Clinical applications of the T-Scan quantitative digital occlusal analysis technology: a systematic review.

STATEMENT OF THE PROBLEM: Occlusion is associated with all disciplines of dentistry and plays a major role in the longevity of both implant- and tooth-borne restorations. Achieving occlusal harmony ensures balance is established between the dental and myofascial structures, which can be measurably established to high numerical tolerances with the T-Scan digital occlusal analysis system. PURPOSE: To describe and evaluate the known and proven applications of T-Scan digital occlusal analysis in various dental practice disciplines through a systematic review of the literature. MATERIALS AND METHODS: An electronic, English-language PubMed/MEDLINE and Cochrane Central Registry of Controlled Trials database search using the keywords "T-Scan," "TMD," "Occlusion," "Implant Protected Occlusion," and "Orthodontics" was conducted without any date restrictions. The related journal findings were hand searched to determine studies that met the eligibility criteria for inclusion in the present systematic review. RESULTS: The PubMed/MEDLINE search identified 423 articles. After removing duplicates, the titles and abstracts of the remaining 421 studies were screened. 274 ineligible articles were excluded, leaving 147 articles. Of those, 33 articles were not in English, 27 full-text articles were not available, 4 were comments and letters to editors, 1 was a review, and 2 described techniques. A total of 86 articles met the eligibility criteria for inclusion. CONCLUSION: Much scientific evidence supports the use of T-Scan, as it measures relative occlusal contact forces and the time sequence durations of occlusal contacts objectively, accurately, and repeatedly for improved treatment outcomes. The system's hardware, sensor, and software evolution from T-Scan I to today's T-Scan 10 Novus system has overcome early sensor and system drawbacks to improve the clinical performance of T-Scan in many disciplines of dental medicine.

Effect of nanoparticles on color stability and mechanical and biological properties of maxillofacial silicone elastomer: A systematic review.

AIM: The aim of this systematic review was to evaluate the effect of addition of various nanoparticles into maxillofacial silicone elastomer on color stability and mechanical and biological properties of the silicone elastomer. SETTINGS AND DESIGN: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines(PRISMA). MATERIALS AND METHODS: The electronic database search in MEDLINE/PubMed was based on population (silicone elastomer), intervention (nanoparticles), comparison (unreinforced silicone elastomer with nanoparticle-reinforced silicone elastomer), outcome (color stability and mechanical, physical, and biological properties), i.e., PICO framework. The key words used are ("maxillofacial silicone" OR "silicone elastomer" OR "facial silicone") AND ("nanoparticles" OR "Nano-oxides") AND ("colour stability" OR "Hardness," "tensile strength" OR "tear strength" OR "antifungal activity"). RESULTS: The database search resulted in 2099 studies, of which 2066 articles were excluded as they were irrelevant, duplicates, and data were not available. The remaining 33 full-text articles were assessed for eligibility, out of which 2 articles were in Chinese language, 3 articles were thesis documents, and 8 were review articles. A total of 12 articles were excluded and the remaining 20 articles were included. One article was yielded by hand search of references of included studies. A total of 21 studies were included in the present systematic review. CONCLUSION: With the available evidence in the literature, it can be concluded that addition of nanoparticles at various concentrations may improve the physical and mechanical properties and color stability of the prosthesis made from the silicone elastomers.

Attitude of dental professionals toward cast partial denture: A questionnaire survey in India.

AIMS: The use of cast partial dentures (CPDs) has been decreased and its importance has been declined in the teaching curriculum. The purpose of this survey was to evaluate the attitudes of dental professionals toward conditions using CPDs in private practice in India. SETTINGS AND DESIGN: Descriptive survey. MATERIALS AND METHODS: This survey consists of eight close-ended questions concerning the use of CPD by dental professionals practicing in India. The URLs of the questionnaire were shared via E-mail to dentists practicing throughout India, to obtain a response of 384 which is a predetermined sample size. STATISTICAL ANALYSIS USED: Statistical analysis was done using counts and percentages and the results were further analyzed statistically by the Chi-square test. RESULTS: Nearly 42.79% of general dental practitioners (GDPs), 47.26% of prosthodontists, and 9.95% of other specialist dentists responded to the questionnaire. GDPs mostly preferred removable partial dentures (RPDs) (71.87%) and fixed partial dentures (57.22%), whereas prosthodontists preferred mostly implant (60.91%). GDPs mostly preferred flexible dentures (62.42%), whereas prosthodontists preferred CPDs 62.84%. Almost 52.50% of the GDPs mostly raised a cost issue and 63.11% of the prosthodontists had difficulty in adjustment with CPDs. Nearly 63.46% of the dentists told that implant-supported restorations are better options compared to CPDs; still, majority of the dentists (53.23%) were in favor that more importance for teaching CPDs in graduation curriculum should be given. CONCLUSIONS: This survey shows that in India a significant proportion of GDPs (71.87%) preferred RPDs, mostly flexible dentures (62.42%) due to their low cost compared to CPDs. Prosthodontists mostly preferred implants (60.91%) because they are more confident and better trained in these. It is recommended that more importance be given in teaching implants along with CPDs in graduation curriculum so that practitioners can better educate their patients about implants and their advantages over flexible dentures and their utilization in cases where patients are not willing for CPDs.

Do antihypertensive medications have an effect on dental implants? A systematic review.

PURPOSE: The purpose of this systematic review was to compare the clinical outcomes of dental implants in users of antihypertensive medication with those of nonusers. METHODS: This systematic review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered in the International Prospective Register of Systematic Reviews under the number CRD42022319336. The electronic databases Medline (PubMed) and Central Cochrane were searched for relevant scientific literature published in English through May 2022. The focused question was, "Do patients taking antihypertensive medications have a similar impact on the clinical outcome and survival of dental implants compared with nonusers?". RESULTS: A total of 49 articles were found, of which 3 articles were finally selected for a qualitative synthesis. The three studies included 959 patients. In all three studies, the commonly used medication was renin-angiotensin system (RAS) inhibitors. Two studies mentioned implant survival rate, which was 99.4% in antihypertensive medication users and 96.1% in the nonusers. One study found a higher implant stability quotient (ISQ) in patients taking antihypertensive medication (75.7 ± 5.9) compared with patients not taking antihypertensive medication (73.7 ± 8.1). CONCLUSIONS: The limited available evidence showed that patient taking antihypertensive medications had comparable success rate and implant stability to patients not taking medications. The studies included patients taking different antihypertensive medications, so a drug-specific conclusion regarding the clinical outcome of dental implants is not possible. Further studies are needed, including patients taking certain antihypertensive medications, to determine their effects on dental implants.

Marginal Gap and Internal Fit of Fixed Dental Prostheses Fabricated Using Intraoral vs Extraoral Scanning: A Systematic Review and Meta-analysis.

PURPOSE: To compare the marginal gap and internal fit of fixed dental prostheses (FDPs) fabricated using intraoral vs extraoral scanning methods. MATERIALS AND METHODS: MEDLINE/PubMed and the Cochrane database were searched. The focused PICO question was: For the fabrication of FDPs, does an intraoral scanning technique result in a different marginal gap than an extraoral scanning technique? The secondary outcome assessed was internal fit. Studies were selected based on the inclusion criteria, and a meta-analysis was performed. RESULTS: A total of 14 studies (10 in vitro and 4 in vivo) were included in the meta-analysis. Marginal gap in single crowns was evaluated in 5 studies, copings for single crowns in 5 studies, three-unit FDPs in 3 studies, and both single-crown and three-unit FDPs in 1 study. Significantly lower marginal gap was found with intraoral scanning compared to impression scanning (P < .001) and cast scanning (P < .001), and for impression scanning compared to cast scanning (P = .037). Internal fit was superior with intraoral scanning compared to impression scanning, and this difference was significant (P < .001). No significant differences were found in internal fit with cast scanning compared to intraoral or impression scanning. The mean marginal gap/internal fit was 188.3 µm/146.2 µm with intraoral scanning, 116.29 µm/168.2 µm with impression scanning, and 195.1 µm/229.1 µm with cast scanning. CONCLUSION: Marginal gap was lower with intraoral scanning than with impression scanning and cast scanning. Impression scanning showed less marginal gap than cast scanning. Internal fit with intraoral scanning was superior to impression scanning, but when compared to cast scanning, no difference was found.

Simplified Zygomatic Implant Perforated (Zip) Flap for Rehabilitation in Low Level Maxillary Defects.

Rehabilitation in Low level maxillectomy cases has plethora of options right from local flaps to microvascular flaps. Subsequent to flap surgery, a maxillary dental rehabilitation can be demanding and a fixed or removable prosthesis is obligatory to provide them with near-normal function and aesthetics. Unlike the original ZIP flaps which were dedicated to microvascular flaps, we present here our unique experience with ZIP-Temporalis flap specifically for rehabilitation for patients of CAM (covid associated mucormycosis), its methods, advantages and limitations.

Bite force evaluation at maximal intercuspal position: An in vivo comparative study between stainless steel and zirconia crowns on primary molar teeth.

Objective: The objective of this study was to clinically evaluate and compare the mean bite force changes at maximum intercuspal position, along with parental satisfaction following full crown restoration using stainless steel crown/zirconia crown on primary molar teeth using digital occlusal analysis system T-Scan III (Tekscan Corp, Boston, Mass., USA). Materials and Methods: Thirty-six primary molars of children aged 6-9 years with pulpal involvement were selected for the study. The selected teeth were allocated to either of the two groups using simple random sampling technique: Group A = stainless steel crowned teeth and Group B = zirconia crowned teeth. The mean bite force was recorded before the placement of the crown, after the placement of the crown, and after 1 month-follow-up. The inter-group and intra-group comparison was done among the groups. After the placement of the crown, parents were asked to fill out a questionnaire for assessing parental satisfaction. Results: A significant result in the bite force on crowned tooth, vertical dimension was seen from baseline to 1-month follow-up between the SSC and zirconia groups. In the zirconia crown group, the mean bite force was more compared to the stainless steel crown group. Parents' satisfaction was higher with zirconia crown in terms of color and esthetics. Conclusion: SSC is more acceptable than zirconia crown since occlusal re-equilibration was attained better in SSC as compared to zirconia crown.

Hybrid tracer - A modified novel extra oral tracer.

Introduction: Gothic arch Tracing has been a common modality in the recording of centric jaw relation. There has been two ways of recording the gothic tracing. They are extra oral and intra oral tracing. Among the extra oral tracers hight tracers are the most used tracers. Aim: Intra-oral and extra-oral tracers have a number of individual advantages and limitations. With the idea to overcome the short comings of both the tracers, hybrid tracers were made. Hybrid tracers could be a good alternative to the Hight-tracer in recording centric relation and can provide better clinical and teaching experience to the students. Methodology: The hybrid tracer is a two-component assembly, upper and lower component. The upper component has a central bearing plate and stylus in continuation with the central bearing plate. The lower component has central bearing device with three central bearing points one anteriorly and two posteriorly, and it has a tracing platform (15 × 35 mm) in continuation with the central bearing device. The length of these upper and lower components ismade to confine within the incisal rod of semi adjustable articulator. Result: hybrid tracers showed more accuracy while recording the centric jaw relation. There was more stability and equalization of pressure during the movement due to a tripod effect of three screws. Hence it provided more precise recording and being less technique sensitive. It was also more comfortable and acceptable by the patient. Conclusion: hybrid tracers hence will provide more accuracy and precision in recording of horizontal jaw relation. This will in turn help in fabricating a successful prosthesis and enhance the well-being of the patient. This tracer will also be significant in institutions for educational purpose. Clinical implication: Hybrid tracers are simple, non-technique sensitive, provide balance, equalization of pressure, stabilize the occlusal rims well, are close to the centre of rotation providing precise record and provide easy access and visibility to the operator which will help the operator in guiding the patient well for a correct jaw relation.

Use of Facebow device in prosthodontics: A systematic review on randomized control trials.

Aim: Recording the maxillomandibular relationship is important in various prosthodontic treatments. Evidence of face-bow transfer resulting in improved outcome is conflicting. Hence the objective of this study is to determine the use of face-bow transfer in prosthodontics. Settings and Design: : Systematic review based on PRISMA guidelines.">. Materials and Methods: A protocol was developed prior, which covered all aspects of the review. The databases explored were MEDLINE database, ScienceDirect, and Cochrane collaboration library. The PICO model included participants who received a complete denture/partial denture prosthesis. Intervention was the use of the face-bow device. Comparator was prosthesis made with a simple procedure of not using a face-bow device for prosthodontic rehabilitation. Outcomes were patient satisfaction with dentures, the stability of the dentures, esthetics, and time taken for clinical and laboratory procedures. Only randomized clinical trials were included in this study. The methodological quality of the studies was assessed according to the Cochrane risk of bias tool. Statistical Analysis Used: Qualitative analysis. Results: A total of 144 articles were identified. On excluding 4 duplicates and screening the title and abstracts of the rest of the records based on exclusion criteria only 15 studies were selected for review. Conclusions: The use of the face-bow did not yield superior results for the quality of the prosthesis. Therefore, there is no evidence for the utility of face-bow transfer in complete denture treatment. However, no inference could be drawn for its utility in partial denture prosthodontics as there was no study to draw an inference.

Comparative Evaluation of Occlusal Bite Force in Relation to the Muscle Activity in the Mixed Dentition Children of Age Group 9-12 Years: A T-scan Analysis.

AIM AND OBJECTIVE: Compare and evaluate the muscle activity and the occlusal force between the mixed dentition boys and girls of 9-12 years. MATERIALS AND METHODS: The study included 15 boys and 15 girls. The occlusal force and activity of the masseter and temporalis muscle were measured with a T-scan device using a sensor, a module to transmit the signals to a computer and the complete data of the bite force and muscle activity with the EMG recordings and data were collected and evaluated. RESULTS: Relative occlusal force in the primary and permanent molars between the boys and girls showed no significant difference on the left side compared to the right. The electromyography values of masseter and temporalis in boys and girls showed a significant difference in which (TAR and MMR), (TAR and MML), (TAL and MMR), and (TAL and MML) are significant. The overall paired sample statistics showed higher muscle activity in masseter. CONCLUSION: T-scan analysis has proved to be a dependable method for the evaluation of occlusal bite force with the muscle activity interpretation using EMG. This study concluded that there is a difference in the occlusal pattern and muscle activity in the mixed dentition that showed the maximum force was on the permanent molars and the symmetry of EMGs activity in children was on the right masseter comparatively with higher bite values in boys compared to girls. CLINICAL SIGNIFICANCE: T-scan is a computerized analysis system that helps in the proper assessment of the patient's occlusion and assists in the proper treatment planning and diagnosis accurately without much effort. HOW TO CITE THIS ARTICLE: Prabahar T, Gupta N, Chowdhary NR, et al. Comparative Evaluation of Occlusal Bite Force in Relation to the Muscle Activity in the Mixed Dentition Children of Age Group 9-12 Years: A T-scan Analysis. Int J Clin Pediatr Dent 2021;14(S-1):S29-S34.