Comparison of the positional accuracy of robotic guided dental implant placement with static guided and dynamic navigation systems: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: The development of robotic computer assisted implant surgery (r-CAIS) offers advantages, but how the positional accuracy of r-CAIS compares with other forms of guided implant surgery remains unclear. PURPOSE: The purpose of this systematic review and meta-analysis was to evaluate the positional accuracy of r-CAIS and to compare the positional accuracy of r-CAIS with s-CAIS and d-CAIS. MATERIAL AND METHODS: Five databases were systematically searched by 2 independent reviewers for articles published before May 2023. A manual search was also performed. Articles evaluating the positional accuracy of r-CAIS were included. The Cochrane risk of bias tool was used for the clinical studies, whereas the QUIN tool was used for the in vitro studies. A meta-analysis was performed to compare the positional accuracy of r-CAIS with d-CAIS. RESULTS: Thirteen studies were included, with 9 in vitro studies, 4 clinical studies, and a total of 920 dental implants. A high risk of bias was noted in 6 studies and low to moderate in 7 studies. R-CAIS showed greater accuracy for the coronal, apical, and angular deviations compared with d-CAIS. (-0.17 [-0.24, 0.09], (P<.001); -0.21 [-0.36, -0.06] (P=.006), and -1.41 [-1.56, -1.26] (P<.001)) CONCLUSIONS: R-CAIS can provide improved positional accuracy compared with d-CAIS when considering coronal, apical, and angular deviations. However, evidence to compare the positional accuracy of r-CAIS with s-CAIS was insufficient. These results should be interpreted with caution because of the limited data and the bias noted in several studies.

Determination of Normal Anal Position Using the Anal Position Index in Pakistani Neonates.

INTRODUCTION: Anterior displacement of the anus (ADA) is recognized as a common congenital abnormality of the anorectal region and is often associated with constipation. It is diagnosed through a physical examination by measuring the Anal Position Index (API) at birth. METHODS: A cross-sectional study was conducted utilizing non-probability consecutive sampling of all patients presenting with ADA at our institute over a six-month period. The study focused on key variables, including the measurement of scroto-anal and scroto-coccygeal distances in boys and fourchette-anal and fourchette-coccygeal distances in girls. Data collection was carried out using a structured proforma, ensuring prospective data collection from neonates meeting the selection criteria (neonates born at our center and identified by the neonatology team as having a normal anal opening, regardless of their gestational period or birthweight). RESULTS: Our study comprised a cohort of 204 neonates. The Anal Position Index was determined to be 0.36 ± 0.07 for male newborns and 0.24 ± 0.06 for female newborns. Notably, a statistically significant correlation was observed between the API and factors such as gestational age, birth weight, and advancing paternal age. CONCLUSION: The assessment of the API proves highly valuable in identifying indicators of ADA in neonates, facilitating early disease detection, and guiding the prompt management of subsequent functional symptoms, such as constipation, during later stages of life.

Migratory dental implant in the maxillary antrum: a case report.

Dental implants offer a predictable solution for the replacement of missing dentition. This report describes the case of a patient who underwent dental implant surgery several years ago but due to negligence on the part of previous dentist, her implant pushed into the maxillary sinus. The patient presented with vague pain and swelling in the right maxillary region. Orthopantomogram (OPG) showed that the implant was lying in the right maxillary sinus which the patient had no clue of. It was decided to retrieve the implant and later restore the missing teeth for definitive function and aesthetics. However, at the time of surgery, the implant in question was missing from the anticipated position as it had migrated to the most posterior-superior compartment of the antrum making its retrieval difficult in the first attempt. Later, a maxillofacial surgeon carried out the retrieval. Fortunately, the implant moved back to a more favourable position at the time of second surgery.

Clinical applications and novel approaches in stem cell: an insight to dental pulp regeneration.

Objectives: The aim of the review is to present the currently applied tissue regeneration through stem cells technology in regenerative endodontics. This review also summarises the various preclinical models used for the evaluation of stem cell-based therapies, their limitations, recent advances and challenges related to clinical applications of human stem cells. Methodology: A literature survey from 2010 to August 2022 was carried out in various electronic databases to identify the articles required for review on Pulp Regeneration through Stem Cells Technology. MeSH terms/keywords such as "Pulp regeneration," "Pulp Revascularization," "Pulp revitalization," "Regenerative Endodontics" were used to search in the electronic databases comprised of PubMed database, SCOPUS, COCHRANRE library, EMBASE, CINAHL, ICTRP, Science Direct and a manual search was also done using the cross references and textbooks. RESULTS: The searches revealed 299 articles. After reading the full text articles and applying the inclusion and exclusion criteria 15 articles were selected for the review fulfilling the criteria of the study. CONCLUSIONS: Currently in regenerative endodontics, there is a broad consent that the final tissue acquired is more likely to bone-like tissue mixed with connective tissue rather than the pulp-dentin complex. Moreover, re-innervation from sensory axons in regenerated tissue, is still to date, difficult to achieve.

The Implication of Stem Cells in Direct Pulp Capping: Where Do We Stand?

Direct pulp capping has been established as a more conservative alternative to root canal therapy, especially in case of an iatrogenic or traumatic exposure of the dental pulp. However, recent literature focuses on regeneration therapies to develop a physiological dentin barrier. The process of tissue regeneration through stem cell therapy involves a complex interaction between stem cells, growth factors and scaffolds known as the 'tissue engineering triad'. Recent advancements in stem cell therapy focus on the re programming of stem cells, development of scaffolds and enhancement of the regenerative potential of these stem cells, using appropriate growth factors and transfer media. This article provides a summary of the current evidence regarding the use of stem cell therapy in direct pulp capping. The sources of stem cells, types of scaffolds and growth factors have been described in detail along with the limitations and future prospects.

Effect of Light Emitting Diode (LED) Curing Modes on Depth of Cure (DoC) in BulkFill Composite Resin: An invitro study.

Objectives: To evaluate the depth of cure in smart dentin replacement bulkfill composite resins polymerized by constant, pulse and ramped light-emitting diode curing modes. METHODS: The in vitro experimental study was conducted in November and December 2019 at the dental clinics of Aga Khan University Hospital, Karachi, and comprised of cylindrical composite specimens 8x4mm in size which were polymerised in Teflon moulds using light-emitting diode under constant mode in Group 1, pulse mode in Group 2 and ramped mode in Group 3. Once polymerised, each specimen was extruded from the mould and, using the International Organisation for Standardisation-4049 scrapping method, uncured resin was removed. Specimen lengths were measured with a Vernier calliper. Each specimen was measured thrice and the mean was taken as the depth of cure. Data was analysed using SPSS 24. RESULTS: Of the 33 specimens, there were 11(33.3%) in each of the 3 groups. Mean depth of cure in Group 1 was 2.92±0.29mm, in Group 2 it was 2.88±0.27mm, and it was 3.18±0.26mm in Group 3. The difference between Group 2 and Group 3 was statistically significant (p<0.05). Conclusion: Maximum depth of cure of smart dentin replacement bulkfill composite was achieved by ramped cure mode of light-emitting diode unit, followed by constant and pulse modes.

Augmented reality in clinical dental training and education.

Dentistry is a profession that requires coordinated motor skills in addition to acquired knowledge for ideal execution of any treatment plan for patients. Learning experiences have been modified over a period of time for students as well as for the healthcare providers. Conventional pre-clinical training employed the use of cadavers, but financial, ethical and supervisory constraints have become a major shortcoming. With the adaptation of technology in dentistry, pre-clinical training has now employed simulation. It provides the opportunity for students to develop psychomotor skills for procedures by practising pre-clinical, standardised learning competencies before they engage in patient-management. Simulation involves computer-aided learning, augmented reality and virtual reality, which are largely taking over pre-clinical teaching. Augmented reality is commonly being employed in maxillofacial, restorative, tooth morphology learning and mastering technique for administering local anaesthesia in dentistry. Virtual reality is being employed particularly in pre-treatment implant planning and dental education for students. Use of haptic technology, like robotics, is also gaining popularity, and facilitates a two-way communication between the user and the environment to better simulate the clinical setting for learning purposes.