Assessment of the fit of lithium disilicate crowns at various locations fabricated by three different methods using the triple-scan protocol.

AIM: The present study aimed to evaluate the marginal and internal fit of lithium disilicate crowns at various locations. MATERIALS AND METHODS: A typodont maxillary left first molar was prepared for a lithium disilicate crown, scanned, and a master die fabricated. Three groups were created according to fabrication method (n = 10): conventional impression and press method (group C); scanning of definitive cast and milling method (group D); and intraoral scanning and milling method (group I). Assessment was performed using the triple-scan protocol. At the buccopalatal and mesiodistal sections, the absolute marginal discrepancy (AMD), marginal gap (MG), axial internal gap (AI), and line angle internal gap (LI) were measured. One-way analysis of variance (ANOVA) and post hoc Tukey HSD tests were used for statistical analysis (α = 0.05). RESULTS: AMD values were significantly lower in group C than in groups D and I (P < 0.05). MG values in group C were significantly lower than those in the buccal and distal areas in group D and all areas in group I (P < 0.05). AI values in the buccal and palatal areas in group D were significantly lower than those in the mesial and distal areas in group D and all areas in groups C and I (P < 0.05). LI values were significantly lower in group C than in groups D and I (P < 0.05). CONCLUSION: All three methods were clinically acceptable except for the marginal fit of the intraoral scanning and milling method, which was on the borderline of a clinically acceptable fit. (Int J Comput Dent 2023;26(1): 37-0; doi: 10.3290/j.ijcd.b3818305).

Clinical and histological evaluation of microneedle fractional radiofrequency treatment on facial fine lines and skin laxity in Koreans.

BACKGROUND: Facial wrinkles and sagging are the most visible signs of aging and can cause profound distress. Microneedle fractional radiofrequency (MFR) is a minimally invasive procedure, which utilizes both microneedling and radiofrequency energy to rejuvenate the skin. OBJECTIVE: To describe the safety and efficacy of a temperature-controlled MFR device on facial fine lines and laxity. PATIENTS AND METHODS: A retrospective chart & histology review was performed on individuals who received bipolar MFR for facial rejuvenation. A total of 15 Koreans with a median age of 46 years were included. All participants underwent a single treatment session. The results were assessed objectively using serial photography and subjectively based on the participants' satisfaction scores. Histologic changes before, immediately after MFR and at 4 months follow-up was examined. Complications were also recorded. RESULTS: Partially denatured collagen fibers and dermal shrinkage was observed immediately after MFR whereas an increase in elastin and collagen was noted at 4 months follow-up. 86.7% of recipients considered the results satisfactory. Consensus ratings by two independent dermatologists on the objective outcomes at 4-month follow-up were very much improved (53.3%), much improved (26.7%) and improved (20%). Treatment was well tolerated and did not cause any significant long-lasting discomfort. CONCLUSION: Temperature-controlled bipolar MFR is a minimally invasive treatment option to consider for facial fine lines and laxity via neo-collagenesis and neo-elastogenesis. The procedure was safe and clinically effective.

Reliability of automatic finish line detection for tooth preparation in dental computer-aided software.

PURPOSE: This study aimed to investigate the accuracy of automatic tooth finish line registration compared to manual registration with regard to various finish line configurations and dental computer-aided design (CAD) software. METHODS: Finish line registrations were performed on 15 digital tooth models with different finish line configurations (edge roundness radius = 0 mm, 0.2 mm, and 0.4 mm; edge angle = 30°, 60°, 90°, 120°, and 150°) using automatic and manual methods for designing virtual copings (N = 150). The discrepancies between the registered finish line extracted from the copings and the actual finish line segmented from the digitized tooth model were measured. Three-way analysis of variance (ANOVA) and post-hoc analyses with Bonferroni correction (α = 0.05) were used to analyze the results. RESULTS: The finish line configurations, registration methods, and CAD software interacted with the accuracy of the registered finish line (p = 0.001). The automatic finish line registration method exhibited larger error values than the manual method, especially at high finish line edge roundness and obtuse edge angles for both EXOCAD and R2CAD software (p < 0.001). The difference in dental CAD software affected the registration accuracy in the automatic method (p < 0.001), but not in the manual method (p = 0.676). CONCLUSIONS: Finish line registration errors may occur when the automatic registration method is applied to the indistinct edge of tooth preparation. The accuracy of the automatic finish line registration could differ according to the CAD software program.

Lactobacillus lactis and Pediococcus pentosaceus-driven reprogramming of gut microbiome and metabolome ameliorates the progression of non-alcoholic fatty liver disease.

BACKGROUND: Although microbioa-based therapies have shown putative effects on the treatment of non-alcoholic fatty liver disease (NAFLD), it is not clear how microbiota-derived metabolites contribute to the prevention of NAFLD. We explored the metabolomic signature of Lactobacillus lactis and Pediococcus pentosaceus in NAFLD mice and its association in NAFLD patients. METHODS: We used Western diet-induced NAFLD mice, and L. lactis and P. pentosaceus were administered to animals in the drinking water at a concentration of 109 CFU/g for 8 weeks. NAFLD severity was determined based on liver/body weight, pathology and biochemistry markers. Caecal samples were collected for the metagenomics by 16S rRNA sequencing. Metabolite profiles were obtained from caecum, liver and serum. Human stool samples (healthy control [n = 22] and NAFLD patients [n = 23]) were collected to investigate clinical reproducibility for microbiota-derived metabolites signature and metabolomics biomarker. RESULTS: L. lactis and P. pentosaceus supplementation effectively normalized weight ratio, NAFLD activity score, biochemical markers, cytokines and gut-tight junction. While faecal microbiota varied according to the different treatments, key metabolic features including short chain fatty acids (SCFAs), bile acids (BAs) and tryptophan metabolites were analogously restored by both probiotic supplementations. The protective effects of indole compounds were validated with in vitro and in vivo models, including anti-inflammatory effects. The metabolomic signatures were replicated in NAFLD patients, accompanied by the comparable levels of Firmicutes/Bacteroidetes ratio, which was significantly higher (4.3) compared with control (0.6). Besides, the consequent biomarker panel with six stool metabolites (indole, BAs, and SCFAs) showed 0.922 (area under the curve) in the diagnosis of NAFLD. CONCLUSIONS: NAFLD progression was robustly associated with metabolic dys-regulations in the SCFAs, bile acid and indole compounds, and NAFLD can be accurately diagnosed using the metabolites. L. lactis and P. pentosaceus ameliorate NAFLD progression by modulating gut metagenomic and metabolic environment, particularly tryptophan pathway, of the gut-liver axis.

Effect of Korean Red Ginseng on metabolic syndrome.

Metabolic syndrome (MS) refers to a clustering of at least three of the following medical conditions: high blood pressure, abdominal obesity, hyperglycemia, low high-density lipoprotein level, and high serum triglycerides. MS is related to a wide range of diseases which includes obesity, diabetes, insulin resistance, cardiovascular disease, dyslipidemia, or non-alcoholic fatty liver disease. There remains an ongoing need for improved treatment strategies for MS. The most important risk factors are dietary pattern, genetics, old age, lack of exercise, disrupted biology, medication usage, and excessive alcohol consumption, but pathophysiology of MS has not been completely identified. Korean Red Ginseng (KRG) refers to steamed/dried ginseng, traditionally associated with beneficial effects such as anti-inflammation, anti-fatigue, anti-obesity, anti-oxidant, and anti-cancer effects. KRG has been often used in traditional medicine to treat multiple metabolic conditions. This paper summarizes the effects of KRG in MS and related diseases such as obesity, cardiovascular disease, insulin resistance, diabetes, dyslipidemia, or non-alcoholic fatty liver disease based on experimental research and clinical studies.

Setting the Sagittal Condylar Inclination on a Virtual Articulator Using Intraoral Scan of Protrusive Interocclusal Position and Cone Beam Computed Tomography.

The articulator is a prerequisite device for the analysis of occlusion and prosthodontic treatment, and it is required to simulate patient jaw movements. This article describes the technique to obtain sagittal condylar inclination (SCI) using cone beam computed tomography (CBCT) data and intraoral scan of the protrusive interocclusal position. The SCI can be used on a virtual articulator in a computer-aided design software, and it can assist in the fabrication of prosthesis which is harmonious with the mandibular movement of individual patient.

Combining Conventional Impressions and Intraoral Scans: A Technique for the Treatment of Complete Denture Patients with Flabby Tissue.

The conventional method for impressions of flabby tissue uses modified trays and highly flowable materials, but mucostatic impressions are difficult to achieve due to the viscous and the elastic natures of impression materials. In this report, a technique is presented in which conventional impression and intraoral scanning for a fully edentulous patient with flabby tissue are combined. The definitive impression was obtained by applying appropriate pressure to each tissue area, and the denture can be maintained passively and stable at rest and during function.

A simplified method for evaluating the 3-dimensional cement space of dental prostheses by using a digital scanner.

Evaluating the cement space of various dental prostheses is important because it is related to the stability and retention of the prosthesis. However, a method for evaluating an overall cement space is complex. The purpose of this technique was to simplify the evaluation of prosthesis cement space by using a digital scanner. The form and thickness of the cement space could be simply recognized in any section the clinician or dental researcher wishes. Moreover, the cement space of several dental prostheses for the same abutment could also be precisely evaluated by superimposition. The method can be applied to various prosthodontic treatments.

Fabrication of a CAD/CAM monolithic zirconia crown to fit an existing partial removable dental prosthesis.

Fabricating a surveyed prosthesis beneath an existing partial removable dental prosthesis (PRDP) is a challenging and time-consuming procedure. The computer-aided design/computer-assisted manufacturing (CAD/CAM) technology was applied to fabricate a retrofitted, surveyed zirconia prosthesis to an existing PRDP. CAD/CAM technology enabled precise and easy replication of the contour of the planned surveyed crown on the existing abutment tooth. This technology ensured excellent adaptation and fit of newly fabricated crown to the existing PRDP with minimal adjustments. In this case report, a seventy-year-old male patient presented with fractured existing surveyed crown. Because the existing PRDP was serviceable, new crown was fabricated to the existing PRDP.

Comparative Analysis of Screw Loosening With Prefabricated Abutments and Customized CAD/CAM Abutments.

PURPOSE: The aim of this study was to determine the stability of computer-aided design and manufacturing (CAD/CAM) and prefabricated abutment by measuring removal torque before and after cyclic loading. MATERIALS AND METHODS: Three types of fixture and 2 types of abutments were used. Removable torque was measured after cyclic loading for 5000 cycles between 25 and 250 N for each group. The same procedure was performed twice. RESULTS: First, removal torque values (Newton centimeter) were measured for stock versus custom abutments as follows: group 1: 27.17 versus 26.67, group 2: 26.27 versus 26.33, and group 3: 37.33 versus 36.67. Second removal torque values (Newton centimeter) were also measured: group 1: 23 versus 23.5, group 2: 22.5 versus 22.33, and group 3: 32.67 versus 32.5. There was no significant difference between the stock and custom abutments in either the first or second removal torque values and also no significant difference among initial tightening torque, first or second removal torque (P > 0.05). CONCLUSION: With precise control of CAD/CAM abutments, good screw joint stability can be achieved.

Accurate transfer of soft tissue morphology with interim prosthesis to definitive cast.

With conventional fixed dental prostheses, the interim restoration is a valuable diagnostic tool in the evaluation of esthetics and function. To achieve predictable definitive esthetic results, information about the subgingival and the supragingival contour of a properly designed restoration should be communicated to the dental laboratory technician. The technique described enables the accurate transfer of the soft tissue morphology developed with an interim prosthesis to the definitive cast. This modified definitive cast allows the dental laboratory technician to fabricate a restoration with an emergence profile identical to that of the interim prosthesis.

Effect of implant position, angulation, and attachment height on peri-implant bone stress associated with mandibular two-implant overdentures: a finite element analysis.

PURPOSE: The aim of this study was to analyze and compare the level and distribution of peri-implant bone stresses associated with mandibular two-implant overdentures with different implant positions. MATERIALS AND METHODS: Mathematical models of mandibles and overdentures were designed using finite element analysis software. Two intraosseous implants and ball attachment systems were placed in the interforaminal region. The overdenture, which was supported by the two implants, was designed to withstand bilateral and unilateral vertical masticatory loads (total 100 N). In all, eight types of models, which differed according to assigned implant positions, height of attachments, and angulation, were tested: MI (model with implants positioned in the lateral incisor sites), MC (implants in canine sites), MP (implants in premolar sites), MI-Hi (greater height of attachments), MC-M (canine implants placed with mesial inclination), MC-D (canine implants placed with distal inclination), MC-B (canine implants placed with buccal inclination), and MC-L (canine implants placed with lingual inclination). RESULTS: Peri-implant bone stress levels associated with overdentures retained by lateral incisor implants resulted in the lowest stress levels and the highest efficiency in distributing peri-implant stress. MI-Hi showed increased stress levels and decreased efficiency in stress distribution. As the implants were inclined, stress levels increased and the efficiency of stress distribution decreased. Among the inclined models, MC-B showed the lowest stress level and best efficiency in stress distribution. CONCLUSION: The lowest stress and the best stability of implants in mandibular two-implant overdentures were obtained when implants were inserted in lateral incisor areas with shorter attachments and were placed parallel to the long axes of the teeth.

The prosthetic rehabilitation of a panfacial fracture patient after reduction: a clinical report.

Panfacial fractures involve trauma to the lower, middle, and upper facial bones and often require a team approach for management. Early and complete restoration of preinjury facial contours and function should be the goal of the oral and maxillofacial surgeon and the prosthodontist. When the intraoral landmarks are lost, overall facial anatomic landmarks can be used to restore the oral cavity. A patient with complex clinical panfacial fractures, including a vertically and horizontally malpositioned native alveolar bone and severe facial asymmetry, is presented. A functional and esthetic rehabilitation was successfully accomplished by using a partial removable dental prosthesis retained with telescopic crowns and magnetic attachments in the maxilla and osseointegrated implants to support a definitive dental prosthesis in the mandible.

Osteoblast-like cell attachment and proliferation on turned, blasted, and anodized titanium surfaces.

PURPOSE: The purpose of this study was to investigate the cellular activities of MG63 osteoblast-like cells on modified titanium surfaces. MATERIALS AND METHODS: MG63 osteoblast-like cells were cultured on titanium disks (n = 20 in each group) with turned, resorbable blast media (RBM)-treated, or anodized surfaces. The surfaces of commercially available implants of Osstem (Osstem Implant) were reproduced for the titanium disks. The morphology of cells cultured on these disks was examined using scanning electron microscopy. X-ray photoelectron spectroscopy (XPS) was employed for the analysis of surface chemistry. Specimens were also evaluated with an initial cell adhesion assay to compare initial adhesion, with a methyl tetrazol sulfate (MTS) assay to compare the proliferation ability, and with an alkaline phosphatase (ALP) assay to compare the differentiation ability. Statistical significance of the differences was determined using the Kruskal-Wallis test for the cell adhesion assay and analysis of variance for the MTS and ALP assays. RESULTS: Attached cells with more defined lamellopodia and flattened morphology were observed on the anodized and RBM surfaces than on the turned surfaces. The titanium surfaces were all oxidized as titanium oxide and polluted by carbon determinants, as determined by XPS. Anodized titanium surfaces exhibited calcium and phosphorus peaks. Initial cell attachment activity, cell proliferation activity, and ALP activity were higher on the anodized surfaces than on the other surfaces. Cell differentiation on the anodized surfaces at culture day 10 was significantly higher (P < .05) than on the other surfaces. CONCLUSIONS: Surface treatment by anodization may improve initial attachment of cells, proliferation ability, and differentiation activity, which play important roles in providing better osseointegration of implants. More rapid and stronger osseointegration of implants may make it possible to offer the best anchorage and shorten the healing time required prior to functional loading.

Overdenture restoration in a growing patient with hypohidrotic ectodermal dysplasia: a clinical report.

Ectodermal dysplasia is a hereditary disorder of ectodermal origin. A 12-year-old boy was referred for management of the oral manifestations of his ectodermal dysplasia. An overdenture retained by natural teeth for the maxilla and a double-crown-retained denture for the mandible were made. Double-crown-retained dentures may be modified into complete dentures if the abutment teeth are lost. The patient was instructed to maintain oral hygiene and return periodically for follow-up visits. This report describes a potential routine approach to restoring the appearance, function, and psyche of a growing boy with ectodermal dysplasia.

Attachment and growth behaviour of human gingival fibroblasts on titanium and zirconia ceramic surfaces.

The attachment, growth behaviour and the genetic effect of human gingival fibroblasts (HGF) cultured on titanium and different zirconia surfaces were investigated. HGF cells were cultured on (1) titanium discs with a machined surface, (2) yttrium-stabilized tetragonal zirconia polycrystals (Y-TZP) with a smooth surface and (3) Y-TZP with 100 microm grooves. The cell proliferation activity was evaluated through a MTT assay at 24 h and 48 h, and the cell morphology was examined by SEM. The mRNA expression of integrin-beta1, type I and III collagen, laminin and fibronectin in HGF were evaluated by RT-PCR after 24 h. From the MTT assay, the mean optical density values for the titanium and grooved zirconia surfaces after 48 h of HGF adhesion were greater than the values obtained for the smooth zirconia surfaces. SEM images showed that more cells were attached to the grooves, and the cells appeared to follow the direction of the grooves. The results of RT-PCR suggest that all groups showed comparable fibroblast-specific gene expression. A zirconia ceramic surface with grooves showed biological responses that were comparable to those obtained with HGF on a titanium surface.