Digitally versus conventionally fabricated complete dentures: A systematic review on cost-efficiency analysis and patient-reported outcome measures (PROMs).

STATEMENT OF PROBLEM: Reports on digitally fabricated complete dentures are increasing. However, comprehensive evidence-based research on their cost-efficiency and patient-reported outcome measures (PROMs) is lacking. PURPOSE: The purpose of this systematic review was to compare the cost-effectiveness and PROMs between digitally and conventionally fabricated complete dentures. MATERIAL AND METHODS: An electronic search of publications from 2011 to mid-2023 was established using PubMed/Medline, EBSCOhost, and Google Scholar. Retrospective, prospective, randomized controlled, and randomized crossover clinical studies on at least 10 participants were included. A total of 540 articles were identified and assessed at the title, abstract, and full article level, resulting in the inclusion of 14 articles. Data on cost, number of visits, patient satisfaction, and oral health-related quality of life were examined and reported. RESULTS: The systematic review included 572 digitally fabricated complete dentures and 939 conventionally fabricated complete dentures inserted in 1300 patients. Digitally fabricated complete dentures require less clinical time with a lower total cost, despite higher material costs compared with the conventional fabrication technique. Digitally and conventionally fabricated complete dentures were found to have significant effects on mastication efficiency, comfort, retention, stability, ease of cleaning, phonetics, and overall patient satisfaction, as well as social disability, functional limitation, psychological discomfort, physical pain, and handicap. CONCLUSIONS: Digitally fabricated complete dentures are more cost-effective than conventionally fabricated dentures. There are various impacts of conventionally and digitally fabricated complete dentures on PROMs, and they are not better than one another.

Development and validation of a questionnaire on perceived prosthodontic treatment needs in Malaysian adults.

STATEMENT OF PROBLEM: A discrepancy between dentists' assessments and patients' expectations during prosthodontic treatment is inevitable. Incorporating dental patients' concerns about their prosthodontic treatment needs is essential during treatment planning, yet studies assessing these needs in adult dental patients are lacking. PURPOSE: The purpose of this study was to develop and validate a novel instrument, termed the questionnaire on perceived prosthodontic treatment needs (PPTN), that assesses perceived prosthodontic treatment needs in adults. MATERIAL AND METHODS: The PPTN was developed following a literature review, consultation with healthcare workers, and patient interviews. It included 15 questions and a self-rated need for prosthodontic treatment, categorized on a Likert scale. A cross-sectional descriptive study was completed on 193 dental patients seeking or receiving prosthodontic treatment. RESULTS: Three perceived prosthodontic treatment need factors were identified (psychosocial impact, esthetic concern, and function) by using exploratory factor analysis. A higher PPTN score indicated greater perceived prosthodontic treatment needs. The identified factors represent 67.8% of the variance with eigenvalues of >1. The PPTN had a high degree of internal consistency and reliability, as the final questionnaire received a Cronbach alpha of 0.75 and an intraclass coefficient of 0.75 with a 95% confidence interval of 0.68 to 0.80 (F(192, 576)=3.94, P<.001). CONCLUSIONS: The newly developed questionnaire was valid and will help understand patients' perceived treatment needs and benefit further prosthodontic research and clinical application.

Smile Attractiveness and Treatment Needs of Maxillary Midline Diastema with Various Widths: Perception among Laypersons, Dental Students, and Dentists in Malaysia.

Smile attractiveness and the need for treatment of maxillary midline diastema with various widths are perceived differently between dentally trained and nondentally trained individuals of different sociodemographic backgrounds. This study aims to evaluate how laypersons, dental students, and dentists in Malaysia differ in their perceptions on smile attractiveness and treatment needs of maxillary midline diastema. A smiling photograph with well-aligned maxillary central incisors with proportionate width-to-height ratio and healthy gingival tissues was selected and digitally manipulated to create maxillary midline diastema with 0.5, 2.0, and 4.0 mm widths. The smile attractiveness and the perceived need for treatment of varying widths of maxillary midline diastemas were rated by laypersons, dental students, and dentists using the Likert scale via a single set of self-administered questionnaires. The impact of sociodemographic variables on aesthetic perception of different gap widths was tested using univariate analysis followed by a multiple linear regression model. A total of 158 laypersons, 118 dental students, and 138 dentists participated in this study. Both laypersons and dentists showed significantly higher mean aesthetic scores for 0.5 mm maxillary midline diastema, lower mean aesthetic scores, and hence higher mean treatment needs scores for 4.0 mm maxillary midline diastema as compared with dental students (p < 0.05). In general, female respondents perceived a gap width of up to 2.0 mm as aesthetically pleasing. Higher educational group and the Malay ethnicity had tolerance threshold of 0.5 mm gap width. The older group considered 4.0 mm gap width as aesthetically unpleasing. In conclusion, both laypersons and dentists accepted a 0.5 mm maxillary midline diastema as an attractive smile but considered 4.0 mm maxillary midline diastema as unpleasing smile which required treatment. Perceptions of laypersons and dentists were significantly different from dental students. Educational level, gender, ethnicity, and age were significantly associated with smile attractiveness of maxillary midline diastema at different investigated widths.

Accuracy and Reliability of Smartphone Virtual Shade-Matching Technique: An In Vitro Study.

PURPOSE: To determine and compare the accuracy and reliability of shade matching using the conventional and smartphone virtual methods. MATERIALS AND METHODS: A phantom head with both maxillary central incisors removed was set up. A central incisor of various standard shades was inserted into the phantom head. Five undergraduate and five postgraduate students were asked to select the closest shade to match the central incisor using the Vita Classic shade guide. The procedure was then repeated using images taken by a smartphone. Each technique was repeated three times. Differences in accuracy of shade matching between the two techniques for every shade tab and between undergraduate and postgraduate dental students were compared using chi-square statistical analysis. The P value was set at .001. Differences in intra-rater and inter-rater reliability between the two techniques and among the three sessions were compared using paired t test and analysis of variance (ANOVA), respectively, with a P value of .05. The reliability of both techniques was further measured using Cohen kappa statistical test. RESULTS: The smartphone virtual shade-matching technique showed significantly higher accuracy in shade matching with most of the tested shade tabs than the conventional method (P < .001), irrespective of observers' clinical experience. Higher repeatability was found in the virtual technique than the conventional technique, with higher intra-rater and inter-rater reliability observed. CONCLUSION: Smartphone virtual shade matching showed better accuracy and reliability than the conventional method and could be used as an alternative shade-matching method.

Occupational ergonomics and related musculoskeletal disorders among dentists: A systematic review.

BACKGROUND: There is an increasing concern about musculoskeletal disorders (MSD), resulting from occupational health hazards among dentists. Dentists who are susceptible to occupational health hazards could develop cumulative trauma disorders, lead to absenteeism from work, loss of productivity and performance or even long-term disability. OBJECTIVE: This study aims to determine the prevalence of musculoskeletal disorders among dentists, explore the risk factors and identify the ergonomic preventive measures for dental professionals. METHODS: Articles published between 2008-2020 were searched in scientific databases (MEDLINE, PubMed, Scopus and Cochrane Library). The Critical Appraisal Skills Programme Systematic Review Checklist was used to assess the quality of the studies. RESULTS: Eighteen studies were found to be suitable in the final review. Relevant data was extracted and summarized from the included studies. The annual prevalence of musculoskeletal disorders in any body site ranged between 68% and 100%. The most predominant regions for musculoskeletal disorders among dental professionals were identified to be the lower back (29% to 94.6%), shoulder (25% to 92.7%), and neck (26% to 92%). The most frequently reported risk factors of MSDs were the individual characteristic female gender (57.1%), followed by awkward working postures (50%), long working experience (50%) and being dental specialists (42.9%). Several preventive measures were identified as the most effective ways in preventing MSDs, the use of magnification (40%) and regular physical activity (40%). CONCLUSIONS: This review reported a high prevalence of musculoskeletal disorders (MSD) among dentists. It critically updates and adds the latest evidence on occupational ergonomics among dentists.

Initial management and long-term follow up after the rehabilitation of a patient with severe dentoalveolar trauma: A case report.

Dental trauma is common and for patients who suffer significant oral injuries, rehabilitation can be challenging to the clinical team. This case report describes the successful prosthetic replacement of multiple missing teeth lost due to severe dentoalveolar trauma, using iliac crest bone grafting, an implant-retained removable dental prosthesis and implant-supported crowns. Good functionality and aesthetic outcome were achieved.

Measurement of Fracture Strength of Zirconia Dental Implant Abutments with Internal and External Connections Using Acoustic Emission.

A single paragraph of about 200 words maximum. For research articles, abstracts should give a pertinent overview of the work. We strongly encourage authors to use the following style of structured abstracts, but without headings: (1) Background: Place the question addressed in a broad context and highlight the purpose of the study; (2) Methods: Describe briefly the main methods or treatments applied; (3) Results: Summarize the article's main findings; and (4) Conclusions: Indicate the main conclusions or interpretations. The abstract should be an objective representation of the article, it must not contain results which are not presented and substantiated in the main text and should not exaggerate the main conclusions. Please add in this section. The aim of the study was to investigate the fracture behaviour of four different groups of zirconia abutments with internal and external connections: (A) Astra Tech ZirDesign™ abutment on Astra Tech Implants, (B) Procera® Esthetic abutment on Nobel Biocare MK III Groovy Implants, (C) IPS e.max® on Straumann Implants, and (D) ZiReal® Posts on Biomet 3I implants. The load was applied on the assemblies using a Zwick universal testing machine: the initial and final failure loads and amplitude were recorded using acoustic emission technique. Mean initial and final failure force was found to be significantly different in each group (P < 0.001). IPS e.max® Straumann abutments exhibited the highest resistance to final fracture force compared to other abutment types. Acoustic emission can be used as one of the methods to detect fracture behaviour of implant abutments. There were no significant differences in fracture loads between the internal and externally connected zirconia abutments studied. However, externally connected abutments demonstrated screw loosening and some deformations.

Knowledge of managing avulsed tooth among general dental practitioners in Malaysia.

BACKGROUND: Dental and maxillofacial injuries are one of the areas of concern highlighted in the Malaysian National Oral Health Plan 2011-2020. General dental practitioners (GDPs) have the responsibility of diagnosing and assessing dental trauma and determining the prognosis and outcomes of trauma along with its management. The purpose of this study was to evaluate the knowledge base and preferred methods of general dental practitioners regarding the management of avulsed tooth. METHODS: A random convenient sampling methodology was employed for sample selection. A pre-tested 11-item questionnaire was validated on the dental officers. The survey was distributed to 182 GDPs attending the annual Malaysian Dental Association conference in January 2010. The data obtained was statistically analyzed using descriptive analysis and logistic regression was employed to predict the probability of achieving high scores. RESULTS: A total of 182 general dental practitioners participated in the study, with the majority being female (n=153, 75%). The place of practice significantly affected the knowledge score. In the group that scored more than 80 points (n=84, 46%), 76% of them worked with government hospitals. Age, work duration and number of traumatised teeth previously treated had no significant effect. The odds ratio for place of practice indicates that respondents who work in government hospitals are 3.6 times more likely to score more than 80 points compared to those who worked in private clinics (OR=3.615, P=0.001). CONCLUSION: The knowledge level on the management of avulsed tooth among general dental practitioners in Malaysia needs to be improved. Strategies in improvement of the Malaysian dental educational system, continuous dental educational activities and utilisation of guidelines on trauma management should be recommended to increase the knowledge level of avulsed tooth management to ensure good treatment outcomes. CLINICAL IMPLICATION: Trauma prevention and further education regarding the management of avulsed tooth is an essential requirement to improve general dental practitioners knowledge and clinical skills.