Technology shaping the future of dentistry.

The art of dentistry and technological advancement in the fourth industrial revolution are interacting at a rapid pace, shaping the future of dentistry. The dental profession has integrated well with advancing technologies such as artificial intelligence (AI), augmented reality (AR), virtual reality (VR), three-dimensional (3D) printing, nanotechnology, and molecular biology resulting in oral healthcare services that are more accurate and predictable. It has enhanced the reach of dental services, made it sustainable, and energy efficient, reducing the carbon foot prints. This communication focuses on recent technological advancements and their influence on oral healthcare services.

Efficacy of titratable mandibular advancement device versus continuous positive airway pressure therapy in the treatment of obstructive sleep apnea: A clinical crossover trial.

Background: To compare efficacy of continuous positive airway pressure (CPAP) and oral appliance (OA) in management of various grades of obstructive sleep apnea (OSA). Methods: Thirty polysomnography diagnosed cases of OSA were divided into three groups based on baseline apnea hypopnea index (AHI) as follows: group 1: mild OSA (AHI = 5-14.9), group 2: moderate OSA (AHI = 15-29.9), and group 3: severe OSA (AHI >30) with 10 patients in each group. Half of the patients in each group were randomly allocated to CPAP or OA therapy, and crossover of therapy was performed after two months. AHI, Epworth's Sleepiness Scale (ESS), and mean oxygen saturation (SPO2) were measured at baseline, after each arm of treatment and after the crossover. A questionnaire survey including information regarding pretreatment sleep symptoms and improvement after therapy was performed at above time frames. At the end of therapy, the patients were surveyed regarding satisfaction and perceived effectiveness with both modalities. Results: CPAP was more efficacious in reducing AHI and SPO2 as compared with OA across the three study groups. The improvement in most sleep-related symptoms was higher with CPAP. The satisfaction and perception on effectiveness of treatment were higher with OA than CPAP across three study groups (P-value<0.05 for all). Conclusions: OA is an effective alternative to CPAP across all grades of OSA in selected cases, which is more preferred owing to higher effectiveness and satisfaction among the patients.

Bony bridge resorption after secondary alveolar grafting and correlation with success of orthodontic treatment: A prospective volumetric cone beam computed tomography (CBCT) study.

BACKGROUND: Cleft lip/palate is the second most observed congenital defect which constitutes a serious dental-medical-social problem. Successful uptake and stability of alveolar graft is required to achieve closure of the oro-nasal fistula and continuity of the dental arches. Resorption of bone graft may compromise the results achieved. This study determined the bony bridge volume required for successful repair of alveolar cleft, evaluated the resorption after 3 months of grafting and correlated the success of orthodontic treatment. METHODS: 30 patients with unilateral cleft lip and palate requiring secondary alveolar bone grafting and orthodontic correction were included in the study. After arch expansion and before alveolar grafting using cone beam computed tomography (CBCT) of maxilla was recorded and was repeated after 3 months of alveolar bone grafting to estimate the volume of grafted bone in the cleft. RESULTS: The bridge bone volume resorption after 3 months post-operative ranged from 14% to 100% with a mean of 36.46%. The percentage of resorption of alveolar bone graft after 3 months of surgery was statistically significant. Success of orthodontic treatment was statistically significant when correlated with percentage of resorption. CONCLUSION: The accurate localization and estimation of the size and extent of alveolar cleft area is important for treatment planning. Post-operative it is important to analyze the outcome of transplanted bone as early as possible. Early evaluation can help to predict the outcome of transplanted bone and may guide to re-grafting of the site immediate or to restart any interrupted orthodontic procedure, if necessary.

Comparative evaluation of anchorage reinforcement between orthodontic implants and conventional anchorage in orthodontic management of bimaxillary dentoalveolar protrusion.

BACKGROUND: Increased upper lip procumbency is commonly associated with maxillary dentoalveolar protrusion with the major goal of reducing maxillary dentoalveolar protrusion. The treatment plan usually includes extraction of the maxillary first premolars, followed by retraction of anterior teeth with maximum anchorage. Dental implants have been widely accepted as successful adjuncts for obtaining maximum anchorage in orthodontic treatment. METHODS: 50 subjects between the ages of 13 and 17 years having bimaxillary dentoalveolar protrusion were included in the study. The patients were divided into two groups. Both groups received treatment with 0.022″ MBT prescription preadjusted edgewise appliance system. In addition, subjects of Group 'I' received the Nance button and lingual arch as anchorage reinforcement in the upper and lower arches, respectively. Subjects of Group 'II' received self-drilling titanium OI for anchorage reinforcement. RESULTS: Significant retraction was achieved in all cases with good vertical control. Anchor loss was observed in both groups. Anchor loss was much higher in Group I compared to Group II, and an intergroup comparison for anchor loss was highly significant. CONCLUSION: Implants as anchorage, for en masse retraction, can be incorporated into orthodontic practice. The use of orthodontic implants for anchorage is a viable alternative to conventional molar anchorage.

Rate of intrusion of maxillary incisors in Class II Div 1 malocclusion using skeletal anchorage device and Connecticut intrusion arch.

BACKGROUND: Nonsurgical correction of deep bite involves either extrusion of posterior teeth, intrusion of incisors, or combination of both. The introduction of skeletal anchorage device with microimplant provides near absolute anchorage without producing any untoward effects on anchor unit. Connecticut Intrusion Arch (CIA) provided an efficient system of intruding anterior segment without producing much adverse affects on anchor teeth. METHODS: The study comprised of 30 patients of Class II Div 1 malocclusion with overbite of >6 mm and required therapeutic extractions of all first premolars, randomly distributed into two groups. Group 1 was treated using orthodontic microimplants, while Group 2 treated with CIA. Lateral cephalograms were taken pre-intrusion (T1) and post-intrusion at the end of six months (T2). RESULTS: The rate of intrusion was 0.51 and 0.34 mm/month for Group 1 and Group 2 respectively. The average amount of change in centroid point to PP distance and U1-SN angle was significantly higher in Group 1 compared to Group 2 (P < 0.001). The average amount of change in U6 to PP distance did not differ significantly between two study groups (P > 0.05). CONCLUSION: The amount of intrusion is significantly higher in SAD group. Although vertical molar positional change was higher in CIA group than the SAD group, it was not changed significantly in both treatment modalities. SAD group overall had better results and was easier in handling during intrusion.