-
Case Reports in Dentistry 2022In this article, two cases with generalized dental wear and four cases with localized dental wear are reported. In some of the cases, the worn teeth were restored with...
BACKGROUND
In this article, two cases with generalized dental wear and four cases with localized dental wear are reported. In some of the cases, the worn teeth were restored with direct composite techniques with no mock-up and articulator mounting according to the canine rise method. This method is used without any change in the intercuspation of posterior teeth without a muscle relaxation appliance. It introduces a stable occlusal condition that can alter neuromuscular reflex activity, leading to improvements in certain muscle pain disorders. It is also used to protect the teeth and supporting structures from abnormal forces that might create a further breakdown and/or tooth wear.
METHODS
The first step of treatment in all the cases was a composite build-up for maxillary and mandibular canines to restrict and guide the horizontal and vertical jaw movements and create adequate space for restorations. The second step was the placement of direct or indirect restorations on upper and lower anterior teeth efficiently and accurately.
RESULTS
This method enhanced the esthetic outcomes in a conservative approach with no reduction in tooth material or time-consuming treatments.
CONCLUSIONS
This technique can be suggested for the treatment of worn teeth in patients with Angle's Cl I and Cl II classifications of malocclusion based on the follow-up results. It is not applicable for the treatment of worn teeth in patients with Angle's class III because occlusion is reversed, and canine teeth do not have guidance role. . This method significantly reduces the overall treatment time, and additional steps are required to restore the worn-out teeth and/or occlusion using the canine rise method.
PubMed: 35265380
DOI: 10.1155/2022/9949879 -
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 -
BioMed Research International 2022This study is aimed at evaluating the impact of the craniofacial structure and occlusal conditions on the position of the articular heads of the mandibular condyles in...
PURPOSE
This study is aimed at evaluating the impact of the craniofacial structure and occlusal conditions on the position of the articular heads of the mandibular condyles in the maximum intercuspal position (MIP) and comparing the centric relation (CR) and MIP of the mandibular condyles prior to orthodontic treatment.
METHODS
The studied group consisted of 33 women and 15 men (median age of 17.75 years). Contact points of opposing teeth in the MIP were assessed by hand-held casts. Condylar displacement (CD) in three spatial planes on both sides was measured on models mounted in an articulator using a mandibular position indicator (MPI). Patients were divided into groups according to craniofacial structures (vertical and horizontal growth directions). The Mann-Whitney, Kruskal-Wallis, post hoc Dwass-Steel-Critchlow-Fligner, and Pearson's independence tests as well as Spearman's nonparametric correlations were used in the statistical analyses.
RESULTS
Within the limitations of this study, no statistically significant correlation of CD with certain cephalometric measurements from a lateral cephalometric radiograph (ANB, SN-ML, and SGo/NMe) was observed. Correlation, however, was found between condylar displacement in the transverse axis and the mandibular plane angle SN-ML ( = 0.033) and also between condylar displacement in the anteroposterior axis and a midline shift of the mandible ( = 0.041). The results revealed a relationship between Angle's classification of molar position on the right side and anteroposterior CD values ( = 0.006).
CONCLUSIONS
Cephalometric measurements cannot be used to predict CD at the level of the condyles. Analysis of occlusal conditions of models mounted in an articulator is desirable for patients with Angle's class I and lower jaw asymmetry.
Topics: Adolescent; Centric Relation; Cephalometry; Dental Articulators; Female; Humans; Jaw Relation Record; Male; Mandible; Mandibular Condyle
PubMed: 35097107
DOI: 10.1155/2022/1439203 -
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 -
Journal of Prosthodontic Research Oct 2022Acquiring adequate attached mucosa is important in restoring masticatory function with a removable dental prosthesis or dental implant. In patients with inadequate...
PURPOSE
Acquiring adequate attached mucosa is important in restoring masticatory function with a removable dental prosthesis or dental implant. In patients with inadequate attached mucosa, a free gingival graft (FGG) with a custom stent is used. However, it is challenging to apply the conventional method for fabricating a stent with a reshaped cast in patients with reconstructed mandibles because the reconstructed mandible has limitations due to a titanium mesh, skin flap, and unique bone morphology. In the present report, we have proposed a new design and fabrication process for a mucocompressive splint via medical engineering to acquire the attached mucosa for the prosthodontic treatment of reconstructed mandibles.
METHODS
Three-dimensional (3D) craniomandibular models were reconstructed from a computed tomography dataset after mandibular reconstruction. The dentition region was replaced with highly precise scan data of the dental casts using a 3D scanner. The alveolar ridge mucosa and teeth were ideally designed using the 3D model while referring to the anatomical structures. The jig used to fabricate the working dental cast with artificial gum in real space was designed and fabricated using a 3D printer. The alveolar ridge was altered into a simulated configuration on the articulator using a jig. A mucocompressive splint was fabricated on an altered dental cast. The splint was immediately seated on the mandible without any major adjustments after the FGG.
CONCLUSION
Adequate attached mucosa for the prosthodontic treatment of a reconstructed mandible was obtained by the pre-surgical fabrication of a mucocompressive splint through medical engineering.
Topics: Dental Implants; Humans; Mandible; Mandibular Reconstruction; Splints; Titanium
PubMed: 35067490
DOI: 10.2186/jpr.JPR_D_21_00160 -
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 Nov 2021The aim of this study was to conduct a cross-sectional questionnaire-based survey concerning the practice of occlusal splint for treating temporomandibular disorders...
AIM
The aim of this study was to conduct a cross-sectional questionnaire-based survey concerning the practice of occlusal splint for treating temporomandibular disorders (TMDs) by the dental practitioners of Jabalpur.
MATERIALS AND METHODS
A questionnaire containing questions on diagnosis, treatment, and management of TMD was given to a total of 157 general dental practitioners in Jabalpur. The responses were collected; data analysis was done by Chi-square test.
RESULTS
Of the General Dental Practitioner's, nearly 78% of participants did not attend any continuing dental education on TMD per year. More than 10 years of experience (82%) was associated with increase in positive response for treatment of TMD patient. Both the diagnosis and treatment of TMD patient were done using combination methods. The duration of splint use was considered patient dependent (42.27%) irrespective of the years of practice. Soft splint was most commonly employed for treatment, and fabrication of splint was done on hinge and mean value articulator.
CONCLUSION
The knowledge of occlusal splint by general practitioners was found to be insufficient for treating TMDs.
PubMed: 35017933
DOI: 10.4103/jpbs.jpbs_157_21 -
Case Reports in Dentistry 2021This case report presents a 19-year-old male patient with hypohidrotic ectodermal dysplasia, having a chief complaint of multiple missing teeth. Atraumatic extraction of...
This case report presents a 19-year-old male patient with hypohidrotic ectodermal dysplasia, having a chief complaint of multiple missing teeth. Atraumatic extraction of the teeth with hopeless prognosis was done, and teeth with grade 2 mobility were submerged using cast dowel and coping. Following this, incremental increase in the vertical dimension was made using removable flexible splint of two-millimeter thickness. After facebow transfer and making appropriate eccentric bite records to program the semiadjustable articulator, wax-up was done at the desired vertical dimension (VD). The upper arch was finally restored using a long-span fixed partial denture and lower arch using bilateral attachment (Rhein 83) retained cast removable partial denture as a definitive prosthesis. Therefore, in conditions like hypodontia or oligodontia caused due to ectodermal dysplasia, attachment retained removable partial denture may prove beneficial by effectively distributing the occlusal forces. In clinical scenarios where implant is not feasible or not opted by the patient, this combination treatment may be a viable option.
PubMed: 34931149
DOI: 10.1155/2021/7469595 -
Journal of Indian Prosthodontic Society 2021The Aim of the study was to evaluate the reproducibility of condylar inclination values obtained using three different interocclusal recording materials in Hanau... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparative evaluation of condylar guidance obtained by three different interocclusal recording materials in a semi-adjustable articulator and digital panoramic radiographic images in dentate patients: An study.
AIM
The Aim of the study was to evaluate the reproducibility of condylar inclination values obtained using three different interocclusal recording materials in Hanau Wide-Vue semi-adjustable articulator and to compare those values of condylar inclination with panoramic radiographic images.
SETTINGS AND DESIGN
In Vivo Comparative study.
MATERIALS AND METHODS
The clinical trial was carried out in the Department of Prosthodontics, M. R Ambedkar Dental College and Hospital, Bengaluru. A total of 30 dentulous subjects aged between 20 and 40 years were selected, without any signs and symptoms of temporomandibular joint disorders. With the help of a custom-made protrusive guide, protrusive records for three materials were made. These records were used for programming the articulator and the respective horizontal condylar inclination (HCI) value, and panoramic radiographs were made. The values obtained were statistically analyzed.
STATISTICAL ANALYSIS USED
Independent t-test, multiple comparisons using Bonferroni method followed by Analysis of variances (ANOVA) were used.
RESULTS
Among each pair of groups there exists a significant difference, i.e., the mean condylar inclination (degree) was found to be statistically significant between wax and polyvinyl siloxane (P < 0.01) as well as between wax and polyether (P < 0.01). No significant difference was observed between polyvinyl siloxane and polyether (P > 0.05).
CONCLUSION
HCI values differed depending on the type of material employed. The study concluded that the protrusive condylar guidance angles obtained by panoramic radiograph can be used in programming the semi-adjustable articulator and among the materials polyether gave the highest Condylar Guidance values with less variability and wax gave lowest values with greater variation.
Topics: Adult; Dental Articulators; Humans; Jaw Relation Record; Mandibular Condyle; Radiography, Dental, Digital; Radiography, Panoramic; Reproducibility of Results; Young Adult
PubMed: 34810368
DOI: 10.4103/jips.jips_239_21 -
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