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Digitalization in Dentistry and Oral and Maxillofacial Surgery. A Step Forward

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Dentistry and Oral Sciences".

Deadline for manuscript submissions: closed (30 April 2023) | Viewed by 15317

Special Issue Editors


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Guest Editor
Department of Dental Techniques, “Carol Davila” University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd, 050474 Bucharest, Romania
Interests: oral and maxillofacial surgery; implant dentistry; maxillofacial prosthodontics; dental materials; digital dentistry; artificial intelligence in dentistry
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Guest Editor
Multidisciplinary Department of Medical, Surgical and Oral Sciences, School of Dentistry, Campania University Luigi Vanvitelli, Via Luigi De Crecchio 7, 80138 Naples, Italy
Interests: prosthodontics; implantology; oral surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Digital technologies have rapidly gained popularity and become a part of everyday practice in the dental profession.

Defined as any dental technology or device incorporating digital or computer-controlled components, digital dentistry provides quantifiable benefits in terms of quality, time savings, and labor cost reductions.

Digital workflows are applicable not only in prosthodontics, but also in oral and maxillofacial surgery, orthodontics and, generally, in all fields of dental care. The use of digital imaging could also contribute to accurate oral diseases diagnosis and improve healthcare service provisions.

The creation of the digital or virtual dental patient, through the use of specific software and application of sophisticated dental imaging techniques (such as 3D cone beam computed tomography, facial scanning, intraoral scanning) could be used for precise pre-operative clinical assessment, simulation of treatment planning in dental practice, and a better compliance of the patient.

Digital management programs are extensively used nowadays in collecting, storing, and sharing patients' medical files with care providers in real time, ensuring a comprehensive multidisciplinary treatment.

The significant reduction of laboratory production and in office treatment time allowed freeing up time for better dentist–patient communication. The virtual planning and communication led to the involvement of patients in their treatment journey.

All the above-mentioned benefits for dentists, technicians and – most importantly – for patients have also some limits that need to be identified and addressed.

We invite authors to submit original research articles and reviews to this exciting topic related to the use of digital technology in dental, oral, and maxillofacial fields.

Dr. Corina Marilena Cristache
Prof. Dr. Alessandro Lanza
Guest Editors

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Keywords

  • CAD/CAM technology
  • additive manufacturing
  • subtractive manufacturing
  • digital imaging
  • intraoral/extraoral scanning
  • facial scanting
  • digital condylography
  • virtual articulator
  • digital orthodontics
  • Virtual Reality (VR)
  • Augmented Reality (AR)
  • virtual patient
  • teledentistry

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Published Papers (6 papers)

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Research

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17 pages, 11696 KiB  
Article
A Finite Element Analysis of a Tooth-Supported 3D-Printed Surgical Guide without Metallic Sleeves for Dental Implant Insertion
by Ionut Gabriel Ghionea, Oana Elena Burlacu Vatamanu, Ana Maria Cristescu, Mihai David, Izabela Cristina Stancu, Cristian Butnarasu and Corina Marilena Cristache
Appl. Sci. 2023, 13(17), 9975; https://doi.org/10.3390/app13179975 - 4 Sep 2023
Cited by 2 | Viewed by 2112
Abstract
Static guided surgery for dental implant insertion is a well-documented procedure requiring the manufacturing of a custom-made surgical guide, either teeth-supported, mucosal-supported, bone-supported, or mixed (teeth-mucosal-supported), depending on the clinical situation. The guidance of the surgical drills during implant bed preparation could be [...] Read more.
Static guided surgery for dental implant insertion is a well-documented procedure requiring the manufacturing of a custom-made surgical guide, either teeth-supported, mucosal-supported, bone-supported, or mixed (teeth-mucosal-supported), depending on the clinical situation. The guidance of the surgical drills during implant bed preparation could be undertaken using a sequence of different diameters of metal drill sleeves or, with the sleeves incorporated in the surgical guide, shank-modified drills, both clinically accepted and used with good results. Despite the great number of advantages associated with the use of guided surgery, one of the major risks is guide fracture during drilling for implant bed preparation. Therefore, the aim of the present study was to evaluate the surgical guides without metal sleeves and to simulate, with the aid of Finite Element Analysis (FEA), the use of such dentally supported guides for implant insertion. The FEA is performed in CATIA v5 software after defining the surgical guide mesh material and bone properties. A maximum stress of 6.92 MPa appeared on the guide at the special built-in window meant to allow cooling during drilling, and the maximum value of the guide displacement during drilling simulation was 0.002 mm. Taking into consideration the limits of the current research, the designed tooth-supported surgical guide can withstand the forces occurring during the surgery, even in denser bone, without the risk of fracture. Full article
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13 pages, 4531 KiB  
Article
A Novel Digitized Method for the Design and Additive Manufacturing of Orthodontic Space Maintainers
by Francesco Tamburrino, Andrea Chiocca, Beatrice Aruanno, Alessandro Paoli, Lisa Lardani, Elisabetta Carli, Giacomo Derchi, Maria Rita Giuca, Armando V. Razionale and Sandro Barone
Appl. Sci. 2023, 13(14), 8320; https://doi.org/10.3390/app13148320 - 18 Jul 2023
Cited by 2 | Viewed by 3777
Abstract
Primary dentition is crucial in influencing the emergence of permanent teeth. Premature primary tooth loss can result in undesired tooth motions and space loss in the permanent dentition. Typically, fixed or removable dental appliances are adopted to maintain edentulous space until the eruption [...] Read more.
Primary dentition is crucial in influencing the emergence of permanent teeth. Premature primary tooth loss can result in undesired tooth motions and space loss in the permanent dentition. Typically, fixed or removable dental appliances are adopted to maintain edentulous space until the eruption of permanent teeth. However, traditional space maintainers have limitations in terms of variability in tooth anatomy, potential allergic reactions in some individuals (i.e., nickel sensitivity), difficulties in maintaining oral hygiene, and patient acceptance. The present study introduces a fully digital framework for the design and manufacturing of customized pediatric unilateral space maintainers using generative algorithms. The proposed approach overcomes the current challenges by using a biocompatible resin material and optimizing the device’s size, design, and color. The methodology involves intraoral scanning, surface selection, and trim, generative 3D modeling, finite element analysis (FEA), and additive manufacturing (AM) through vat photopolymerization. FEA results demonstrate the device’s mechanical performance and reliability, while additive manufacturing ensures design freedom, high resolution, surface finishing, dimensional accuracy, and proper fit. The mechanical interlocking system facilitates easy and effective positioning of the device. This digital approach offers the potential for wider usage of space maintainers and can be further validated through experimental assessments and clinical studies. Full article
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20 pages, 48141 KiB  
Article
Crystalline Structure Assessment of Ceramic Veneered Co-Cr-W Dental Alloy Substructures Obtained by Selective Laser Melting—A Pilot Study
by Caius Stoian, Lavinia Cosmina Ardelean, Meda Lavinia Negrutiu, Marinela Miclau, Cristian Casut, Cosmin Sinescu, Anastasia Alexandratou, Athanasios Katsavrias, Alexandra Denisa Stoian and Mihai Rominu
Appl. Sci. 2023, 13(14), 8052; https://doi.org/10.3390/app13148052 - 10 Jul 2023
Viewed by 1490
Abstract
The aim of this work is to assess the crystalline structure modification of an SLM Co-Cr-W dental alloy, veneered with two different ceramics, by means of X-ray diffraction (XRD), atomic force microscopy (AFM), and scanning electron microscopy, coupled with energy-dispersive spectroscopy (SEM-EDS). Ten [...] Read more.
The aim of this work is to assess the crystalline structure modification of an SLM Co-Cr-W dental alloy, veneered with two different ceramics, by means of X-ray diffraction (XRD), atomic force microscopy (AFM), and scanning electron microscopy, coupled with energy-dispersive spectroscopy (SEM-EDS). Ten identical plates were fabricated using SLM and were subsequently subjected to ceramic veneering. Following the repeated firing of the ceramic layers, carried out at temperatures exceeding 900 °C, new crystalline phases and variations in the crystallite sizes in the SLM Co-Cr-W dental alloy used for the substructure were detected via XRD. The two veneering ceramics showed significant differences in their behavior, beginning with the first firing, accompanied by structural changes. AFM micrographs and histograms of the surface heights over the whole scanned area of the samples showed that the surface of the Co-Cr-W dental alloy is strongly affected by the repeated firings necessitated by the ceramic firing process, a finding in accordance with the XRD results. The SEM investigation revealed that the different firing parameters had an impact on the alloy, the ceramic microstructure, and the surface quality. The differences in the chemical composition of the ceramics, highlighted by EDS, are reflected in their behavior. The crystalline alloy structure is influenced by the repeated firings of the ceramic layers. Full article
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20 pages, 4559 KiB  
Article
Traditional, 2D and 3D Workflows: What Is Better for Aesthetic Rehabilitation of Superior Anterior Teeth?
by Francesca Zotti, Francesca Marchesini, Giorgia Lanzaretti, Jacopo Bottonelli, Annalisa Cominziolli and Luciano Malchiodi
Appl. Sci. 2023, 13(10), 6205; https://doi.org/10.3390/app13106205 - 18 May 2023
Cited by 1 | Viewed by 1705
Abstract
This study aimed to compare conventional, digital 2D and digital 3D workflows as possible aesthetic rehabilitation processes for the maxillary anterior area using “open-source” software. For the conventional workflow, a diagnostic wax-up was produced by a dental technician. For the 2D digital workflow, [...] Read more.
This study aimed to compare conventional, digital 2D and digital 3D workflows as possible aesthetic rehabilitation processes for the maxillary anterior area using “open-source” software. For the conventional workflow, a diagnostic wax-up was produced by a dental technician. For the 2D digital workflow, Keynote software (version 11.1) was used to perform digital aesthetic analysis and smile planning. Measurements were taken and used by the technician to obtain a dental wax-up. For the 3D session, a plaster model was scanned and used to perform 3D analysis and the guide for the mock-up was digitally printed. Symmetry and aesthetic parameters were assessed for each mock-up, and the opinion of dental professionals and laypeople about the aesthetic outcome of three mockups was assessed by an anonymous questionnaire. The 2D mock-up received the highest score, and this mock-up was found to be the most symmetrical, even though it had the longest operating times. There was a statistically significant difference (p = 0.000) between the scores given to this picture: experts in the dental field gave lower scores compared with non-professionals. Digital planning of aesthetic rehabilitation represents a technologically innovative procedure in dental practice, making it possible to achieve excellent aesthetic results, even when using open-source software. Full article
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9 pages, 4184 KiB  
Communication
Planning the Aesthetics of the Mandibular Angles in Orthognathic Surgery: Traditional vs. Virtual 3D Articulators
by Chiara Di Blasio, Marco Di Blasio, Benedetta Vaienti, Fabrizio Di Francesco, Alessandro Lanza, Giuseppe Minervini, Marzia Segù and Alberto Di Blasio
Appl. Sci. 2022, 12(23), 12064; https://doi.org/10.3390/app122312064 - 25 Nov 2022
Cited by 4 | Viewed by 1659
Abstract
The surgical correction of dento-maxillofacial deformities for aesthetic reasons is increasingly required. In order to obtain the results that our patients expect, it is necessary to very thoroughly evaluate every aesthetic detail of the face, because an optimal result comes from the correction [...] Read more.
The surgical correction of dento-maxillofacial deformities for aesthetic reasons is increasingly required. In order to obtain the results that our patients expect, it is necessary to very thoroughly evaluate every aesthetic detail of the face, because an optimal result comes from the correction of all parameters. The region of the mandibular angles is very important in determining the final aesthetics but is at the same time difficult to predict. Traditional programming based on model surgery is inadequate in this regard compared to that based on CT (Computed Tomography) reconstruction. The authors explain the reasons for this and demonstrate the problems by reporting a typical clinical case. Full article
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11 pages, 8365 KiB  
Case Report
A Case Report of Zygomatic Fracture Reconstruction: Evaluation with Orbital Measurements and Models Registration
by Khalil Yousof, Mhd Ayham Darwich, Khaldoun Darwich, Ghina Alassah, Ahmed Imran and Hasan Mhd Nazha
Appl. Sci. 2023, 13(10), 6154; https://doi.org/10.3390/app13106154 - 17 May 2023
Viewed by 2627
Abstract
The repair and reconstruction of defects in the craniomaxillofacial region can be particularly challenging due to the complex anatomy, individuality of each defect, and sensitivity of the involved systems. This study aims to enhance the facial appearance and contribute to the reconstruction of [...] Read more.
The repair and reconstruction of defects in the craniomaxillofacial region can be particularly challenging due to the complex anatomy, individuality of each defect, and sensitivity of the involved systems. This study aims to enhance the facial appearance and contribute to the reconstruction of the zygomatic arch. This was achieved through virtual planning of the surgery and assessment of clinical matching, including orbital measurements and registration of numerical models. A three-dimensional design of a young female case was generated on a skull model using Mimics® software, and the orbit was isolated using 3-Matic® to assess the reconstructive effect. 3D-printed implants were then surgically placed on the injured region, and Netfabb® software was used to make a virtual registration between the numerical models before and after the intervention. This allowed for the calculation of a deviation of 7 mm, equivalent to 86.23% of the shape restoration rate, to assess the success of the surgery. The computerized method enabled a precise design of the needed plates and analysis of the fixation places, resulting in a satisfactory cosmetic and functional outcome for the patient with minimal complications and good implant stability. Notably, a significant difference was observed in the orbital frontal area after 3 months of surgery (p < 0.001). Within the limitations of the study, these results suggest that virtual planning and customized titanium implants can serve as useful tools in the management of complex zygomatic-orbital injuries. Full article
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