthesia using needleless jet anesthesia (JA) when compared to a conventional syringe (CS) in periodontal surgery. Method and Materials: 60 sites were designated for injection in a split-mouth design in 30 subjects who required periodontal surgery. Local anesthesia was administered in two appointments scheduled one week apart using either a JA system or a CS. The Visual Analogue Scale (VAS), Verbal Rating Scale (VRS), and Beck’s anxiety inventory were used to report the pain and anxiety levels while injecting local anesthesia. Statistical analysis of the results was performed using the Shapiro–Wilks test and Paired t-test. Results: Patients reported greater comfort with JA. The VAS and VRS values were statistically significant—(p = 0.003) and (p = 0.001), respectively. Patients showed fear and were nervous about receiving a local anesthetic using a CS. A few subjects experienced lingering pain with the CS, whereas greater comfort and no lingering soreness were reported post-operatively at the site of JA administration. Conclusion: This study provides the first comprehensive assessment of using JA for periodontal surgical procedures. Lower pain scores were consistently observed with the use of jet injectors. Patients were at ease and reported lesser anxiety and greater comfort with jet injectors, making it ideally suited for providing local anesthesia in periodontal surgery.

Assessment of Marginal Integrity and Color Stability of Provisional Restoration Fabricated from Different Autopolymerizing Acrylic Resins - A Comparative Study

Aim:

The present study is aimed to assess the marginal integrity and color stability of provisional restorations fabricated from different autopolymerizing acrylic resins.

Materials and Methods:

Totally, 60 provisional crowns were fabricated. A mandibular first molar artificial typodont was mounted on a base of dental stone. The mandibular first molar which was mounted was prepared for full cast crown, using the tooth preparation standard principles with shoulder finish line of 1 mm and taper 6°. There were 20 samples in each acrylic resin group: Group I: Polyvinyl-ethyl methacrylate resin, Group II: Autopolymerizing bis-acrylic material, and Group III: Polymethyl methacrylate (PMMA) autopolymerizing resin. Crowns were verified for marginal adaptation using stereomicroscope at a ×40. The color stability was measured using spectrophotometer poststaining period.

Results:

Autopolymerizing bis-acrylic material group showed minimum mean vertical marginal discrepancy (128.68 ± 18.036 μm) followed by PMMA autopolymerizing resin group (147.49 ± 20.128 μm) and polyvinyl-ethyl methacrylate resin group (172.89 ± 22.118 μm). Analysis of variance demonstrated a statistically significant difference between different autopolymerizing acrylic resins. The color change values did not show any significant difference between the groups on numerous comparisons between different autopolymerizing acrylic resin groups. A statistically significant difference was seen between Groups I and II, Groups I and III, and Groups II and III (P < 0.05).

Conclusion:

This study concluded that the autopolymerizing bis-acrylic material demonstrated significantly improved marginal integrity when compared to PMMA autopolymerizing resin and polyvinyl-ethyl methacrylate resin.

Examining the Effect of Gravity on Different Irrigation Systems: An In vitro Study

Background

Periapical extrusion is frequently observed during endodontic therapy. It can lead to acute injury of periapical tissues, resulting in interappointment pain or swelling. The effect is pronounced in teeth with immature apex, which are more susceptible to the extrusion of irrigant. The aim of this study was to evaluate the effect of gravity on the apical extrusion of irrigating solution with different irrigation protocols in single-rooted premolars.

Methodology

A total number of 80 permanent single-rooted teeth (premolars) with same working length (WL) were divided into two main groups: Group A: Penetration depth of irrigation syringe to 2 mm from the WL and Group B: Penetration depth of irrigation syringe to 4 mm from the WL. Each group was subdivided into four subgroups. (n = 10). The extruded debris and irrigants were weighed, and the data were statistically analyzed by the analysis of variance and the Tukey test.

Results

Irrespective of the irrigation technique used, the amount of irrigant extruded from the apex showed a statistically significant difference related to the effect of gravity (P < 0.05). There was no statistically significant difference observed between irrigation methods (P > 0.05).

Conclusion

The degree of apical extrusion of irrigant was dependent on the type of irrigation technique and gravity. Greater caution should be taken during irrigation to prevent postoperative pain.

Antimicrobial Efficacy of Different Pulp-Capping Materials against Enterococcus faecalis: An In vitro Study

Aim:

The present study aims to assess the antimicrobial action of three different pulp-capping agents against Enterococcus faecalis.

Materials and Methods:

Three pulp-capping agents were chosen for this study: Calcicur, mineral trioxide aggregate (MTA)-Angelus, and Dycal. The zone of inhibition produced by these three pulp-capping agents was measured at 24 h and 72 h to assess their antimicrobial efficacy against E. faecalis. The agar diffusion method was used to examine the antimicrobial effect of pulp-capping agents. Mueller-Hinton agar plates were used to inoculate the microorganisms. Analysis of variance (ANOVA) and Tukey's post hoc tests were done to compare the different groups. P < 0.05 was considered as statistically significant.

Results:

At 24 h, the highest zone of inhibition was found in MTA-Angelus (3.32 ± 0.11 mm), followed by Dycal (2.02 ± 0.46 mm) and Calcicur (1.84 ± 0.92 mm). After 72 h, MTA-Angelus demonstrated a zone of inhibition of 4.60 ± 0.22 mm, followed by Dycal (3.48 ± 0.74 mm) and Calcicur (2.90 ± 0.18 mm). ANOVA test showed a highly statistical significance. A statistically significant difference (P < 0.001) was shown between MTA-Angelus and Dycal. Calcicur did not show any significant difference.

Conclusion:

This trial found that the freshly mixed MTA-Angelus has a significantly superior antimicrobial effect against E. faecalis than Dycal and Calcicur.