In vitro scanning accuracy using different aids for multiple implants in the edentulous arch.

OBJECTIVES: Optical impressions of implants in the edentulous arch are challenged by the absence of distinct surface morphology between multiple implant scan bodies. The purpose of this in vitro study was to evaluate a newly developed scan aid in various designs and colors to improve the accuracy of multi-implant scans. MATERIALS AND METHODS: A universal scan aid in three different designs (circular, square, irregular) and three different materials (colors: beige, gray, white) was applied to the implant scan bodies of a master model of six implants in an edentulous maxilla. Ten scans using an intra-oral scanner of each scan aid were acquired. Reference scanning was performed using a desktop optical scanner. Alignment of scans was performed at the first scan body in a three-dimensional modeling and inspection software and deviations for trueness and precision were calculated using the signed nearest-neighbor method and then statistically analyzed (α = .05). RESULTS: Overall, the beige irregular scan aid had the highest trueness and showed significant differences compared to unsplinted scans. The precision showed more heterogenous results and decreased when using the scan aid. Ease of use was observed with the irregular gray scan aid due to its increased elongation at break. CONCLUSIONS: The evaluated scan aid led to improved trueness when compared to unsplinted scans. Even though the irregular design in beige color showed highest trueness, the poor fracture strength of the tested material requires further improvement.

Horizontal bone grafting using equine-derived cancellous bone blocks is associated with severe complications: A prospective clinical and histological pilot study.

AIMS: The aim of this prospective, clinical study was to evaluate the clinical performance and histological outcome of a new equine hydroxyapatite collagenated bone block (eHAC) for horizontal bone grafting prior to implant placement. MATERIALS AND METHODS: Five patients (two male/three female) with a mean age of 51.6 years (range 22-66 years) and a reduced horizontal bone width of the alveolar ridge (mean 3.5 mm) underwent horizontal bone grafting using eHAC at 10 grafting sites. Reentry was performed 6.9 months after the horizontal grafting procedure. Clinical follow-up (mean 28.9 month) considered width gain of the alveolar ridge, soft tissue healing, and complications. To evaluate graft incorporation, four additional patients underwent histological assessment of equine blocks adjacent to autologous blocks 3 and 6 months after grafting. RESULTS: The study was terminated after graft failure was observed in four of five patients. Mean horizontal bone width had increased by 3.6 ± 1.22 mm. Three out of nine implants placed had to be removed due to graft failure. Histological evaluation revealed large amounts of soft connective tissue within the grafts (mean 67.3 ± 9.5%). The proportion of new bone formation 3 months after the lateral grafting procedure revealed an average of 8.6%, compared to 11.4% after 6 to 7 months. CONCLUSION: Lateral ridge grafting using eHAC achieved measurable horizontal width gain but revealed high rates of severe complications. CLINICAL IMPLICATIONS: Within the limitations of this study, eHAC bone blocks cannot be recommended for horizontal bone grafting.

Articulation and vocal tract acoustics at soprano subject's high fundamental frequencies.

The role of the vocal tract for phonation at very high soprano fundamental frequencies (F0s) is not yet understood in detail. In this investigation, two experiments were carried out with a single professional high soprano subject. First, using two dimensional (2D) dynamic real-time magnetic resonance imaging (MRI) (24 fps) midsagittal and coronal vocal tract shapes were analyzed while the subject sang a scale from Bb5 (932 Hz) to G6 (1568 Hz). In a second experiment, volumetric vocal tract MRI data were recorded from sustained phonations (13 s) for the pitches C6 (1047 Hz) and G6 (1568 Hz). Formant frequencies were measured in physical models created by 3D printing, and calculated from area functions obtained from the 3D vocal tract shapes. The data showed that there were only minor modifications of the vocal tract shape. These changes involved a decrease of the piriform sinus as well as small changes of tongue position. Formant frequencies did not exhibit major differences between C6 and G6 for F1 and F3, respectively. Only F2 was slightly raised for G6. For G6, however, F2 is not excited by any voice source partial. Therefore, this investigation was not able to confirm that the analyzed professional soprano subject adjusted formants to voice source partials for the analyzed F0s.

Precision of intraoral digital dental impressions with iTero and extraoral digitization with the iTero and a model scanner.

INTRODUCTION: Digital impression devices are used alternatively to conventional impression techniques and materials. The aims of this study were to evaluate the precision of digital intraoral scanning under clinical conditions (iTero; Align Technologies, San Jose, Calif) and to compare it with the precision of extraoral digitization. METHODS: One patient received 10 full-arch intraoral scans with the iTero and conventional impressions with a polyether impression material (Impregum Penta; 3M ESPE, Seefeld, Germany). Stone cast models manufactured from the impressions were digitized 10 times with an extraoral scanner (D250; 3Shape, Copenhagen, Denmark) and 10 times with the iTero. Virtual models provided by each method were roughly aligned, and the model edges were trimmed with cutting planes to create common borders (Rapidform XOR; Inus Technologies, Seoul, Korea). A second model alignment was then performed along the closest distances of the surfaces (Artec Studio software; Artec Group, Luxembourg, Luxembourg). To assess precision, deviations between corresponding models were compared. Repeated intraoral scanning was evaluated in group 1, repeated extraoral model scanning with the iTero was assessed in group 2, and repeated model scanning with the D250 was assessed in group 3. Deviations between models were measured and expressed as maximums, means, medians, and root mean square errors for quantitative analysis. Color-coded displays of the deviations allowed qualitative visualization of the deviations. RESULTS: The greatest deviations and therefore the lowest precision were in group 1, with mean deviations of 50 µm, median deviations of 37 µm, and root mean square errors of 73 µm. Group 2 showed a higher precision, with mean deviations of 25 µm, median deviations of 18 µm, and root mean square errors of 51 µm. Scanning with the D250 had the highest precision, with mean deviations of 10 µm, median deviations of 5 µm, and root mean square errors of 20 µm. Intraoral and extraoral scanning with the iTero resulted in deviations at the facial surfaces of the anterior teeth and the buccal molar surfaces. CONCLUSIONS: Scanning with the iTero is less accurate than scanning with the D250. Intraoral scanning with the iTero is less accurate than model scanning with the iTero, suggesting that the intraoral conditions (saliva, limited spacing) contribute to the inaccuracy of a scan. For treatment planning and manufacturing of tooth-supported appliances, virtual models created with the iTero can be used. An extended scanning protocol could improve the scanning results in some regions.

Precision of Dental Implant Digitization Using Intraoral Scanners.

PURPOSE: The digitization of scanbodies on dental implants is required to use computer-aided design/computer-assisted manufacture processes for implant prosthetics. Little is known about the accuracy of scanbody digitization with intraoral scanners and dental lab scanners. This study aimed to examine the precision of different intraoral digital impression systems as well as a dental lab scanner using commercially available implant scanbodies. MATERIALS AND METHODS: Two study models with a different number and distribution of dental implant scanbodies were produced from conventional implant impressions. The study models were scanned using three different intraoral scanners (iTero, Cadent; Trios, 3Shape; and True Definition, 3M ESPE) and a dental lab scanner (D250, 3Shape). For each study model, 10 scans were performed per scanner to produce repeated measurements for the calculation of precision. The distance and angulation between the respective scanbodies were measured. The results of each scanning system were compared using analysis of variance, and post hoc Tukey test was conducted for a pairwise comparison of scanning devices. RESULTS: The precision values of the scanbodies varied according to the distance between the scanbodies and the scanning device. A distance of a single tooth space and a jaw-traversing distance between scanbodies produced significantly different results for distance and angle measurements between the scanning systems (P < .05). CONCLUSION: The precision of intraoral scanners and the dental lab scanner was significantly different. The precision of intraoral scanners decreased with an increasing distance between the scanbodies, whereas the precision of the dental lab scanner was independent of the distance between the scanbodies.