Dental implant planning using artificial intelligence: A systematic review and meta-analysis.

STATEMENT OF PROBLEM: Data on the role of artificial intelligence (AI) in dental implant planning is insufficient. PURPOSE: The purpose of this systematic review with meta-analysis was to analyze and evaluate articles that assess the effectiveness of AI algorithms in dental implant planning, specifically in detecting edentulous areas and evaluating bone dimensions. MATERIAL AND METHODS: A systematic review was conducted across the MEDLINE/PubMed, Web of Science, Cochrane, and Scopus databases. In addition, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies that examined the accuracy of AI-based diagnostic tools on dental radiographs for dental implant planning. The most recent search was conducted in January 2024. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included articles. RESULTS: Twelve articles met the inclusion criteria for this review and focused on the application of AI in dental implant planning using cone beam computed tomography (CBCT) images. The pooled data indicated an overall accuracy of 96% (95% CI=94% to 98%) for the mandible and 83% (95% CI=82% to 84%) for the maxilla in identifying edentulous areas for implant planning. Eight studies had a low risk of bias, 2 studies had some concern of bias, and 2 studies had a high risk of bias. CONCLUSIONS: AI models have the potential to identify edentulous areas and provide measurements of bone as part of dental implant planning using CBCT images. However, additional well-conducted research is needed to enhance the accuracy, generalizability, and applicability of AI-based approaches.

Clinical assessment of maxillary screw-retained implant prosthesis fabricated from digital versus conventional full- arch implant impression. A randomized controlled clinical trial.

OBJECTIVES: To evaluate the peri-implant marginal bone loss (MBL) and prosthodontic complications of maxillary screw-retained implant prosthesis fabricated from digital versus conventional full- arch implant impression. MATERIAL AND METHODS: 28 participants with edentulous maxillary arches were randomly selected and enrolled in two equal groups; Group I conventional impression group (CIG) and Group II Digital impression group (DIG). All patients were rehabilitated with maxillary screwretained implant prosthesis retained by 6 implants. Peri-implant MBL and prosthodontic complications and were registered at 6, 12, and 24 months (m). Data was collected and statistically analyzed. RESULTS: Regarding the effect of time, there was a statistically significant increase in MBL at 6, 12 and 24 m follow-up periods (P<.001). As for the effect of groups, there was no statistically significant difference in MBL between CIG and DIG at 6, 12 and 24 m where P value was 0.083, 0.087 and 0.133 respectively. Prosthetic complications were recorded 19 times in the conventional group and 12 times in the digital group with no significant difference between both groups (P=.303). CONCLUSION: Digital full -arch implant impression is a reliable impression technique and may represent an alternative to conventional impression technique in the fabrication of maxillary screw-retained implant prosthesis.

3D Printing/Additive Manufacturing of Single- Implant Overdentures. A Randomized controlled clinical trial.

OBJECTIVES: Mandibular single-implant overdenture is a well-established treatment modality for the management of completely edentulous patients. The use of CAD/CAM printing technology to fabricate complete dentures and overdentures is burgeoning. The trial aimed to clinically evaluate 3D-printed single-implant overdentures and compare outcomes to those of overdentures manufactured using conventional techniques. MATERIALS AND METHODS: A randomized clinical trial (RCT) was designed. Twenty-eight participants were randomly allocated into two equal groups. Participants in the control group received conventionally manufactured single-implant overdentures, while participants in the printed group received digital light processing (DLP) printed single-implant overdentures. An evaluation was conducted to assess the rates of implant survival and success, as well as overdenture survival and success, along with the measurement of maximum biting force (MBF) over a one-year follow-up period. Data was collected and subjected to statistical analysis. Statistical significance was determined using a two-sided p-value with a threshold of less than 0.05. RESULTS: The printed denture group had higher implant survival (100%) and success rates (92.8%) compared to the conventional denture group (85.7% survival, 85.7% success). Overdenture survival and success rates were 100% in the printed group and 78.6% in the conventional group. Both groups showed a significant increase in maximum biting force (MBF) at 3, 6, and 12 months of follow-up (P<0.001). The printed group demonstrated a statistically significant improvement in MBF compared to the conventional group (P<0.001). CONCLUSIONS: 3D-printed mandibular single-implant overdentures may represent an alternative to conventionally fabricated ones.

Advancements in artificial intelligence algorithms for dental implant identification: A systematic review with meta-analysis.

STATEMENT OF PROBLEM: The evidence regarding the application of artificial intelligence (AI) in identifying dental implant systems is currently inconclusive. The available studies present varying results and methodologies, making it difficult to draw definitive conclusions. PURPOSE: The purpose of this systematic review with meta-analysis was to comprehensively analyze and evaluate articles that investigate the application of AI in identifying and classifying dental implant systems. MATERIAL AND METHODS: An electronic systematic review was conducted across 3 databases: MEDLINE/PubMed, Cochrane, and Scopus. Additionally, a manual search was performed. The inclusion criteria consisted of peer-reviewed studies investigating the accuracy of AI-based diagnostic tools on dental radiographs for identifying and classifying dental implant systems and comparing the results with those obtained by expert judges using manual techniques-the search strategy encompassed articles published until September 2023. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of included articles. RESULTS: Twenty-two eligible articles were included in this review. These articles described the use of AI in detecting dental implants through conventional radiographs. The pooled data showed that dental implant identification had an overall accuracy of 92.56% (range 90.49% to 94.63%). Eleven studies showed a low risk of bias, 6 demonstrated some concern risk, and 5 showed a high risk of bias. CONCLUSIONS: AI models using panoramic and periapical radiographs can accurately identify and categorize dental implant systems. However, additional well-conducted research is recommended to identify the most common implant systems.

Clinical influence of digital vs analog impressions in all-on-4 implant prostheses: a randomized controlled trial.

AIM: To compare the clinical outcomes of conventional and digital implant impressions in all-on-4 mandibular implant prostheses. MATERIALS AND METHODS: Fifty-six participants were randomly stratified into two control groups (Axial Conventional Impression Group [ACIG] and Tilted Conventional Impression Group [TCIG]), and two test groups (Axial Digital Impression Group [ADIG] and Tilted Digital Impression Group [TDIG]). Conventional pick-up and digital impressions were made for each group, respectively. Participants in ACIG and ADIG received four axial implants, and those in TCIG and TDIG received two anterior axial and two distal tilted implants. All participants received all-on-4 mandibular prostheses and maxillary complete dentures. Implant survival, prosthetic complications, and marginal bone loss were recorded at 6, 12, and 24 months. Data were statistically described in terms of mean ± standard deviation. RESULTS: After 24 months, the implant survival rate was 100%. A significant difference in bone loss was shown between ACIG and ADIG at 6, 12, and 24 months, with P = 0.647, 0.821, and 0.505, respectively. An insignificant difference in bone loss was shown between TCIG and TDIG at 6 ,12, and 24 months, with P = 0.671, 0.935, and 0.687, respectively. No significant difference was shown in prosthodontic complications between all groups throughout the follow-up period. CONCLUSIONS: The digital impressions showed clinically better implant survival, stable peri-implant marginal bone level, and reasonable prosthodontic complications. The present study represents a steppingstone and proof of concept that supports the routine clinical use of digital impressions, especially in a post-COVID-19 world.

Clinical evaluation of implant overdentures fabricated using 3D-printing technology versus conventional fabrication techniques: a randomized clinical trial.

AIM: To evaluate the oral health-related quality of life (OHRQoL) of patients rehabilitated with conventional or 3D-printed implant overdentures. MATERIALS AND METHODS: A randomized clinical trial (RCT) was designed. Twenty-eight completely edentulous participants were randomly allocated into two equal groups. All participants received two implants with ball attachments. Participants in the control group were rehabilitated with conventionally manufactured polymethyl methacrylate (PMMA) maxillary complete dentures (CDs) and mandibular implant overdentures, while those in the intervention group received digital light processing (DLP)-printed photopolymerizable PMMA maxillary CDs (NextDent) and mandibular implant overdentures. Follow-up appointments were scheduled at 3, 6, and 12 months where Oral Health Impact Profile 19 (OHIPEDENT19) data were used to assess the OHRQoL of the participants. Denture retention was measured using a digital force gauge device. RESULTS: The OHRQoL values were significantly higher (less improvement) in the conventional overdenture group at 6 months (P = 0.02) and 12 months (P = 0.04). A statistically significant difference was found between the mean retention values of the conventional and 3D-printed overdenture groups. For all the follow-up periods, the mean retention values were higher for the 3D-printed overdenture group (P = 0.001). CONCLUSION: 3D-printed overdentures may represent an alternative to conventionally fabricated ones. This study represents a stepping stone and proof of concept that support the potential future use of 3D-printed dentures.

Does the facebow affect the outcome of CAD/CAM occlusal splint. Randomized clinical trial.

BACKGROUND: Occlusal appliances can distribute aggressive loads which are generated by bruxism and can reduce their frequency. The facebow record, when used in the construction of occlusal appliances, helps in minimizing occlusal discrepancies. This study aimed to compare the effect of CAD/CAM stabilization occlusal splint made with and without facebow for management of bruxer patients. METHOD: 24 Patients who were diagnosed as bruxers were randomly assigned into two equal groups and obtained maxillary CAD/CAM occlusal stabilizing splint recorded with centric relation either with or without using a facebow. The patient satisfaction using the visual analog scale (VAS) was recorded at baseline, one month and three months' follow-up periods. The adjustment time of both splints, from the start of splint delivery until becoming well-fitted and occlusally adjusted, was calculated using a stopwatch. RESULTS: The CAD/CAM occlusal splints with or without the use of facebow improved the patient's satisfaction with no statistically significant difference between both groups at baseline, one month and three months with p values of 0.73, 0.24 and 0.45 respectively. The comparison between the two modalities regarding the adjustment time showed no statistically significant difference between both groups (P = 0.06). CONCLUSION: According to the results of this study; no difference was detected in patient satisfaction and the time required for adjustment of CAD/CAM occlus.