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1.
J Dent Educ ; 2021 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-33586142

RESUMEN

PURPOSE: Objective of this study was to determine if perceptual abilities test (PAT), quantitative reasoning (QR), and academic average (AA) scores predict performance in a rudimentary dental anatomy laboratory exercise. METHODS: First-year dental students (n = 88) completed two identical wax carving exercises during the first and last weeks of the dental anatomy course. After being given detailed instructions and a wax block, students carved a cube and a semilunar shape using the wax subtraction technique. Using a rubric, students self-assessed their work as unsatisfactory, satisfactory, or ideal in the following areas: finish, sharpness, symmetry, and accuracy. Two calibrated and blinded faculty graded the exercise using the same rubric as the students. Cohen's kappa coefficient assessed faculty interrater reliability and student-faculty reliability. Changes in scores between the two exercises were evaluated using Wilcoxon signed rank and paired t-tests. Spearman's correlation coefficient and repeated measures analysis assessed the association between shape carving scores and DAT, QR, and AA scores. RESULTS: Faculty interrater reliability ranged from 0.2554 to 0.4186 for the assessed criteria over the two exercises. Student-faculty rater reliability ranged from 0.1299 to 0.4461. Only PAT scores correlated significantly to higher scores for the four grading criteria for both exercises. Student self-assessment improved with the second exercise. CONCLUSIONS: This rudimentary exercise was useful to identify students early in their dental education who may require more guidance in other manual dexterity courses. Faculties require additional training and calibration. Self-assessment is a life-long process of critical thinking that students are just beginning to learn.

2.
Materials (Basel) ; 13(23)2020 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-33297316

RESUMEN

(1) Background: Prefabricated zirconia crowns are used to restore teeth in children. The purpose of this study was to evaluate the removal of these crowns with the erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser; (2) Methods: A total of 12 primary and 12 permanent teeth were prepared and prefabricated zirconia crowns were passively fitted and cemented with two resin modified glass-ionomer (RMGI) cements. Surface areas of prepared teeth and crowns were calculated. Crowns were removed using two laser settings: 4.5 Watts, 15 Hertz, 20 water/20 air, and 5 Watts, 15 Hertz, 50 water/50 air. The retrieval time and temperature changes were tested recorded. Data were analyzed using ANOVA with Tukey's adjusted post hoc pairwise comparison t-test; (3) Results: The average time for crown removal was: 3 min, 47.7 s for permanent; and 2 min 5 s for primary teeth. The mean temperature changes were 2.48 °C (SD = 1.43) for permanent; and 3.14 °C (SD = 1.88) for primary teeth. The time to debond was significantly positively correlated with tooth inner surface area and volume, outer crown volume, and the cement volume; (4) Conclusions: Use of the Er,Cr:YSGG laser is an effective, safe and non-invasive method to remove prefabricated zirconia crowns cemented with RMGI cements from permanent and primary teeth.

4.
Clin Exp Dent Res ; 2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-33150685

RESUMEN

PURPOSE: The purpose of this study was to investigate if the addition of biologic agents to a particulate bone graft enhances horizontal ridge augmentation outcomes in terms of bone dimensions, bone density, and successful implant placement. MATERIALS AND METHODS: A retrospective chart review was done to assess the clinical and radiographic outcomes in 52 horizontal ridge augmentation sites in 43 patients. Information was gathered regarding surgical technique, type of graft material, biologic agents used (PRP or rhPDGF-BB), method of space maintenance, and achieved alveolar ridge width and bone density changes as quantified on CBCT scans. RESULTS: The use of tenting screws, a resorbable membrane, and a combination of particulate allogenic and xenogenic bone graft material provided an average horizontal bone gain of 3.6 mm in the 52 augmented sites. There was no statistically significant difference observed in the amount of horizontal bone gain between sites treated with the addition of biologic agents (n = 21), or with a particulate bone graft alone (n = 31). A marginally statistically significant difference was found in the density of the grafted bone with the addition of biologics (p value = .0653). CONCLUSION: The addition of biologic agents to the graft materials did not have a significant effect on the amount of horizontal bone gain or successful implant placement; however, it marginally enhanced the bone density of the grafted area.

5.
Am J Orthod Dentofacial Orthop ; 158(6): 799-806, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33010979

RESUMEN

INTRODUCTION: Patients and parents want shorter treatment times, but it is unclear whether they would compromise outcome quality to shorten treatment. The purpose of this study was to compare orthodontists' and parents' perceptions of finished occlusion and their willingness to extend treatment time to achieve improved outcomes. The effects of elapsed treatment time and patient compliance were also investigated. METHODS: Parallel surveys for orthodontists (n = 1000) and parents (n = 750) displayed simulated treatment outcomes of well-aligned teeth with occlusions in 1 mm increments from 3 mm Class III to 3 mm Class II. Participants rated their preferences on a visual analogue scale (VAS; 0-100) and specified whether they would extend treatment, and for how long, to improve the occlusion. RESULTS: Two hundred thirty-three orthodontists (23%) and 243 parents (32%) responded. Despite differences between the scores given (P < 0.0001), both groups rated Class I occlusion most acceptable (mean VAS = 93.9 and 80.7, respectively) and 3 mm Class III malocclusion least acceptable (mean VAS = 25.9 and 40.9, respectively). Parents were willing to extend treatment more often and for a greater time than orthodontists to improve results (P < 0.0001). In addition, parents were less willing to terminate treatment early (P < 0.05). Both groups perceived existing outcomes as more acceptable if the patient was noncompliant (P < 0.05), but elapsed time in treatment had no significant effect on ratings. CONCLUSIONS: For outcomes with well-aligned teeth, orthodontists and parents agreed on what the most and least acceptable occlusal relationships were. To achieve better outcomes, parents were willing to extend treatment duration more often and for a greater time than were orthodontists. In addition, parents were less willing than orthodontists to terminate treatment early.


Asunto(s)
Maloclusión de Angle Clase III , Ortodoncia , Actitud del Personal de Salud , Oclusión Dental , Humanos , Ortodoncistas , Padres
6.
J Endod ; 46(12): 1894-1900, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32919987

RESUMEN

INTRODUCTION: This study presents a novel method to deliver intraosseous anesthesia using dynamic navigation technology. The study aimed to evaluate its safety and 3-dimensional (3D) accuracy in comparison to traditional freehand injection of intraosseous anesthesia. METHODS: Six identical sets of 3D-printed surgical jaw models (TrueJaw; DELendo, Santa Barbara, CA) comprising simulated alveolar and dental anatomy with 54 interradicular sites were used in this study. The injection sites were equally distributed based on the range of the inter-radicular distance (ie, 1.5-2.5 mm, 2.5-3.5 mm, and 3.5-4.5 mm). A board-certified endodontist randomly completed intraosseous drilling at inter-radicular sites of varying distance using freehand technique and the Navident dynamic navigation system (ClaroNav, Toronto, Ontario, Canada) with the X-Tip system (Dentsply Sirona, York, PA). The rate of root perforation associated with inter-radicular distance was compared between the 2 groups using the Fisher exact test. Two-dimensional (2D) and 3D horizontal, vertical, and angulation discrepancies between the planned and dynamically navigated guide sleeves were digitally measured using superimposed cone-beam computed tomographic scans. Analysis of variance models were used to determine if the interdental distance was associated with the accuracy measures from the dynamic navigation system. The significance level was set at 0.05. RESULTS: The rate of root perforation was significantly higher for the freehand group than the dynamic navigation (22% vs 0%, P < .05). For dynamic navigation, the 2D entry deviation was 0.71 mm (95% confidence interval [CI], 0.56-0.87). The mean 2D horizontal deviation was 0.96 mm (95% CI, 0.79-1.14), and the mean 2D vertical deviation was 0.70 mm (95% CI, 0.55-0.84). The 3D deviation at the tip was on an average 1.23 mm (95% CI, 1.05-1.42). The overall 3D angular deviation was on average 1.36° (95% CI, 1.15-1.56). The inter-radicular distance was not significantly associated with any 2D or 3D discrepancies. CONCLUSIONS: Successful and accurate drilling of dynamically navigated intraosseous delivery occurred in 100% of injection sites irrespective of the inter-radicular distance. It was significantly safer in comparison to freehand intraosseous drilling to prevent injury of the roots of the adjacent teeth in close proximity.


Asunto(s)
Anestesia Dental , Cirugía Asistida por Computador , Diente , Anestesia Dental/efectos adversos , Tomografía Computarizada de Haz Cónico , Ontario
7.
J Endod ; 2020 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-32795551

RESUMEN

INTRODUCTION: The aim of this in vitro study was to compare the speed, qualitative precision, and quantitative loss of tooth structure with freehand and dynamically navigated access preparation techniques for root canal location in 3-dimensional-printed teeth with simulated calcified root canals. METHODS: Forty maxillary and mandibular central incisors (tooth #9 and tooth #25) were 3-dimensionally printed to simulate canal calcification. Under simulated clinical conditions, access preparations were randomly performed with contemporary freehand and dynamically navigated techniques. Qualitative precision and quantitative loss of tooth structure were assessed on postoperative cone-beam computed tomographic scans using ITK-SNAP open-source segmentation (http://www.itksnap.org/). The associations between jaw, technique, volume of substance loss, and operating time were determined using analysis of variance models with Tukey-adjusted post hoc pair-wise comparisons. The kappa statistic was used to determine agreement between 2 independent, blinded raters on the qualitative assessment of the drill path. The association between the technique and jaw and qualitative assessment scoring was compared using the Fisher exact test. The significance level was set at .05. RESULTS: Dynamically navigated accesses resulted in significantly less mean substance loss in comparison with the freehand technique (27.2 vs 40.7 mm3, P < .05). Dynamically navigated accesses were also associated with higher optimal precision (drill path centered) to locate calcified canals in comparison with the freehand technique (75% vs 45%, P > .05). Mandibular teeth were associated with a negligible difference in substance loss between the access techniques (19.0 vs 19.1 mm3, P > .05). However, qualitatively the freehand technique was still prone to 30% higher chance of suboptimal precision (drill path tangentially transported) in locating calcified canals. Overall, dynamically navigated accesses were prepared significantly faster than freehand preparations (2.2 vs 7.06 minutes, P < .05). CONCLUSIONS: Within the limitations of this in vitro study, overall dynamically navigated access preparations led to significantly less mean substance loss with optimal and efficient precision in locating simulated anterior calcified root canals in comparison with freehand access preparations.

8.
J Oral Implantol ; 2020 Aug 11.
Artículo en Inglés | MEDLINE | ID: mdl-32780820

RESUMEN

The aim of this randomized in vitro study was to compare the time and accuracy of implant site preparation and implant placement using a trephine drill versus a conventional drilling technique under dynamic navigation. A total of 42 implants were placed in simulation jaw models with the two drilling techniques by two operators with previous experience with dynamic navigation. The timing of each implant placement was recorded, and horizontal, vertical, and angulation discrepancies between the planned and placed implants were compared. There was no significant difference in time or accuracy between the trephine and conventional drilling techniques. Implant site preparation with a single trephine drill using dynamic navigation was as accurate under in vitro experimental conditions as a conventional drilling sequence.

9.
J Endod ; 46(6): 839-845, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32340763

RESUMEN

INTRODUCTION: This study aimed to present a novel dynamic navigation method to attain minimally invasive access cavity preparations and to evaluate its 3-dimensional (3D) accuracy in locating highly difficult simulated calcified canals among maxillary and mandibular teeth. METHODS: Three identical sets of maxillary and mandibular 3D-printed jaw models composed of 84 teeth in their anatomic locations with simulated calcified canals (N = 138 canals) were set up on dental manikins. The Navident dynamic navigation system (ClaroNav, Toronto, Ontario, Canada) was used to plan and execute access preparations randomly with high-speed drills by a board-certified Endodontist. Two-dimensional (2D) and 3D horizontal, vertical, and angulation discrepancies between the planned and placed access preparations were digitally measured using superimposed cone-beam computed tomographic scans. Analysis of covariance models were used to evaluate the associations and the interaction between tooth type and jaw, the canal orifice depth, and the discrepancies between planned and prepared access cavities. The significance level was set at .05. RESULTS: The mean 2D horizontal deviation from the canal orifice was 0.9 mm, and it was significantly higher on maxillary compared with mandibular teeth (P < .05). The mean 3D deviation from the canal orifice was 1.3 mm, and it was marginally higher on maxillary teeth in comparison with mandibular teeth (P ≥ .05). The mean 3D angular deviation was 1.7 degrees, and it was significantly higher in molars compared with premolars (P < .05). The 3D and 2D discrepancies were independent of the canal orifice depths (P > .05). The average drilling time was 57.8 seconds with significant dependence on the canal orifice depth, tooth type, and jaw (P < .05). CONCLUSIONS: This study shows the potential of applying dynamic 3D navigation technology with high-speed drills to preserve tooth structure and accurately locate root canals in teeth with pulp canal obliteration.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Cavidad Pulpar , Diente Premolar , Diente Molar , Ontario , Raíz del Diente
10.
J Dent Educ ; 84(1): 57-61, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31977088

RESUMEN

The aims of this study were to describe patient utilization of an urgent care clinic (UCC) in a dental school for one year and to assess dental students' perceptions of the benefits of training in this clinic. Aggregate clinic data from July 3, 2017, through July 6, 2018, were used to determine number of patients, number of new patients, number of new patients who elected to transfer their primary dental care to the university, number who were seen for a follow-up, and service/clinic to which each patient was referred. Student evaluations were used to determine the benefits students perceived in their training in the UCC. Results showed that 1,674 patients were seen in the UCC during the study period. Of these, 67% were new patients, and 53% of these new patients opted to transfer their primary dental care to the university. An average of 7.03 patients were treated per day, and 2.48 new patients per day were generated for the predoctoral student clinic. The most common referrals were to oral surgery (37%), endodontics (30%), and the predoctoral dental clinic (28%). Among these patients, 39% scheduled follow-up appointments, and the attendance rate was 69%. About 80% of eligible students (40/50) completed the questionnaire, and many provided optional comments. Over 80% of the responding students responded favorably regarding the learning experiences and assessments during the UCC rotation. This study found that establishment of the UCC increased the pool of patients and provided students the necessary experiences in triaging and treating dental emergencies.


Asunto(s)
Facultades de Odontología , Estudiantes de Odontología , Instituciones de Atención Ambulatoria , Actitud del Personal de Salud , Educación en Odontología , Humanos
11.
J Dent Educ ; 84(5): 566-577, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31985083

RESUMEN

OBJECTIVES: Resilience is the ability to bounce back or recover from major life stressors. The aim of this study was to investigate resilience in dental students and how it may or may not vary across demographic characteristics such as gender, socioeconomic status, race/ethnicity, self-reported health, and parental educational level. METHODS: Data were collected from 151 dental students at Virginia Commonwealth University School of Dentistry with an anonymous survey that included the Resilience Scale for Adults (RSA) and various demographic variables. Associations between RSA and variables of interest were assessed using linear models. RESULTS: Dental students demonstrated relatively high levels of resilience. Resilience was significantly associated with gender (with females showing more resilience than males (P = 0.0395)), race (P = 0.0025), overall health (P = 0.0101), and mental health (P < 0.0001). Results from Exploratory Factor Analysis (EFA) supported a 5-factor solution that explained 82.6% of the variability of resilience in the sample of dental students. The 5 factors were nearly identical to the 5 subscales originally described by the RSA demonstrating validity in this population. Overall health ratings were significantly related to resilience, suggesting that perceived resilience in dental students may protect against negative health outcomes. This study can inform internal and external support systems of dental students as well as institutional programmatic development to better support their educational experiences.


Asunto(s)
Resiliencia Psicológica , Estudiantes de Odontología , Adulto , Femenino , Humanos , Masculino , Salud Mental , Encuestas y Cuestionarios , Virginia
12.
J Prosthodont ; 29(3): 201-206, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31994818

RESUMEN

PURPOSE: To evaluate the accuracy of two intraoral scanners (IOS) in terms of different preparation designs and scan angulation limitation due to the presence of adjacent teeth. MATERIALS AND METHODS: Eight different complete coverage (CC) and partial coverage (PC) tooth preparations were scanned by two IOS, the 3Shape TRIOS (TRI) and the 3M True Definition (TRU). All teeth preparations were scanned in the presence and absence of adjacent teeth. Four groups were established for each IOS; Group 1: PC preparations with adjacent teeth. Group 2: CC preparations with adjacent teeth. Group 3: PC preparations without adjacent teeth. Group 4: CC preparations without adjacent teeth. 3D analysis was performed to examine average absolute discrepancy (AAD) and maximum absolute discrepancy (MAD). A Two-way ANOVA was performed followed by a post-hoc Tukey's test HSD to evaluate the effect of adjacent teeth, preparation design, and the type of IOS used. RESULTS: For TRI, AAD for groups 1, 2, 3, and 4 were 20 ± 1.8 µm, 19.6 ± 2.4 µm, 15.5 ± 2.7 µm, and 12.9 ± 1.4 µm, respectively, whereas MAD for groups 1, 2, 3, and 4 were 109.7 ± 13.5 µm, 93.2 ± 28.9 µm, 85.6 ± 16.1 µm, and 66 ± 20.1 µm, respectively. For TRU IOS, AAD for groups 1, 2, 3, and 4 were 22.0 ± 3.6 µm, 17.9 ± 2 µm, 20 ± 5.9 µm, and 14.9 ± 1.7 µm, respectively, whereas the MAD for groups 1, 2, 3, and 4 were 151.4 ± 38.4 µm, 92.2 ± 17. µm, 92.6 ± 23.6 µm, and 71.4 ± 11.9 µm, respectively. Two-way ANOVA showed statistically significant differences between the AAD and MAD of TRI and TRU (p < 0.001). There were also statistically significant differences for presence or absence of adjacent teeth (p < 0.001), and preparation design (p < 0.001). CONCLUSIONS: PC preparation scans revealed lower accuracy than CC. The presence of adjacent teeth decreased the accuracy of both IOS. TRI gave higher accuracy than TRU for PC, but both IOS showed comparable accuracy for CC groups.


Asunto(s)
Técnica de Impresión Dental , Modelos Dentales , Diseño Asistido por Computadora , Arco Dental , Imagenología Tridimensional , Preparación del Diente
13.
J Oral Maxillofac Surg ; 78(2): 275-283, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31574260

RESUMEN

PURPOSE: Studies have shown that an asymmetrical smile is a relatively common problem. Yet, many patients are unaware of having this condition. Because having an asymmetrical smile can affect the final esthetic result of orthodontic therapy or orthognathic surgery, such patients need to be aware of the problem. The purpose of this study was to determine what amount of smile asymmetry is clinically evident to orthodontists, oral and maxillofacial surgeons (OMSs), and the lay public. MATERIALS AND METHODS: A total of 56 OMSs, 117 orthodontists, and 123 laypersons participated in the study. They were asked to view a randomly arranged series of computer-generated male and female facial photographs with the smile symmetrical or altered in 0.5-mm increments from 1 to 4 mm and to indicate whether the person had an asymmetrical smile. RESULTS: The OMSs and orthodontists were able to recognize relatively smaller amounts of asymmetry than the laypersons (2 mm vs 3 to 3.5 mm). CONCLUSIONS: Although the clinicians performed better than the laypersons, both groups were able to recognize relatively small amounts of asymmetry. Because such a condition is generally not correctable and can affect the esthetic result, patients undergoing orthodontic therapy or orthognathic surgery need to be made aware of the situation before treatment.


Asunto(s)
Ortodoncistas , Procedimientos Quirúrgicos Ortognáticos , Actitud del Personal de Salud , Estética Dental , Femenino , Humanos , Masculino , Cirujanos Oromaxilofaciales , Sonrisa
14.
J Periodontol ; 91(7): 917-924, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-31811744

RESUMEN

BACKGROUND: The purpose of the study was to investigate if the prescription of oral postoperative steroids has an effect on clinical outcomes of horizontal ridge augmentation including implant placement and characteristics of the grafted bone. METHODS: A retrospective chart review of 73 horizontal ridge augmentation cases was completed to assess the clinical outcomes, 53 of those cases were further assessed radiographically. Information was gathered regarding surgical technique, grafting materials, postoperative healing, medications used postoperatively, bone growth, and density changes as quantified on a cone-beam computed tomography (CBCT) scan. Statistical analysis was completed to identify whether the use of postoperative oral steroids altered outcomes. RESULTS: Steroids were used postoperatively following various horizontal ridge augmentation procedures. The use of tenting screws and resorbable membranes with a combination of osseous allograft and xenograft was used in 73 cases, 53 of which had preoperative and postoperative CBCT scans. Graft exposure occurred in five of the cases (9%), with the majority (n = 4) among those with postoperative steroids, but this was not statistically significant (P-value = 0.6510). Use of steroids was also not significantly associated with the number of courses of antibiotics (P-value > 0.05), but it was significantly associated with increased number of postoperative visits (P-value < 0.05). Among the subset for radiographic analysis (n = 53), there were significant clinical and radiographic dimensional changes in alveolar ridge width with an average horizontal bone gain of 3.6 mm. There were no statistically significant differences found in radiographic linear bone gain or clinical outcomes with the addition of steroids. A marginally statistically significant in the density of grafted bone was found with the addition of steroids (P-value > 0.05). CONCLUSION: The prescription of postoperative steroids did not make a significant difference in clinical outcomes, success of implant placement or on radiographic assessment of grafted sites following horizontal alveolar ridge augmentation.


Asunto(s)
Aumento de la Cresta Alveolar , Trasplante Óseo , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea , Xenoinjertos , Estudios Retrospectivos
15.
J Prosthet Dent ; 123(6): 821-828, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31653399

RESUMEN

STATEMENT OF PROBLEM: Implant guided surgery systems promise implant placement accuracy and precision beyond straightforward nonguided surgery. Recently introduced in-office stereolithography systems allow clinicians to produce implant surgical guides themselves. However, different implant designs and osteotomy preparation protocols may produce accuracy and precision differences among the different implant systems. PURPOSE: The purpose of this in vitro study was to measure the accuracy and precision of 3 implant systems, Tapered Internal implant system (BioHorizons) (BH), NobelReplace Conical (Nobel Biocare) (NB), and Tapered Screw-Vent (Zimmer Biomet) (ZB) when in-office fabricated surgical guides were used. MATERIAL AND METHODS: A cone beam computed tomography (CBCT) data set of an unidentified patient missing a maxillary right central incisor and intraoral scans of the same patient were used as a model. A software program (3Shape Implant Studio) was used to plan the implant treatment with the 3 implant systems. Three implant surgical guides were fabricated by using a 3D printer (Form 2), and 30 casts were printed. A total of 10 implants for each system were placed in the dental casts by using the manufacturer's recommended guided surgery protocols. After implant placement, postoperative CBCT images were made. The CBCT cast and implant images were superimposed onto the treatment-planning image. The implant positions, mesiodistal, labiopalatal, and vertical, as well as implant angulations were measured in the labiolingual and mesiodistal planes. The displacements from the planning in each dimension were recorded. ANOVA with the Tukey adjusted post hoc pairwise comparisons were used to examine the accuracy and precision of the 3 implant systems (α=.05). RESULTS: The overall implant displacements were -0.02 ±0.13 mm mesially (M), 0.07 ±0.14 mm distally (D), 0.43 ±0.57 mm labially (L), and 1.26 ±0.80 mm palatally (P); 1.20 ±3.01 mm vertically in the mesiodistal dimension (VMD); 0.69 ±2.03 mm vertically in the labiopalatal dimension (VLP); 1.69 ±1.02 degrees in mesiodistal angulation (AMD); and 1.56 ±0.92 degrees in labiopalatal angulation (ALP). Statistically significant differences (ANOVA) were found in M (P=.026), P (P=.001), VMD (P=.009), AMD (P=.001), and ALP (P=.001). ZB showed the most displacements in the M and vertical dimensions and the least displacements in the P angulation (P<.05), suggesting statistically significant differences among the M, VMD, VLP, AMD, and ALP. NB had the most M variation. ZB had the least P deviation. NB had the fewest vertical dimension variations but the most angulation variations. CONCLUSIONS: Dimensional and angulation displacements of guided implant systems by in-office 3D-printed fabrication were within clinically acceptable limits: <0.1 mm in M-D, 0.5 to 1 mm in L-P, and 1 to 2 degrees in angulation. However, the vertical displacement can be as much as 2 to 3 mm. Different implant guided surgery systems have strengths and weaknesses as revealed in the dimensional and angulation implant displacements.


Asunto(s)
Implantes Dentales , Cirugía Asistida por Computador , Diseño Asistido por Computadora , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea , Humanos , Imagenología Tridimensional , Impresión Tridimensional
16.
Clin Exp Dent Res ; 5(4): 365-376, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31452948

RESUMEN

Objectives: From casual observation of our colleagues, only a few individuals use the dental dam for operative procedures in their faculty practice. The purpose of this study was to obtain faculty perceptions of the dental dam, quantify its utilization in their intramural faculty practice, and determine the factors that influence dental dam usage. Material and Methods: A survey containing 11 questions was sent to 19 faculty members who teach full time and maintain an intramural dental practice involving operative dentistry. Thirty electronic dental health records of the 19 providers were reviewed to gather the following information from restorative procedures they completed: isolation methods, tooth location and involved surfaces, and dental restorative material. Results: Overall, dental dam was utilized for 30% of all restorative procedures and was used less than 20% of the time for placement of class II and class III composite resins. Dental dam utilization rate by general dentists was 37% and 17.6% for prosthodontists. Those general dentists with prior history of military dental practice had a utilization rate of 78.6% and nonmilitary dentists only 7.6%. Eight faculty members responded to the questionnaire for a 42% return rate. Those who practiced dentistry in the military strongly agreed that the dental dam is the standard of care, improves their quality of restorative work, and should be documented in the dental record. Conclusions: There were significantly different dental dam utilization rates between general dentists and prosthodontists and between dentists with prior military experience and those without.


Asunto(s)
Operatoria Dental/instrumentación , Odontólogos/estadística & datos numéricos , Docentes/estadística & datos numéricos , Pautas de la Práctica en Odontología/estadística & datos numéricos , Dique de Goma/estadística & datos numéricos , Humanos , Encuestas y Cuestionarios/estadística & datos numéricos
17.
J Periodontol ; 90(11): 1287-1296, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31257595

RESUMEN

BACKGROUND: The aim of this survey was threefold: (1) describe the demographics of periodontists and their practices in Virginia; (2) explore periodontists' perceptions of the impact that changes in the field of dentistry (i.e. increasing corporate dentistry, graduate debt, digitalization, and volume of periodontal procedures done by general practitioners [GPs]) are having on the specialty; (3) explore how periodontists might adjust their practices to account for these trends. METHODS: An electronic survey was emailed to Virginia-based American Academy of Periodontology (AAP) members assessing personal and practice demographics, trends in treatment modalities and practice models, and to survey how periodontists plan to adapt their practices for these trends. Virginia has large urban, suburban and rural municipalities, which renders the state a favorable representation of the United States as a whole. RESULTS: The response rate was 31% (n = 46). Most respondents (87%) were male and practiced full-time (70%). Respondents reported practicing predominantly in urban (n = 19, 41%) and suburban (n = 24, 52%) and less in rural areas (n = 3, 7%). In current practice, respondents reported greater numbers of referrals from more experienced GPs. Student debt after periodontal residency was significantly associated with age (P value = 0.0002), with 56% of respondents aged <40 years reporting student loans >$250,000 compared with 3% for those aged ≥40 years. Respondents ranked biologic advances, treatment of peri-implantitis, advances in digital dentistry, development of corporate and group practice models, and integration of more periodontal services in GP practices as the most likely trends to impact periodontal practices. The most commonly reported practice adjustments included expansion of existing services, increasing the number of periodontists in the practice, and joining with other specialists or GPs to create group practices. CONCLUSION: Periodontists perceive the need to expand services, increase the number of providers in their practices or create group practices to account for increased corporate dentistry, graduate debt, digitalization, and volume of periodontal procedures performed by GPs.


Asunto(s)
Odontólogos , Periodoncia , Adulto , Atención Odontológica , Humanos , Masculino , Derivación y Consulta , Encuestas y Cuestionarios , Estados Unidos , Virginia
18.
Eur J Dent Educ ; 23(4): 415-423, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31141291

RESUMEN

INTRODUCTION: Recent computer-guided dynamic navigation systems promise a novel training approach for implant surgery. This study aimed to examine learning progress in placement of dental implants among dental students using dynamic navigation on a simulation model. MATERIALS AND METHODS: Senior students with no implant placement experience were randomly assigned five implant placement attempts involving either three maxillary or four mandibular implants distributed in the anterior/posterior, and left/right segments. Implant placement was planned using a Navident Dynamic Guidance system. Surgical time was recorded. Horizontal, vertical and angulation discrepancies between the planned and placed implant positions were measured using superimposed CBCT scans. Data were analysed with repeated measures regression with Tukey's adjusted pairwise comparisons (α = 0.05). RESULTS: Fourteen students participated, with a mean age of 26.1 years and equal males and females. Mean time for implant placement was associated with attempt number (P < 0.001), implant site (P = 0.010) and marginally related to gender (P = 0.061). Students had a significant reduction in time from their first attempt to their second (10.6 vs 7.6 minutes; adjusted P < 0.001) then plateaued. Overall 3D angulation (P < 0.001) and 2D vertical apex deviation (P = 0.014) improved with each attempt, but changes in lateral 2D (P = 0.513) and overall 3D apex deviations (P = 0.784) were not statistically significant. Implant sites were associated with lateral 2D, 2D vertical and overall 3D apex deviation (P < 0.001). DISCUSSION: Males were marginally faster than females, had slightly lower overall 3D angulation, and reported higher proficiency with video games. Novice operators improved significantly in speed and angulation deviation within the first three attempts of placing implants using dynamic navigation. CONCLUSION: Computer-aided dynamic implant navigation systems can improve implant surgical training in novice population.


Asunto(s)
Competencia Clínica , Implantes Dentales , Cirugía Asistida por Computador , Adulto , Educación en Odontología , Femenino , Humanos , Masculino , Mandíbula , Proyectos Piloto , Estudiantes
19.
Am J Orthod Dentofacial Orthop ; 155(4): 592-599, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30935614

RESUMEN

INTRODUCTION: In the literature, there is little information available on 3D-printed orthodontic retainers. This study examined the accuracy of 3D-printed retainers compared with conventional vacuum-formed and commercially available vacuum-formed retainers. METHODS: Three reference models (models 1, 2, and 3) were used to fabricate traditional vacuum-formed, commercially available vacuum-formed, and 3D-printed retainers. For each model, retainers were made using the 3 methods (a total of 27 retainers). To determine the trueness, ie, closeness of a model to a true model, the distance between the retainer and its digital model at reference points were calculated with the use of engineering software. The measurements were reported as average absolute observed values and compared with those of the conventional vacuum-formed retainers. RESULTS: Average differences of the conventional vacuum-formed retainers ranged from 0.10 to 0.20 mm. The commercially available and 3D-printed retainers had ranges of 0.10 to 0.30 mm and 0.10 to 0.40 mm, respectively. CONCLUSIONS: The conventional vacuum-formed retainers showed the least amount of deviation from the original reference models and the 3D-printed retainers showed the greatest deviation. However, all 3 methods yielded measurements within 0.5 mm, which has previously been accepted to be clinically sufficient.


Asunto(s)
Diseño de Aparato Ortodóncico/métodos , Retenedores Ortodóncicos , Impresión Tridimensional , Modelos Dentales , Humanos
20.
Angle Orthod ; 89(5): 727-733, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-30888840

RESUMEN

OBJECTIVES: To investigate the reliability and accuracy of a monitoring system in patients undergoing orthodontic treatment with a rapid maxillary expander. Specifically, the amount of tooth movement calculated by the software was compared with the actual measurements taken on plaster models obtained during an in-office visit. MATERIALS AND METHODS: Patients took intraoral video scans using the monitoring software's smartphone application (Dental Monitoring, Paris, France), immediately followed by impressions for plaster models. Intercanine and intermolar width measurements were calculated by the software and compared with those made on the plaster models. Data were analyzed using two one-sided t-tests for equivalence with equivalence bounds of ±0.5 mm. The significance level was set at .05. RESULTS: Thirty sets of measurements were compared. The intercanine and intermolar measurement differences were on average 0.17 mm and -0.02 mm, respectively, and were deemed equivalent. CONCLUSIONS: The monitoring software seems to provide an accurate assessment of linear tooth movements.


Asunto(s)
Modelos Dentales , Técnica de Expansión Palatina , Teléfono Inteligente , Humanos , Imagenología Tridimensional , Maxilar , Proyectos Piloto , Reproducibilidad de los Resultados
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