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Dental Clinics of North America Oct 2022Although the accuracy of direct digitization of oral structure has been improved, indirect digitization is still required in specific situations such as full-arch... (Review)
Review
Although the accuracy of direct digitization of oral structure has been improved, indirect digitization is still required in specific situations such as full-arch scanning. Once accurate images are imported, efficient designing can be achieved by CAD software. Although smile design using a 3-dimensional facial scan better predicts planned restorations, further improvement in virtual articulators is needed for complex cases. Computer-aided manufacturing can be offered in several formats such as chairside, laboratory, or centralized fabrications. The subtractive technique is mainly used for restorations, and many chairside CAM materials are available now, but the additive technique has the potential to save materials and an advantage in fabricating complex geometries. Limited evidence is available in applying CAD/CAM technologies in implant restorations. However, it is used to fabricate custom implant abutments and crowns from various materials such as titanium, zirconia, and PEEK and hybrid crowns using stock titanium base abutments.
Topics: Computer-Aided Design; Crowns; Dental Prosthesis Design; Digital Technology; Humans; Titanium; Zirconium
PubMed: 36216447
DOI: 10.1016/j.cden.2022.05.006 -
Journal of Prosthodontics : Official... Jan 2021A virtual articulator is a computer software tool that is capable of reproducing the relationship between the jaws and simulating jaw movement. It has gradually gained... (Review)
Review
A virtual articulator is a computer software tool that is capable of reproducing the relationship between the jaws and simulating jaw movement. It has gradually gained research interest in dentistry over the past decade. In prosthodontics, the virtual articulator should be considered as an additional diagnostic and treatment planning tool to the mechanical articulator, especially in complex cases involving alterations to the vertical dimension of occlusion. Numerous authors have reported on the available digital methodologies used for the assembly of virtual arch models in a virtual articulator, focusing their attention on topics such as the virtual facebow and digital occlusal registration. To correctly simulate jaw movement, the jaw models have to be digitalized and properly mounted on the virtual articulator. The aim of this review was to discuss the current knowledge surrounding the various techniques and methodologies related to virtual mounting in dentistry, and whether virtual articulators will become commonplace in clinical practice in the future. This review also traces the history of the virtual articulator up to its current state and discusses recently developed approaches and workflows for virtual mounting based on current knowledge and technological devices.
Topics: Dental Articulators; Dental Occlusion; Jaw Relation Record; Models, Dental; Patient Care Planning; Prosthodontics; Vertical Dimension
PubMed: 32827222
DOI: 10.1111/jopr.13240 -
BMC Oral Health Jan 2022Patient- and technology-related parameters influence the successful implementation of virtual implant planning and guided implant surgery. Besides data processing and... (Review)
Review
BACKGROUND
Patient- and technology-related parameters influence the successful implementation of virtual implant planning and guided implant surgery. Besides data processing and computer aided design of drill guides as described in Part I, the possibilities and limitations for prosthetic set-up and virtual implant planning are essential (Part II).
METHODS
The following software systems were examined using two different clinical situations for implant therapy: coDiagnostiX™, DentalWings, Canada (CDX); Simplant Pro™, Dentsply, Sweden (SIM); Smop™, Swissmeda, Switzerland (SMP); NobelClinician™, Nobel Biocare, Switzerland (NC); Implant Studio, 3Shape, Denmark (IST). Assessment criteria geared towards interfaces and integrated tools for prosthetic set-up and virtual implant planning.
RESULTS
A software interface for an individual virtual prosthetic set-up was provided by two systems (CDX, IST), whereas the set-up of standardized teeth was provided by four systems (CDX, SIM, SMP, IST). Alternatively, a conventional set-up could be scanned and imported. One system could solely work with the digitization of a conventional set-up for virtual implant planning (NC). Stock abutments could be displayed for implant planning, but none of the tested software systems provided tools for the design of an individual abutment. All systems displayed three-dimensional reconstructions or two-dimensional cross-sections with varying orientation for virtual implant placement. The inferior alveolar nerve could be marked to respect a minimum distance between the nerve and the planned implant. Three implant planning systems provided a library to display more than 50 implant systems (CDX, SIM, IST), one system provided 33 implant systems (SMP) and one implant system provided 4 implant systems (NC).
CONCLUSION
Depending on the used software system, there are limited options for a virtual set-up, virtual articulators and the display of a virtual prosthetic set-up. The implant systems used by the clinician is important for the decision which software system to choose, as there is a discrepancy between available implant systems and the number of supported systems in each software.
Topics: Computer-Aided Design; Dental Implantation, Endosseous; Dental Implants; Humans; Imaging, Three-Dimensional; Patient Care Planning; Software; Surgery, Computer-Assisted
PubMed: 35094677
DOI: 10.1186/s12903-022-02057-w -
The Journal of Prosthetic Dentistry Dec 2022Currently available dental articulators have limitations for reproducing human mandibular movements. The present article describes an innovative device that is a true...
Currently available dental articulators have limitations for reproducing human mandibular movements. The present article describes an innovative device that is a true patient-specific anatomical articulator that accurately simulates patient anatomy and eliminates all technique-sensitive mounting procedures, thus substantially diminishing potential errors in mounting and articulator settings. By using three-dimensional (3D) printing technology, patient cone beam computed tomography (CBCT) data are used to print 3D replicas of the condylar fossae, as well as the actual condyles, at the correct intercondylar distance. The maxilla (maxillary teeth and edentulous ridge) is printed with the correct spatial relationship to the condylar complexes and the Frankfort horizontal plane (FHP). Those printed structures are then premounted onto a modified articulator frame to render it "anatomic." This new custom anatomical articulator, which accurately mimics patient anatomical movements rather than relying on average values, represents the first truly fully adjustable articulator that is more precise than can be generated by a pantographic tracing. It saves money, time, and effort by eliminating earbow transfers and mounting errors in complex prosthodontic treatment.
Topics: Humans; Dental Articulators; Jaw Relation Record; Maxilla; Mandible; Cone-Beam Computed Tomography
PubMed: 33814096
DOI: 10.1016/j.prosdent.2021.02.029 -
Cranio : the Journal of... Jul 2022: The purpose of the present review was to demonstrate the utility of articulator systems and link instrumentation in determining the occlusal plane. The impact of the... (Review)
Review
: The purpose of the present review was to demonstrate the utility of articulator systems and link instrumentation in determining the occlusal plane. The impact of the natural head position and anatomical landmarks on the occlusal plane location has been reported in the literature. Properly chosen instrumentation and management methods eliminate errors in determining the occlusal plane.: The PubMed and the Dentistry & Oral Sciences Source (through EbscoHost) databases were searched for ways to minimize the occurrence of errors when registering and determining the occlusal plane location, with or without the use of face-bows. A hand search and citation mining supplemented the results.: Overall, 11 original approaches to occlusal plane determination were identified.: Identified methods of occlusal plane transfer are based on real or virtual solutions. Owing to the large variety of devices, additional comparative studies are needed.
Topics: Cephalometry; Dental Articulators; Dental Occlusion; Humans
PubMed: 31851868
DOI: 10.1080/08869634.2019.1703093 -
The Journal of Prosthetic Dentistry Mar 2023Establishing new dentition and occlusal schemes requires a thorough understanding of the principles of occlusion, mandibular movements, phonetics, and esthetics. This...
Establishing new dentition and occlusal schemes requires a thorough understanding of the principles of occlusion, mandibular movements, phonetics, and esthetics. This presentation is designed to help understand the dynamics of mandibular movements, form and function of the dentition, occlusal schemes, patient simulation, and the interaction of those factors on occlusal rehabilitation. Special emphasis is laid upon articulator design and the current innovations utilizing digital technology in the development of this instrument from an articulator to a patient simulator.
Topics: Humans; Dental Articulators; Esthetics, Dental; Dental Care; Dental Occlusion; Mandible
PubMed: 36870756
DOI: 10.1016/j.prosdent.2023.01.015 -
Cureus Jan 2024The virtual articulator (VA) is a technology that simulates the jaw relation in a computer-generated setting. Augmented and virtual reality have been utilized as digital... (Review)
Review
The virtual articulator (VA) is a technology that simulates the jaw relation in a computer-generated setting. Augmented and virtual reality have been utilized as digital technology, which aids in many areas of dentistry and dental education. Today, a practicing dentist must keep up with the newer technologies, but with technology evolving so quickly it becomes challenging. In dentistry, the possibilities for digitization and technological advancements are limitless. Virtual articulators (VAs) allow a complete occlusion analysis using dental models that replicate all mandibular motions in static and dynamic scenarios. VA when executed in addition to other software enhances treatment planning and patient education, allowing quicker and more precise individualized diagnoses. The main objective of this study was to describe and evaluate the study outcomes in the available research on VAs, assess their needs, and evaluate their advantages and limitations in various aspects. A PubMed Central search was made of dental journals, with the identification of 135 articles out of which 30 were finally selected. The investigations conducted to evaluate the VA's dependability provide good visualization of the quantity and location of the dynamic interactions. A precise instrument for fully analyzing occlusion in a real patient is the virtual articulator.
PubMed: 38371021
DOI: 10.7759/cureus.52554 -
The Journal of Contemporary Dental... Sep 2022The aim of this article is to discuss the infection control measures with focus on those related to prosthodontic work.
AIM
The aim of this article is to discuss the infection control measures with focus on those related to prosthodontic work.
BACKGROUND
The risk of transmission of several infectious microorganisms during dental procedures and the increased awareness and knowledge of infectious diseases have led to an increased attention to the importance of infection control. Prosthodontists and dental personnel are exposed directly or indirectly to a significant risk of acquiring healthcare-associated infections.
REVIEW RESULTS
High standards of occupational safety and dental infection control must be applied by dental personnel for the safety of patients and dental healthcare workers. All reusable items (critical and semicritical instruments) that come in contact with the patient's saliva, blood, or mucous membranes must be heat-sterilized. Proper disinfectants should be used to disinfect nonsterilizable instruments (e.g., wax knifes, dental shade plastic mixing spatula, guides, fox bite plane, articulators, and facebows).
CONCLUSION
In prosthodontics, items potentially contaminated with patient's blood and saliva are transported between dental clinics and dental laboratories. Such fluids may contain microorganisms with high potential for transmission of several diseases. Therefore, sterilization and disinfection of all items used during prosthodontic work should be part of infection control protocol in dental care setting.
CLINICAL SIGNIFICANCE
In prosthodontic practice, a strict infection prevention plan should be implemented to minimalize the risk of infectious diseases transmission among prosthodontists, dental office, dental laboratory personnel, and patients.
Topics: Humans; Prosthodontics; Dental Clinics; Infection Control; Sterilization; Disinfection; Communicable Diseases; Infection Control, Dental
PubMed: 37283004
DOI: 10.5005/jp-journals-10024-3305 -
Computer Methods and Programs in... Nov 2020Temporomandibular joint has been considered one of the most complex joints in human body. Dental articulation hinged upon temporomandibular joint is essential and...
BACKGROUND AND OBJECTIVES
Temporomandibular joint has been considered one of the most complex joints in human body. Dental articulation hinged upon temporomandibular joint is essential and fundamentally important for dental restoration design and prosthetic/orthodontic occlusion analysis. As digital dentistry rapidly grows, a complete digital work flow requires the use of a digital articulator for occlusion analysis. However, commercial CAD/CAM systems do not provide any method to verify the modeling accuracy of a digital articulator. There is also a lack of detail and generalized mathematical modeling of the digital articulator for simulating the jaw movement.
METHODS
This paper presents the development of a digital articulator by mathematically modeling a general dental articulator which simulates the relative jaw motion between the maxilla and mandible. As the digital articulator moves, the digital upper teeth move relatively to the digital lower teeth, thus simulating the occlusal path with teeth collision detection function. To verify the accuracy of our modeled digital articulator, an improved optical tracking method is proposed to measure the pose of a mechanical articulator with 6 degrees of freedom and compare that with the digital articulator.
RESULTS
The digital articulator system proposed in this paper achieves the following functions: 1. Digitalize the dental articulator with verified precision. Combined with dental design software, restorations can be designed with more efficiency and accuracy. 2. Provide an improved optical tracking method which can compare the movement error between the mechanical articulator and digital articulator. Thus the accuracy of the digital articulation can be verified. The result shows the error of our system is controlled under sub-millimeter which provides sufficient accuracy for the design of restoration under static and dynamic occlusion conditions.
CONCLUSIONS
We develop a general digital articulator which can simulate jaw movement between opposing teeth and an improved optical tracking method to verify the accuracy of the digital articulator. The modeling and accuracy verification of the digital articulator shows that there is a systematic and reliable way to replace traditional mechanical articulator and can close the gap for digital restoration fabrication.
Topics: Computer-Aided Design; Dental Articulators; Humans; Mandible; Maxilla; Movement
PubMed: 32682091
DOI: 10.1016/j.cmpb.2020.105646 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: The purpose of the study was to determine the indications for the use of articulator in orthodontics based on the results of the analysis of scientific and...
OBJECTIVE
The aim: The purpose of the study was to determine the indications for the use of articulator in orthodontics based on the results of the analysis of scientific and foreign literature.
PATIENTS AND METHODS
Materials and methods: 23 scientific sources were selected, from more than 11 countries over the past 39 years (1981 - 2020) devoted to the use of orthodontics articula¬tors. As a result of processing 23 key international scientific papers on the use of articulators in orthodontics, we can talk about three areas of opinion regarding this problem.
CONCLUSION
Conclusions: To sum up 30.34% of authors consider the articulator to be an obligatory orthodontist's tool for correct diagnosis. The idea of 34.78% of specialists is that the articulator cannot simulate the physiology of the TMJ - therefore, it is more a source of additional errors than an assistant in the orthodontic diagnostics. The rest of the scientists (34.78%) agree that it is advisable to use the articulator selectively - namely, if the doctor deals with "complex" orthodontic pathologies.
Topics: Humans; Dental Articulators; Orthodontics
PubMed: 36591778
DOI: 10.36740/WLek202211221