Standard Tessellation Language Research Articles

Direct slicing of microcellular structures for digital light processing (DLP) additive manufacturing

PurposeAdditive Manufacturing (AM) conventionally necessitates an intermediary slicing procedure using the standard tessellation language (STL) data, which can be computationally burdensome, especially for intricate microcellular architectures. This study aims to propose a direct slicing method tailored for digital light processing-type AM processes for the efficient generation of slicing data for microcellular structures.Design/methodology/approachThe authors proposed a direct slicing method designed for microcellular structures, encompassing micro-lattice and triply periodic minimal surface (TPMS) structures. The sliced data of these structures were represented mathematically and then convert into 2D monochromatic images, bypassing the time-consuming slicing procedures required by 3D STL data. The efficiency of the proposed method was validated through data preparations for lattice-based nasopharyngeal swabs and TPMS-based ellipsoid components. Furthermore, its adaptability was highlighted by incorporating 2D images of additional features, eliminating the requirement for complex 3D Boolean operations.FindingsThe direct slicing method offered significant benefits upon implementation for microcellular structures. For lattice-based nasopharyngeal swabs, it reduced data size by a factor of 1/300 and data preparation time by a factor of 1/8. Similarly, for TPMS-based ellipsoid components, it reduced data size by a factor of 1/60 and preparation time by a factor of 1/16.Originality/valueThe direct slicing method allows for bypasses the computational burdens associated with traditional indirect slicing from 3D STL data, by directly translating complex cellular structures into 2D sliced images. This method not only reduces data volume and processing time significantly but also demonstrates the versatility of sliced data preparation by integrating supplementary features using 2D operations.

Effect of a Novel ‘Scan Body’ on the In Vitro Scanning Accuracy of Full-Arch Implant Impressions

ObjectiveThis in vitro study aimed to determine whether a newly designed arcuate scan body can improve intraoral scanning accuracy for implant rehabilitation of edentulous jaws. Material and methodsA master model containing 4 implant abutment replicas was fabricated and digitized with different scan bodies using an intraoral scanner. Four types of scan bodies were evaluated: original scan bodies (group OS), computer-aided design and computer-aided manufacturing (CAD/CAM) scan bodies without extension (group CS), CAD/CAM scan bodies with straight extension (group CSS), and CAD/CAM scan bodies with arcuate extension (group CSA). Conventional splinted open-tray impressions (group CI) were used as controls. The master model and the poured casts were digitized using a laboratory scanner. Impressions were repeated 10 times each in 5 groups. Scans in standard tessellation language format were exported to reverse engineering software and root mean square (RMS) values were used for trueness and precision assessments. In each group, 45 RMS values were acquired for precision evaluation and 10 RMS values were obtained for trueness assessment. Statistical evaluation was performed with the Kruskal–Wallis test and Dunn–Bonferroni test (α = 0.05). ResultsThe median trueness values were 41.40, 55.95, 39.80, 39.75, and 22.30 μm for group OS, CS, CSS, CSA, and CI, respectively. CI showed better trueness than OS (P = .020), CS (P < .001), and CSS (P = .035). The median precisions for group OS, CS, CSS, CSA, and CI were 47.40, 51.50, 43.90, 25.20, and 24.60 μm. respectively. The precision of CSA and CI were higher than OS (P < .001), CS (P < .001), and CSS (P < .001). Between CI and CSA, there was no significant difference (P = 1.000). ConclusionsFor full-arch implant rehabilitation, the scan body with arcuate extension could improve the intraoral scanning precision and showed similar 3-dimensional discrepancy compared to conventional splinted open-tray impressions.

Digital technique to analyze the wear of screw-retained implant supported metal-ceramic dental prostheses and natural tooth as antagonist: a pilot study

The aim of this study was to describe a novel digital technique to analyze the wear of screw-retained implant-supported metal-ceramic dental prostheses and natural tooth as antagonist.Materials and methods Ten patients were consecutively included to rehabilitate partial edentulism by dental implants. Both the screw-retained implant-supported metal-ceramic dental prostheses and the natural tooth as antagonist were submitted to a digital impression through an intraoral scan to generate a Standard Tessellation Language digital file preoperatively (STL1), at 3 months (STL2), and 6 months (STL3) follow-up. Afterwards, an alignment procedure of the digital files (STL1-STL3) was performed on a reverse engineering morphometric software (3D Geomagic Capture Wrap) and volume changes at the screw-retained implant-supported metal-ceramic dental prostheses and the natural tooth as antagonist were analyzed using Student’s t-test. Moreover, Gage R&R statistical analysis was conducted to analyze the repeatability and reproducibility of the digital technique.Results Gage R&R showed a variability attributable to the digital technique of 3.8% (among the measures of each operator) and 4.5% (among operators) of the total variability; resulting repeatable and reproducible, since the variabilities were under 10%. In addition, statistically significant differences were shown at the wear volume (μm3) of both the natural tooth as antagonist (p < 0.0001) and the screw-retained implant-supported metal-ceramic dental prostheses between 3- and 6-months follow-up (p = 0.0002).Conclusion The novel digital measurement technique results repeatable and reproducible to analyze the wear of screw-retained implant-supported metal-ceramic dental prostheses and natural tooth as antagonist.

Effect of Duplication Techniques on the Fitting Accuracy of CAD-CAM Milled, 3D-Printed, and Injection-Molded Mandibular Complete Denture Bases.

Digital technology has been introduced in prosthodontics, and it has been widely used in denture duplication instead of a conventional denture duplication technique. However, research comparing different denture duplication techniques and how they affect the fitting accuracy of the denture base is scarce. The aim was to assess the impact of duplication techniques on the accuracy of the fitting surface of computer-aided design and manufacturing (CAD-CAM) milled, 3D-printed, and injection-molded complete denture bases (CDBs). This study involved fabricating a mandibular complete denture base with three marked dimples as reference marks (A, B, and C at the incisive papilla, right molar, and left molar areas) using a conventional compression molded technique. This denture was then scanned to generate a standard tessellation language (STL) file; after that, it was duplicated using three different techniques (milling, 3D printing, and injection molding) and five denture base resin materials-two milled CAD-CAM materials (AvaDent and IvoBase), two 3D-printed materials (NextDent and HARZ Labs), and one injection-molded material (iFlextm). Based on the denture base type, the study divided them into five groups (each with n = 10). An evaluation of duplication accuracy was conducted on the fitting surface of each complete denture base (CDB) using two assessment methods. The first method was a two-dimensional evaluation, which entailed linear measurements of the distances (A-B, A-C, and B-C) between reference points on both the scanned reference mandibular denture and the duplicated dentures. Additionally, a three-dimensional superimposition technique was employed, involving the overlay of the STL files of the dentures onto the reference denture's STL file. The collected data underwent statistical analysis using a one-way analysis of variance and Tukey's pairwise post hoc tests. Both evaluation techniques showed significant differences in fitting surface accuracy between the tested CDBs (p ˂ 0.001), as indicated by one-way ANOVA. In addition, the milled CDBs (AvaDent and IvoBase) had significantly higher fitting surface accuracy than the other groups (p ˂ 0.001) and were followed by 3D-printed CDBs (NextDent and HARZ Labs), while the injection-molded (iFlextm) CDBs had the lowest accuracy (p ˂ 0.001). The duplication technique of complete dentures using a CAD-CAM milling system produced superior fitting surface accuracy compared to the 3D-printing and injection-molded techniques.

Accuracy of zirconia crown manufactured using stereolithography and digital light processing

ObjectivesThe aim of this study is to evaluate the accuracy of zirconia crowns fabricated using stereolithography (SLA) and digital light processing (DLP) and to compare their accuracy with those fabricated using the subtractive manufacturing (SM) method. MethodsA typodont model with a prepared maxillary first molar was scanned, and the anatomical contour crown was designed using dental computer-aided-design (CAD) software. The designed file in standard tessellation language (STL) format was used to fabricate 10 crowns per group. The crowns were manufactured using a dental milling machine (Datron D5; MLC group), SLA (CERAMAKER 900; SLAC group), and DLP (ZIPRO; DLPC group) printers. The fabricated crowns were scanned using a dental laboratory scanner and saved in three parts: the external, intaglio, and marginal surfaces. For accuracy assessment, these parts were superimposed to the reference file. Root mean square (RMS) values were evaluated using three-dimensional analysis software (Geomagic Control X). Statistical significance was evaluated using a nonparametric Kruskal–Wallis test (α = 0.05) and a post-hoc Mann–Whitney U test with Bonferroni correction (α = 0.016). ResultsTrueness evaluation revealed the lowest RMS value in all areas in the MLC group, followed by that in the DLPC group. The precision evaluation revealed the lowest RMS value in all areas in the MLC group. Statistically significant differences were observed among the groups in the external, intaglio, and marginal surface (P < 0.05). ConclusionsAlthough the restorations fabricated using SM revealed higher accuracy, the crowns manufactured using SLA and DLP methods were considered clinically acceptable. Clinical SignificanceIn the production of zirconia crowns, subtractive manufacturing continues to demonstrate significantly higher accuracy compared to additive manufacturing. However, crowns fabricated using the additive manufacturing method also demonstrated high accuracy.

Accuracy of merging scans of definitive fixed prosthodontic impressions to obtain single, accurate digitized master casts.

Many elastomeric impressions sent to commercial laboratory dental technicians may include marginal defects. To fabricate accurate restorations, digital technology may be used to merge digital files of defective impressions into a single standard tessellation language (STL) file free of errors. This would save clinicians and patients time and may improve clinical care. The purpose of this study was to compare the accuracy of digital master casts reconstructed from merged STL files of defective impressions with the file of the original defect-free preparations. Ivorine teeth on a dentoform were prepared to receive a posterior fixed dental prosthesis (FDP) with complete coverage preparations. An impression was made in a stock tray using polyvinyl siloxane (PVS) impression material and an extraoral scanner (E3, 3Shape, Denmark) was used to digitize the impression; this was the reference cast. Wax was used to create defects on the buccal and lingual margins of the preparations. Fifteen PVS impressions were made of the FDP preparations with defects in the mesial and distal margins; another set of 15 PVS impressions was made of FDP preparations with defects in the buccal and palatal margins for a total of 30 impressions. All impressions were digitized using the same extraoral scanner (E3, 3Shape, Denmark). Corresponding STL files were paired and merged, and a master cast was created by eliminating the defects using the scanned data. This master cast was compared to the reference cast using reverse engineering software (Geomagic, Morrisville, NC, USA). The results were expressed as average errors and standard deviations in the master casts relative to the reference cast. To account for the presence of positive and negative values in the data set, in terms of errors, the root mean square (RMS) value was calculated for each sample. The mean average error in the sample was -0.4 μm. The average upper limit of 95% confidence interval was +36.5 μm, while the average lower limit of 95% confidence interval was -37.3 μm. The mean RMS of the errors found was 18.9 μm. The results of this study indicated that merging digitized definitive impressions to correct marginal defects resulted in master casts with a high level of accuracy relative to the reference cast.

In vitro comparative study between complete arch conventional implant impressions and digital implant scans with scannable pick-up impression copings

Statement of problemIntraoral digital scan techniques have been widely used and sufficient evidence supports this technique in partially edentulous patients. However, the evidence supporting the use of intraoral scanners (IOSs) for edentulous patients is limited. PurposeThe purpose of this in vitro study was to measure and compare the accuracy of complete arch conventional pick-up implant impressions with open and closed trays, complete arch digital implant scans with IOSs, and 3-dimensional (3D) printed casts from complete arch digital implant scans. Material and methodsSix implants were placed in a mandibular model. Scannable pick-up impression copings were inserted in the implants, scanned with a reference scanner, and exported in standard tessellation language (STL) format (Group Control). Splinted open-tray pick-up impressions (Group OT, n=5) and closed-tray pick-up impressions (Group CT, n=5) were made, and stone casts were fabricated. Digital scans (Group DS, n=5) were made with an IOS, and the STL files were exported to fabricate 3D printed casts (Group STL, n=5). Scannable pick-up impression copings were inserted in the dental implant analogs in Groups OT, CT, and STL and scanned with the reference scanner. Using a 3D inspection software program, the recording techniques were compared with the control. Root mean square (RMS) values were calculated from the control, and superimposed digitized casts from different recording techniques. Analysis of variance was used to determine differences in RMS values, and theTukey post hoc test was used to determine difference between different groups. ResultsGroup CT had the lowest mean dimensional difference when superimposed with Group Control, followed by Groups DS, OT, and STL. Significant differences were found in RMS values between Control and digitized casts fabricated with different techniques (P<.05). The post hoc Tukey test revealed that Group DS (P<.05) was significantly different from the other groups, while no significant difference was found among Groups CT, OT, and STL (P>.05). ConclusionsBased on the findings of the present study, 3D printed casts from digital scans have the same accuracy as stone casts from conventional impressions in complete arch implant cases. Intraoral scans had the highest accuracy. Complete arch pick-up impression techniques using dual-functioning scannable pick-up impression copings are as accurate as splinted complete arch pick-up impressions.

An evaluation of the sources and extent of error in the position of implants placed using 3D-printed stereolithographic surgical guides.

Introduction/Background. Errors can be introduced in implant placement when using stereolithographically manufactured fully limiting surgical guides due to various factors, such as discrepancies in designing and manufacturing of surgical guides (intrinsic error), built-in variations in design of mechanical components of guide systems and implant dimensions (inherent error) or due to placement error by the operator (operator error). Aim. The aim of this study was to evaluate influence of various factors on implant position when using these guides. Materials and Methods. Prosthetically-driven implant positions were planned with pre-operative cone beam computed tomography (CBCT) data and digital scans using a computer aided designing (CAD) software. Static guided implant surgery was performed under local anaesthesia using fully limiting mucosa-supported surgical guide. Pre-operative and post-operative CBCTs were superimposed using surgical sleeve as a reference to evaluate the placement error by operator (N=12). To evaluate intrinsic error, standard tessellation language (STL) files of the virtual design of the surgical guides and the STL file obtained after scanning the 3D printed stereolithographic surgical guides were superimposed. Inherent error was calculated using a geometric model. Results. Intrinsic error was observed to be a major contributing factor in angular deviation of implant, linear deviation observed at implant shoulder as well as at implant apex. Operator error was observed to be a major contributing factor for mean vertical deviation observed at apex of implant. Conclusion. This study showed that accuracy of implant placement was largely influenced by discrepancies introduced during designing and manufacturing of stereolithographic surgical guides as compared to other sources.

An evaluation of the sources and extent of error in the position of implants placed using 3D-printed stereolithographic surgical guides.

Introduction/Background. Errors can be introduced in implant placement when using stereolithographically manufactured fully limiting surgical guides due to various factors, such as discrepancies in designing and manufacturing of surgical guides (intrinsic error), built-in variations in design of mechanical components of guide systems and implant dimensions (inherent error) or due to placement error by the operator (operator error). Aim. The aim of this study was to evaluate influence of various factors on implant position when using these guides. Materials and Methods. Prosthetically-driven implant positions were planned with pre-operative cone beam computed tomography (CBCT) data and digital scans using a computer aided designing (CAD) software. Static guided implant surgery was performed under local anaesthesia using fully limiting mucosa-supported surgical guide. Pre-operative and post-operative CBCTs were superimposed using surgical sleeve as a reference to evaluate the placement error by operator (N=12). To evaluate intrinsic error, standard tessellation language (STL) files of the virtual design of the surgical guides and the STL file obtained after scanning the 3D printed stereolithographic surgical guides were superimposed. Inherent error was calculated using a geometric model. Results. Intrinsic error was observed to be a major contributing factor in angular deviation of implant, linear deviation observed at implant shoulder as well as at implant apex. Operator error was observed to be a major contributing factor for mean vertical deviation observed at apex of implant. Conclusion. This study showed that accuracy of implant placement was largely influenced by discrepancies introduced during designing and manufacturing of stereolithographic surgical guides as compared to other sources.

Design and Additive Manufacturing of a Prototype Using Fused Deposition Modeling Technique

A screw jack is a tool for lifting heavy loads with little effort. In this paper, the design, model and fabrication of a Screw jack using 3D Printing Technology is discussed. Digital fabrication, or 3D printing or additive manufacturing, creates physical objects from a geometrical representation by successive addition of materials. In agriculture, health care, motor vehicles, locomotives and aviation, 3D Printing is increasingly being applied for mass customization or production for all types of open-source design. Design is an important industrial activity which influences the quality of the product. The parts of a screw jack are modelled by using the modelling software Creo Parametric. The CAD model of the screw jack is then converted into. STL (Standard Tessellation Language) format in which the 3D Printer receives the printing input. The STL files are then imported to modelling software to analyze mesh and rectify errors. The rectified STL files of parts of the screw jack are imported to Makerbot software, and parts are made ready for 3D Printing using Makerbot FDM (Fused Deposition Modelling) 3D Printer. The parts printed in an FDM 3D printer are assembled based on the tolerances obtained, and the final prototype is fabricated.

Palatal vault configuration and its influence on intraoral scan time and accuracy in completely edentulous arches: a prospective clinical study.

The aim of this prospective clinical study was to compare the influence of palatal vault forms on accuracy and speed of intraoral (IO) scans in completely edentulous cases. Based on the palatal vault form, participants were divided into three equal groups (n = 10 each); Class I: moderate; Class II: deep; Class III: flat palatal vault. A reference model was created for each patient using polyvinylsiloxane impression material. The poured models were digitized using an extraoral scanner. The resultant data were imported as a solid CAD file into 3D analysis software (GOM Inspect 2018; Gom GmbH, Braunschweig, Germany) and aligned using the software's coordinate system to determine its X, Y, and Z axes. Five digital impressions (DIs) of maxilla were captured for each patient using an intraoral scanner (TRIOS; 3Shape A/S, Copenhagen, Denmark) and the resultant Standard Tessellation Language (STL) scan files served as test models. Trueness was evaluated by calculating arithmetic mean deviation (AMD) of the vault area between reference and test files while precision was evaluated by calculating AMD between captured scans to measure repeatability of scan acquisition. The scan time taken for each participant was also recorded. There was no significant difference in trueness and precision among the groups (P = .806 and .950, respectively). Average scan time for Class I and III palatal vaults was 1 min 13 seconds and 1 min 37 seconds, respectively, while class II deep palatal vaults showed the highest scan time of 5 mins. Palatal vault form in edentulous cases has an influence on scan time. However, it does not have a substantial impact on the accuracy of the acquired scans.

Trueness of vat-photopolymerization printing technology of interim fixed partial denture with different building orientation: A Microcomputed tomography study.

The aim was to assess the consequence of different printing orientation on the marginal misfit and internal gap of 3-unit interim fixed partial denture manufactured by two different additive manufacturing technologies compared to milling technique. Three-unit interim fixed partial denture (FPD) was designed by using exocad software (Dental CAD 3.0 Galway) in the format of standard tessellation language (STL) , which was transferred to a nesting software (PreForm) and printed by A Next Dent C&B resin liquid (NextDent; Soesterberg, Neitherland) by using two printing technologies; stereolithography (SLA, n=30) and digital light processing (DLP, n=30) with 3 different orientations (occlusal direction [0°] ,buccal direction [90°] & lingual direction [270°]) for each technology (n=10). Additionally, a control group was milled (CAD/Milling, n=10) from DC PMMA A1 Disc (White peaks dental solutions; Gmbh& co., Germany). A Microcomputed tomography was used to measure the marginal misfit and internal gap for each specimen in 12 different points. The average value of the marginal and internal gaps measurements was calculated, and one-way ANOVA was used for the comparison between groups. SLA printing technology showed a similar result to CAD/Milling with all different printing orientations tested. DLP printing technology showed the highest gap values within all the printing orientations with significant difference (p< 0.001) with the CAD/Milling and SLA. Regarding the trueness of the interim FPDs, SLA was a promising technology for its superior adaptation. Marginal misfit and Internal gap for DLP printing technology limiting the use of that technology as it exceeded the acceptable clinical range. Key words:3D Printing, Microcomputed topography, Marginal Gap, Internal Misfit.

Soft-tissue volume augmentation using a connective tissue graft and a volume-stable collagen matrix with polydeoxyribonucleotide for immediate implant placement: a pilot study in a dog model.

The aims of this study were 1) to investigate the effects of a subepithelial connective tissue graft (SCTG) and a volume-stable collagen matrix (VCMX) on soft-tissue volume gain in the immediate implant placement protocol, and 2) to determine whether polydeoxyribonucleotide (PDRN) can enhance the effects of a VCMX. Dental implants were placed in 4 mongrel dogs immediately after extracting the distal roots of their third and fourth mandibular premolars. The gap between the implant and the buccal bone plate was filled with synthetic bone substitute particles. The following soft-tissue augmentation modalities were applied buccally: 1) control (no augmentation), 2) SCTG, 3) VCMX, and 4) VCMX/PDRN. After 4 months, histomorphometric analysis was performed. Tissue changes were evaluated using superimposed standard tessellation language (STL) files. Wound dehiscence was found in more than half of the test groups, but secondary wound healing was successfully achieved in all groups. Histomorphometrically, tissue thickness was favored in group SCTG at or above the implant platform level (IP), and group SCTG and the groups with VCMX presented similar tissue thickness below the IP. However, the differences in such thickness among the groups were minor. The keratinized tissue height was greater in group VCMX/PDRN than in groups SCTG and VCMX. Superimposing the STL files revealed a decrease in soft-tissue volume in all groups. Wound dehiscence after soft-tissue volume augmentation might be detrimental to obtaining the expected outcomes. PDRN appears not to have a positive effect on the soft-tissue volume gain.

Influence of different palatal morphologies on the accuracy of intraoral scanning of the edentulous maxilla: A three-dimensional analysis.

This study investigated the influence of different palatal morphologies on the accuracy of intraoral scanning (TRIOS 4) of edentulous maxillae. Six typodonts were fabricated for different palatal morphologies with flat (F), medium (M), and deep (D) palates, with palatal wrinkles (W), or smooth palates (S), resulting in six groups: WF, WM, WD and SF, SM, SD. Ten scans were performed for each group; standard tessellation language files obtained were imported into a software to measure trueness and precision in micrometer. Trueness was calculated as the mean of the standard deviation values obtained by superimposing each scan onto the reference scan. Precision was achieved by overlapping each scan with that with the best trueness in the group. Descriptive and post-hoc analyses were conducted. The mean values for trueness were as follows: WM=48.7±4.7, WD=161.7±18.4, WF=85.9±16, SM=48.1±2.4, SD=349.9±8.8, and SF=349.1±25.5. The precision values were as follows: WM=46.7±7.3, WD=46.9±9, WF=48.9±6.7, SM=46±2.7, SD=105.9±17.4, SF=72.6±10.8. Significant differences were observed for trueness between SM and SD (P < 0.001), SM and SF (P < 0.001), and WF and SF (P = 0.003); whereas for precision, significant differences were reported between WD and SD (P = 0.015). Regarding trueness and precision, no difference was found between WM and SM (P = 1.0). Medium palatal depth showed the best accuracy. The mean accuracy values were within the clinical acceptability thresholds for all palatal morphologies. The presence of rugae improved the precision of deeper palates and the trueness of flat palates. No differences were observed in the medium palates with or without rugae.

Fabrication of sports mouthguards using a semi-digital workflow with 4D-printing technology.

Purpose This technical procedure report explains the fabrication protocol for a newly developed 4D-printed sports mouthguard (MG) based on 4D-printing technology.Methods An intraoral scanner was used to scan a maxillary arch model. A two-layer sports MG was designed based on the scanned model using computer-aided design software and output in a standard tessellation language file format. Two types of filament materials were used for the MG material: a thermoplastic shape memory polyurethane elastomer with a unique glass transition temperature for the external layer and a thermoplastic elastomer for the internal layer. Both MGs were printed using a fused deposition modeling 3D printer and assembled using adhesives after trimming the support material. To confirm the shape-memory performance of the fabricated 4D-printed MG, a deviation analysis was performed by superimposing the internal surface data of the fabricated MG and the MG whose shape was recovered. The distance between the data obtained by deviation analysis was calculated, and the root mean square error value (mm) was determined.Conclusions The 4D-printing technology simplifies the complex processes required with conventional methods. It also overcomes the issues of conventional and 3D-printed MGs, such as the reduced fitting accuracy caused by deformation, because this technology employs shape memory materials.

Influence of Augmented Reality Appliances on Tooth Preparation Designs-An In Vitro Study.

The aim of this work was to analyze and compare the tooth structure removal between a free-hand preparation technique and a computer-aided preparation technique using an augmented reality appliance for complete-crowns preparation designs and "root mean square" (RMS) alignment value. Ten upper teeth representatives of all dental sectors were selected from a generic model library as "Standard Tessellation Language" (STL-1) digital files and 3D-printed in an anatomically based acrylic resin experimental model. Then these were randomly assigned to the following tooth preparation techniques: Group A: free-hand preparation technique (n = 5) (FHT) and Group B: computer-aided preparation technique using an augmented reality appliance (n = 5) (AR). Experimental models were submitted to a digital impression through an intraoral scan and (STL-2) uploaded into a reverse engineering morphometric software to measure the volumetric reduction in the planned and performed tooth structure (mm3) and RMS using the Student's t-test and the Mann-Whitney non-parametric test. Statistically significant differences were observed between the volumetric reduction in the planned and performed tooth structure (mm3) of the AR and FHT study groups (p = 0.0001). Moreover, statistically significant differences were observed between the RMS of the planned and performed tooth preparations in both the AR and FHT study groups (p = 0.0005). The augmented reality appliance provides a more conservative and predictable complete-crowns preparation design than the free-hand preparation technique.

Low translational and rotational movements with 2-point stainless-steel retainers over aperiod of 1and 3years.

Long-term stabilization of orthodontic treatment outcomes is an everyday challenge in orthodontics. The use of permanently attached lingual retainers has become gold standard. However, in some cases, patients with fixed lingual retainers show retainer-associated side effects. Aiming to reduce these side effects, clinical knowledge about how tooth and arch form stability adaption takes place over time is important to improve long-term retention protocols. Therefore, the present study aimed to investigate occlusion stability and risks for anewly developing malocclusion in atime-dependent manner in patients being treated with permanent 2‑point steel retainers. In this retrospective cohort study, atotal of 66consecutive patients with round stainless-steel retainers were analyzed for postorthodontic occlusion changes after 1year (group1, n = 33) and 3years (group2, n = 33). Digital Standard Tessellation Language (STL) datasets of the lower jaw were obtained before retainer insertion (T0), and after a1-(T1) or 3‑year (T2) retention period. Using superimposition software, T1and T2 situations were compared to T0 regarding rotational and translational changes in tooth positions in all three dimensions. Occlusion changes were low in both groups. The investigated lower canines were nearly stable in the 1‑ and 3‑year group, although aretention-time-dependent increase in tooth position change of the central and lateral incisors could be observed. The present data provide evidence for time-dependent development of posttherapeutic occlusal adaption limited to central and lateral incisors in patients treated with a2-point retainer. The observed occlusal changes should be interpreted as an occlusal adaption process rather than severe posttreatment changes associated with the orthodontic retainer.

Accuracy of impression scan bodies for complete arch fixed implant-supported restorations

Statement of problemDespite the extensive studies on and comparisons of different implant impression techniques for completely edentulous patients, studies on novel techniques that combine conventional impression making with digital scanning are lacking. PurposeThe primary aim of this study was to compare the accuracy of the impression scan body technique with conventional impression making and digital scanning for a completely edentulous mandibular arch. The secondary aim was to assess the relationship between different implant angulations and interimplant distances in relation to the recording accuracy. Material and methodsAn edentulous mandibular definitive cast (control) was designed with 5 implants placed at different angles and interimplant distances. Three recording techniques were tested: a conventional impression with splinted copings (conventional) (n=15), an impression scan body technique where impression scan bodies were attached to the splinted impression copings in a conventional elastomeric impression and then digitally scanned with an extraoral scanner (n=15), and an intraoral digital scanning technique (digital) (n=15). For comparison, the definitive cast and the conventional impression stone casts were digitized into standard tessellation language (STL) datasets using the extraoral scanner. The 3-dimensional (3D) deviations between the 3 test groups and the control were calculated by superimposing the STL datasets. The 3D deviations from the control were compared by using the Kruskal-Wallis test followed by the Dunn post hoc test (α=.05). The Mann-Whitney test was used to investigate the effect of implant angulation and interimplant distance on impression accuracy (α=.05). ResultsThe conventional splinted-coping impression technique showed a mean 3D deviation of 0.408 mm. The impression scan body and intraoral digital scan showed similar mean 3D deviations, 0.219 mm and 0.257 mm, respectively (P=.334). Both techniques showed significantly lower 3D deviations than the conventional technique (P<.001). Implants at an angle of 5 degrees and 10 degrees showed a statistically significant difference (P=.010) with mean 3D deviations of 0.340 mm and 0.396 mm, respectively. Implants with 5-mm and 10-mm interimplant distance showed a significant difference (P<.001) with mean 3D deviations of 0.301 mm and 0.423 mm, respectively. ConclusionsThe impression scan body technique is comparable with intraoral digital scanning for a completely edentulous arch. Increased implant angulation and increased interimplant distance significantly reduced the accuracy of implant impression making or scanning.

Effect of different intraoral scanning strategies on the marginal and internal fit of CAD-CAM inlay restorations: An in vitro study

Whether the scanning strategy of intraoral scanners (IOSs) affects the accuracy of the digital recording for an indirect ceramic inlay restoration is unclear. Furthermore, which strategy would be optimal and most effective is uncertain. The purpose of this in vitro study was to evaluate the impact of 3 different scanning strategies using the Carestream CS 3700 IOS on the marginal and internal fit of a mesio-occluso-distal (MOD) ceramic inlay restoration. A typodont master model (ANA-4 VCER; Frasaco) was used with a standardized preprepared MOD inlay maxillary first molar typodont tooth (ANA-4 ZP16 CER99-008; Frasaco) (N=30). These inlay preparations were scanned with the CS 3700 IOS using 3 different scanning strategies: linear, wave, and S-figure scanning strategies. Each scan strategy group was scanned 10 times for all groups to obtain 30 standard tessellation language (STL) files. Thirty restorations were milled from lithium disilicate CAD blocks (IPS e.max; Ivoclar AG) and cemented into their typodont-prepared inlay cavities. A single examiner used a stereomicroscope to measure the marginal and internal gaps at the predetermined points. A 1-way ANOVA was used for the statistical analysis, followed by the Tukey post hoc test with Bonferroni adjustment. All tests were 2-tailed (α=.05). All scanning strategy groups demonstrated statistically significant differences for the marginal and internal fit of the inlay restorations (P<.001). Overall, the linear scanning strategy showed the lowest mean marginal and internal gap values (29.2 ±3.6µm and 39.0 ±6.4µm), followed by the wave scanning strategy, which had comparable mean marginal and internal gap values: 49.1 ±3.6µm and 48.2 ±6.0µm, respectively. The S-figure scan strategy had the highest mean marginal and internal gap values: 50.2 ±12.6µm and 71.3 ±7.7µm, respectively. Inlay restorations scanned by the linear scan strategy had the best marginal and internal fit when scanned with the CS 3700 IOS.

Accuracy in static guided implant surgery: Results from a multicenter retrospective clinical study on 21 patients treated in three private practices

PurposeTo evaluate the accuracy of a static computer-assisted implant surgery (s-CAIS) system across different private practices. MethodsThis retrospective clinical study was based on data retrieved from 21 patients who received 61 implants between 2018 and 2020 in 3 private practices run by surgeons with extensive experience with s-CAIS. All patients were treated using the same s-CAIS system, planning software, template manufacturing process, and surgical guides. The standard tessellation language (STL) file of the intraoral scan of the fixture taken immediately after implant placement was matched with that of the preoperative plan for comparisons of preoperative and planned implant positions with postoperative and actual implant positions. The study outcomes were linear and angular deviations between the planned and actual implant positions. ResultsNo surgical or postsurgical complications occurred. The overlap of the two STL files resulted in a mean angular deviation of 2.94° The mean linear deviation at the implant shoulder was 0.73 mm, and that at the apex was 1.06 mm. The mean vertical deviations at the implant shoulder and the apex were 0.29 mm and 0.01 mm, respectively. ConclusionAll cases showed satisfactory accuracy within the limits of this study (small number of patients and retrospective design). These results might be related to the use of a standardized digital workflow by experienced operators. Statement of clinical relevanceThe study shows that careful control of each step, from data acquisition to final execution, is key for the accuracy of stent-guided systems.