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Journal of Indian Prosthodontic Society 2020Identification and establishment of the occlusal plane in patients with impaired occlusal plane, presents a major hurdle for the execution of natural esthetics, speech,...
AIMS
Identification and establishment of the occlusal plane in patients with impaired occlusal plane, presents a major hurdle for the execution of natural esthetics, speech, and function. The aim of this study was to minimize such errors while occlusal rehabilitation, and employ hamular notchincisive papilla (H.I.P) plane as landmark and scribe it on the cast using H. I. P evaluator and utilise for occlusal corrections.
SETTINGS AND DESIGN
HIP plane being parallel to the occlusal plane could ease the operator when it could be scribed on cast to analyze and restore the compromised occlusal plane.
MATERIALS AND METHODS
Dentulous casts of two hundred participants were mounted on the Hanau Wide-Vue articulator. Reference points were marked on the maxillary right central incisor and maxillary molars on casts for attaining different occlusal planes, the incisive papilla and hamular notch region were also marked for HIP plane. A plane parallel HIP was scribed on cast using HIP Evaluator. The casts were then scanned using a three-dimensional coordinate measuring machine attached to perception V5 laser scanner and measurements were made using Geomagic X design software. The most parallel occlusal plane to HIP plane was evaluated, and the reliability of HIP evaluator was verified.
STATISTICAL ANALYSIS USED
ANOVA test, -Bonferroni test, and independent sample ""-test were carried out for the comparison between occlusal planes, among the genders and for the analysis of the angle of deviation of scribed plane on the cast to HIP plane on the right and left sides.
RESULTS
Occlusal plane III (Mesio-labial incisal edge of upper right central incisor to Mesio-buccal cusp tips of upper second molars) showed least angle of deviation with 1.316° ± 1.158° to HIP plane among tested subjects. There is no significant difference between the genders. The plane scribed on the cast with H. I. P evaluator showed relative parallelism to H. I. P plane with minimum deviation of 0.010° ± 0.363°.
CONCLUSION
Occlusal plane III is more parallel to H. I. P plane. Scribed plane on the cast using H. I. P evaluator is parallel to H. I. P plane. H. I. P evaluator can be used as an alternative tool to establish the occlusal plane to rehabilitate patient with deficient dentition or disordered occlusal plane.
PubMed: 32089600
DOI: 10.4103/jips.jips_167_19 -
The Journal of Prosthetic Dentistry Jul 2023This technique report describes a fully digital workflow to create a prosthetic articulator-based implant rehabilitation (PAIR) virtual patient for complete-arch or...
This technique report describes a fully digital workflow to create a prosthetic articulator-based implant rehabilitation (PAIR) virtual patient for complete-arch or complete-mouth implant rehabilitation. This workflow uses a custom gothic arch tracer during the cone beam computed tomography (CBCT) scan and a 3-dimensional virtual facebow when superimposing data. The PAIR virtual patient possesses reliable centric relation and vertical dimension of occlusion and is compatible with virtual articulators. Computer-aided implant planning and a digital prosthetic design can be seamlessly integrated by using this virtual patient.
Topics: Humans; Dental Implants; Dental Articulators; Computer-Aided Design; Image Processing, Computer-Assisted; Cone-Beam Computed Tomography; Imaging, Three-Dimensional
PubMed: 34756772
DOI: 10.1016/j.prosdent.2021.09.013 -
The Saudi Dental Journal Sep 2023Digitalized workflow eliminates the need for the tray, impression materials, its decontamination, packaging and shipping, pouring with plaster, cast fabrication,...
Digitalized workflow eliminates the need for the tray, impression materials, its decontamination, packaging and shipping, pouring with plaster, cast fabrication, mounting in an articulator, reducing storage spaces, and the risks of any loss or fracture of the plaster model is overcome by archiving on the computer. This clinical investigation aimed to evaluate the effectiveness of the fully digitalized rehabilitation [implant-supported prosthesis] method in partially edentulous patients and with TMD, using advanced software. Twelve patients requiring implant-supported prosthesis in the mandibular molar area with Temporomandibular disorders [TMD] were selected. The fully digitalized rehabilitation method with advanced software was used for rehabilitation. For each subject, Optical impressions, CBCT scan, and Digital recording of jaw movement data. Guided implant surgery and digitalized prosthetic rehabilitation; were performed. The effectiveness of the digitalized workflow was assessed by evaluating the changes in the joint symptoms before and after the end of the treatment, changes in the electromyographic tracings, the precision of the prosthetic artefact, assessed through the amount of chair adjustment operating time and the number of retouching/ modifications to be carried out before the completion of the work. The results showed that the mean operative time required in 12 patients was 9.42 min, significantly less than the time recorded in previous studies when the medium mean was 16.00 min. The mean number of touch-ups [adjustments] was less than 3, most of which were on the interproximal surfaces. There were no significant changes recorded in the electromyography tracings. There were also no changes in joint symptoms. It was found that this way of working was entirely reliable and significantly reduced operating times and the number of appointments. Digital flow is beneficial ei dysfunctional patients, not about improvements in temporomandibular symptoms but in times of operability and prosthetic retouching.
PubMed: 37817790
DOI: 10.1016/j.sdentj.2023.05.024 -
Journal of International Society of... 2019The objectives of this study were to determine the condylar guidance by the conventional method using interocclusal records and by panoramic radiographs in healthy...
Comparison of Sagittal Condylar Guidance Determined by Panoramic Radiographs to the One Determined by Conventional Methods Using Lateral Interocclusal Records in the Saudi Arabian Population.
OBJECTIVES
The objectives of this study were to determine the condylar guidance by the conventional method using interocclusal records and by panoramic radiographs in healthy dentate patients and to compare the values obtained from panoramic radiographs with the values obtained by a conventional method.
MATERIALS AND METHODS
Thirty healthy dentulous subjects of either sex with an age range of 20-40 years visiting Jazan University, College of Dentistry, Dental Clinics for replacement of missing teeth or crowns, were selected according to the inclusion criteria. Maxillary and mandibular casts were obtained and mounted on Whipmix 2240 articulator. Right and left lateral interocclusal records were then made in patients by base plate wax (Dentsply truwax baseplate). This record was transferred to articulator, and condylar values were determined. In all the cases, articulator was programmed. Left and right condylar values were also measured on digital radiographs and readings were recorded. Condylar guidance readings obtained from interocclusal records and those obtained from panoramic radiographic images were compared and analyzed statistically using the -test.
RESULTS
The condylar guidance values obtained from the interocclusal record method for both left and right sides were less when compared to the values obtained from tracing the panoramic radiographs (radiographic method). The difference in values of both the methods was highly significant.
CONCLUSION
Although a significant amount of correlation was found between the two methods, better radiographic techniques should be further investigated.
PubMed: 32039080
DOI: 10.4103/jispcd.JISPCD_11_19 -
The Journal of Prosthetic Dentistry Jun 2023Occlusal collisions of articulated intraoral digital scans can be corrected by intraoral scanners (IOSs) or dental design software programs. However, the influence of...
STATEMENT OF PROBLEM
Occlusal collisions of articulated intraoral digital scans can be corrected by intraoral scanners (IOSs) or dental design software programs. However, the influence of these corrections on the accuracy of maxillomandibular relationship is unclear.
PURPOSE
The purpose of this clinical investigation was to measure the effect of occlusal collision corrections completed by the IOSs or dental design software programs on the trueness and precision of maxillomandibular relationship.
MATERIAL AND METHODS
Casts of a participant mounted on an articulator were digitized (T710). The experimental scans were obtained by using 2 IOSs: TRIOS4 and i700. The intraoral digital scans of the maxillary and mandibular arches were obtained and duplicated 15 times. For each duplicated pair of scans, a bilateral virtual occlusal record was acquired. Articulated specimens were duplicated and assigned into 2 groups: IOS-not corrected and IOS corrected (n=15). In the IOS-not corrected groups, the IOS software program postprocessed the scans maintaining the occlusal collisions, while in the IOS-corrected groups, the IOS software program eliminated the occlusal collisions. All articulated specimens were imported into a computer-aided design (CAD) program (DentalCAD). Three subgroups were developed based on the CAD correction: CAD-no change, trimming, or opening the vertical dimension. Thirty-six interlandmark distances were measured on the reference and each experimental scan to compute discrepancies by using a software program (Geomagic Wrap). Root mean square (RMS) was selected to compute the cast modifications performed in the trimming subgroups. Trueness was examined using 2-way ANOVA and pairwise comparison Tukey tests (α=.05). Precision was evaluated with the Levene test (α=.05).
RESULTS
The IOS (P<.001), the program (P<.001), and their interaction (P<.001) impacted the trueness of the maxillomandibular relationship. The i700 obtained higher trueness than the TRIOS4 (P<.001). The IOS-not corrected-CAD-no-changes and IOS-not-corrected-trimming subgroups obtained the lowest trueness (P<.001), while the IOS-corrected-CAD-no-changes, IOS-corrected-trimming, and IOS-corrected-opening subgroups showed the highest trueness (P<.001). No significant differences in precision were found (P<.001). Furthermore, significant RMS differences were found (P<.001), with a significant interaction between Group×Subgroup (P<.001). The IOS-not corrected-trimmed subgroups obtained a significantly higher RMS error discrepancy than IOS-corrected-trimmed subgroups (P<.001). The Levene test showed a significant discrepancy in the RMS precision among IOSs across subgroups (P<.001).
CONCLUSIONS
The trueness of the maxillomandibular relationship was influenced by the scanner and program used to correct occlusal collisions. Better trueness was obtained when the occlusal collisions were adjusted by the IOS program compared with the CAD program. Precision was not significantly influenced by the occlusal collision correction method. CAD corrections did not improve the results of the IOS software. Additionally, the trimming option caused volumetric changes on the occlusal surfaces of intraoral scans.
PubMed: 37365066
DOI: 10.1016/j.prosdent.2023.05.015 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Dec 2020To establish the workflow of determining the jaw position of repositioning splint with the aid of digital technique, and to evaluate the accuracy of this workflow and...
OBJECTIVE
To establish the workflow of determining the jaw position of repositioning splint with the aid of digital technique, and to evaluate the accuracy of this workflow and compare the accuracy of raising different vertical dimensions .
METHODS
A volunteer was recruited. The data of full-arch scans, cone beam computed tomography (CBCT) image and ultrasonic jaw motion tracking of the volunteer were acquired. The full-arch scans were merged with the CBCT image, which were then matched to the jaw motion tracking reference system. The jaw position of repositioning splint was determined when the anterior teeth opening was 3 mm and the condyle was in centric relation of the fossa in the sagittal plane. A digital repositioning splint was designed in the software based on virtual articulator and fabricated with additive manufacturing technique. After the splint was tried in, another CBCT image was taken and a qualitative analysis was conducted to compare the position of condyle between these two CBCT images. In the study, standard dental plaster casts with resin ball markers attached to the base were mounted onto a fully adjustable articulator in the intercuspal position. The dental casts were scanned by an extraoral scanner to establish digital models. The ultrasonic jaw motion tracking device was used to obtain simulated jaw movements on the articulator, which was repeated for three times. The digital models and data of jaw movements were merged in one coordination with the aid of bite forks. The jaw position of repositioning splint was determined by adjusting data of jaw movements, each of which was used to determine three vertical jaw positions 4 mm, 5 mm, and 6 mm with the horizontal jaw position of protrusion 2 mm. The virtual articulators with differently adjusted jaw movements were applied in designing repositioning splints, and the final repositioning splints and virtual jaw relationships were exported in STL format. Then the repositioning splints were fabricated with additive manufacturing technique and tried in plaster casts on the mechanical articulator, which were scanned and the jaw relationships on the mechanical articulator were exported later. The virtual jaw relationships and scanned jaw relationships were registered according to lower models and displacement of upper models was calculated. Ball markers were fit to acquire the coordinates of centers and absolute difference values of centers along three coordinating axes , , and were calculated. One-way analysis of variance was conducted using SPSS 18.0 software to compare deviations of the three different vertical jaw relationships in two-side test and the significance level was 0.05.
RESULTS
With the aid of multi-source data fusion and individualized jaw motion, the clinical workflow of determining jaw position of repositioning splint was preliminarily established. The designed jaw position was realized on the right and the condyle was more inferior than the designed position on the left. Both displacement of the upper models and absolute difference values of centers showed no significant differences (>0.05) in different vertical jaw dimensions. The displacement of the upper models was (0.25±0.04) mm. The absolute difference values of centers along the three coordinating axes , , and were respectively (0.08±0.01) mm, (0.30±0.02) mm, and (0.21±0.04) mm.
CONCLUSION
A novel method of determining the jaw position of repositioning splint with the aid of digital technique is established. It is proved to be feasible by try-in after multi-data fusion, computer-aided design and computer-aided manufacturing. As is shown , it is accurate to apply this method in adjusting jaw position. Further clinical trial will be designed to evaluate its clinical effect.
Topics: Computer-Aided Design; Cone-Beam Computed Tomography; Dental Articulators; Humans; Jaw Relation Record; Occlusal Splints; Software; Splints
PubMed: 33550339
DOI: 10.19723/j.issn.1671-167X.2021.01.012 -
Journal of Prosthodontics : Official... Feb 2021Mounting dental casts in an articulator is an important prerequisite for prosthodontic rehabilitation cases where the design of an accurate static and dynamic occlusion...
Mounting dental casts in an articulator is an important prerequisite for prosthodontic rehabilitation cases where the design of an accurate static and dynamic occlusion is needed. Virtual mounting can be achieved through the superimposition of various 3D images acquired from the hard and soft tissues of the patient. The purpose of this technical report is to describe a digital cross-mounting technique for patients undergoing implant-supported fixed prosthetic treatment. Through the use of face scanning, intraoral scanning, and cone beam computed tomography, this technique enables creation of a 3D virtual patient with occlusal registration in centric relation. Ultimately, the described methodology allows for the fabrication of definitive full-mouth implant-supported fixed prostheses.
Topics: Computer-Aided Design; Cone-Beam Computed Tomography; Dental Articulators; Dental Implants; Humans; Workflow
PubMed: 32865872
DOI: 10.1111/jopr.13247 -
Dentistry Journal Jan 2022With the advent of a digital workflow in dentistry, the inter-occlusal articulation of digital models is now possible through various means. The Cadent iTero intraoral...
With the advent of a digital workflow in dentistry, the inter-occlusal articulation of digital models is now possible through various means. The Cadent iTero intraoral scanner uses a buccal scan in maximum intercuspation to record the maxillomandibular relationship. This in-vitro study compares the occlusion derived from conventionally articulated stone casts versus that of digitally articulated quadrant milled models. Thirty sets of stone casts poured from full arch polyvinyl siloxane impressions (Group A) and thirty sets of polyurethane quadrant models milled from digital impressions (Group B) were used for this study. The full arch stone casts were hand-articulated and mounted on semi-adjustable articulators, while the digitally derived models were pre-mounted from the milling center based on the data obtained from the buccal scanning procedure. A T-scan sensor was used to obtain a bite registration from each set of models in both groups. The T-scan data derived from groups A and B were compared to that from the master model to evaluate the reproducibility of the occlusion in the two groups. A statistically significant difference of the contact region surface area was found on #11 of the digitally articulated models compared to the master. An analysis of the force distribution also showed a tendency for a heavier distribution on the more anterior #11 tooth for the digitally articulated models. Within the limitations of this study, the use of a digitally articulated quadrant model system may result in a loss of accuracy, in terms of occlusion, the further anteriorly the tooth to be restored is located. Care must be taken to consider the sources of inaccuracies in the digital workflow to minimize them for a more efficient and effective restorative process.
PubMed: 35049609
DOI: 10.3390/dj10010011 -
Journal of Pharmacy & Bioallied Sciences Jun 2021Various clinical methods for recording the condylar guidance (CG) are the intraoral check bite method, graphic tracings, and functional recordings. Accuracy of graphic...
BACKGROUND
Various clinical methods for recording the condylar guidance (CG) are the intraoral check bite method, graphic tracings, and functional recordings. Accuracy of graphic tracings is affected by patient-related factors such as neuromuscular control of the individual, stability of record bases as well as stability of recording media. The current recommended average settings using Hanau's formula questionable, and thus reassessment is needed.
PURPOSE
The purpose of this study is to use radiographic technique to determine the lateral CG and compare these values with those obtained using Hanau's formula and to evaluate whether there are differences between the right and left paths of the condyles.
MATERIALS AND METHODS
Twenty completely edentulous patients were selected. Articulator was modified with sectioned protractor for obtaining per degree interval calibration. With the protrusive records, the horizontal CG (H) was adjusted and the Bennett's angle (LCG-C) was calculated using the formula. With the tracing device in the mouth, sub-mento vertex projection radiographs were obtained. Each radiograph was traced and superimposed for Bennett angle determination (LCG-M).
RESULTS
The median (interquartile range [IQR]) of right and left LCG-C were 15.45 (0.8) and 15.50 (0.7), respectively. The median (IQR) of right and left LCG-M were 37.00 (6.0) and 36.50 (6.8), respectively. A statistically significant difference exists between LCG-C and LCG-M. Both LCG-C and-M values exhibited no variations on both sides.
CONCLUSIONS
Radiographic technique yielded an amplified LCG when compared to the value obtained by Hanau's formula.
PubMed: 34447149
DOI: 10.4103/jpbs.JPBS_640_20 -
Sensors (Basel, Switzerland) Feb 2022Automatic feature extraction from images of speech articulators is currently achieved by detecting edges. Here, we investigate the use of pose estimation deep neural...
Automatic feature extraction from images of speech articulators is currently achieved by detecting edges. Here, we investigate the use of pose estimation deep neural nets with transfer learning to perform markerless estimation of speech articulator keypoints using only a few hundred hand-labelled images as training input. Midsagittal ultrasound images of the tongue, jaw, and hyoid and camera images of the lips were hand-labelled with keypoints, trained using DeepLabCut and evaluated on unseen speakers and systems. Tongue surface contours interpolated from estimated and hand-labelled keypoints produced an average mean sum of distances (MSD) of 0.93, s.d. 0.46 mm, compared with 0.96, s.d. 0.39 mm, for two human labellers, and 2.3, s.d. 1.5 mm, for the best performing edge detection algorithm. A pilot set of simultaneous electromagnetic articulography (EMA) and ultrasound recordings demonstrated partial correlation among three physical sensor positions and the corresponding estimated keypoints and requires further investigation. The accuracy of the estimating lip aperture from a camera video was high, with a mean MSD of 0.70, s.d. 0.56 mm compared with 0.57, s.d. 0.48 mm for two human labellers. DeepLabCut was found to be a fast, accurate and fully automatic method of providing unique kinematic data for tongue, hyoid, jaw, and lips.
Topics: Biomechanical Phenomena; Dental Articulators; Humans; Jaw; Lip; Speech; Tongue
PubMed: 35161879
DOI: 10.3390/s22031133