Surface Activation of Titanium Dental Implants by Using UVC-LED Irradiation.

Organic contaminants significantly limit the bioactivity of titanium implants, resulting in the degradation known as the ageing of titanium. To reactivate the surfaces, they can be photofunctionalized, i.e., irradiated with C-range ultraviolet (UVC) light. This descriptive in vitro study compares the effectiveness of novel light-emitting diode (LED) technology to remove contaminant hydrocarbons from three different commercially available titanium dental implants: THD, TiUnite, and SLA. The surface topography and morphology were characterized by scanning electron microscopy (SEM). The chemical compositions were analyzed by X-ray photoelectron spectroscopy (XPS), before and after the lighting treatment, by a pair of closely placed UVC (λ = 278 nm) and LED devices for 24 h. SEM analysis showed morphological differences at the macro- and micro-scopic level. XPS analysis showed a remarkable reduction in the carbon contents after the UVC treatment: from 25.6 to 19.5 C at. % (carbon atomic concentration) in the THD; from 30.2 to 20.2 C at. % in the TiUnite; from 26.1 to 19.2 C at. % in the SLA surface. Simultaneously, the concentration of oxygen and titanium increased. Therefore, LED-based UVC irradiation decontaminated titanium surfaces and improved the chemical features of them, regardless of the kind of surface.

The Benefits of Smart Nanoparticles in Dental Applications.

Dentistry, as a branch of medicine, has undergone continuous evolution over time. The scientific world has focused its attention on the development of new methods and materials with improved properties that meet the needs of patients. For this purpose, the replacement of so-called "passive" dental materials that do not interact with the oral environment with "smart/intelligent" materials that have the capability to change their shape, color, or size in response to an externally stimulus, such as the temperature, pH, light, moisture, stress, electric or magnetic fields, and chemical compounds, has received much attention in recent years. A strong trend in dental applications is to apply nanotechnology and smart nanomaterials such as nanoclays, nanofibers, nanocomposites, nanobubbles, nanocapsules, solid-lipid nanoparticles, nanospheres, metallic nanoparticles, nanotubes, and nanocrystals. Among the nanomaterials, the smart nanoparticles present several advantages compared to other materials, creating the possibility to use them in various dental applications, including preventive dentistry, endodontics, restoration, and periodontal diseases. This review is focused on the recent developments and dental applications (drug delivery systems and restoration materials) of smart nanoparticles.

Pressure Cycling Technology Assisted Mass Spectrometric Quantification of Gingival Tissue Reveals Proteome Dynamics during the Initiation and Progression of Inflammatory Periodontal Disease.

Understanding the progression of periodontal tissue destruction is at the forefront of periodontal research. The authors aimed to capture the dynamics of gingival tissue proteome during the initiation and progression of experimental (ligature-induced) periodontitis in mice. Pressure cycling technology (PCT), a recently developed platform that uses ultra-high pressure to disrupt tissues, is utilized to achieve efficient and reproducible protein extraction from ultra-small amounts of gingival tissues in combination with liquid chromatography-tandem mass spectrometry (MS). The MS data are processed using Progenesis QI and the regulated proteins are subjected to METACORE, STRING, and WebGestalt for functional enrichment analysis. A total of 1614 proteins with ≥2 peptides are quantified with an estimated protein false discovery rate of 0.06%. Unsupervised clustering analysis shows that the gingival tissue protein abundance is mainly dependent on the periodontitis progression stage. Gene ontology enrichment analysis reveals an overrepresentation in innate immune regulation (e.g., neutrophil-mediated immunity and antimicrobial peptides), signal transduction (e.g., integrin signaling), and homeostasis processes (e.g., platelet activation and aggregation). In conclusion, a PCT-assisted label-free quantitative proteomics workflow that allowed cataloging the deepest gingival tissue proteome on a rapid timescale and provided novel mechanistic insights into host perturbation during periodontitis progression is applied.

Technical note on introducing a digital workflow for newborns with craniofacial anomalies based on intraoral scans - part I: 3D printed and milled palatal stimulation plate for trisomy 21.

BACKGROUND: Advanced digital workflows in orthodontics and dentistry often require a combination of different software solutions to create patient appliances, which may be a complex and time-consuming process. The main objective of this technical note is to discuss treatment of craniofacial anomalies using digital technologies. We present a fully digital, linear workflow for manufacturing palatal plates for infants with craniofacial anomalies based on intraoral scanning. Switching to intraoral scanning in infant care is advantageous as taking conventional impressions carries the risk of impression material aspiration and/or infections caused by material remaining in the oronasal cavity. MATERIAL AND METHODS: The fully digital linear workflow presented in this technical note can be used to design and manufacture palatal plates for cleft palate patients as well as infants with functional disorders. We describe the workflow implemented in an infant with trisomy 21. The maxilla was registered using a digital scanner and a stimulation plate was created using dental CAD software and an individual impression tray module on a virtual model. Plates were manufactured using both additive and subtractive methods. Methacrylate based light curing resin and Poly-Ether-Ether-Ketone were the materials used. RESULTS: The palatal area was successfully scanned to create a virtual model. The plates fitted well onto the palatal area. Manual post-processing was necessary to optimize a functional ridge along the vestibular fold and remove support structures from the additively manufactured plate as well as the milled plate produced from a blank. The additively manufactured plate fitted better than the milled one. CONCLUSION: Implementing a fully digital linear workflow into clinical routine for treatment of neonates and infants with craniofacial disorders is feasible. The software solution presented here is suitable for this purpose and does not require additional software for the design. This is the key advantage of this workflow, which makes digital treatment accessible to all clinicians who want to deal with digital technology. Whether additive or subtractive manufacturing is preferred depends on the appliance material of choice and influences the fit of the appliance.

Accuracy of Dental Monitoring 3D digital dental models using photograph and video mode.

INTRODUCTION: This study aimed to test the accuracy of the 3-dimensional (3D) digital dental models generated by the Dental Monitoring (DM) smartphone application in both photograph and video modes over successive DM examinations in comparison with 3D digital dental models generated by the iTero Element intraoral scanner. METHODS: Ten typodonts with setups of class I malocclusion and comparable severity of anterior crowding were used in the study. iTero Element scans along with DM examination in photograph and video modes were performed before tooth movement and after each set of 10 Invisalign aligners for each typodont. Stereolithography (STL) files generated from the DM examinations in photograph and video modes were superimposed with the STL files from the iTero scans using GOM Inspect software to determine the accuracy of both photograph and video modes of DM technology. RESULTS: No clinically significant differences, according to the American Board of Orthodontics-determined standards, were found. Mean global deviations for the maxillary arch ranged from 0.00149 to 0.02756 mm in photograph mode and from 0.0148 to 0.0256 mm in video mode. Mean global deviations for the mandibular arch ranged from 0.0164 to 0.0275 mm in photograph mode and from 0.0150 to 0.0264 mm in video mode. Statistically significant differences were found between the 3D models generated by the iTero and the DM application in photograph and video modes over successive DM examinations. CONCLUSIONS: 3D digital dental models generated by the DM smartphone application in photograph and video modes are accurate enough to be used for clinical applications.

Comparison of Resonance Frequency Analysis and of Quantitative Ultrasound to Assess Dental Implant Osseointegration.

Dental implants are widely used in the clinic. However, there remain risks of failure, which depend on the implant stability. The aim of this paper is to compare two methods based on resonance frequency analysis (RFA) and on quantitative ultrasound (QUS) and that aim at assessing implant stability. Eighty-one identical dental implants were inserted in the iliac crests of 11 sheep. The QUS and RFA measurements were realized after different healing times (0, 5, 7, and 15 weeks). The results obtained with the QUS (respectively RFA) method were significantly different when comparing two consecutive healing time for 97% (respectively, 18%) of the implants. The error made on the estimation of the healing time when analyzing the results obtained with the QUS technique was around 10 times lower than that made when using the RFA technique. The results corresponding to the dependence of the ISQ versus healing time were significantly different when comparing two directions of RFA measurement. The results show that the QUS method allows a more accurate determination of the evolution of dental implant stability when compared to the RFA method. This study paves the way towards the development of a medical device, thus providing a decision support system to dental surgeons.

NON-REMOVABLE DENTURE PROTOTYPES, EFFECTIVE IN DENTAL IMPLANTATION.

Temporary prosthesis transformed into a prosthetic prototypes and manufactured by CAD/CAM technologies (computer copy milling) are used to specify the final form of future permanent restoration and to correct occlusal relationships, vertical size of non-removable dentures, and their occlusal surfaces. A progressive loading on bone tissue in the implantation area and soft tissues formation, have been assessed. In this regard, the choice and placement of temporary mini-implants, as the supports for non-removable denture prototypes for the period of osseointegration of two-stage intraosseous dental implants, are the issues of great importance. Temporary dental implants are the object of complex loads of different magnitude, duration and direction. The action of the prosthesis is closely related to load delivery to the surface of dental implant between the components of the system - "implant-temporary prosthesis". According to the study results, minimization of the momentum acting on temporary implants in the mesiodistal direction allows reducing stress level in the areas of permanent implant placement.

PECULIARITIES OF THE OCCLUSION FORMATION IN DENTAL IMPLANT SUPPORTED ARTIFICIAL TEETH.

The aim of this study was to assess and develop an effective computer technology assisted method for improved treatment of dental implant patients. Both an experimental and clinical assessments were conducted. The experimental part was performed to develop the mathematical models for calculating and analyzing the tensely deformed condition (TDC) in the system "non-removable prosthesis - dental implant - lower jaw " (PIJ). Clinical study was conducted on 76 patients with previously placed dental implant supported prostheses in the posterior parts of the lower jaw (with and without signs of bone receding around the implants) allocated into three groups. Results of the study allowed the authors to suggest an effective computer technology supported method for assessing the required angles of dental implants, which provides an opportunity for individual calculation of the dental implant in the bone of the mandible depending on the direction of functional load.

[Diagnossis and treatment of complicated anterior teeth esthetic defects by combination of whole-process digital esthetic rehabilitation with periodontic surgery].

OBJECTIVE: To explore a new method of whole-process digital esthetic prosthodontic rehabilitation combined with periodontic surgery for complicated anterior teeth esthetic defects accompanied by soft tissue morphology, to provide an alternative choice for solving this problem under the guidance of three-dimensional (3D) printing digital dental model and surgical guide, thus completing periodontic surgery and digital esthetic rehabilitation of anterior teeth. METHODS: In this study, 12 patients with complicated esthetic problems accompanied by soft tissue morphology in their anterior teeth were included. The dentition and facial images were obtained by intra-oral scanning and three-dimensional (3D) facial scanning and then calibrated. Two esthetic designs and prosthodontic outcome predictions were created by computer aided design /computer aided manufacturing (CAD/CAM) software combined with digital photography, including consideration of white esthetics and comprehensive consideration of pink-white esthetics. The predictive design of prostheses and the facial appearances of the two designs were evaluated by the patients. If the patients chose the design of comprehensive consideration of pink-white esthetics, they would choose whether they would receive periodontic surgery before esthetic rehabilitation. The dentition design cast of those who chose periodontic surgery would be 3D printed for the guide of periodontic surgery accordingly. RESULTS: In light of the two digital designs based on intra-oral scanning, facing scanning and digital photography, the satisfaction rate of the patients was significantly higher for the comprehensive consideration of pink-white esthetic design (P<0.05) and more patients tended to choose priodontic surgery before esthetic rehabilitation. The 3D printed digital dental model and surgical guide provided significant instructions for periodontic surgery, and achieved success transfer from digital design to clinical application. The prostheses were fabricated by CAD/CAM, thus realizing the whole-process digital esthetic rehabilitation. CONCLUSION: The new method for esthetic rehabilitation of complicated anterior teeth esthetic defects accompanied by soft tissue morphology, including patient-involved digital esthetic analysis, design, esthetic outcome prediction, 3D printing surgical guide for periodontic surgery and digital fabrication is a practical technology. This method is useful for improvement of clinical communication efficiency between doctor-patient, doctor-technician and doctors from different departments, and is conducive to multidisciplinary treatment of this complicated anterior teeth esthetic problem.

Digital Michigan splint - from intraoral scanning to plasterless manufacturing.

AIM: To investigate whether the fully digital, plasterless fabrication of clinically usable Michigan splints can be accomplished in a time- and cost-efficient manner. MATERIALS AND METHODS: Digital scans of the maxillary and mandibular arches of 10 subjects were acquired with an intraoral scanner (3Shape, Copenhagen) and used to generate virtual models of the dental arches. Jaw relation records were made using jigs placed on the subjects' anterior teeth, and silicone registration material was referenced to the jaw models. The data sets were then sent via the company's online portal to the dental laboratory, where computer-aided design (CAD) of the Michigan-type maxillary splints was performed. After receiving the designs, the splints were milled in-office using computer-aided manufacturing (CAM) software, and finished manually. During try-in, the splints where checked for fit, retention quality, and occlusal contacts of the mandibular teeth on the splint surfaces in static and dynamic occlusion. RESULTS: Fit and retention were clinically acceptable in 10 splints and 9 splints, respectively. The number of initial occlusal contacts on the splint surfaces ranged from 4 to 16. CONCLUSIONS: The question addressed in this study can be answered in the affirmative. Some of the main advantages of digital manufacturing of Michigan splints over traditional, conventional, impression-based manufacturing are the time-efficient manufacturing process, the high material quality, and the possibility of manufacturing duplicate splints.

Intraoral versus extraoral measurement of the height of the interproximal contact area in maxillary anterior teeth.

OBJECTIVES: This study aimed to clinically quantify the apicoincisal height of the upper interproximal areas directly in patients' mouths compared to measurements on stone models. SUBJECTS AND METHODS: One hundred and fifty participants (75 females and 75 males, age range 20-45 years) were recruited for this study. A digital caliper was used to measure the anterior maxillary interproximal contact areas directly in patients' mouths and on stone models. The digital caliper accuracy was up to 0.01. The Statistical Package for Social Sciences software (SPSS, version 19.0, Chicago, Ill., USA) was used for statistical analysis. Statistical significance was based on probability values <0.05. RESULTS: The intraoral measurement of proximal contacts as well as the measurement on stone models showed that the dimensions of interproximal contacts on both sides of each tooth were significantly different (p < 0.001) and that the dimension of the mesial contact point was larger than that of the distal contact point of each tooth. The largest contact point was the one between the central incisors (direct intraoral measurement = 2.9-6.49 mm; model measurement = 3.31-6.91 mm). On the other hand, the contact point between the canine and first premolar was the smallest on both sides of the arch (0.63-2.52 mm intraorally, 0.98-2.88 mm on models). The intraoral measurement of contact points was more accurate than model measurements, and the differences were statistically significant (p < 0.001). CONCLUSIONS: The clinical evaluation of contact point dimensions using a digital caliper was more precise than measuring contact points on stone models; hence, it is a viable, quick and adequate method to be used routinely.

Guide to Digital Radiographic Imaging.

This is a resource for clinicians who are considering purchasing a digital imaging system or those already using one who want to optimize its use. It covers selected topics in digital imaging fundamentals, detector technology, image processing and quality assurance. Through a critical appraisal of the strengths and limitations of digital imaging components, the goal of this guide is to contribute to the appropriate use of these systems to maximize the health benefit for patients.

Shall I go digital?

UNLABELLED: Dental radiographic imaging is slowly transferring to digital format. The decision to invest in this new technology should be based on a good understanding of the different types of digital imaging available within the dental field. This article outlines its use in general dental practice, highlighting the pros and cons of the various systems both for intra-oral and extra-oral radiography. CLINICAL RELEVANCE: An understanding of the mechanisms of digital imaging and their associated potential problems are required by any clinician moving to film-less imaging.

Customized orthodontics: The Insignia System.

Customized treatment systems offer both patient and clinician numerous advantages, first and foremost the possibility of viewing a computerized rendering of the dentition in three dimensions. This allows the orthodontist to perform accurate measurements, analyses and simulations, and for both to be able to view the end result on screen. Thus, computerized technology consents optimization of not only the diagnostic phase, by means of extremely accurate three-dimensional imaging systems, but also the operative phase, by supplying individualized appliances with little or no correction while the treatment is in progress. In this article we present a customized orthodontic system called Insignia and how it works through two different clinical cases.

Mirror-image anterior crown fabrication with computer-aided design and rapid prototyping technology: a clinical report.

This clinical report describes the fabrication of a maxillary central incisor single crown with rapid prototyping (RP) technology. A patient with a recently replaced metal ceramic crown had discomfort due to the nonanatomic lingual contour of the crown. With computer-aided design (CAD) software and rapid prototyping (RP) technology, the shape of the contralateral central incisor was duplicated and reproduced to make a mirror-image for a new crown. The prosthodontic planning and treatment approach are discussed.

Applying microwave technology to sintering dental zirconia.

STATEMENT OF PROBLEM: When sintering zirconia, conventional processing may not provide uniform heating and consumes more energy than an alternative method using microwave energy. PURPOSE: The purpose of this study was to compare the surface quality, mechanical and physical properties, and dimensional stability obtained by sintering yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) in a conventional furnace versus a microwave furnace. MATERIAL AND METHODS: Twenty bars of Y-TZP were prepared from Zircad blocks. Ten specimens were used for sintering in a conventional furnace. The remaining 10 specimens were sintered in a microwave furnace. The sintering temperature used for both techniques was 1500°C. The flexural strength of all specimens was measured with the 3-point bend test with a universal testing machine with a cross head speed of 1.0 mm/min. Density was measured by applying the Archimedes method, and specimen length, width, and thickness were measured with a digital micrometer. The phase composition and average grain size of these ceramics were examined by using X-ray diffraction, and microstructure characteristics were studied with scanning electron microscopy. Data obtained were analyzed by using independent t tests (α=.05). RESULTS: No significant difference between conventional and microwave sintering for either flexural strength, t18=0.49 (P=.63) or density, t18=0.07 (P=.95) was found. Specimens in both groups exhibited a uniform firing shrinkage of approximately 24.6% in all dimensions. The surface of selected specimens examined with a scanning electron microscope showed no visible difference in grain shape or porosity size between the 2 sintering methods. CONCLUSIONS: Under the conditions of this study, it appears that either microwave or conventional zirconia sintering may be used for processing zirconia for dental use. However, microwave energy provides uniformity of heating, allowing the use of higher heating rates, which can increase productivity and save energy.

Digital dentistry: innovation for restorative treatment.

The evolution of digital technology and computer-aided design/computer-aided manufacture (CAD/CAM) systems are creating exciting opportunities for improving the delivery of restorative dentistry. Digital systems now offer the opportunity to avoid traditional, analog impressions, including the usual impression materials, time, and handling limitations associated with them. Intraoral scanners have the potential to offer excellent accuracy with a more comfortable experience for the patient and more efficient workflow for the office.

[Preparation of anodic oxidation layer on the surface of pure titanium and its biological activity study].

This paper introduces how TiO2 film was prepared on pure titanium by anodic oxidation. Surface morphology and composition of the oxide film were analyzed by SEM coupled with EDAX. The deposition ability of hydroxyapatite of the anodized titanium in simulated body fluid (SBF) at 37 degrees C was evaluated. The results indicated that the oxide film was rough and honeycomb holes, connecting with each other, could be found on the surface. The holes with the diameter of 1-2 microm were distributed uniformly, which was typical for anodic oxidation. After alkaline treatment, hydroxyapatite deposition on the oxidized specimens in SBF was improved significantly.

Implant-supported fixed hybrid acrylic complete dentures opposing fully restored mandibular metal ceramic restorations.

This report presents a full-mouth rehabilitation case. A patient came with a failing dentition in maxilla, and after the treatment, the patient had a shortened full-arch, implant-supported, screw-retained hybrid acrylic complete denture in the maxilla and full-arch metal ceramic restorations in the mandible. The report describes the steps involved in the prosthodontic rehabilitation; a cost-effective treatment plan, the restoration of vertical dimension, an immediate denture, an implant-level impression, a verified-master cast, the fabrication of definitive prosthesis, the occlusal scheme and multiple follow-ups in 6 months. We discussed the merits/demerits of screw-retained prosthesis, impression techniques and various types of fixed complete dentures. We learnt the difficulty in hygiene measures and dissatisfaction of the patient with the hygienic gaps under the acrylic fixed dentures.