Chairside Time Research Articles

A novel pre-formed distal shoe eruption guidance appliance in chairside management of early loss of primary second molar: a case report

Preservation of the primary teeth until exfoliation is one of the most important aspects of preventive and interceptive dentistry. Premature loss of the second primary molar before the eruption of the permanent first molar may lead to space loss that results in tooth size/arch length discrepancy. Early loss of a second primary molar is a challenge to paediatric dentists if the first permanent molar has not erupted. A space maintainer of the intra-alveolar type assists in controlling the eruption of the permanent first molar in these circumstances. This report describes the case of space maintenance in a 3-year-old girl for whom the primary second molar was extracted owing to a poor prognosis. A pre-formed intra-alveolar space maintainer, which in this case was a Roche's distal shoe type, was given and followed up for 12 months. CPD/Clinical Relevance: This pre-formed distal shoe space maintainer gives the advantage of reduced chairside time, more stability and strength, and is better accepted by the child.

Single posterior implant-supported restorations fabricated using a scannable healing abutment versus a conventional scan body: A randomized controlled trial

Statement of problemThe use of a scannable healing abutment is a convenient option for fabricating implant-supported restorations (ISRs) with a digital workflow; however, clinical studies evaluating prosthetic efficacy are lacking. PurposeThe purpose of this randomized controlled trial was to investigate the prosthetic efficacy of definitive posterior single ISRs fabricated after scanning using a scannable healing abutment-scan peg (SHA-SP) in comparison with a conventional scan body (CSB). The time for data acquisition, quality of proximal and occlusal contacts, and relative occlusal force of ISRs were measured. Material and methodsTwenty-four participants eligible for single ISRs to replace the mandibular first molar with adjacent and antagonist teeth present were randomly allocated to either a study group (n=12) receiving ISRs after intraoral scanning using an SHA-SP or a control group (n=12) receiving ISRs after intraoral scanning using CSB. During the surgical procedure, a prefabricated contoured scannable healing abutment was screwed to the implant in the SHA-SP group, while a custom-made healing abutment was used in the CSB group. After a healing period of 3 months, an intraoral scan was made, and the duration of data acquisition was recorded. The ISRs were milled from zirconia and evaluated for the quality of proximal and occlusal contacts using dental floss and shim stock, respectively. The relative occlusal forces of the ISRs and their contralateral natural teeth were measured using a digital occlusal analyzer. Statistical analysis was done using an independent sample t test for quantitative variables and a Pearson chi-squared test for qualitative variables between the tested groups (α=.05). ResultsThe direct digital workflow using SHA-SP was statistically less time consuming than the CSB (P<.001). The 2 groups were statistically similar regarding the quality of the proximal contacts (P=.281) or occlusal contacts (P=.307) and the relative occlusal forces of ISRs (P=.315). The relative occlusal forces of the ISRs in both groups were significantly lower than those of their contralateral natural teeth (P<.001). ConclusionsDirect digital workflow using SHA-SP was more rapid, saving clinical chairside time, and produced proximal and occlusal contacts of comparable quality with those obtained with CSB. The relative occlusal forces of ISRs in both workflows were lower than their contralateral natural teeth.

Comparative evaulation of condylar guidance obtained by digital panoramic radiographic images with that of obtained during jaw relation and try-in using two different interocclusal record material in completely edentulous patients: an in vivo study

Background In completely edentulous patients, maintaining the patient's temporomandibular joint (TMJ) health and intraoral components is very important, which can be achieved by an accurate interocclusal record, which can we taken by various materials and also at various stages. Simulation of the temporomandibular joint anatomy and mandibular movements is possible on a semi-adjustable articulator, which is widely used in prosthodontics. Transferring the record on articulator is a critical step in the fabrication of complete dentures so it should be done precisely to reduce chair side time and also to avoid complications for patients. This study examines which material is more accurate and records which stage gives more precision, by comparing the Condylar guidance on radiographs. This is because it is a fairly consistent bony landmark and can be used for correlating with the clinical methods in terms of verification. The objective is to determine the inter occlusal records created during the Jaw Relation stage and Try-in using reinforced wax and Polyvinyl siloxane and compare these values to the condylar guidance obtained by oethopantomogram (OPG). Methods Recording the Condylar Guidance value on OPG by tracing the Glenoid fossa, Articular eminence and the Frankfurt Horizontal Plane. Followed by conventional steps in making complete dentures, at jaw relation and try-in stage. We will record values of condylar guidance with the two different Interocclusal record materials. Expected result It will help the clinicians to gain knowledge about obtaining precise condylar inclination angle by using suitable interocclusal record materials. Conclusions This study will help us to obtain condylar inclination which inturn helps the patients satisfaction as it preserves the intraoral components and health of TMJ.

Quantitate evaluation of photogrammetry with CT scanning for orbital defect

Facial deformities can be caused by cancer, tumours, trauma, infections, congenital or acquired defects and may lead to alteration in basic functions such as communication, breathing, and mastication and aesthetic thereby affecting quality of life. Traditional processes for manufacturing maxillofacial prostheses involve complicated, time-consuming and tedious processes for the patient and the operator. Impression of the defect area, which is the one of the crucial step in fabrication of prosthesis, is the longest and most difficult process as it requires a long contact with the patient. The digital revolution is now changing the landscape of prosthetic production and making the impression making procedure simpler. Digital technology reduces patient chair side time by providing more accurate display data in less time (3–5 min) than traditional methods. Digital impressions eliminate the need for bulky impression materials and provide a more comfortable patient experience.

The Digital Era Heralds a Paradigm Shift in Dentistry: A Cross-Sectional Study.

Background The transformation of dental practice from conventional methods to digital technology has been widely discussed. This study aimed to examine the awareness, understanding, and attitudes towards the use of digital technology in dentistry, with a particular focus on computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Methods A cross-sectional study was conducted, involving a questionnaire distributed to a diverse group of participants from the dental field. The questionnaire covered aspects of digital technology in dentistry, including awareness, perceived usefulness, understanding of CAD/CAM technology, perceived benefits and shortcomings, system awareness, and the impact on clinical decision-making. Results Almost all participants (99.3%) reported being aware of digital technology in dentistry. The perceived utility of digital technology varied widely, but it was considered particularly useful for specific dental procedures. Most of the respondents (948 out of 953) were aware of CAD/CAM technology, and many acknowledged its benefits, including fewer appointments, less chairside time, and greater precision. However, high cost, lack of knowledge, and preference for traditional methods were identified as barriers to adoption. Most participants believed that CAD/CAM would influence clinical decision-making and expressed interest in integrating it into their regular workflow. A majority had attended CAD/CAM training programs and believed there was a need to increase education on CAD/CAM during undergraduate and postgraduate courses. While a significant majority agreed that digital technology was the future of dentistry, a substantial number also expressed reservations. Conclusion The study concluded that there is a high level of awareness and readiness to adopt digital technology in dentistry. However, its perceived utility varied among participants, and several barriers to adoption were identified, indicating the need for expanded education and training. Despite some resistance, there is a growing recognition of the potential benefits of CAD/CAM technology and a trend towards integrating it into regular practice.

Comparison of Shear Bond Strength, Adhesive Remnant and Precision Fit between Conventional Lingual Retainers and Customised CAD/CAM Fabricated Lingual Retainers: An In-vitro Study

Introduction: Fixed lingual bonded retainers offer the comfort of aesthetics and reduced tissue irritation after orthodontic treatment but are wrought with frequent bond failures. Numerous techniques have been used to adapt the retainer to the lingual surface of the lower anterior teeth, but research on customised lower lingual retainers is scarce. Aim: To evaluate and compare the Shear Bond Strength (SBS), Adhesive Remnant Index scores (ARI), and precision fit of a novel Computer-aided Designing-Computer-aided Machining/ Manufacturing (CAD-CAM) fabricated retainer and conventional retainers. Materials and Methods: This invitro study was conducted at the Department of Orthodontics, and Dentofacial Orthopaedics, SRM Dental College, Ramapuram, Chennai-89 from June 2022 to February 2023. It included a total of 360 human mandibular anterior teeth were collected and embedded in acrylic blocks in groups of six to simulate the mandibular anterior arch form. A total of 60 retainers made of braided Stainless Steel (SS) wires, co-axial wires, customised through CAD/CAM technology were evaluated. The retainers were bonded to the lingual aspect of the teeth using composite resin. A universal testing machine was used for testing SBS. Precision fit was observed using Exocad software. Statistical analysis included one-way Analysis of Variance (ANOVA) for SBS, Kruskal-Wallis for ARI score, and Mann-Whitney U test for precision fit. Results: The CAD-CAM retainers had a more precise fit when compared to conventional retainers (p=0.009). SBS was highest for CAD-CAM fabricated retainer and lowest in the co-axial retainer, and this finding was statistically significant (p&lt;0.001). The CAD-CAM retainer had the highest mean rank in ARI scores (33.90) when compared to braided SS and co-axial wire. Conclusion: The CAD-CAM fabricated retainers would be more effective clinically, as higher bond strength due to precise fit would reduce the failure rate, thus preventing relapse and minimising chairside time.

Esthetic rehabilitation of labial tooth defects caused by caries of the anterior teeth using a composite resin injection technique with veneer-shaped 3D printing indices.

An 18-year-old woman sought treatment for caries of the anterior teeth after completing orthodontic treatment. Direct composite resin restoration was chosen because the patient preferred a minimally invasive and cost-effective treatment whenever possible. Based on diagnostic wax-up, veneer-shaped indices for composite resin injection were designed to replicate and restore tooth defects rapidly and accurately. The overall esthetic result was excellent after a 1-year of follow-up. Direct freehand composite resin restorations are clinically challenging. The recently proposed 3D printing index for the composite resin injection technique is helpful for direct restoration but is challenging to remove. The veneer-shaped indices avoid the formation of an undercut in the direction of removing the index, making them easy to remove after finishing the restorations. Using veneer-shaped indices for composite resin injection enables rapid esthetic rehabilitation of labial tooth defects caused by caries. This approach reduces chairside time and operational difficulty while allowing for easy index removal after completing the restorations.

Non-extraction Treatment of Class Ii Division 1 Malocclusion using the Forsus Fatigue Resistant Device – Case Report

Devices commonly used for correction of Class II malocclusions can be classified as extra-oral (headgear), intra-arch or inter-arch. The intra-arch devices are either removable (Cetlin or sagittal appliance) or fixed appliances (Distal-jet, Jones-jig, etc). Fixed intra-arch appliances often depend on a Nance button for anchorage. Interarch devices, which use the mandibular arch for anchorage, can be removable or fixed. They can pull (Class II elastics) or push (Frankel, Herbst, Japer jumper). The Forsus Fatigue resistant device is an inter-arch push spring that produces 200g of force when fully compressed, the force levels being comparable to heavy Class II elastics. The Forsus FRD has be effective in correcting Class II division 1 malocclusions without the need for patient compliance and considerably reducing chair-side time. The optimum force levels increase patient comfort and provides faster resolution of Class II skeletal base maxillo-mandibular relationship.

Robotic Applications in Orthodontics: Overview of Existing Research

Malocclusion is the world's third most common oral ailment. The fixed orthodontic procedure is now the most successful treatment strategy for malocclusion. Archwire bending is an important part of orthodontic therapy. However, because to the great stiffness and exceptional flexibility of orthodontic wire, it is a very difficult task. The old method of obtaining the created archwire curve is dependent on manual operation, which would bring various errors induced by human causes. Customised archwires are required in clinics for lingual orthodontics treatment. Previously, only expert orthodontists could physically bend these archwires. This is a pattern demands specialised skill training, precision, and extensive chairside time, but cannot guarantee the accuracy of appliances. So, what are the most recent developments?

Comparative Evaluation of the Color Stability and Clinical performance of bulk-filled composites: A Split-mouth Randomized Controlled Trial

Background: Bulk fill composites are relatively novel and are a boon to esthetic dentistry, as they decrease the chairside time during the restoration while offering as good esthetics and clinical performance as incrementally filled composites. This study was conducted to find out the best composite regarding its color stability and clinical performance among bulk-filled and incrementally-filled composite restorations. Materials and methods: It was a split-mouth randomized controlled trial conducted on 16 patients with 2 anterior teeth each indicated for composite restoration. One tooth was restored using incremental fill composite and the other using bulk-fill composite, the choice of which was made randomly. The patient was recalled after 1 year. Standardized photographs were taken immediately after the restoration and at 1-yearfollow-up, which was analyzed using Image J software for color stability. Clinical performance was evaluated using modified USPHS criteria. Statistical analysis: The comparison of the greyscale values of color stability was done using Paired t-test. The various parameters indicating the clinical performance were compared between the two groups using McNemar’s Chi-square test. Results: There was no statistically significant difference in the mean color change between bulk fill and incremental fill composites at 1-year follow-up (p =0.806). Clinical evaluation of the restorations done using the modified USPHS criteria also showed statistically no significant difference between the groups. Conclusion: The bulk-fill composite performed similarly to incrementally filled composites in terms of color stability and clinical performance.

Comparative evaulation of condylar guidance obtained by digital panoramic radiographic images with that of obtained during jaw relation and try-in using two different interocclusal record material in completely edentulous patients: an in vivo study

Background: In completely edentulous patients, maintaining the patient's TMJ health and intraoral components is very important. This can be achieved by an accurate interocclusal record, which can we taken by various materials and also at various stages. Simulation of the temparomandibular joint anatomy and mandibular movements is possible on a semi adjustable articulator which is use widely in prosthodontics. Transferring the record on articulator is a critical step in fabrication of complete dentures so it should be done precisely to reduce chair side time and also to avoid complications for patients. This study examines which material is more accurate and also records which stage gives more precision, by comparing the Condylar guidance on radiographs. This is because it has consistent bony landmarks and is comparable to clinical methods in terms of standardisation. The objective will be to determine the inter occlusal records created during Jaw Relation stage and Try-in using reinforced wax and Polyvinyl siloxane and compare these values to the condylar guidance obtained by OPG. Methods: Recording the Condylar Guidance value on OPG, obtained with tracing Glenoid fossa, Articular eminence and the Frankfurt Horizontal Plane. Followed with conventional steps in making complete dentures, at jaw relation and try-in stage. we will record values of condylar guidance with the two different Interocclusal record materials. Expected result: It will help the clinicians to get knowledge about obtaining precise condylar inclination angle by using right interocclusal record materials. Conclusions: This study will help us to obtain condylar inclination which inturn helps the patients satisfaction as it maintains the patient's TMJ health and intraoral components.

The Influence of Indirect Bonding Technique on Adhesion of Orthodontic Brackets and Post-Debonding Enamel Integrity-An In Vitro Study.

The increasing demand for orthodontic treatments due to the high prevalence of malocclusion has inspired clinicians and material scientists to investigate innovative, more effective, and precise bonding methods with reduced chairside time. This study aimed at comparing the shear bond strength (SBS) of metal and ceramic brackets bonded to enamel using the indirect bonding technique (IDB). Victory Series metal brackets (Metal-OPC, Metal-APC) and Clarity™ Advanced ceramic brackets (Ceramic-OPC) (3M Unitek, Monrovia, CA, USA) were bonded indirectly to extracted human premolars through the etch-and-rinse technique. A qualitative assessment of the enamel surface using microscopic methods was performed, and the amount of residual adhesive was reported as per the adhesive remnant index (ARI). Moreover, the bracket surface was evaluated with SEM-EDS. The highest SBS mean values were observed in the Ceramic-OPC group (16.33 ± 2.01 MPa), while the lowest ones were obtained with the Metal-OPC group (11.51 ± 1.40 MPa). The differences between the Metal-AOPC vs. Metal-APC groups (p = 0.0002) and the Metal-OPC vs. Ceramic-OPC groups (p = 0.0000) were statistically significant. Although the Ceramic-OPC brackets bonded indirectly to the enamel surface achieved the highest SBS, the enamel damage was significantly higher compared to that of the other groups. Thus, considering the relatively high bond SBS and favourable debonding pattern, Metal-APC brackets bonded indirectly may represent the best choice.

A Comprehensive Review of Lesion Sterilization and Tissue Repair: An Alternative for Pulpectomy in Deciduous Teeth.

Pulpectomy has always been a treatment choice when irreversible damage to the pulpal and periapical tissues occurs, but in a pediatric patient, expecting cooperation and adequate chair side time is a huge task as they fear the dentists and the instruments. Hence, it was required that there come an advanced treatment protocol that helps overcome the drawbacks of the existing treatment modality. A new therapeutic strategy called lesion sterilization and tissue repair (LSTR) is revolutionizing how dental lesions are treated today. Through a non-invasive antimicrobial treatment, this cutting-edge method seeks to halt the spread of carious lesions while encouraging tissue repair and regeneration. In LSTR, the infected tooth tissues are treated directly with a special antimicrobial combination of antibiotics, reducing agents, and disinfectants. Through the elimination of the microorganisms that cause dental decay and the creation of an environment that is favorable for natural tissue healing, this intervention targets the microbial etiology. This article mainly focuses on using antibiotics as a treatment modality in a tooth affected by caries and where the pulp and periradicular tissues are irreversibly inflamed. Pulpectomy has always been the most practiced technique, but in children, due to the lack of cooperation during the treatment and harm to the underlying developing tooth bud, a less invasive protocol had to be used, which is LSTR. This review delves into the basic ideas, techniques, and clinical applications of lesion sterilization and tissue restoration to look at its various aspects. This review clarifies the effectiveness and safety of LSTR in controlling diverse dental diseases, ranging from early-stage caries to deep dentin infections, by critically assessing previous study findings. It also emphasizes LSTR's ability to preserve vital tooth pulp, obviating the need for invasive and frequently uncomfortable endodontic operations. The review advocates for integrating LSTR into contemporary dental practices, showcasing its potential to transform the landscape of oral healthcare. By providing a comprehensive overview of this innovative technique, this review encourages further research and clinical implementation, heralding a new era in dentistry focused on preservation, regeneration, and enhanced patient well-being.

A comparison of the shear bond strength of metal orthodontic brackets that have been treated with various light-emitting diode intensities and curing times: In-vitro research

The study aims to test the effects of LED light at three different power settings (500mW/cm2, 1000mW/cm2&amp; 1500m W/cm2) and three different exposure times (5sec, 10sec &amp; 20sec) adhesive composites for use with stainless steel orthodontic brackets, and their shear bond strengths. Current In-vitro work used 120 teeth, mostly premolars, separated into 10 equal groups of 12. After the crowns of the teeth were exposed by mounting them vertically into self-heal acrylics, the buccal-enamel exterior was prepared for bonding (PEA) 0.022”x 0.028” stainless steel premolar bracket using a thin layer of light cure adhesive primer and paste (Transbond-XT-3M Unitek Monrovia, Calif). Brackets in Group 1 comprising the Control group treated by usual halogen light source for forty sec, in remaining 9 groups (Experimental group) three commercially available LED curing light units i.e., Woodpecker, Guilin, Guangxi, China; Stealth Soft Equinox, Denmark, Holland; Radii plus, SDI, Australia, having three different light intensity 500mW/cm2, 1000mW/cm2, 1500mW/cm2 respectively were used to bond the brackets at three contact time (5/10/20 sec). The universal testing equipment was used to determine the shear bond strength of each specimen. The uppermost average SBS was found in the group cured with LED of intensity 1500 mW/cm2 for 20 sec (20.08 + 4.82 MPa) which was statistically significant compared the to control group (12.72 + 2.42 MPa). The lowest mean SBS values were obtained for groups cured with LED of intensity 500 mW/cm2 even at different curing times of 5, 10 and 20 sec i.e., 5.46 + 1.99 MPa, 8.77 + 2.38 Mpa and 11.24 + 2.59 MPa, respectively. Increasing the intensity of the LED light curing unit provides a clinically acceptable SBS even after reducing the curing times, thereby reducing the chairside time for bonding of orthodontic brackets.The study aims to test the effects of LED light at three different power settings (500mW/cm2, 1000mW/cm2&amp; 1500m W/cm2) and three different exposure times (5sec, 10sec &amp; 20sec) adhesive composites for use with stainless steel orthodontic brackets, and their shear bond strengths. Current In-vitro work used 120 teeth, mostly premolars, separated into 10 equal groups of 12. After the crowns of the teeth were exposed by mounting them vertically into self-heal acrylics, the buccal-enamel exterior was prepared for bonding (PEA) 0.022”x 0.028” stainless steel premolar bracket using a thin layer of light cure adhesive primer and paste (Transbond-XT-3M Unitek Monrovia, Calif). Brackets in Group 1 comprising the Control group treated by usual halogen light source for forty sec, in remaining 9 groups (Experimental group) three commercially available LED curing light units i.e., Woodpecker, Guilin, Guangxi, China; Stealth Soft Equinox, Denmark, Holland; Radii plus, SDI, Australia, having three different light intensity 500mW/cm2, 1000mW/cm2, 1500mW/cm2 respectively were used to bond the brackets at three contact time (5/10/20 sec). The universal testing equipment was used to determine the shear bond strength of each specimen. The uppermost average SBS was found in the group cured with LED of intensity 1500 mW/cm2 for 20 sec (20.08 + 4.82 MPa) which was statistically significant compared the to control group (12.72 + 2.42 MPa). The lowest mean SBS values were obtained for groups cured with LED of intensity 500 mW/cm2 even at different curing times of 5, 10 and 20 sec i.e., 5.46 + 1.99 MPa, 8.77 + 2.38 Mpa and 11.24 + 2.59 MPa, respectively. Increasing the intensity of the LED light curing unit provides a clinically acceptable SBS even after reducing the curing times, thereby reducing the chairside time for bonding of orthodontic brackets.

Integration of an evidence-based caries management approach in dental education: The perspectives of dental instructors.

Evidence-based caries management (EBCM) has developed into an internationally recognized tool for integration of comprehensive non-surgical caries treatment in dental education. However, uptake of the EBCM approach remains uneven across Canadian dental schools. Our project sought to understand how dental instructors perceive the challenges and solutions to the integration of the EBCM approach in undergraduate clinical education. Using a qualitative descriptive design, we recruited a purposeful sample of clinical instructors supervising undergraduate dental students in caries-related dental care. Semi-structured, online interviews focused on the main characteristics of EBCM. Interviews were analyzed using the awareness, desire, knowledge, ability, and reinforcement (ADKAR) change management model to understand challenges with EBCM implementation in undergraduate education. The analysis process started with verbatim transcription; then, transcripts were coded deductively based on the interview guide and the ADKAR model domains, and inductively to generate emergent codes. Finally, thematic analysis was used to develop themes and subthemes. We interviewed 11 dental instructors with a wide range of clinical experience. Our results show that participants had sufficient awareness regarding the need for the EBCM approach and portrayed a strong desire to participate in bringing curricular changes. Knowledge and ability of participants depended on their training, experience, and involvement in continuing education courses. A lack of standardized caries management practices, less chairside time, and poor remuneration for instructors were major barriers in EBCM clinical implementation. Potential solutions suggested included providing continuing education courses, credits for students for non-surgical caries management, and remunerating instructors for implementation. In conclusion, most participants were aware of the need for a substantive change toward EBCM and demonstrated the desire to participate and improve its implementation. Our analysis showed that to facilitate full integration of the EBCM approach into the undergraduate dental clinics, organizational focus needs to be placed on the individual's knowledge and ability, with tailored efforts toward reinforcement.

A Case report of full-mouth implant placement utilizing 3D-guided surgery

Dental implants are widely recognized as a dependable and cost-effective solution for replacing missing teeth. Achieving successful outcomes in modern implantology and prosthetics depends on rigorous diagnostic methods and diligent planning that meet the expectations of patients and dentists and leverage advancements in materials and digital technologies. The predictability and success rates of implant dentistry have significantly improved following the development of computed tomography, implant planning software, guided implant surgery techniques, and advanced materials. This report presents the case of a 54 year-old healthy male with partial tooth loss who received seven implants in the upper jaw and six in the lower jaw. Based on comprehensive Cone Beam Computed Tomography imaging, the treatment plan was devised to support a fixed prosthesis. Precise implant placement, guided by the treatment plan, addressed the optimal prosthodontic requirements while minimizing invasiveness through a flapless surgery approach. The landscape of rehabilitation practices is evolving due to the incorporation of computer-aided design in treatment planning and the increased application of computer-assisted manufacturing. Guided implant techniques have emerged as a means to mitigate the limitations associated with traditional methods. Compared to conventional approaches, guided implant surgery significantly improves implant placement precision by reducing chairside time, involves minimally invasive procedures, and augments predictability.

Accuracy of intraoral scan with prefabricated aids and stereophotogrammetry compared with open tray impressions for complete-arch implant-supported prosthesis: A clinical study.

The aim of this clinical study was to compare the accuracy of intraoral scan system (IOS) with prefabricated aids and stereophotogrammetry (SPG) compared with open tray implant impression (OI) for complete-arch implant-supported fixed dental prostheses (CIFDP). Patients needing CIFDP were enrolled in this study. OI, reference standard, IOS with prefabricated aids, and SPG were performed for each patient. Distance and angle deviations between all pairs of abutment analogs, root mean square (RMS) errors between the aligned test and reference model, and chairside time were measured. The effect of inter-abutment distance, jaw (maxilla or mandible), number of implants, and arch length on deviations was analyzed. The mixed effect model was applied to analyze deviations and RMS errors. Fifteen consecutive individuals (6 females and 9 males, 47-77 years old) with 22 arches (9 upper and 13 lower jaws) and 115 implants were included. There was no significant difference in distance deviation comparing SPG and IOS with OI (p > .05). IOS showed a significantly greater angle deviation and RMS errors than SPG (median 0.40° vs. 0.31°, 69 μm vs. 45 μm, p < .01). The inter-abutment distance was negatively correlated with the accuracy of SPG and IOS (p < .05). The chairside time for IOS, SPG, and OI was 10.49 ± 3.50, 14.71 ± 2.86, and 20.20 ± 3.01 min, respectively (p < .01). The accuracy of SPG and IOS with prefabricated aids was comparable. IOS was the most efficient workflow.

Additively manufactured devices with varying designs and sizes for acquiring initial intraoral implant scans.

Dental literature has reported greater intraoral scanning accuracy when implant scan bodies (ISBs) are connectedcompared with non-connected methods. Initial intraoral digital implant scans are required for the fabrication of a custom framework to connect implant scan bodies (IOSFix; IOSFix Dental). This calibrated metal framework is used to acquire definitive intraoral implant scans. However, the acquisition of initial intraoral implant scans can be challenging when ISBs are not connected. This article describes a step-by-step technique for connecting ISBs by using additively manufactured devices to acquire initial intraoral implant scans. This technique aims to facilitate the recording of initial intraoral implant scans, provide different device designs and sizes to connect ISBs, and reduce chairside time.

A double-blind randomized within-subject study to evaluate clinical applicability of four digital workflows for the fabrication of posterior single implant crown.

To compare efficiency and clinical efficacy of posterior single implant crowns (PSIC) fabricated using four digital workflows. Twenty-two patients with one missing first molar were included. Each patient received four screw-retained implant crowns fabricated through four different workflows including a fully digital workflow with immediate digital impression (Group i-IOS), a fully digital workflow with digital impression after implant osseointegration (Group d-IOS), a model-based hybrid workflow using immediate analogue impression (Group i-AI), and a model-based hybrid workflow with conventional analogue impression after implant osseointegration (Group d-AI). The crown delivery sequence was randomized and blinded. The efficiency for each workflow and clinical outcome of each crown were recorded. The average clinical working time in fully digital workflows (i-IOS 46.90 min, d-IOS 45.66 min) was significantly lower than that in the hybrid workflows (i-AI 54.59 min, d-AI 55.96 min; p < .001). Significantly more laboratory time was spent in hybrid workflows (i-AI 839.60 min, d-AI 811.73 min) as compared to fully digital workflows (i-IOS 606.25 min, d-IOS 607.83 min, p < .01). No significant differences in the chairside time at delivery were found. More crowns in Group i-AI (15%) needed additional laboratory interventions than in the other groups (p = .029). Digital impression and model-free fully digital workflow improved prosthetic efficiency in the fabrication of PSIC. With the limitation that the results were only applicable to the implant system used and the digital technologies applied, findings suggested that workflows integrating immediate impression with implant surgery procedure was clinically applicable for restoration of PSIC.

Insta-Jig: A Quick-fix Chairside Mini-implant Placement Guide

Microimplants have changed the face of orthodontic clinical practice. One of the most important factors in a practice is reduced chairside time for the patient as well as the clinician. This article presents a short clinical tip for accurate placement of microimplant.