Effectiveness of virtual reality interactive simulation practice in prosthodontic education: A systematic review and meta-analysis.

INTRODUCTION: Virtual reality-based interactive simulation (VRIS) provides a safe and controlled environment for dental students and professionals to develop skills and knowledge. This study aimed to investigate the effectiveness of using the VRIS for prosthodontic practice and to explore the trends, application areas, and users' attitudes towards VRIS. MATERIALS AND METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for searching studies published until 21 March 2023 that reported quantitative or qualitative learning outcomes related to the use of VRIS for dental prosthodontic practice and clinical training. The quality of the included studies was assessed using the Medical Education Research Study Quality Instrument (MERSQI) and Newcastle-Ottawa Scale-Education (NOS-E) tools. A random-effects meta-analysis was conducted to compare the intervention group (utilizing VRIS) and the control group (employing conventional prosthodontic training methods) based on performance skill scores and task completion time, with a significance level set at <.05. RESULTS: The meta-analysis revealed that the utilization of VRIS generally improves students' performance scores (SMD = 1.04; 95% CI, -0.35 to 2.44; I2 > 50%; p = .13) and reduces task completion time (SMD = -0.03; 95% CI, 1.39-7.72; I2 > 50%; p = .93). Notably, using VRIS significantly enhanced the performance scores in implant surgery practice (SMD = 0.26; 95% CI, 0.09-0.42; p < .05). Additionally, the VRIS method significantly reduced task completion time in the cavity restorative preparation task (SMD = -1.19; 95% CI, -1.85 to -0.53; p < .05). CONCLUSION: Engaging in practice with VRIS has the potential to enhance learning proficiency in prosthodontic education. The advantages associated with VRIS encompass the provision of immediate feedback, decreased task completion time, heightened confidence and motivation, accelerated skill acquisition, improved performance scores, and increased learning engagement.

ACCURACY OF REMOVABLE PARTIAL DENTURE METAL FRAMEWORKS FABRICATED BY COMPUTER-AIDED DESIGN/ COMPUTER-AIDED MANUFACTURING METHOD: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVE: This systematic review and meta-analysis aimed to investigate the accuracy of removable partial denture (RPD) frameworks fabricated by computer-aided design/ computer-aided manufacturing (CAD/CAM) systems compared to frameworks produced by conventional casting methods. METHODS: A systematic literature search was conducted in electronic databases following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, using formulated Boolean operator for searching articles evaluating the fit accuracy of CAD/CAM-fabricated RPD metal frameworks. The agreement of data collection among the reviewers was confirmed using the Cohen kappa coefficient. The modified methodological index for non-randomized studies (MINORS) scale was used to assess the quality of the included studies. Heterogeneity among studies was evaluated, and meta-analyses with global and subgroup analyses were performed. RESULTS: A total of 208 articles were identified with 18 articles available for the narrative review and 7 studies available for meta-analysis on the 3D-printed frameworks for RPD (the overall Cohen kappa coefficient = 0.944). There was no article on the accuracy of RPD frameworks made by milling method. The meta-analysis revealed that the misfit of frameworks obtained with the CAD/CAM method was significantly higher than that of the conventional lost wax and casting method (SMD = 1.23 µm, 95% CI = 0.3610-2.0981 µm, z = 2.77, P = .0055). Regarding the CAD/CAM techniques used for fabricating RPD metal frameworks, the within subgroup analysis showed that the CAD/CAM-based indirect fabrication method produced frameworks with fit accuracy more similar to the conventional lost-wax and casting method (SMD = 1.15 µm, 95% CI = - 0.06136-2.9192 µm, z = 1.28, P < .01) than the CAD/CAM-based direct fabrication method (SMD = 1.35 µm, 95% CI = -0.2722-2.4381 µm, z = 2.45, P < .01), even though there was no statistical difference between the techniques (P = .8482). CONCLUSIONS: The fit accuracy of RPD metal frameworks fabricated by the CAD/CAM method was lower than that of frameworks fabricated by the conventional casting method, but it was within the clinically acceptable range in dimensional misfit. The indirect metal 3D printing technique based on pattern printing and subsequent casting produced frameworks with fit accuracy more similar to the conventional method than the direct fabrication technique.

Impact of scanning strategy on the accuracy of complete-arch intraoral scans: a preliminary study on segmental scans and merge methods.

PURPOSE: This study investigated the accuracy of full-arch intraoral scans obtained by various scan strategies with the segmental scan and merge methods. MATERIALS AND METHODS: Seventy intraoral scans (seven scans per group) were performed using 10 scan strategies that differed in the segmental scan (1, 2, or 3 segments) and the scanning motion (straight, zigzag, or combined). The three-dimensional (3D) geometric accuracy of scan images was evaluated by comparison with a reference image in an image analysis software program, in terms of the arch shape discrepancies. Measurement parameters were the intermolar distance, interpremolar distance, anteroposterior distance, and global surface deviation. One-way analysis of variance and Tukey honestly significance difference post hoc tests were carried out to compare differences among the scan strategy groups (α = .05). RESULTS: The linear discrepancy values of intraoral scans were not different among scan strategies performed with the single scan and segmental scan methods. In general, differences in the scan motion did not show different accuracies, except for the intermolar distance measured under the scan conditions of a 3-segmental scan and zigzag motion. The global surface deviations were not different among all scan strategies. CONCLUSION: The segmental scan and merge methods using two scan parts appear to be reliable as an alternative to the single scan method for full-arch intraoral scans. When three segmental scans are involved, the accuracy of complete arch scan can be negatively affected.

Impact of Matching Point Selections on Image Registration Accuracy between Optical Scan and Computed Tomography.

The point-based surface registration method involves the manual selection process of paired matching points on the data of computed tomography and optical scan. The purpose of this study was to investigate the impact of selection error and distribution of fiducial points on the accuracy of image matching between 3-dimensional (3D) images in dental planning software programs. Computed tomography and optical scan images of a partial edentulous dental arch were obtained. Image registration of the optical scan image to computed tomography was performed using the point-based surface registration method in planning software programs under different conditions of 3 fiducial points: point selection error (0, 1, or 2 mm), point distribution (unilateral, bilateral), and planning software (Implant Studio, Blue Bio Plan) (n = 5 per condition, N = 60). The accuracy of image registration at each condition was evaluated by measuring linear discrepancies between matched images at X, Y, and Z axes. Kruskal-Wallis test, Mann-Whitney U test with Bonferroni correction, and 3-way analysis of variance were used to statistically analyse the measurement data (α = 0.05). No statistically significant difference was exhibited between the 0 and 1 mm point mismatch conditions in either unilateral or bilateral point distributions. The discrepancy values in the 2 mm mismatch condition were significantly different from the other mismatch conditions, especially in the unilateral point distribution (P < 0.05). Strong interactions among point selection error, distribution, and software programs on the image registration were found (P < 0.001). Minor matching point selection error did not influence the accuracy of point-based automatic image registration in the software programs. When the fiducial points are distributed unilaterally with large point selection error, the image matching accuracy could be decreased.

Reliability of digital measurement methods on the marginal fit of fixed prostheses: A systematic review and meta-analysis of in vitro studies.

STATEMENT OF PROBLEM: Digital methods have been increasingly used to evaluate the fit of prostheses, but the accuracy of digital methodology has not been fully clarified. PURPOSE: The purpose of this systematic review and meta-analysis was to assess the reliability of digital measurement methods for evaluating the marginal fit of fixed dental prostheses (FDPs) and to identify the potential factors that can influence the accuracy of the measurement methods. MATERIAL AND METHODS: The differences between digital and conventional measurement methods were analyzed by searching PubMed, Scopus, Web of Science, and Google Scholar databases for studies reporting the marginal fit of FDPs. The agreement of data collection among the reviewers was confirmed by the Cohen kappa coefficient, and the MINORS scale was used to rate the quality of the included studies. The heterogeneity among the studies was evaluated, and meta-analyses with global and subgroup analyses were performed. RESULTS: Ten in vitro studies were selected according to the eligibility criteria with substantial interreader concordance (κ=0.88). The standard mean difference of the meta-analysis for marginal discrepancy was 0.12 µm (95% confidence interval: -0.12 to 0.35), indicating that no statistically significant differences were found in the marginal discrepancies observed with digital and conventional methods (P=.343). The subgroup analysis for alloy-based prostheses was not significantly different, nor between the material and measurement methods (P=.060). CONCLUSIONS: Digital methods appear to be reliable as an alternative to conventional methods for evaluating the marginal fit of FDPs. To confirm the results of this study and to identify the influencing factors on the accuracy of digital measurement methods, further controlled laboratory and clinical studies are needed.

The Effects of Distribution of Image Matched Fiducial Markers on Accuracy of Computer-Guided Implant Surgery.

PURPOSE: Image registration of the optical intraoral scan to computed tomography image is essential for computer-guided implant surgery. The remaining teeth, which are considered to be congruent structures observed in the scan and radiographic images, are used to perform the image registration. The purpose of this study was to evaluate the effects of the distribution of matching fiducial points on the accuracy of the image registration. MATERIALS AND METHODS: A partially edentulous model with three anterior remaining teeth was prepared. Two mini dental implants were inserted in the posterior edentulous areas on both sides, and computed tomography and surface scan data were obtained. Three groups were set according to the distribution of the image matching points used: localized distribution, unilateral distribution, and bilateral distribution. Fifteen graduate students performed the registration process in each group using the same image matching method. The accuracy of image registration was evaluated by measuring the geometric discrepancies between the radiographic and registered scan images in the anterior, middle, and posterior regions. One-way and two-way analysis of variance with the Tukey HSD post hoc test were used for statistical analysis (α = 0.05) RESULTS: In general, the registration discrepancy was lowest in the bilateral distribution group, followed by the unilateral distribution and localized distribution groups (p< 0.001). In the regional analysis, the registration error tended to increase as the measurement region moved farther from the matching points. The distribution of the matching points and measurement regions had a statistical interaction in the accuracy of image registration. CONCLUSION: The accuracy of image registration of the surface scan to the computed tomography is affected by the matching point distribution that can be improved by placing artificial markers in the edentulous areas.