International Journal of Dental Materials
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CAD/CAM in Orthodontics – A Magnanimous Journey
Get PDFOrthodontics is one branch of dentistry which deals with dynamic manipulation and function of the stomatognathic system. Likewise, it has to witness the dynamic changes in its diagnosis method and treatment planning. The field of orthodontics has witnessed many revolutionary techniques and evolved enormously in terms of benefiting the patient. CAD/CAM is one promising methodology that has shown a significant impact in modern dentistry and surpassed some of the challenges an orthodontist has been facing all these years. It has changed the view through which we see the patient’s condition. The application of 3D technology allows the practitioner and patient to utilize virtual treatment planning software to better identify case objectives and visualize treatment outcomes.
CAD/CAM has many applications in orthodontics, which include aids for diagnosis and treatment planning, clear aligner treatment, customized lingual appliances, customized brackets with patient-specific torque, machine-milled indirect bonding jigs, robotically bent archwires, indirect bonding systems, customization of orthodontic appliances like distalization appliance etc., Acceleration of orthodontic treatment (OT) has received growing attention in recent years, especially in adult patients.
Digital workflow is the current trend in orthodontic practice and has speckled every aspect of orthodontics in terms of documentation, study casts, analysis of dental malocclusion, smile designing, treatment planning and fabrication of orthodontic appliances. The current article aimed to establish a narrative description of the digital workflow and applications of the CAD/CAM process in Orthodontics
Navigating the clinical ambiguity of implant placement in two young pubescent patients: an insight from two case reports
Get PDFThe horizon of implant dentistry has been ever-expanding owing to its long-term success in rehabilitating partially or completely edentulous cases. This perennial success and efficiency have encouraged clinicians to use osseo-integrated implants to replace teeth lost in children either due to trauma or congenital absence. Although a myriad of studies and publications suggest the placement of implants only after the attainment of skeletal maturity, as the growth-related changes such as remodelling, displacement, and mesial drift can put the future of implant and restoration in jeopardy, the use of implants in young pubescent or adolescent looks promising due to its evident psychological and social advantages over other contemporary alternatives such as a removable prosthesis or resin-bonded bridge. The first case report highlights a 16-year follow-up of a young girl treated at the age of 10 with an implant-supported prosthesis for the replacement of a missing maxillary left central incisor. The second case report centers around a 19-year-old teenage girl who underwent rehabilitation with a permanent fixed prosthesis, replacing her previous implant-supported temporary prosthesis. The implant was initially placed when she was 10 years old
Evaluation of radio-morphometric indices of mandible using digital panoramic radiography: a radiographic study
Get PDFBackground: Bone mineral density (BMD) varies with race, ethnicity, age, and gender. Thus arises the need for population-specific value ranges. Qualitative and quantitative indices of the mandible have also been used for panoramic radiographs to assess bone quality and to observe signs of resorption and osteoporosis.
Aim: To measure the radio-morphometric indices in a digital panoramic radiograph and to find the inter-relationship of the indices with the age and sex of the patients.
Materials and Methods: The study included 100 digital panoramic radiographic images of patients, and the samples were divided into four age groups. A panoramic radiograph of each patient was taken, and radio-morphometric indices were determined. Four indices, namely, cortical width at the gonion (GI) and below the mental foramen (MI), Mandibular cortical index (MCI) and Panoramic Mandibular Index (PMI), were measured bilaterally in all panoramic radiographs. All images were analyzed, and index values were calculated by applying linear measurements on the panoramic radiographs.
Results: Statistically significant differences were observed among the study population.
Conclusion: Radio-morphometric indices in a panoramic radiograph may possibly be used as a potential screening tool in identifying individuals with osteoporosis
Factors that influence the quality of final impressions for fixed dental prostheses in Nairobi, Kenya
Get PDFBackground: Good quality dental impressions free of air bubbles, voids, steps, drags, streaks and tears are a pre-requisite for the fabrication of well-fitting fixed dental prostheses (FDP). The quality of impressions is dependent on clinician and material factors.
Aim: To evaluate factors that influence the quality of final impressions for FDP in Nairobi, Kenya.
Methods: In this cross-sectional study, 234 impressions received by five dental laboratories were analyzed. The study collected information on the type of tray, impression material, technique, type of prostheses, and clinically detectable errors, including voids, inadequate material at margins, tears, steps, drags, and streaks. Impression quality was the outcome assessed as good, fair, or poor by two investigators. The independent variables influencing impression quality included clinician specialty, experience, impression material, technique, and tray type.
Results: Inter-rater agreement was 96.8% (p<0.001). Clinician experience ranged between 1-45yrs, median 13.5yrs and mean 8.39±11.96yrs. The majority were GPs, 80.8% while restorative dentists were 11.5% and other specialists, 7.7%. Most impressions were non-aqueous elastomers, 97.9% employing dual-viscosity technique, 75.6%. Impression trays included stock metal, 60.3%, stock plastic, 34.2%, and custom, 5.5%. Impression quality was good, 24.8%, fair, 37.2% or poor, 38.0%. Cumulatively, 74.5% impressions had bubbles/voids, 53.0% tears and 43.2% poor margins. Clarity of margins was associated with clinician specialty, (Fisher’s exact=9.372, p=0.047), and impression technique with impression quality, (Pearson’s ?2 = 6.385, p=0.041). Compared to restorative specialists, estimated odds of other specialists producing poor margins was 5.71, 95%CI 1.55,21.06, Wald ?2=5.24, p=0.009 while for GPs, the estimated odds was 2.19, 95%CI 0.88, 5.43, Wald ?2 = 2.86, p=0.09. Compared to dual viscosity, estimated odds of monophase giving a poor-quality impression was 1.52, 95%CI 0.83,2.78, Wald ?2 = 1.52, p=0.18.
Conclusion: Most impressions were good or fair hence acceptable. Quality of impressions was influenced by clinician specialty and impression technique
Management of midline diastema using pressable ceramics and zirconia crowns: a case series
Get PDFMaxillary and mandibular midline diastema (MMD) is frequently observed in various populations. The occurrence of MMD can be attributed to multiple factors, including etiological, developmental, and patient habits. The diverse options to treat MMD are orthodontic correction, direct and indirect restorations, crowns, and veneers. This case series presents instances of closing maxillary and mandibular midline diastema using e.max veneers and zirconia crowns
The effect of irrigating solutions on the hydration of tricalcium silicate cements: an in vitro study
Get PDFBackground: Calcium silicate cements are hydraulic cements, routinely used for perforation repairs. During such repairs, these cements are invariably exposed to irrigating solutions.
Aim: This study aimed to understand the effect of irrigating solutions on the hydration of calcium silicate cements.
Materials and Methods: Sixty extracted teeth were taken and horizontal sections of 2mm were obtained. These samples were randomly divided into two groups viz. Biodentine and BioMTA Plus groups later these cements were condensed into the canal spaces and allowed to set until their setting time. These samples were further subdivided and allowed to encounter three irrigating solutions viz. Normal saline, 17% EDTA, and 2% Chlorhexidine for 5 minutes. These were allowed to mature in an incubator for seven days and subjected to Scanning Electron Microscopy and Energy Dispersive X-ray analysis.
Results: The SEM analysis of the Biodentine/control group displayed a petal-like appearance, with a Ca/Si ratio of 2. Whereas, the Biodentine/Normal saline, Biodentine/17% EDTA and Biodentine/2% Chlorhexidine group displayed crumbled paper-like appearance. The Ca/Si ratios for the Biodentine/Normal saline, Biodentine/17% EDTA and Biodentine/2% Chlorhexidine were 2.72, 1.6, and 4.21, respectively. In the BioMTA Plus group, all the SEM analyses displayed round crystalline structures in all groups. The Ca/Si ratio of BioMTA Plus/Control, BioMTA Plus/17% EDTA and BioMTA Plus/2% Chlorhexidine were 25.5, 17.42, 24.1, and 39.4, respectively.
Conclusion: The study concluded that the irrigating solutions did not affect the hydration mechanism of Biodentine and BioMTA Plus despite the variations in the Ca/Si ratios and surface morphology
An unconventional impression method using implant mount: an alternative to open- and closed-tray impression technique
Get PDFBackground: Various impression techniques have been proposed for making implant prostheses. Impressions are made at implant level – closed and open tray impressions, as well as abutment level impressions. Closed and open tray copings are used to make the impressions. The limitations associated with the implant impression copings, including expensive ones, pose a significant challenge in limited mouth-opening cases, and customization of copings is not feasible.
Aim: This study aimed to compare the dimensional accuracy of four impression methods, open-tray, closed-tray, disposable mount as coping and splinted mount as coping.
Materials and methods: An ideal maxillary edentulous acrylic model was used with windows created at the canine and molar regions. Four analogues were implanted in the canine and molar areas to represent implants. The analogues were parallel to one other and were orientated at 0 degrees using the surveyor\u27s assistance. Four groups were made: closed-tray, open-tray, implant mount as coping and splinted mount as coping. The custom trays were fabricated, accordingly. The implant-level impressions were made in all the groups using polyether impression material. The impressions were fitted with their respective impression copings with the analogues. The impressions were poured using die stone type-IV, and the casts were made. The resulting casts were 3D scanned, and a virtual model (.stl File) was created. Each .stl file was subjected to Geomagic software to evaluate the three-dimensional accuracy of conventional implant copings and implant mount as copings.
Results: The Open-tray and the closed-tray groups exhibited the mean dimensional accuracy of 0.011±0.0016 µm and 0.018±0.0012 µm, respectively. The mount as coping and splinted mount displayed a mean dimensional accuracy of 0.017±0.0008 µm and 0.013±0.0020µm, respectively.
Conclusions: This pilot study concludes that the implant mount can be used as implant impression coping and an alternative to the conventional impression coping
Biomaterials in Endodontics: a review
Get PDFBiomaterials have evolved over the past three decades and are relatively specialized, highly biocompatible, but low-strength dental materials. Bioactive materials can interact with living tissues or systems. The newly emerging bioactive category of dental materials has expanded clinical uses in restorative dentistry and endodontics. Examples of bioactive materials are Calcium Silicate containing Mineral Trioxide Aggregate (Portland cement); Calcium Silicate cements lacking aluminium and containing phosphate: Bioagrregate, iRoot SP and iRoot BP (Endosequence), Calcium Silicate cements containing predominantly Tricalcium Silicate: Bio-active Glass, Calcium Phosphate based materials: Tricalcium Phosphate, Hydroxyapatite, Calcium Phosphate cements and Calcium Aluminate based materials: GIC based luting cements; Bioactive Glass. Other biomimetic materials include Emdogain, Platelet Rich Plasma, Platelet Rich Fibrin, Bone grafts and barrier membranes. Thus, the objective of this review was to compare and review the composition, and properties of these bioactive materials in endodontics
Photodynamic therapy: a distinct therapeutic modality
Get PDFPhotodynamic therapy (PDT) is an innovative treatment modality that utilizes a combination of a photosensitizing agent, specific wavelengths of light, and molecular oxygen to selectively target and destroy abnormal cells or tissues while sparing healthy surrounding structures. This approach has gained significant attention in the medical field due to its potential to provide effective and less invasive treatment options for various conditions. The development of PDT was driven by the need for treatments that overcome the limitations of conventional modalities such as surgery, radiation therapy, and chemotherapy. PDT offers several benefits over these approaches, including its ability to provide targeted therapy, reduced side effects, minimal damage to healthy tissues, and versatility in treating different diseases. One of the key advantages of PDT is its selectivity. By utilizing photosensitizers that accumulate in diseased or abnormal cells, PDT can precisely target the affected tissue while minimizing damage to healthy tissues. This selectivity allows for focused treatment, reducing the potential for unnecessary harm to surrounding structures. Furthermore, PDT offers faster recovery times and potentially better cosmetic outcomes compared to surgery, as it does not require extensive incisions or removal of tissues. Additionally, the localized nature of PDT minimizes systemic toxicity and long-term complications, making it a well-tolerated treatment option. PDT has demonstrated efficacy in various medical fields, including oncology, dermatology, and ophthalmology. It has been used to treat different types of cancers, including skin, lung, oesophagal, and bladder cancer, as well as manage conditions like age-related macular degeneration and certain dermatological disorders. This article reviewed the development, mechanism, and applications of PDT in the medical field
Prosthodontic management of subtotal maxillectomy with minimally invasive interim obturator: a case report
Get PDFThe interim obturator serves as a pathway between the immediate or surgical obturator and the final prosthesis, offering functional and aesthetic benefits until the delivery of the definitive prosthesis. Furthermore, it acts as a guide during the fabrication of the definitive prosthesis, influencing aspects such as prosthesis extension, teeth arrangement, and the positioning of retentive aids. These aids may encompass orthodontic wiring, surgical suturing, and other non-invasive techniques. This case report details a conservative and less invasive method for retaining an interim obturator in maxillectomy patients, providing an alternative approach in prosthodontic care