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BMC Oral Health Mar 2024To compare the crown accuracy and time efficiency of a complete digital workflow, utilizing an auxiliary occlusal device and IO scanning, with a conventional workflow,... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
To compare the crown accuracy and time efficiency of a complete digital workflow, utilizing an auxiliary occlusal device and IO scanning, with a conventional workflow, for multiple implant-supported single crowns.
MATERIALS AND METHODS
24 patients with two adjacent posterior implants were included. 12 patients were randomly assigned to digital workflow group, involving intra-oral scanning with an auxiliary occlusal device and manufacture of customized abutments and zirconia single crowns (test group). The other 12 were assigned to the conventional workflow (control group), involving conventional impression and CAD-CAM crowns based on stone casts. Crown scanning was done before and after clinical adjustment using an intraoral scanner. Two 3D digital models were overlapped to assess dimension changes. Chair-side and laboratory times for the entire workflow were recorded and a linear mixed model and Independent-sample t tests were used for the statistical analysis.
RESULTS
The maximum occlusal deviation was 279.67 ± 112.17 μm and 479.59 ± 203.63 μm in the test and control group, respectively (p < 0.001). The sizes of the occlusion adjustment areas were 12.12 ± 10.51 mm and 25.12 ± 14.14 mm in the test and control groups, respectively (p = 0.013). The mean laboratory time was 46.08 ± 5.45 and 105.92 ± 6.10 min in the test and control groups, respectively (p < 0.001).The proximal contact adjustment and mean chair-side time showed no statistically significant difference between two groups.
CONCLUSIONS
A digital workflow for two implants-supported single crowns using an auxiliary device required fewer occlusal crown adjustments, and less laboratory time compared to conventional workflow.
CLINICAL RELEVANCE
The use of auxiliary occlusal devices in IOS enhances the accuracy of virtual maxillomandibular relationship in extended edentulous spans. Consequently, employing a digital workflow for multiple implants-supported crowns using IO scanning and an auxiliary occlusal device proves to be a feasible, accurate and efficient approach.
Topics: Humans; Workflow; Dental Prosthesis Design; Dental Implants; Crowns; Computer-Aided Design
PubMed: 38519905
DOI: 10.1186/s12903-024-03986-4 -
BMC Oral Health Mar 2024Overerupted maxillary molars is common in adults, which can lead to insufficient intermaxillary vertical space ,great difficulty in prosthetic reconstruction ,and cause...
BACKGROUND
Overerupted maxillary molars is common in adults, which can lead to insufficient intermaxillary vertical space ,great difficulty in prosthetic reconstruction ,and cause occlusal interference in movements.To reconstruct occlusal function, it is necessary to prepare enough space for prostheses. The aim of the present study was to evaluate the effect of space-adjustment occlusal splint on overerupted maxillary molars by clinical and electromyographic signals analysis.
METHODS
Eighteen patients with overerupted maxillary molars were selected to wear space-adjustment occlusal splint suppressing overerupted maxillary molars for three months. Satisfaction was assessed by 5-point Likert; intermaxillary vertical space and the teeth transportation distance were measured in models; clinical periodontal status were evaluated by periodontal probing depth (PPT) and bleeding index (BI); electromyographic recordings of the masseter and anterior temporal muscles were monitored by Cranio-Mandibular K7 Evaluation System.
RESULTS
All the patients were satisfied with the treatment effect (Likert scale ≧ 4). The intermaxillary space in edentulous areas after treatment showed statistically significant increasing when compared with those before treatment. PPT and BI showed no significant difference. No statistically significant differences were found in electromyographic activity of anterior temporal muscles, while a reduction of muscle activity in masseter in the contralateral side were detected in post-treatment evaluations compared with pre-treatment at mandibular rest position.
CONCLUSIONS
Space-adjustment occlusal splint is an efficient treatment option on overerupted maxillary molars by intruding the maxillary molar to obtain adequate intermaxillary space for prostheses.
Topics: Adult; Humans; Splints; Molar; Masseter Muscle; Temporal Muscle; Occlusal Splints; Electromyography
PubMed: 38431564
DOI: 10.1186/s12903-024-04039-6 -
Cranio : the Journal of... Feb 2024The aim of this study was to assess the received TMD treatment modalities and the perceived outcome among the frequent types of EDS. A digital questionnaire was sent to...
The aim of this study was to assess the received TMD treatment modalities and the perceived outcome among the frequent types of EDS. A digital questionnaire was sent to the member of the National Swedish EDS Association during January-March 2022. The subsamples of hypermobile and classical EDS were constructed. Almost 90% reported TMD symptoms. Bite splint therapy, counselling, jaw training and occlusal adjustment were reported as the most common treatments with no statistically significant difference in terms of good effect between the two subsamples. Hypermobile and classical EDS might consider as an entity with regards to TMD.
PubMed: 38415674
DOI: 10.1080/08869634.2024.2319565 -
BMC Oral Health Feb 2024This study aims to analyze the longitudinal variation of occlusal force distribution prior to and after fixed restoration for molar full-crowns with T-SCAN III which...
BACKGROUND
This study aims to analyze the longitudinal variation of occlusal force distribution prior to and after fixed restoration for molar full-crowns with T-SCAN III which provide reference for occlusal adjustment and long-term maintenance.
METHODS
We enrolled a total of 20 patients who received conventional restorative treatment for molars. The occlusion examination was conducted in 3 stages (before placement, immediately after placement, and 3 months after placement) using T-SCAN III (Tekscan South Boston, MA, USA, 10.0) to examine and measure the occlusal contact areas of the full dentition.
RESULTS
The results indicated that the occlusal force distribution in the molar region of the patients changed before and after the fixed restoration, but the percentages of occlusal force in the dental arch of the molar did not differ significantly before and after the restoration (P > 0.05). Three months after the fixed restoration, the percentage of occlusal force in the restored dental arches of lateral teeth increased significantly (P < 0.05).
CONCLUSION
The results of this study indicated that the occlusal forces of the patients changed with tooth movement and adaptation, which is mainly reflected in the increasing occlusal force. Quantitative occlusal force analysis using T-SCAN III occlusal analyzer can provide more objective and accurate data to effectively guide clinical occlusion adjustments.
Topics: Humans; Dental Occlusion; Bite Force; Molar; Crowns; Dentures
PubMed: 38388920
DOI: 10.1186/s12903-024-04014-1 -
The International Journal of... Feb 2024To compare the static and dynamic occlusion of all-ceramic single crowns designed by mechanical and virtual articulators, by evalua6ng the accuracy of occlusal contacts...
PURPOSE
To compare the static and dynamic occlusion of all-ceramic single crowns designed by mechanical and virtual articulators, by evalua6ng the accuracy of occlusal contacts of prostheses designed by virtual articulators and the feasibility of clinical application of CAD/CAM virtual articulators.
MATERIALS AND METHODS
Nine subjects with an average age of 27 years who needed crown repair were recruited. After preparation of the all-ceramic crowns, two zirconia crowns were designed and fabricated through digital procedures and traditional methods. The intraoral scanner, Geomagic software, and T-Scan analyzer were used to analyze the occlusal contact points, areas, and the occlusal force percentage peak before the treatment and after the two crowns were temporarily fixed.
RESULTS
There was a significant difference in the number of occlusal contact points and areas between the mechanical group and control group (preoperation group), but there was no obvious difference between the virtual group and control group. The occlusal contact overlapping areas of the virtual-control group were significantly larger than those of the mechanical-control group. The occlusal force percentage peak of the tested teeth was slightly larger in the mechanical group than in the virtual group.
CONCLUSIONS
The posterior single crown designed by a virtual articulator restored the intercuspal occlusal better than one designed by a mechanical articulator, and it produced less dynamic occlusal interference. This finding suggests that virtual articulators can provide guidance for the design and adjustment of the occlusal surface of posterior single crown prostheses.
Topics: Humans; Adult; Dental Articulators; Crowns; Computer-Aided Design; Molar; Ceramics; Dental Prosthesis Design
PubMed: 38381992
DOI: 10.11607/ijp.8298 -
Clinical Oral Investigations Feb 2024Single denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Single denture rehabilitated patients have negative appraisals regarding oral function, mostly associated by stability and retention issues regarding mandibular prosthetics. Therefore, this study assessed patients' occlusal equilibration, muscle activity, and oral health-related quality of life (OHRQoL) receiving milled removable or fixed mandibular implant retained prostheses.
MATERIALS AND METHODS
Twenty-two edentulous mandibular ridges patients were randomly distributed into two groups based on the definitive prosthesis received. Group I: Removable mandibular implant-supported overdenture, Group II: Implant retained fixed prosthesis. Occlusal equilibration was evaluated utilizing Occlusense, muscle activity via Electromyograph (EMG) at delivery, after one, and three months. The OHRQoL was evaluated by Oral Health Impact Profile questionnaire (OHIP-19) before delivery and after follow-ups. Data were collected, tabulated, and analyzed, utilizing independent t-test and One-way ANOVA followed Tukey`s post-hoc test. Significance level set at P ≤ 0.05.
RESULTS
Groups I &II showed significant improvement in occlusal equilibration, muscle activity and OHRQoL. Group II demonstrated significantly higher improvement than group I in occlusal equilibration associated with muscle activity after 1 month, and in functional limitations domain in OHRQoL questionnaire after 3 months.
CONCLUSION
Implant retained mandibular prosthesis showed improvement in occlusal equilibration, muscle activity, and OHRQoL regardless of prosthesis type employed. Fixed implant-supported prosthesis revealed better outcomes than removable mandibular implant-supported overdenture concerning occlusal equilibration, muscle activity, and OHRQoL regarding functional limitations.
CLINICAL RELEVANCE
Implant retained mandibular prosthesis is one of best treatment options for single mandibular completely edentulous patients, as dental implants improved occlusal equilibration, muscle activity, and OHRQoL.
Topics: Humans; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Jaw, Edentulous; Mandible; Mouth, Edentulous; Muscles; Occlusal Adjustment; Patient Satisfaction; Quality of Life
PubMed: 38378935
DOI: 10.1007/s00784-024-05558-w -
Clinical Oral Investigations Jan 2024The aim of this study was to compare failure load and initial damage in monolithic, partially veneered, and completely veneered (translucent) zirconia cantilevered fixed...
OBJECTIVES
The aim of this study was to compare failure load and initial damage in monolithic, partially veneered, and completely veneered (translucent) zirconia cantilevered fixed partial dentures (CFPDs), as well as completely veneered metal-ceramic CFPDs under different support and loading configurations.
MATERIALS AND METHODS
Eight test groups with anatomically congruent CFPDs (n = 8/group) were fabricated, differing in CFPD material/support structure/loading direction (load applied via steel ball (Ø 6 mm) 3 mm from the distal end of the pontic for axial loading with a 2-point contact on the inner cusp ridges of the buccal and oral cusps and 1.3 mm below the oral cusp tip for 30° oblique loading): (1) monolithic zirconia/CoCr abutment teeth/axial, (2) monolithic zirconia/CoCr abutment teeth/oblique, (3) partially veneered zirconia/CoCr abutment teeth/axial, (4) partially veneered zirconia/CoCr abutment teeth/oblique, (5) completely veneered zirconia/CoCr abutment teeth/axial, (6) completely veneered CoCr/CoCr abutment teeth/axial (control group), (7) partially veneered zirconia/implants/axial, and (8) partially veneered zirconia/natural teeth/axial. Restorations were artificially aged before failure testing. Statistical analysis was conducted using one-way ANOVA and Tukey post hoc tests.
RESULTS
Mean failure loads ranged from 392 N (group 8) to 1181 N (group 1). Axially loaded monolithic zirconia CFPDs (group 1) and controls (group 6) showed significantly higher failure loads. Oblique loading significantly reduced failure loads for monolithic zirconia CFPDs (group 2). Initial damage was observed in all groups except monolithic zirconia groups, and fractography revealed design flaws (sharp edges at the occlusal boundary of the veneering window) in partially veneered zirconia CFPDs.
CONCLUSIONS
Monolithic zirconia CFPDs might be a viable alternative to completely veneered CoCr CFPDs in terms of fracture load. However, oblique loading of monolithic zirconia CFPDs should be avoided in clinical scenarios. Design improvements are required for partially veneered zirconia CFPDs to enhance their load-bearing capacity.
CLINICAL RELEVANCE
Monolithic zirconia may represent a viable all-ceramic alternative to the established metal-ceramic option for CFPD fabrication. However, in daily clinical practice, careful occlusal adjustment and regular monitoring should ensure that oblique loading of the cantilever is avoided.
Topics: Dental Restoration Failure; Ceramics; Zirconium; Denture, Partial, Fixed; Dental Porcelain; Materials Testing; Dental Stress Analysis; Crowns
PubMed: 38221600
DOI: 10.1007/s00784-024-05501-z -
Journal of Dentistry Mar 2024This study aimed to assess the effectiveness of patient-specific motion in restoring anterior guidance and to investigate the influence of occlusal plane position within...
OBJECTIVES
This study aimed to assess the effectiveness of patient-specific motion in restoring anterior guidance and to investigate the influence of occlusal plane position within a virtual articulator on the design of the anterior guide slope for incisors.
METHODS
Twenty participants' intraoral scan, occlusal plane position, and jaw motion data were recorded. The maxillary anterior teeth were virtually prepared, and the crowns were designed based on average virtual articulator (AVR), personalized virtual articulator (ART), and patient-specific motion (PSM). The anterior guide slope of maxillary central incisors (S, S, S, S) and the mesio-distal angle (MDA) of the canine of prostheses were compared to that of natural teeth (NAT). One-Way ANOVA was utilized to evaluate the effectiveness of the three methods in restoring the anterior guidance of maxillary anterior teeth.
RESULTS
The comparison of S and MDA showed no significant difference between the PSM and NAT groups (p > 0.05). However, S of the ART group was significantly smaller, while MDA was higher than that of the NAT group (p < 0.05). S did not differ significantly (p > 0.05) when the angle of the occlusal plane (AOP) was small. As the AOP increased, S of the ART and AVR groups were significantly smaller than that of the NAT group (p < 0.05). With a large AOP, S of the ART group was notably smaller than that of the NAT group (p < 0.05), while there was no significant difference between the AVR and NAT groups (p > 0.05).
CONCLUSIONS
Occlusal design based on patient-specific motion proved more effective in restoring natural anterior guidance. The anterior guidance of prostheses designed using a virtual articulator was influenced by occlusal plane position.
CLINICAL SIGNIFICANCE
The utilization of a jaw motion tracer facilitated the transfer of personalized occlusal plane positions and recorded jaw motion, which can be integrated into the digital prosthetic workflow for virtual occlusion adjustment. Occlusal design based on patient-specific motion more effectively restored lingual guidance of maxillary anterior crowns.
Topics: Humans; Jaw Relation Record; Dental Occlusion; Incisor; Maxilla; Dental Articulators; Computer-Aided Design
PubMed: 38199326
DOI: 10.1016/j.jdent.2024.104833 -
Orthodontics & Craniofacial Research Jun 2024Investigate associations between cleft laterality in patients with non-syndromic unilateral cleft lip and palate (UCLP) and oral-health, dental-arch, speech,...
OBJECTIVES
Investigate associations between cleft laterality in patients with non-syndromic unilateral cleft lip and palate (UCLP) and oral-health, dental-arch, speech, audiological, psychological and nasolabial-aesthetic outcomes.
METHODS
Secondary data analysis of the outcomes of 5-year-old children with non-syndromic complete UCLP identified from three studies: Cleft Collective (n = 155), Cleft Care UK (CCUK) (n = 266) and Clinical Standards Advisory Group (CSAG) study (n = 238). Outcome measures included occlusal assessment using the 5-year-old's index score, speech intelligibility rating using the CAPS-A Audit tool, audiological assessment using pure tone audiometry, nasolabial aesthetic assessment using the Asher-McDade tool, oral-health assessment using decayed, missing, filled teeth scores and parent-reported outcomes. Logistic regression with adjustment for age, sex and index-of-multiple-deprivation scores were performed.
RESULTS
No differences were found in patient-reported outcomes between the left and right clefts in the Cleft Collective study. From the CCUK study, right clefts had poorer speech (n = 236; 95% CI 1.09, 3.42; and P = .03) and hearing outcomes (n = 211; 95% CI 1.03, 3.43; P = .04). In the CSAG study, patients with left clefts were more likely to be teased (n = 213; 95% CI 0.26, 0.85; and P = .01).
CONCLUSION
Weak associations between cleft laterality, speech, hearing and psychological outcomes were found, however the findings were inconsistent across the studies. This study contributes to evidence of associations between laterality and outcomes in children born with UCLP.
Topics: Humans; Cleft Lip; Cleft Palate; Female; Male; Child, Preschool; Patient Reported Outcome Measures; Speech Intelligibility; Esthetics, Dental; Oral Health
PubMed: 38193240
DOI: 10.1111/ocr.12747 -
Heliyon Jan 2024The effect of using the custom disk method (CDM) for fabricating digital dentures on patients' masticatory function should be studied to support its use in clinical...
STATEMENT OF PROBLEM
The effect of using the custom disk method (CDM) for fabricating digital dentures on patients' masticatory function should be studied to support its use in clinical practice.
PURPOSE
To investigate the effect of digital dentures fabricated using CDM on patients' masticatory function.
MATERIAL AND METHODS
This single-center prospective clinical study included 20 patients with edentulous maxillary and mandibular arches who used a complete denture. The digital impression and complete denture manufacturing procedures using CDM have already been reported by Kanazawa et al. (2018) [32] and Soeda et al. (2022) [18] Thedigital dentures fabricated with CDM were delivered to the participants, and periodic adjustments were made until the patient could use the denture without pain. A color-changeable chewing gum, two types of gummy jellies that can evaluate the masticatory function, and pressure-sensitive sheets were used to evaluate the participants' masticatory function at baseline, 1 month, and 6 months following adjustment of the new digital complete dentures fabricated with CDM. These masticatory function values had already been measured in the previous conventional dentures and were recorded as baseline values.
RESULTS
The study participants included 8 women and 12 men (mean age, 77.6 years). The color-changeable chewing gum analysis indicated that there was no significant improvement of masticatory function from baseline to 1 M (P = .083) and 6 M (P = .157).The gummy jelly analysis indicated no significant differences between the masticatory function baseline and 1 month (P = .387); however, a significant improvement was observed from baseline to 6 months (P = .020). Tests with Glucolum indicated a significant improvement from baseline to 1 month (P = .012) and 6 months (P = .003). The maximum bite force and occlusal contact area showed no significant difference at any time point.
CONCLUSIONS
Significant improvement in masticatory function was observed upon evaluation with gummy jelly and Glucolum 6 months after delivering the new digital complete dentures. Under limited conditions, the digital denture fabricated using CDM resulted in good recovery of the masticatory function in elderly edentulous patients. The present results combined with the cost-effectiveness and patient satisfaction associated with CDM indicate its clinical utility.
PubMed: 38192789
DOI: 10.1016/j.heliyon.2023.e23938