The Quality of AI-Generated Dental Caries Multiple Choice Questions: A Comparative Analysis of ChatGPT and Google Bard Language Models.

Statement of problem: AI technology presents a variety of benefits and challenges for educators. Purpose: To investigate whether ChatGPT and Google Bard (now is named Gemini) are valuable resources for generating multiple-choice questions for educators of dental caries. Material and methods: A book on dental caries was used. Sixteen paragraphs were extracted by an expert consultant based on applicability and potential for developing multiple-choice questions. ChatGPT and Bard language models were used to produce multiple-choice questions based on this input, and 64 questions were generated. Three dental specialists assessed the relevance, accuracy, and complexity of the generated questions. The questions were qualitatively evaluated using cognitive learning objectives and item writing flaws. Paired sample t-tests and two-way analysis of variance (ANOVA) were used to compare the generated multiple-choice questions and answers between ChatGPT and Bard. Results: There were no significant differences between the questions generated by ChatGPT and Bard. Moreover, the analysis of variance found no significant differences in question quality. Bard-generated questions tended to have higher cognitive levels than those of ChatGPT. Format error was predominant in ChatGPT-generated questions. Finally, Bard exhibited more absolute terms than ChatGPT. Conclusions: ChatGPT and Bard could generate questions related to dental caries, mainly at the cognitive level of knowledge and comprehension. Clinical significance: Language models are crucial for generating subject-specific questions used in quizzes, tests, and education. By using these models, educators can save time and focus on lesson preparation and student engagement instead of solely focusing on assessment creation. Additionally, language models are adept at generating numerous questions, making them particularly valuable for large-scale exams. However, educators must carefully review and adapt the questions to ensure they align with their learning goals.

Mapping the Landscape of the Digital Workflow of Esthetic Veneers from Design to Cementation: A Systematic Review.

The purpose of this systematic review was to map all the existing literature on digitally designed and fabricated esthetic veneers. We aimed to compare the accuracy of digitally designed preparation and cementation guides for esthetic indirect veneers with the conventional workflow. We evaluated studies comparing the accuracy and predictability of workflows between digitally fabricated indirect-esthetic veneers and conventional indirect veneers. Searches were performed in August 2023 across three databases, specifically Google Scholar, Cochrane, and PubMed, and were restricted to English-language publications. The search strategy was based on the PICO criteria. Reference lists of identified articles were manually checked to find further pertinent studies that were not discovered during the electronic search. The titles and abstracts were reviewed in the first stage, and then the full article texts were reviewed and cross-matched against the predetermined inclusion criteria. Following the search, 169 articles were identified: 41 from Google Scholar, 44 from Cochrane, and 71 from PubMed, with 13 added manually. Of these, 20 were chosen for a detailed quality assessment of the digital veneer workflow and the accuracy of digital preparations and cementation guides for laminate veneers. Based on our findings, the digitally fabricated laminate-veneer workflow demonstrated superior predictability and accuracy compared to the conventional workflow.

Evaluation of the trueness and precision of conventional impressions versus digital scans for the all-on-four treatment in the maxillary arch: An in vitro study.

PURPOSE: To compare the accuracy of digitizing conventional impressions to intraoral surface scans for all-on-four treatment in the maxillary arch. MATERIALS AND METHODS: An edentulous maxillary arch model with four implants placed in an all-on-four design was fabricated. Intraoral surface scans (n = 10) were obtained using an intraoral scanner after scan body insertion. For conventional polyvinylsiloxane impressions of the model, implant copings were inserted into the implant fixation for implant level, opened tray impressions (n = 10). The model and conventional impressions were digitized to obtain digital files. A reference file was created using a laboratory-scanned conventional standard tessellation language (STL) file with analog to scan the body using exocad software. STL datasets from the two digital and conventional impression groups were superimposed with reference files to assess the 3D deviations. Two-way ANOVA and paired-samples t-test was performed to assess the difference in trueness and examine the effects of impression technique and implant angulation on the deviation amount. RESULTS: No significant differences were found between the conventional impression and intraoral surface scan groups F(1, 76) = 2.705, p = 0.104. No significant differences were found between conventional straight and digital straight implants and between conventional and digital tilted implants F(1, 76) = .041, p = 0.841. No significant differences were found between conventional straight and conventional tilted implants p = 0.07 and between digital straight and digital tilted implants p = 0.08. CONCLUSION: Digital scans were more accurate than conventional impressions. The digital straight implants were more accurate than the conventional straight implants, and the digital tilted implants were more accurate than the conventional tilted implants, with higher accuracy for digital straight implants.

Artificial intelligence in the detection and classification of dental caries.

STATEMENT OF PROBLEM: Automated detection of dental caries could enhance early detection, save clinician time, and enrich treatment decisions. However, a reliable system is lacking. PURPOSE: The purpose of this study was to train a deep learning model and to assess its ability to detect and classify dental caries. MATERIAL AND METHODS: Bitewings radiographs with a 1876×1402-pixel resolution were collected, segmented, and anonymized with a radiographic image analysis software program and were identified and classified according to the modified King Abdulaziz University (KAU) classification for dental caries. The method was based on supervised learning algorithms trained on semantic segmentation tasks. RESULTS: The mean score for the intersection-over-union of the model was 0.55 for proximal carious lesions on a 5-category segmentation assignment and a mean F1 score of 0.535 using 554 training samples. CONCLUSIONS: The study validated the high potential for developing an accurate caries detection model that will expedite caries identification, assess clinician decision-making, and improve the quality of patient care.

Mechanical Properties of Three-Dimensional Printed Provisional Resin Materials for Crown and Fixed Dental Prosthesis: A Systematic Review.

The emergence of digital dentistry has led to the introduction of various three-dimensional (3D) printing materials in the market, specifically for provisional fixed restoration. This study aimed to undertake a systematic review of the published literature on the Mechanical Properties of 3D- Printed Provisional Resin Materials for crown and fixed dental prosthesis (FDP). The electronic database on PubMed/Medline was searched for relevant studies. The search retrieved articles that were published from January 2011 to March 2023. The established focus question was: "Do provisional 3D-printed materials have better mechanical properties than conventional or milled provisional materials?". The systematically extracted data included the researcher's name(s), publication year, evaluation method, number of samples, types of materials, and study outcome. A total of 19 studies were included in this systematic review. These studies examined different aspects of the mechanical properties of 3D-printed provisional materials. Flexural Strength and Microhardness were the frequently used mechanical testing. Furthermore, 3D-printed provisional restorations showed higher hardness, smoother surfaces, less wear volume loss, and higher wear resistance compared to either milled or conventional, or both. 3D-printed provisional resin materials appear to be a promising option for fabricating provisional crowns and FDPs.

Maxillary and mandibular complete-arch implant rehabilitation using a complete digital workflow: A case report.

This article summarizes the clinical steps involved in maxillary and mandibular complete-arch implant rehabilitation using a complete digital workflow. The maxillary arch was recorded using the double digital scan technique, and the mandibular arch using the triple digital scan technique. The digital protocol used in this case report allowed the recording of implant positions via scan bodies, soft tissues, and, most importantly, the interocclusal relationship in the same visit. A new technique for mandibular digital scan was described that uses soft tissue landmarks by creating windows in the patient's provisional prostheses to superimpose the three digital scans and consequently fabricate and verify the maxillary and mandibular prototype prostheses and definitive complete-arch zirconia prostheses.

Classification of maxillectomy in edentulous arch defects, algorithm, concept, and proposal classifications: A review.

OBJECTIVES: Aramany's classification of postsurgical maxillectomy defects was introduced for partially edentulous situations, and has been widely used for education and effective communication among practitioners. Numerous classifications of maxillofacial defects, based on surgical procedure, resultant defects, or prosthodontist's perspective after rehabilitation, exist in the literature. However, no single classification has incorporated all these factors. The purpose of this review was to highlight the classification systems and describe a pragmatic classification series for edentulous maxillary arch defects (maxillectomy) by applying the Aramany classification criteria, to enhance treatment outcomes and communication among practitioners. MATERIAL AND METHODS: An electronic search of the literature published in English was conducted using the PubMed/MEDLINE and Google Scholar database. Keywords used were "maxillectomy classification" AND "surgical resection," "maxillectomy classification" AND "complete edentulous." In addition, a manual search was also performed followed the same criteria in the following journals: Journal of Prosthetic Dentistry and Journal of Prosthodontics. RESULTS: Several classification systems for partial dentition were found in terms of size, location, dentition, and extension of the defect (isolated or communication defects). The findings revealed a variety of maxillectomy defect classifications for partially dentate, considering surgical factors and rehabilitation. However, no study or classification system exist for the edentulous arch defects. CONCLUSIONS: Different classification systems for maxillectomy defects exist in the literature, only for partially dentate patients. To the authors best knowledge, no classification system for completely edentulous maxillary arch defects have been proposed till date. A simple classification system with clear characteristics for edentulous maxillectomy dental arch defects has been proposed. This classification was modeled after Aramany classification for easier memorization and application.

Evaluation of split-cast techniques for remounting casts on a dental articulator: A survey and an in vitro study.

INTRODUCTION: This study aimed to investigate the difference between senior dental students and prosthodontic faculty members regarding their opinions, attitudes and adoption of six split-cast techniques for remounting complete dentures. The accuracy of each technique for measurements of the vertical and the anteroposterior dimensions was assessed. MATERIALS AND METHODS: Six split-cast techniques to remove the casts were compared. A total of 115 participants removed a set of casts on six different articulators, and a questionnaire survey was administered. A digital Vernier caliper was used to measure the linear dimensional changes between the laterally pindexed references on each cast. The data were statistically analysed at α = 0.05. RESULTS: There were significant differences between senior dental students and prosthodontic faculty members in their responses regarding adoption of daily practice and techniques requiring more skill (p = .001). To adopt a specific technique in daily practice, most students and faculty members chose long round die pins (36.4%) and central groove indexing (CGI; 40.7%), respectively. For techniques requiring more skills, most students and faculty members chose long rectangular die pins (30.7%) and short round dowel pins (33.3%), respectively. CONCLUSION: Dental students preferred ShRP, whilst faculty members preferred LReP. All participants considered CGI to be the easiest amongst the techniques. For comparison with baseline measurements, both senior dental students and prosthodontic faculty members considered side notch indexing and double dowel pins to be the most accurate techniques for vertical measurements, and CGI for anteroposterior measurements.

Maxillary complete-arch implant-supported restoration: A digital scanning and maxillomandibular relationship workflow.

Intraoral scanners are increasingly used as a replacement for conventional impressions, including the capturing of edentulous arches, although their use may be clinically challenging. This technique article describes the fabrication and use of a custom scanning device to scaffold an intraoral complete-arch scan of at least 6 implant scan bodies in the edentulous maxilla while simultaneously capturing the maxillomandibular relationship for the purpose of establishing a digital workflow to fabricate a maxillary complete-arch implant-supported prosthesis.

Emotional, behavioral, and social effects of anterior tooth loss: a cross-sectional study / Efeitos emocionais, comportamentais e sociais da perda dentária anterior: um estudo tranversal

Objective: The study aims to evaluate the emotional, behavioural, and social effects of single or multiple anterior tooth loss. It also compares the effectiveness of the removable and fixed prosthesis to address the impact of anterior tooth loss. Material and Methods: The study was carried out on 70 subjects who presented to the Department of Prosthetic Dental Sciences. A questionnaire was distributed and the data were statistically analyzed using SPSS version 18.0 and values less than 0.05 % were considered statistically significant. Results: The participant's difficulty to accept loss of their anterior tooth, embarrassment and confidence were changed significantly after wearing the prosthesis (P< 0.05). Moreover, fixed partial denture had more effect than removal partial denture. It was claimed by 62.9% of the participants that they were not prepared for the effect of tooth loss and 47.1% of them thought that a prior explanation from the dentist would have helped them overcome their fear of losing their teeth. Conclusion: The maximum impact of anterior tooth loss was felt on confidence followed by embarrassment. The participants felt more comfortable after wearing their prosthesis. Fixed partial denture had more effect than removable partial denture.(AU)

Objetivo: O estudo visa avaliar os efeitos emocionais, comportamentais e sociais da perda dentária anterior unitária ou múltipla. Ele também compara a eficácia da protese removível e da fixa para lidar com o impacto da perda dentária anterior. Material e Métodos: O estudo foi realizado em 70 indivíduos que se apresentaram ao Department of Prosthetic Dental Sciences. Foi distribuído um questionário e os dados analisados estatisticamente no SPSS versão 18.0 e valores inferiores a 0,05% foram considerados estatisticamente significativos. Resultados: A dificuldade do participante em aceitar a perda de seu dente anterior, constrangimento e confiança mudaram significativamente após usar a prótese (P <0,05). Além disso, a prótese parcial fixa teve mais efeito do que a prótese parcial removível. Foi alegado por 62,9% dos participantes que não estavam preparados para o efeito da perda dentária e 47,1% deles achavam que uma explicação prévia do cirurgião-dentista os teria ajudado a superar o medo de perder os dentes. Conclusão: O impacto máximo da perda dentária anterior foi sentido na confiança, seguido de constrangimento. Os participantes se sentiram mais confortáveis após o uso de suas próteses. A prótese parcial fixa teve mais efeito do que a prótese parcial removível (AU)

Fit of tooth-supported zirconia single crowns-A systematic review of the literature.

PURPOSE: The purpose of this study is to systematically map all the factors that influence the fit and adaptation of zirconia crowns and/or copings. MATERIALS AND METHODS: The investigational strategy involved carrying out an electronic search between December 1, 2009 and September 1, 2019 through the Embase and Medline databases using Boolean operators to locate appropriate articles. RESULTS: A total of 637 articles were discovered after the removal of duplicates, and 46 of these were selected for evaluation. Further, a quality assessment was performed using GRADE evaluation criteria. CONCLUSIONS: Shoulder finish line preparations had slightly better marginal fit compared to chamfer finish lines. Crowns obtained from digital impressions had comparable to superior marginal adaptation compared to conventional impressions. Increasing cement space showed to improve zirconia crown adaptation. Cementation and veneering zirconia frameworks found to increase the marginal and internal gaps. Limited information is available on the effect of the alteration of sintering time/Temperature and/or sintering techniques on the adaptation of zirconia crowns. Most of the selected studies had a moderate quality assessment evaluation. Future studies could investigate the chair-side, ultra-fast sintering effect on the marginal gap of zirconia crowns.

Managing Excessive Gingival Display Using a Digital Workflow.

This technique article describes an approach to managing excessive gingival display by lengthening of the clinical crowns using a digital workflow. An intraoral scanner was used to obtain a template to be used for the crown lengthening surgical procedure considering the patient-desired diagnostic setups while fully seating the template on the patient's teeth during surgery. Using a digital approach for lengthening the clinical crowns decreased the likelihood of the need for postsurgical modifications, thus shortening the treatment duration. After the crown lengthening healed for 12 weeks, full-mouth reconstruction proceeded. Maxillary and mandibular preparation reduction guides were digitally designed and printed to facilitate conservative crown preparations. An intraoral scanner was used to make full-arch scans and interocclusal records for the fabrication of provisional and final crowns. Fully guided implant planning and placement were also executed.

Dimensional Changes of Yttria-stabilized Zirconia under Different Preparation Designs and Sintering Protocols.

PURPOSE: To evaluate the linear and volumetric dimensional changes that occur throughout the fabrication process of monolithic 4.5-6% yttria-stabilized zirconia copings under the influence of different preparation designs and two sintering protocols. MATERIALS AND METHODS: A titanium master die was fabricated using Atlantis core file implant-abutment. Six copings were designed virtually according to different finish line offsets and coping thicknesses, with four equidistant occlusal posts for linear measurements. Zirconia copings were milled using IPS e.max ZirCAD LT zirconia blanks. The experimental groups according to the coping designs were the following: G1: 0.5 mm finish line offset, 0.5 mm thickness; G2: 0.5 mm finish line offset, 1.0 mm thickness; G3: 0.5 mm finish line offset, 1.5 mm thickness; G4: 1.2 mm finish line offset, 0.5 mm thickness; G5: 1.2 mm finish line offset, 1.0 mm thickness; G6: 1.2 mm finish line offset, 1.5 mm thickness. Six samples per group were sintered by standard sintering (SS) and the other six by fast sintering (FS). Linear and volumetric measurements were taken at the three fabrication stages (virtual design, milling stage, and sintering) by using an intraoral scanner and imported as the .stl file to Meshmixer software for analysis. Statistical analysis was performed by a linear mixed effect model via statistical software R (R Core team, 2018). RESULTS: There was a significant interaction between the coping design group, stage of fabrication and sintering protocol on the linear (F = 4.451, p < 0.001) and volumetric (F = 2.716; p < 0.001) dimensional changes. Standard sintering G1 showed the smallest linear and dimensional changes among the groups compared to the reference design. Sintered copings had shrunk on average 1.32% within SS and 1.54% within FS linearly and 3.82% within SS and 3.90% within FS volumetrically compared to the initial design parameters. CONCLUSION: The linear and volumetric dimensional changes did not differ significantly between standard and fast sintering protocols, and the preparation designs had more influence on the dimensional changes compared to sintering protocols.

Marginal Discrepancies of Monolithic Zirconia Crowns: The Influence of Preparation Designs and Sintering Techniques.

PURPOSE: The marginal fit is an essential component for the clinical success of prosthodontic restorations. The aim of this study was to investigate the influence of different abutment finish line widths and crown thicknesses on the marginal fit of zirconia crowns fabricated using either standard or fast sintering protocols. MATERIALS AND METHODS: Six titanium abutments were fabricated for receiving zirconia molar crowns. Crowns were designed virtually and milled from partially sintered zirconia blanks and divided into 12 groups (n = 10/group). Crowns in groups 1 to 6 were sintered by standard sintering, while those in groups 7 to 12 were sintered by fast sintering. Groups were further categorized according to abutment finish line and crown thickness: G1/G7 (0.5 mm chamfer, 0.8 mm thick); G2/G8 (0.5 mm chamfer, 1.5 mm thick); G3/G9 (1.0 mm chamfer, 0.8 mm thick); G4/10 (1.0 mm chamfer, 1.5 mm thick); G5/G11 (1.2 mm chamfer, 0.8 mm thick); G6/G12 (1.2 mm chamfer, 1.5 mm thick). The marginal gaps were assessed at 8 locations using digital microscopy. The linear mixed effect model analysis was performed at a significance level of 0.05. RESULTS: All vertical marginal gaps were within the clinically acceptable range (∼11-52 µm). G8 (FS, 0.5 mm chamfer, 1.5 mm thick) demonstrated the largest gaps (47.95 µm, 95% CI: 44.57-51.23), whereas G3 (SS, 1.0 mm chamfer, 0.8 thick) had the smallest marginal gap (14.43 µm, 95% CI: 11.15-17.71). A linear mixed effect models showed significant differences for the interaction between finish line × crown thickness × sintering (F = 18.96, p < 0.001). The lingual surfaces showed the largest gaps in both sintering protocols, while the mesial and mesiobuccal surfaces demonstrated the smallest gaps. CONCLUSIONS: There was a significant interaction between finish line widths, crown thickness, and sintering protocol on the marginal gaps in both sintering protocols; 1.0 mm finish line preparations with either 0.8 mm or 1.5 mm occlusal reduction had better marginal fit in both sintering protocols compared to 0.5 mm or 1.2 mm finish lines. Smaller marginal discrepancies were observed for standard sintering crowns with a 0.5 mm finish line and 1.5 mm occlusal reduction. Conservative occlusal reduction should be accompanied with a 1.2 mm finish line to obtain better marginal fit for full-contoured zirconia crowns.