Clinical Performance of CAD/CAM Monolithic Lithium Disilicate Implant-Supported Single Crowns Using Solid or Predrilled Blocks in a Fully Digital Workflow: A Retrospective Cohort Study With Up To 33 Months of Follow Up.

PURPOSE: To assess the clinical performance of CAD/CAM monolithic implant-supported restorations manufactured using a fully digital workflow and two different types of ceramic blocks. MATERIALS AND METHODS: One hundred and one patients received single-unit implant-supported restorations at a University predoctoral clinic. All restorations were designed and fabricated using either a predrilled LS2 block (group P, n = 59) or a conventional solid LS2 block with an occlusal opening drilled manually prior to crystallization (group M, n = 42). The mean follow-up time after restoration delivery was 18.4 ± 4.8 months (range 12 to 33 months). Patients with less than a 12-month follow-up were excluded. Electronic health records were reviewed to identify number and type of complications during the follow-up time. Clinical outcomes were classified as success, survival, and failure of the restoration. Chi-square tests were used to identify differences in success and survival rates between the groups. Nonparametric Mann-Whitney U tests were used to identify differences in the number of major and minor complications as well as the total number of complications that were observed among groups. RESULTS: Overall success and survival rates were 80.2% and 97%, respectively. Seventy one restorations (70.3%) were complication-free. There were no significant differences between the groups with regards to the number of complications or success and survival rates. CONCLUSIONS: Single-unit CAD/CAM monolithic implant-supported restorations that are fabricated in a fully digital workflow present relatively high complication rates and moderate short-term clinical outcomes. Clinical studies with longer follow-up times are needed to evaluate long-term outcomes of these restorations.

Dentist-laboratory communication and quality assessment of removable prostheses in Oregon: A cross-sectional pilot study.

STATEMENT OF PROBLEM: When fabricating a removable dental prosthesis, it is unclear if the information received by the dental laboratory technician is clear and sufficient. PURPOSE: The purpose of this survey study was to evaluate the dentist's work authorizations for removable prostheses as well as determine common practices used by laboratories during the fabrication of removable prostheses. MATERIAL AND METHODS: A 24-item questionnaire was developed based on previously published questionnaires and incorporating new topics. A public uniform resource locator (URL) survey link was generated and sent to the office of the Oregon Association of Dental Laboratories (OADL). The executive director of the board then sent out the link to 163 participants that included members and nonmembers of the OADL who were still active in the state of Oregon. Two reminder e-mails were sent 2 weeks apart. Study data were collected and managed by using the Research Electronic Data Capture (REDCap) software program. Descriptive statistics were tabulated, and responses displayed as a percentage of the total. RESULTS: From the 163 invited participants, 26 responded to the survey representing a 15.9% response rate. Only 11% of the laboratories stated that they routinely receive work authorizations with clear instructions. All participants stated that they always (62.5%) or frequently (37.5%) design the partial prostheses frameworks. Only 37.5% of the laboratories stated that they usually receive adequately extended and accurate definitive casts to fabricate the framework. Fifty percent of the laboratories stated that they very rarely perform altered cast procedures and 50% indicated that half or more of the removable partial prostheses they fabricate were entirely made of acrylic resin. Most laboratories stated that thermoplastic resin partial dentures were less than 25% of their produced volume of removable prostheses. Only 22% of respondents stated that they usually receive adequate information to complete a denture tooth arrangement and most (78%) dentists do not routinely specify the type of occlusal scheme desired for their complete denture tooth arrangements. In most prostheses (77%), posterior palatal seal was marked by the prescribing dentists rarely or very rarely. CONCLUSIONS: Work authorizations provided by the dentists were less than adequate and left much decision-making to the dental laboratory technician.

Management of ectodermal dysplasia with tooth-supported computer-engineered complete overdentures: A clinical report.

Ectodermal dysplasia (ED) is a genetic disorder affecting organs derived from the embryonic ectoderm. Symptoms manifest early in life, and dental anomalies, including partial or complete edentulism, affect most of these patients. Overdentures have been a popular and conservative treatment option for patients with ED with a few natural teeth. Advancements in digital technology have improved and positively influenced dentistry, including removable prosthodontics. This clinical report describes a positive treatment outcome using computer-engineered complete overdentures to rehabilitate a patient with dental manifestations of ectodermal dysplasia.

Dental Technicians' Perception of the Quality of Dentists' Communication on the Fabrication of Removable Partial Dentures: A Cross-Sectional Study in Saudi Arabia.

BACKGROUND: Effective and clear communication between the dentist and dental technician plays a vital role in rendering quality prostheses for patients. When fabricating a removable dental prosthesis, it is uncertain if the information received by the dental laboratory technician is clear and sufficient. This investigation aimed to assess dental technicians' perceptions of the quality of dentists' communication on the fabrication of removable partial dentures (RPDs) in Saudi Arabia. METHODOLOGY: After obtaining the institutional review board (IRB) approval from Riyadh Elm University, Riyadh, Saudi Arabia, a cross-sectional survey on a convenient sample of 115 dental technicians registered with the Saudi Commission for Health Specialties was conducted in January 2022. The voluntary participation of 94 technicians fabricating RPDs was included. A 19-item online questionnaire was developed, including quality of written instruction, selection of impression trays, and impression materials for RPD fabrication, shared through Google Docs. Descriptive statistics were tabulated, and responses were displayed as a percentage of the total. RESULTS: Of the 94 study subjects, 35% had less than five years of experience, 44% stated that they routinely receive work authorizations with clear instructions, 13% always used digital technology to fabricate prostheses, and 58% reported difficulty with communicated work authorization by dentists having less than five years of experience. Thirty-three respondents (35.1%) reported that 75% or more of the fabricated partial dentures were cast framework partials. Thirty-three respondents (35.1%) indicated that the master casts received for partial framework construction were usually accurate. Tooth alterations, however, were reported as usually adequate by only 28 respondents (29.8%). For creating the artificial gingiva portion of cast partials, 56 respondents (59.6%) preferred heat-cured acrylic resin. Furthermore, 40 respondents (42.6%) said that 75% or more of the requested partials were entirely made out of acrylic resin. Regarding case design discussions, 26 respondents (27.7%) always engaged with dentists, while 39 (41.5%) did so occasionally. CONCLUSION: The obtained assessments pointed to the fact that dental technicians expressed a perception of inadequacy regarding the work authorizations provided by dentists for the fabrication of RPDs, where they seemingly felt that the instructions conveyed by the dentists were not sufficiently comprehensive or clear.

A Blended Prosthesis Design for an Implant-Supported Fixed Complete Denture to Manage Restricted Restorative Space.

With new materials and manufacturing techniques being constantly introduced in dentistry, in order to provide optimal patient care clinicians need to know the properties and limitations of these materials before incorporating them into practice. In the past, with fewer restorative material options available, the patient's biological tissues often needed to be surgically prepared to optimize the physical properties of the materials. With today's newer materials and technology, restorative dentists have more choices for restoring oral structures without having to sacrifice or alter biological tissue. This case report describes the benefits of using CAD/CAM technology and various contemporary materials when restorative space is limited.

Interdisciplinary management of nonsyndromic tooth agenesis in the digital age.

BACKGROUND AND OVERVIEW: Tooth agenesis is the most common congenital condition affecting the oral cavity. This condition can involve single or multiple missing teeth. Severe forms of tooth agenesis are best managed by a team of specialists, as they can be daunting for a single provider. CASE DESCRIPTION: As the goal of most patients is to replace missing teeth to improve cosmesis and function, a prosthodontist or restorative dentist plays a major role in the team's effort. Although diagnostic skills and careful planning are still the mainstay of this treatment, digital technology and modern materials can greatly facilitate implementation of the treatment plan. The authors present a case of a patient with nonsyndromic oligodontia who had a deficient occlusal vertical dimension that was treated by means of an interdisciplinary approach. The management included a combination of orthodontics, fixed and removable prosthodontics, and oral surgery. CONCLUSIONS AND PRACTICAL IMPLICATIONS: When treating patients with complex congenital tooth anomalies, the prosthodontist or restoring dentist is well positioned to take the lead and orchestrate treatment of the patient.

Successful development and implementation of a digital dentistry curriculum at a US dental school.

Introducing new technology in the dental school curriculum may face some uphill challenges navigating through university-level bureaucracy, financial ramifications, and influencing the mindset of certain faculty. A dental school that relies heavily on teaching traditional restorative procedures may particularly face many challenges to embrace new technology. The restorative department at a US dental school created a division of computer-aided design and computer-aided manufacturing (CAD/CAM) dentistry to introduce the concept of digital dentistry to dental students and faculty. This article describes methods that were adopted to improve acceptance and increase the productivity of chairside CAD/CAM restorations for both students and faculty at the dental school in US.

A simple technique for impression taking of teeth and functionally generated paths.

The objective of this case report is to introduce a simple technique for simultaneously taking a closed-mouth impression and functionally generated path (FGP) for a full coverage crown restoration. A monolithic zirconia crown was the restoration of choice. An alginate impression of the abutment tooth was taken to fabricate a custom-made closed-mouth impression tray covering the abutment tooth and the adjacent teeth. The tray had an FGP table and an abutment tray in cameo and intaglio surfaces, respectively. The impression was taken with silicone impression material after adjusting the abutment tray and inscribing the FGP using self-curing acrylic resins. Plaster casts were made from the impression, and a zirconia crown was fabricated. The crown was cemented to the abutment tooth with minimal adjustments. This simple technique resulted in a well-fitting crown that accounted for mandibular movements. Using the custom closed-mouth impression tray incorporating an FGP table simultaneously aids in fabricating an accurately fitting restoration that incorporates harmonious mandibular movements using a single impression capture.

Dental Impression Materials and Techniques.

Dental impression making is the process of creating a negative form of the teeth and oral tissues, into which gypsum or other die materials can be processed to create working analogues. Contemporary dentistry generates new information every year and digital dentistry is becoming established and influential. Although dentists should stay abreast of new technologies, some of the conventional materials and time-tested techniques remain widely used. It is important to review the impression-making process to ensure that practitioners have up-to-date information about how to safely and effectively capture the exact form of the oral tissues to provide optimal patient management.