Robotic-assisted total knee arthroplasty is not associated with improved accuracy in implant position and alignment compared to conventional instrumentation in the execution of a preoperative digital plan.

Purpose: The primary objective of the present study was to evaluate if robotic-assisted total knee arthroplasty (RO-TKA) results in improved accuracy compared to conventional TKA (CO-TKA) with respect to alignment and component positioning executing a preoperative digital plan. The secondary objective was to compare patient-reported outcome measures (PROMs) between the two groups at 6 months of follow-up (FU). Methods: Patients who underwent primary TKA using the concept of constitutional alignment were identified from the database. Each patient underwent preoperative digital planning as well as postoperative evaluation of the preoperative plan (alignment and component position) using mediCAD® software (Hectec GmbH). Two groups were formed: (i) The RO-TKA group (n = 30) consisted of patients who underwent TKA with a robotic surgical system (ROSA®, Zimmer Biomet) and (ii) the CO-TKA group (n = 67) consisted of patients who underwent TKA with conventional instrumentation. To assess accuracy, all qualitative variables were analysed using the χ 2 test. Tegner activity scale, Oxford Knee Score and visual analogue scale were assessed preop and at 6-month FU. To assess differences between the two groups, a 2 × 2 repeated measures analysis of variance was performed. Results: There was no significant (p > 0.05) difference in the accuracy of alignment as well as tibial and femoral component position between the two groups. At the 6-month FU, there was no significant (p > 0.05) difference in PROMs between the two groups. Conclusion: While robotic TKA may have some potential advantages, no significant difference was found between robotic and conventional TKA with respect to limb alignment, clinical outcomes and component positioning. Level of Evidence: Level III.

Analyzing the Accuracy of Digital Sizing on Long-Leg Alignment X-rays by Using a 1-Inch Ball Bearing: A Cheap and Effective Method.

Background and objective Sizing on digital films is important for implants and planning deformity correction. CT is the most accurate digital measurement method. We use a 1-inch ball bearing (cost: $1) to size our long-leg standing films (LLSFs) when planning deformity correction. In this study, we aimed to assess the accuracy of digital measurements calibrated by this method. Methods We conducted An IRB-approved study involving 25 patients having both an LLSF with a 1-inch ball bearing taped to the inner mid-thigh and a CT scanogram. The longest distance in the axial cut of the bilateral ankle, knee, and femoral heads of the CT images were compared to the same anatomic locations on LLSFs calibrated with the ball bearing using the online digital planning software DetroitBonesetter (DBS) and measurements from our Picture Archiving Communication Software (PACS). Five observers performed each measurement. Results The average measurement differences between the gold standard CT scan and LLSFs calibrated with DBS were as follows: 0.110 ± 0.432 mm (femoral head); 2.173 ± 0.0619 mm (knee); and 3.671 ± 0.30 mm (ankle). In PACS, they were as follows: 5.470 ± 0.381 mm (femoral head); 6.248 ± 0.712 mm (knee); and 1.806 ± 0.548 mm (ankle). The intraclass correlation coefficient for 600 measurements by five observers was 0.972. Conclusions The $1 ball-bearing sizing on DBS using LLSFs provides accuracy to <1 mm for the femoral head, 2 mm at the knee, and 3.7 mm at the ankle. It was significantly better than the PACS system for both the femoral head and knee (<0.001), while PACS was better at the ankle (<0.001).

Shaping the 4D frontier in maxillofacial surgery with faceMesh evolution.

OBJECTIVES: This work aims to introduce a Python-based algorithm and delve into the recent paradigm shift in Maxillofacial Surgery propelled by technological advancement. The provided code exemplifies the utilization of the MediaPipe library, created by Google in C++, with an additional Python interface available as a binding. TECHNICAL NOTE: The advent of FaceMesh coupled with artificial intelligence (AI), has brought about a transformative wave in contemporary maxillofacial surgery. This cutting-edge deep neural network, seamlessly integrated with Virtual Surgical Planning (VSP), offers surgeons precise 4D facial mapping capabilities. It accurately identifies facial landmarks, tailoring surgical interventions to individual patients, and streamlining the overall surgical procedure. CONCLUSION: FaceMesh emerges as a revolutionary tool in modern maxillofacial surgery. This deep neural network empowers surgeons with detailed insights into facial morphology, aiding in personalized interventions and optimizing surgical outcomes. The real-time assessment of facial dynamics contributes to improved aesthetic and functional results, particularly in complex cases like facial asymmetries or reconstructions. Additionally, FaceMesh has the potential for early detection of medical conditions and disease prediction, further enhancing patient care. Ongoing refinement and validation are essential to address limitations and ensure the reliability and effectiveness of FaceMesh in clinical settings.

New complementary alternatives in third molar autotransplantation: A systematic review

Background: Dental autotransplantation (DAT) is defined as the replacement or direct transfer of an impacted, semi-impacted or erupted tooth to a donor site, either to a post-extraction socket or to a surgically created socket within the same individual. The use of new technological advances, such as 3-D dental models based on computer-aided design, among others, have been reported to improve the success rate of DAT. Therefore, we aimed to perform a systematic review to explore the possible benefits that the use of these innovative techniques can provide when applied to DAT. Material and Methods: The literature search was conducted in PubMed, Scopus, and Web of Science databases following the PRISMA guidelines. The research question was: "Are computerized technological advancements a useful tool for improving the success of third molar autotransplantation technique? Results: The initial literature search identified 195 articles, of which only 11 were included for qualitative analysis. All studies used 3D dental models based on computer-aided design data. Surgical guides and stereolithographic models were used by 4 and 1 study respectively. A total of 91 transplanted teeth were evaluated, out of which only 88 were considered within the parameters of clinical success (96.7%). Only 7 out of the 11 articles reported the specific autotransplanted tooth, being mandibular third molars the most prevalent autotransplanted teeth. Conclusions: Although the application of new technologies for DAT increases the success rate of this technique, further primary studies are still needed to address long-term teeth survival rates and complications. The cost and availability to implement the integration of these techniques to DAT may be a variable to consider, as this can be a limitation for some patients or for low-income countries. (AU)

Risk factors for oral mucositis in patients with solid tumorsunder treatment with cetuximab: a retrospective cross-sectional study

Background: This study retrospectively analyzed the risk factors for oral mucositis (OM) during cetuximab treatment. Material and Methods: We screened patients using cetuximab and retrospectively evaluated the presence of OM based on medical records. We collected information from 2 years of evaluations. Patient medical records were reviewed to obtain data on chemotherapy cycle and dose, sex, age, primary tumor, TNM stage, and head and neck radiotherapy (HNR) history. The X2 test and multinomial logistic regression were used for statistical analysis (SPSS 20.0, p < 0.05). Results: Among 1831 patients, OM was showed in 750 in any grade (41%), during cetuximab treatment. Most patients were female (n=944, 51.6%), <70years-old (n=1149, 62.8%), had larynx cancer (n=789, 43.1%) in T4 (n=579, 47.7%), N0 (n=509, 52.6%) stages. Primary tumor surgery was performed in 1476 (80.6%) patients, radiotherapy in 606 (33.1%) patients and cetuximab protocols most used involved up to four cycles (n=1072, 58.5%) of <400mg (n=996, 54.4%) cetuximab doses. Female (OR [odds ratio] = 2.17, CI95% = 1.26-3.75), >70 years-old patients (OR = 16.02, CI95% = 11.99-21.41), with HHNR (OR = 1.84, 1.41-2.40), treated with >4 cycles (OR = 1.52, CI95% = 1.16-2.01) and high doses of cetuximab (OR = 3.80, CI95% = 2.52-5.71) are the greatest risk factors for OM. Conclusions: Since the clinical benefit of cetuximab in the treatment of older patients is limited and there is a high OM, especially in women with head and neck treated with radiotherapy, high doses and a high number of cetuximab cycles must be administered with caution. (AU)

'One millimetre equals one degree' is a major source of inaccuracy in planning osteotomies around the knee for metaphyseal deformities compared to the digital planning.

PURPOSE: The objective of this study was to compare the accuracy of virtually performed osteotomies around the knee. The comparison was made between the Miniaci method (method 1), considered the gold standard planning, with the widely held dogma that one degree of correction required equates to one millimetre of opening/closing (method 2). METHODS: This retrospective cross-sectional study was conducted between December 2018 and September 2022 in patients aged at least 15 years with metaphyseal knee deformity. Osteotomy planning was performed in methods 1 and 2 utilising calibrated long-leg alignment X-rays in the frontal plane. In both methods, the desired correction was defined by the Fujisawa point. The error % in measurement (ratio method 1/method 2) and the difference in millimetres (method 1 - method 2) between the two methods were analysed. RESULTS: A total of 107 osteotomies with 27 (25.2%) distal femoral osteotomies, 54 (50.5%) proximal tibial osteotomies and 26 (24.3%) double-level osteotomies were performed virtually with a mean hip-knee-ankle angle of 176.4 ± 6.6. In distal femur osteotomy, the mean error % between methods 1 and 2 was 38.9 ± 16.7% and 22.4 ± 16.8% for the opening and closing groups, respectively. In proximal tibial osteotomies, the mean error % was 22.7 ± 15.6% and 9 ± 10.8% for the opening and closing groups, respectively. In double-level osteotomy, the mean error % of femur-based corrections was 34.9 ± 19% and 19.5 ± 21% for the opening and closing groups, respectively, and the mean error of the tibial-based corrections was 26.4 ± 12.1% for the opening group and 10.8 ± 10% for the closing group, respectively. CONCLUSION: Planning one millimeter per degree of desired correction for osteotomies around the knee in metaphyseal deformities is a major source of error when compared with digital planning using the Miniaci method. This was seen most frequently with osteotomies of the distal femur and all opening wedge osteotomies. LEVEL OF EVIDENCE: Level Ⅲ, retrospective cross-sectional study.

Assessment of interproximal enamel reduction planned by the digital set-up of a customized lingual orthodontic appliance: A comparison cohort study.

Objectives: Interproximal enamel reduction (IER), commonly known as stripping, is a frequently used technique in orthodontic treatment to address issues related to arch length discrepancies and tooth size discrepancies (TSD). The use of digital set-up allows for precise prediction of the amount of IER required. TSD occurs when the sizes of maxillary and mandibular teeth are not in proportion to each other. This study aims to evaluate and compare the suggested IER values generated by the digital set-up of a customized lingual orthodontic appliance in both upper and lower arches, across sextants, and among different teeth concerning TSD. Materials and methods: We analyzed suggested IER values from 809 cases. The statistical analysis was divided into two parts: part 1 focused on the number of stripped surfaces, and part 2 assessed the quantity of enamel removed. Comparisons were made between upper and lower arches, sextants, and teeth using the Friedman test, followed by pairwise Wilcoxon tests with Bonferroni correction. Results: The study found that mandibular and frontal stripping were more frequently suggested than maxillary and posterior stripping. Lower canines were the teeth most commonly recommended for stripping, followed by upper incisors. Conclusion: Within the scope and limits of this cohort study, we conclude that, in general, more IER is required in the mandible as compared to the maxilla. Particularly in the anterior sextants, IER might be necessary to achieve optimal alignment and occlusion.

Lower Jaw Full-Arch Restoration: A Completely Digital Approach to Immediate Load.

The digital transformation has revolutionized various sectors, including dentistry. Dentistry has emerged as a pioneer in embracing digital technologies, leading to advancements in surgical and prosthetic oral healthcare. Immediate loading for full-arch edentulous dental implants, once debated, is now widely accepted. This case report describes a 74-year-old patient with dental mobility and significant bone loss who was rehabilitated using a Toronto Bridge protocol on four dental implants with immediate loading. Digital planning, surgical guides, 3D printing, and precision techniques were employed. The surgery involved implant placement and prosthetic procedures. The patient reported minimal post-operative discomfort, and after four months, the definitive prosthesis was successfully placed. This case demonstrates the efficacy of immediate loading in complex dental scenarios with digital innovation, resulting in improved patient outcomes. The full digital workflow, including 3D printing and the use of modern materials, enhances the efficiency and predictability of oral rehabilitation, marking a transformative era in dental care. The integration of digital technology in all phases of treatment, from diagnosis to finalization, makes this approach safer, reliable, and efficient, thereby benefiting both patients and clinicians.

An evaluation of the Invisalign® Aligner Technique and consideration of the force system: a systematic review.

OBJECTIVE: Since its introduction 25 years ago, the Invisalign® system has undergone multiple digital and biomechanical evolutions and its effectiveness is often compared to traditional systems without considering the many differences which characterize them. The main aim of this systematic review is to look at the literature dealing with studies on teeth movements using the Invisalign® system and the management of these movements through digital planning and artificial intelligence. MATERIALS AND METHODS: The following electronic databases were searched: MEDLINE, Embase, the Cochrane Oral Health Group's Trials Register, and CENTRAL. Unpublished studies were searched on ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. RESULTS: Twenty-four studies (15 retrospective, 5 prospective, 2 pilot, and 2 case-control) were included. The results of the analysis carried out on the available literature show that the Invisalign® system is recognized to be a valid alternative to conventional orthodontic treatment in no-extraction cases. The results are influenced by the methods for assessing the effectiveness of this technique and by the comparison bias of the traditional system with the innovative digital system. CONCLUSIONS: Since the introduction of SmartForce and SmartTrack material, the efficacy of the treatment has improved. There is still a shortage of high-quality evidence concerning the treatment modality. In order to make the treatment with the aligners more efficient, a correct management of the ClinCheck® software and a proper use of the biomechanics are necessary. The aligned force-driven system should be taken into account when developing the digital planning.

Computer-assisted orbital and midfacial reconstruction.

Objective: Computer assistance has become indispensable in the reconstruction of the orbit and midface. Although these are key areas of an individual's esthetic appearance, defects or deformities of the midface, especially those of the orbit, are treated diversely. Methods: The aim of this article is to present the wide utility of computer-assistance in modern craniomaxillofacial surgery, including virtual planning, computer-aided design, guided surgery, navigational control, patient-specific implants, and quality control via image fusion. Results: There have been rapid advances in both digital planning and manufacturing processes, with continual improvements. Conclusions: Patient-specific implants have pushed the boundaries of reconstructive surgery in all surgical specialties.

Dental prosthesis extraoral indexing and pick-up technique for mandibular full arch immediate rehabilitation in fibula free flap reconstruction.

Same-day ablative and reconstructive surgeries for the treatment of head and neck pathologies are gaining in popularity with the recognition that single-day surgeries reduce morbidity and increase quality of life. Implant-borne prosthetics on the donor graft provide immediate dental reconstruction. This report describes a novel technique for extraoral pickup of a full arch immediate prosthesis from the donor site free flap. This technique minimizes intraoperative occlusal adjustments, saves intraoperative time, prevents undesirable "rolling" of a fibula segment, and immediately rehabilitates patients with dental prosthetics.

Proficiency of Clear Aligner Therapy: A Systematic Review and Meta-Analysis.

The aim of this study was to evaluate the efficacy and efficiency of orthodontic treatment using clear aligner therapy (CAT). This efficiency was measured using the Peer Assessment Rating (PAR) index, the American Board of Orthodontics (ABO) index, or the similarity between the final ClinCheck and the final scanned models. A search was done electronically between 1998 and 2021 using the Cochrane Library, PubMed, and Google Scholar databases. Three reviewers individually rated the articles. The ROBINS tool and the Cochrane risk of bias tool were used to evaluate the quality of observational research and randomized controlled trials, respectively. The degree of certainty for each selected outcome was evaluated using the grading of recommendations assessment, development, and evaluation (GRADE) approach. Six studies with a total of 166 participants were considered after the full texts of 61 potential reports were reviewed. This research included in the review covered the period from 1998 to 2021 in retrospect. According to the current systematic review and meta-analysis, transparent aligners had a successful outcome. In mild to moderate cases, aligner treatment appears to have a significant advantage in terms of efficiency (treatment time); nonetheless, insufficient evidence of efficacy was observed based on multiple cross-sectional investigations. When compared to traditional brackets, clear aligners provided a more stable course of treatment.

The Accuracy of Digital Preoperative Templating in Primary Total Hip Replacements.

Background​ Digital templating is an essential part of preoperative planning in elective total hip replacement (THR) surgery. The goals of templating are to predict femoral and acetabular implant sizes, to assess leg length, offset, and implant positioning. Templating markers such as the KingMark device (Brainlab, Munich, Germany) have been developed to improve the accuracy. Although templating is commonly used in many centres, there are challenges related to the accuracy of the process, such as true magnification ideal positioning of the pelvis and hips/body habit (obesity). Objectives The aim of this study was to assess the accuracy of preoperative templating in THR patients, and to assess the difference between templating performed with and without the KingMark device. Methods​ Our retrospective study included 642 consecutive patients who had primary THR at the Royal Bournemouth Hospital in the UK. Four hundred fifty-three (71%) of patients had the KingMark device on their templated radiographs. Patients who had hybrid total hip replacements using an uncemented acetabular component and cemented femoral component were included in the study. Digital templating was done using TraumaCad software (Brainlab). Analysis of the accuracy of predicting component size has been evaluated by comparing preoperative planned sizes with implanted sizes as documented by the surgeons and labels attached to the operative note. ​ ​Results​ The templated size corresponded to the actual femoral implant used in approximately 65.2% of cases. When femoral prostheses within one size above or below the templated size were included,​the accuracy of preoperative templating rose to 97.2%. Regarding the uncemented acetabular component, the templated size corresponded to the actual acetabular implant used in 46.3% of cases. When acetabular cup within one size above or below the templated size were included, the accuracy of preoperative templating rose to 87.5%. Similarly, there was minimal difference between the predicted templated sizes using the KingMark device compared to templating performed without it. ​Conclusions​ Preoperative templating is an essential part in optimizing the outcome of THRs. Templating allows the surgeon to estimate the size of the components to be used. It also provides a starting point, from which the surgeon can proceed from, and saves valuable intraoperative time by assessing the level of the femoral neck osteotomy and the degree of lateral rasping. Multiple factors affect the accuracy of preoperative templating including the patient BMI, external rotation of the hip and surgeon's experience. Although there are different methods of templating, digital templating with 2D radiographs is likely the most cost-effective and efficient process available at this time.

Aesthetic Management of Tooth Size Discrepancies.

The aesthetic management of tooth size discrepancies is an essential component when dealing with simple and complex dental rehabilitation. Tooth size and shape is a crucial factor that strongly influences both the smile and the face in the treatment outcome. From an orthodontic perspective, evaluation of the ideal mesiodistal widths relating to both maxillary and mandibular arches is required to plan the correct occlusal, aesthetic, and functional result.The aim of this paper is to propose a safe and repeatable method to evaluate and correct tooth size discrepancy through the presentation of two case reports. Both cases were managed using a combination of clear aligner therapy and minimally invasive restorative procedures, as well as the use of digital tools.

Digitally Guided Lateral Sinus Floor Elevation With Simultaneous Implant Placement: 3 Case Reports With Technical Considerations.

A sinus floor elevation via lateral window (LSFE) is one of the most widely used bone augmentation procedures for implant therapy in the posterior area of the maxilla. Locating and preparing a correct opening window on the lateral sinus wall is a key step of this procedure. Conventionally, the surgeon designs and locates the window after the flap is reflected based on the information obtained from cone-beam computed tomography (CBCT) images or other diagnostic aids. Nevertheless, in spite of the advancements in CBCT imaging, clinicians may still experience hardships in situating and procuring meticulous access to the maxillary sinus by using CBCT alone. Therefore, in cases requiring an LSFE simultaneous to implant placement, a maxillary sinus surgical guide has been tested and reported to be the amiable method to be utilized as a conjunct to prevent unpredictable consequences according to its application in implying both the direction for the implant and the location of the lateral window. This article presents 3 clinical cases with a fully digital approach to guide the opening of the lateral wall of the maxillary sinus as well as the simultaneous placement of a single implant in an ideal 3D position. Based on the CBCT images and intraoral scan, a surgical guide was fabricated based on 3D software. During surgery, this teeth-supported template can be placed intraorally, guiding sinus window opening preparation. This technique makes the sinus window opening procedure simple and predictable, reduces surgical time and the risk of complications, and allows the placement of the implant in the ideal 3D position.

Applications of CAD/CAM Technology for Craniofacial Implants Placement and Manufacturing of Auricular Prostheses-Systematic Review.

This systematic review was aimed at gathering the clinical and technical applications of CAD/CAM technology for craniofacial implant placement and processing of auricular prostheses based on clinical cases. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, an electronic data search was performed. Human clinical studies utilizing digital planning, designing, and printing systems for craniofacial implant placement and processing of auricular prostheses for prosthetic rehabilitation of auricular defects were included. Following a data search, a total of 36 clinical human studies were included, which were digitally planned and executed through various virtual software to rehabilitate auricular defects. Preoperative data were collected mainly through computed tomography scans (CT scans) (55 cases); meanwhile, the most common laser scanners were the 3dMDface System (3dMD LLC, Atlanta, Georgia, USA) (6 cases) and the 3 Shape scanner (3 Shape, Copenhagen, Denmark) (6 cases). The most common digital design software are Mimics Software (Mimics Innovation Suite, Materialize, Leuven, Belgium) (18 cases), Freeform software (Freeform, NC, USA) (13 cases), and 3 Shape software (3 Shape, Copenhagen, Denmark) (12 cases). Surgical templates were designed and utilized in 35 cases to place 88 craniofacial implants in auricular defect areas. The most common craniofacial implants were Vistafix craniofacial implants (Entific Medical Systems, Goteborg, Sweden) in 22 cases. A surgical navigation system was used to place 20 craniofacial implants in the mastoid bone. Digital applications of CAD/CAM technology include, but are not limited to, study models, mirrored replicas of intact ears, molds, retentive attachments, customized implants, substructures, and silicone prostheses. The included studies demonstrated a predictable clinical outcome, reduced the patient's visits, and completed the prosthetic rehabilitation in reasonable time and at reasonable cost. However, equipment costs and trained technical staff were highlighted as possible limitations to the use of CAD/CAM systems.

Digitally-Guided Lateral Sinus Floor Elevation with Simultaneous Implant Placement: Three Case Reports with Technical Considerations.

INTRODUCTION: A sinus floor elevation via lateral window (LSFE) is one of the most widely used bone augmentation procedures for implant therapy in the posterior area of the maxilla.  Locating and preparing a correct opening window on the lateral sinus wall is a key step of this procedure. Conventionally, the surgeon design and locate the window after the flap is reflected based upon the information obtained from cone-beam computed tomography (CBCT) images or other diagnostic aids. Nevertheless, in spite of the advancements in CBCT imaging, clinicians may still experience hardship in situating and procuring meticulous access to the maxillary sinus by using CBCT alone. Therefore, in cases requiring a LSFE simultaneous to implant placement, a maxillary sinus surgical guide (MSSG) has been tested and reported to be the amiable method to be utilized as a conjunct, to prevent unpredictable consequences according to its application in implying both the direction for the implant and the location of the lateral window. CASE SERIES: This article presents 3 clinical cases with a fully digital approach to guide the opening of the lateral wall of the maxillary sinus, as well as the simultaneous placement of a single implant in an ideal 3D position. Based on the CBCT images and intraoral scan, a surgical guide was fabricated base on 3D software. During the surgery, this teeth-supported template can be placed intraorally, guiding sinus window opening preparation. CONCLUSION: This technique makes the sinus window opening procedure simple and predictable, reduces surgical time as well as the risk of complications, and allows the placement of the implant in the ideal 3D position.

Benefícios do planejamento digital para cirurgias periodontais estéticas: relato de caso / Benefits of digital planning for esthetic periodontal surgeries: case report

Sorriso gengival é comumente conhecido pela exposição excessiva das gengivas ao sorrir, acarretando assim na diminuição das coroas dos elementos. No que tange a etiologia dessa condição, ela se apresenta de maneiras diversas e sua identificação é fundamental para o desenvolvimento de um plano de tratamento eficaz. O planejamento clínico pode ser feito usando uma abordagem dinâmica e digital do sorriso, como softwares, exames de imagem, modelos virtuais 3D e guias cirúrgicos, melhorando a qualidade e precisão do tratamento, oferecendo diversos benefícios aos pacientes. Sendo assim esse estudo teve como objetivo demonstrar a importância dos processos digitais no planejamento e correção do sorriso gengival. Paciente queixou-se da desproporção do sorriso, caracterizado por coroas curtas nas regiões de pré-molares e incisivos ligadamente com a exposição excessiva da gengiva ao sorrir. Após estudos clínicos e de imagem, a etiologia foi diagnosticada como erupção passiva alterada, tipo I (fenótipo espesso). O tratamento de escolha foi o remodelamento gengival associado à osteotomia e osteoplastia obtendo assim uma maior precisão no tratamento, sendo confeccionado um guia cirúrgico duplo. Sendo assim, é possível contemplar que o planejamento digital permite uma maior previsibilidade da execução, compatibilidade em relação a expectativa do paciente e profissional, além da total individualização do caso, tornando os resultados mais favoráveis e exatos e minimizando as chances de iatrogenias(AU)

Gummy smile is commonly known for exposing the gums to the smile, thereby increasing the crowns elevation of the elements. Regarding a condition, it presents itself in different ways and its identification is fundamental for the development of a treatment plan. The clinician can be done using a dynamic and digital approach to image treatment, such as software, imaging exams, various 3D virtual models and elaborate guides, improving the quality and precision of treatment, offering benefits to patients. Therefore, this study aimed to demonstrate the importance of digital processes in planning and correcting the gummy smile. Patient complained of disproportion of the smile, facing the regions of premolar crowns and incisors of the smile, facing the exposure of the gingiva when smiling. After clinical and imaging exams, the diagnostic studies were diagnosed as passive eruption, type I (phenotype and specific). The choice of choice was remodeling associated with surgery treatment and surgery treatment, thus providing a greater precision in the treatment, being a double guide elaborated. Therefore, it is possible that the digital is possible a predictability of execution, compatibility in relation to patient and professional care, in addition to the greater possibility of individualization planning than it allows, making the results more planned as possibilities and exactly the iatrogenic(AU)

Overall Accuracy of Radiological Digital Planning for Total Hip Arthroplasty in a Specialized Orthopaedics Hospital.

Preoperative radiological planning is a key factor in the prediction of implant size and positioning that influences surgical time, the risk of complications, and functional outcomes. We have tested the accuracy of the digital templating performed in our hospital for a sample of 215 patients that underwent total hip arthroplasty. We assessed the accuracy of correctly predicting implant size for the femoral and acetabular components, as well as the stem neck length. We found that our method of templating proved accurate (within one size) in 95.8% of cases for the stem and 94.9% for the cup when using the anteroposterior view only, while the lateral view was accurate in 95.8% of cases for the stem and 97.2% for the cup. Exact prediction of the stem size was obtained in 77.7% of cases using the anteroposterior view and 67.0% of cases on the lateral view, and 73.0% and 74.4% of cases for the cup on the AP and LL views, respectively. Stem neck size was predicted exactly in 75.35% of cases and within one size in 93.49% of cases. We concluded that our method of digital templating using dedicated software is highly effective in accurately predicting implant size.

Accuracy of digital workflow for placing orthodontic miniscrews using generic and licensed open systems. A 3d imaging analysis of non-native .stl files for guided protocols.

BACKGROUND: This study aimed to assess the accuracy of digital workflow for guided insertion of miniscrews in the anterior palate using restorative implant dentistry software and licensed software for orthodontic applications. METHODS: Twenty subjects (8 males, 12 females, mean age = 16.7 ± 2.1 years) were prospectively selected to receive guided insertion of bicortical palatal miniscrews. Virtual planning was performed using restorative implant dentistry software (Blue Sky Plan*, version 4.7) (group 1 = 10 subjects) and licensed orthodontic software (Dolphin Imaging Software, version 11.0) (group 2 = 10 subjects). A specific 3D Imaging technology was applied to permit the registration of the planned and achieved position of the miniscrews based on the superimposition of maxillary models. The angular deviation (accuracy error) between the planned and the achieved positions of the miniscrews were recorded. Independent Student's test was used with statistical significance set at p value < 0.05. RESULTS: The mean accuracy error recorded in group 1 was 7.15° ± 1.09 (right side) and 6.19 ± 0.80 (left side) while the mean error in group 2 was 6.74° ± 1.23 (right side) and 5.79 ± 0.95 (left side). No significant differences were recorded between the two groups (p > 0.05); instead, miniscrews placed on the right side were almost one degree higher than the left side (p < 0.05) in both groups. CONCLUSIONS: The clinical accuracy error was similar when using generic and licensed orthodontic software for guided systems.