Purpose: The purpose of this study was to test heat-treatment methods for improving the cytocompatibility of dental 3D printable photopolymer resins.

Methods: Nextdent C&B resin and a digital light processing 3D printer were used to print all specimens, which were divided into seven groups as follows: 1-month storage at controlled room temperature, 20 to 25 °C (RT), 24-hour storage at RT, 24-hour storage in RT water, 1-min immersion in 80 °C water, 1-min immersion in 100 °C water, 5-min immersion in 100 °C water, and autoclaving. Cell viability tests, cytotoxicity tests, and confocal laser scanning microscopy were performed to analyze the cytocompatibility of the 3D-printed resin. Fourier-transform infrared spectroscopy was performed after heat-treatment to determine the degree of conversion (DC).

Results: Immersing printed resin samples in 100 °C water for 1 or 5 min after the curing process was an effective method for increasing cytocompatibility by inducing the preleaching of toxic substances such as unpolymerized monomers, photoinitiators, and additives. Moreover, the DC can be increased by additional polymerization without affecting the mechanical properties of the material.

Conclusions: Immersing the printed photosensitive dental resins in 100 °C water for 5 min is a suitable method for increasing cytocompatibility and the DC.

In studies that assessed the accuracy of implant surgical guides, evaluations were based on the placement position of the implant by using a manufactured surgical guide. However, such assessments could involve errors that may occur during implant placement. Therefore, evaluating the 3-dimensional accuracy of the fabrication of the implant surgical guide itself is not enough. In the evaluation method described in this article, location-related information is obtained by connecting a scan body to the sleeve of the surgical guide instead of directly placing the implant. This helps to evaluate the accuracy of the surgical guide without errors in the placement of an implant.

This study analyzed the flexural properties, Vickers hardness, degree of conversion (DC), and cell viability of 3D printed crown and bridge resin postcured using various types of postcuring equipment (PCE). 3D printed specimens were postcured for various times using different types of 3D printing PCE [for 5, 15, and 30 min using LC 3D Print Box (LC), Form Cure (FC), Cure M (CM), and Veltz 3D (VE) devices] and the VALO handheld light-curing (VA) device for 20, 40, and 60 s. Neither the flexural strength (132.27–145.79 MPa) nor the flexural modulus (1.52–1.83 GPa) differed significantly when postcuring for 30 min using the LC, FC, CM, or VE device, or for 20, 40, or 60 s of postcuring using the VA device (p > 0.05). The Vickers hardness was highest after 30 min of postcuring for all groups, and varied significantly with the postcuring time in the LC (p < 0.001) and CM (p < 0.001) groups. DC was significantly higher for the 5-min CM group (84.97 ± 4.02%) than for the GS, 30-min FC, 5-min VE, and 20-s VA groups. Cell viability of the postcured resin specimens was 56.46–92.29%, and varied significantly in the CM and VE groups according to the postcuring time (p < 0.05). Confocal laser scanning microscopy observations showed well-developed cell morphology and numerous cell–cell contacts in all groups except the GS group. This study found that the use of different types of PCE did not significantly affect the flexural properties of 3D printed crown and bridge resin, whereas there were significant variations in DC, Vickers hardness, and cell viability.

The aim of this study was to determine the color stability of 3D printed resin according to the post-curing conditions (polymerization conditions and temperature). Specimens were post-polymerized under different conditions of oxygen inhibition, such as on glycerin immersion (GLY), medium-low vacuum environment (VA), and oxygen contact (CON, the control group), and temperature (35 °C, 60 °C, and 80 °C). The degree of conversion (DC), water sorption (Wsp) and solubility (Wsl), surface roughness (Ra) were measured. Additionally, surface free energy (SFE), pH values of colorants were measured. Grape juice (grape), coffee, and curry were used as the colorants, and distilled water (DW) was used as a control. And the color value was measured before and after immersion using a spectrophotometer. Then, Calculated the color change. For statistical methods, The Shapiro-Wilk test performed to check for normality revealed that the data presented a normal distribution (p>0.05). ΔE values were analyzed using three-way ANOVA. DC, Wsp, Wsl, SFE, and Ra were analyzed using two-way ANOVA. To confirm the linear correlation, Pearson’s correlation coefficient was determined. The threshold for significance (p) was set at 0.05 (95% confidence interval) for all tests. DC was the highest at 80 °C in the GLY group (95.08 ± 4.88%). And Wsl decreased with increasing temperature, and was lowest at 80 °C in the GLY group (0.46 ± 0.30 um/mm3). After the colorants were immersed for 30 days, as the temperature increased, ΔE decreased in the GLY group but not in the VA and CON groups, and was the lowest at 80 °C in the GLY group: (DW, 0.95 ± 0.45 [mean± SD]; grape, 6.45± 0.69; coffee, 4.50± 0.56; curry, 9.37± 1.40). There was also a significant inverse relation between DC and ΔE. A significant inverse relation was found between Wsl and DC, and a significant positive correlation was found between Wsl and ΔE. Wsp, SFE, and Ra did not affect color stability. In the post-polymerization process, increasing the temperature and GLY were effective in reducing ΔE, which was lowest at 80 °C in the GLY group. It was also observed that a complex mechanism between the DC, Wsl of 3D printed resin affects ΔE of the resin.

Digital smile design (DSD) technology, which takes pictures of patients’ faces together with anterior dentition and uses them for prosthesis design, has been recently introduced. However, the limitation of DSD is that it evaluates a patient with only one photograph taken in a still state, and the patient’s profile cannot be observed from various viewpoints. Therefore, this study aims to segment the patient’s anterior teeth, gingiva and facial landmarks using YOLACT++. We trained YOLACT++ on the annotated data of the teeth, lips and gingiva from the Flickr-Faces-HQ (FFHQ) data. We evaluated that the model trained by 2D candid facial images for the detection and segmentation of smile characteristics. The results show the possibility of an automated smile characteristic identification system for the automatic and accurate quantitative assessment of a patient’s smile.

The photosensitive resin used in additive manufacturing is cured by free radical polymerization by UV irradiation. However, undesired reaction with oxygen during polymerization inhibits polymerization and results in an under-cured polymer. Therefore, in this study, the hypothesis that successful oxygen shielding in the post-polymerization step could affect the properties of the final polymer was tested. 3D printed specimens using denture base resin were post polymerized either by immersion in glycerin for oxygen shielding (GL group) or placed in a medium-low vacuum chamber at 5 × 10⁻² Torr (VA group). Specimens cured with no additional conditioning served as the control (CON group). To consider the effect of temperature, all groups were additionally compared with 80 °C and without an increase in temperature (room temperature) during post-polymerization. Fourier transform infrared spectroscopy was used to measure the monomer conversion ratios between different groups. In addition, the mechanical properties were quantified by the micro-hardness, flexural strength, and elasticity of the surface, and the water sorption and solubility. Dynamic mechanical analysis (DMA) was conducted to observe the trend in storage and loss modulus between the groups against temperature. Differences in the surface as a function of the post-polymerization conditions were qualitatively observed by scanning electron microscopy (SEM).

This study evaluated the effects of the light intensity of curing and the post-curing duration on the mechanical properties and accuracy of the interim dental material. After designing the specimen, 3D printing was performed, and the light intensity was divided into groups G20, G60, G80, and G120 (corresponding to 1.4–1.6, 2.2–3.0, 3.8–4.4, and 6.4–7.0 mW/cm², respectively), with no post-curing or 5, 10, or 20 min of post-curing being performed. The flexural properties, Vickers microhardness, degree of conversion (DC), and 3D accuracy were then evaluated. The flexural properties and Vickers microhardness showed a sharp increase at the beginning of the post-curing and then tended to increase gradually as the light intensity and post-curing time increased (p < 0.001). On the other hand, there was no significant difference between groups in the accuracy analysis of a 3D-printed three-unit bridge. These results indicate that the light intensity of the post-curing equipment influences the final mechanical properties of 3D-printed resin and that post-curing can be made more efficient by optimizing the light intensity and post-curing time.

This study investigates the effect of acid etching treatment on the surface microstructure, surface roughness, and surface contact angle of zirconia and compares the effects of air abrasion, different etching times, and aging on the shear bond strength (SBS) of resin cement on the zirconia surface. 480 specimens (9 × 10 × 10 mm) were divided into as-sintered and air-abraded groups, and each group was further subdivided into six groups based on etching time (0, 3, 5, 10, 20, and 30 min). The etching solution comprised hydrofluoric acid 25%, sulfuric acid 16%, hydrogen peroxide, methyl alcohol, and purified water. The shear bond strength (SBS), scanning electron microscopy, surface roughness, contact angle, and failure mode were measured. The results indicated that the mean SBS values increased and decreased significantly when the etching times increased to 20 min and 30 min, respectively, in both groups. Further, SBS after aging was lower than that before aging in all groups. Sandblasting, etching time, and aging all showed significant effects (p < 0.001) in the three-way analysis of variance. In addition, the surface roughness increased and the contact angle decreased significantly with an increase in etching time. Thus, the acid-etching treatment induced significant changes on the zirconia surface and increased the SBS of the resin cement. The results of this in vitro study suggest that acid etching is a promising alternative for zirconia surface treatment.

Improvements in computer-aided design/computer-aided manufacturing technologies have led to multiple attempts being made to simplify and improve the workflow of prosthesis fabrication for completely edentulous patients. However, most attempts still involve the conventional methods of impression-making and recording the maxillomandibular relationships using alginate, rubber impression materials, and wax materials. In the case of a completely edentulous arch, the presence of movable tissues and the absence of stable landmarks make it difficult to perform direct digitization using an intraoral scanner and to digitally determine the vertical dimension. In the alternative technique described herein, data are obtained by scanning a template such as the patient’s existing old dentures and jaw movement data using target materials and an optical scanner, and an appropriate maxillomandibular relationship that has the desired restorative space is determined on the basis of the obtained trajectory of mandibular movements while opening and closing the mouth. After designing dentures on the basis of the newly established maxillomandibular relationships and performing a try-in process, the final dentures can be manufactured. This alternative technique can reduce the need for multiple visits and complex procedures, improving the workflow for fabricating prostheses with the correct maxillomandibular relationships for individual patients.

Reproduction of the exact interocclusal relationship using digital workflow is crucial for precise fabrication of accurate prostheses. Intraoral scanner is known to be valid for the measurement of quadrants, however, the role of missing area in the quadrant scan on the virtual interocclusal record (VIR) is uncertain. This study aimed to evaluate the accuracy of VIR in quadrant scans using an intraoral scanner (IOS) under four different edentulous conditions. Eight scans per group were obtained using a laboratory scanner and three IOSs (Trios3, CS3600, i500). Based on trueness and precision, Trios3 had the best results, followed by CS3600 and i500. The trueness and precision were affected by edentulous conditions. The three IOSs showed deviation in the posterior region during assessment of VIR for the missing area with posterior support. CS3600 and i500 showed deviation in the short-span edentulous area without support. In extended edentulous condition without support, Trios3 showed overclosure, while i500 showed an angular deviation. In some groups scanned with Trios3 and i500, the tilting effect was observed. Based on the edentulous condition and type of IOS used, local or general deviations in occlusion were seen. The accuracy of VIR was dependent on accurate scan data. Thus, registration of the occlusal relationship in an edentulous area with more than two missing teeth using IOSs may be clinically more inaccurate than that with a laboratory scanner.

This study investigated the trueness of a digital implant impression according to the orientation of the implant scan body (ISB) and the scanning method. With the flat surface of the ISB facing either the buccal or proximal direction, the ISB was scanned using one tabletop scanner (T500) and three types of intraoral scanner (TRIOS 3, CS3600, and i500). The effects of differences in the scanning method and ISB orientation were assessed. Postalignment data were subsequently obtained with the abutments generated using a digital library, and superimposed with reference data using a best-fit algorithm, followed by root-mean-square error (RMSE) analysis. The RMSE was lower in the buccal groups (28.15 ± 8.87 μm, mean ± SD) than in the proximal groups (31.94 ± 8.95 μm, p = 0.031), and lower in the full-scan groups (27.92 ± 10.80 μm) than in the partial-scan groups (32.16 ± 6.35 μm, p = 0.016). When using the tabletop scanner, the trueness was higher when the ISB was connected buccally (14.34 ± 0.89 μm) than when it was connected proximally (29.35 ± 1.15 μm, p < 0.001). From the findings of this study it can be concluded that the operator should connect the ISB so that its flat surface faces the buccal direction, and attempt to scan all areas. Additionally, it is advantageous to connect an ISB buccally when using a tabletop scanner.

This study attempted to determine the dimensional stability of maxillary and mandibular edentulous denture bases constructed using three-dimensional (3D) printing systems based on stereolithography and digital light processing according to the postcuring treatment time and the removal time of the support structure. Three-dimensional printing of the designed denture base file was performed using two types of 3D printing photocurable resin (standard gray resin (Formlabs) (Somerville, MA, USA) and MAZIC D resin (Vericom) (Anyang, Korea)) and their compatible 3D printers (Form3 (Formlabs) and Phrozen Shuffle (Phrozen) (Hsinchu City, Taiwan)). Different postcuring times (no postcuring, and 15, 30, 45, and 60 min) and times of removal of the support structure were set for each group. Data relating to the denture bases in all groups were obtained using 3D scanning with a tabletop scanner after postcuring. All acquired data were exported to 3D analysis software, and the dimensional changes during postcuring of the denture base were analyzed using RMSE (root-mean-square error) values. It could be confirmed that the dimensional changes increased with postcuring time, and the accuracy was higher in the maxilla than in the mandible. The accuracy was highest for the group in which the postcuring process was performed while the support structure was present.

During the three-dimensional (3D) printing process of a dental prosthesis, using photopolymer resin, partially polymerized resin is further cured through the postcuring process that proceeds after the printing, which improves the stability of the printed product. The mechanical properties of the end product are known to be poor if the postcuring time is insufficient. Therefore, this study evaluated the effect of the postcuring time of the 3D-printed denture base on its dimensional stability, according to the aging period. The 3D prints were processed after designing maxillary and mandibular denture bases, and after the following postcuring times were applied: no postcuring, and 5, 15, 30, and 60 min. The dimensional stability change of the denture base was evaluated and analyzed for 28 days after the postcuring process. The trueness analysis indicated that the mandibular denture base had lower output accuracy than the maxillary denture base, and the dimensional stability change increased as postcuring progressed. In the no postcuring group for the mandible, the error value was 201.1 ± 5.5 µm (mean ± standard deviation) after 28 days, whereas it was 125.7 ± 13.0 µm in the 60 min postcuring group. For both the maxilla and the mandible, shorter postcuring times induced larger dimensional stability changes during the aging process. These findings indicate that in order to manufacture a denture base with dimensional stability, a sufficient postcuring process is required during the processing stage.

The printing accuracy of three-dimensional (3D) dental models using photopolymer resin affects dental diagnostic procedures and prostheses. The accuracy of research into the outer wall thickness and printing direction data for partial-arch model printing has been insufficient. This study analyzed the effects of wall thickness and printing direction accuracy. Anterior and posterior partial-arch models were designed with different outer wall thicknesses. After 3D printing, a trueness analysis was performed. Those with full-arch models were the control group. The full-arch model had an error value of 73.60 ± 2.61 µm (mean ± standard deviation). The error values for the partial-arch models with 1-, 2-, and 3-mm thick outer walls were 54.80 ± 5.34, 47.58 ± 7.59, and 42.25 ± 9.19 μm, respectively, and that for the fully filled model was 38.20 ± 4.63 μm. The printing accuracies differed significantly between 0 degrees and 60 degrees, at 49.54 ± 8.16 and 40.66 ± 6.80 μm, respectively (F = 153.121, p < 0.001). In conclusion, the trueness of the partial-arch model was better than that of the full-arch model, and models with thick outer walls at 60 degrees were highly accurate.

Three-dimensional (3D) printing technology is highly regarded in the field of dentistry. Three-dimensional printed resin restorations must undergo a washing process to remove residual resin on the surface after they have been manufactured. However, the effect of the use of different washing solutions and washing times on the biocompatibility of the resulting resin restorations is unclear. Therefore, we prepared 3D-printed denture teeth and crown and bridge resin, and then washed them with two washing solutions (isopropyl alcohol and tripropylene glycol monomethyl ether) using different time points (3, 5, 10, 15, 30, 60, and 90 min). After this, the cell viability, cytotoxicity, and status of human gingival fibroblasts were evaluated using confocal laser scanning. We also analyzed the flexural strength, flexural modulus, and surface SEM imaging. Increasing the washing time increased the cell viability and decreased the cytotoxicity (p < 0.001). Confocal laser scanning showed distinct differences in the morphology and number of fibroblasts. Increasing the washing time did not significantly affect the flexural strength and surface, but the flexural modulus of the 90 min washing group was 1.01 ± 0.21 GPa (mean ± standard deviation), which was lower than that of all the other groups and decreased as the washing time increased. This study confirmed that the washing time affected the biocompatibility and mechanical properties of 3D printed dental resins.

Three-dimensional (3D) printing is an attractive technology in dentistry. Acrylic-based 3D printed resin parts have to undergo postcuring processes to enhance their mechanical and biological properties, such as UV-light and thermal polymerization. However, no previous studies have revealed how the postcuring temperature influences the biocompatibility of the produced parts. Therefore, we postprocessed 3D printed denture teeth resin under different postcuring temperatures (40, 60 and 80 °C) for different periods (15, 30, 60, 90 and 120 min), and evaluated their flexural properties, Vickers hardness, cell cytotoxicity, cell viability, and protein adsorption. In addition, confocal laser scanning was used to assess the condition of human gingival fibroblasts. It was found that increasing the postcuring temperature significantly improved the flexural strength and cell viability. The flexural strength and cell viability were 147.48 ± 5.82 MPa (mean ± standard deviation) and 89.51 ± 7.09%, respectively, in the group cured at 80 °C for 120 min, which were higher than the values in the 40 and 60 °C groups. The cell cytotoxicity increased in the 40 °C groups and for longer cultivation time. Confocal laser scanning revealed identifiable differences in the morphology of fibroblasts. This study has confirmed that the postcuring temperature influences the final mechanical and biological properties of 3D printed resin.

This study evaluated the internal fit and the accuracy of the implant placement position in order to determine how the surface shape of the tooth and the offset influence the accuracy of the surgical guide. The acquired digital data were analyzed in three dimensions using 3D inspection software. The obtained results confirmed that the internal fit was better in the groove sealing (GS) group (164.45 ± 28.34 μm) than the original shape (OS) group (204.07 ± 44.60 μm) (p < 0.001), and for an offset of 100 μm (157.50 ± 17.26 μm) than for offsets of 30 μm (206.48 ± 39.12 μm) and 60 μm (188.82 ± 48.77 μm) (p < 0.001). The accuracy of implant placement was better in the GS than OS group in terms of the entry (OS, 0.229 ± 0.092 mm; GS, 0.169 ± 0.061 mm; p < 0.001), apex (OS, 0.324 ± 0.149 mm; GS, 0.230 ± 0.124 mm; p < 0.001), and depth (OS, 0.041 ± 0.027 mm; GS, 0.025 ± 0.022 mm; p < 0.001). In addition, the entries (30 μm, 0.215 ± 0.044 mm; 60 μm, 0.172 ± 0.049 mm; 100 μm, 0.119 ± 0.050 mm; p < 0.001) were only affected by the amount of offset. These findings indicate that the accuracy of a surgical guide can be improved by directly sealing the groove of the tooth before manufacturing the surgical guide or setting the offset during the design process.

This study analyzed the surface roughness and waviness, Vickers hardness (VHN), and color changes of six types of 3D printed resins and computer-aided design/computer-aided manufacturing (CAD/CAM) materials after artificial toothbrushing. The average surface roughness height (Ra) change of Formlabs denture teeth A2 resin (FMLB) was not significant between after artificial toothbrushing (0.17 ± 0.02 μm and 0.17 ± 0.05 μm, respectively; mean ± standard deviation). However, the Ra value increased significantly in all remaining groups. Regarding waviness, polymethylmethacrylate (PMMA) had the largest increases in average waviness height (Wa) and maximum surface waviness height (Wz) between, before (0.43 ± 0.23 μm and 0.08 ± 0.02 μm), and after (8.67 ± 4.03 μm, 1.30 ± 0.58 μm) toothbrushing. There were no significant changes in Wa for Formlabs denture teeth A2 resin (FMLB) and NextDent C&B (NXT). After artificial toothbrushing, the dispersed-filler composite (DFC) group had the largest color difference (ΔE, of 2.4 ± 0.9), and the remaining materials had smaller changes than the clinical acceptance threshold of ΔE = 2.25. The VHN of FMLB and NXT were 9.1 ± 0.4 and 15.5 ± 0.4, respectively, and were not affected by artificial toothbrushing. The flexural strengths of the 3D printed materials were 139.4 ± 40.5 MPa and 163.9 ± 14.0 MPa for FMLB and NXT, respectively, which were similar to those of the polycarbonate and PMMA groups (155.2 ± 23.6 MPa and 108.0 ± 8.1 MPa, respectively). This study found that the evaluated 3D printed materials had mechanical and optical properties comparable to those of CAD/CAM materials and were stable even after artificial toothbrushing and hydrothermal aging.

The aim of this work was to evaluate the effects of application time of an acid mixture solution on the surface roughness, phase transformation, and biaxial flexural strength of 3Y-TZP after sintering or air abrasion. For the biaxial flexural strength measurement, 220 3Y-TZP disk-shaped specimens were prepared after as-sintering or air abrasion. The etching solution comprised a mixture of hydrofluoric acid, sulfuric acid, hydrogen peroxide, methyl alcohol, and purified water. The samples were divided into 11 subgroups according to the etching times (Control, 1, 2, 3, 5, 8, 10, 12, 15, 20, and 30 min). The results showed that acid treatment on both as-sintered and air-abraded 3Y-TZP surfaces increased the surface roughness. However, it had no significant effects on the monoclinic phase or flexural strength of as-sintered zirconia. The monoclinic phase and flexural strength of air-abraded zirconia increased sharply after air abrasion; however, they gradually decreased after acid treatment, to a similar level to the case of the untreated surface. Surface treatment with acid mixture increased the roughness, but the lack of increase of monoclinic phase is thought to be because the loose monoclinic particles remaining on the surface were removed through the etching process.

The purpose of this study was to examine and compare color and translucency stability of three-dimensional (3D) printable dental materials for crown and bridge restorations. Five different materials were investigated, and twelve disc-shaped specimens of two different thicknesses (1 and 2 mm) were prepared using a digital light processing 3D printer. Color measurements were made according to the CIELAB color scale (L*, a*, and b*) using a spectrophotometer 1 h, 1 day, 1 week, one month, and six months after post-curing of the materials, and the translucency parameter (TP) was calculated. The L*, a*, b*, and TP values were compared among the different materials and storage periods using repeated measures analysis of variance. Color and translucency changes of the specimens after the different storage periods were compared with 1 h measurements to determine whether they exceeded clinically perceivable thresholds. The L*, a*, b*, and TP values showed significant differences according to the storage periods, as well as among the materials. Until one month, some materials demonstrated distinct color differences, while others showed small color differences below a clinically perceivable threshold. The translucency differences were not clinically perceivable for any specimen. After six months, all specimens demonstrated large color changes, whereas the changes in translucency were relatively small. In conclusion, the color of 3D printable dental materials changed with time, and the differences varied with the materials used. On the contrary, the changes in translucency were small. Overall, the materials became darker, more yellowish, and more opaque after six months of water storage.

Clinicians and researchers have used various methods to reproduce the maxillomandibular relationship and mandibular movement of individual patients using an articulator, with efforts being made to reduce errors associated with the conventional technique. When a change to a vertical dimension is required during the conventional prosthesis construction process, the maxillary and mandibular casts are mounted on the mechanical articulator using a facebow and bite registration and the elevation of the anterior guide pin of the articulator is used. However, this can inevitably cause errors due to differences between the articulator hinge movement and the actual trajectory of the patient. There has recently been increasing interest in tracking the trajectory of jaw motion of a patient, and this paper presents a new technique for altering the vertical dimension based on the measured trajectory. Target materials for performing tracking are attached to the maxillary and mandibular anterior teeth to record opening and closing movements of the patient’s mouth in real time and align the patient’s scanned intraoral data or cast data. The movements of the targets are replaced with the movement of the patient’s oral scan data. Additionally, then the occlusal vertical dimension is set to a new position based on the obtained trajectory. After determining the optimal vertical dimension with consideration of the space required for restoration, maxillary and mandibular STL files are exported and the designed cast is created using a 3D printer. The printed cast is mounted on an articulator for subsequent procedures. This approach maintains the patient’s actual maxillomandibular relationship at various vertical heights and can also reduce the chair time required when adjusting for errors.

Accuracy of implant position reproduction according to various types of scanners, implant placement depths, and tooth positions are unknown. The purpose of this study was to compare the accuracy of implant position reproduction for differences in the exposed length of the implant scan body according to scanner type and tooth position. Implants were placed at the positions of the lateral incisor, first premolar, and first molar in the study model at the bone level and submerged 1.5 mm, 3.0 mm, 4.5 mm, and 6.0 mm. The completed models were scanned with one type of tabletop scanner and three types of intraoral scanners (TRIOS 3, i500, and CS3600). A matching process was performed for all scan data to superimpose abutment library data on the scan body, and the root mean square errors were analyzed in three dimensions to evaluate the position reproducibility of the replaced abutment library. In the trueness analysis, the error increased rapidly for an implant placement depth of 4.5 mm, and was largest for a submersion of 6.0 mm. The precision analysis confirmed that the error increased for depths of at least 3.0 mm. The analysis by position identified that the accuracy was lowest for an implant placed at the position of the lateral incisor. These findings indicate that special care is required when making an impression of a deep implant with an optical scanner.

The properties of underlying substrates influence the quality of an intraoral scan, but few studies have compared the outcomes using common restorative materials. In this study, we aimed to compare the accuracy of digital and conventional impressions recorded for four different dental materials as the substrates. Experimental crowns were produced with a metallic surface (gold or cobalt-chromium alloy (Co-Cr)) or without a metallic surface (zirconia or PMMA (polymethyl methacrylate)). A conventional impression was made in the conventional group (CON group), and gypsum models were subsequently scanned with a tabletop scanner. An intraoral scanner was used to scan the crowns either after applying a powder spray to reduce the surface reflectivity (IOS-P group) or without the powder spray (IOS group). The scans were assessed in three dimensions for precision and trueness. The accuracy did not differ between the CON and IOS groups for the non-metallic crowns. However, it was statistically different for the Co-Cr metallic crown, reducing trueness observed between groups as CON > IOS > IOS-P. The study evidences the differences in outer surface accuracy observed with a change in the substrate material to be imaged using an oral scanner and with the impression method. These findings suggest that the restoration material present in the oral cavity should be considered when selecting an impression-taking method.

In the absence of accurate medical records, it is critical to correctly classify implant fixture systems using periapical radiographs to provide accurate diagnoses and treatments to patients or to respond to complications. The purpose of this study was to evaluate whether deep neural networks can identify four different types of implants on intraoral radiographs. In this study, images of 801 patients who underwent periapical radiographs between 2005 and 2019 at Yonsei University Dental Hospital were used. Images containing the following four types of implants were selected: Brånemark Mk TiUnite, Dentium Implantium, Straumann Bone Level, and Straumann Tissue Level. SqueezeNet, GoogLeNet, ResNet-18, MobileNet-v2, and ResNet-50 were tested to determine the optimal pre-trained network architecture. The accuracy, precision, recall, and F1 score were calculated for each network using a confusion matrix. All five models showed a test accuracy exceeding 90%. SqueezeNet and MobileNet-v2, which are small networks with less than four million parameters, showed an accuracy of approximately 96% and 97%, respectively. The results of this study confirmed that convolutional neural networks can classify the four implant fixtures with high accuracy even with a relatively small network and a small number of images. This may solve the inconveniences associated with unnecessary treatments and medical expenses caused by lack of knowledge about the exact type of implant.

Purpose

Material and methods

Results

Conclusions

A facebow transfer is typically used for mounting a maxillary gypsum cast in an ideal location in a mechanical articulator. However, the facebow transfer procedure is difficult and may cause the patient discomfort. This proposed technique uses a patient’s cone beam computed tomography (CBCT) data to reproduce the occlusal plane in relation to digital articulator scan data, align the patient’s gypsum cast or intraoral scan data on the reproduced plane, and then transfer the data to a mechanical articulator.

Recent advances in three-dimensional (3D) printing have introduced new materials that can be utilized for dental restorations. Nonetheless, there are limited studies on the color stability of restorations using 3D-printed crowns and bridge resins. Herein, the color stability of conventional computer-aided design/computer-aided manufacturing (CAD/CAM) blocks and 3D-printing resins was evaluated and assessed for their degrees of discoloration based on material type, colorant types (grape juice, coffee, curry, and distilled water (control group)), and storage duration (2, 7, and 30 days) in the colorants. Water sorption, solubility, and scanning electron microscope (SEM) analyses were conducted. A three-way ANOVA analysis showed that all three factors significantly affected the color change of the materials. Notably, the discoloration (ΔE₀₀) was significantly higher in all 3D printing resins (4.74–22.85 over the 30 days) than in CAD/CAM blocks (0.64–4.12 over the 30 days) following immersion in all colorants. 3D-printing resins showed color differences above the clinical limit (2.25) following storage for 7 days or longer in all experimental groups. Curry was the most prominent colorant, and discoloration increased in almost all groups as the storage duration increased. This study suggests that discoloration must be considered when using 3D printing resins for restorations.

The amount of photopolymer material consumed during the three-dimensional (3D) printing of a dental model varies with the volume and internal structure of the modeling data. This study analyzed how the internal structure and the presence of a cross-arch plate influence the accuracy of a 3D printed dental model. The model was designed with a U-shaped arch and the palate removed (Group U) or a cross-arch plate attached to the palate area (Group P), and the internal structure was divided into five types. The trueness and precision were analyzed for accuracy comparisons of the 3D printed models. Two-way ANOVA of the trueness revealed that the accuracy was 135.2 ± 26.3 µm (mean ± SD) in Group U and 85.6 ± 13.1 µm in Group P. Regarding the internal structure, the accuracy was 143.1 ± 46.8 µm in the 1.5 mm-thick shell group, which improved to 111.1 ± 31.9 µm and 106.7 ± 26.3 µm in the roughly filled and fully filled models, respectively. The precision was 70.3 ± 19.1 µm in Group U and 65.0 ± 8.8 µm in Group P. The results of this study suggest that a cross-arch plate is necessary for the accurate production of a model using 3D printing regardless of its internal structure. In Group U, the error during the printing process was higher for the hollowed models.

Three-dimensional (3D) printing is increasingly being utilized in the dental field. After fabricating a prosthesis using a 3D printed resin, a post-curing process is required to improve its mechanical properties, but there has been insufficient research on the optimal post-curing conditions. We used various 3D printed crown and bridge materials in this study, and evaluated the changes in their properties according to post-curing time by evaluating the flexural strength, Weibull modulus, Vickers hardness, color change, degree of conversion, and biocompatibility. The obtained results confirmed that the strength of the 3D printed resin increased when it was post-cured for 60–90 min. The Vickers hardness, the degree of conversion, and biocompatibility of the 3D printed resins increased significantly around the beginning of the post-curing time, and then increased more gradually as the post-curing time increased further. It was observed that the color tone also changed as the post-curing time increased, with some groups showing a ΔE₀₀ value of ≥ 2.25, which can be recognized clinically. This study has confirmed that, after the printing process of a 3D printed resin was completed, a sufficient post-curing time of at least 60 min is required to improve the overall clinical performance of the produced material.

Esthetic dental computer-aided design/computer-aided manufacturing (CAD/CAM) polymers such as disperse-filled composites (DFC) and polymer-infiltrated ceramic networks (PICN) should be subjected to surface treatment before bonding. However, such treatment can lead to defect formation and a decrease in strength. Therefore, in this study, we compared the flexural strengths of DFC and PICN materials air-abraded with alumina particles of different sizes at different pressures. In addition to Weibull analysis, the samples (untreated and treated) were characterized by scanning electron microscopy and atomic force microscopy. Both DFC and PICN exhibited the lowest flexural strength at large particle sizes and high pressures. Therefore, we optimized the air abrasion parameters to maintain the flexural strength and significantly increase surface roughness. In the case of DFC, the optimal particle size and pressure conditions were 50 µm at 2 bar and 110 µm at 1 bar, while for PICN, the best performance was obtained using Al₂O₃ particles with a size of 50 µm at 1 bar. This study reveals that optimization of the surface treatment process is crucial in the fabrication of high-performance clinical materials for dental restorations.

During production of an immediate interim implant-supported fixed restoration with interim cylinders, the formation of an access hole in the dentures is critical. Traditional access hole formation involves repeated prosthesis insertion and removal in the oral cavity, primarily through trial and error, to adjust the hole position and size. The presented technique simulates the interim cylinder position based on the healing abutment position, enabling confirmation of the access hole position and ensuring more precise seating of the interim implant-supported fixed restoration.

Recently, digital technology has been used in dentistry to enhance accuracy and to reduce operative time. Due to advances in digital technology, the integration of individual mandibular motion into the mapping of the occlusal surface is being attempted. The Patient Specific Motion (PSM) is one such method. However, it is not clear whether the occlusal design that is adjusted using PSM could clinically show reduced occlusal error compared to conventional methods based on static occlusion. In this clinical comparative study including fifteen patients with a single posterior zirconia crown treatment, the occlusal surface after a clinical adjustment was compared to no adjustment (NA; design based on static occlusion), PSM (adjusted using PSM), and adjustment using a semi-adjustable articulator (SA) for the assessment of occlusal error. The root mean square (RMS; μm), average deviation value (±AVG; μm), and proportion inside the tolerance (in Tol; %) were calculated using the entire, subdivided occlusal surface and the out of tolerance area. Using a one-way ANOVA, the RMS and +AVG from the out of tolerance area showed a statistical difference between PSM (202.3 ± 39.8 for RMS, 173.1 ± 31.3 for +AVG) and NA (257.0 ± 73.9 for RMS, 210.9 ± 48.6 for +AVG). For the entire and subdivided occlusal surfaces, there were no significant differences. In the color-coded map analysis, PSM demonstrated a reduced occlusal error compared to NA. In conclusion, adjustment occlusal design using PSM is a simple and effective method for reducing occlusal errors that are difficult to identify in a current computer-aided design (CAD) workflow with static occlusion.

To simulate the current oral status of patients, including maxillofacial defects, the digital method described uses a method based on multisource data. These include data recorded from scans made with and without wearing an obturator and data obtained by scanning the surgical or interim obturator. This method eliminates the need for preliminary impressions and complex border-molding steps during the process of creating a definitive obturator, thereby greatly simplifying the fabrication process.

PURPOSE:

To evaluate differences in implant placement accuracy depending upon the presence or absence of metal restorations, as well as between distal extension and tooth-end cases.

MATERIALS AND METHODS:

Five experimental groups were designed with mandibular models exhibiting the following dental statuses: six anterior teeth and bilateral second molars, with bilaterally edentulous sites between them (group NN); six anterior teeth (group NDE); identical to group NN, with the six anterior teeth restored with metal crowns (group MN); identical to group NDE, with the six anterior teeth restored with metal crowns (group MDE); identical to group NN, with all remaining teeth restored with metal crowns (group MM). Six implants were placed on the bilateral first and second premolars and first molars; the linear and angular deviations between the preoperatively planned and actually placed implant positions were computed.

RESULTS:

Implant position errors were 0.55 to 0.87 mm and 0.53 to 0.80 mm at the entry point and apex, respectively, and were 0.35 to 0.71 mm and 2.02 to 3.12 degrees in depth and angular deviations, respectively. Significant differences were observed between groups NN and MM in overall deviations at the entry point (P = .009) and apex (P = .026), as well as in depth deviation (P = .008).

CONCLUSION:

The presence of metal restorations on all anterior and posterior remaining teeth resulted in significant differences in linear deviation at the entry point and apex between preoperatively planned and actually placed implant positions, compared with natural teeth without restorations. No significant differences were observed in placement accuracy between distal extension and tooth-end cases.

STATEMENT OF PROBLEM:

Zirconia is a widely used restorative material. However, phase transformation on clinical application of zirconia has not yet been studied.

PURPOSE:

The purpose of this study was to evaluate the wear, surface roughness, and aging associated with polished translucent zirconia in both in vitro and clinical experiments.

MATERIAL AND METHODS:

In vitro experiments were performed with Rainbow and Katana zirconia blocks and natural tooth enamel as the control. They were subjected to 100 000 loading cycles with a maxillary premolar antagonist. All specimens were analyzed for wear, and the zirconia specimens were evaluated for surface roughness and monoclinic phase (m-phase) transformation by X-ray diffractometry before and after cyclic loading. The clinical study included participants who required single-crown implant-supported restorations replacing the first or second molar. The participants received Rainbow or Katana zirconia prostheses (n=15, each). For wear analysis, impressions of each prosthesis, antagonist, and adjacent tooth were made at 1 week and 6 months after crown delivery. The occlusal relationship of the crowns in maximum intercuspation was evaluated by using the T-Scan 8 occlusal diagnostic system. The degree of transformation of zirconia to the m-phase was measured by using X-ray diffractometry of the crowns after 6 months of use.

RESULTS:

Zirconia induced significantly greater enamel wear than the natural tooth control. Katana specimens exhibited significantly greater wear and surface roughness than the Rainbow specimens. The degrees of antagonistic wear and zirconia phase transformation in the clinical experiment were significantly greater than those in the in vitro experiment. The Katana groups showed significantly higher m-phase levels than the Rainbow groups.

CONCLUSIONS:

Phase transformation of zirconia occurs within 6 months of clinical use, and the wear and degrees of phase transformation varied according to the zirconia product used.

The purpose of this technical report was to describe a method for the fabrication of a custom tray with landmark structures to coordinate cone beam computed tomography and scan data for use in guided implant surgery in patients with numerous artifact-causing metal prostheses. The fabricated custom tray can be used to coordinate cone beam computed tomography data and scan data from the dentition, as well as to fabricate the prostheses.

PURPOSE:

To introduce a new and simple digital workflow to record dynamic occlusion, and apply it to occlusal analysis and prosthetic treatment in a virtual environment.

METHODS:

A table-top scanner (Identica hybrid) was used to transfer fabricated casts into a virtual environment. A facial scanner (Rexcan CS2) was used for facial scanning and target tracking. Four targets were attached to each of the four incisors in the maxilla and mandible to track jaw movement. Target position data were recorded in real time during eccentric movement. The targets were replaced with maxilla and mandible cast scan data, and mandibular movement relative to the maxilla was reconstructed. Four types of antagonist meshes were reconstructed in computer-aided design (CAD) software (EzScan8). The CAD software (Exocad) enabled checking of occlusal contacts in the maximal intercuspation position during eccentric movement.

CONCLUSIONS:

Target tracking data were transformed into video clips of dental cast scan data, which showed jaw movements in real time. Occlusal contact information was produced by the CAD software. Both dynamic and static occlusion analyses were performed with reconstructed eccentric movement antagonist meshes. Our new method for reconstructing eccentric movements of the mandible can reveal the occlusal dynamics of a patient within a virtual environment.

OBJECTIVES:

The aim of the present study was to investigate the adaptation and guide hole tolerance of metal sleeve-free computer-assisted implant surgical guides fabricated with 3D printers.

METHODS:

An implant surgical guide for full-guided implant placement was designed with a total of eight different guide holes. Ten implant surgical guides (n=10) were fabricated from the same design with each of five in-office 3D printers (D1, FOR, ONE, PER, and ZEN) using compatible printing materials. Ten surgical guides fabricated by the manufacturer of the implant company were used as the control group (CON). The adaptation of the surgical guides was evaluated by the replica technique. The tolerance of the guide holes was evaluated by measuring the degree of diversion with guide drills.

RESULTS:

CON and D1 showed superior internal adaptation with a gap distance of less than 1mm. The mean degree of diversion of the guide holes ranged from 3.45° for ZEN to 6.55° for PER. The tolerances of CON (4.70°) and D1 (4.50°) did not differ at the level of statistical significance at α=0.05.

SIGNIFICANCE:

The characteristics of implant surgical guides were evaluated per se. None of the 3D printers fabricated superior implant surgical guides to those produced by the manufacturer with regard to the internal fit and guide tolerance. However, the potential for the routine clinical use of in-office 3D printers was demonstrated. Further studies are required to determine how the guide hole tolerance and the angular deviation between the preplanned and actual implant positions are related.

PURPOSE:

To determine the accuracy of a digital manufacturing method for dental implant restorations on stock abutments using intraoral scanners and prefabricated stock-abutment libraries.

MATERIALS AND METHODS:

Two dental implants with internal hexagonal connections were placed in the mandibular second premolar and second molar areas of a partially edentulous dentoform model; stock abutments with a diameter of 5 mm, abutment height of 5.5 mm, and gingival cuff height of 2 mm were connected. The study model was scanned 10 times using a reference tabletop scanner and 5 types of intraoral scanners (IOSs). The data collected by 5 types of IOSs were divided into 3 groups, based on the type and matching of stock abutment library data: no library, optical library, and contact library groups. A total of 160 data files were analyzed, including reference data. The resulting data were used to evaluate trueness and precision.

RESULTS:

Trueness and precision values in the group in which library data of the stock abutment were not used were 42.0 to 76.3 µm and 30.5 to 99.7 µm; corresponding values when the library data using an optical scanner were matched were 51.2 to 73.4 µm and 26.3 to 62.8 µm, and those when contact scanner library data were used were 30.1 to 62.4 µm and 15.5 to 55.9 µm. Thus, the accuracy of the contact library group was significantly higher than the accuracies of the no library (p < 0.001) and optical library groups (p < 0.001).

CONCLUSION:

The application of prefabricated library data of stock abutments using a contact scanner improved the accuracy of scan data. Scan accuracy of the stock abutments differed significantly based on the type of scanner.

Endodontic microsurgery is defined as the treatment performed on the root apices of an infected tooth, which was unresolved with conventional root canal therapy. Recently, the advanced technology in 3-dimensional model reconstruction based on computed tomography such as cone beam computed tomography has opened a new avenue in application of personalized, accurate diagnosis and has been increasingly used in the field of dentistry. Nevertheless, direct intra-oral localization of root apex based on the 3-dimensional information is extremely difficult and significant amount of bone removal is inevitable when freehand surgical procedure was employed. Moreover, gingival flap and alveolar bone fenestration are usually required, which leads to prolonged time of surgery, thereby increasing the chance of trauma as well as the risk of infection. The purpose of this case report is to present endodontic microsurgery using the guide template that can accurately target the position of apex for the treatment of an anterior tooth with calcified canal which was untreatable with conventional root canal therapy and unable to track the position of the apex due to the absence of fistula.

The technique described allowed an implant custom tray to be fabricated referencing the location of connected impression copings. The technique uses dental computer-aided design (CAD) software and 3D printing technology. The method controls the thickness of the impression material around the impression copings, improving the impression-making process.

PURPOSE:

This technical procedure describes a method for tracking mandibular movement using a three-dimensional (3D) optical scanner and target tracking system to digitally portray the motion of the mandible and temporomandibular joints by merging cone beam computed tomography (CBCT) data.

METHODS:

Four nonreflective targets were attached to the labial surface of the incisors in a noncolinear arrangement. Mandibular movement was tracked directly using a 3D facial scanner and target tracking software after merging facial scanning data, digital data obtained from a diagnostic cast, and CBCT scan data based on several landmarks of the anterior teeth. The moving path of the subjects’ mandible was converted to CBCT-based data to confirm the actual movement of the mandible and temporomandibular joints.

CONCLUSIONS:

The digital implementation of mandibular movement using a 3D optical scanner and target tracking system is not prone to the same restrictions and limitations inherent in mechanical equipment; therefore, it is possible to reconstruct more realistic movement(s). This technique can be used in a wide variety of dental applications involving movement of the mandibular jaw, such as fabrication of dental prostheses, or for the diagnosis and treatment of temporomandibular joint disease.

Various attempts have been made to transfer the transverse hinge axis and mandibular movement pattern to the mechanical articulator and to fabricate dental prostheses with the fewest errors. However, the occlusal adjustment of a dental prosthesis is always necessary to ensure a precise intraoral fit even when the facebow transfer technique is used in the cast mounting procedure. This is because the true hinge axis is not obtained when the facebow is applied to a patient who exhibits a variable mandible movement pattern rather than a single rotational axis. This technique merges facial scanning data and digital data obtained from a diagnostic cast based on measurements of several landmarks of the anterior teeth and makes it possible to design a dental prosthesis while considering the mandibular opening and closing movements of the patient. This technique could be used to design prosthetic restorations, occlusal splints, and intermediate splints for orthognathic surgery and for complete mouth rehabilitation when changes in vertical dimensions are needed.

This clinical report describes the management of a patient who had an excessively tight reconstructed lip because of oral cancer surgery and postoperative radiotherapy. The presented technique used an intraoral scanner for a preliminary impression and computer-aided design and computer-aided manufacturing (CAD-CAM) technology for preliminary laboratory procedures. This digital impression technique may reduce patient discomfort.

The aim of this study was to determine the effect of aging on the biaxial flexural strength (BFS) of Ce-TZP/Al₂O₃ and Y-TZP after occlusal adjustment. NanoZr block (Ce-TZP/Al₂O₃ nanocomposite) and Katana zirconia block (Y-TZP) were prepared by milling with the aid of CAD/CAM into disk-shaped specimens. For each type of zirconia, 16 specimens were prepared without grinding for the control group (diameter of 16 mm and thickness of 1.20±0.05 mm, mean±SD), while 48 specimens were prepared for 3 experimental groups (n=16 each; 16 mm in diameter and 1.50±0.05 mm thick) with different types of surface grinding: superfine diamond bur (group I), zirconia stone bur (group II), and zirconia stone and fine polishing bur (group III). These specimens underwent an aging process in a steam autoclave for 5 h at 0.2 MPa and 134 °C, and then X-ray diffractometry was applied along with measurements of surface roughness and BFS. After occlusal adjustment, the monoclinic phase percentage increased in 3 experimental groups. Overall the increase was greater for Ce-TZP/Al₂O₃ than for Y-TZP. The Ra value showed similar changes for both types of zirconia. Following the aging process, Y-TZP showed a greater increase in the monoclinic phase percentage, but the change was not statistically significant. The Ra value showed similar changes in both types of zirconia, with no significant differences between before and after the aging process. The results of the BFS test showed that applying the aging process after grinding significantly increased the strength of both types of zirconia, with Ce-TZP/Al₂O₃ being significantly stronger than Y-TZP. The specimens treated by a superfine diamond bur exhibited the highest BFS in the four tested groups. Ce-TZP/Al₂O₃ had a higher BFS and greater resistance to low-temperature degradation than did Y-TZP.

This study aimed to determine the appropriate pressure for airborne-abrasion by comparing the shear bond strength values for different hybrid ceramic surfaces. Two materials were used to produce hybrid ceramic specimens: Lava Ultimate and MAZIC Duro. The group of specimens whose surfaces were not subjected to airborne-abrasion was set as the control group. In the experimental group, airborne-abrasion was performed at pressures of 0.1, 0.2, and 0.3 MPa. After the adhesive and resin cement was applied, an SBS test was performed. For the MAZIC Duro block, the SBS increased monotonically with the airborne-abrasion pressure increased, peaking at 0.3 MPa. For the Lava Ultimate block, the SBS increased as the airborne-abrasion pressure increased to 0.2 MPa, and then decreased in the 0.3-MPa group, thereby peaking at 0.2 MPa. This study has confirmed that the bonding strength varies with the material used even when applying the same surface treatment.

Most digital prosthesis designs consider only the maximal intercuspal position (MIP) and not the lateral movement. During the computer-aided design and computer-aided manufacture (CAD-CAM) prosthesis delivery process, the clinician has to adjust the prosthesis to avoid occlusal interference during lateral excursion. The novel digital workflow described in this report can be divided into 2 steps. After obtaining interocclusal records for the MIP and the lateral excursion position, the crown CAD data were designed using a general digital workflow considering only the MIP. The previous crown CAD data were then adjusted in the lateral excursion state before manufacturing the prosthesis. This process using information for 2 occlusal positions means that the definitive prosthesis design reflects not only static occlusion but also lateral mandibular relation.

Converting a conventional removable partial dental prosthesis (RPDP) into an implant-assisted removable partial dental prosthesis (IARPDP) may be facilitated by using data from the intaglio surface of the RPDP for proper implant placement. This procedure can be done by connecting the data from the intaglio surface of the RPDP to the residual ridge data of the cone beam computed tomography scan with implant planning software. However, although a misplaced implant under an RPDP can cause various complications, as yet, no technique has connected the information on a patient’s existing RPDP to the implant planning software. This article presents computer-guided implant planning, using a patient’s existing RPDP.

The aim of this study was to evaluate the biomechanical behavior and long-term safety of high performance polymer PEKK as an intraradicular dental post-core material through comparative finite element analysis (FEA) with other conventional post-core materials. A 3D FEA model of a maxillary central incisor was constructed. A cyclic loading force of 50 N was applied at an angle of 45° to the longitudinal axis of the tooth at the palatal surface of the crown. For comparison with traditionally used post-core materials, three materials (gold, fiberglass, and PEKK) were simulated to determine their post-core properties. PEKK, with a lower elastic modulus than root dentin, showed comparably high failure resistance and a more favorable stress distribution than conventional post-core material. However, the PEKK post-core system showed a higher probability of debonding and crown failure under long-term cyclic loading than the metal or fiberglass post-core systems.

STATEMENT OF PROBLEM:

Intraoral scanners have been reported to have limited accuracy in edentulous areas. Large amounts of mobile tissue and the lack of obvious anatomic landmarks make it difficult to acquire a precise digital impression of an edentulous area with an intraoral scanner.

PURPOSE:

The purpose of this in vitro study was to determine the effect of an artificial landmark on a long edentulous space on the accuracy outcomes of intraoral digital impressions.

MATERIAL AND METHODS:

A mandibular model containing 4 prepared teeth and an edentulous space of 26 mm in length was used. A blue-light light-emitting diode tabletop scanner was used as a control scanner, and 3 intraoral scanners were used as experimental groups. Five scans were made using each intraoral scanner without an artificial landmark, and another 5 scans were performed after application of an artificial landmark (a 4×3 mm alumina material) on the edentulous area. The obtained datasets were used to evaluate trueness and precision.

RESULTS:

Without an artificial landmark on the edentulous area, the mean trueness for the intraoral scanner ranged from 36.1 to 38.8 μm and the mean precision ranged from 13.0 to 43.6 μm. With an artificial landmark on the edentulous area, accuracy was improved significantly: the mean trueness was 26.7 to 31.8 μm, and the mean precision was 9.2 to 12.4 μm.

CONCLUSIONS:

The use of an alumina artificial landmark in an edentulous space improved the trueness and precision of the intraoral scanners tested.

PURPOSE:

The aim of the present randomized controlled trial was to determine the safety and efficacy of injectable demineralized bone matrix (DBM) gel combined with recombinant human bone morphogenetic protein-2 (rhBMP-2) on alveolar ridge preservation after tooth extraction.

MATERIALS AND METHODS:

A total of 69 patients were randomly assigned to either a test group (n = 35) or a control group (n = 34). In the test group, DBM, together with rhBMP-2 (0.05 mg/mL; rhBMP-2/DBM) was transplanted into the extraction sockets. The control group received DBM alone. The safety of rhBMP-2/DBM was evaluated by oral examination, serum chemistry, and hematologic examination. The radiographic changes in alveolar bone height and width were measured using computed tomography scans performed immediately after transplant and again 3 months thereafter.

RESULTS:

Healing was uneventful in all subjects, with no anticipated adverse events and no clinically significant changes in the serum chemistry and hematologic findings. No meaningful immune response was found among the study groups. No significant difference was found in the radiographic changes of alveolar bone height and width (P > .05).

CONCLUSIONS:

This new injectable biomaterial can be used easily and safely in clinical applications.

With the advance of dental implant technology and the consequential increase in its success rate, the implant has become a highly predictable treatment method. Despite this, related complications are on the rise, with peri-implant mucositis and peri-implantitis being the most commonly observed. As in the case of conventional periodontitis, many patients experience peri-implant mucositis and peri-implantitis. In this case presentation, extensive bone loss occurred around the implant due to peri-implantitis, and the infection was first treated by applying chlorhexidine-soaked gauze and topical antibiotics. Then the guided bone regeneration procedure was performed using a bovine bone material and a collagen membrane, which resulted in the recovery of the lesion. With follow-ups of the healing process for 30 months, a successful outcome was observed that is reported herein.

OBJECTIVES:

The aim of this study was to evaluate the effect of anodized implants coated with combined rhBMP-2 and recombinant human vascular endothelial growth factors (rhVEGFs) on vertical bone regeneration in the marginal portion of the peri-implant.

STUDY DESIGN:

Supra-alveolar defects were created in 3 male beagle dogs. Each animal received 8 implants that were either coated with a single growth factor (rhBMP-2) or combined growth factors (rhBMP-2 + rhVEGF), or an anodized implant (the control group). The amount of the vertical bone regeneration, the bone-implant contact, and the intrathread bone density were investigated using histomorphometric analysis at 8 weeks.

RESULTS:

The bone morphogenetic protein (BMP) group and the BMP-VEGF group showed vertical alveolar bone regeneration and enhanced bone-implant contact in the microthread compared with the control group (P < .05).

CONCLUSIONS:

Anodized implants coated with rhBMP-2 and rhBMP – 2 + rhVEGF can induce vertical alveolar bone regeneration, but the combined effect of rhBMP-2 and rhVEGF was not verified.

Frequently reported is a case wherein a lesion caused by periodontitis or periapical lesion in a natural tooth enlarged, invaded the inferior alveolar nerve canal, and induced paresthesia. Cases wherein paresthesia occurred because of peri-implantitis have been rarely reported. The patient in this case report had experienced transient paresthesia after implant placement and recovered normal sensation 3 months later. Thirteen years later, this patient visited the authors’ hospital with paresthesia in the same region because the peri-implantitis progressed to the apex of the implant. One week after removal of the implant, sense recovery and pain relief started, and 15 days after removal, the paresthesia and pain completely disappeared. For patients who experience transient paresthesia and recovery owing to nerve damage caused by the placement of an implant in the mandibular molar or premolar area, or in patients in whom the implant is close to the inferior alveolar nerve canal or the mental nerve, the spread of inflammation caused by peri-implantitis can induce paresthesia.