Deep Learning-Based Nystagmus Detection for BPPV Diagnosis.

In this study, we propose a deep learning-based nystagmus detection algorithm using video oculography (VOG) data to diagnose benign paroxysmal positional vertigo (BPPV). Various deep learning architectures were utilized to develop and evaluate nystagmus detection models. Among the four deep learning architectures used in this study, the CNN1D model proposed as a nystagmus detection model demonstrated the best performance, exhibiting a sensitivity of 94.06 ± 0.78%, specificity of 86.39 ± 1.31%, precision of 91.34 ± 0.84%, accuracy of 91.02 ± 0.66%, and an F1-score of 92.68 ± 0.55%. These results indicate the high accuracy and generalizability of the proposed nystagmus diagnosis algorithm. In conclusion, this study validates the practicality of deep learning in diagnosing BPPV and offers avenues for numerous potential applications of deep learning in the medical diagnostic sector. The findings of this research underscore its importance in enhancing diagnostic accuracy and efficiency in healthcare.

Fully digital workflow for the fabrication of a tooth-colored space maintainer for a young patient.

OBJECTIVES: Preventive orthodontic therapy with a band and loop is recommended to reduce the prevalence and severity of malocclusion on premature loss of a primary molar. However, when young patients are less cooperative and have a severe gag reflex, using traditional impression methods may be challenging. The use of a conventional metal space maintainer (SM) requires manual laboratory procedures and does not provide optimal esthetics. Moreover, gingival submergence of the wire and gingivitis caused by metal structures may occur. This clinical report describes a complete digital workflow for the fabrication of a zirconia SM to overcome these limitations. CLINICAL CONSIDERATIONS: An 8-year-old boy with a band and loop SM for a missing primary mandibular right second molar presented with plaque accumulation around the band, soft tissue impingement by the loop, and loss of cement. A reverse band and loop SM had been proposed for the restoration of the primary mandibular right first molar. After conservative tooth preparation, a digital impression procedure was performed. A customized band and loop SM was designed using a computer-aided design software and milled out of the zirconia block. After sintering, the SM was luted with adhesive resin cement. CONCLUSIONS: Using an intraoral scanner, computer-aided design, and computer-aided manufacturing technology, the limitations of traditional impression procedures were overcome, and a zirconia SM with mechanical, biological, and esthetic advantages was fabricated. CLINICAL SIGNIFICANCE: Advancements in dental materials and digital technologies allow for the efficient fabrication of a tooth-colored SM with an improved patient satisfaction and reduced human error.

Digital approach to fabricating a retrofitted abutment for reuse of an existing implant-supported fixed partial denture after the failure of an implant.

The failure of an implant that supports an implant-supported fixed partial denture (ISFPD) may result in a failure of the prosthesis. Although fabricating a new ISFPD after replacing the implant is ideal, patients may hope to reuse the existing ISFPD because of financial constraints. A technique for rescuing a 6-unit metal-ceramic ISFPD with computer-aided design and computer-aided manufacturing (CAD-CAM) technology is described.

Fabricating a custom tray for an impression of multiple abutment teeth by using an open-source software program.

Although intraoral scanners have gained in popularity, the traditional impression technique with a custom tray is still useful, particularly when making a definitive impression of multiple abutment teeth. A custom tray can be fabricated with a dental software program, avoiding the disadvantages of the manual laboratory procedures. However, additional module purchasing is necessary. This article presents a digital workflow for designing a custom tray by using an open-source software program.

Digital Workflow for Establishing the Posterior Palatal Seal on a Digital Complete Denture.

The posterior palatal seal (PPS) plays important roles in improving denture retention, preventing food and debris from entering under the denture base, reducing the gag reflex, providing more strength across the denture, and making the distal border less noticeable to the tongue. Digital dentures have become popular, owing to the use of computer-aided design and computer-aided manufacturing and rapid prototyping technologies. However, limited research has been conducted on a digital workflow to establish the PPS. This article presents a technique to establish the PPS by using digital technologies for providing the advantages of the PPS to patients wearing digital dentures.

A completely digital approach to scanning dental implants placed in a limited space or with an adverse angulation.

Unfavorable implant placement may cause difficulties in making implant impressions or scans. If the impression posts or scan bodies cannot be properly seated on the implants because of contact between them, adjustment with a rotary instrument or the use of gold cylinders is necessary. This article introduces a technique for obviating the clinical difficulties without the need to adjust the impression posts or scan bodies or the use of gold cylinders.

Digital approach to fabricating an implant indexing device for dental implant abutments.

When dental implant abutments are fabricated, the use of an implant indexing device (IID) is recommended to evaluate the accuracy of a definitive cast. An IID is also useful to position multiple implant abutments on implants. Several methods have been used to fabricate an IID. However, the existing methods are labor-intensive. This article presents a digital workflow for fabricating an IID using computer-aided design and computer-aided manufacturing (CAD-CAM) technology with minimal human error.

Design concept for preventing aspiration or ingestion of CAD-CAM crowns: A dental technique.

Accidental aspiration or ingestion of a crown is a risk during dental treatment. To prevent this, dental floss can be tied to a loop attached to the lingual surface of the crown. However, the method needs an additional laboratory procedure and is applicable only to cast crowns. This article introduces a technique for fabricating a zirconia crown with a loop using computer-aided design and computer-aided manufacturing (CAD-CAM) technology.

Fabricating a crown under an existing removable partial denture with impression scanning and CAD-CAM technology.

Retrofitting a new crown to an existing removable partial denture (RPD) is a challenging procedure. Recently, intraoral scanners (IOSs) have been successfully used to solve this issue. However, purchase of IOSs is necessary, and most clinicians still use the conventional impression technique. This article describes a combined conventional and digital approach to fabricating a new crown under an RPD without an IOS.

Fabricating a reduction guide for parallel guiding planes with computer-aided design and computer-aided manufacturing technology.

Preparing appropriate guiding planes is essential for the success of a removable partial denture. Owing to the difficulty of determining the location and dimension of proximal reduction, establishing optimal guiding planes may challenge even skilled clinicians. This article introduces a digital workflow for fabricating a reduction guide to establish parallel guiding planes.

A Digital Approach to Retrofitting a Post and Core Restoration to an Existing Crown.

One problem that may arise in full-coverage restorations is clinical crown fracture. Fracture of an endodontically treated and crowned tooth in the esthetic zone may be embarrassing to both the patient and clinician. If a completely sound margin and at least 2 mm of coronal structure remain, a fractured tooth may possibly be retreated by a repair. Several methods have been introduced to reproduce the original contour of the tooth for retrofitting an existing crown. If an existing crown is used as a template, excessive core material may remain over the margin, as loading the proper amount of core material is difficult, and making vent holes on the existing crown is not feasible. This article presents a repair technique to reuse an existing crown with computer-aided design and computer-aided manufacturing (CAD/CAM) technology. By using a milled poly(methylmethacrylate) matrix, the mentioned limitations are eliminated, and the original contour of the tooth can be effectively restored with minimal intervention. As an existing crown is reused, the issues of additional time and cost for repreparation, reimpression, and new crown are eliminated.

Fabricating a custom zirconia post-and-core without a post-and-core pattern or a scan post.

Due to the increased esthetic demands, custom zirconia post-and-cores have recently become popular. A post-and-core pattern with acrylic resin or wax is scanned using a laboratory scanner for the design of a definitive post-and-core restoration. This procedure requires additional time and material handling experience. If a scan post is used for an intracanal digital scan, substantial initial investments for hardware and software are required. This article introduces an alternative technique for fabricating a custom zirconia post-and-core with a conventional impression. By using this technique, a properly fitted zirconia post-and-core is quickly and easily fabricated with less human error.

Intraoral digital impression for fabricating a replica of an implant-supported interim prosthesis.

Even though a customized scannable impression coping is used, the precise replication of the emergent profile developed by an implant-supported interim prosthesis (ISIP) is difficult. This article describes a method for overcoming the limitations of a customized scannable impression coping. With this technique, a customized scannable impression coping is eliminated, and the information from an ISIP is obtained.

Digital approach to a ceramic-pressed-to-metal restoration.

Even though a traditional metal ceramic restoration is still popular, it demands both time and effort. A ceramic-pressed-to-metal restoration (PTM) can be an alternative because this restoration reduces the complicated laboratory procedure and risk of ceramic chipping. However, no method has yet been reported for fabricating a PTM without a stone cast. This article describes an accelerated technique for a PTM with an intraoral scanner and computer-aided design and computer-aided manufacturing technology.

Completely digital approach to fabricating a crown under an existing partial removable dental prosthesis by using an intraoral digital scanner in a single appointment.

Retrofitting a crown to an existing partial removable dental prosthesis (PRDP) is difficult, labor intensive, and time consuming. This article presents an alternative technique for fabricating a crown under an existing PRDP by using an intraoral digital scanner and computer-assisted design and computer-aided manufacturing (CAD/CAM) technology. This technique involves less human error and provides a well-fitting restoration.

A digital approach to fabricating an abutment replica to control cement volume in a cement-retained implant prosthesis.

If a cement-retained implant prosthesis is placed on an abutment, excess cement should be minimized or removed to prevent periimplant inflammation. Various methods for fabricating an abutment replica have been introduced to maintain tissue health and reduce clean-up time. The purpose of this article is to present an alternative technique for fabricating an abutment replica with computer-aided design/computer-aided manufacturing (CAD/CAM) technology.

Accelerated Peri-Implant Soft Tissue Conditioning With Computer-Aided Design and Computer-Aided Manufacturing Technology and Surgical Intervention: A Case Report.

The conventional soft tissue conditioning technique around implant demands time and effort for optimizing soft tissue contour. This article describes an alternative technique for achieving proper emergence profile with a custom-milled titanium abutment, interim restoration, and surgical intervention. With this technique, peri-implant soft tissue is conditioned and healed against a correct designed interim restoration without composite resin addition.