Accuracy of the novel digital non-cross-arch surgical guides with integration of tooth undercut retention and screw-bone support for implant placement in mandibular free-end.

BACKGROUND: Large cross-arch free-end surgical guides can obscure the visual field, compromising surgical accuracy due to insufficient stability at the free-end. This in vitro study aims to evaluate the accuracy of novel digital non-cross-arch surgical guides designed for implant placement at the mandibular free-end, incorporating tooth undercut retention and screw-bone support. MATERIALS AND METHODS: A mandibular dental model lacking left molars was utilized to fabricate unilateral (cross-arch) tooth-supported surgical guides (GT I, n = 20). Subsequently, two additional types of surgical guides were fabricated: GT II (covering two teeth, n = 20) and GT III (covering three teeth, n = 20). These novel surgical guides were designed to utilize the undercut of the supporting teeth for retention and enhance stability with screw-bone support at the guide's free-end. Furthermore, 60 identical guiding blocks were assembled on the three types of surgical guides to facilitate the implants' insertion. On a phantom head, 120 implant replicas were placed at the Federal Dentaire Internationale (FDI) teeth positions #36 and #37 on the dental model, employing a combination of surgical guides and guiding blocks. To assess accuracy, planned and placed implant positions were compared using intraoral optical scanning. Discrepancies in angulation and linear deviations, including the coronal/apical 3D deviations, lateral deviation as well as depth deviation, were measured. Statistical analysis was performed using two-way ANOVA and Bonferroni test (α = 0.05). RESULTS: GT I exhibited significantly largest discrepancies, including angular and linear deviations at the crest and apex at every implant site. Especially in depth, at implant site #36, the mean deviation value of GT I (0.27 ± 0.13 mm) was twice as large as GT III (0.13 ± 0.07 mm), and almost twice as large as GT II (0.14 ± 0.08 mm). However, at implant site #37, this deviation increased to almost a five-fold relationship between GT I (0.63 ± 0.12 mm) and II (0.14 ± 0.09 mm), as well as between GT I and III (0.13 ± 0.09 mm). No significant discrepancies existed between the novel surgical guides at either implant site #36 or #37. CONCLUSION: This study provides a practical protocol for enhancing accuracy of implant placement and reducing the size of free-end surgical guides used at mandibular molar sites.

Stepwise Removal Process Analysis Based on Layered Corrosion Oxides.

The parts of engineering machinery quickly generate rusty oxides in the working process, which seriously affects their service life and safety. How to remove oxides efficiently without damaging the surface of the matrix is a crucial problem. This paper analyzes the critical laser parameters that affect the distribution of material temperature field, which determines the ablation depth of different oxides, by using the central composite experimental design method and taking the surface-ablation depth of Fe2O3 and Fe3O4 before and after laser cleaning as response variables to establish the prediction model of single removal volume with the help of Comsol Multiphysics software. The results show a positive correlation between ablation depth and peak power density and a negative correlation with scanning speed. In this process, the experimental results show that the prediction model is natural and effective. A flow chart of laser stepwise cleaning of layered corroded oxides can provide theoretical guidance for the laser cleaning of engineering machinery.

Recording jaw relation of a pediatric patient with ectodermal dysplasia and complete anodontia using a digital mini arch tracer: A case report.

Children with ectodermal dysplasia and complete anodontia experience difficulties in oral rehabilitation because of the small arch size. A case of a 7-year-old boy, whose arch size (length and width) was 30-40% smaller than that of a male adult and who presented with difficulties in jaw relation recording using commercially available devices is described. A digital workflow involving a mini arch tracer was introduced. Primary impressions were made using three-dimensionally (3D) printed mini trays produced based on the patient's computed tomography images, and digital primary casts were obtained based on the scanned and reversed primary impressions. The final custom impression trays with mini tracing plates were designed based on the primary casts. In addition, the hand shank, retention plate, and retainers were placed on the designed custom trays and 3D-printed to produce an individual arch tracer system. In addition, two height-checking buckles were designed to help adjust the height of a tracing screw. Finally, the jaw relation of the patient was recorded and transferred, and a set of complete dentures were delivered, satisfying both the patient and his family.

Effects of loupes and microscopes on a dental technician's working posture from ergonomic aspects.

OBJECTIVES: This work aimed to study the effects of loupes and microscopes on a dental technician's working posture during practical operation from ergonomic aspects. The technician's working postures under the conditions of the naked eye, loupes, and microscopes were compared. The practical value of loupes and microscopes was assessed based on the evaluation index of working posture from ergonomic aspects. METHODS: Three dental technicians who were skilled in using loupes and microscopes from West China Stomatology Technology Department of Sichuan University were involved in this prospective rando-mized controlled trial. Before the operation, cameras were installed in the sagittal position, top-view position, and dorsal position of the operation. Each technician made five porcelain veneers of the right maxillary central incisor following the standard process. A chairside computer-aided design and computer-aided manufacturing (CAD/CAM) system was used to mill and layer the ceramic block under the naked eye (A: control group), 3.5× headwear loupes (B: loupe group), and 9× desktop microscopes (C: microscope group). The working posture was recorded by videos throughout the entire process. After each operation, the investigator used OpenPose to recognize the working posture. The joint angles of the arm, elbow, wrist, neck, and trunk, as well as their corresponding rapid upper limb assessment (RULA) scores, were calcula-ted by MATLAB. The working posture was assessed from ergonomic aspects based on the joint angles, RULA scores, and operation time. Statistical analysis was performed using SPSS 26.0. RESULTS: The RULA score of upper limb joint angles showed that the angles of the arm, elbow, wrist, neck, and trunk under the naked eye were 14.93°±9.44°, 120.19°±2.99°, 23.97°±2.84°, 47.27°±5.72°, and 7.76°±2.30°, respectively. All of the joint angles were significantly different among the three groups (P<0.05). Compared with the control group, the angles of the neck and trunk in the loupe group were reduced by 29.09% and 42.53%, respectively, whereas those in the microscope group were significantly reduced by 43.99% and 87.11%, respectively. Multiple comparisons by LSD for the angles of neck and trunk revealed that the loupe group and the microscope group were significantly different from the control group (P<0.05), and they were also significantly different from each other (P<0.05). The mean RULA scores were 6.24±0.34 in the control group, 5.53±0.35 in the loupe group, and 3.31±0.19 in the microscope group. Compared with the control group, the mean RULA score in the loupe group was lower, and that in the microscope group was significantly lower. The differences between every two groups were statistically significant (P<0.05). The mean RULA score in the microscope group was significantly lower than that in the loupe group (P<0.05). The average operation times of the control group, loupe group, and microscope group were (50.69±36.78), (52.01±34.65), and (59.44±35.81) min, respectively. No significant difference was found among the three groups (P>0.05). CONCLUSIONS: Use of loupes and microscopes showed an improvement in ergonomics and working posture of dental technicians. Microscopes had a better effect in the ergonomic convenience of the technician than loupes.

An investigation of the microstructure and mechanical properties of dental zirconia manufactured by digital light processing 3D printing.

OBJECTIVES: This study was performed to investigate the microstructure and mechanical properties of dental zirconia manufactured by digital light processing (DLP) 3D printing and the clinical application prospects of this material. METHODS: The experiment (DLP) group was zirconia manufactured by DLP 3D printing, and the control (MILL) group was milled zirconia. The density, grain size, and phase composition were measured to study the microstructure. Flexural strength was measured by using three-point bending tests, while Vickers hardness was determined through a Vickers hardness tester. Fracture toughness was tested using the single-edge V-notched beam method. RESULTS: Zirconia density of the DLP group was (6.019 8±0.021 3) g·cm-3, and the average grain size was (0.603 0±0.032 6) µm, but without statistical difference with the corresponding values of the MILL group (P>0.05). Tetragonal phase was found in the X-ray diffraction patterns of the DLP and MILL groups. The flexural strength of the DLP group was (1 012.7±125.5) MPa, and Vickers hardness was (1 238.5±10.8) HV1, which was slightly lower than that of the MILL group (P<0.05). The fracture toughness of the DLP group was (7.22±0.81) MPa·m1/2, which was not statistically different from that of the MILL group (P>0.05). CONCLUSIONS: Zirconia manufactured by DLP 3D printing had microstructure and mechanical properties similar to those of the milled zirconia. Only the flexural strength and the Vickers hardness of the experimental zirconia were slightly lower than those of the milled zirconia. Therefore, DLP-manufactured zirconia has a promising future for clinical use.

Corrigendum to "Determination of Hardness and Fracture Toughness of Y-TZP Manufactured by Digital Light Processing through the Indentation Technique".

[This corrects the article DOI: 10.1155/2021/6612840.].

Application of polymeric porcelain color-masking cast posts in the aesthetic repair of anterior teeth: a case report.

Many patients with large-area tooth defect need cast post-core crown restoration. However, the color defect of the cast post-core will affect the final restorative result, especially that of the anterior teeth. A new technology of color masking by applying CERAMAGE polymeric porcelain to the cast metal post-core surface improves the color of a full-ceramic restoration of anterior teeth and may provide a new alternative for the aesthetic repair of anterior teeth with a large area of defective tooth.

Determination of Hardness and Fracture Toughness of Y-TZP Manufactured by Digital Light Processing through the Indentation Technique.

OBJECTIVE: The purpose of the study was to determine the hardness and fracture toughness of dental yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) manufactured by digital light processing (DLP) technology to study its clinical prospects. METHODS: The experimental group was DLP-manufactured zirconia, and the control group was milled zirconia. The hardness was investigated under a range of test loads (0.49 N, 0.98 N, 1.96 N, 4.90 N, 9.81 N, 29.42 N, 49.03 N, 98.07 N, and 196.1 N). Meyer's law was applied to describe the indentation size effect (ISE). Meanwhile, the PSR model and MPSR model were utilized to generate true hardness values. The cracks were observed to be induced by indentation under loads above 49.03 N, while the cracks showed the radial-median type under the load of 196.1 N, under which the fracture toughness was calculated. RESULTS: The true hardness of DLP-manufactured zirconia was 1189 HV based on the PSR model and 1193 HV based on the MPSR model, a bit lower than that of milled zirconia. The fracture toughness was 3.43 ± 0.29 MPa√m, which showed no statistical difference with the milled zirconia. CONCLUSION: The dental zirconia manufactured by the DLP 3D printing technique is similar to that manufactured by the conventional milling process in hardness and fracture toughness, thus having a promising future of clinical use.