Longevity of composite restorations in posterior teeth placed by dental students: a 12-year retrospective study.

OBJECTIVES: To evaluate the longevity of resin composite restorations placed in posterior teeth by dental students, using data from electronic records from 2008 to 2019. MATERIALS AND METHODS: Demographic (gender and age) and clinical variables (dental group, position in dental arch, and the number of restored surfaces) were evaluated. The 5-year follow-up was assessed according to the day the restoration was placed. Kaplan-Meier curves were generated to calculate the annual failure rate. Data were analyzed by Chi-Square, Kruskal-Wallis, and Mann-Whitney tests (α = 0.05). RESULTS: In total, 3.883 records relative to return periodicity were analyzed. The final sample consisted of 900 restorations from 479 patients. The majority were females, aged between 31 and 60. In total, 256 failures were reported (success rate = 78%), showing an annual failure rate of 2.05%. The main reasons for failures were restoration replacement (55.5%), endodontics (21.9%), prosthetics (14.5%) and extraction (8.2%). There was a higher risk of failure in restorations involving three or more surfaces (p = 0.000) and in patients over 60 years (p < 0.001). In females (p = 0.030), molars (p = 0.044), and maxillary teeth (p = 0.038) failed in a shorter time. CONCLUSIONS: Resin composite restorations placed in permanent posterior teeth by dental students had high survival rates. The main reason for failure was the replacement of restorations. The age group and the number of restored surfaces significantly affected the success of the restorations. CLINICAL RELEVANCE: The electronic health records over 12 years showed that 78% of the resin restorations in posterior teeth placed by dental students were successful for a minimum of five years.

Effect of metal artefact reduction level on the assessment of dental implant positioning by cone-beam computed tomography.

OBJECTIVES: This study evaluated the effect of metal artefact reduction (MAR) level and tube current on the assessment of dental implant positioning relative to the mandibular canal (MC) through cone-beam computed tomography (CBCT). METHODS: Titanium dental implants were placed in dried mandibles at 0.5-mm superior to the MC (group 1/n = 8) and 0.5-mm inside the MC with perforation of the cortex (group 2/n = 10). CBCT scans were obtained with different levels of MAR (off, medium, and high) and 2 tube currents (4 and 8 mA). Four examiners analysed the images and scored the contact between the implant and the MC using a 5-point scale. Sensitivity, specificity, area under receiver operating characteristic curve (ROC), and frequency of scores were calculated. Data were compared with analysis of variance 2-way and Tukey's test and scores with Chi-square test. RESULTS: Specificity and area under ROC curve decreased significantly when MAR level was high compared with MAR-medium and MAR-off. The frequency of score 3 (inconclusive) was the highest, and scores 1 and 5 (definitely no contact and definitely contact, respectively) were the lowest with MAR-high, regardless of the tube current. When MAR was off, there were higher frequencies of scores 1 and 5. CONCLUSIONS: The level of MAR influences the assessment of the relationship between the dental implant and the MC. MAR-high led to lower diagnostic accuracy compared with MAR-medium and off. ADVANCES IN KNOWLEDGE: This article shows that high level of MAR can interfere in the diagnostic of dental implant positioning relative to the MC, decreasing its accuracy.

Influence of metal artefact reduction on the diagnosis of contact between implant and mandibular canal in cone beam computed tomography: An ex-vivo study.

OBJECTIVE: To evaluate the influence of metal artefact reduction (MAR) in the diagnosis of dental implant contact with the mandibular canal (MC) using cone beam computed tomography (CBCT). METHODS: Dental implants were installed with surgical guides in the posterior hemiarches of 10 dry human mandibles: 0.5 mm above to the MC cortex (G1/n = 8) and 0.5 mm inside the MC (G2/n = 10). The experimental set-up was scanned with two CBCT equipment using 85 kV and 90 kV, MAR ON or OFF, and different tube currents (4 mA, 8 mA and 10 mA). Two dentomaxillofacial radiologists (DMFRs) and two dentists (DDS) scored the relation between the dental implant and MC. Descriptive statistics were used to observe the absolute frequency of scores. Sensitivity, specificity and accuracy were calculated considering the known relation between the dental implant and the MC interior. McNemar's test (α = .05) was applied to compare the diagnostic efficacy of MAR ON versus MAR OFF. RESULTS: Overall specificity was higher than sensitivity for both DDS and DMFR (97% vs. 50% and 92.0% vs. 78.0% respectively). There was a significant effect of MAR (p = .031) for DMFR in the case of contact between the dental implant with the MC interior, in which sensitivity decreased with MAR activation from 90% to 40%. DMFR observers showed a better diagnostic performance compared with the DDS observers (accuracy of 84.0% and 71.0%, respectively). CONCLUSIONS: Due to the limited efficacy of MAR, it should not be used when conducting CBCT scans for the evaluation of contact between the implant and the mandibular canal.

Is the digital workflow more efficient for manufacturing partial-coverage restorations? A systematic review.

STATEMENT OF PROBLEM: A consensus on whether a fully digital workflow can replace conventional methods of manufacturing partial-coverage restorations is lacking. PURPOSE: The purpose of this systematic review was to evaluate the accuracy, fit, and clinical outcomes of inlay, onlay, overlay, and endocrown restorations obtained with both digital and conventional workflows. MATERIAL AND METHODS: This study complied with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the International Prospective Register of Systematic Reviews database (CRD42021258696). Studies evaluating the accuracy, fit, and clinical outcomes of inlay, onlay, overlay, and endocrown restorations obtained with digital and conventional workflows were included from 5 databases searched in November 2022. The Checklist for Reporting Randomized Clinical Studies (ROB 2) and the Checklist for Reporting In vitro Studies (CRIS guidelines) were used to assess the risk of bias. RESULTS: Twenty-three studies were included in this review. Sixteen studies evaluated marginal and internal fit, 5 evaluated accuracy, 3 evaluated fracture resistance, and 1 evaluated long-term clinical performance. Although most studies reported acceptable clinical outcomes for both workflows, 11 studies showed better results with the conventional workflow, 10 with the digital workflow, and 2 reported that the outcomes of the workflows were similar. CONCLUSIONS: Clinically acceptable values have been reported for the parameters evaluated in both digital and conventional workflows, and no consensus has been reached regarding the more efficient method.

Is the clinical performance of incremental and bulk-fill resin composite different?

Data sources PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature, Brazilian Bibliography in Dentistry and Cochrane Library. The grey literature was searched using the System for Information on Grey Literature in Europe database. Abstracts from the Annual Session of the International Association for Dental Research and its regional subgroups (1990-2020) were searched. Theses and dissertations (full texts) were searched in the ProQuest and Capes databases. Unpublished and ongoing studies were searched in clinical trial databases (Current Controlled Trials, International Clinical Trials Registry Platform, ClinicalTrials.gov, Registro Brasileiro de Ensaios Clínicos and EU Clinical Trials Register).Study selection In total, 14 randomised clinical trials comparing the clinical performance of composite resin restorations in posterior teeth placed with the incremental or the bulk-filling techniques were evaluated.Data extraction and synthesis Relevant information on the research project, participants, interventions and outcomes was collected using extraction forms by three study authors. Data extraction was pilot-tested using a sample of four studies to ensure that the data were consistent with the specific research question. To avoid overlapping, multiple reports of the same study with different follow-ups were extracted into a single form.Results Considering the primary and secondary outcomes (retention/fracture rate, anatomical form, surface texture, colour match, marginal adaption, marginal discoloration, caries and postoperative sensitivity), it is possible to state that there was no difference between incremental or bulk fill resin composite techniques in Class II and I cavities.Conclusions A systematic review and meta-analysis with moderated quality of evidence bulk fill and incremental techniques showed similar clinical performance on posterior resin composite restorations.

Artefacts at different distances from titanium and zirconia implants in cone-beam computed tomography: effect of tube current and metal artefact reduction.

OBJECTIVES: To evaluate the effect of cone-beam computed tomography (CBCT) tube current (mA) on the magnitude of artefacts at different distances from titanium or zirconia implants, with and without activation of a proprietary metal artefact reduction (MAR). MATERIAL AND METHODS: Human mandibles were scanned on an OP300 Maxio CBCT unit (Instrumentarium, Tuusula, Finland) before and after the installation of dental implants, with four different tube currents (4 mA, 6.3 mA, 8 mA and 10 mA), with and without activation of proprietary MAR. The effect of mA on the standard deviation (SD) of gray values and contrast to noise ratio (CNR) were assessed in regions of interest located 1.5 cm, 2.5 cm, and 3.5 cm from implants. RESULTS: In the presence of titanium implants, a significant decrease in SD was found by increasing tube current from 4 mA to 6.3 mA or 8 mA. For zirconia implants, 8 mA yielded better results for all distances. MAR improved CNR in the presence of zirconia implants at all distances, whereas no differences were observed with the use of MAR for titanium implants. CONCLUSION: Increased tube current can improve overall image quality in the presence of implants, at all the distances tested. When a zirconia implant is present, such increase in mA should be higher in comparison to that for examinations with titanium implants. Activation of OP300 Maxio proprietary MAR improved image quality only among examinations with zirconia implants. CLINICAL RELEVANCE: Artefact-generating implants are common in the field of view of CBCT examinations. Optimal exposure parameters, such as tube current, ensure high image quality with lowest possible radiation exposure.

Digital photography vs. clinical assessment of resin composite restorations.

PURPOSE: To compare direct clinical and indirect digital photographic assessment of resin composite restorations. Ninety-two posterior resin composite restorations were classified using World Dental Federation (FDI) criteria by two different clinical examiners (C1 and C2). In the same appointment of clinical assessment, intraoral high-quality digital photographs were taken and posteriorly two different digital examiners (D1 and D2) classified the images of each restoration. Restorations of each patient were assessed once by C1 and C2 independently. D1 and D2 assessed the digital images from different locations and in different time. Data were analyzed using the Cohen's kappa coefficient, Kruskal-Wallis non-parametric test and Dunn's multiple shared test, with 95% confidence. Agreement levels varied from very good (0.81-1.00) to fair (0.21-0.40). Statistically significant differences (p < 0.05) between assessments were found for surface lustre, staining, color match and translucency, esthetic anatomical form, fracture of material and retention and marginal adaptation. The classification of the resin composite restorations varied significantly according to clinical or high-quality digital photographic assessments. Overall, clinical assessment detected more demand for repair or replacement.

FOXP3+ and CD25+ cells are reduced in patients with stage IV, grade C periodontitis: A comparative clinical study.

BACKGROUND AND OBJECTIVE: Some studies suggest that regulatory T cells (Tregs) have suppressive effects on inflammatory osteolysis. The aim of this study was to evaluate Treg immunomarkers in periodontitis-affected tissues from patients with periodontitis and clinically healthy gingiva (control). MATERIAL AND METHODS: The presence and distribution of positive cells for CD4, CD25 and FOXP3 (Treg immunomarkers) in periodontitis-affected tissues (epithelium and lamina propria) of 30 patients (ten per group) with a diagnosis of stage IV, grade C periodontitis (IV-C), stage III, grade B periodontitis (III-B) and the control were evaluated. A two-way ANOVA followed by Fisher's LSD test was used to demonstrate differences between the groups and immunomarkers; Student's t test was used to demonstrate differences between the epithelium and the lamina propria. RESULTS: Both IV-C and III-B periodontitis presented a significantly high proportion of immune-stained cells for all immunomarkers when compared to the control group. Notably, CD25+ and FOXP3+ cells were detected in a significantly higher number in III-B than IV-C periodontitis (P < .05). CONCLUSION: Our results suggest the participation of Tregs on the osteoimmunological mechanisms in IV-C and III-B periodontitis patients, notably contributing to strategies for alveolar bone regeneration in clinical treatment decisions.

Topical pilocarpine for xerostomia in patients with head and neck cancer treated with radiotherapy.

OBJECTIVE: To evaluate a pilocarpine spray as a treatment for xerostomia in patients treated with radiotherapy (RT) for head and neck cancer (HNC). METHODS: This was a placebo-controlled, double-blind, crossover clinical trial of patients complaining of dry mouth after RT for HNC. Forty patients were randomly assigned to either placebo or pilocarpine (1.54%) spray and instructed to use three times a day for 3 months. After 1-month washout period, patients were crossed over to receive placebo or pilocarpine. The assessments were salivary flow (Stimulated Whole Saliva Flow - SWSF), xerostomia (Xerostomia Inventory - XI), and quality of life (QoL/Oral Health Impact Profile - OHIP-14), assessed at baseline, 1 hr (only SWSF), and at 1, 2, and 3 months of treatment. RESULTS: Posttreatment SWFS was not statistically different between pilocarpine and placebo regardless of the treatment sequence (paired T test; p > .05), except for the SWFS rates at 2 months after therapy. When comparing pilocarpine with placebo in the time points, there was no significant difference (p > .05) for QoL or XI. Significant differences in improvement in QoL and xerostomia experience appeared along time for pilocarpine group. CONCLUSION: The topical application of pilocarpine spray tested was similar to placebo on SWSF assessments in patients treated with RT for HNC.

Influence of 2D vs 3D imaging and professional experience on dental implant treatment planning.

OBJECTIVES: This study investigated whether professional experience and type of image examination (panoramic radiography (PAN) or cone beam computed tomography (CBCT)) could influence the pre-surgical planning for dental implant treatment. MATERIALS AND METHODS: Six dentists, from two different levels of experience (senior (Sr) and junior (Jr)) performed simulated pre-surgical planning by using PANs and after 1 month, by using CBCTs, considering implant length (IL), implant width (IW), need for bone graft (BG), and other surgical procedures (OP). Bland-Altman test and Kappa coefficient were used to identify agreements. RESULTS: Bland-Altman test showed good agreement in the plans for inter-professional (i.e., Sr vs Jr) comparisons. Bland-Altman plots displayed intra-observer agreement (i.e., differences between PAN and CBCT), showing discrepancy between imaging modalities for IL and a tendency towards selecting larger dental implant options when using PAN and smaller options with CBCT. Kappa showed almost perfect (0.81-1.0) agreement between Jr and Sr for OP (PAN and CBCT). For BG, agreement was substantial (0.61-0.80) when planning was done with PAN and CBCT. Descriptive statistics showed evidence that when Jrs used CBCT, they no longer indicated the BG they had planned when they used PAN. CONCLUSION: There were differences in the pre-surgical planning for treatment with dental implants depending on the professional experience and the type of imaging examination used. CLINICAL RELEVANCE: Variation in dental implant planning can affect treatment time, cost, and morbidity in patients.

Clinical, double blind, randomized controlled trial of experimental adhesive protocols in caries-affected dentin.

OBJECTIVE: To evaluate the clinical performance of posterior resin composite restorations regarding experimental and regular adhesive protocols in caries affected-dentin (CAD). MATERIAL AND METHODS: A total of 92 class I and class II cavities with carious lesions were selected and randomly assigned to the following groups: (1) bioactive glass-ceramic powder/two-step etch and rinse system, (2) control/two-step etch and rinse system, (3) bioactive glass-ceramic powder/two-step self-etching system, and (4) control/two-step self-etching system. Two operators carried out the adhesive protocols and restored the cavities with a nano-hybrid resin composite. Participants were followed up at 1 week and 6, 12, and 18 months for clinical evaluation performed by two blinded examiners and calibrated according to FDI criteria. Data were analyzed using Kruskal-Wallis and Dunn tests with a confidence of 95%. RESULTS: The clinical performance of resin composite restoration was not affected by the experimental use of an adhesive protocol including a bioactive glass-ceramic powder for 18 months post-procedure. However, there was a significant difference between group 2 and group 4 (p < 0.05) for marginal adaptation (18 months). Group 2 was significantly different from group 3 (p < 0.05) for fracture of material/retention (18 months) and marginal adaptation (1 week); group 2 showed a better performance. CONCLUSION: Adhesive protocols can alter the clinical performance of posterior restorations in terms of marginal adaptation and the fracture of material/retention in CAD. CLINICAL SIGNIFICANCE: Adhesive protocols may influence the success of resin composite restorations in CAD; this is important because failure can lead to caries, re-incidence, and/or clinical re-work.

The effect of electronic cigarettes on dental enamel color.

OBJECTIVE: The use of electronic cigarettes (ECIGs) has recently increased as an alternative to conventional smoking tobacco products. The literature is scarce on the effects of ECIGs on dental and oral structures. Therefore, the objective of this study was to observe whether ECIG aerosol could alter the color of dental enamel. MATERIALS AND METHODS: Sixty-three bovine enamel specimens were randomly separated into groups (n = 7) and treated with aerosols with different e-liquid flavors (neutral, menthol, and tobacco) and nicotine content (0, 12, and 18 mg). The initial color assessment was performed using a spectrophotometer (Easy Shade-Vita). Dental enamel was exposed to 20 cycles of ECIG aerosol in a smoking machine, and the final color was measured. The color change was evaluated using ΔEab, ΔE00, and Whiteness Index (WID ) formulae. Differences in L* a* b* coordinates were calculated, and data were analyzed (two-way ANOVA, uncorrected Fisher's LSD post hoc test, α = 0.05). RESULTS: Luminosity (ΔL) was reduced by aerosols with almost all levels of nicotine content and neutral and menthol flavors. Flavored e-liquids caused more color change (P < .05) according to ΔEab and ΔE00. ΔE values from both formulae exceeded the thresholds for perceptible visual alterations of color. WID increased after ECIGs exposure for menthol and tobacco and decreased for neutral flavors. CONCLUSIONS: ECIG aerosol from e-liquids with different nicotine contents and flavors altered enamel color. Menthol and tobacco e-liquids may alter the enamel color decreasing the yellowness of the enamel compared to neutral e-liquid. CLINICAL SIGNIFICANCE: Electronic cigarettes can cause perceptible changes in tooth color, altering dental esthetics.

Color stability and surface roughness of composite resins submitted to brushing with bleaching toothpastes: An in situ study.

OBJECTIVE: To evaluate, in situ, the color stability (CS) and surface roughness (SR) of composite resins after toothbrushing with whitening toothpaste. MATERIALS AND METHODS: Specimens (6 × 2 mm/) of composite resin (Tetric N-Ceram, Z250 and Z350) were randomly fixed on thirty participants' upper molars (buccal surface). For an initial standardization (7 days), participants used a soft toothbrush and nonwhitening toothpaste (SDB - Sorrisos Dentes Brancos). Initial CS (Easyshade) and SR (Surfcorder RS) measurements were performed. For SR, impressions of specimens were taken (Express, 3 M ESPE) to produce replicas in polyurethane resin (Axon F16, Abcol). Participants were randomly separated into three groups (n = 10) regarding used toothpaste (SDB; Close up White Now - CWN; Colgate Luminous White - CLW). After 90 days, CS and SR measurements were obtained, and data were analyzed (2-way ANOVA, repeated measures, Bonferroni, P < .05). RESULTS: Z250 showed higher (P < .05) color change than Z350. Tetric N-Ceram presented an intermediary value for ΔE, however, it also demonstrated higher SR (P < .05) after brushing with CLW, compared with SDB and CWN. CONCLUSIONS: The SR change of composite resin after toothbrushing with a whitening toothpaste is material dependent, but the toothpaste abrasiveness does not change the CS. CLINICAL SIGNIFICANCE: Whitening toothpaste do not change the color stability of composites; however, it can alter the restorative composite surface roughness.

Randomized clinical study of alterations in the color and surface roughness of dental enamel brushed with whitening toothpaste.

OBJECTIVES: This clinical study evaluated the influence of whitening toothpaste on color and surface roughness of dental enamel. MATERIALS AND METHODS: Initially, the abrasiveness of the toothpastes used (Sorriso Dentes Brancos [SDB]; Colgate Luminous White and Close up White Now) was tested on 30 (n = 10) plexiglass acrylic plates that were submitted to mechanical tooth brushing totalizing 29,200 cycles. Subsequently, 30 participants were selected, and received a toothbrush and nonwhitening toothpaste (SDB). The participants used these products for 7 days and initial color readouts (Spectrophotometer) and surface roughness of one maxillary central incisors was performed after this period of time. For surface roughness readouts, one replica of the maxillary central incisor was obtained by a polyvinyl siloxane impression material (Express) and polyurethane resin. After baseline measurements, participants were separated into three groups (n = 10), according to the toothpaste used. The participants returned after 7, 30, and 90 days when new color readouts and surface roughness were recorded. The measured values were statistically analyzed (2-way-ANOVA, repeated measures, Tukey, P < .05). RESULTS: Whitening toothpastes did not promote significant (P > .05) color alteration and nor increased the surface roughness of the dental enamel in brushing time of the study. CONCLUSIONS: The abrasiveness of whitening toothpaste and the brushing trial period did not affect the surface roughness of dental enamel. However, color changes observed on enamel were above the perceptibility and acceptability thresholds reported in the literature. CLINICAL SIGNIFICANCE: The over-the-counter toothpastes tested had an effect on dental enamel color above the perceptibility and acceptability thresholds but did not change the surface roughness of the teeth.

Interactive audience response systems in oral and maxillofacial radiology undergraduate lectures.

OBJECTIVES: To evaluate the impact of audience response systems (ARS) on student participation (SP) during Oral and Maxillofacial Radiology (OMR) undergraduate lectures and on final examination scores (FES). Furthermore, an analysis of unanimity assessed the influence of ARS on students' responses. Students' perceptions were also assessed. METHODS: A controlled crossover study was designed. Four lectures covering topics of OMR were each taught with ARS and without ARS (i.e. hand-raising method). SP and FES were compared between ARS and HR groups. Unanimity of answers was analyzed for both groups. Questionnaires assessed students' impressions about ARS. RESULTS: Mean SP of ARS and HR groups were 97.6% and 47.3%, respectively, and this difference was statistically significant (P<.05). Mean FES for the ARS group (77%) was slightly higher than HR group (75.1%), however, not statistically significant. There was positive correlation between SP and FES. With ARS, only 5.7% of the questions were unanimous, whilst 51.4% were unanimous with HR method. Most students reported that the use of ARS had positive influence on their attention (92%), participation (96%), classmates' participation (82.7%), interest (74.7%), and learning (86.7%). For the five-point scale ratings of the relevance of ARS features, anonymity had an average 3.6, whilst other items received an average 4.6 or higher. CONCLUSIONS: ARS significantly increased participation in OMR lectures; however, an increase in FES could not be associated with ARS by itself. Not taking into consideration which method was used to answer questions posed during lectures, higher participation correlated with higher scores. ARS is well-accepted and students believe that these devices positively influence their performance. Among the recognized advantages of ARS, anonymity was considered the least relevant.

Development of a dental digital data set for research in artificial intelligence: the importance of labeling performed by radiologists.

OBJECTIVE: The aim of this study was to present the development of a database (dataset) of panoramic radiographs. STUDY DESIGN: Three radiologists labeled an image set consisting of 936 panoramic radiographs. Labeling includes tooth numbering (including teeth present and missing) and annotation of dental conditions (e.g., caries, dental restoration, residual root, endodontic treatment, implant, fixed prosthesis, incisal wear). The annotation process was performed in a Picture Archive and Communication System software customized for the study purposes using a small bounding box to delimit the entire tooth and items for radiographic diagnosis and a large bounding box to simultaneously delimit the 2 dental arches (maxilla and mandible). A JSON file was generated for each annotation. RESULTS: The database encompassed 23,619 annotations; disagreement between radiologists occurred in 0.7% of the notes. CONCLUSIONS: This work aimed to inform researchers about the importance of the labeling process, in addition to providing the scientific community with a bank of labeled images to implement artificial intelligence systems in clinical practice.

Comparison of intraoral scanning and CBCT to generate digital and 3D-printed casts by fused deposition modeling and digital light processing.

OBJECTIVES: to evaluate trueness and precision of digital casts from intraoral scanning (IOS) and cone beam computed tomography (CBCT); trueness and precision of 3D-printed casts using digital light processing (DLP) and fused deposition modeling (FDM); the influence of digitizing method in the 3D-printed casts and, to compare STL data after DICOM segmentation and conversion. METHODS: a reference cast was digitized with IOS and CBCT, and 3D-printed using FDM and DLP. Linear measurements of occlusocervical (OC), interarch (IEA), and mesiodistal (MD) dimensions were taken on reference, digital and 3D-printed casts. Trueness was observed as the distortion, and precision was observed as the variation of measurements. One and Two-way ANOVA, Student t-test, and Chi-Square were applied to analyze data. RESULTS: distortion varied between digital casts for all dimensions; at OC, both showed expanded dimensions with IOS being significantly greater; in turn, CBCT digital casts showed higher distortion at IEA and MD. Dimensions of 3D-printed casts showed a predominance of shrinkage, DLP presented higher distortion compared to FDM for both digitizing methods. Digitizing methods influenced the 3D-printing of casts, especially for DLP. Regarding precision, no statistical difference was found. STL converted from DICOM showed statistical difference in IEA (p < 0.001). CONCLUSIONS: digital casts showed distortion depending on the digitizing method. IOS was better in IEA and MD, and CBCT in OC dimensions. Overall, DLP casts presented higher distortion compared to FDM. The digitizing method influences trueness on 3D-printed casts. File conversion from DICOM to STL per se could change the dimension. CLINICAL SIGNIFICANCE: This investigation showed that digital casts from IOS and CBCT as well 3D-printed casts from FDM and DLP can show different trueness. It is clinically relevant as clinicians have various workflows available in Digital Dentistry which involve these digitizing and manufacturing methods.

Patients´ satisfaction concerning direct anterior dental restoration.

The objective of this study was to observe patients' satisfaction with their in-service direct anterior dental restorations and to compare it with clinical evaluation using FDI (Federation Dental International) criteria. Patients scored their own anterior dental restorations regarding satisfaction (satisfactory /dissatisfactory). If dissatisfaction was mentioned, then, they would be interviewed about the complaint. In the same session, the dental restorations were clinically evaluated by two dentists using FDI criteria (1-5 score) concerning esthetic, functional, and biological domains. Descriptive statistics were used for frequencies of scores attributed by patients and clinicians. In order to compare patients' to clinicians' frequencies, the Chi-square test was applied (p ≤ 0.05). A total of 106 restorations were evaluated by patients and clinicians. Patients reported 52.8% of restorations satisfactory and 47.8% dissatisfactory. Overall, clinicians reported the same restorations as 82,3% satisfactory and 17,6% dissatisfactory. Patients' most frequent complaints referred to color, followed by anatomical form, fracture of material and retention, and approximal anatomical form. Comparing patients' satisfaction and dissatisfaction rates to clinicians' evaluation per criteria, there was no difference regarding esthetics. The frequency of dissatisfactory restorations by clinicians was significantly lower when functional and biological properties were compared with patients' opinions. Direct anterior dental restorations were more frequently reported as satisfactory by patients and clinicians, being the main complaints related to esthetic issues. When clinicians and patients' evaluations were compared, it was observed that the frequencies of satisfactory restoration by patients and clinicians were similar regarding esthetic properties, and significantly different regarding functional and biological properties.

Comparison between intraoral scanning and direct visual analysis for the assessment of developmental defects of enamel.

OBJECTIVE: To compare direct visual analysis (DVA) and intraoral scanning (IOS) for the assessment of developmental defects of the enamel (DDE). METHODS: Thirty-nine extracted permanent human teeth with DDE were selected by an experienced examiner and digitised using IOS. The scanning was recorded using the OBS Studio software parallel to the IOS software to obtain a coloured high-definition MP4 file of the process. Two other experienced, blinded, and calibrated examiners randomly analysed the same teeth through DVA and IOS. A third examiner resolved any disagreements between the two examiners. Descriptive statistics were used to analyse the frequencies of the scores. Cohen's kappa test was used to determine whether the DVA scores were different from those assigned using IOS. Spearman's test was used to verify non-random examiner errors. The Chi-square test was used to compare score frequencies. Statistical significance was set at p <0.05. RESULTS: Scores indicating more severe and extended DDE (p <0.05) were more frequently assigned with IOS than with DVA (IOS: 25.64%, 25.64%, 38.46%, and 35.90% between one-third to two-third of the lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 10.26%, 7.69%, 15.38%, and 10.26% for the respective aforementioned tooth surfaces). Contrarily, 'no visible enamel defect' was significantly less assigned for IOS than for DVA (IOS: 15.38%, 43.59%, 35.90%, 15.38%, and 17.95% for buccal, lingual, occlusal, mesial, and distal surfaces, respectively; vs. DVA: 38.46%, 66.67%, 56.41%, 51.28%, and 43.59% for the respective aforementioned tooth surfaces). Kappa agreement ranged from fair to moderate when comparing DVA and IOS; the correlation between both methods was positive, indicating that the examiners assigned the scores properly and the differences arose from employing different methods. CONCLUSION: The assessment of DDE differed depending on the method used. IOS scores indicated more severe and extended DDE than DVA scores. Clinical investigation is the next step in validating the use of IOS for DDE diagnosis. CLINICAL SIGNIFICANCE: This study showed that DDE can be assessed differently using IOS. It is clinically relevant as it directly affects the determination of the severity of the defect and dental treatment planning.

Effect of Non-Surgical Periodontal Therapy on Clinical Parameters of Periodontitis, Oral Candida spp. Count and Lactoferrin and Histatin Expression in Saliva and Gingival Crevicular Fluid of HIV-Infected Patients.

BACKGROUND: Periodontitis (PDT) has gained attention in the literature with the increase in life expectancy of people living with HIV on combined antiretroviral therapy (cART). Thus, the search for inflammatory biomarkers could be useful to understand the pathophysiology of chronic oral diseases in the cART era. OBJECTIVE: The aim of this study was to evaluate the impact of non-surgical periodontal therapy (NSPT) on clinical parameters of PDT, Candida spp. count and expression of lactoferrin (LF) and histatin (HST) in saliva and gingival crevicular fluid (GCF) of HIV-infected patients. METHODS: Bleeding index (BI), probing depth (PD), clinical attachment level (CAL), colonyforming units (CFUs) of Candida spp, and LF and HST levels were measured in saliva and GCF of both groups at three different times: baseline (before treatment), and 30 and 90 days after the NSPT. Clinical, mycological and immunoenzymatic analyses were also performed. RESULTS: Twenty-two HIV-infected patients and 25 non-HIV-infected patients with PDT participated in the study. NSPT was effective in improving periodontal clinical parameters, including ≤ 4 sites with PD ≤ 5mm and BI ≤ 10%. Significant change in oral Candida spp. count occurred neither between the two groups nor after NSPT. And the salivary and GCF levels of LF and HST were not influenced by the NSPT; by contrast, except for salivary LF, HST and LF were shown to exhibit significantly higher levels in HIV-infected than in non-HIV-infected patients. CONCLUSION: NSPT was effective in improving periodontal disease parameters in HIV-infected patients, but did not affect LF and HST expression in saliva and GCF of HIV-infected patients.