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International Journal of Environmental... Jan 2021Digital impressions in implant dentistry rely on many variables, and their accuracy, particularly in complete edentulous patients, is not well understood. The purpose... (Review)
Review
INTRODUCTION
Digital impressions in implant dentistry rely on many variables, and their accuracy, particularly in complete edentulous patients, is not well understood. The purpose of this literature review was to determine which factors may influence the accuracy of digital impressions in implant dentistry. Emphasized attention was given to the design of the intra-oral scan body (ISB) and scanning techniques.
MATERIALS AND METHODS
A Medline, PubMed and EBSCO Host databases search, complemented by a hand search, was performed in order to select relevant reports regarding the appliance of digital impressions in implant dentistry. The search subject included but was not limited to accuracy of digital impressions in implant dentistry, digital scanning techniques, the design and material of the ISBs, and the depth and angulation of the implant. The related titles and abstracts were screened, and the remaining articles that fulfilled the inclusion criteria were selected for full-text readings.
RESULTS
The literature search conducted for this review initially resulted in 108 articles, among which only 21 articles fulfilled the criteria for inclusion. Studies were evaluated according to five subjects: accuracy of digital impressions in implant dentistry; the design and material of the intra-oral scan bodies; scanning technique; the influence of implants depth/angulations on the digital impression and accuracy of different intra-oral scanner devices.
CONCLUSIONS
The accuracy of digital impressions in implant dentistry depends on several aspects. The depth/angulation of the implant, the experience of the operator, the intra-oral scanner used, and environmental conditions may influence the accuracy of digital impressions in implant dentistry. However, it seems that ISBs' design and material, as well as scanning technique, have a major impact on the trueness and precision of digital impressions in implant dentistry. Future research is suggested for the better understanding of this subject, focusing on the optimization of the ISB design and scanning protocols.
Topics: Computer-Aided Design; Dental Impression Technique; Dentistry; Humans; Mouth, Edentulous; Prostheses and Implants
PubMed: 33498902
DOI: 10.3390/ijerph18031020 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Feb 2021Digital technologies use high-precision three-dimensional scanning, intelligence-aided design software, and multi-axis numerical control milling or 3D printing, which... (Review)
Review
Digital technologies use high-precision three-dimensional scanning, intelligence-aided design software, and multi-axis numerical control milling or 3D printing, which can produce restorations with reliable precision and suitable function. However, the development of digital technologies in the field of complete denture restoration has been slow due to the complexity of prosthesis. This review article introduces the current research status and clinical applications of digital complete dentures in prosthodontic clinics and dental laboratories to provide beneficial references to prosthodontists and dental technicians.
Topics: Computer-Aided Design; Denture, Complete; Printing, Three-Dimensional
PubMed: 33723930
DOI: 10.7518/hxkq.2021.01.001 -
Gels (Basel, Switzerland) Mar 2022Immediate dentin sealing (IDS) involves applying an adhesive system to dentin directly after tooth preparation, before impression. This was considered an alternate to... (Review)
Review
Immediate dentin sealing (IDS) involves applying an adhesive system to dentin directly after tooth preparation, before impression. This was considered an alternate to delayed dentin sealing (DDS), a technique in which hybridization is performed following the provisional phase and just before the indirect restoration luting procedure. This study aimed to compare the bond strength of restorations to dentin of the IDS and the DDS techniques throughout a systematic review and meta-analysis. The following PICOS framework was used: population, indirect restorations; intervention, IDS; control, DDS; outcomes, bond strength; and study design, in vitro studies. PubMed (MedLine), The Cochrane Library, ISI Web of Science, Scielo, Scopus, and Embase were screened up to January 2022 by two reviewers (L.H. and R.B.). In vitro papers studying the bond strength to human dentin of the IDS technique compared to the DDS technique were considered. Meta-analyses were carried out by using a software program (Review Manager v5.4.1; The Cochrane Collaboration). Comparisons were made by considering the adhesive used for bonding (two-step etch-and-rinse, three step etch-and-rinse, one-step self-etch, two-step self-etch, and universal adhesives). A total of 3717 papers were retrieved in all databases. After full-text assessment, 22 potentially eligible studies were examined for qualitative analysis, leaving a total of 21 articles for the meta-analysis. For the immediate bond strength, regardless of the adhesive strategy used, the IDS technique improved the bond strength of restorations to the dentin (p < 0.001). Taking into account the subgroup analysis, it seems that the use of the IDS technique with a two-step etch-and-rinse or a one-step self-etch adhesive system does not represent any advantage over the DDS technique (p = 0.07, p = 0.15). On the other hand, for the aged bond strength, regardless of the adhesive strategy used, the IDS technique improved the bond strength of restorations to the dentin (p = 0.001). The subgroups analysis shows that this improvement is observed only when a three-step etch-and-rinse adhesive system (p < 0.001) or when a combination of an adhesive system plus a layer of flowable resin (p = 0.01) is used. The in vitro evidence suggests that the use of the IDS technique improves the bond strength of dentin to resin-based restorations regardless of the adhesive strategy used. The use of a three-step etch-and-rinse adhesive system or the combination of an adhesive system plus a layer of flowable resin seems to considerably enhance the bond strength in the long term.
PubMed: 35323288
DOI: 10.3390/gels8030175 -
Dental Materials Journal Jan 2020An optical-impression by an intraoral scanner (IOS) involves optically measuring the surface shape of the target teeth or gums directly in the patient's mouth. IOSs have...
An optical-impression by an intraoral scanner (IOS) involves optically measuring the surface shape of the target teeth or gums directly in the patient's mouth. IOSs have many advantages, such as reduce patients pain and discomfort, the operator's burden and the risk on infection, real-time impression scanning and visualization, simple replication and selective scanning, reduction of cost and waste of materials and detection of dental caries and crack . IOSs have become one of the most valuable dental-treatment devices for patients, dentists, dental technicians, and dental hygienists. The IOS accuracy matches or supersedes the accuracy of the conventional-impression and indirect method with working models. IOS is clinically applicable in restoration up to four units. IOS's high reproducibility, information-processing ability, multimedia capability, and simplicity and speed in communication can apply to group examination and identification of disaster victims or dementia patients.
Topics: Computer-Aided Design; Dental Caries; Dental Impression Technique; Dentistry; Humans; Imaging, Three-Dimensional; Models, Dental; Reproducibility of Results
PubMed: 31723066
DOI: 10.4012/dmj.2019-224 -
Clinical Oral Investigations Dec 2021The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures... (Review)
Review
OBJECTIVES
The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS procedures based on available prosthodontic outcomes.
MATERIALS AND METHODS
Electronic and manual literature searches were performed to collect evidence concerning the outcomes of IOS and CI performed during the treatment of partially and complete edentulous patients for tooth- or implant-supported restorations. Qualitative analysis was conducted to evaluate the time efficiency and PROMs produced by the two different techniques. Clinical prosthodontic outcomes were analyzed among the included studies when available.
RESULTS
Seventeen studies (9 randomized controlled trials and 8 prospective clinical studies) were selected for qualitative synthesis. The 17 included studies provided data from 430 IOS and 370 CI performed in 437 patients. A total of 7 different IOS systems and their various updated versions were used for digital impressions. The results demonstrated that IOS was overall faster than CI independent of whether quadrant or complete-arch scanning was utilized, regardless of the nature of the restoration (tooth or implant supported). IOS was generally preferred over CI regardless of the size of the scanned area and nature of the restoration (tooth- or implant-supported). Similar prosthodontic outcomes were reported for workflows implementing CI and IOS.
CONCLUSIONS
Within the limitations of this systematic review, IOS is faster than CI, independent of whether a quadrant or complete arch scan is conducted. IOS can improve the patient experience measured by overall preference and comfort and is able to provide reliable prosthodontic outcomes.
CLINICAL RELEVANCE
Reduced procedure working time associated with the use of IOS can improve clinical efficiency and the patient experience during impression procedures. Patient-reported outcome measures (PROMs) are an essential component of evidence-based dental practice as they allow the evaluation of therapeutic modalities from the perspective of the patient. IOS is generally preferred by patients over conventional impressions.
Topics: Computer-Aided Design; Dental Implants; Dental Impression Technique; Humans; Patient Comfort; Prospective Studies; Prosthodontics
PubMed: 34568955
DOI: 10.1007/s00784-021-04157-3 -
Journal of Clinical and Experimental... Sep 2020Biologically oriented preparation technique (BOPT) is a vertical preparation technique without a finish line to create a new anatomic crown with a prosthetic emergence...
Biologically oriented preparation technique (BOPT) is a vertical preparation technique without a finish line to create a new anatomic crown with a prosthetic emergence profile. This case report describe the protocol realized digitally in a patient who required a new fixed partial denture (FPD) in the anterior esthetic zone. After time of temporary restoration, definitive conventional (CI) (double-cord retraction and vinyl polysiloxane material), and digital impression (DI) with three different intraoral scanner (IOS) (Trios®, True Definition® and iTero®) were taken. All digital impression were obtained through three different scans: temporary restoration in the mouth after healing period, prepared teeth, and temporary restoration out of the mouth. To establish which of the IOS was the most accurate, it was necessary to compare the STL files obtained from each of the IOS with the STL file of the conventional impression, which was digitized with a laboratory scanner (3Shape D800). All these STL were imported to a software (ExoCAD 2.4 Plovdiv®), and they were superimposed. To establish the difference in trueness with SC, 6 points were chosen, 3 points in teeth, and another 3 points in soft tissue. The mean measurement in terms of trueness in teeth were: STS (0,039 mm), SI (0,054 mm), STD (0,067 mm); and in soft tissue were: STS (0,051 mm), SI (0,09 mm), STD [0,236 mm]. The IOSs showed differences between them in terms of trueness, being the Trios the most accuracy IOS. Final restoration was fabricated and cemented. The patient was examined at 3, 6 and 12 months, without any type of biological or mechanical complications. Digital impression with an IOS seems to be a viable alternative to perform zirconia FPD in the BOPT tecbique. Intraoral scanners, accuracy, vertical preparation, precision, CAD-CAM, prosthodontics.
PubMed: 32994882
DOI: 10.4317/jced.56967 -
Journal of Prosthodontic Research Jan 2022This study comprehensively reviewed the current status of digital workflows in fabricating removable partial dentures (RPDs) using evidence from clinical trials and case...
PURPOSE
This study comprehensively reviewed the current status of digital workflows in fabricating removable partial dentures (RPDs) using evidence from clinical trials and case reports.
STUDY SELECTION
We performed a systematic review of the literature on the materials and fabrication of RPDs using digital technologies published in online databases from 1980 to 2020. We selected eligible articles from the search results, retrieved information on digital RPDs from these, and conducted a qualitative analysis. We report evidence from clinical papers and case reports, digital impression-taking methods, and maxillomandibular relationship (MMR) records.
RESULTS
A case report electronically published in 2019 introduced a clasp-retained RPD fabricated via a full-digital workflow without a gypsum definitive cast. Computer-aided design and computer-aided manufacturing of double-crown-retained RPDs with nonmetal materials were described in some case reports. Intraoral scanners were used to obtain digital impressions and MMR records in the fabrication of digital RPDs, which have potential advantages for reducing the number of clinical appointments and simplifying laboratory procedures. Evidence from clinical trials is scarce; a randomized controlled trial reported higher patient satisfaction with digital clasp-retained RPDs than with conventional RPDs.
CONCLUSIONS
Full-digital RPDs can be fabricated without a gypsum definitive cast. However, the indication for full-digital RPDs is limited to cases with Kennedy Class III/IV partially edentulous arches with several missing teeth. Challenges in digital impression-taking and MMR recording remain to be solved to extend these indications. More evidence from clinical trials is required to evaluate the efficacy and usefulness of digital RPDs.
Topics: Computer-Aided Design; Denture, Partial, Removable; Humans; Mouth, Edentulous; Randomized Controlled Trials as Topic
PubMed: 33504721
DOI: 10.2186/jpr.JPR_D_20_00116 -
Dentistry Journal Aug 2022Over the past 20 years, there have been many innovations in orthodontic diagnosis and therapy. Among the innovations, there is the taking of dental impressions (DIs)....
Over the past 20 years, there have been many innovations in orthodontic diagnosis and therapy. Among the innovations, there is the taking of dental impressions (DIs). Dental impressions are the negative imprint of hard and soft tissues of one or both arches, and they allow a plaster model to be formed, i.e., a positive reproduction. Traditional dental impressions can be made of different materials, such as alginate, while digital impression is captured by an intra-oral scanner. Digital impression, despite the evident advantages, has not yet replaced the conventional impression. The aim of this study is to evaluate which dental impressions are the most used by dentists. For this purpose, we considered 120 questionnaires sent electronically to patients of different dental private practices from different countries, where the dentists can use both techniques. The results highlighted that the kind of impression adopted is very much influenced by the type of therapy and orthodontic devices used in the treatment. We can conclude that, despite the advent of digital technology, conventional impressions are still used for fixed devices, while digital impressions are more adopted for orthodontic customized devices and therapies with clear aligners, that are very widespread among adult patients.
PubMed: 36005245
DOI: 10.3390/dj10080147