Cadiax Compact 2 and MODJAW comparative analysis of condylar inclination: Innovative digital approaches in dentistry.

STATEMENT OF PROBLEM: Artificial intelligence has been used to enhance the digitalized workflow, especially when undergoing complex oral rehabilitations. However, the reliability of real-time jaw motion registration devices is unclear, and no standard measurement method of the sagittal condylar inclination (SCI) and Bennett angle (BA) has been established. PURPOSE: The purpose of this clinical study was to compare and evaluate the reliability of the SCI and BA values recorded by using 2 different digital devices. MATERIAL AND METHODS: A total of 17 participants, aged between 20 and 30 years (10 women and 7 men) were included in the study. For each participant, the Cadiax Compact 2 and MODJAW tracking devices were used to measure the SCI and BA values at 3 mm and 5 mm of condylar displacement during 3 separate recording sessions. The intraclass correlation coefficient (ICC) was used to assess the reliability of the recordings. Comparisons between the devices were performed with the Wilcoxson rank-sum test (α=.05). The Bland-Altman plot was used to evaluate the quantitative agreement between the 2 devices. RESULTS: All ICC intrarater reliability values for Cadiax and MODJAW were higher than 0.90. Both at 3 and 5 mm, the SCI measurements were higher for MODJAW registrations than for those recorded by Cadiax. The Bland-Altman plot showed that the SCI values were higher for MODJAW than for Cadiax by 5.9 (95% CI 3.9 to 8.2) and that the BA differences between the MODJAW and the Cadiax were not consistent with the measured value. CONCLUSIONS: Excellent reliability was found with the MODJAW and Cadiax recordings. The SCI and BA values for MODJAW measurements were higher at 3 mm and 5 mm than those acquired with Cadiax. MODJAW showed higher values than Cadiax, and the discrepancies were more pronounced for 3 mm than for 5 mm of condylar displacement, highlighting the need for precision in measurements at lower ranges of motion.

Therapeutic challenges in temporomandibular disorders.

Background and aims: This study aimed at evaluating the etiology and treatment challenges of temporomandibular disorders (TMDs). Methods: 160 subjects with TMDs, 38 males (23.8%) and 122 females (76.3%) were studied. A personalized coefficient was designated, which included the resolution of the main symptom, correction of secondary symptoms, patient collaboration (emotional parameter), treatment duration, and cost. Results: The most frequent cause for consultation was muscle impairment (42.5%), or limitation of mouth opening, followed by joint impairment (23.1%). Muscle pain was noticed, particularly in the masseter (57.5%) and lateral pterygoid muscles (51.9%). Tooth pain or gingival retraction was frequently associated with tooth wear (48.1%) and dental abfraction (31.3%). Remote symptomatology was dominated by otologic symptomatology. Iatrogenic etiology was highest (69.4%), followed by untreated missing teeth (66.9%). Treatment options included muscle relaxation, occlusal balancing (equilibration), kinesitherapy, medication, and swallowing re-education. Most patients benefited from four to seven different types of therapy, which resulted in a higher cost and a longer and more uncomfortable treatment. The primary symptom was relieved in 82.3% of cases, with recurrence occurring in 15.7%. Conclusion: The treatment of temporomandibular joint dysfunction is time-consuming, demanding, and intricate. Most patients required four to seven different types of therapy, which increased the expense, treatment duration, and suffering.

Perceptions in Digital Smile Design: Assessing Laypeople and Dental Professionals' Preferences Using an Artificial-Intelligence-Based Application.

Digital Smile Design (DSD) is used in many fields of dentistry. This prospective observational study assessed laypeople's and dental professionals' perceptions of a DSD application. SmileCloud, an online DSD platform, was used to create two different designs for three patients; after that, the participants, in a 30-question online illustrated survey, were asked about the most attractive design and other features of the smile. Dentists' and laypeople's perceptions about specific DSD features were assessed. The Kolmogorov-Smirnov normality test was used. Descriptive and crosstab analyses compared the respondents' opinions for each statement. Chi-square tests were used to determine the relationship between the questions and any association with age, gender, and profession. The test results were rated as significant at a p-value < 0.05. A total of 520 participants (dental professionals, students, dental technicians, and laypeople) were enrolled. The statistically significant features were self-esteem related to appearance (p = 0.05), facial and smile symmetry (p = 0.42, p < 0.0001), tooth color (p = 0.012), and symmetry of gums (p < 0.001). For each patient, the design with dominant round upper incisors and perfect symmetry was preferred (p < 0.001). Digital pre-visualization benefits diagnosis and enriches treatment planning. The dentist-dental technician-patient team should be involved in the decision-making process of pre-visualization.

Insights into Occlusal Analysis: Articulating Paper versus Digital Devices.

Background: As the demand for digital dentistry constantly increases, digital devices are gradually replacing conventional methods of recording occlusal contacts. The study aimed to assess the inter-rater reliability of occlusal contact point detection using 40 µm articulating paper, Medit i700, and OccluSense and to compare the distribution of occlusal contacts using the articulating paper and intraoral scanner. Material and Methods: The study included 25 participants aged 20 to 30 (13 women and 12 men). Photographs of contact points were taken and marked in maximum intercuspal position (MIP), in protrusive and laterotrusive movements, on working and non-working sides using 40 µm articulating paper and digital devices. The Cohen's Kappa coefficient assessed the inter-rater reliability. The Wilcoxon signed-rank test was used to compare dependent groups, articulating paper, and Medit i700. Results: The Cohen's Kappa index showed that almost perfect agreement was achieved with 40 µm articulating paper. Compared to Medit i700, the 40 µm articulating paper showed an increased mean number of contacts per tooth, except for the third molars. Conclusions: The 40 µm articulating paper has detected more overall contacts than the digital devices, particularly in the posterior areas. An ideal method for registering occlusal contacts has not been established yet.

Immunomodulatory Effect of Novel Electrospun Nanofibers Loaded with Doxycycline as an Adjuvant Treatment in Periodontitis.

The immunomodulatory effect of a novel biomaterial obtained through electrospinning, based on polylactic acid (PLA) and nano-hydroxyapatite (nano-HAP), loaded with doxycycline (doxy) was evaluated in an animal model. The treatment capabilities as a local non-surgical treatment of periodontitis was investigated on the lower incisors of Wistar rats, after the induction of localized periodontitis using the ligature technique. Following the induction of the disease, the non-surgical treatment of scaling and root planing was applied, in conjunction with the application of the new material. The results of the treatment were evaluated clinically, using the tooth mobility and gingival index scores, as well as histologically. The salivary concentrations of matrix metalloproteinase 8 (MMP-8) and plasmatic concentrations of interleukin 1 (IL-1), interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) were also monitored. Two weeks after the ligature application, the periodontal disease was successfully induced in rats. The application of the novel biomaterial obtained through electrospinning was proven to be more effective in improving the clinical parameters, while decreasing the salivary MMP-8 and plasmatic IL-1 and TNF-α concentrations, compared to the simple scaling and root planing. Thus, the novel electrospun biomaterial could be a strong candidate as an adjuvant to the non-surgical periodontal therapy.