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Chairside 3D digital design and trial restoration workflow

The Journal of Prosthetic Dentistry

Available online 7 January 2020

The Journal of Prosthetic Dentistry

Abstract

Different digital tools have been used in clinical practice to assist in the planning and rehabilitation of patients. Some applications (apps) and software programs used in esthetic planning allow simulation of the smile design, improving communication between patients and professionals. Nonetheless, they are usually difficult to use, time-consuming, unattractive to present to the patient, and complicated to link with the 3D workflow. This article presents a new 3D digital smile design app for esthetic planning, smile simulation, chairside 3D virtual wax pattern, and trial restoration performed with portable devices. In this technique description, a facial frontal photograph, a facial scan standard tessellation language (STL) file, and a maxillary intraoral scan STL file were uploaded to the app. The files were calibrated to each other to allow a 3D facially driven smile design project. The definitive maxillary 3D digital waxing of facial templates was exported to a 3D printer as an STL file. The printed resin templates were directly placed in the mouth with flowable composite resin for an immediate trial restoration without the need for casts, silicone guides, or autopolymerizing resin. The workflow presented in this article linked the 3Dapp project to a printer and allowed straightforward chairside trial restorations.

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Tissue surface adaptation of CAD-CAM maxillary and mandibular complete denture bases manufactured by digital light processing: A clinical study

The Journal of Prosthetic Dentistry

Available online 8 January 2020

The Journal of Prosthetic Dentistry

Abstract

Statement of problem

Clinical studies evaluating the tissue surface adaptation of complete denture bases fabricated by digital light processing (DLP) are lacking.

Purpose

The purpose of this clinical study was to assess the tissue surface adaptation of complete denture bases generated by the DLP technique and to compare the adaptation with that of denture bases manufactured by 5-axis milling (MIL) and pack-and-press (PAP) method.

Material and methods

A total of 9 participants with 12 edentulous arches (7 maxillary and 5 mandibular) were included in this study. For each edentulous arch, the complete denture bases with occlusion rims were prepared by 3 different techniques (PAP, MIL, and DLP). A virtual denture base with occlusion rim was designed by means of a digital subtraction tool and served to fabricate the DLP and MIL denture bases. The complete denture bases were placed intraorally with an indicator applied to the intaglio surfaces. The thickness of the indicator was measured within the denture-bearing areas and anatomic landmarks of the edentulous arch to obtain the absolute tissue surface adaptation (ATA) value. The relative tissue surface adaptation (RTA) value was calculated from the differences between the ATA values of DLP or MIL techniques and those of the PAP technique. The Kruskal-Wallis test and the McNemar test were used for statistical analysis (α=.05).

Results

No statistically significant differences were found among the 3 denture base fabrication techniques with respect to the ATA values of either arch (P>.05). In terms of the RTA values for the maxillary arch, the DLP base was significantly different from the MIL base in the RC and P areas (both P<.05). The DLP base exhibited a higher frequency of negative RTA values than the MIL base. Regarding the RTA values for the mandibular arch, no significant differences were detected between the DLP and MIL denture bases (P>.05).

Conclusions

The DLP and MIL denture bases demonstrated clinically acceptable tissue surface adaptation to both edentulous the maxilla and mandible. The DLP denture base was likely to exhibit intimate tissue adaptation in the stress-bearing areas of maxillary arches compared with the PAP denture base. The maxillary MIL denture base was likely to exhibit small gaps between the supporting tissue and denture base. Both DLP and MIL mandibular denture bases were likely to show intimate adaptation on the lingual slope compared with the PAP base.
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Formlabs Launches Formlabs Dental and Form 3B Printer

The Form 3B is able to print using the latest generation of seven dental materials and can create devices for over ten dental applications, including:

  • Crown and bridge models
  • Clear aligner and retainer models
  • Diagnostic models
  • Surgical guides
  • Occlusal splints
  • Patterns for casting and pressing
  • Dentures with 4 base and 6 tooth shades

According to Formlabs CEO and Co-Founder Max Lobovsky, “Our new Form 3B printer is uniquely tailored to seamlessly digitize, streamline and expedite workflow so dentists and technicians can focus on providing patients with the outcomes they expect and deserve.” On the shift towards in-office printing facilitated by Formlabs’ technology, Dr. Jay Burton, Board Certified Orthodontist at SmileMaker Orthodontics, adds, “Since launching the Form 2, 3D printing adoption within the dental industry has increased significantly… Today’s announcement of the Form3B will continue to grow the technology’s adoption and help to provide dental products you’d be proud to deliver.”
On the service side of Formlabs Dental, the business unit will leverage its team of dental professionals to offer a new Formlabs Dental Service Plan. The plan includes personalized in-person and video training, priority multichannel support, and printer hot swapping to ensure continuous production.
As part of the announcement, Formlabs also announced its Formlabs Materials Partner Platform specifically for the Form B. The platform allows third-party manufacturers to bring new materials to market by making them available as part of the Form 3B’s suite of compatible material

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Clinical evaluation of a self-etch and an etch-and-rinse adhesive system in class V noncarious composite restorations

Balbinot CE, Antoniazzi RP, Parode JT, Farias Ld, Zamboni C, Skupien JA. Clinical evaluation of a self-etch and an etch-and-rinse adhesive system in class V noncarious composite restorations. Eur J Gen Dent [serial online] 2020 [cited 2020 Jan 7];9:23-7. Available from: http://www.ejgd.org/text.asp?2020/9/1/23/274666

Context: Adhesive restorations in cervical, noncarious, and nonretentive cavities are used as a clinical model for the evaluation of adhesive systems.  

Aim: The aim of this study is to evaluate restorations made by dental students of the last year of dentistry made with a self-etching and etching-and-rinse adhesive system.

Materials and Methods: Eighty-two noncarious cervical lesions Class V cavities were restored after randomly be allocated into two adhesive groups: self-etch (AdheSe self-etch) or an etch-and-rinse (Tetric N-Bond). Operators were two well-trained students of the last year of dental school and the restorations were evaluated using a single examiner, specialist in restorative dentistry, blinded and calibrated using the criteria according to the modified United States Public Health Service. Descriptive analysis, Chi-square test to evaluate associations, and survival analysis by the Kaplan–Meier were used for statistical analysis.  

Results: There was no statistically significant difference in the evaluation of adhesive systems in Class V restorations (P = 0.160). There was also no statistically difference (P = 0.751) in the assessment of the existence of occlusal interference on lateral movement and loss of restorations. The survival rate calculated for the total restorations was 89%. The survival rate of the restorations when used etch-and-rinse adhesive systems was 92.7% while with the self-etching of 85.4%. Nine restorations were classified as lost, and one restoration cannot be assessed due to the patient having it replaced before evaluation, and the other eight restorations were lost getting the score Charlie for retention.  

Conclusions: Class V dental restorations had a satisfactory survival rate irrespective of the adhesive system.

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Evaluation of ozone as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A randomized clinico-microbial study

Vasthavi C, Babu HM, Rangaraju VM, Dasappa S, Jagadish L, Shivamurthy R. Evaluation of ozone as an adjunct to scaling and root planing in the treatment of chronic periodontitis: A randomized clinico-microbial study. J Indian Soc Periodontol [serial online] 2020 [cited 2020 Jan 7];24:42-6. Available from: http://www.jisponline.com/text.asp?2020/24/1/42/269576

Background and Objectives: Mechanical plaque control is an essential part of periodontal therapy. In the present study, the efficacy of ozone water irrigation as an adjunct to scaling and root planing was evaluated in the treatment of generalized chronic periodontitis.  

Materials and Methods: Twenty-four patients with chronic periodontitis selected for the study were randomly divided into Group A and Group B, receiving ozone water irrigation and distilled water irrigation, respectively, after scaling and root planing. Subgingival plaque was collected from the selected investigational teeth and was analyzed using BANA-Zyme™ Processor to evaluate the “red complex” periodontal pathogens. The clinical and microbiological parameters were recorded at baseline, 14 days, 21 days, and 2 months.  

Results: The mean probing pocket depth scores for Group A and Group B at the baseline were 6.833 ± 1.193 and 7.833 ± 1.276; on day 14th, they were 6.616 ± 1.403 and 7.083 ± 1.378; on day 21st, they were 5.166 ± 0.937 and 6.083 ± 1.443;and on the 2nd month, they were 4.500 ± 0.797 and 5.166 ± 1.029, respectively. At the 2nd month, in Group A, 9 samples showed BANA negative and 3 samples showed BANA positive, and in Group B, 12 samples showed BANA negative and 0 sample showed BANA positive. The microbiological analysis showed a reduction in periodontal pathogens in both the groups.  

Conclusion: Significant improvement in both clinical and microbiological parameters suggests that subgingival ozonated water irrigation could be an efficient adjunct to scaling and root planing in the treatment of chronic periodontitis.

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