Search Results (285)

Successful dental implant therapy relies on accurate planning and placement, e.g., through static, computer-aided implant surgery using CAD/CAM-fabricated surgical guides. This study examined production methods’ influence on surgical guide sleeve housing geometry. A model with two edentulous spaces was digitized using intraoral scanning and CBCT, and two virtually positioned implants were planned. Ten guides per group were produced using milling (MCX5), DLP printing (ASIGA and SHERA), and SLA printing (FORM), printing with 50 µm and 100 µm layers each. Each guide (n = 70) was then digitized using an industrial scanner before and after sterilization. Superimposition of the actual guide data with the reference data allowed for evaluation of deviations at the drill sleeve housing along the x-, y-, z-, and dxyz-axes. Descriptive and statistical evaluation was performed (significance level: p ≤ 0.0125). Significant differences existed among the production methods: Milling and SLA showed higher deviations than the DLP group (p < 0.001). Milled guides post-sterilization showed the highest deviations (0.352 ± 0.08 mm), while one DLP printer at 50 μm layer thickness showed lowest deviations (0.091 ± 0.04 mm). The layer thickness was insignificant, whereas sterilization increased deviation (p < 0.001). DLP produced the most precise implant surgical guides. All 3D printers were suitable for fabricating clinically acceptable surgical guides. Full article

Background: Accuracy of optical impressions—defined by the intraoral scanner (IOS)’s trueness and precision per International Organization for Standardization (ISO) standards—is influenced by both operator- and patient-related factors. Thus, this in vitro study aimed to (1) evaluate how scanning distance affects the accuracy of three different intraoral scanners (IOSs), and (2) identify the optimal scanning distance for each scanner. Methods: A maxillary arch model was obtained using polyvinyl siloxane impression material and poured with Type IV stone (Octa-rock royal^®, Kulzer, Germany). Using three different types of IOSs—the trios 3 shape (TRIOS ^® cart, 3Shape, Copenhagen, Denmark); the Helios 500 (Eighteeth ^®, Changzhou, China); and the Heron (3Disc ^®, Herndon, VA 20170, USA)—ten scans were performed with each of the IOSs with five predetermined distances: 0 mm, 2.5 mm, 5 mm, 7.5 mm, and 10 mm. Spacers of varying heights were designed using Meshmixer version 3.5 (Autodesk, Inc., Mill Valley, CA, USA) and three-dimensional printed with the Form 2 printer (Formlabs, Somerville, MA, USA). The scanned data was processed using Geomagic Control X (Version 16.0.2.16496, 3D Systems, Wilsonville, OR, USA). Statistical analyses were performed using R Statistical Software (version 4.2.2), with significance set at α = 0.05. Results: Scanning distance significantly influenced scan accuracy for all three scanners. The 3Disc scanner (3Disc, Herndon, VA, USA) demonstrated the highest accuracy at a 7.5 mm distance, while both the Helios 500 (Eighteeth, Changzhou, China) and Trios 3 (3Shape, Copenhagen, Denmark) scanners achieved their best accuracy at a 5 mm distance, as indicated by the lowest root mean square (RMS) values (p < 0.05). Conclusions: To conclude, each IOS has an optimal scanning distance for best accuracy. Trios 3 (3Shape, Copenhagen, Denmark) outperformed the others in both trueness and precision. Future studies should examine these effects under full-arch and clinical conditions. Full article

Objective: Several studies have compared the accuracy of digital scans and conventional impressions for post space capture. However, only a few have specifically investigated the precision of intraoral scanners in measuring post spaces of varied lengths. This study aimed to evaluate the accuracy of various intraoral scanning techniques in capturing long and short post spaces. Material and Methods: This study grouped samples into eight categories based on four techniques and two post space depths (7 and 11 mm). After tooth preparation, root canal treatment, and post space preparation, laboratory scans were performed using Duralay. Intraoral scans were obtained directly and indirectly with the Trios fourth generation scanner using the Duralay and PVS techniques. The accuracies, in terms of trueness, and precisions were compared after ten repetitions for each group using the Kruskal–Wallis or Mann–Whitney U tests. Results: The Duralay Intraoral Scan groups demonstrated a high consistency, while the Direct Intraoral Scan groups showed moderate consistency. Variability was higher for the Duralay Lab Scan and PVS Intraoral Scan groups for short post spaces. Conclusions: The capture technique significantly affected the accuracies of the post space measurements. The techniques also demonstrated varying consistency and precision. These findings provide critical insights to guide their selections for clinical and research applications. Clinical Significance: This study is one of the few to compare the accuracy of intraoral scanners for the capture of both short and long post spaces. It addresses a key gap in current dental research and offers practical guidance for clinicians and researchers in selecting appropriate scanning techniques for various clinical scenarios. The findings have the potential to enhance the accuracy and reliability of post space measurements and improve patient outcomes. Full article

(1) Background: This study aimed to evaluate the marginal and internal fit of ceramic crowns produced by various digital methods using microcomputed tomography (MCT) imaging. (2) Methods: The ceramic crown preparation was performed on typodont maxillary first premolar. The crown preparation was scanned with an intraoral scanner and a model scanner, and cone-beam computed tomography (CBCT) scans were performed with three different voxel sizes (0.075 mm, 0.1 mm, and 0.15 mm). The space between the crown and prepared teeth was measured at nine different points in both coronal and sagittal sections. Three different digital model acquisition techniques, namely, intraoral scanning, model scanning, and CBCT-based standard tessellation language (STL) reconstruction, were compared in terms of marginal and internal fit. (3) Results: Quantitative analyses revealed that model scanners exhibited the lowest marginal and internal gap values, indicating superior fit compared to intraoral scanners and CBCT-based models. The highest gap values were observed in the CBCT group with a voxel size of 0.15 mm. Overall, crowns obtained from model scanners demonstrated the highest success rates in both marginal and internal fit. (4) Conclusions: In conclusion, this study highlights the critical role of digital scanning accuracy in achieving clinically acceptable prosthetic fits and emphasizes the need for continued technological advancement. Full article

This in vitro study aims to compare the trueness of digital impressions obtained using two intraoral scanners (IOS) and one photogrammetry device for full-arch implant-supported rehabilitations. According to the Caramês Classification I, three models were produced with Straumann implants arranged in different spatial distributions: Option A with six implants and Options B and C with four implants each. The three models were scanned using a 12-megapixel scanner to create digital master casts. For each reference model, 30 digital impressions were acquired: 10 with the 3Shape Trios 3 intraoral scanner, 10 with the Medit i500 intraoral scanner, and 10 with the PIC Dental photogrammetry device. Trueness was assessed through best-fit superimpositions between the digital master casts and the corresponding virtual models. The Shapiro–Wilk test was applied to assess the normality of the data distribution, and Levene’s test was used to evaluate the homogeneity of variances. The non-parametric Kruskal–Wallis test was employed to compare group differences, with post hoc adjustments made using the Bonferroni correction. A significance threshold of p = 0.05 was adopted for all statistical tests. Statistically significant differences were observed in the root mean square values among the three devices. The Medit i500 demonstrated the highest trueness, with a median (interquartile range) deviation of 24.45 (18.18) µm, whereas the PIC Dental exhibited the lowest trueness, with a median deviation of 49.45 (9.17) µm. Among the implant distribution, the Option C showed the best trueness, with a median deviation of 19.00 (27.83). Considering the results of this in vitro study, intraoral scanners demonstrated comparable trueness, whereas the photogrammetry-based system exhibited lower trueness values. Additionally, a smaller number of implants and reduced inter-implant distances were associated with improved trueness in digital impressions for full-arch implant rehabilitation. Full article

Background/Objectives: The introduction of composite attachments has greatly improved orthodontic aligner therapy, through better force delivery, more predictable movements, and enhanced retention. This in vitro study aims to present and investigate an innovative digital protocol for aligner attachment fabrication incorporating the latest 3D technology used in dentistry. Methods: A virtual attachment measuring 2.5 × 2 × 2 mm was designed using computer-aided design (CAD) software (Meshmixer, Autodesk Inc., San Francisco, CA, USA) and exported as an individual STL file. The attachments were fabricated using a digital light processing (DLP) 3D printer (model: Elegoo 4 DLP, Shenzhen, China) and a dental-grade biocompatible resin. A custom 3D-printed placement guide was used to ensure precise positioning of the attachments on the printed maxillary dental models. A flowable resin was applied to secure the attachments in place. Following attachment placement, the models were scanned using a laboratory desktop scanner (Optical 3D Smart Big, Open Technologies, Milano, Italy) and three intraoral scanners: iTero Element (Align Technology, Tempe, AZ, USA), Aoral 2, and Aoral 3 (Shining 3D, Hangzhou, China). Results: Upon comparison, the scans revealed that the iTero Element exhibited the highest precision, particularly in the attachment, with an RMSE of 0.022 mm and 95.04% of measurements falling within a ±100 µm tolerance. The Aoral 2 scanner showed greater variability, with the highest RMSE (0.041 mm) in the incisor area and wider deviation margins. Despite this, all scanners produced results within clinically acceptable limits. Conclusions: In the future, custom attachments made by 3D printing could be a valid alternative to the traditional composite attachments when it comes to improving aligner attachment production. While these preliminary findings support the potential applicability of such workflows, further in vivo research is necessary to confirm clinical usability. Full article

Background: The integration of digital imaging tools in dentistry has transformed clinical workflows, diagnostic accuracy, and patient outcomes. However, less attention has been given to how these tools influence dentists’ self-reported outcomes, including clinical confidence, efficiency, perceived treatment quality, communication, and professional satisfaction. This article aimed at assessing AI-powered digital tools in dentistry and their self-reported impact on dental practitioners’ activity and treatment outcomes. Methods: A comprehensive survey was distributed to 126 dental professionals of different genders, ages, years of experience, and types of dental practice to assess their experiences and attitudes towards AI applications in diagnostics and treatment planning, as well as how patients and dentists perceive the benefits and challenges associated with digital dentistry. Results: Digital photographs and CBCT were regarded as essential tools to have in clinical practice, in contrast with intraoral scanners. However, barriers like high initial costs, specialty differences, and lack of formal training may influence the results. Conclusion: These findings suggest that when used appropriately, AI digital tools can significantly elevate the quality of clinical practice and professional fulfillment and underscore the importance of tailored training programs and supportive infrastructures to facilitate the effective integration of digital technologies in dental practice. Full article

Background: Digital dental photography is increasingly essential for documentation and smile design. This study aimed to compare the linear measurement accuracy of various smartphones and a Digital Single-Lens Reflex (DSLR) camera against digital models obtained by intraoral and desktop scanners. Methods: Tooth height and width from six different casts were measured and compared using images acquired with a Canon EOS 250D DSLR, six smartphone models (iPhone 13, iPhone 15, Samsung Galaxy S22 Ultra, Samsung Galaxy S23 Ultra, Samsung Galaxy S24, and Vivo T2), and digital scans obtained from the Helios 500 intraoral scanner and the Ceramill Map 600 desktop scanner. All image measurements were performed using ImageJ software (National Institutes of Health, Bethesda, MD, USA), and statistical analysis was conducted using one-way analysis of variance (ANOVA) with Tukey’s post hoc test (α = 0.05). Results: The results showed no significant differences in measurements across most imaging methods (p > 0.05), except for the Vivo T2, which showed a significant deviation (p < 0.05). The other smartphones produced measurements comparable to those of the DSLR, even at distances as close as 16 cm. Conclusions: These findings preliminary support the clinical use of smartphones for accurate dental documentation and two-dimensional smile design, including the posterior areas, and challenge the previously recommended 24 cm minimum distance for mobile dental photography (MDP). This provides clinicians with a simplified and accessible alternative for high-accuracy dental imaging, advancing the everyday use of MDP in clinical practice. Full article

Background: The increasing adoption of digital workflows in implant dentistry necessitates rigorous assessment of intraoral scanning, particularly for complex full-arch rehabilitations like All-on-Four prostheses, where posterior implant angulation may impact the accuracy of optical data acquisition. Objectives: This in vitro study aimed to assess the accuracy of digital intraoral scanners in scanning All-on-Four implant models with different posterior implant angulations. Methods: Two epoxy resin All-on-Four implant models were fabricated with two posterior implant angulations (30-degree and 45-degree). Both models were digitized to obtain control datasets using a Smart Optics reference scanner (REF). Four intraoral scanners were comparatively assessed: Cerec Omnicam AC (OMN), Trios 4 (TRI), Cerec Primescan AC (PRI), and Medit i700 (MED), with nine scans per each scanner (n = 9). All STL files were exported and analyzed using Geomagic Control X with root mean square (RMS) values computed for trueness and precision assessments. Results: The comparison between IOS types in terms of trueness revealed that with 30° angulation, the MED group showed the statistically significant least deviation (p = 402). With 45° angulation, both PRI and OMN scanners showed the statistically significant highest deviation values (p = 0.047 and 0.007, respectively). MED again showed the statistically significant least deviation (p = 402). For precision evaluation in 30° angulation models, PRI and OMN scanners showed the statistically significant least deviation values (p = 402 and <0.001, respectively). While, in 45° angulation models, no statistically significant inter-scanner differences were observed. Conclusions: While MED, PRI, and OMN scanners demonstrated clinical validity for 30° angled posterior implants, only the MED system achieved sufficient accuracy for 45° tilt. These findings emphasize the critical relationship between scanner selection and extreme implant angulations in full-arch digital workflows. Full article

Background/Objectives: Alginate dental impressions are often among the most anxiety-inducing procedures for pediatric patients due to discomfort caused by nausea, gagging, and the vomiting reflex. This technique frequently raises anxiety levels in children. In contrast, intraoral scanners are increasingly used in clinical practice and offer a more comfortable alternative. Physiological parameters such as heart rate (HR) and oxygen saturation (SpO₂) are useful, objective indicators of anxiety. This study aimed to evaluate significant changes in HR and SpO₂ during dental impression procedures using two techniques—an analog (alginate) and a digital (intraoral scanner) one—in both dental arches, to determine the method inducing the least anxiety. Methods: A non-interventional clinical study was conducted on a sample of 30 children. A fingertip pulse oximeter was used to measure HR and SpO₂ during impression taking with alginate and with an intraoral scanner. Statistical analysis was performed using SPSS^® (Version 30.0. Amonk, NY, USA: IBM Corp). Descriptive statistics (mean and standard deviation) were calculated, and the Friedman and Wilcoxon tests with Bonferroni correction were applied, using a 5% significance level. The study was approved by the Ethics Committee of the University of Murcia. Results: Alginate impressions produced a statistically significant increase in HR in both the upper [(19 ± 11) bpm] and lower [(18 ± 9) bpm] arches compared to the scanner [(7 ± 5) bpm and (7 ± 4) bpm, respectively] (χ² = 49.30; p < 0.001). SpO₂ levels also dropped more when using alginate for both the upper and lower arches [(−2 ± 2)% and (−2 ± 3)%, respectively] than when using the scanner [(−1 ± 1)% in both arches] (χ² = 21.41; p < 0.001). Conclusions: Alginate impressions triggered a significant anxiety response, as evidenced by significant changes in HR and SpO₂. Intraoral scanners were less invasive, as indicated by the greater proximity of the physiological parameters to the baseline values, making them a promising alternative in pediatric dentistry. Full article

Objectives: This study investigated the use of artificial intelligence (AI) in the design of lingual bracket indirect bonding trays and its association with bracket transfer accuracy using three-dimensional (3D) printing. Methods: Digital impressions of patient’s dental arches were captured using an intraoral scanner, and orthodontic setups were virtually constructed. Brackets were virtually positioned in their ideal locations using the digital setups guided by virtual archwire templates. Indirect bonding trays were automatically generated using the AI-powered Auto Creation function of the Medit Splints application, which analyzes anatomical features to streamline design. Bracket transfer accuracy was evaluated in vivo by comparing planned and actual bracket positions across grouped and individual tray configurations. Linear and angular deviations were measured using conventional 3D inspection software. Results: Most bracket transfer errors were within clinically acceptable thresholds, although torque accuracy remained suboptimal. Grouped trays generally exhibited greater precision than individual trays in several dimensions. Conclusions: These findings support the application of AI-assisted design tools to enhance digital workflows and improve consistency in appliance fabrication. Full article

Cosmetic restorative dentistry focuses on restoring teeth affected by caries or trauma using materials that mimic natural teeth in shape, texture, and color. Composite resins, particularly nanofilled composites, are widely used due to their superior mechanical and aesthetic properties. Accurate tooth color selection is crucial, and methods include visual (shade guides) and instrumental (spectrophotometers, colorimeters, and intraoral scanners). Newer biomimetic composites, such as Admira Fusion 5 and Clearfil Majesty ES-2 Universal, simplify shade selection through advanced optical technologies. A randomized clinical study involving 30 patients compared the color-matching accuracy of two biomimetic composite resins: Admira Fusion 5 (Voco) and Clearfil Majesty ES-2 Universal (Kuraray). The study utilized the Vita Easyshade spectrophotometer and the Primescan intraoral scanner. Patients were treated following standardized protocols, and shade accuracy was evaluated pre- and post-restoration using Cohen’s Kappa index. Admira Fusion 5 showed higher shade-matching accuracy, with good agreement between pre- and post-restoration measurements using both instruments. Clearfil Majesty ES-2 Universal demonstrated lower reproducibility in shade matching, particularly in posterior teeth, with lower agreement in pre- and post-tests. Instrumentation Comparison: Primescan showed slightly better performance than Easyshade, but both provided comparable results. In conclusions, universal composites may not always achieve optimal shade matching in posterior teeth. Layered composites provide better color adaptability. While digital instruments enhance shade accuracy, combining them with visual methods yields the best clinical outcomes. Further research with larger sample sizes is needed to improve shade-matching techniques in aesthetic restorative dentistry. Full article

Background/Objectives: Accurate implant impressions are critical for capturing the three-dimensional (3D) spatial positioning of implants. Digital workflows using intraoral scanners (IOSs) and scan bodies offer distinct advantages over conventional elastomeric techniques. However, the geometry of scan bodies may influence the precision and trueness of IOS-acquired data, and optimal design parameters remain undefined. This systematic review aims to evaluate the effects of scan body geometry on the trueness of digital implant impressions captured using IOSs. Methods: A systematic search was conducted across PubMed, Scopus, EMBASE, Web of Science, the Cochrane Library, and Google Scholar up to 25 February 2025. Eligible studies assessed the impact of scan body geometry on the accuracy of implant-level impressions acquired with IOSs. Study quality was assessed using the Quality Assessment Tool for In Vitro Studies of Dental Materials (QUIN). Results: Twenty-eight studies were included, of which twenty-six were in vitro. The included studies, published between 2020 and 2025, demonstrated that variations in macro- and micro-geometries influenced both linear and angular trueness. Cylindrical designs with optimal dimensions generally outperformed cuboidal or spherical forms. Structural modifications, such as rigid bar extensions and surface facets, often improved scan accuracy. Some hybrid or modified designs performed comparably to conventional scan bodies. According to QUIN, 27 studies were moderate quality and one had high quality. Conclusions: Scan body geometry affected the accuracy of intraoral implant digital impressions. Designs featuring rigid extensions or simplified geometries improve trueness and precision. Further standardized clinical studies are needed to define optimal design features and validate current in vitro findings. Full article

Background: Intraoral scanners have become increasingly popular for final dental prostheses due to their precision, efficiency, and patient-friendly approach. However, their use for capturing final impressions of highly esthetic and thin restorations, such as ceramic veneers, presents unique challenges. Veneer preparations differ significantly from traditional full-coverage crowns, with their smaller and more delicate margins often located at or below the gingival level. This complexity may lead to hesitancy among clinicians regarding the routine use of intraoral scanners in such cases. Methods: A comprehensive literature review was performed to evaluate the effectiveness of intraoral scanners for final digital impressions in ceramic veneer restorations within the esthetic zone. Studies published between January 2010 and January 2025 were included in the review. Additionally, a case illustration was provided, detailing the use of an intraoral scanner to capture final impressions for a patient requiring 10 ceramic veneers in the esthetic zone. Results: The review demonstrated that intraoral scanning is a reliable technique for veneer impressions, delivering clinically acceptable outcomes. The benefits include enhanced patient comfort, improved workflow efficiency, and a reduction in chairside time. Nonetheless, clinicians must overcome a learning curve with digital technologies and ensure optimal conditions, such as maintaining a dry tooth surface during scanning. The presented case successfully illustrated the use of intraoral scanning, resulting in precise impressions and the fabrication of highly esthetic and functional veneers. Conclusions: Intraoral scanning is a predictable and effective method for capturing final impressions for veneer restorations. It offers results comparable to traditional methods while enhancing patient experience and enabling the fabrication of high-quality restorations within an efficient workflow. Full article

Background/purpose: Fiber-reinforced materials are commonly used as biobases beneath indirect restorations, potentially affecting the seating and marginal accuracy of the restorations. This study intended to assess the impact of various biobase techniques on the marginal adaptation of lithium disilicate overlay restorations. Methods: Fifty sound maxillary first premolar teeth of comparable dimensions were prepared using a full-bevel overlay design (3 mm occlusal reduction) and allocated randomly to five groups as follows (n = 10): Group A, delayed dentin sealing; Group B, immediate dentin sealing using Optibond FL; Group C, immediate dentin sealing with a 1 mm flowable composite layer (Clearfil AP-X Flow); Group D, immediate dentin sealing followed by a 1 mm short-fiber-reinforced composite layer (everX Flow); and Group E, immediate dentin sealing coated with a 1 mm flowable composite layer reinforced with polyethylene Ribbond fibers. Digital impressions were obtained using a Medit i700 intraoral scanner, and the overlays were digitally designed via the Sirona inLab CAD software and milled via a four-axis milling machine. The overlays were luted with a preheated composite (Clearfil AP-X). Marginal gap assessments were conducted pre- and post-cementation via a digital microscope at 230× magnification. The data were statistically analyzed using a one-way analysis of variance and paired t-tests. Results: The one-way ANOVA disclosed no significant differences among the groups before or after cementation (p > 0.05). Conclusions: The presence or absence of fiber-reinforced biobases did not impact the marginal adaptation of the restorations; these biobases can be incorporated to optimize the mechanical behavior of indirect restorations without adversely affecting their seating accuracy. These findings suggest that fiber-reinforced and non-reinforced biobase techniques can be safely integrated into clinical adhesive protocols to enhance the mechanical performance of restorations without comprising their marginal adaptation. Full article