Special Issue "Advances in Dental Materials: A Look inside Digital Workflows"

A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Dentistry".

Deadline for manuscript submissions: 10 July 2021.

Special Issue Editor

Prof. Dr. Nicola Scotti
Website
Guest Editor
Department of Surgical Sciences, Dental School Lingotto, University of Turin, Italy
Interests: adhesive dentistry; CASD-CAM materials; luting techniques; interface degradation; fatigue cycling; endodontically treated teeth

Special Issue Information

Dear Colleagues,

In recent years, we have witnessed an increasingly rapid and decisive affirmation of digital dentistry, which has seen an increase in its quality levels and, consequently, in its fields of application. On the basis of this evolution, there is a constant development of materials related to digital dentistry, which are giving dentistry other ways of seeing and thinking about treatments.

This Special Issue will focus on dental materials and techniques that revolve around digital workflows. What are the latest developments in CAD-CAM hybrid materials? Do we have reliable protocols for the cementation of the latest generation of zirconia? Which adhesive approaches allow us to reliably lute CAD-CAM materials? What stage have we reached on surgical guides and implant-prosthetic rehabilitations? What do we know about fiber-reinforced resinous materials or the reliability and precision of 3D printing in oral rehabilitations? Can intraoral scanner completely substitute “analogical” impressions?

Many questions require updated answers in this field: scientific research often finds itself chasing digital progress due to the rapid evolution of everything that revolves around the fascinating and risky digital dentistry.

Prof. Dr. Nicola Scotti
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Applied Sciences is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • digital dentistry
  • CAD-CAM
  • luting
  • implant-supported prosthodontics
  • intraoral scanner
  • 3D printing
  • fiber-supported resins
  • adhesive system

Published Papers (11 papers)

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Research

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Open AccessArticle
Effects of Veneering Ceramic and Methods on Failure Load of Veneered Zirconia
Appl. Sci. 2021, 11(5), 2129; https://doi.org/10.3390/app11052129 - 27 Feb 2021
Viewed by 290
Abstract
Background: A variety of veneering options to zirconia frameworks are now available. The purpose of this study is to evaluate the effect of veneer materials, veneering methods, cement materials, and aging on the failure load of bilayered veneer zirconia. Material and methods: Zirconia [...] Read more.
Background: A variety of veneering options to zirconia frameworks are now available. The purpose of this study is to evaluate the effect of veneer materials, veneering methods, cement materials, and aging on the failure load of bilayered veneer zirconia. Material and methods: Zirconia bars (20 × 4 × 1 mm) were veneered to 2 mm total thickness (n = 10/group). Veneering method groups included: 1. Hand-layered feldsparthic porcelain (VM = Vita VM9, Vident) and fluorapatite glass–ceramic (CR = IPS e.max Ceram, IvoclarVivadent); 2. Pressed feldspathic porcelain (PM = Vita PM9, Vident) and fluorapatite glass–ceramic (ZP = IPS e.max ZirPress, IvoclarVivadent); 3. CAD-/CAM-milled feldspathic ceramic (TF = Vitablocs Triluxe Forte, Vident) and lithium-disilicate glass–ceramic (CAD = IPS e.max CAD, IvoclarVivadent). CAD/CAM veneers were either cemented with resin cements (P = Panavia21, KurarayDental), (R = RelyX Ultimate, 3M ESPE), (M = Multilink Automix, Ivoclar Vivadent) or fused with fusion glass–ceramic (C = CrystalConnect, IvoclarVivadent). A three-point bending test (15 mm span, zirconia on tension side) was performed on Instron universal testing machine (ISO 6872) recording load-to-failure (LTF) of first veneer cracks or catastrophic failure. For group VM, PM, TF-M, TF-C, CAD-M, CAD-C, ten more bars were prepared and aged with cyclic loading (100,000 cycles, 50% LTF) and thermocycling (2000 cycles) before testing. Data were analyzed by ANOVA, Tukey HSD post hoc tests, and t-test (α = 0.05). Zirconia veneered with IPS e.max CAD by fusing had significantly higher failure load compared with zirconia veneered with other veneering materials (p ≤ 0.05). For cemented veneers, the cement type had a significant effect on the failure load of the veneer zirconia specimens. Specimens cemented with Panavia 21 had a lower resistance to loading than other cements. The aging experiment revealed a significant difference in failure load between non-aged and aged bars in groups VM and PM, but not in the groups with CAD-/CAM-milled veneers. In conclusion, veneer materials, veneering methods, and cement materials have a significant effect on the failure load of bilayered veneer zirconia. CAD-/CAM-milled veneer zirconia is not susceptible to aging performed in this study. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Open AccessArticle
Assessment of Dental Arch Reproduction Quality by Using Traditional and Digital Methods
Appl. Sci. 2021, 11(3), 1263; https://doi.org/10.3390/app11031263 - 30 Jan 2021
Viewed by 255
Abstract
Background: There exists few scientific reports on the quality of digitally reproduced dental arches, even though digital devices have been used in dentistry for many years. This study assesses the accuracy of the standard dental arch model reproduction using both traditional and digital [...] Read more.
Background: There exists few scientific reports on the quality of digitally reproduced dental arches, even though digital devices have been used in dentistry for many years. This study assesses the accuracy of the standard dental arch model reproduction using both traditional and digital methods. Methods: The quality of the full upper dental arch standard model reproduction by physical models obtained through traditional and digital methods was compared: gypsum models (SGM) and models printed from data obtained using an intraoral scanner (TPM) (n = 20). All models were scanned with a reference scanner. Comparisons were made using Geomagic Control X program by measuring deviations of the models relative to the standard model and analyzing linear dimensions deviations. Results: The average error of reproduction accuracy of the standard model ranged from 0.0424 ± 0.0102 millimeters (mm) (SGM) to 0.1059 ± 0.0041 mm (TPM). In digital methods, all analyzed linear dimensions were shortened to a statistically significantly degree compared to traditional. The SGM method provided the smallest deviations to a significant degree of linear dimensions from the pattern, and TPM the largest. The intercanine dimension was reproduced with the lowest accuracy, and the intermolar the highest in each method. Conclusions: Traditional methods provided the highest reproduction trueness of the full dental arch and all analyzed linear dimensions. The intercanine dimension was reproduced with the lowest accuracy, and the intermolar the highest in each method, where digital methods shortened all analyzed linear dimensions. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Open AccessArticle
Accuracy Improvement of Intraoral Scanning and Buccal Bite Registration Using Healing Abutment as Landmarks: An In Vitro Study
Appl. Sci. 2021, 11(1), 318; https://doi.org/10.3390/app11010318 - 30 Dec 2020
Viewed by 338
Abstract
This study aimed to determine the influence of the healing abutment (HA), placed at the implant placement site, on the accuracy of intraoral scanning and buccal bite registration in quadrant maxillary and mandibular models when using three types of intraoral scanner (IOS) and [...] Read more.
This study aimed to determine the influence of the healing abutment (HA), placed at the implant placement site, on the accuracy of intraoral scanning and buccal bite registration in quadrant maxillary and mandibular models when using three types of intraoral scanner (IOS) and elucidate the distribution of arch distortion. Six experimental groups based on whether the HA was connected and the location of missing teeth were digitized using one laboratory scanner (Identica T500) and three IOSs (Trios 3, CS3600, and i500). Three-way ANOVA was used to analyze the effects of the scanner, location and number of missing teeth, and HA using Tukey investigation analyses for multiple comparisons (α = 0.05). Linear distances between hemispheres from the upper and lower arches were analyzed using the Jonckheere–Terpstra trend test to investigate the tendency of distortion from anterior to posterior tooth positions (α = 0.05). The accuracy of IOSs in groups with HAs was found significantly more accurate than groups without HAs. There was a significant trend in distortion from anterior to posterior tooth positions when using the Trios 3 and i500 IOSs. The scanning accuracy was affected by the presence of an HA, and the distortion along with the arch span may vary with the IOS utilized. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Open AccessArticle
Postoperative Quality of Life after Single-Visit Root Canal Treatment Performed with Reciprocating Shaping Systems: An Observational Study
Appl. Sci. 2021, 11(1), 273; https://doi.org/10.3390/app11010273 - 30 Dec 2020
Cited by 1 | Viewed by 356
Abstract
Postoperative pain is a frequent complication of root canal treatment. It could worse patients’ quality of life (QoL) and it may be associated to several factors, including the shaping technique. The aim of the study was to compare the impact of WaveOne Gold [...] Read more.
Postoperative pain is a frequent complication of root canal treatment. It could worse patients’ quality of life (QoL) and it may be associated to several factors, including the shaping technique. The aim of the study was to compare the impact of WaveOne Gold (WOG) and WaveOne Classic (WOC) reciprocating instrumentation on postoperative QoL after single-visit primary root canal treatment. Healthy subjects with pulp necrosis on multirooted teeth were observed. Canal shaping was performed with WaveOne Gold Primary (n = 25) or WaveOne Classic Primary (n = 29) and canal filling was completed with a carrier-based technique. Mean and maximum scores for postoperative pain were assessed through a Visual Analogue Scale (VAS) and QoL indicators were evaluated with a self-assessment questionnaire based on a Likert scale. Postoperative pain curves were similar in both groups (mean pain p = 0.43; maximum pain p = 0.27) and quality of life indicators showed no significant differences (p > 0.05). There was a more favourable trend of QoL values in the WOG group, reaching statistical significance on day six posttreatment (p = 0.021). Within the limitations of the study, reciprocating instrumentation may have an impact on patients’ QoL, but the innovative geometrical and alloy properties of the WaveOne Gold seemed to induce a faster resolution of the postoperative symptoms. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Open AccessArticle
A New Combined Protocol to Treat the Dentin Hypersensitivity Associated with Non-Carious Cervical Lesions: A Randomized Controlled Trial
Appl. Sci. 2021, 11(1), 187; https://doi.org/10.3390/app11010187 - 28 Dec 2020
Viewed by 396
Abstract
The goal of this research is to assess the desensitizing effect of a diode laser on non-carious cervical lesions (NCCLs) responsible for dentin hypersensitivity (DH) in two separate output forces implemented both independently and in sequential combination modalities. A randomized controlled trial for [...] Read more.
The goal of this research is to assess the desensitizing effect of a diode laser on non-carious cervical lesions (NCCLs) responsible for dentin hypersensitivity (DH) in two separate output forces implemented both independently and in sequential combination modalities. A randomized controlled trial for this study was applied. Sixty-nine NCCLs responsible for DH pain with severity between 6 and 9 on the VAS scale were considered. Three study groups were developed using just one lesion from three different quadrants of the oral cavity of each patient. All treatment procedures were conducted using a laser diode (810 nm, 5 W) with varying power outputs used separately or in combination. The pain by DH was evaluated at baseline, at treatment completion, and at 15 days and 3 months after each laser procedure. Data analysis was performed using a Wilcoxon test for paired samples, a one-way ANOVA test, and an unpaired t-test. The significant reduction of the mean VAS score was estimated in each study group immediately and at 15 days and 3 months after the end of treatment and compared with the baseline mean VAS score (p-value < 0.0001). The best result concerning the improvement of DH symptomatology was assessed when a combined protocol of two different output powers of the diode laser was used. The authors conclude that the diode laser (810 nm) therapy procedure combining two separate output forces (low and high power) can improve the painful symptoms of DH from NCCLs. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Open AccessArticle
Comparison between Occlusal Errors of Single Posterior Crowns Adjusted Using Patient Specific Motion or Conventional Methods
Appl. Sci. 2020, 10(24), 9140; https://doi.org/10.3390/app10249140 - 21 Dec 2020
Viewed by 447
Abstract
Recently, digital technology has been used in dentistry to enhance accuracy and to reduce operative time. Due to advances in digital technology, the integration of individual mandibular motion into the mapping of the occlusal surface is being attempted. The Patient Specific Motion (PSM) [...] Read more.
Recently, digital technology has been used in dentistry to enhance accuracy and to reduce operative time. Due to advances in digital technology, the integration of individual mandibular motion into the mapping of the occlusal surface is being attempted. The Patient Specific Motion (PSM) is one such method. However, it is not clear whether the occlusal design that is adjusted using PSM could clinically show reduced occlusal error compared to conventional methods based on static occlusion. In this clinical comparative study including fifteen patients with a single posterior zirconia crown treatment, the occlusal surface after a clinical adjustment was compared to no adjustment (NA; design based on static occlusion), PSM (adjusted using PSM), and adjustment using a semi-adjustable articulator (SA) for the assessment of occlusal error. The root mean square (RMS; μm), average deviation value (±AVG; μm), and proportion inside the tolerance (in Tol; %) were calculated using the entire, subdivided occlusal surface and the out of tolerance area. Using a one-way ANOVA, the RMS and +AVG from the out of tolerance area showed a statistical difference between PSM (202.3 ± 39.8 for RMS, 173.1 ± 31.3 for +AVG) and NA (257.0 ± 73.9 for RMS, 210.9 ± 48.6 for +AVG). For the entire and subdivided occlusal surfaces, there were no significant differences. In the color-coded map analysis, PSM demonstrated a reduced occlusal error compared to NA. In conclusion, adjustment occlusal design using PSM is a simple and effective method for reducing occlusal errors that are difficult to identify in a current computer-aided design (CAD) workflow with static occlusion. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Open AccessArticle
Upper Second Molar Distalization with Clear Aligners: A Finite Element Study
Appl. Sci. 2020, 10(21), 7739; https://doi.org/10.3390/app10217739 - 01 Nov 2020
Cited by 1 | Viewed by 1054
Abstract
Among orthodontists and scientists, in the last years, upper molar distalization has been a debated topic in the orthodontic aligner field. However, despite that few clinical studies have been published, no insights on aligners’ biomechanics regarding this movement are available. The aim of [...] Read more.
Among orthodontists and scientists, in the last years, upper molar distalization has been a debated topic in the orthodontic aligner field. However, despite that few clinical studies have been published, no insights on aligners’ biomechanics regarding this movement are available. The aim of this study was to assess, through finite element analysis, the force system resulting in the upper arch during second maxillary molar distalization with clear aligners and variable attachments settings. The average tooth distalization was found to be 0.029, with buccal flaring of the upper incisors in all attachment configurations. The mesial deformation of the aligner was registered to be 0.2 mm on average. Different pressure areas on the interface between aligners and upper molars were registered, with the mesial attachment surface to be directly involved when present. Periodontal ligament pressure was reported to range between 67 g/cm2 and 132 g/cm2. Configurations with rectangular attachments from second molar-to-canine and from first molar-to-canine present, in an in silico environment, almost equal efficiency in distalizing the upper second molar. However, attachments from the second molar to the canine are suggested to be adopted in clinical environments due to greater feasibility in everyday practice. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Open AccessArticle
Digital Intraoral Scanners and Alginate Impressions in Reproducing Full Dental Arches: A Comparative 3D Assessment
Appl. Sci. 2020, 10(21), 7637; https://doi.org/10.3390/app10217637 - 29 Oct 2020
Cited by 1 | Viewed by 383
Abstract
The purpose of this in vivo study was to compare in vivo full arch intraoral scans obtained using two intraoral scanners and conventional impression. Twenty patients were scanned using TRIOS and iTero scanners, as well as conventional impression. Dental models obtained from alginate [...] Read more.
The purpose of this in vivo study was to compare in vivo full arch intraoral scans obtained using two intraoral scanners and conventional impression. Twenty patients were scanned using TRIOS and iTero scanners, as well as conventional impression. Dental models obtained from alginate impression were scanned with a laboratory desktop scanner. Individual intraoral scan data were compared with corresponding model scans using three-dimensional (3D) surface analysis. The average surface deviations were calculated for quantitative evaluation, and these values were compared between two intraoral scanners using the paired t-test. In the 3D surface analysis, most deviations between intraoral scans and model scans presented on the posterior teeth. The average surface deviations were less than 0.10 ± 0.03 mm. The results of 3D surface analysis indicated that there was 0.10 mm of overall deviation between conventional alginate impressions and in vivo full dental arch intraoral scans. Clinicians should take this into consideration when performing intraoral scanning for full dental arches. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Review

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Open AccessReview
Digital Workflow in Maxillofacial Prosthodontics—An Update on Defect Data Acquisition, Editing and Design Using Open-Source and Commercial Available Software
Appl. Sci. 2021, 11(3), 973; https://doi.org/10.3390/app11030973 - 21 Jan 2021
Viewed by 335
Abstract
Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore [...] Read more.
Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore oral functions such as swallowing, speech and chewing, with the main goal being to improve the quality of life of the patients. The conventional procedures for maxillofacial prosthesis manufacturing involve several complex steps, are very traumatic for the patient and rely on the skills of the maxillofacial team. Computer-aided design and computer-aided manufacturing have opened a new approach to the fabrication of maxillofacial prostheses. Our review aimed to perform an update on the digital design of a maxillofacial prosthesis, emphasizing the available methods of data acquisition for the extraoral, intraoral and complex defects in the maxillofacial region and assessing the software used for data processing and part design. Methods: A search in the PubMed and Scopus databases was done using the predefined MeSH terms. Results: Partially and complete digital workflows were successfully applied for extraoral and intraoral prosthesis manufacturing. Conclusions: To date, the software and interface used to process and design maxillofacial prostheses are expensive, not typical for this purpose and accessible only to very skilled dental professionals or to computer-aided design (CAD) engineers. As the demand for a digital approach to maxillofacial rehabilitation increases, more support from the software designer or manufacturer will be necessary to create user-friendly and accessible modules similar to those used in dental laboratories. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Other

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Open AccessCase Report
Using a Preoperative Scan Digital Impression and a Digital Index to Build Immediate Interim Full-Arch Implant-Supported Prosthesis. A Case Report and Proof of Concept
Appl. Sci. 2021, 11(3), 996; https://doi.org/10.3390/app11030996 - 22 Jan 2021
Viewed by 240
Abstract
The transfer of information such esthetics and occlusion from the preoperative to the postoperative digital impression could reduce the time needed to build an immediately loaded full-arch not-guided rehabilitation and improve the quality of the immediate interim restoration. Based on the digital technology [...] Read more.
The transfer of information such esthetics and occlusion from the preoperative to the postoperative digital impression could reduce the time needed to build an immediately loaded full-arch not-guided rehabilitation and improve the quality of the immediate interim restoration. Based on the digital technology advances of the last years, the purpose of the present clinical report is to describe a novel digital workflow based on computer-aided design and computer-aided manufacturing aimed at fabricating an interim fixed full-arch restoration. The protocol entails recording preoperative information such as esthetics, the occlusal plane and the intermaxillary relationship in implant-supported complete rehabilitations before the surgical insertion of the fixtures. Then, the information is transferred to the postoperative impression using a digital index in the lower jaw and the palatal rugae in the upper jaw. Within the inherent limitations of a case report, the workflow was accurate, predictable, without errors from conventional protocols and was apparently characterized by low biological costs. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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Open AccessTechnical Note
A Novel Method for Precise Guided Hole Fabrication of Dental Implant Surgical Guide Fabricated with 3D Printing Technology
Appl. Sci. 2021, 11(1), 49; https://doi.org/10.3390/app11010049 - 23 Dec 2020
Viewed by 408
Abstract
A dental implant surgical guide fabricated by 3-dimensional (3D) printing technology is widely used in clinical practice due to its convenience and fast fabrication. However, the 3D printing technology produces an incorrect guide hole due to the shrinkage of the resin materials, and [...] Read more.
A dental implant surgical guide fabricated by 3-dimensional (3D) printing technology is widely used in clinical practice due to its convenience and fast fabrication. However, the 3D printing technology produces an incorrect guide hole due to the shrinkage of the resin materials, and in order to solve this, the guide hole is adjusted using a trimmer or a metal sleeve is attached to the guide hole. These methods can lead to another inaccuracy. The present method reports a technique to compensate for a decreased guide hole caused by shrinkage that can occur when a computer-guided implant surgical guide is fabricated with a 3D printer. The present report describes a technique to adjust the size of the guide hole using a free software program to identify the optimized guide hole size that is fabricated with the 3D printer. Full article
(This article belongs to the Special Issue Advances in Dental Materials: A Look inside Digital Workflows)
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