Search Results (123)

Objective: This observational study aimed to evaluate occlusal changes in patients with obstructive sleep apnea (OSA) treated with a mandibular advancement device after two years of therapy. Methods: Sixty adult patients with mild to moderate OSA (apnea–hypopnea index 15–30 events/h) were treated with the IMYS MAD for 24 months. Digital dental impressions were analyzed using Autodesk Meshmixer and Fusion 360 to measure sagittal, frontal, and occlusal angles, as well as upper incisor inclination at baseline (T0) and after treatment (T1). In addition, changes in the polysomnographic indices AHI and ODI were evaluated. Statistical analyses were performed using paired t-tests or Wilcoxon signed-rank tests depending on data normality (p < 0.05). Results: No significant differences were found between T0 and T1 in sagittal (IC 95% −2.053,1.433), occlusal (IC 95%, −1.202, 0.722) or frontal angles (IC 95% −1.487, 0.447), or in upper incisor inclination (IC 95%, 0.06,3.04). Polysomnographic parameters improved significantly, with mean AHI decreasing from 27.7 ± 12.3 (IC 95% 24.53–30.87) to 6.2 ± 4.0 events/h (IC 95% 5.17–7.27) and ODI from 19.7 ± 9.4 (IC 95% 17.27–22.13) to 4.7 ± 3.2 (IC 95% 3.82–5.48, p < 0.001). Conclusions: This study found that the IMYS MAD did not induce significant variations in occlusal plane orientation or upper incisors inclination after two years of treatment. These null findings suggest that the IMYS device may provide effective OSA management while minimizing the risk of occlusal or dental side effects. However, the retrospective design and the 24-month follow-up duration should be taken into consideration. Full article

Background: This retrospective comparative clinical study aimed to evaluate the performance of digital versus conventional impression techniques in the fabrication of implant-supported prosthetic restorations. Materials and Methods: A total of 40 cases were included: 20 impressions obtained with conventional elastomeric materials (polyvinyl siloxane and polyether), and 20 impressions acquired digitally using two intraoral scanners (TRIOS 3 and Medit i700). All patients received partial fixed implant restorations and were documented across all stages of prosthetic treatment. Accuracy and passive fit were assessed using radiographic measurements and the Sheffield test. Linear distances (mm) at the implant–abutment interface, chairside time (min), and VAS scores (1–10) were analyzed. Clinical efficiency was evaluated based on procedural steps, chairside time, and adjustment frequency. Patient satisfaction was assessed through a structured 10-item Visual Analog Scale (VAS) questionnaire. Results: Results showed a lower misfit rate in the digital group (15%) compared to the conventional group (25%), with no final-stage misfits in digital cases. Digital workflows demonstrated shorter impression times, fewer procedural steps, and reduced the need for prosthetic adjustments. Patient satisfaction scores were significantly higher in the digital group across all VAS parameters (p < 0.001), particularly in comfort and esthetic satisfaction. Conclusions: These findings support the use of digital impressions as a clinically efficient and patient-preferred alternative to conventional methods for partial implant restorations. However, conventional impressions remain a viable option in settings where digital technology is not available. Further studies with larger sample sizes and long-term follow-up are recommended to assess outcomes in full-arch rehabilitation. Full article

Background/Objectives: Occlusal analysis is an important component of oral rehabilitation with a determining role in the prognosis of restorations. Over time, several qualitative and quantitative occlusal analysis methods have been proposed, starting with occlusion wax up to the most advanced digital systems. The objective of the present study was to evaluate and compare the data obtained through dental occlusion analysis using the Medit i700 and Exocad Elefsina v3.2 in a group of subjects, in order to establish the reliability or compatibility between the two occlusal analysis systems. Methods: The study was conducted on 20 subjects, aged between 24 and 53 years, who presented in the Dental Prosthetics Clinic of the University of Medicine and Pharmacy of Craiova. Digital impressions were acquired using the Medit Link v.3.3.6 intraoral scanner, and the digital files were subsequently uploaded from the Medit i700 into the Medit Occlusion Analyzer application and the Dental CAD Exocad software. For the analysis of occlusion in dynamics, mandibular movements and data acquisition, positions of edge-to-edge in protrusion, edge-to-edge in right laterotrusion and edge-to-edge in left laterotrusion were recorded, using the corresponding print screens. The 2D occlusal contact images generated by the two software programs were converted into .jpeg format and subsequently imported into Adobe Photoshop CS6 (2021) for comparative analysis. The data were statistically processed for each software used and the obtained data were subsequently compared. Results: The occlusal surfaces recorded with the Medit Occlusion Analyzer application represent 94% of the occlusal surfaces recorded with the Exocad software for the maxilla and 90% of the occlusal surfaces recorded for the mandible. In maximum intercuspation, the highest values were recorded by the Medit i700 software, whereas in edge-to-edge protrusion and both right and left edge-to-edge laterotrusion positions, the highest values were reported by the Exocad software. The discrepancy between maxillary and mandibular values arises from the conversion of the data from a three-dimensional to a two-dimensional format during image processing. Conclusions: The occlusal areas recorded by the DentalCAD Exocad software show higher values than those provided by the Medit Link software with the Medit Occlusion Analyzer application. The differences in recorded values, in the case of the digital flow of prosthetic restorations, require the intervention of the dentist to perform clinical adjustments to optimize occlusal relationships after the fabrication and cementation of restorations. Full article

Background/Objectives: To compare patient-reported outcome measures (PROMs) between digital and conventional impression techniques for implant-supported fixed dental prostheses (iFDPs). Methods: A systematic literature search was conducted in PubMed, Embase, Scopus, and the Cochrane Library databases up to June 2025, following PRISMA guidelines. Human clinical studies reporting PROMs between digital and conventional impression techniques for iFDPs were included. Studies using structured, but not necessarily validated, questionnaires were eligible. Two reviewers independently performed study selection, data extraction, and risk of bias assessment. Where possible, meta-analyses were conducted using a random-effects model to pool comparable outcomes across studies using mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CIs). Results: Out of 1784 records screened, eighteen studies were included. Most studies showed that digital impressions were associated with higher patient satisfaction, compared to conventional impressions. Ten studies contributed data to at least one outcome; pooled analyses included the following: overall satisfaction (k = 5), comfort (k = 7), gagging/nausea (k = 5), esthetic satisfaction (k = 2), unpleasant taste (k = 5), anxiety (k = 5), discomfort (k = 2), pain (k = 5), and overall discomfort (k = 5). Digital impressions were significantly favored (p < 0.05) for anxiety (MD = 13.3, 95% CI: −22 to −4.5), nausea (MD = −26.4, 95% CI −46.8 to −6.0), bad taste (MD = −34.8, 95% CI −58.3 to −11.3), discomfort (SMD = −2.24, 95% CI −3.51 to −0.98), comfort (SMD = 1.77, 95% CI: 0.60 to 2.94), perceived procedure time (SMD = 0.96; 95% CI 0.29 to 1.62), and overall satisfaction (SMD = 0.55; 95% CI 0.01 to 1.09). No statistically significant differences were found for pain or esthetic evaluation. Substantial between-study heterogeneity was observed among the included studies. Conclusions: Current evidence indicates that digital impression workflows enhance the overall patient experience for implant-supported fixed restorations, especially in domains linked to comfort and procedural efficiency. These findings support PROM-informed personalization of impression workflows: screening for gagging, anxiety, or intolerance to impression materials could guide patient-tailored use of intraoral scanning while acknowledging no consistent advantage for pain or esthetic perception. Full article

The Maxillary Skeletal Expander (MSE) is used for maxillary expansion in adolescents and young adults. Virtual planning using 3D models, CBCT and 3D printers help in case selection, appliance design and fabrication. Using the proposed digital workflow, the accuracy of the patient selection phase and appliance delivery are increased, and the required number of visits to the clinic is decreased. The MSE serves as a guide for the insertion of mini-implants, reducing the number of appointments needed for installation. (1) Introduction: Mini-Implant-Assisted Rapid Palatal Expansion (MARPE) appliances, like the MSE, decrease the side effects that regular tooth-anchored appliances have on dental and periodontal structures, especially for skeletally mature patients, combining palatal anchorage with dental support for guidance. The digital planning of the insertion sites, length and angulation of the mini screws, and the fabrication of the 3D-printed appliance that stands as a mini-implant insertion guide give an undeniable precision. (2) Materials and methods: The laboratory steps used in the digital design and fabrication, and clinical steps needed for the insertion protocol are described. (3) Discussions: The individual assessment of the anatomical structures and the use of virtual integrated dental impressions and CBCT increase the accuracy of diagnosis, appliance fabrication and treatment progress. Implementing a digital workflow for mini-implant-supported expansion is a real advantage for both dental teams and patients. (4) Conclusions: The wide range of advantages and the ease of the process support the introduction of this digital workflow in every orthodontic practice. Full article

Digital dentistry is undergoing rapid evolution, with three-dimensional imaging technologies increasingly integrated into routine clinical workflows. Originally developed for accurate dental arch reconstruction, modern intraoral scanners have demonstrated expanding versatility in capturing intraoral mucosal as well as perioral cutaneous structures. Concurrently, photogrammetry has emerged as a powerful method for full-face digital reconstruction, particularly valuable in orthodontic and prosthodontic treatment planning. These advances offer promising applications in forensic sciences, where high-resolution, three-dimensional documentation of anatomical details such as palatal rugae, lip prints, and bite marks can provide objective and enduring records for legal and investigative purposes. This study explores the forensic potential of two digital acquisition techniques by presenting two cadaveric cases of animal bite injuries. In the first case, an intraoral scanner (Dexis 3600) was used in an unconventional extraoral application to directly scan skin lesions. In the second case, photogrammetry was employed using a digital single-lens reflex (DSLR) camera and Agisoft Metashape, with standardized lighting and metric scale references to generate accurate 3D models. Both methods produced analyzable digital reconstructions suitable for forensic archiving. The intraoral scanner yielded dimensionally accurate models, with strong agreement with manual measurements, though limited by difficulties in capturing complex surface morphology. Photogrammetry, meanwhile, allowed for broader contextual reconstruction with high texture fidelity, albeit requiring more extensive processing and scale calibration. A notable advantage common to both techniques is the avoidance of physical contact and impression materials, which can compress and distort soft tissues, an especially relevant concern when documenting transient evidence like bite marks. These results suggest that both technologies, despite their different origins and operational workflows, can contribute meaningfully to forensic documentation of bite-related injuries. While constrained by the exploratory nature and small sample size of this study, the findings support the viability of digitized, non-destructive evidence preservation. Future perspectives may include the integration of artificial intelligence to assist with morphological matching and the establishment of digital forensic databases for pattern comparison and expert review. Full article

Objective: Several studies have compared the accuracy of digital scans and conventional impressions for post space capture. However, only a few have specifically investigated the precision of intraoral scanners in measuring post spaces of varied lengths. This study aimed to evaluate the accuracy of various intraoral scanning techniques in capturing long and short post spaces. Material and Methods: This study grouped samples into eight categories based on four techniques and two post space depths (7 and 11 mm). After tooth preparation, root canal treatment, and post space preparation, laboratory scans were performed using Duralay. Intraoral scans were obtained directly and indirectly with the Trios fourth generation scanner using the Duralay and PVS techniques. The accuracies, in terms of trueness, and precisions were compared after ten repetitions for each group using the Kruskal–Wallis or Mann–Whitney U tests. Results: The Duralay Intraoral Scan groups demonstrated a high consistency, while the Direct Intraoral Scan groups showed moderate consistency. Variability was higher for the Duralay Lab Scan and PVS Intraoral Scan groups for short post spaces. Conclusions: The capture technique significantly affected the accuracies of the post space measurements. The techniques also demonstrated varying consistency and precision. These findings provide critical insights to guide their selections for clinical and research applications. Clinical Significance: This study is one of the few to compare the accuracy of intraoral scanners for the capture of both short and long post spaces. It addresses a key gap in current dental research and offers practical guidance for clinicians and researchers in selecting appropriate scanning techniques for various clinical scenarios. The findings have the potential to enhance the accuracy and reliability of post space measurements and improve patient outcomes. Full article

This in vitro study aims to compare the trueness of digital impressions obtained using two intraoral scanners (IOS) and one photogrammetry device for full-arch implant-supported rehabilitations. According to the Caramês Classification I, three models were produced with Straumann implants arranged in different spatial distributions: Option A with six implants and Options B and C with four implants each. The three models were scanned using a 12-megapixel scanner to create digital master casts. For each reference model, 30 digital impressions were acquired: 10 with the 3Shape Trios 3 intraoral scanner, 10 with the Medit i500 intraoral scanner, and 10 with the PIC Dental photogrammetry device. Trueness was assessed through best-fit superimpositions between the digital master casts and the corresponding virtual models. The Shapiro–Wilk test was applied to assess the normality of the data distribution, and Levene’s test was used to evaluate the homogeneity of variances. The non-parametric Kruskal–Wallis test was employed to compare group differences, with post hoc adjustments made using the Bonferroni correction. A significance threshold of p = 0.05 was adopted for all statistical tests. Statistically significant differences were observed in the root mean square values among the three devices. The Medit i500 demonstrated the highest trueness, with a median (interquartile range) deviation of 24.45 (18.18) µm, whereas the PIC Dental exhibited the lowest trueness, with a median deviation of 49.45 (9.17) µm. Among the implant distribution, the Option C showed the best trueness, with a median deviation of 19.00 (27.83). Considering the results of this in vitro study, intraoral scanners demonstrated comparable trueness, whereas the photogrammetry-based system exhibited lower trueness values. Additionally, a smaller number of implants and reduced inter-implant distances were associated with improved trueness in digital impressions for full-arch implant rehabilitation. Full article

Background/Objectives: Alginate dental impressions are often among the most anxiety-inducing procedures for pediatric patients due to discomfort caused by nausea, gagging, and the vomiting reflex. This technique frequently raises anxiety levels in children. In contrast, intraoral scanners are increasingly used in clinical practice and offer a more comfortable alternative. Physiological parameters such as heart rate (HR) and oxygen saturation (SpO₂) are useful, objective indicators of anxiety. This study aimed to evaluate significant changes in HR and SpO₂ during dental impression procedures using two techniques—an analog (alginate) and a digital (intraoral scanner) one—in both dental arches, to determine the method inducing the least anxiety. Methods: A non-interventional clinical study was conducted on a sample of 30 children. A fingertip pulse oximeter was used to measure HR and SpO₂ during impression taking with alginate and with an intraoral scanner. Statistical analysis was performed using SPSS^® (Version 30.0. Amonk, NY, USA: IBM Corp). Descriptive statistics (mean and standard deviation) were calculated, and the Friedman and Wilcoxon tests with Bonferroni correction were applied, using a 5% significance level. The study was approved by the Ethics Committee of the University of Murcia. Results: Alginate impressions produced a statistically significant increase in HR in both the upper [(19 ± 11) bpm] and lower [(18 ± 9) bpm] arches compared to the scanner [(7 ± 5) bpm and (7 ± 4) bpm, respectively] (χ² = 49.30; p < 0.001). SpO₂ levels also dropped more when using alginate for both the upper and lower arches [(−2 ± 2)% and (−2 ± 3)%, respectively] than when using the scanner [(−1 ± 1)% in both arches] (χ² = 21.41; p < 0.001). Conclusions: Alginate impressions triggered a significant anxiety response, as evidenced by significant changes in HR and SpO₂. Intraoral scanners were less invasive, as indicated by the greater proximity of the physiological parameters to the baseline values, making them a promising alternative in pediatric dentistry. Full article

Background: Patient satisfaction is a critical outcome in the rehabilitation of edentulous patients. While conventional fabrication methods are widely used, digital workflows are emerging as viable alternatives. However, direct comparative evidence from the patient’s perspective remains limited. Objective: To compare patient satisfaction between conventional complete dentures (C-CD) and digital complete dentures (D-CD) in maxillary edentulous patients, including changes in perceptions over time and final prosthesis preference. Methods: A prospective, randomized crossover clinical trial was conducted in 2023–2024 involving 40 completely maxillary edentulous patients meeting specific inclusion criteria. Participants were randomly allocated into two sequence groups: Group 1 (n = 20) received C-CD first, and Group 2 (n = 20) received D-CD first, each for 6 months (T1), followed by crossover to the alternate denture for another 6 months (T2). Patient satisfaction was measured using a 10-item questionnaire at 6 and 12 months. Statistical analysis: Wilcoxon signed-rank tests were used for within-subject comparisons of denture types, and Mann–Whitney U tests for between-group comparisons, with significance set at p ≤ 0.05. Results: Using the paired crossover analysis, D-CD showed significantly better comfort than C-CD (p < 0.05). D-CD scored significantly higher than C-CD in most satisfaction domains, including comfort, retention, speech, esthetics, and need for adjustments (p ≤ 0.05). Median scores for retention, speech, esthetics, and other domains were slightly higher with D-CD but did not reach statistical significance (p > 0.05). Additionally, the D-CD required fewer post-insertion adjustment visits than the C-CD (p < 0.05). By the end of the trial, 28 patients (70%) preferred the digital denture as their final prosthesis, whereas 12 patients (30%) preferred the conventional denture. Conclusions: Incorporating digital technology in the fabrication of complete dentures significantly enhances patient satisfaction compared to conventional methods. This study highlights the clinical relevance of modern dental prosthesis technology and supports the wider integration of digital workflows. Within the limitations of this pilot study, digitally fabricated complete dentures provided overall patient satisfaction comparable to conventional dentures, with the D-CD offering a notable improvement in comfort. The majority of patients ultimately favored the digital denture, supporting the clinical viability of CAD/CAM workflows. Full article

Objectives: This study investigated the use of artificial intelligence (AI) in the design of lingual bracket indirect bonding trays and its association with bracket transfer accuracy using three-dimensional (3D) printing. Methods: Digital impressions of patient’s dental arches were captured using an intraoral scanner, and orthodontic setups were virtually constructed. Brackets were virtually positioned in their ideal locations using the digital setups guided by virtual archwire templates. Indirect bonding trays were automatically generated using the AI-powered Auto Creation function of the Medit Splints application, which analyzes anatomical features to streamline design. Bracket transfer accuracy was evaluated in vivo by comparing planned and actual bracket positions across grouped and individual tray configurations. Linear and angular deviations were measured using conventional 3D inspection software. Results: Most bracket transfer errors were within clinically acceptable thresholds, although torque accuracy remained suboptimal. Grouped trays generally exhibited greater precision than individual trays in several dimensions. Conclusions: These findings support the application of AI-assisted design tools to enhance digital workflows and improve consistency in appliance fabrication. Full article

Background/Objectives: Accurate implant impressions are critical for capturing the three-dimensional (3D) spatial positioning of implants. Digital workflows using intraoral scanners (IOSs) and scan bodies offer distinct advantages over conventional elastomeric techniques. However, the geometry of scan bodies may influence the precision and trueness of IOS-acquired data, and optimal design parameters remain undefined. This systematic review aims to evaluate the effects of scan body geometry on the trueness of digital implant impressions captured using IOSs. Methods: A systematic search was conducted across PubMed, Scopus, EMBASE, Web of Science, the Cochrane Library, and Google Scholar up to 25 February 2025. Eligible studies assessed the impact of scan body geometry on the accuracy of implant-level impressions acquired with IOSs. Study quality was assessed using the Quality Assessment Tool for In Vitro Studies of Dental Materials (QUIN). Results: Twenty-eight studies were included, of which twenty-six were in vitro. The included studies, published between 2020 and 2025, demonstrated that variations in macro- and micro-geometries influenced both linear and angular trueness. Cylindrical designs with optimal dimensions generally outperformed cuboidal or spherical forms. Structural modifications, such as rigid bar extensions and surface facets, often improved scan accuracy. Some hybrid or modified designs performed comparably to conventional scan bodies. According to QUIN, 27 studies were moderate quality and one had high quality. Conclusions: Scan body geometry affected the accuracy of intraoral implant digital impressions. Designs featuring rigid extensions or simplified geometries improve trueness and precision. Further standardized clinical studies are needed to define optimal design features and validate current in vitro findings. Full article

Background: Intraoral scanners have become increasingly popular for final dental prostheses due to their precision, efficiency, and patient-friendly approach. However, their use for capturing final impressions of highly esthetic and thin restorations, such as ceramic veneers, presents unique challenges. Veneer preparations differ significantly from traditional full-coverage crowns, with their smaller and more delicate margins often located at or below the gingival level. This complexity may lead to hesitancy among clinicians regarding the routine use of intraoral scanners in such cases. Methods: A comprehensive literature review was performed to evaluate the effectiveness of intraoral scanners for final digital impressions in ceramic veneer restorations within the esthetic zone. Studies published between January 2010 and January 2025 were included in the review. Additionally, a case illustration was provided, detailing the use of an intraoral scanner to capture final impressions for a patient requiring 10 ceramic veneers in the esthetic zone. Results: The review demonstrated that intraoral scanning is a reliable technique for veneer impressions, delivering clinically acceptable outcomes. The benefits include enhanced patient comfort, improved workflow efficiency, and a reduction in chairside time. Nonetheless, clinicians must overcome a learning curve with digital technologies and ensure optimal conditions, such as maintaining a dry tooth surface during scanning. The presented case successfully illustrated the use of intraoral scanning, resulting in precise impressions and the fabrication of highly esthetic and functional veneers. Conclusions: Intraoral scanning is a predictable and effective method for capturing final impressions for veneer restorations. It offers results comparable to traditional methods while enhancing patient experience and enabling the fabrication of high-quality restorations within an efficient workflow. Full article

Background/Objectives: Intraoral scanning, a fast-evolving technology, is increasingly integrated into actual dental workflows due to its numerous advantages. Despite its growing adoption, challenges related to the accuracy of digital impressions remain. The existing literature identifies most of the factors influencing intraoral scanning accuracy (defined by precision and trueness), but it is fragmented and lacks a unified synthesis. In response to this gap, the present study aims to consolidate and structure the current evidence on the determinant factors and, based on these findings, to develop a clinically applicable procedural guideline for dental practitioners. Methods: A comprehensive literature review identified 43 distinct factors influencing intraoral scanning. Results: These factors encompass variables such as software versions and updates, implant characteristics (e.g., position, angulation, scan body design), materials, environmental conditions (e.g., lighting), and procedural elements including scanning strategy, pattern, aids, and operator experience. Subsequently, these identified factors were systematically classified into five distinct groups based on inherent similarities and relevance within the scanning workflow: IOS—characteristics and maintenance, intraoral morphology, materials, ambient conditions, and scanning strategy. To translate these findings into a practical framework, a four-step protocol was developed, designed for straightforward application by researchers and clinicians. Conclusions: This protocol—comprising: (1) Maintenance, (2) Evaluation, (3) Establishment and Execution of Scanning Strategy, and (4) Verification—aims to guide users effectively through the intraoral scanning process, mitigate common clinical challenges, and ensure broad applicability across diverse scanner systems, irrespective of the manufacturer or model. Full article

Background: Mucostatic impressions have been always indicated in thin, sharp, or flabby ridges, and have been addressed for their beneficial effect on long-term residual ridge stability. Nonetheless, a purely mucostatic impression was not possible until intraoral scans became available. This provides an option for digital removable denture which is biologically sensible but might reduce retention in comparison with a mucocompressive impression with border molding. On the other hand, pressure applied to the mucosa may have harmful effects on the long-term residual ridge stability, causing higher resorption and ultimately reduced denture retention. Hence, the possibility to merge mucostatics and mucocompressive philosophies would be a clinically and biologically sensible option for oral rehabilitation in aging populations where patients will potentially wear dentures for longer periods. This possibility is demonstrated in this technical report with a cast-free digital workflow. Technique: Baseplates for occlusion rims, closely adapted to the mucosa, were designed on intraoral scans of edentulous arches and, once 3D-printed, used to register maxillomandibular relations and information for tooth arrangement, as well as to perform border molding. Occlusion rims were then scanned and, within the 3Shape Dental System 2024 software program, the intaglio surfaces of their baseplates were segmented and inverted to obtain the digital master casts which incorporated the precise reproduction of the molded borders. Then, denture design was performed and manufactured; no limitations regarding manufacturing options are applicable to the presented technique. Conclusions: The potential benefits (i.e., improved retention in the initial period after denture delivery and the preservation of tissues) of the presented digital cast-free workflow, based on merging mucostatic and mucocompressive philosophies to obtain dentures with a mucostatic intaglio surface and functional borders, are sensible clinical outcomes which recommend the clinical application of the technique, although further validation, especially in the long term, is required. Full article