Facial scanner accuracy with different superimposition methods - In vivo study.

PURPOSE: To compare trueness and precision between conventional and digital facial measurements and to evaluate the accuracy of different superimposition techniques for facial scans. MATERIALS AND METHODS: Twenty volunteers were recruited. Predetermined facial landmarks were marked with a black pen, and the interlandmark distances were measured manually with a conventional caliper and digitally with Geomagic software. Two consecutive facial scans were performed and superimposed using as best-fit reference the full face, the face without the eyes, and the bone-supported areas (eg, forehead and zygomatic areas) in order to assess root mean square (RMS) differences. Trueness and precision were evaluated and compared between the conventional and digital techniques. Mann-Whitney U and Kruskal-Wallis post hoc tests were used. The significance level was established at α = .05. RESULTS: Trueness between conventional and digital measurements was 1,151.75 ± 1,265.52 µm (3.04% ± 4.82%), and precision was 322.31 ± 300.54 µm (0.93% ± 1.10%). Global mean RMS values for each superimposition technique were 334.15 ± 172.07 for the full face, 339.57 ± 173.13 for the face without the eyes, and 385.65 ± 182.29 for the bone-supported areas, with the latter presenting statistically significant differences compared to the other two. CONCLUSION: Although statistically significant differences were detected in facial measurements, they were below the clinically detectable threshold. Superimposition with the full face and the face without the eyes area presented smaller discrepancies than with the bone-supported areas, with higher discrepancies in the lower third of the face.

Soft tissue replication in single unit implant impressions-A three dimensional clinical study.

OBJECTIVE: Comparison of soft tissue replication between conventional and digital impressions for definitive single unit implant rehabilitation in the esthetic zone. MATERIALS AND METHODS: Six patients were recruited according to inclusion criteria for this cross-over pilot study and submitted to a conventional silicone implant impression with customized coping and a digital impression with an intraoral scanner. Stereolithography files obtained from the same patient were superimposed with appropriate software and trueness evaluated between methods at predetermined locations (56 in hard and soft tissues and 18 in the emergence profile, per patient). Results were presented as mean root mean square (RMS) ± 95% confidence interval and effect size calculated with Hedges' g ± 95%. Mann-Whitney and Kruskal-Wallis were performed when appropriate and α was set at .05. RESULTS: Trueness between methods equated to 51.08[45.68;56.47] µm and 60.46[52.29;68.62] µm in hard and soft tissues, respectively. Soft tissue replication by intraoral scanner acquisition corresponded to a statistically significant RMS of 243.89[209.15;278.63] µm equating to a Hedges' g of 1.52[1.22;1.82] which corresponded to a large effect size. CONCLUSIONS: The proposed method could be considered for soft tissues assessment and the results suggest that intraoral impression techniques produce statistically significant changes in peri-implant soft tissue replication, although below the clinically detectable threshold. CLINICAL SIGNIFICANCE: The proposed technique allows for the 3D determination of peri-implant tissues changes in digital models with higher sensitivity than visual techniques, thus presenting itself as a promising alternative in clinical studies and that the use of an intraoral scanner obtained significant differences in the soft tissue emergence profile replication when compared with the gold standard.

Short implants versus bone grafting and standard-length implants placement: a systematic review.

OBJECTIVES: The aim of this study was to conduct a systematic review to compare the survival rates between short implants (length < 10 mm) versus standard-length implants (≥ 10 mm) inserted in grafted bone. As secondary outcomes, marginal bone loss and survival rates of the implant supported prostheses were also analysed. MATERIALS AND METHODS: Randomised controlled trials (RCT) that compared both techniques were searched on three electronic databases till June 2016, a manual search was performed on the bibliography of the collected articles, and the authors were contacted for additional references. The estimates of the interventions were expressed in relative risk (RR), mean implant survival rates and mean differences in marginal bone. RESULTS: Eight RCTs were included in this study. From a total of 458 short implants, 15 failed (mean survival rates = 96.7%), While from 488 regular implants, 13 failed (mean survival rates = 97.3%). The technique did not significantly affect: the implant failure rate (P > 0.05), with RR of 1.34 (95% CI 0.67-2.87), the mean differences of marginal bone loss (P = 0.18; MD - 0.04 mm [- 0.10; 0.02] 95% CI), at loading or prosthesis failures rates (RR:0.98; 95% CI 0.40-2.41). The mean differences of marginal bone at 1 year follow-up (post loading) presented significant marginal changes in the short implant group (P = 0.002; MD - 0.10 mm [- 0.16; - 0.03] 95% CI) although a significant high heterogeneity was found between groups. CONCLUSIONS: This systematic review suggests no difference between both techniques in the treatment of atrophic arches. However, more long-term RCTs are needed to evaluate the predictability at the long run. CLINICAL RELEVANCE: The use of short implants might be considered an alternative treatment, since it usually requires fewer surgical phases and tends to be a more affordable option.

Ceramic-Veneered Zirconia Frameworks in Full-Arch Implant Rehabilitations: A 6-Month to 5-Year Retrospective Cohort Study.

PURPOSE: This was a retrospective cohort study designed to evaluate the clinical performance of ceramic-veneered zirconia frameworks. MATERIALS AND METHODS: Patients were recruited according to defined inclusion criteria. All patients were checked every 4 months from the time of definitive rehabilitation. At the end of 2013, all patients were rescheduled and rechecked for study purposes. The restorative procedures assessment was performed by previously established methods. The primary outcomes were the survival and success rates of the prosthesis. Descriptive statistics were used for the patient's demographics, implant distribution, and occurrence of complications. To study the survival and success of the prostheses, a Cox Regression analysis was used with a model constructed in a forward conditional stepwise mode. Predictive variables were included in the model, and adjusted survival curves were obtained for each outcome. RESULTS: From 2008 to 2013, 75 patients were rehabilitated with 92 implant-supported, screw-retained, full-arch ceramic-veneered zirconia framework rehabilitations. The range of follow-up was between 6 months and 5 years. From the 92 full implant-supported screw-retained full-arch rehabilitations, Cox regression analysis indicated that within a 5-year time frame, the probability of framework fracture, major chipping, minor chipping, or any of the former combined to occur was 17.6%, 46.5%, 69.2%, and 90.5%, respectively. CONCLUSION: Results suggest zirconia as a suitable material for framework structure in implant-supported, full-arch rehabilitations. However, it experiences a high incidence of technical complications, mainly due to ceramic chipping. Further clinical studies should aim to ascertain the effects of clinical features and manufacturing procedures on the survival rates of these prostheses.

Kinetic release of hydrogen peroxide from different whitening products.

The objective of this in vitro study was to evaluate the kinetics of hydrogen peroxide (HP) release from five different bleaching products: VivaStyle® 10% fitted tray gel, VivaStyle® 30% in-office bleaching gel, VivaStyle® Paint-On Plus paint-on bleaching varnish, Opalescence PF® 10% carbamide peroxide gel and Trèswhite Supreme™ 10% HP gel. Each product was firstly titrated for its HP content by a described method. HP release kinetics was assessed by a modified spectrophotometric technique. One sample t test was performed to test for differences between the manufacturers' claimed HP concentrations and the titrated HP content in the whitening products. Analysis of variance plus Tamhane's post hoc tests and Pearson correlation analysis were used as appropriate. Values of P < 0.05 were taken as significant. Titrated HP revealed an increased content when compared to the manufacturer's specifications for all the products tested (P < 0.05), although only products from one manufacturer produced significantly higher results. All products presented a significant (P < 0.05) and sustained release of HP. However, the product with paint-on cellulose-based matrix resulted in significantly (P < 0.05) faster kinetics when compared to other products tested. These results are consistent with manufacturers' reduced recommended application times. The results of this study suggest that modifying the matrix composition may be a viable alternative to HP concentration increase, since this may result in faster release kinetics without exposure to high HP concentrations.

Effects of gustatory stimulants of salivary secretion on salivary pH and flow in patients with Sjögren's syndrome: a randomized controlled trial.

OBJECTIVES: To compare salivary pH changes and stimulation efficacy of two different gustatory stimulants of salivary secretion (GSSS) in patients with primary Sjögren syndrome. SETTING: Portuguese Institute for Rheumatological Diseases. DESIGN: Double-blind randomized controlled trial. SUBJECTS: Eighty patients were randomized to two intervention groups. Sample size was calculated using an alpha error of 0.05 and a beta of 0.20. MATERIALS AND METHODS: Participants were randomly assigned to receive a new GSSS containing a weaker malic acid, fluoride and xylitol or a traditionally citric acid-based one. Saliva collection was obtained by established methods at different times. The salivary pH of the samples was determined with a pH meter and a microelectrode. MAIN OUTCOME MEASURES: Salivary pH variations and counts of subjects with pH below 4.5 for over 1 min and stimulated salivary flow were the main outcome measures. RESULTS: Both GSSS significantly stimulated salivary output without significant differences between the two groups. The new gustatory stimulant of salivary secretion presented an absolute risk reduction of 52.78% [33.42-72.13 (95% CI)] when compared with the traditional one. CONCLUSIONS: In Xerostomic Primary Sjögren syndrome patients, gustatory stimulants of salivary secretion based on acid mail only with fluoride and xylitol present similar salivary stimulation capacity when compared to citric acid-based ones, besides significantly reducing the number of salivary pH drops below 4.5. This could be related to a diminished risk for dental erosion and should be confirmed with further studies.