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.

Transcriptomic analysis provides insights into the molecular mechanism of melatonin-mediated cadmium tolerance in Medicago sativa L.

Cadmium (Cd), a toxic element, often makes a serious threat to plant growth and development. Previous studies found that melatonin (Mel) reduced Cd accumulation and reestablished the redox balance to alleviate Cd stress in Medicago sativa L., however, the complex molecular mechanisms are still elusive. Here, comparative transcriptome analysis and biochemical experiments were conducted to explore the molecular mechanisms of Mel in enhancing Cd tolerance. Results showed that 7237 differentially expressed genes (DEGs) were regulated by Mel pretreatment to Cd stress compared to the control condition in roots of Medicago sativa L. Besides, in comparison with Cd stress alone, Mel upregulated 1081 DEGs, and downregulated 1085 DEGs. These DEGs were mainly involved in the transcription and translation of genes and folding, sorting and degradation of proteins, carbohydrate metabolism, and hormone signal network. Application of Mel regulated the expression of several genes encoding ribosomal protein and E3 ubiquitin-protein ligase involved in folding, sorting and degradation of proteins. Moreover, transcriptomic analyse suggested that Mel might regulate the expression of genes encoding pectin lyase, UDP-glucose dehydrogenase, sucrose-phosphate synthase, hexokinase-1, and protein phosphorylation in the sugar metabolism. Therefore, these could promote sucrose accumulation and subsequently alleviate the Cd damage. In conclusion, above findings provided the mining of important genes and molecular basis of Mel in mitigating Cd tolerance and genetic cultivation of Medicago sativa L.

Digital intraoperative evaluation of restorative space and nontemplate-guided tooth preparation when replacing failed anterior restorations: A dental technique.

Assessing the correlation between the current restorative space and the target restorative space is important in determining whether additional tooth preparation is required when replacing failed prostheses. However, existing techniques are not always accurate or efficient. This article describes a digital workflow for the accurate chairside evaluation of the current restorative space and nontemplate-guided tooth preparation. Reference data was obtained from an initial scan of the existing restoration with an intraoral scanner. After removing the existing restoration, a second scan of the tooth was made and compared with the reference data to evaluate the current restorative space. Subsequently, the abutment tooth was prepared and rescanned, with the restorative space being re-evaluated until it met the requirements. This workflow enables the immediate and accurate evaluation of the restorative space, facilitating accurate chairside tooth preparation without the need for silicone indices or other templates, thereby saving time and cost.

Microbial fermentation and black soldier fly feeding to enhance maize straw degradation.

This study used an innovative synergistic microbial and insect approach to treat maize straw and kitchen waste substrates, including cyclic microbial fermentation and feeding of black soldier fly larvae (BSFL) using the fermented substrate. Increasing cycle numbers led to significantly increased cellulose, hemicellulose, and lignin degradation rates (DR) in the maize straw, which increased by 68.28%, 81.43% and 99.95%, respectively, compared to those in the blank group without frass addition. Moreover, according to the experimental results, it was revealed that the structure of lignocellulose, the composition and structure of the bacterial community in the BSFL gut and frass changed significantly after the addition of the previous cycle of frass treatment. Moreover, the differences in amplicon sequence variants (ASVs) between the gut and frass further increased. The relative abundances of Enterococcus and Actinobacteria in the gut and Gammaproteobacteria_unclassified and Dysgonomonas in the frass increased significantly, which may play a more positive role in lignocellulose degradation. In conclusion, this study showed that frass fermentation + BSFL feeding to degrade straw is a promising method and that frass fermentation is beneficial for the whole cycle. Furthermore, these findings underscore the beneficial impact of frass fermentation on the entire cycle.

MOCSS: Multi-omics data clustering and cancer subtyping via shared and specific representation learning.

Cancer is an extremely complex disease and each type of cancer usually has several different subtypes. Multi-omics data can provide more comprehensive biological information for identifying and discovering cancer subtypes. However, existing unsupervised cancer subtyping methods cannot effectively learn comprehensive shared and specific information of multi-omics data. Therefore, a novel method is proposed based on shared and specific representation learning. For each omics data, two autoencoders are applied to extract shared and specific information, respectively. To reduce redundancy and mutual interference, orthogonality constraint is introduced to separate shared and specific information. In addition, contrastive learning is applied to align the shared information and strengthen their consistency. Finally, the obtained shared and specific information for all samples are used for clustering tasks to achieve cancer subtyping. Experimental results demonstrate that the proposed method can effectively capture shared and specific information of multi-omics data and outperform other state-of-the-art methods on cancer subtyping.

Digital workflow of labial guides for alveolar ridge reduction during implant-supported full-arch rehabilitation.

This article presents a technique for fabricating two-piece labial guides using resin and cobalt-chromium for guided alveoloplasty, implant placement, and immediate full-arch implant-supported fixed complete denture placement. This technique reduces tissue damage and overcomes the negative effect of the anatomical position of the palatal neuropore and mobility of the tissue flap on the positioning and stability of the guide. The use of labial retention metal guides with improved mechanical properties of cobalt-chromium and fixation plugs allows the unilateral placement of the guide. Thus, minimally invasive implant surgery can be performed owing to the absence of large palatal flap elevation and obstruction. Such a design provides better stability of the guides and clear visual access during surgery.

A digital strategy for intraoperative acquisition of actual drill position and rapid assessment of bony preparation accuracy using an intraoral scanner.

A digital workflow to acquire actual position of the drill and assess bony preparation accuracy intraoperatively was described. Based on the widely used intraoral scanner, this digital workflow was a relatively practical and economical option for digital intraoperative measurement. As a result, it could help the clinician in accurate verification and immediate correction of the drill position and consequently facilitating the accurate implant placement in implant surgery.

Simultaneous implantation and tooth preparation technology guided by 3D-printed guide.

Using digital technologies in concurrently performing missing tooth implantation and preparation of remaining teeth is a solution to reduce the number of visits and improve efficiency. This paper proposes a digital process for simultaneously implanting and preparing teeth. It integrates implant surgical guide and 3D-printed tooth preparation guide into a single guide and completes guided implant placement and precise tooth preparation. Based on "repair-oriented" virtual implant planning, the implant surgical guide can improve the efficiency and predictability of implant placement, and its linear accuracy is about 1 mm. The tooth preparation guide precisely guides tooth preparation and restoration space visualization, ensuring the quality of the tooth preparation. The two guides have different design accuracy requirements, and thus their combination improves the overall guiding accuracy requirements. The concurrent application of the two guides minimizes the clinical operation time, number of visits, and economic burden of patients.

Accuracy of the preparation depth in mixed targeted restorative space type veneers assisted by different guides: An in vitro study.

PURPOSE: Most veneers are mixed targeted restorative space (MTRS)-type restorations that are partially within the original tooth and require inconsistent preparation depths. This study aimed to evaluate the accuracy of the preparation depth for MTRS veneer preparation. METHODS: MTRS veneer preparation models were developed using the twisted maxillary central incisor (MCI) as the original tooth and the standard MCI as the waxing. Veneer preparations were performed using freehand (MF), silicone (MS), thermoplastic (MT), 3D-printed uniform (MD), and auto-stop (MA) guides. The prepared and original MCI were scanned and superimposed using a custom-made base. The mean absolute differences (MADs) were measured to evaluate the accuracy of the preparation depth. Statistical analysis was performed using the multivariate analysis of variance (MANOVA) test (α=0.05). RESULTS: The accuracy of the preparation depth was 0.237±0.090, 0.191±0.099, 0.149±0.078, 0.093±0.050, and 0.059±0.040 mm in MF, MS, MT, MD, and MA, respectively. The MADs between the groups were significant (P<0.05). The accuracy of the trial restoration was 0.140±0.081 mm in the MS, and the accuracy of the guiding tube was 0.055±0.033, 0.036±0.011, and 0.033±0.010 mm in the MT, MD, and MA, respectively. CONCLUSIONS: In MTRS veneer preparation for MCI, tooth preparation guides improved the accuracy of the preparation depth by visualizing the TRS profile and providing clear measurement points. The accuracy of the guide is influenced by its flexibility, and the accuracy of the preparation depth is affected by the accuracy of the measurement points.

Proanthocyanins and anthocyanins in chestnut (Castanea mollissima) shell extracts: biotransformation in the simulated gastrointestinal model and interaction with gut microbiota in vitro.

BACKGROUND: Chestnut (Castanea mollissima) shell is rich in flavonoids and our previous studies showed that proanthocyanins and anthocyanins were the two markedly varied flavonoids in chestnut shell extracts (CSE) during digestion. Here, the biotransformation of proanthocyanins and anthocyanins in a simulated gastrointestinal model, and the interactions between non-absorption CSE (NACSE) and gut microbiota in vitro, were investigated by ultra-high-performance liquid chromatography combined with triple-quadrupole mass spectrometry and 16S rRNA sequencing. RESULTS: Chestnut shell was richer in proanthocyanins and anthocyanins, while the loss of proanthocyanins was greater after digestion. Additionally, the content of anthocyanin decreased after gastric digestion but increased after intestinal digestion and remained stable after fermentation. After fermentation, delphinidin-3-O-sambubioside and pelargonidin-3-O-galactoside were newly formed. Furthermore, microbiome profiling indicated that NACSE promoted the proliferation of beneficial bacteria, while inhibiting pathogenic bacteria. CONCLUSION: All these data suggest that CSE may be a promising candidate to protect gut health. © 2023 Society of Chemical Industry.

Guided removal of a fractured fiber post and immediate restoration with a digitally prefabricated titanium post-and-core and zirconia crown: A clinical report.

A completely digital workflow is described for the immediate restoration of a fractured fiber post with a digitally prefabricated definitive restoration using 3-dimensionally printed guides. The geometric morphology and axis of the root canal were digitally determined by using cone beam computed tomography to localize the 3-dimensional position of the fractured fiber post. A virtual drill modeled on the shape of the fractured post was fabricated and customized for removal of the post by using a guide to facilitate the intraoral transfer of the drilling procedure. A titanium post-and-core and crown had been virtually predesigned and fabricated before the procedure, and 2 digital guides were designed for their placement. All guides were 3-dimensionally printed. By following this workflow, the removal of the fractured fiber post and immediate definitive restoration were completed in 1 visit, facilitating a more efficient, predictable, and straightforward treatment.

Mechanical stability of angulated zirconia abutments supporting maxillary anterior single crowns on narrow-diameter implants.

OBJECTIVES: To investigate the fracture strength of angulated hybrid abutments supporting anterior single crowns on narrow-diameter implants (NDIs). MATERIAL AND METHODS: Zirconia abutment with angulations of labial inclination 0° (TZ0Z), 15° (TZ15Z), 30° (TZ30Z) and palatal inclination 15° (TZ - 15Z) was designed on 3.3-mm titanium-zirconium (Ti-Zr) NDIs. Titanium abutment connected with Ti-Zr implant (TZ0T) and 0° zirconia abutment connected with pure titanium (Ti) implant (T0Z) were control groups. Thirty-six un-restored abutments and 36 abutments restored with highly translucent zirconia (HTZ) crowns were tested. Failure loads were compared among 6 groups, and bending moments were calculated for comparison between un-restored and restored abutments. RESULTS: Failure loads of un-restored abutments were affected by the abutment angle. Sixty-seven percent samples in TZ30Z and 83% samples in TZ - 15Z group fractured at the thinnest part of the zirconia abutment and exhibited lower failure load (p < .05). Failure loads of restored abutments were close to or exceeded the maximum bite force of anterior teeth, and no differences were found among six groups (p > .05). Except TZ15Z and TZ0T group, the bending moment increased with the crown construction, especially for TZ30Z and TZ - 15Z groups (p < .001). CONCLUSIONS: The fracture strength of hybrid abutments restored with HTZ crown on Ti-Zr NDIs exceeded the bite forces of anterior teeth for all the groups and were not affected by the abutment angle. CLINICAL RELEVANCE: In terms of fracture strength, Ti-Zr NDIs combined with angulated hybrid abutments and HTZ crowns can be used in the anterior region.

Accuracy of Intraoperative Measuring Guide and Conventional Surgical Guide in Anterior Implant Surgery: A Retrospective Case-Control Study

PURPOSE: To verify a novel method that improves the accuracy of static computer-aided implant surgery (sCAIS) through intraoperative measurement. MATERIALS AND METHODS: Forty-seven patients were selected for this study, each with a missing tooth or a tooth that required extraction from the anterior area. The patients were divided into the intraoperative measuring guide (MG) and conventional guide (CG) groups. Following the preoperative implant planning, the surgical guides were designed and fabricated. In the MG group, the drill was guided by double-armed zirconia sleeves, and the axial direction of the drill was assessed using the indicator components. The implant was guided using a resin guide tube. In the CG group, the drills were guided using a metal sleeve and handles, and the implants were placed with the guidance of the metal sleeve only. The angular and linear deviations at the entry and apex between the planned and actual implant positions were measured after matching the preoperative and postoperative CBCT data. The independent-samples t test was used to compare the deviation between the MG and CG groups. RESULTS: The 3D deviations for the MG group at the entry and apex were 0.67 ± 0.44 mm and 0.93 ± 0.40 mm, respectively. The angular deviation was 2.27 ± 0.96 degrees. Statistical differences were found in the 3D deviation at the entry point and apical position between the MG and CG groups, yielding relatively smaller deviations in the MG group. CONCLUSION: The use of an intraoperative measuring guide could improve the accuracy of implant placement in sCAIS.

Application of measurable surgical guides in immediate implant placement and immediate restoration.

This article reports a case of using immediate implant placement and immediate restoration combined with measurable implant surgical guides to restore compromised maxillary incisors caused by dental trauma. Target restoration was designed in the exoCAD software preoperatively, intraoral measurements were obtained in three directions, and the correct position of virtual implants was determined in BlueSky Plan 4. Afterward, measurable implant guides were designed and fabricated by 3D printing. Under the guidance of the measurable implant surgical guides and intraoperative measurement, the entry point was determined, the axial direction was verified when drilling to half the depth, and the 3D position was verified when drilling to total depth. Implants were inserted followed by verification once again. The temporary restoration, which was designed based on the target restoration and emergence profile of the original teeth and milled preoperatively, was connected to the implant immediately after surgery. Postoperative accuracy analysis showed that the mean linear deviations between the actual implant position and the pre-planned position were (0.57±0.17) mm at the entry point and (0.82±0.27) mm at the apex, and the mean angular deviation was (1.86±0.89) °, demonstrating that precise implant placement and immediate restoration were implemented.

A digital workflow for layering composite resin restorations by using 3-dimensionally printed templates to replicate the contralateral tooth accurately and rapidly.

This article described a digital workflow for layering composite resin restorations by using a digital software program and 3-dimensionally printed templates. To mimic the appearance of the natural tooth, the computer-aided design was used to copy the shape of the contralateral tooth. Three-dimensionally printed templates to replicate the contralateral tooth accurately and rapidly can help dentists build different layers of dentin and enamel composite resin, achieving layered esthetic outcomes. This workflow provides an efficient and accurate procedure, reduces chairside time, and simplifies the application of the technically sensitive composite resin layering technique.

A digital workflow for the fabrication of an immediate implant-supported interim restoration.

Immediate interim restorations in the esthetic region are usually fabricated in situ by using the pick-up technique, which is time-consuming and has a potential for cross-infection. This article describes a rapid and precise workflow for the fabrication of an immediate implant-supported interim restoration. A cast with gingival contours and an extended tube to accommodate the implant analogs is generated preoperatively based on the virtual implant planning and a predesigned restoration. After guided osteotomy and implant insertion, the actual three-dimensional (3D) implant position is transferred precisely from the mouth to the printed cast by using the surgical guide. This technique can achieve the rapid and precise fabrication of the interim restoration with guidance immediately after the surgery, decreasing the risk of cross-infection and reducing clinical steps and time.

Accuracy of three digital waxing-guided trial restoration protocols for controlling the depths of tooth preparation for ceramic veneers.

STATEMENT OF PROBLEM: The accuracy of digital waxing-guided trial restoration protocols that have been implemented with ceramic veneers has not been reported. PURPOSE: The purpose of this in vitro study was to evaluate the accuracy of 3 digital trial restorations fabricated from digital waxing for ceramic veneers. MATERIAL AND METHODS: A uniform 0.3-mm digital waxing added to the facial surface of 30 maxillary central typodont incisors was created in a software program. The trial restorations were fabricated on typodont teeth with autopolymerizing acrylic resin by using a silicone index based on 3-dimensionally printed casts designed from the digital waxing. The 30 maxillary central incisors were divided into 3 groups: the depth cutter (0.5 mm, Komet) (DC) group, the round bur (1.5 mm, Diatech) (RB) group, and the specially designed calibrated depth bur (laser mark of 0.5 mm, Gaofeng) (CD) group. The 3 groups were randomly prepared with a random number table by 2 experienced prosthodontists aiming to produce an even facial clearance of 0.5 mm. The dimensional differences in the standard tessellation language (STL) files between the surfaces of the original teeth, digital waxing, trial restorations, and prepared teeth in the software program were measured and analyzed at the same 9 points on the labial surface. One-way ANOVA with a post hoc test was used to identify significant discrepancies between trial restorations and waxing and differences in the reduction depth of typodont teeth (RDT) and the reduction depth (RD) among the 3 techniques (α=.05). The mean relative differences (MRDs) were calculated to determine the accuracy (%). RESULTS: The thickness of the trial restorations was significantly greater than that of the digital waxings, with a discrepancy of 0.20 ±0.14 mm, especially at the cervical site. With the use of a trial restoration, the RDTs of the middle (-0.01 ±0.11 mm) and cervical locations (0.09 ±0.20 mm) showed significantly smaller preparation depths than did the other locations. Significant differences in RD were found among the 3 guided techniques (P<.05). Group DC presented the most accurate result of 0.51 ±0.08 mm with an MRD of 2%, whereas the results of 0.57 ±0.10 mm with an MRD of 14% and 0.60 ±0.11 mm with an MRD of 20% were obtained from group RB and group DC, respectively. CONCLUSIONS: The trial restoration was significantly thicker than its corresponding waxing. The DC technique presented the most accurate reduction result among the 3 protocols examined.

Shear bond strength of ceramic laminate veneers to finishing surfaces with different percentages of preserved enamel under a digital guided method.

BACKGROUND: The purpose of this in vitro study was to evaluate the effect of the percentages of preserved enamel on ceramic laminate veneers' (CLVs) shear bond strength (SBS). METHODS: Seventy extracted human maxillary central incisors were scanned and reconstructed into three-dimensional models. The extracted teeth were then embedded and randomly divided into seven groups (n = 10 per group). Based on digital analyses of the three-dimensional models, guided tooth preparation and bonding procedures were performed individually to form seven different percentages (100%, 80%, 60% 50%, 40%, 20% and 0%) of remaining enamel thickness on the bonding surface. Finally, the SBS test was performed, and the data were statistically analysed by one-way ANOVA with LSD post hoc test (α = 0.05). RESULTS: The complete enamel surface exhibited the highest SBS (19.93 ± 4.55 MPa), followed by 80% enamel (19.03 ± 3.66 MPa), 60% enamel (18.44 ± 3.65 MPa), 50% enamel (18.18 ± 3.41 MPa), 40% enamel (17.83 ± 3.01 MPa) and 20% enamel (11.32 ± 3.42 MPa) group. The lowest SBS (9.63 ± 3.46 MPa) was detected in 0% enamel group. No significant difference was observed among the 40-100% enamel groups, while the 20% or 0% enamel group demonstrated a significantly lower mean SBS than the 40% enamel group (p < 0.05). CONCLUSION: The SBS value of CLVs bonded to 100% enamel on the finishing surfaces (nearly 20 MPa) was twice that which bonded to 0% enamel (nearly 10 MPa). Bonding to 100% enamel is the most reliable treatment. When dentin exposure is inevitable, enamel should be preserved as much as possible to maintain good bonding. In addition, 40% of preserved enamel on the bonding surface was the minimal acceptable value to fulfil the requirements of good bonding strength.

Accuracy of Reduction Depths of Tooth Preparation for Porcelain Laminate Veneers Assisted by Different Tooth Preparation Guides: An In Vitro Study.

PURPOSE: To evaluate the accuracy (trueness and precision) of reduction depths of guided veneer preparation assisted by four tooth preparation guides. MATERIALS AND METHODS: Fifty resin artificial teeth were randomly divided into five groups (n = 10): a freehand group (F), silicone guide group (S), thermoplastic guide group (T), 3D printed uniform guide group (D), and 3D printed auto-stop guide group (A). A preparation for a window veneer on the maxillary right central incisor was performed by two surgeons who used tooth preparation guides for assistance. The maxillary right central incisors were scanned before and after the preparation. The reduction depths were measured in the cervical, middle, and incisal thirds of the prepared surface, and depth maps were created using Geomagic Control X software. The accuracy of the reduction depths at each third was evaluated using both trueness and precision values. The trueness of the reduction depths was determined by calculating the mean absolute differences (MADs) compared to the planning depth, and precision was determined by the standard deviation (SD). The collected data were statistically analyzed using one-way ANOVA and the least significant difference test (α = 0.05). RESULTS: The MAD ± SD values of the reduction depths in the cervical-third region in groups F, S, T, D, and A were 0.19 ± 0.04, 0.12 ± 0.03, 0.09 ± 0.02, 0.07 ± 0.02, and 0.05 ± 0.01 mm, respectively. In the middle-third region, the MAD ± SD values of groups F-A were 0.19 ± 0.05, 0.13 ± 0.02, 0.09 ± 0.01, 0.06 ± 0.01, and 0.05 ± 0.01 mm. In the incisal-third region, the MAD ± SD values were 0.27 ± 0.05, 0.16 ± 0.04, 0.11 ± 0.03, 0.07 ± 0.01, and 0.05 ± 0.01 mm, respectively. Significant differences in trueness and precision values were found across different groups (F = 45.378, p = 0.000), where group F showed higher MADs than the other 4 groups (p = 0.000), and the highest MADs were detected in group S among the 4 groups in all regions (p = 0.000). Group T showed significantly higher MADs than groups D (P = 0.008) and A (p = 0.001), except in the cervical-third region, where no significant difference was observed between groups T and D (p = 0.077). There was no significant difference between groups D and A (p = 0.148). The deviation map showed significant differences among groups (F = 15.963, p = 0.000), group T presented less deviation than group F (p = 0.000) and group S (p = 0.027) and showed more deviation than group A (p = 0.007). CONCLUSION: Tooth preparation guides provided more accuracy for veneer preparation than freehand preparation. Among the 4 guides, the 3D printed auto-stop guide presented the lowest absolute difference (0.05 mm) and the silicone guide showed the highest absolute difference of preparation (0.12-0.16 mm).