Influence of augmented reality technique on the accuracy of autotransplanted teeth in surgically created sockets.

BACKGROUND: The objective of the present study was to evaluate the reliability of an augmented reality drilling approach and a freehand drilling technique for the autotransplantation of single-rooted teeth. MATERIALS AND METHODS: Forty samples were assigned to the following surgical techniques for drilling guidance of the artificial sockets: A. augmented reality technique (AR) (n = 20) and B. conventional free-hand technique (FT) (n = 20). Then, two models with 10 teeth each were submitted to a preoperative cone-beam computed tomography (CBCT) scan and a digital impression by a 3D intraoral scan. Afterwards, the autotrasplanted teeth were planned in a 3D dental implant planning software and transferred to the augmented reality device. Then, a postoperative CBCT scan was performed. Data sets from postoperative CBCT scans were aligned to the planning in the 3D implant planning software to analize the coronal, apical and angular deviations. Student's t-test and Mann-Whitney non-parametric statistical analysis were used to analyze the results. RESULTS: No statistically significant differences were shown at coronal (p = 0.123) and angular (p = 0.340) level; however, apical deviations between AR and FT study groups (p = 0.008) were statistically significant different. CONCLUSION: The augmented reality appliance provides higher accuracy in the positioning of single-root autotransplanted teeth compared to the conventional free-hand technique.

Digital technique to analyze the wear of screw-retained implant supported metal-ceramic dental prostheses and natural tooth as antagonist: a pilot study.

The aim of this study was to describe a novel digital technique to analyze the wear of screw-retained implant-supported metal-ceramic dental prostheses and natural tooth as antagonist.Materials and methods Ten patients were consecutively included to rehabilitate partial edentulism by dental implants. Both the screw-retained implant-supported metal-ceramic dental prostheses and the natural tooth as antagonist were submitted to a digital impression through an intraoral scan to generate a Standard Tessellation Language digital file preoperatively (STL1), at 3 months (STL2), and 6 months (STL3) follow-up. Afterwards, an alignment procedure of the digital files (STL1-STL3) was performed on a reverse engineering morphometric software (3D Geomagic Capture Wrap) and volume changes at the screw-retained implant-supported metal-ceramic dental prostheses and the natural tooth as antagonist were analyzed using Student's t-test. Moreover, Gage R&R statistical analysis was conducted to analyze the repeatability and reproducibility of the digital technique.Results Gage R&R showed a variability attributable to the digital technique of 3.8% (among the measures of each operator) and 4.5% (among operators) of the total variability; resulting repeatable and reproducible, since the variabilities were under 10%. In addition, statistically significant differences were shown at the wear volume (µm3) of both the natural tooth as antagonist (p < 0.0001) and the screw-retained implant-supported metal-ceramic dental prostheses between 3- and 6-months follow-up (p = 0.0002).Conclusion The novel digital measurement technique results repeatable and reproducible to analyze the wear of screw-retained implant-supported metal-ceramic dental prostheses and natural tooth as antagonist.

Novel Technique of Interproximal Enamel Reduction Based on Computer-Aided Navigation Technique-An In Vitro Study.

The aim of this study was to analyze and compare the accuracy of a novel interproximal enamel reduction (IPR) technique based on a computer-aided static navigation technique with respect to a conventional free-hand-based technique for interproximal enamel reduction. Twenty anatomical-based experimental cast models of polyurethane were randomly distributed into the following IPR techniques: IPR technique based on computer-aided static navigation technique (n = 10) (GI) for Group A and conventional free-hand-based technique for the IPR (n = 10) (FHT) for Group B. The anatomical-based experimental cast models of polyurethane randomly assigned to the GI study group were submitted for a preoperative 3D intraoral surface scan; then, datasets were uploaded into 3D implant-planning software to design virtual templates for the interproximal enamel reduction technique. Afterward, the anatomical-based experimental cast models of polyurethane of both GI and FHT study groups were subjected to a postoperative digital impression by a 3D intraoral surface scan to compare the accuracy of the interproximal enamel reduction techniques at the buccal (mm), lingual/palatal (mm), and angular (◦) levels using the Student t-test. Statistically significant differences between the interproximal enamel reduction technique based on the computer-aided static navigation technique and the conventional free-hand-based technique for the interproximal enamel reduction at the buccal (p = 0.0008) and lingual/palatal (p < 0.0001) levels; however, no statistically significant differences were shown at the angular level (p = 0.1042). The interproximal enamel reduction technique based on computer-aided static navigation technique was more accurate than the conventional free-hand-based technique for interproximal enamel reduction.

Influence of parallel pins on the angle deviation for placement of dental implants: an in vitro study.

The aim of the present study was to analyze and compare the angle deviation of two, four and six adjacent dental implants placed with and without straight parallel pins. MATERIALS AND METHODS: Two hundred and forty (240) dental implants were selected and randomly allocated into the following study groups: Two dental implants placed with straight parallel pins (Ref.: 144-100, BioHorizons, Birmingham, AL, USA) (n = 10) (2PP); Two dental implants placed without parallel pins (n = 10) (2withoutPP); Four dental implants placed with straight parallel pins hT(n = 10) (4PP); Four dental implants placed without parallel pins (n = 10) (4withoutPP); Six dental implants placed with straight parallel pins (n = 10) (6PP) and Six dental implants placed without parallel pins (n = 10) (6withoutPP). The dental implants randomly assigned to groups 2PP and 2withoutPP were placed into standardized polyurethane models of partially edentulous upper jaws in tooth positions 2.4 and 2.6, the dental implants randomly assigned to groups 4PP and 4withoutPP were placed into standardized polyurethane models of fully edentulous upper jaws in tooth positions 1.6, 1.4, 2.4 and 2.6, and the dental implants randomly assigned to groups 6PP and 6withoutPP were placed into standardized polyurethane models of fully edentulous upper jaws in tooth positions 1.6, 1.4, 1.2, 2.2, 2.4 and 2.6. Afterwards, postoperative CBCT scans and digital impressions were aligned in a 3D implant-planning software to compare the angle deviation (°) of two, four and six adjacent dental implants placed with and without straight parallel pins using the General Linear Model statistical analysis. RESULTS: Statistically significant differences were found between the angle deviation of 2 dental implants placed with straight parallel pins (p < 0.0001) and between the angle deviation of 4 dental implants placed with straight parallel pins (p = 0.0024); however, no statistically significant differences were found in the angle deviation of 6 dental implants placed with straight parallel pins (p = 0.9967). CONCLUSION: The use of a straight parallelization pin results in lower angle deviation between two and four adjacent dental implants; however, it is not effective for a larger number of dental implants.

Mandibular advancement devices decrease systolic pressure during the day and night in patients with obstructive sleep apnea: A systematic review and meta-analysis.

The aim of this systematic review and meta-analysis was to analyze whether or not mandibular advancement devices (MADs) produce changes in blood pressure in patients with obstructive sleep apnea (OSA) in relation to use time and if the device is used at night or day. MATERIALS AND METHOD: A systematic review of the literature and meta-analysis was carried out in accordance with PRISMA guidelines. In the bibliographic search, a total of four databases were consulted: PubMed-Medline, Scopus, Web of Science, and Cochrane. Of the 622 articles initially revealed, 160 duplicates were eliminated. After applying the selection criteria, 17 articles were included for the qualitative analysis and 4 for the meta-analysis. The studies were combined using a random effects model with the inverse method of variance, determining the mean differences in systolic and diastolic pressure before and after treatment using the MAD splint as the effect size. Day/night circadian effect and treatment time were analyzed using meta-regression with a mixed-effects model. RESULTS: MAD treatment was not found to affect diastolic pressure. By combining the four studies with the control group in a meta-analysis (I2 = 75%; z = - 0.15; p-value = 0.882), the mean difference in diastolic pressure between the MAD group and the control group was estimated at - 0.06 (- 0.86; 0.74). The meta-regression also showed no significant effect of day/night (p = 0.560) or treatment time (p = 0.854) on diastolic pressure. When combining the four studies with the control group (I2 = 84%%; z = - 1.47; p-value = 0.142), a non-significant mean difference in systolic pressure between the MAD group and the control group of - 0.99 (- 2.31; 0.33) was estimated in the meta-analysis. However, when assessing the effect of day/night or treatment time on systolic blood pressure using a meta-regression, the latter showed significant covariates that reduce systolic blood pressure values in the model at night (p < 0.001) and in relation to treatment time (p < 0.001). CONCLUSIONS: Only systolic pressure appears to be affected by the use of the MAD in patients with OSA, and this decrease in systolic pressure is greater at night and when treatment time is longer.

Nasal and maxillary sinus volume change in patients with obstructive sleep apnea after bimaxillary advancement surgery.

The airway complex is modified by bimaxillary advancement surgery performed in patients suffering from obstructive sleep apnea (OSA). The aim of the present study is to analyse the volume of nasal and maxillary sinus after bimaxillary advancement surgery in patients suffering from OSA. The maxillary sinus and nasal complex of eighteen patients with OSA was measured through cone-beam computed tomography (CBCT) before and after they were treated with bimaxillary advancement surgery. Digital planning software was used to effectively measure the upper volume changes, as well as, statistical analysis of the results was performed.Methods Eighteen patients were diagnosed with OSA the severity of which was measured by the apnea hypopnea index and were selected and submitted to preoperative and postoperative CBCT scans. Afterwards, datasets were uploaded into therapeutic digital planning software (Dolphin Imaging) to measure the volume of the right and left maxillary sinus and nasal and maxillary sinus complex. Statistically analysis between preoperative and postoperative measures was performed by Student t-test statistical analysis.Results The paired t-test showed statistically significant volumetric reductions in the left maxillary sinus (p = 0.0004), right maxillary sinus (p < 0.0001) and nasal and maxillary sinus complex (p = 0.0009) after bimaxillary advancement surgery performed in patients suffering from OSA.Conclusion The results showed that bimaxillary advancement surgery reduces the maxillary sinus volume as well as, the fossa nasal and sinus complex volume.

Relationship between Prostate Inflammation and Periodontal Disease-A Systematic Review and Meta-Analysis.

The aim of this systematic review and meta-analysis was to analyze the association between periodontal disease and prostate inflammation with a null hypothesis stating that periodontal disease does not increase the incidence of prostate inflammation. MATERIALS AND METHODS: A systematic literature review and meta-analysis of longitudinal observational cohort and case-control studies that evaluated the odds ratio or hazard ratio and confidence interval was undertaken based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations (2020). A total of four databases were consulted in the literature search: PubMed-Medline, Scopus, Embase, and Web of Science. After eliminating duplicated articles and applying the inclusion criteria, seven articles were selected for the qualitative and quantitative analyses. RESULTS: Four observational cohort studies and three observational cohort case-control studies were included in the meta-analysis. The four observational cohort studies were combined using the random effects model to estimate a hazard ratio of 1.32 with a confidence interval of 95% between 0.87 and 1.77. The meta-analysis presented high heterogeneity (Q test = 56.1; p value < 0.001; I2 = 94.9%). Moreover, the three observational case-control studies were combined using the random effects model to estimate an odds ratio of 1.62 with a confidence interval of 95% between 1.41 and 1.84. The meta-analysis presented high heterogeneity (Q test = 1.07; p value = 0.782; I2 = 0%). CONCLUSIONS: The incidence of periodontal disease does not increase the risk of the incidence of prostate inflammation.

Comparative analysis of two navigation techniques based on augmented reality technology for the orthodontic mini-implants placement.

To analyze and compare the accuracy and root contact prevalence, comparing a conventional freehand technique and two navigation techniques based on augmented reality technology for the orthodontic self-drilling mini-implants placement. Methods Two hundred and seven orthodontic self-drilling mini-implants were placed using either a conventional freehand technique (FHT) and two navigation techniques based on augmented reality technology (AR TOOTH and AR SCREWS). Accuracy across different dental sectors was also analyzed. CBCT and intraoral scans were taken both prior to and following orthodontic self-drilling mini-implants placement. The deviation angle and horizontal were then analyzed; these measurements were taken at the coronal entry point and apical endpoint between the planned and performed orthodontic self-drilling mini-implants. In addition, any complications resulting from mini-implant placement, such as spot perforations, were also analyzed across all dental sectors.Results The statistical analysis showed significant differences between study groups with regard to the coronal entry-point (p < 0.001), apical end-point(p < 0.001) and angular deviations (p < 0.001). Furthermore, statistically significant differences were shown between the orthodontic self-drilling mini-implants placement site at the coronal entry-point (p < 0.0001) and apical end-point (p < 0.001). Additionally, eight root perforations were observed in the FHT group, while there were no root perforations in the two navigation techniques based on augmented reality technology.Conclusions The navigation techniques based on augmented reality technology has an effect on the accuracy of orthodontic self-drilling mini-implants placement and results in fewer intraoperative complications, comparing to the conventional free-hand technique. The AR TOOTH augmented reality technique showed more accurate results between planned and placed orthodontic self-drilling mini-implants, comparing to the AR SCREWS and conventional free-hand techniques. The navigation techniques based on augmented reality technology showed fewer intraoperative complications, comparing to the conventional free-hand technique.

Effect of the computer-aided static navigation technique on the accuracy of bicortical mini-implants placement site for maxillary skeletal expansion appliances: an in vitro study.

The objective of the present study was to evaluate and compare the effect of the computer-aided static navigation technique on the accuracy of the maxillary skeletal expansion (MSE) appliances. MATERIAL AND METHODS: Forty orthodontic self-drilling mini-implants were placed in ten anatomically based standardized polyurethane models of a completely edentulous upper maxilla, manufactured using a 3D impression procedure. The four orthodontic self-drilling mini-implants for anchoring the MSE appliance were digitally planned on 3D planning software, based on preoperative cone-beam computed tomography (CBCT) scan and a 3D extraoral surface scan. Afterwards, the surgical templates were virtually planned and manufactured using stereolithography. Subsequently, the orthodontic self-drilling mini-implants were placed an postoperative CBCT scans were performed. Finally, coronal entry-point, apical end-point and angular deviations were calculated using a t-test for independent samples or a non-parametric Signed Rank test. RESULTS: Statistically significant differences were not shown at coronal entry-point (p = 0.13), apical end-point (p = 0.41) and angular deviations (p = 0.27) between the planned and performed orthodontic self-drilling mini-implants. CONCLUSIONS: Computer-aided static navigation technique enables accurate orthodontic mini-implant placement for the MSE appliances.

Endodontic re-treatment and restorative treatment of a dens invaginatus type II through new technologies.

BACKGROUND: The complex anatomy of dens invaginatus makes access cavity to root canal system difficult, which has an impact on the prognosis of these teeth. A novel technique, based on new technologies, is proposed to make access cavity conservative and guided with minimal dental structure lost. MATERIAL AND METHODS: This case report shows the root canal retreatment and the endodontic surgery of a dens invaginatus type II in a left lateral upper incisor previously treated which was affected by a chronic apical abscess and an apical fracture. A Cone Beam Computed Tomography was performed to better diagnosis the dental anatomy. An intraoral scan was performed to get a digital 3D model. A computer-guided implant planning software was used to plan the access cavity and design the splint guided. Finally, the clinical crown was restored by a resin nanoceramic veneer made by a chairside system made up of an intraoral scanning unit and a grinding unit. Last, the authors carried through the endodontic surgery to extract the apical fractured fragment. RESULTS: Follow-up appointments at 6, 12 and 18 months showed a radiographic reduction of the periapical lesion and absence of clinical signs. CONCLUSIONS: The splint guide allowed a guided and conservative access cavity to root canal system. It facilitates the root canal retreatment and improves the prognosis of the teeth with dental malformations. Key words:CAD-CAM, Cone-Beam Computed Tomography, dens in dente, dens invaginatus, dental pulp cavity, endodontics.

Endodontic treatment of dens evaginatus by performing a splint guided access cavity.

AIM: Dens evaginatus (DE) is described as an unusual dental malformation. Tooth structure variations attached to this anatomical disturbance complicates the performance of a conservative access cavity for a conventional root canal treatment. Author's purpose is to describe the treatment of a type V DE by using splits as guides to perform access cavity. CLINICAL CONSIDERATIONS: This clinical case shows a root canal treatment of a type V DE diagnosed by using a cone beam computed tomography (CBCT). Access cavity was planned through an osseointegrated implant planning software and guided by a stereolithographied split. After endodontic treatment, tooth was sculpted for placing a veneer, processed by a chair-side system in a single session. CONCLUSIONS: CBCT is an effective method for obtaining internal anatomical information of teeth with anatomical malformations. The osseointegrated implant planning software is an effective method for planning root canal treatment and designing stereolithograped splits (for performing minimally invasive access cavities). CLINICAL SIGNIFICANCE: Stereolithographed splints allow performing a guided and conservative access cavity of teeth affected by dental malformations whereas digital technology allows us to esthetically reconstruct a tooth in a single session.

Análisis comparativo in vitro de la capacidad de sellado marginal en cavidades a retro del MTA y del cemento de óxido de cinc-eugenol reforzado / In vitro analysis and comparison of the apical sealing capability of MTA and a reinforced zinc oxide-eugenol cement

Objetivo: El objetivo de este estudio consiste en comparar la capacidad de sellado apical de dos materiales empleados en la obturación de cavidades a retro en cirugía periapical: MTA y un cemento de óxido de cinc-eugenol reforzado (Super EBA(R)). Material y métodos: Se llevó a cabo un estudio in vitro con dientes unirradiculares extraídos, a fin de evaluar la capacidad de sellado apical de dos materiales empleados como material de obturación en cavidades a retro: cemento de óxido de cinc reforzado (Súper EBA(R)) (n = 30) y MTA (n = 30). Además, se creó un grupo control negativo (n = 5) y otro positivo (n = 5). Las muestras procesadas fueron sumergidas en tinta China y posteriormente diafanizadas. Tras secar las muestras, se cuantificó el grado de filtración (mm) mediante un software de análisis de imagen. Los resultados fueron analizados utilizando el test de la t de Student, empleando el programa SPSS versión 20.0. Un valor de p ≤ 0,05 fue considerado significativo. Resultados: El 6,6% y el 10% de las muestras obturadas con MTA o con Súper EBA(R), respectivamente, sufrieron una filtración completa. Estas referencias revelaron que el grado de filtración no depende del material empleado (p = 0,133). Conclusión: No existen diferencias respecto al grado de filtración entre ambos materiales empleados en el sellado retrocavitario

Objectives: The aim of this study was to compare the apical sealing capabilities of the mineral trioxide aggregate (MTA) and of the reinforced zinc oxide-eugenol cement Super EBA(R). Material and methods. An in vitro study was carried out using extracted single-rooted teeth samples. Two materials were tested as root-end filling materials: a reinforced zinc oxide-eugenol cement (Super EBA(R)) (n = 30) and mineral trioxide aggregate (MTA) (n = 30). Another two groups were created as negative (n = 5) and positive (n = 5) control groups. The samples were put in Chinese ink and then diafanizated. Once dried, the level of leakage (mm) was measured by an image software program. The results were analysed using Student's t-test, using the SPSS version 20.0. Differences with p value lower or equal 0.05 were considered significant. Results: Mean filtration in MTA group was 0.77 ± 1.006, whereas in the SuperEba group it was 1.20 ± 1.186 (p = 0.133). Complete leakage was found in 6.6% of the samples filled with MTA and in 10% of those filled with Super EBA(R) (p = 0.133). The level of leakage was not influenced by the material used and null hypothesis can be accepted. Conclusion: Both type of root-end filling materials analysed in this research, are indicated for sealing the retropreparation, without differences in the leakage

Reabsorción radicular interna. A propósito de un caso / Internal root resorption. A case report

Las reabsorciones radiculares internas (RRI) se describen como un proceso infrecuente localizado en el interior del conducto radicular, que acontece como resultado de un aumento de la actividad odontoclástica. La aparición de este proceso patológico se encuentra vinculado al grado de afectación del complejo dentinopulpar; advirtiéndose una mayor incidencia en aquellos dientes afectados por necrosis pulpar (77%) y periodontitis apical crónica (75%). Los dientes afectados por RRI se muestran asintomáticos con frecuencia, pudiendo observarse lesiones fistulosas en los casos más avanzados. El diagnostico por imagen constituye el método más eficaz para establecer un diagnóstico precoz, y el tratamiento de conductos supone la terapia de elección. Este caso clínico describe el caso de una reabsorción radicular interna secundaria a un antecedente traumático. Con objeto de favorecer la desinfección del defecto cavitario, se planificó la aplicación de medicación intraconducto entre citas. La obturación del conducto radicular se llevó a cabo mediante una técnica de gutapercha termoplástica. Durante esta fase se produjo una sobreextensión del material de obturación radicular, hecho que justificó la cirugía endodóntica a la que se sometió a la paciente posteriormente. La retrocavidad configurada en el extremo apical resultó obturada con MTA, atendiendo a su elevada capacidad de sellado marginal y sus propiedades osteoinductoras

The internal root resorption ( IRR ) are described as an uncommon process located inside the root canal, that occurs as a result of the increase of clastic cells stimulated by pulpal inflammation. The appearance of this disease process is linked to the degree of involvement of the dentin-pulp complex, noticeable a higher incidence in those teeth affected by pulp necrosis (77%) and chronic apical periodontitis (75 %). Teeth affected by IRR are often non-symptomatic, fistulous lesions can be seen in more advanced cases. The imaging diagnostic is the most effective method to establish an early diagnosis and root canal treatment involves the treatment of choice. This case report describes the case of internal root resorption secondary to a traumatic history. In order to promote disinfection cavitary defect ,the application of intracanal medication was planned between appointments. The root canal filling was carried out by a technique of thermoplastic guttapercha. Throughout this phase there was an overextension of root canal filling material, a fact which justified endodontic surgery the patient underwent later. The rootend preparation was sealed with MTA , based on its high level of marginal seal and osteoinductive properties