Dentistry Journal

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11 pages, 728 KB

Open AccessArticle

Consistency of Intraoral-Scanner-Derived Occlusal Contact Distance Maps Between Centric Relation and Maximal Intercuspation

by Dubravka Knezović Zlatarić and Maja Žagar

Dent. J. 2026, 14(4), 199; https://doi.org/10.3390/dj14040199 - 1 Apr 2026

Viewed by 384

Abstract

Background/Objectives: Intraoral scanners (IOSs) are increasingly used for digital occlusal evaluation; however, the interpretation of IOS-derived occlusal contact distance visualizations remains influenced by registration and alignment factors. This study aimed to compare occlusal contact distance distributions obtained with an intraoral scanner between maximal [...] Read more.

Background/Objectives: Intraoral scanners (IOSs) are increasingly used for digital occlusal evaluation; however, the interpretation of IOS-derived occlusal contact distance visualizations remains influenced by registration and alignment factors. This study aimed to compare occlusal contact distance distributions obtained with an intraoral scanner between maximal intercuspation (MIP) and centric relation (CR) under controlled scanning conditions. Methods: Fifteen participants underwent standardized digital bite registration in both mandibular positions. Only scans exhibiting interocclusal overlap ≤ 0.1 mm were included. Occlusal contact distance maps were exported, standardized, and quantified using an open-source image segmentation workflow to calculate the relative area of distance-based contact categories. Paired statistical analyses were performed to compare CR and MIP distributions. Results: No statistically significant differences were observed in the distribution of occlusal contact distance categories between centric relation and maximal intercuspation (p > 0.05). The proportion of very close contact distances remained low in both positions (approximately 6–9%), while moderately close and distant contact distances predominated across all scans, indicating comparable distance-based occlusal visualization patterns under controlled acquisition conditions. Conclusions: Under controlled scanning conditions, IOS-derived occlusal contact distance maps exhibited comparable distribution patterns between centric relation and maximal intercuspation. These findings support the use of intraoral scanning for comparative evaluation of occlusal contact distance distributions, while highlighting the importance of interpreting IOS-derived visualizations within their methodological and technical limitations. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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15 pages, 1927 KB

Open AccessArticle

Reliability of Automated Cephalometric Analysis: A Comparative Assessment of Stratification Strategies Based on Chronological Age Versus Dentition Stage

by Anh Thi Ngoc Do, Hung Trong Hoang, Hieu Ngoc Le and Thuy-Trang Thi Ho

Dent. J. 2026, 14(3), 167; https://doi.org/10.3390/dj14030167 - 12 Mar 2026

Viewed by 440

Abstract

Objectives: This study evaluated the accuracy of an artificial intelligence (AI)-based cephalometric software (WebCeph version 2.0.0.) compared with manual tracing and determined whether stratifying patients by chronological age or dentition stage provides a more clinically relevant assessment of AI accuracy. Methods: [...] Read more.

Objectives: This study evaluated the accuracy of an artificial intelligence (AI)-based cephalometric software (WebCeph version 2.0.0.) compared with manual tracing and determined whether stratifying patients by chronological age or dentition stage provides a more clinically relevant assessment of AI accuracy. Methods: Three hundred lateral cephalometric radiographs of Vietnamese patients were traced manually by an orthodontist (reference standard) and analyzed automatically by WebCeph. Intra-observer reliability was validated using ICC and Dahlberg’s error. We analyzed the data using three stratification strategies: (1) Overall; (2) Chronological age (<18, 18–25, >25 years); and (3) Dentition stage (<9 primary-early mixed, 9–12 late mixed, >12 permanent). The primary outcome was the absolute measurement difference (∣Δ∣), analyzed using the Kruskal–Wallis test and effect size (

η^{2}

). Results: Overall, WebCeph showed high concordance with manual tracing (ICC > 0.80 for most parameters). Chronological age stratification showed weak associations with measurement error; differences between groups were largely non-significant (

p > 0.05

) with a small effect size (

η^{2} \approx 0.015

). In contrast, the dentition stage revealed significant performance disparities (

p < 0.05

). Notably, accuracy for the Mandibular Arc (ICC = 0.349) and Mandibular Plane Angle (

p = 0.048

) degraded significantly in the primary-early mixed group, a vulnerability obscured by chronological age-based stratification. Conclusions: Dentition stage is a more sensitive and biologically relevant predictor of AI accuracy than chronological age. While WebCeph is reliable for permanent dentition, accuracy degrades significantly in the primary-early mixed phase. Clinicians should prioritize manual verification of mandibular and incisor landmarks in mixed-dentition children. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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16 pages, 1745 KB

Open AccessArticle

Evaluation of Four 3D Facial Scanning Technologies: From Photogrammetry to Structured-Light Systems in Clinical Dentistry

by Oana Elena Burlacu Vatamanu, Corina Marilena Cristache, Sergiu Drafta and Vanda Roxana Nimigean

Dent. J. 2026, 14(2), 113; https://doi.org/10.3390/dj14020113 - 14 Feb 2026

Cited by 1 | Viewed by 656

Abstract

Background/Objectives: Accurate three-dimensional (3D) facial scanning is increasingly important in digital dentistry for diagnosis, treatment planning, and virtual patient creation. Multiple facial scanning technologies are available; however, their metric reliability varies depending on acquisition principles and anatomical orientation. This study aimed to evaluate [...] Read more.

Background/Objectives: Accurate three-dimensional (3D) facial scanning is increasingly important in digital dentistry for diagnosis, treatment planning, and virtual patient creation. Multiple facial scanning technologies are available; however, their metric reliability varies depending on acquisition principles and anatomical orientation. This study aimed to evaluate the trueness, orientation-dependent performance (vertical midline versus horizontal facial measurements), and scanning time of four facial scanning technologies using calibrated manual anthropometry as the reference standard. Methods: Thirty dentate adult participants received adhesive fiducial markers on five predefined facial landmarks. Four linear facial distances were measured clinically using a digital caliper and compared with corresponding measurements obtained from standardized 3D facial scans. Digital measurements were extracted following uniform metric normalization. Inter-examiner reliability, measurement trueness, orientation-related differences, and scanning time were analyzed. Results: Inter-examiner reliability was excellent for both clinical and digital measurements (ICC > 0.93). All facial scanning technologies significantly overestimated manual distances (p < 0.001). The structured-light scanning system showed the smallest deviations (typically <1 mm) and the highest overall accuracy, followed by the depth-fusion system, while photogrammetry-based and NeRF-based approaches demonstrated larger errors, frequently exceeding 2–3 mm. Horizontal facial distances consistently showed greater deviations than vertical midline measurements across all systems. Scanning time differed significantly between technologies, with passive image-based approaches being the fastest and NeRF-based acquisition requiring the longest capture time. Conclusions: Active structured-light facial scanning demonstrated the highest trueness for linear facial anthropometry, whereas passive photogrammetry and NeRF-based approaches showed lower metric trueness and are currently more suitable for educational applications. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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14 pages, 1270 KB

Open AccessArticle

Accuracy of a Novel Desktop Micro-CT Scanner for Direct Digitization of Dental Impressions: A Comparative In Vitro Study

by Jiaying Gu, Liqing Zhu, Wenyue Yang, Yuan Zhang, Fan He, Yunwen Xu, Xiaoyu Gu, James Kit Hon Tsoi and Yuanfei Fu

Dent. J. 2026, 14(1), 16; https://doi.org/10.3390/dj14010016 - 1 Jan 2026

Viewed by 659

Abstract

Background/Objectives: This study aimed to evaluate the clinical feasibility of a novel desktop micro-computed tomography (micro-CT) scanner for digital impressions through comprehensively assessing its dimensional trueness and morphological accuracy in comparison with other optical-based scanners. Methods: A modified reference model was used [...] Read more.

Background/Objectives: This study aimed to evaluate the clinical feasibility of a novel desktop micro-computed tomography (micro-CT) scanner for digital impressions through comprehensively assessing its dimensional trueness and morphological accuracy in comparison with other optical-based scanners. Methods: A modified reference model was used to create ten silicone impressions and corresponding plaster models. Four digitization protocols were evaluated: (1) direct scanning of impressions via micro-CT scanner (MCTI), (2) extraoral scanning of impressions via F8 scanner (F8I), (3) extraoral scanning of plaster models via F8 scanner (F8PM), and (4) intraoral scanning of plaster models using Trios 5 scanner (IOSPM). Dimensional trueness was quantified via six linear measurements, and morphological accuracy (trueness and precision) was assessed by 3D surface deviation analysis. Results: Statistically significant differences in linear measurements between the digital impressions and the reference model were observed (p < 0.05). MCTI, F8PM and IOSPM demonstrated higher dimensional trueness than F8I. Although all methods showed high morphological precision, F8I (398.5 ± 43.0 µm) exhibited significantly greater root mean square (RMS) deviations for morphological trueness than MCTI (114.8 ± 42.2 µm), F8PM (142.1 ± 27.7 µm) and IOSPM (134.6 ± 12.0 µm) (p < 0.01). MCTI also demonstrated the highest reliability for morphological trueness according to relative standard deviation (RSD) analysis, with RSD values of 30.83% for MCTI, 41.80% for F8I, 37.26% for F8PM, and 42.55% for IOSPM. Conclusions: The novel micro-CT scanner enables accurate and reliable direct digitization of dental impressions. Its performance is comparable to scanning plaster models with high-end scanners and significantly superior to direct optical scanning of impressions, making it a promising alternative in digital dental workflow. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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8 pages, 1287 KB

Open AccessArticle

Accuracy of Surgical Guides in Guided Apical Surgery: An In Vitro Comparative Study

by Nancy Soraya Romero Mora, Maria Soledad Peñaherrera Manosalvas and Henry Paul Valverde Haro

Dent. J. 2025, 13(12), 561; https://doi.org/10.3390/dj13120561 - 1 Dec 2025

Cited by 1 | Viewed by 1069

Abstract

Background/Objectives: Guided endodontic microsurgery is a novel approach designed to improve safety and precision compared with conventional freehand techniques. The present study aimed to evaluate the accuracy, stability, and operative time of trephinations performed using stereolithographic surgical guides designed with Blue Sky Plan [...] Read more.

Background/Objectives: Guided endodontic microsurgery is a novel approach designed to improve safety and precision compared with conventional freehand techniques. The present study aimed to evaluate the accuracy, stability, and operative time of trephinations performed using stereolithographic surgical guides designed with Blue Sky Plan and Exoplan software compared with the conventional technique. Methods: A comparative in vitro study was conducted on 72 roots from 12 stereolithographic mandibles. Cone-beam computed tomography (CBCT) and intraoral scans were superimposed to design 16 surgical guides with verification windows and metallic sleeves. Trephinations were performed using a control freehand group, Blue Sky Plan, and Exoplan. Stability, accuracy, and operative time were assessed. Statistical analysis included ANOVA, Kruskal–Wallis, and chi-square tests. Results: Exoplan demonstrated superior accuracy (0.17 mm deviation), stability (12.5% failures vs. 50% in Blue Sky Plan), and shortest operative time (106 s vs. 127 s and 155 s). Differences were statistically significant (p < 0.05). Operative accuracy was independent of surgical duration. Conclusions: Exoplan outperformed Blue Sky Plan and freehand trephinations in stability, accuracy, and efficiency. These findings highlight the potential of digital guides for safer and more predictable endodontic microsurgery. Further clinical validation is required. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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10 pages, 2036 KB

Open AccessArticle

An Updated Digital Approach to Regional Anesthesia: A Pilot Study on Computer-Guided Maxillary Nerve Block via the Greater Palatine Canal

by Ioannis Fotopoulos, Anastasia Fardi, Vasileios Zisis, Athanasios Poulopoulos, Nikolaos Dabarakis and Theodoros Lillis

Dent. J. 2025, 13(11), 521; https://doi.org/10.3390/dj13110521 - 6 Nov 2025

Cited by 1 | Viewed by 1728

Abstract

Objectives: Maxillary nerve block via the greater palatine canal (GPC) offers the potential for profound regional anesthesia of the maxilla but remains underutilized due to anatomical variability and technical complexity. The aim of this study was to explore the clinical feasibility, accuracy, and [...] Read more.

Objectives: Maxillary nerve block via the greater palatine canal (GPC) offers the potential for profound regional anesthesia of the maxilla but remains underutilized due to anatomical variability and technical complexity. The aim of this study was to explore the clinical feasibility, accuracy, and anesthetic effectiveness of a computer-guided approach by using CBCT-based surgical guides to access the pterygopalatine fossa via the GPC. Methods: Thirty-one patients underwent the procedure with patient-specific guides designed from cone-beam computerized tomography (CBCT) and intraoral scans. A 27G needle was directed through the guide to deliver 1.8 mL of 2% lidocaine with epinephrine 1:80.000. Pulpal anesthesia was assessed via electric pulp testing (EPT), and soft tissue anesthesia via pressure algometry at predefined oral and facial sites. Success was defined as absence of EPT response at maximum output and pressure pain threshold ≥ 700 g. To assess variations in anesthetic efficacy among multiple related groups, Cochran’s Q test and McNemar’s test were employed. Results: Successful needle placement was achieved in 30 out of 31 patients (96.7%) using the computer-guided approach, with a mean of 1.45 insertion attempts per case. Complete palatal soft tissue anesthesia was achieved in all subjects across the tested sites (100%). Pulpal anesthesia was most effective in posterior teeth, with success rates of 96.7% for first molars and 93.3% for first premolars, while the central incisor showed a reduced success rate of 50%. Transient visual disturbances occurred in three patients (10%), with no other adverse effects reported. Conclusions: These findings support the use of computer-guided GPC block as a method for achieving maxillary nerve anesthesia. Although anesthetic spread to anterior and buccal regions was limited, the technique demonstrated consistent effectiveness in the posterior maxilla, highlighting its potential utility in complex dental and surgical interventions requiring deep and long-lasting regional anesthesia. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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15 pages, 3613 KB

Open AccessArticle

A Digital Workflow for Virtual Articulator Mounting Using Face Scan and Facebow Capture: A Proof-of-Concept

by Giuseppe D’Albis, Marta Forte, Laura Stef, Diana Ramona Feier, Victor Diaz-Flores García, Massimo Corsalini and Saverio Capodiferro

Dent. J. 2025, 13(8), 378; https://doi.org/10.3390/dj13080378 - 20 Aug 2025

Cited by 6 | Viewed by 3398

Abstract

Objectives: This article introduces a digital technique for virtual articulator mounting by employing the scan of a facebow worn by the patient as a virtual reference. Methods: The digital technique enables the transfer of the maxillary arch orientation relative to the cranial base [...] Read more.

Objectives: This article introduces a digital technique for virtual articulator mounting by employing the scan of a facebow worn by the patient as a virtual reference. Methods: The digital technique enables the transfer of the maxillary arch orientation relative to the cranial base into a CAD-CAM environment (Ceramill Mind; AmannGirrbach), without the need for ionizing radiation or identification of facial landmarks. By digitally aligning the intraoral scans of the dental arches (Trios 4; 3Shape) with a 3D facial scan and the scanned facebow in position (Artex; AmannGirrbach), clinicians can reproduce the cranium-to-maxilla spatial relationship accurately and intuitively. Results: This radiation-free protocol provides virtual cross-mounting and allows for the use of a semi-adjustable articulator within common CAD-CAM software. Conclusions: Given that intraoral scanners, facial scanners, and design software with articulator simulation are becoming more available in modern clinical workflows, this method introduced here could be a viable radiation-free and easy-to-use alternative. However, larger cohorts and standardized testing protocols are needed to determine its clinical reproducibility and reliability. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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17 pages, 3114 KB

Open AccessArticle

Spontaneous Growth Induced by a Biologically Oriented V Class Restoration (BOVR) Technique: A 3D Prospective Study

by Davide Farronato, Giuseppe Messina, Luciano Laveglia, Pietro Mario Pasini, Lorenzo Azzi and Marco Farronato

Dent. J. 2025, 13(7), 296; https://doi.org/10.3390/dj13070296 - 30 Jun 2025

Cited by 1 | Viewed by 1626

Abstract

Background: The behavior of soft tissues following recession type 1 (RT1) and/or non-carious cervical lesions (NCCLs) treated with class V restorations is not well understood. These conditions cause both functional and esthetic issues. Recent studies show that increased cervical thickness can influence gingival [...] Read more.

Background: The behavior of soft tissues following recession type 1 (RT1) and/or non-carious cervical lesions (NCCLs) treated with class V restorations is not well understood. These conditions cause both functional and esthetic issues. Recent studies show that increased cervical thickness can influence gingival tissue response. This suggests that restoration design has a key impact. This study aims to evaluate the effect of tooth shape modification on gingival tissue response and periodontal health with 3D analysis. Methods: Seven patients with buccal gingival recession and NCCL were selected, resulting in 50 treated teeth. Patients underwent class V buccal restorations using the BOVR technique. Three-dimensional evaluation through scanned dental impressions was performed at baseline and at T1 to monitor tissue profile changes in the buccal zenith sagittal plane. The average observation period was 4 months. Following the assessment, linear measurements were calculated according to standard planes. These measurements aimed to monitor transverse and axial tissue modifications. Probing depth, plaque index, and bleeding index were also recorded. Results: Increased tooth thickness led to tissue alteration. Greater composite thickness was significantly associated with an increase in tissue thickness (p ≤ 0.001) and gingival creeping (p ≤ 0.001) at the free gingival margin. Periodontal health remained unaffected, and 50% of the teeth required no additional surgical treatment due to satisfactory outcomes. Conclusions: Class V restorations that increase cervical thickness may promote soft tissue volume gain over a 4-month period without compromising periodontal health. A 4-month observation period is recommended before considering the surgical correction. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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11 pages, 1279 KB

Open AccessArticle

Evaluation of Color Stability and Marginal Integrity in Provisional Restorations: A Study of Milling, 3D Printing, and Conventional Fabrication Methods

by Austin Galbraith, Mai Doan, Tyson Galbraith and Neamat Hassan Abubakr

Dent. J. 2025, 13(5), 189; https://doi.org/10.3390/dj13050189 - 25 Apr 2025

Cited by 9 | Viewed by 3536

Abstract

Background: The quality of a provisional restoration, especially its color and marginal integrity, can play a critical role in its survival and overall patient satisfaction. This study aims to evaluate the color stability and marginal fit differences between provisional restorations fabricated by non-traditional [...] Read more.

Background: The quality of a provisional restoration, especially its color and marginal integrity, can play a critical role in its survival and overall patient satisfaction. This study aims to evaluate the color stability and marginal fit differences between provisional restorations fabricated by non-traditional methods compared to manual fabrication. Methods: A total of 80 extracted teeth were prepared for ceramic crowns and randomly divided into four groups: acrylic, 3D printing, computer-aided design/computer-aided manufacturing (CAD/CAM), and bis-acryl. The examined teeth were subjected to artificial aging using a thermocycling machine dwelling for 5000 cycles (simulating 6 clinical months). Color stability and marginal integrity were measured before and after thermal aging using a VITA Easyshade V spectrophotometer and 3D surface non-contact profilometer. ANOVA was used to determine whether the mean value difference was significantly different. Results: The 3D-printed and bis-acryl provisional crowns displayed the lowest change in marginal integrity, while the acrylic provisional crowns showed the greatest change in marginal integrity (p = 0.0001). Additionally, the acrylic provisional material revealed a significantly greater color change. Conclusions: The 3D-printed provisional crowns demonstrated the best marginal integrity and color stability. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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13 pages, 7576 KB

Open AccessArticle

Five Numerical Methods to Assess the Ischemic Risks in Dental Pulp and Neuro-Vascular Bundle Under Orthodontic Movements in Intact Periodontium In Vitro

by Radu-Andrei Moga, Cristian Doru Olteanu and Ada Gabriela Delean

Dent. J. 2025, 13(1), 15; https://doi.org/10.3390/dj13010015 - 27 Dec 2024

Cited by 1 | Viewed by 1331

Abstract

Background/Objectives: Dental pulp and its neuro-vascular bundle (NVB) are among the least studied dental tissues. This study identified the best method for evaluating ischemic risks in the dental pulp and NVB of healthy lower premolars under orthodontic forces and in intact periodontium. [...] Read more.

Background/Objectives: Dental pulp and its neuro-vascular bundle (NVB) are among the least studied dental tissues. This study identified the best method for evaluating ischemic risks in the dental pulp and NVB of healthy lower premolars under orthodontic forces and in intact periodontium. Methods: Nine 3D models of the second lower premolar were reconstructed based on the CBCT scans from nine patients. Nine patients (CBCT scan) were subjected to 3 N of intrusion, extrusion, rotation, tipping, and translation. Five numerical methods, Tresca, von Mises (VM), Maximum and Minimum Principal, and hydrostatic pressure were used to biomechanically assess (totaling 225 simulations) the color-coded stress distribution in pulp and NVB. The results (both qualitative and quantitative) were correlated with the physiological maximum hydrostatic pressure (MHP) and known tissular biomechanical behavior. Results: All five methods displayed quantitative amounts of stress lower than MHP and did not seem to induce any ischemic risks for the NVB and pulp of healthy intact premolars. Among the five movements, rotation seemed the most stressful, while translation was the least stressful. The NVB displayed higher amounts of stress and tissular deformations than the pulp, seeming to be more exposed to ischemic risks. Higher tissular deformations are visible in NVB during intrusion and extrusion, while pulpal coronal stress is visible only during translation. Only the VM and Tresca methods showed a constant stress display pattern for all five movements. The other three methods displayed various inconsistencies related to the stress distribution pattern. Conclusions: Only the Tresca and VM methods can provide correct qualitative and quantitative data for the analysis of dental pulp and NVB. The other three methods are not suitable for the study of the pulp and NVB. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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10 pages, 3175 KB

Open AccessArticle

Effects of Different Crystallization Protocols on Marginal Gap of Lithium Disilicate Single Crowns: SEM Analysis

by Alon Shadur, Joseph Nissan, Diva Lugassy, Ariana Umansky, Eran Zenziper and Gil Ben-Izhack

Dent. J. 2024, 12(12), 416; https://doi.org/10.3390/dj12120416 - 18 Dec 2024

Cited by 3 | Viewed by 2044

Abstract

Objective: In everyday dentistry, lithium disilicate is a valid option for single-fix partial dentures, and this material crystallization process is available with two protocols: long and short. This study’s aim was to assess the effects of these two different crystallization protocols, long and [...] Read more.

Objective: In everyday dentistry, lithium disilicate is a valid option for single-fix partial dentures, and this material crystallization process is available with two protocols: long and short. This study’s aim was to assess the effects of these two different crystallization protocols, long and short, on the marginal gap of lithium disilicate single crowns. Methods: A total of 24 abutment plastic teeth were scanned using an intra-oral scanner. For each plastic tooth, an identical pair of lithium disilicate crowns was milled (a total of 48 crowns) by a four-axis machine. Each paired sample was categorized into two groups: long crystallization (24 crowns) and short crystallization (24 crowns). To assess precision, each unit’s marginal gap (including abutments and crowns) was meticulously measured at four specified regions using a scanning electron microscope. A Kolmogorov–Smirnov test performed on the study variables indicated a normal distribution (p > 0.05), and it was followed by independent t-tests (α = 0.05). Results: For the long crystallization group, the mean total marginal gap values were 42.91 ± 9.67 μm, and for the short crystallization group, the values were 43.25 ± 8.14 μm, with no significant difference between the groups (p = 0.894). In addition, no significant differences were found between the groups regarding the mean marginal gap measurements for all four surfaces (distal (p = 0.310), mesial (p = 0.732), palatal (p = 0.655), and buccal (p = 0.535)). Conclusions: Both the long and short crystallization methods used for lithium disilicate single crowns demonstrated marginal gap values of less than 120 μm, which are within the clinically acceptable range, with no significant differences across any parameters between the two groups. Regarding the marginal gap value, it is recommended to use the short crystallization protocol as it is more time-efficient. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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17 pages, 2636 KB

Open AccessArticle

Bilateral Symmetry in the Aesthetic Area Achieved by Digital Smile Design on 3D Virtual Patient and Conventional Diagnostic Wax-Up—A Comparative Study

by Maria Hristozova, Mariya Dimitrova and Stefan Zlatev

Dent. J. 2024, 12(12), 373; https://doi.org/10.3390/dj12120373 - 21 Nov 2024

Cited by 5 | Viewed by 2887

Abstract

Background: Digital diagnostic waxing is a contemporary alternative to the conventional wax-up method. This study aims to evaluate the impact of both techniques on the perceived frontal symmetry in aesthetic treatment planning. Dental symmetry significantly influences smile perception and, consequently, the acceptance [...] Read more.

Background: Digital diagnostic waxing is a contemporary alternative to the conventional wax-up method. This study aims to evaluate the impact of both techniques on the perceived frontal symmetry in aesthetic treatment planning. Dental symmetry significantly influences smile perception and, consequently, the acceptance of treatment outcomes, highlighting its clinical importance in restorative dentistry. Materials and Methods: A total of 100 teeth were measured, with 50 (n = 50) waxed up using traditional modeling techniques and 50 using a face-guided digital approach. The study involved ten patients requiring fixed restorations in the aesthetic zone. Both digital and conventional wax-ups were performed for each participant. Gypsum models with wax-ups were digitized and superimposed onto the digital diagnostic design using 3Shape Dental Designer Studio software, Version 2023 (3Shape, Copenhagen, Denmark). Screenshots of the frontal view were captured, and the width of each morphologically altered tooth was measured using ImageJ software Version 1.54 (National Institutes of Health, Bethesda, MD, USA). Results: The results indicated no statistically significant difference in symmetry between the right and left sides achieved by the two diagnostic approaches (t-value = −1.89, p-value = 0.07). The perceived symmetry of morphologically modified frontal teeth, as achieved by digital and conventional waxing, was found to be comparable. Conclusions: Digital diagnostic planning is validated as a reliable alternative to the conventional wax-up method, offering comparable accuracy in achieving dental symmetry while potentially enhancing efficiency and precision in the aesthetic treatment planning process. This result underscores the potential of digital technologies to streamline clinical workflows and improve patient outcomes. Clinically, achieving symmetry in the aesthetic zone is crucial for patient satisfaction and acceptance of restorative procedures, emphasizing the need for continued integration of digital tools in dental practice. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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16 pages, 3011 KB

Open AccessArticle

An In Vivo Comparison of Trueness and Precision of Two Novel Methods for Improving Edentulous Full Arch Implant Scanning Accuracy: A Pilot Study

by Adam Brian Nulty

Dent. J. 2024, 12(11), 367; https://doi.org/10.3390/dj12110367 - 18 Nov 2024

Cited by 19 | Viewed by 7223

Abstract

Background: This retrospective in vivo study evaluated the trueness and precision of two digital intraoral scanners—Dentsply Sirona Primescan and Medit i900—, both with and without two variants of the novel Scan Ladder aids, and compared their performance to a new intraoral photogrammetry scanner [...] Read more.

Background: This retrospective in vivo study evaluated the trueness and precision of two digital intraoral scanners—Dentsply Sirona Primescan and Medit i900—, both with and without two variants of the novel Scan Ladder aids, and compared their performance to a new intraoral photogrammetry scanner (Shining 3D Elite). Methods: Data from ten edentulous patients, previously collected during routine clinical treatment, were analyzed using a master STL generated from traditional impression casts as the reference. A custom positional change calculator and comprehensive statistical analysis were used to assess scanner accuracy. Results: The findings demonstrated that the use of the Scan Ladder significantly enhanced the overall accuracy of both intraoral scanners, showing no statistically significant differences when compared to the intraoral photogrammetry system. Conclusions: These results indicate that the Scan Ladder improves the performance of conventional intraoral scanners and suggests that the Shining 3D Elite intraoral photogrammetry scanner is a reliable alternative to extraoral photogrammetry for edentulous cases. Further research, with a larger and more diverse cohort, is warranted to validate and expand upon these findings. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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18 pages, 2199 KB

Open AccessFeature PaperArticle

Efficacy of Virtual Preparation Simulators Compared to Traditional Preparations on Phantom Heads

by Lea Stoilov, Fabian Stephan, Helmut Stark, Norbert Enkling, Dominik Kraus and Milan Stoilov

Dent. J. 2024, 12(8), 259; https://doi.org/10.3390/dj12080259 - 14 Aug 2024

Cited by 5 | Viewed by 4565

Abstract

Background: Virtual simulators are increasingly being introduced in dental education. This study investigates whether virtual simulators offer comparable or superior educational efficacy when compared to traditional phantom simulators. Materials and Methods: Participants were randomly allocated into groups: Virtual Preparation (SIM; n = 30) [...] Read more.

Background: Virtual simulators are increasingly being introduced in dental education. This study investigates whether virtual simulators offer comparable or superior educational efficacy when compared to traditional phantom simulators. Materials and Methods: Participants were randomly allocated into groups: Virtual Preparation (SIM; n = 30) and Traditional Preparation (FRA; n = 30). Students were tasked with preparing tooth 36 for a full-cast crown during free practice for four days. Faculty staff provided feedback to both groups. Examinations were administered and graded by three examiners (preclinical and clinical consultants and a dental surgery consultant). Additionally, a survey was conducted to assess each training concept. Results: The FRA group achieved significantly better grades in the preparation exam evaluations by all three examiners, compared to the SIM group. Interrater reliability showed only moderate agreement, with the clinical examiner giving better grades than the other two. The questionnaire results indicate that while participants managed with the virtual system, they preferred the analog system for exams and patient preparation. Conclusion: Virtual simulators do not seem to be as good when it comes to practicing for a preparation exam or clinical preparation, especially for unexperienced students. However, they still appear to be useful as an additional tool for introducing students to the topic of preparation. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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22 pages, 22805 KB

Open AccessArticle

Trabecular Bone Component Assessment under Orthodontic Loads and Movements during Periodontal Breakdown—A Finite Elements Analysis

by Radu-Andrei Moga, Cristian Doru Olteanu and Ada Gabriela Delean

Dent. J. 2024, 12(6), 190; https://doi.org/10.3390/dj12060190 - 20 Jun 2024

Cited by 2 | Viewed by 1841

Abstract

This numerical analysis, by employing Tresca and Von Mises failure criteria, assessed the biomechanical behavior of a trabecular bone component subjected to 0.6, 1.2, and 2.4 N orthodontic forces under five movements (intrusion, extrusion, tipping, rotation, and translation) and during a gradual horizontal [...] Read more.

This numerical analysis, by employing Tresca and Von Mises failure criteria, assessed the biomechanical behavior of a trabecular bone component subjected to 0.6, 1.2, and 2.4 N orthodontic forces under five movements (intrusion, extrusion, tipping, rotation, and translation) and during a gradual horizontal periodontal breakdown (0–8 mm). Additionally, they assessed the changes produced by bone loss, and the ischemic and resorptive risks. The analysis employed eighty-one models of nine patients in 405 simulations. Both failure criteria showed similar qualitative results, with Tresca being quantitatively higher by 1.09–1.21. No qualitative differences were seen between the three orthodontic loads. Quantitatively, a doubling (1.2 N) and quadrupling (2.4 N) were visible when compared to 0.6 N. Rotation and translation followed by tipping are the most stressful, especially for a reduced periodontium, prone to higher ischemic and resorptive risks. In an intact periodontium, 1.2 N can be safely applied but only in a reduced periodontium for extrusion and intrusion. More than 0.6 N is prone to increasing ischemic and resorptive risks for the other three movements. In an intact periodontium, stress spreads in the entire trabecular structure. In a reduced periodontium, stress concentrates (after a 4 mm loss—marker for the stress change distribution) and increases around the cervical third of the remaining alveolar socket. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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19 pages, 690 KB

Open AccessReview

Methodologies for Assessing the Dimensional Accuracy of Computer-Guided Static Implant Surgery in Clinical Settings: A Scoping Review

by Sorana Nicoleta Rosu, Monica Silvia Tatarciuc, Anca Mihaela Vitalariu, Roxana-Ionela Vasluianu, Irina Gradinaru, Nicoleta Ioanid, Catalina Cioloca Holban, Livia Bobu, Adina Oana Armencia, Alice Murariu, Elena-Odette Luca and Ana Maria Dima

Dent. J. 2026, 14(1), 43; https://doi.org/10.3390/dj14010043 - 8 Jan 2026

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Abstract

Background: Computer-guided static implant surgery (CGSIS) is widely adopted to enhance the precision of dental implant placement. However, significant heterogeneity in reported accuracy values complicates evidence-based clinical decision-making. This variance is likely attributable to a fundamental lack of standardization in the methodologies [...] Read more.

Background: Computer-guided static implant surgery (CGSIS) is widely adopted to enhance the precision of dental implant placement. However, significant heterogeneity in reported accuracy values complicates evidence-based clinical decision-making. This variance is likely attributable to a fundamental lack of standardization in the methodologies used to assess dimensional accuracy. Objective: This scoping review aimed to systematically map, synthesize, and analyze the clinical methodologies used to quantify the dimensional accuracy of CGSIS. Methods: The review was conducted in accordance with the PRISMA-ScR guidelines. A systematic search of PubMed/MEDLINE, Scopus, and Embase was performed from inception to October 2025. Clinical studies quantitatively comparing planned versus achieved implant positions in human patients were included. Data were charted on study design, guide support type, data acquisition methods, reference systems for superimposition, measurement software, and accuracy metrics. Results: The analysis of 21 included studies revealed extensive methodological heterogeneity. Key findings included the predominant use of two distinct reference systems: post-operative CBCT (n = 12) and intraoral scanning with scan bodies (n = 6). A variety of proprietary and third-party software packages (e.g., coDiagnostiX, Geomagic, Mimics) were employed for superimposition, utilizing different alignment algorithms. Critically, this heterogeneity in measurement approach directly manifests in widely varying reported values for core accuracy metrics. In addition, the definitions and reporting of core accuracy metrics—specifically global coronal deviation (range of reported means: 0.55–1.70 mm), global apical deviation (0.76–2.50 mm), and angular deviation (2.11–7.14°)—were inconsistent. For example, these metrics were also reported using different statistical summaries (e.g., means with standard deviations or medians with interquartile ranges). Conclusions: The comparability and synthesis of evidence on CGSIS accuracy are significantly limited by non-standardized measurement approaches. The reported ranges of deviation values are a direct consequence of this methodological heterogeneity, not a comparison of implant system performance. Our findings highlight an urgent need for a consensus-based minimum reporting standard for future clinical research in this field to ensure reliable and translatable evidence. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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11 pages, 3472 KB

Open AccessCase Report

The Use of a Digitally Generated Matrix for Consistent Shade Recording in Tooth Bleaching—A Case Report

by Cristian Abad-Coronel, Guissell Vallejo-Yupa, Paulina Aliaga, Nancy Mena-Córdova, Jorge Alonso Pérez-Barquero and José Amengual-Lorenzo

Dent. J. 2025, 13(8), 339; https://doi.org/10.3390/dj13080339 - 24 Jul 2025

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Abstract

Objectives: The aim of this study was to evaluate the effectiveness of spectrophotometers for objective tooth color measurement, particularly in bleaching procedures enhanced by digital positioning templates. Methods: Tooth color registration was conducted using both subjective methods with shade guides and objective methods [...] Read more.

Objectives: The aim of this study was to evaluate the effectiveness of spectrophotometers for objective tooth color measurement, particularly in bleaching procedures enhanced by digital positioning templates. Methods: Tooth color registration was conducted using both subjective methods with shade guides and objective methods with spectrophotometers. Spectrophotometers were chosen for their ability to provide objective, quantifiable, and reproducible results, crucial for monitoring color modifications accurately. Digital workflows were implemented to enhance the registration process further. These workflows included providing a precise positioning matrix for spectrophotometer sensors and optimizing working models to ensure high-quality therapeutic splints. Results: The use of spectrophotometers demonstrated superior performance in registering tooth color objectively compared to subjective shade guides. Digital workflows significantly improved the precision and efficiency of spectrophotometer measurements through a digital matrix, enhancing the quality of therapeutic splints obtained. Conclusions: Spectrophotometers are recommended for objective and precise tooth color registration, particularly in bleaching procedures. Integrating a digital positioning matrix enhances measurement accuracy and reliability, supporting effective monitoring and treatment outcomes. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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12 pages, 5900 KB

Open AccessTechnical Note

Digitally-Driven Surgical Guide for Alveoloplasty Prior to Immediate Denture Placement

by Zaid Badr, Jonah Jaworski, Sofia D’Acquisto and Manal Hamdan

Dent. J. 2025, 13(8), 333; https://doi.org/10.3390/dj13080333 - 22 Jul 2025

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Abstract

Objective: This article presents a step-by-step digital technique for fabricating a 3D-printed surgical guide to assist in alveoloplasty for immediate denture placement. Methods: The workflow integrates intraoral scanning, virtual tooth extraction, digital soft tissue modeling, and additive manufacturing to produce a customized guide [...] Read more.

Objective: This article presents a step-by-step digital technique for fabricating a 3D-printed surgical guide to assist in alveoloplasty for immediate denture placement. Methods: The workflow integrates intraoral scanning, virtual tooth extraction, digital soft tissue modeling, and additive manufacturing to produce a customized guide with an occlusal window and buccal slot, along with a verification stent. Results: This method ensures precise ridge recontouring and verification, enhancing surgical predictability and prosthetic fit. Conclusions: Unlike traditional surgical guides based on conventional casts or manual fabrication, this fully digital approach offers a practical and replicable protocol that bridges digital planning and clinical execution. By improving surgical precision, reducing operative time, and ensuring optimal denture fit, this technique represents a significant advancement in guided pre-prosthetic surgery. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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9 pages, 4649 KB

Open AccessTechnical Note

MAMA—Mandibular Advancement Magnetic Appliance: A Digital Workflow and a CAD–CAM Development of a New Mandibular Advancement Device for the Treatment of Obstructive Sleep Apnea Syndrome

by Riccardo Nucera, Enrico Nastro Siniscalchi, Giancarlo Consolo, Luigi Calabrese, Daniela Caccamo, Angela Mirea Bellocchio and Marco Portelli

Dent. J. 2025, 13(3), 104; https://doi.org/10.3390/dj13030104 - 27 Feb 2025

Cited by 1 | Viewed by 2744

Abstract

Background/Objectives: Mandibular advancing devices (MADs) are removable intraoral apparatuses to use during sleep that modify the spatial position of the mandible, increasing airway patency and improving respiratory function at night in patients with obstructive sleep apnea syndrome (OSAS). Methods: In this work, a [...] Read more.

Background/Objectives: Mandibular advancing devices (MADs) are removable intraoral apparatuses to use during sleep that modify the spatial position of the mandible, increasing airway patency and improving respiratory function at night in patients with obstructive sleep apnea syndrome (OSAS). Methods: In this work, a new mandibular advancement device useful for mild-to-moderate OSAS patients is presented. It is developed through a CAD–CAM process and involves a passive propulsion of the mandible thanks to the attraction of rare-earth magnets positioned in the thickness of two thermally molded PET-G devices. The use of a PET-G device compared to traditional resin ones offers several clinical advantages related to the innovative characteristics of this polymer, which allows the fabrication of thinner devices, with high resistance to fluid corrosion, resulting in less bulk inside the oral cavity. Results: The innovative feature of the device proposed by the authors is that mandibular propulsion induced by the attraction of the magnetic jigs is not affected by a patient’s mandibular posture during sleep. Conclusions: The original apparatus proposed by the authors determines a mesializing movement of the jaw through a different mechanism to traditional MADs and presents the great advantage of a digital and CAD–CAD workflow that can be developed directly by the clinicians in the practice. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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12 pages, 8463 KB

Open AccessCase Report

Application of CAD-CAM 3D Technology in Designing a Molar Distalization Device with Skeletal Anchorage: A Case Report

by Martina Mezio, Alessandra Putrino, Ersilia Barbato, Stefano Pandolfi and Michele Cassetta

Dent. J. 2024, 12(12), 417; https://doi.org/10.3390/dj12120417 - 18 Dec 2024

Cited by 2 | Viewed by 2258

Abstract

Objectives: Mandibular molar distalization is a complex orthodontic movement due to anatomic and biomechanical limitations. The opportunity to use a custom-made appliance with skeletal anchorage should be an advantageous alternative to traditional solutions: multiple extractions, interproximal reductions, vestibular inclination of incisal group. Methods [...] Read more.

Objectives: Mandibular molar distalization is a complex orthodontic movement due to anatomic and biomechanical limitations. The opportunity to use a custom-made appliance with skeletal anchorage should be an advantageous alternative to traditional solutions: multiple extractions, interproximal reductions, vestibular inclination of incisal group. Methods: A 14-year-old female patient with Class II malocclusion and ectopic upper and lower canines was treated in the lower arch with a custom-made appliance anchored on a mini-screw in the right buccal-shelf where the ectopy and crowding was severe. The miniscrew was connected to a rigid arm with a rail equipped with a coil that activated promoted the distalization of first and second molars bonded with metallic bands. Results: After 8 months of treatment with activations repeated every 4 weeks, an effective distalization has been reached. Conclusions: Mandibular molars’ distalization is a challenging orthodontic result to achieve. When the need to obtain space cannot be beneficially obtained with conventional approaches, and distalization of the lower molars could be desirable, a custom distalization device with skeletal anchorage and biomechanics based on a pressed coil sliding on a rigid arm is an efficient solution. Full article

(This article belongs to the Special Issue New Trends in Digital Dentistry)

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