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The authors of this study aimed to compare the treatment outcomes and time efficiency between digital and conventional complete denture restorations and propose suggestions for clinical use. The authors used digital (functionally suitable digital complete denture [FSD]) and conventional complete denture restorations to make 2 dentures each for 10 edentulous patients. All the operations of both techniques before denture delivery were completed in the first 4 visits, and then 2 dentures were delivered successively for the patients. The clinical and laboratory times were recorded to evaluate the time efficiency; treatment outcomes were evaluated via scoring the denture satisfaction of the dentist and patients in a double-blind manner. The satisfaction scores of FSDs (7.6-9.6 [dentist's scores], 8.4-10 [patients' scores]) were higher than those of conventional dentures (7.2-9.7 [dentist's score], 7.4-9.8 [patients' scores]), but there were no significant differences. The clinical and laboratory operation times of the FSD group were less than those of the conventional group, saving an average of 28.0 minutes and 64.3 minutes in the clinic and laboratory, respectively. FSD technology can improve the efficiency of clinical and laboratory operations and shorten the manufacturing cycle of dentures. The occlusion stability of FSDs was statistically better than that of traditional dentures, but there was no statistical difference in other clinical indicators. FSD technology is low cost and easy to operate and has several applications. Compared with conventional complete denture restoration technology, FSDs can save time and have a comparable clinical effect. This clinical trial was registered at the Chinese Clinical Trial Registry. The registration number is ChiCTR1900021722. [ABSTRACT FROM AUTHOR]

Purpose: To compare the accuracy of chairside, fused deposition modeling (FDM) three‐dimensional (3D)‐printed surgical guides with that of stereolithographic guides for implant placement in single edentulous sites within a clinical setting. Materials and Methods: A total of 28 participants with 30 single posterior edentulous sites were included. The sites were randomized into a FDM 3D‐printed surgical guide group (test) or stereolithographic guide group (control) of equal size (n = 15). In both groups, digital implant planning was performed using data from cone beam‐computed tomography and intraoral scans. The test group's surgical guides were fabricated using a chairside, FDM 3D‐printer; those in the control group were fabricated using a light‐curing 3D‐printer. Postoperative intraoral scans were used to obtain the 3D position of the implants. Compared to preoperative design, the angular, 3D, mesiodistal, buccolingual and apicocoronal deviations at the implant shoulder and apex were recorded. Results: The workflow for the design and chairside fabrication of implant guides was established. The mean angular deviations of the test and control group were (4.23 ± 2.38) ° and (4.13 ± 2.42) ° (p >.05), respectively. The respective 3D deviations at the implant shoulder were (0.70 ± 0.44) mm and (0.55 ± 0.27) mm (p >.05); those at the implant apex were (1.25 ± 0.61) mm and (1.11 ± 0.54) mm (p >.05). The mesiodistal, buccolingual, and apicocoronal deviations at the implant shoulder and apex did not significantly differ between the groups (p >.05). Conclusions: Implants for single posterior edentulous spaces were placed as accurately with the test guide as with the control. Further research under more complex situations involving multiple missing teeth is needed. [ABSTRACT FROM AUTHOR]

Purpose: This in vitro study aims to explore the effects of selective laser melting (SLM) process parameters on the accuracy of the intaglio surface of cobalt–chromium alloy (Co–Cr), commercially pure titanium (CP Ti) and titanium alloy (Ti–6Al–4V) maxillary removable partial denture (RPD) frameworks and optimize these process parameters. Design/methodology/approach: Maxillary RPD framework specimens designed on a benchmark model were built. The process parameters, including contour scan speed and laser power, infill scan speed and laser power, hatch space, build orientation and metallic powder type, were arranged through the Taguchi design. Three-dimensional deviations of the clasps area, connector area and overall area of maxillary RPD frameworks were analyzed by using root mean square (RMS) as a metric. One-way analyses of variance with the above RMSs as the dependent variable were carried out (α = 0.05). Findings: Maxillary RPD frameworks built horizontally had a more accurate intaglio surface than those built at other orientation angles; CP Ti or Ti–6Al–4V maxillary RPD frameworks had a more accurate intaglio surface than Co–Cr ones; the Maxillary RPD framework built with a higher infill scan speed and lower infill laser power had the more accurate intaglio surface than the one built with other levels of these two process parameters. Originality/value: A novel benchmark model for evaluating the accuracy of the intaglio surface of maxillary RPD frameworks manufactured by SLM is proposed. The accuracy of the intaglio surface of maxillary RPD frameworks can be improved by adjusting SLM process parameters. The optimal setting of process parameters concerning the accuracy of the intaglio surface of maxillary RPD frameworks was given. [ABSTRACT FROM AUTHOR]

Volatile organic compounds (VOCs) undergo substantial photochemical losses during their transport from emission sources to receptor sites, resulting in serious implications for their source apportionment and ozone (O 3) formation. Based on the continuous measurements of VOCs in suburban Jinan in August 2022, the effects of photochemical losses on VOC source contributions and O 3 formation were evaluated in this study. The observed and initial concentrations of total VOCs (TVOC) were 12.0 ± 5.1 and 16.0 ± 7.4 ppbv, respectively. Throughout the observation period, alkenes had the most prominent photochemical losses (58.2%), followed by aromatic hydrocarbons (23.1%), accounting for 80.6% and 6.9% of the total losses, respectively. During high O 3 episodes, the photochemical loss of VOCs was 6.9 times higher than that during the cleaning period. Alkene losses (exceeding 67.3%), specifically losses of isoprene, propylene, ethylene, and n-butene, dominated the total losses of VOCs during the O 3 increase period. Eight sources of VOCs were identified by positive matrix factorization (PMF) based on the observed and initial concentration data (OC-PMF and IC-PMF, respectively). Concentrations of all emission sources in the OC-PMF were underestimated by 2.4%–57.1%. Moreover, the contribution of each emission source was over- or underestimated compared with that in case of the IC-PMF. The contributions of biogenic and motor vehicle exhaust emissions were underestimated by 5.3 and 2.8 percentage points, respectively, which was associated with substantial oxidation of the emitted high-reactive species. The contributions of coal/biomass burning and natural gas were overestimated by 2.4 and 3.9 percentage points, respectively, which were related to the emission of low-reactive species (acetylene, ethane, and propane). Based on our results, the photochemical losses of VOCs grossly affect their source apportionment and O 3 formation. Thus, photochemical losses of VOCs must be thoroughly accounted to establish a precise scientific foundation for air-pollution control strategies. [Display omitted] • Photochemical losses contributed 58.2% of initial alkenes and 23.1% of initial aromatics. • Photochemical loss of VOCs during high ozone period was 6.9 times higher than that during cleaning period. • Source apportionment based on measured VOCs might lead to biased conclusions. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to establish a chair-side design and production method for a tooth-supported fixed implant guide and to evaluate its accuracy. Design/methodology/approach: Three-dimensional (3D) data of the alveolar ridge, adjacent teeth and antagonistic teeth were acquired from models of the edentulous area of 30 patients. The implant guides were then constructed using self-developed computer-aided design software and chair-side fused deposition modelling 3D-printing and positioned on a dental model. A model scanner was used to acquire 3D data of the positioned implant guides, and the overall error was then evaluated. Findings: The overall error was 0.599 ± 0.146 mm (n = 30). One-way ANOVA revealed no statistical differences among the 30 implant guides. The gap between the occlusal surface of the teeth covering and the tissue surface of the implant guide was measured. The maximum gap after positioning of the implant guide was 0.341 mm (mean, 0.179 ± 0.019 mm). The implanted axes of the printed implant guide and designed guide were compared in terms of overall, lateral and angular error, which were 0.104 ± 0.004 mm, 0.097 ± 0.003 mm, and 2.053° ± 0.017°, respectively. Originality/value: The results of this study demonstrated that the accuracy of a new chair-side tooth-supported fixed implant guide can satisfy clinical requirements. [ABSTRACT FROM AUTHOR]

The abnormal occlusal contact can disrupt the coordination and health of the oral jaw system. Therefore, the dynamic adjustment of the occlusal surface is of great significance for assessing the status of occlusal contact and clarifying jaw factors of stomatognathic system diseases. To solve this problem, a trajectory subtraction algorithm based on screw theory to improve the accuracy of the occlusal movement trajectory is proposed in our paper. Driving by the relative trajectory, a virtual dynamic occlusal adjustment system is developed to realize 3D occlusal movement simulating, automatic occluding relation detection, and automatic occlusal adjustment. Furthermore, we adapt an active occlusal adjustment method based on Laplacian deformation to increase the contact areas of the occlusal surface, which can aid dentists to realize the automatic adjustment of the non-interference regions. As a consequence, the proposed subtraction algorithm is feasible and the root-mean-square is 0.097 mm, and the adjusted occlusal surface is more consistent with the natural occlusal morphology. Graphical abstract ᅟ. [ABSTRACT FROM AUTHOR]

Background and objective In dentistry, the complete denture is a conventional treatment for edentulous patients. The computer-aided design and computer-aided manufacturing (CAD/CAM) has been applied on the digital complete denture which is developed rapidly. Tooth selection and arrangement is one of the most important parts in digital complete denture. In this paper, we propose a new method of personalized teeth arrangement. Methods This paper presents a method of arranging teeth virtually for a complete denture. First, scan and extract the feature points of the 3D triangular mesh data of artificial teeth (PLY format), then establish a tooth selection system. Second, scan and mark the anatomic characteristics of the maxillary and mandibular cast surfaces, such as facial midline, the curve of the arches. With the enter information, the study calculates the common arrangement lines of artificial teeth. Third, select the preferred artificial teeth and automatically arrange them virtually in the correct position by using our own software. After that, design the gingival part of the dentures on the basic of the arranged teeth on the screen and then fabricated it by using Computerized Numerical Control (CNC) technology, Rapid Prototyping (RP) technology or 3D printer technology. Finally, select artificial teeth were embedded in wax rims. Results This system can choose artificial teeth reasonably and the teeth placement can meet the dentist's request to a certain extent, whereas all the operations are based on the medical principles. Conclusions The study performed here involves computer sciences, medicine, and dentistry, a teeth selection system was proposed and virtual teeth arrangement was described. This study has the capacity of helping operators to select teeth, which improved the accuracy of tooth arrangement, and customized complete denture. [ABSTRACT FROM AUTHOR]

With the development of 3D printing and computer graphics technology, mouth rehabilitation has increasingly adopted digital methods. This research proposes a new method to transform the appearance of facial model after complete denture prosthesis. A feature template with few feature points is first constructed according to the facial muscle anatomy and facial deformation after complete denture prosthesis. Next, the traditional as-rigid-as-possible (ARAP) method is optimised by clustering based on facial muscles. The optimised ARAP method is then used for real-time and interactive simulations. Finally, by classifying the degrees of elasticity in the model with additional weights, the simulation can be customised to the skin of individual patients. Different degrees of elastic deformation and post-operative models are superimposed for match analysis. Compared with our previous study, the error is reduced by 24.05%. Results show that our method can deform facial models accurately and efficiently. [ABSTRACT FROM AUTHOR]

Copper nanowire networks are considered a promising alternative to indium tin oxide as transparent conductors. The fast degradation of copper in ambient conditions, however, largely overshadows their practical applications. Here, we develop the synthesis of ultrathin Cu@Au core-shell nanowires using trioctylphosphine as a strong binding ligand to prevent galvanic replacement reactions. The epitaxial overgrowth of a gold shell with a few atomic layers on the surface of copper nanowires can greatly enhance their resistance to heat (80 °C), humidity (80%) and air for at least 700 h, while their optical and electrical performance remained similar to the original high-performance copper (e.g, sheet resistance 35 Ω sq-1 at transmittance of ∼89% with a haze factor <3%). The precise engineering of core-shell nanostructures demonstrated in this study offers huge potential to further explore the applications of copper nanowires in flexible and stretchable electronic and optoelectronic devices. [ABSTRACT FROM AUTHOR]

Based on the continuous online measurements of volatile organic compounds (VOCs) at a suburban site in Jinan, Shandong province in the wintertime of 2021, characteristics, chemical transformations and sources of VOCs were analyzed. The total mixing ratio of VOCs was 30.35 ± 19.9 ppbv, with alkanes being the most abundant species. Alkenes and aromatics were the major contributors to the hydroxyl radical loss rate (L OH) and the ozone formation potential (OFP), accounting for 44.9% and 32.7% to L OH , and 43.2% and 33.4% to OFP, respectively. Aromatics had the primary contribution (98.1%) to the secondary organic aerosol potential (SOAP), and the high correlation between SOAP and PM 2.5 concentrations (R = 0.70) suggested that VOCs were critical precursors of PM 2.5. Coal/biomass burning and motor vehicle emissions were the main sources of VOCs (24.6% and 23.8%, respectively), followed by petrochemical and fuel evaporation (19.9%), industrial sources (16.9%), and liquefied petroleum gas/natural gas use (14.8%). Backward trajectories and the potential source contribution function (PSCF) analysis results suggested that short-range transport from the southeast was the primary potential source of VOC concentrations in suburban Jinan. The results can provide theoretical support for local governments to develop VOC emission control strategies in suburban areas. • Daytime VOCs were significantly influenced by strong localized emissions. • SOAP of VOCs and PM 2.5 were highly correlated. • Coal/biomass burning and vehicle emissions were the most significant sources of VOCs. • Short-distance transport from the southeast was important for VOCs control. [ABSTRACT FROM AUTHOR]

To restore the complex oral soft tissue defect, porous antibacterial poly(3-hydroxybutyrate- co -4-hydroxybutyrate) (P34HB)-based scaffold (PAP34HB) presents with unique asymmetry interconnected porous structure conferring barrier property. PAP34HB possesses a superior performance in biocompatibility, antibacterial and pro-healing properties simultaneously compared to that of the commercial collagen membranes (CM), leading to remarkable regenerative effect of oral soft tissue defect even under infection conditions. [Display omitted] • Porous antibacterial scaffolds based on PHA (PAP34HB) were fabricated for oral soft tissue regeneration. • Antibacterial efficiency of PAP34HB against oral bacteria was confirmed. • PAP34HB scaffolds exhibited better in vitro biocompatibility with HGFs and BMSCs. • PAP34HB scaffolds demonstrated significant gingival repair improvements for the in vivo infectious intra-oral wounds. Due to the moist, warm and intricate oral environments, pathogenic bacteria pose a threat to periodontal health especially under the circumstances of soft tissue defects. Clinical practices employ commercial collagen membranes that often fail to combat opportunistic pathogens without antibiotic prophylaxis. Therefore, the design of gingival substitutes should take antibacterial property into account while facilitating the tissue regeneration process. Porous antibacterial scaffolds based on polyhydroxyalkanoates (PHA) containing 3-hydroxybutyrate (3HB) and 4-hydroxybutyrate (4HB) (P34HB) (or PAP34HB) for oral soft tissue regeneration were prepared in this study via a phase separation method with antibacterial property due to the presence of zinc oxide nanoparticles (ZnO NPs). The resulted scaffolds favorably formed porous structures with reduced Young's modulus for patients' comfort feeling. In vitro studies using the scaffold exhibited better biocompatibility and antibacterial activity against oral-specific bacteria including Porphyromonas gingivalis and Streptococcus mutans compared to that of the commercial membranes. The scaffolds demonstrated significant improvements on the healing process even in the infectious intraoral wounds. The porous antibacterial scaffolds based on P34HB were revealed as a gingival substitute for oral soft tissue regeneration. [ABSTRACT FROM AUTHOR]

Purpose The use of removable complete dentures is a selectable restorative procedure for edentulous patients. To improve the fabrication quality and efficiency of removable complete dentures, this paper aims to introduce a new method to fabricate customized wax complete dentures with additive manufacturing. This process uses complementary digital technologies, and allows faster and better manufacture of complete dentures.Design/methodology/approach In the study, a dental scanner was used to obtain surface data from edentulous casts and rims made by the dentist. A parameterized three-dimensional graphic database of artificial teeth was pre-established. Specialized computer-aided design software was used to set up the artificial dentition and design the esthetic gingiva and base plate. A selective laser sintering machine was used to transfer the data from stereolithography files into a wax base plate with location holes for each artificial tooth.Findings Under this method, a set of wax base plates with 28 location holes available for the placement of the artificial teeth were designed and fabricated within 6 h. The try-in wax dentures fitted the patient’s mouth well, besides occlusion relationships. Then, the occlusion relationships can be adjusted manually to achieve a balanced centric occlusion.Originality/value This method can be used to design and fabricate wax try-in removable complete dentures semi-automatically and rapidly; however, the algorithm for the occlusion contact design needs to be improved. [ABSTRACT FROM AUTHOR]

Purpose: To explore the clinical application of one-piece polyetheretherketone (PEEK) removable partial dentures (RPDs) fabricated using a novel digital workflow and to evaluate their weights and fits in vivo and patient satisfaction., Materials and Methods: Fifteen cases with posterior partially edentulous situations were selected, and each patient received two types of RPDs, including a novel digital workflow (test group) and a conventional workflow (control group). For the test group, one-piece RPDs were designed through three-dimensional (3D) methods by scanning stone casts and fabricated by milling PEEK discs. Each RPD was weighed. The gaps between the oral tissue and RPDs in each group were duplicated using a polyvinylsiloxane (PVS) replica and measured by 3D analysis. A visual analog scale (VAS) was used to evaluate the patient's satisfaction. Paired t-tests were used to compare the differences in the weight, the gaps of each RPD, and VAS values between the two groups. One-way analysis of variance tests was used to compare the differences in the gap among different components in each group., Results: The RPD in the test group weighed less than that in the control group (p < 0.01). No statistically significant differences in the gaps of denture bases and rests (p > 0.05) were found between the two groups, but the gaps of major connectors in the test group were significantly smaller than in the control group (p < 0.05). The VAS scores for comfortableness and masticatory efficiency were not significantly different between the two groups (p > 0.05) but the scores for the aesthetic appearance of the clasps in the test group were significantly higher than that in the control group (p < 0.05)., Conclusions: One-piece PEEK RPDs manufactured using a novel digital workflow weighed less than conventional RPDs and exhibited a clinically acceptable internal fit. Although the aesthetic appearance of the PEEK clasps was superior to the control, there is still room for improvement., (© 2024 by the American College of Prosthodontists.)

Purpose: To evaluate the accuracy of guiding plane preparation for removable partial dentures (RPDs) using 3D-printed templates compared to the freehand method., Materials and Methods: Twenty partially edentulous patients requiring RPDs were randomly divided into two groups: the template-aided group (n = 10) and the freehand group (n = 10). Fifty-six guiding planes were prepared by a single clinician using two different methods. The angle deviation between the prepared guiding plane and the RPD path of placement was measured for both groups. The 3D deviations between the prepared guiding plane and the designed guiding plane were measured for the template-aided group. Patient satisfaction with the RPD was evaluated 2 weeks post-RPD wearing., Results: The angular deviation observed in the template-aided group (1.77±1.11 degrees) was significantly lower than that (6.29±4.18 degrees) in the freehand group (p < .001). Additionally, the 3D deviation between the prepared guiding plane and the designed guiding plane of the template-aided group was 106.2±40.9 µm. No significant difference in patient satisfaction scores related to RPD wearing was found between the two groups., Conclusions: Utilizing the cobalt-chromium (CoCr) alloy template significantly improved the accuracy of guiding plane preparation in the clinic, irrespective of the site of the abutment tooth., (© 2024 by the American College of Prosthodontists.)

This article presents a digital technique to construct a virtual occlusion in the maximal intercuspal position (MIP), considering physiological tooth displacement and reducing intermesh penetrations between occlusal surfaces, in order to design more precise and accurate occlusal contacts of a posterior full crown., (© 2024 by the American College of Prosthodontists.)

Aim: Quantitative dental plaque evaluation is necessary for clinical and scientific work. The present study aimed to examine the reliability of a 3D image analysis method by digitally analyzing the color 3D images obtained from an intraoral scanner (IOS) and then detecting and quantifying the plaque information and comparing it with the clinical examination results., Materials and Methods: A total of 140 teeth from five subjects with a standard dentition were enrolled. Plaque examination was performed at two different time points: after 24 h without oral hygiene (T1), and after habitual brushing (T2). At each time point, the Quigley-Hein Plaque Index (PI) of each tooth surface was recorded separately, followed by color 3D images obtained using an IOS, and image analysis and calculation using Geomagic Wrap 2021 software., Results: The percentage of plaque staining area calculated from the 3D image analysis correlated well with the PI recorded during the clinical examination: the Spearman correlation coefficients were 0.9136 and 0.9061 (P < 0.001) for all tooth surfaces at T1 and T2, respectively. The measurements of the three investigators were in good agreement, with intraclass correlation coefficients of 0.989 and 0.992 (P < 0.001) for the vestibular and lingual surfaces at T1, respectively, and 0.964 and 0.983 (P < 0.001) for the vestibular and lingual surfaces at T2, respectively., Conclusion: In the present study, a digital 3D evaluation system of dental plaque suitable for research and clinical practice was initially developed and its reliability demonstrated.

Background and Objective: Complete denture is a common restorative treatment in dental patients and the design of the core components (major connector and retentive mesh) of complete denture metal base (CDMB) is the basis of successful restoration. However, the automated design process of CDMB has become a challenging task primarily due to the complexity of manual interaction, low personalization, and low design accuracy., Methods: To solve the existing problems, we develop a computer-aided Segmentation Network-driven CDMB design framework, called CDMB-SegNet, to automatically generate personalized digital design boundaries for complete dentures of edentulous patients. Specifically, CDMB-SegNet consists of a novel upright-orientation adjustment module (UO-AM), a dental feature-driven segmentation network, and a specific boundary-optimization design module (BO-DM). UO-AM automatically identifies key points for locating spatial attitude of the three-dimensional dental model with arbitrary posture, while BO-DM can result in smoother and more personalized designs for complete denture. In addition, to achieve efficient and accurate feature extraction and segmentation of 3D edentulous models with irregular gingival tissues, the light-weight backbone network is also incorporated into CDMB-SegNet., Results: Experimental results on a large clinical dataset showed that CDMB-SegNet can achieve superior performance over the state-of-the-art methods. Quantitative evaluation (major connector/retentive mesh) showed improved Accuracy (98.54 ± 0.58 %/97.73 ± 0.92 %) and IoU (87.42 ± 5.48 %/70.42 ± 7.95 %), and reduced Maximum Symmetric Surface Distance (4.54 ± 2.06 mm/4.62 ± 1.68 mm), Average Symmetric Surface Distance (1.45 ± 0.63mm/1.28 ± 0.54 mm), Roughness Rate (6.17 ± 1.40 %/6.80 ± 1.23 %) and Vertices Number (23.22 ± 1.85/43.15 ± 2.72). Moreover, CDMB-SegNet shortened the overall design time to around 4 min, which is one tenth of the comparison methods., Conclusions: CDMB-SegNet is the first intelligent neural network for automatic CDMB design driven by oral big data and dental features. The designed CDMB is able to couple with patient's personalized dental anatomical morphology, providing higher clinical applicability compared with the state-of-the-art methods., Competing Interests: Declaration of competing interest The authors report no conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Grading laryngeal squamous cell carcinoma (LSCC) based on histopathological images is a clinically significant yet challenging task. However, more low-effect background semantic information appeared in the feature maps, feature channels, and class activation maps, which caused a serious impact on the accuracy and interpretability of LSCC grading. While the traditional transformer block makes extensive use of parameter attention, the model overlearns the low-effect background semantic information, resulting in ineffectively reducing the proportion of background semantics. Therefore, we propose an end-to-end network with transformers constrained by learned-parameter-free attention (LA-ViT), which improve the ability to learn high-effect target semantic information and reduce the proportion of background semantics. Firstly, according to generalized linear model and probabilistic, we demonstrate that learned-parameter-free attention (LA) has a stronger ability to learn highly effective target semantic information than parameter attention. Secondly, the first-type LA transformer block of LA-ViT utilizes the feature map position subspace to realize the query. Then, it uses the feature channel subspace to realize the key, and adopts the average convergence to obtain a value. And those construct the LA mechanism. Thus, it reduces the proportion of background semantics in the feature maps and feature channels. Thirdly, the second-type LA transformer block of LA-ViT uses the model probability matrix information and decision level weight information to realize key and query, respectively. And those realize the LA mechanism. So, it reduces the proportion of background semantics in class activation maps. Finally, we build a new complex semantic LSCC pathology image dataset to address the problem, which is less research on LSCC grading models because of lacking clinically meaningful datasets. After extensive experiments, the whole metrics of LA-ViT outperform those of other state-of-the-art methods, and the visualization maps match better with the regions of interest in the pathologists' decision-making. Moreover, the experimental results conducted on a public LSCC pathology image dataset show that LA-ViT has superior generalization performance to that of other state-of-the-art methods.

Zirconium-based metallic glasses (Zr-MGs) are demonstrated to exhibit high mechanical strength, low elastic modulus and excellent biocompatibility, making them promising materials for endosseous implants. Meanwhile, tantalum (Ta) is also well known for its ideal corrosion resistance and biological effects. However, the metal has an elastic modulus as high as 186 GPa which is not comparable to the natural bone (10-30 GPa), and it also has a relative high cost. Here, to fully exploit the advantages of Ta as endosseous implants, a small amount of Ta (as low as 3 at. %) was successfully added into a Zr-MG to generate an advanced functional endosseous implant, Zr 58 Cu 25 Al 14 Ta 3 MG, with superior comprehensive properties. Upon carefully dissecting the atomic structure and surface chemistry, the results show that amorphization of Ta enables the uniform distribution in material surface, leading to a significantly improved chemical stability and extensive material-cell contact regulation. Systematical analyses on the immunological, angiogenesis and osteogenesis capability of the material are carried out utilizing the next-generation sequencing, revealing that Zr 58 Cu 25 Al 14 Ta 3 MG can regulate angiogenesis through VEGF signaling pathway and osteogenesis via BMP signaling pathway. Animal experiment further confirms a sound osseointegration of Zr 58 Cu 25 Al 14 Ta 3 MG in achieving better bone-implant-contact and inducing faster peri-implant bone formation., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors.)

Statement of Problem: The accuracy of virtual dentofacial patients has been explored, but the accuracy of virtual patients established by using a straightforward and reliable method and the accuracy of different virtual patients are unclear., Purpose: The purpose of this clinical study was to compare the accuracy of virtual dentofacial patients digitized by using registered-block impression, exposed anterior teeth, and cone beam computed tomography (CBCT) reconstruction methods based on 3-dimensional (3D) facial and dental images., Material and Methods: From the 15 selected participants who needed CBCT scanning, 3 kinds of virtual dentofacial patients were established by using 3 registration methods based on digital dental casts: 3D facial images, CBCT data, and registered-block impression. Compared with actual measurement, 25 linear distances of all virtual dentofacial patients were selected and measured by using a software program, and 3 separate measurements were calculated by the same person. The 1-way analysis of variance (ANOVA) was used to compare the deviations among 3 kinds of virtual dentofacial patients (trueness) and the deviations within groups (precision). The 1-sample t test was used to compare the difference between the deviation and the ideal error of 0.00 (α=.05)., Results: Compared with the actual measurement, the trueness of the average deviations for registered-block impression (1.02 ±1.24 mm) was better than that of exposed anterior teeth (2.35 ±1.71 mm) and CBCT reconstruction (2.86 ±1.61 mm). The precision of the average deviations for registered-block impression (1.29 ±1.43 mm) was better than that of exposed anterior teeth (2.00 ±1.72 mm) and CBCT reconstruction (2.12 ±1.94 mm). Significant differences in trueness and precision were found among the 3 groups of virtual dentofacial patients (P<.01). Significant differences among the deviations of all linear distances and the ideal error of 0.00 were observed for all groups of virtual dentofacial patients (P<.05)., Conclusions: The accuracy of registered-block impression was better than that of the exposed anterior teeth and CBCT reconstruction. The accuracy of exposed anterior teeth was lower than that of the other methods but could satisfy the requirements of clinical diagnostics and scientific methods. The accuracy of CBCT reconstruction was poor and could only be used for special situations that permitted low accuracy., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Statement of Problem: Additive manufacturing is emerging as an alternative method of fabricating dental restorations, but the support design needs to be optimized., Purpose: The purpose of this in vitro study was to evaluate the 3-dimensional trueness and adaptations of zirconia crowns manufactured by stereolithography (SLA) with an occlusal full-supporting structure, compared with those SLA-printed with pillar supports, and those made by milling., Material and Methods: A zirconia abutment was prepared, and an anatomic contour crown was designed. The crowns were manufactured by SLA and milling (n=6). For SLA manufacturing, a full-supporting base and pillar supports were designed. The 3-dimensional (3D) trueness of the fabricated crowns was characterized by 3D deviation analysis. The adaptations of crowns in the SLA-base and milling groups were measured by using a triple-scan method. Color-difference maps and the root mean square (RMS) values were used to characterize the 3D trueness. One-way analysis of variance (ANOVA) and Tukey post hoc test were used to analyze the difference in RMS values among the 3 groups, and Student t test was used to analyze the difference in cement-gap width between the milling group and the SLA group with the full-supporting base (α=.05)., Results: The 3D deviation analysis showed that in the external area, the RMS value of the SLA-pillar group was significantly higher than that of the SLA-base and the milling groups (P<.05). In the intaglio area, the milling group showed a lower RMS value than the 2 SLA groups (P<.05). The color-difference maps showed the SLA-base group had smaller positive errors at the cusp inclines than the SLA-pillar group. No statistically significant difference was found in adaptations between the SLA-base and milling groups (P>.05)., Conclusions: The occlusal full-supporting base provided improved support in fabricating the crowns, and no remnants were left after removal. The zirconia crowns manufactured by SLA with an occlusal full-supporting structure had good external 3D trueness and clinically acceptable adaptation., (Copyright © 2022 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: In clinical practice, control of the marginal fit of fixed dental prostheses is hindered by evaluation method, which needs to be further improved to increase its clinical applicability. This study aimed to quantitatively analyze the absolute marginal discrepancy of three-unit ceramic fixed dental prostheses fabricated by conventional and digital technologies using a digital measurement method based on the digital impression technology and open source software., Methods: A digital workflow and the conventional impression combined with the lost-wax heat-pressed technique were adopted to separately fabricate 10 glass ceramic fixed dental prostheses. Three-dimensional data for the abutments, fixed dental prostheses, and fixed dental prostheses seated on the abutments, were obtained using a dental scanner. The two datasets were aligned using registration technology, specifically "multi-points registration" and "best fit alignment," by reverse engineering software. Subsequently, the three-dimensional seated fit between the fixed dental prostheses and abutments were reconstructed. The margin of the abutment and crown was extracted using edge-sharpening and other functional modules, and the absolute marginal discrepancy was measured by the distance between the margin of the abutment and crown. One-way analysis of variance was used to statistically analyze the measurement results., Results: Using the digital measurement method, the mean value of absolute marginal discrepancy for fixed dental prostheses fabricated by the conventional method was 106.69 ± 6.46 μm, and that fabricated by the digital workflow was 102.55 ± 6.96 μm. The difference in the absolute marginal discrepancy of three-unit all-ceramic fixed dental prostheses fabricated using the two methods was not statistically significant (p > 0.05)., Conclusions: The digital measurement method for absolute marginal discrepancy was preliminarily established based on open source software and applied in three-unit ceramic fixed dental prostheses. The absolute marginal discrepancy of three-unit ceramic fixed dental prostheses fabricated using digital technology was comparable to that of conventional technique., (© 2023. The Author(s).)

In severe service environments, the presence of high local residual stress, significant organizational gradient, and nonlinear changes in material properties often leads to stress corrosion cracking (SCC) in dissimilar metal welded (DMW) joints. To accurately predict the crack growth rate, researching the initiation and propagation behavior of SCC cracks in DMW joints under residual stress (RS) is one of the most important methods to ensure the safe operation of nuclear power plants. Using the extended finite element method (XFEM), the crack propagation behaviors in DMW joints under different RS states are predicted and compared. The effects of RS, crack location, and initial crack length on crack propagation behavior are investigated. The crack in a DMW joint without RS deflects to the material of low yield strength. High residual stress urges the crack growing direction to deflect toward the material of high yield strength. Young's modulus has little impact on the crack deflection paths. The distance between the specimen symmetric line and the boundary line has little effect on the crack initiation and propagation within the RS field. A long initial crack is more likely to initiate and propagate than a short crack. To a long crack and the crack that is far from the interface of two materials, the impact of residual stress on the crack propagation path is significant when it is located in a material with high yield strength, while when the initial crack is located in the material with low yield strength, RS has a great influence on the deflection of a short crack growth direction on the condition that the crack is adjacent to the interface.

The ever-growing aging population has led to an increasing need for removable partial dentures (RPDs) since they are typically the least expensive treatment options for partial edentulism. However, the digital design of RPDs remains challenging for dental technicians due to the variety of partially edentulous scenarios and complex combinations of denture components. To accelerate the design of RPDs, we propose a U-shape network incorporated with Transformer blocks to automatically generate RPD clasps, one of the most frequently used RPD components. Unlike existing dental restoration design algorithms, we introduce the voxel-based truncated signed distance field (TSDF) as an intermediate representation, which reduces the sensitivity of the network to resolution and contributes to more smooth reconstruction. Besides, a selective insertion scheme is proposed for solving the memory issue caused by Transformer blocks and enables the algorithm to work well in scenarios with insufficient data. We further design two weighted loss functions to filter out the noisy signals generated from the zero-gradient areas in TSDF. Ablation and comparison studies demonstrate that our algorithm outperforms state-of-the-art reconstruction methods by a large margin and can serve as an intelligent auxiliary in denture design.

Bone substitute material implantation has become an important treatment strategy for the repair of oral and maxillofacial bone defects. Recent studies have shown that appropriate inflammatory and immune cells are essential factors in the process of osteoinduction of bone substitute materials. Previous studies have mainly focused on innate immune cells such as macrophages. In our previous work, we found that T lymphocytes, as adaptive immune cells, are also essential in the osteoinduction procedure. As the most important antigen-presenting cell, whether dendritic cells (DCs) can recognize non-antigen biomaterials and participate in osteoinduction was still unclear. In this study, we found that surgical trauma associated with materials implantation induces necrocytosis, and this causes the release of high mobility group protein-1 (HMGB1), which is adsorbed on the surface of bone substitute materials. Subsequently, HMGB1-adsorbed materials were recognized by the TLR4-MYD88-NFκB signal axis of dendritic cells, and the inflammatory response was activated. Finally, activated DCs release regeneration-related chemokines, recruit mesenchymal stem cells, and initiate the osteoinduction process. This study sheds light on the immune-regeneration process after bone substitute materials implantation, points out a potential direction for the development of bone substitute materials, and provides guidance for the development of clinical surgical methods., (© 2023. The Author(s).)

Objectives: This study evaluated the accuracy of digital implant impressions with or without prefabricated landmarks compared with the conventional method in the edentulous mandible., Methods: An edentulous mandibular stone cast with implant abutment analogs and scan bodies in FDI #46, #43, #33, and #36 served as the master model. The scans captured with intraoral scanners (IOS) were divided into four groups: IOS-NT (no landmarks + Trios 4 scanner), IOS-NA (no landmarks + Aoralscan 3 scanner), IOS-YT (landmarks + Trios 4 scanner), and IOS-YA (landmarks + Aoralscan 3 scanner) (n=10). Landmarks were attached to the scan bodies with resin to improve scanning fluency. Conventional open-trayed technique (CNV) was performed with the 3D-printed splinting frameworks (n=10). The master model and conventional castings were scanned using a laboratory scanner, and the former served as the reference model. Overall distance and angle deviations between scan bodies were measured to determine trueness and precision. The ANOVA or Kruskal-Wallis test compared CNV group to scans without landmarks, while a generalized linear model analyzed scan groups with and without landmarks., Results: Compared to the CNV group, the IOS-NA and IOS-NT groups showed higher overall distance trueness (p=0.009), and precision (distance, p<0.001 and angular, p<0.001). With landmarks, the IOS-YA group had higher overall trueness (distance, p<0.001 and angular, p<0.001) than the IOS-NA group, and the IOS-YT group has higher distance trueness (p=0.041) than the IOS-NT group. Moreover, the precision in distance and angle was significantly improved for IOS-YA and IOS-YT groups, compared with the IOS-NA (p<0.001) and IOS-NT (p<0.001) groups separately., Conclusions: Digital scans were more accurate than conventional splinting open-trayed impressions. Prefabricated landmarks significantly improved the accuracy of full-arch implant digital scans, regardless of the scanner used., Clinical Significance: Prefabricated landmarks can enhance the accuracy of intraoral scanners for full-arch implant rehabilitation, improving scanning efficiency and clinical outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Statement of Problem: Studies that have used digital methods to quantitatively evaluate physiological tooth displacement under occlusal force are sparse., Purpose: The purpose of this clinical study was to measure physiological posterior tooth displacement under occlusal force by intraoral scanning and reverse engineering technology by using implants as the reference., Material and Methods: A total of 14 participants received 15 implant-supported single mandibular first molar crowns. The surface data of maxillary and mandibular posterior teeth (U1 and L1) and the buccal occlusal data in the maximum intercuspal position (MIP) with habitual occlusal force were obtained by using an intraoral scanner (TRIOS 3, v20.1.2). The U1 and L1 data were segmented into single teeth, which were then aligned to the buccal occlusal data by using the "best-fit alignment" command to build the data under occlusal force (U2 and L2). U1 and L1 data were compared with U2 and L2 data to calculate the centroid and functional cusp vertex displacements and the long axis deflections of the second premolars and second molars, taking the first molar as the reference. The medians, and first quartile (Q 1 ), third quartile (Q 3 ) of the above data were reported, and the Shapiro-Wilk and Wilcoxon tests were used to analyze the differences (α=.05)., Results: Under occlusal force, the median (Q 1 , Q 3 ) centroid displacements of posterior teeth ranged from 61 (52, 101) μm to 146 (80, 186) μm; the functional cusp vertex displacements ranged from 82 (62, 117) μm to 146 (98, 189) μm, and the long axis deflections ranged from 0.45 (0.25, 0.87) degrees to 1.03 (0.52, 1.41) degrees. Mandibular second premolars displaced lingually, mesially, and apically; mandibular second molars displaced distally and apically; and maxillary second premolars and second molars displaced lingually and apically., Conclusions: A digital method taking implant-supported single crowns as the reference was used to demonstrate physiological posterior-tooth displacement under habitual occlusal force., (Copyright © 2023 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The present study aimed to predict the envelope surfaces from facial morphology. Condylar envelope surfaces for 34 healthy adults were formed and simplified as sagittal section curves. Cephalometric and maximum mandibular moving distances measurement were performed on the participants. There was no statistically significant difference (p = 0.763) between the left and right maximum lateral movements. There was a statistically significant difference in the mandibular body length between the sexes. The envelope surfaces were divided into type 1 with H p2 ≥ 1/3 H p1 and type 2 with H p2 < 1/3 × H p1 . SNA and SNB for type 2 were significantly greater than those for type 1 (p < 0.001). Therefore, the participants were divided into four groups based on gender and envelope surface morphology. The curves could be fitted using the second-order Fourier function (R-square ≥0.95). Six facial parameters were selected and a matrix was used to map facial morphology to the envelope surface. Individual sagittal curves were predicted using the matrix and facial parameters, and the envelope surface was predicted using the curve and the condyle model. Deviation analysis for the predicted envelope surface using the actual envelope as a reference was carried out (root mean square = 0.9970 mm ± 0.2918 mm). This method may lay a foundation for the geometric design of artificial fossa components of temporomandibular joint replacement systems. It may improve prosthesis design without flexible tissue repair and guide the movement of the artificial joint head., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

Objective: Femtosecond laser (fs-laser) is a novel tooth preparation tool but its ablation efficiency is insufficient. The purpose is to establish a new fs-laser tooth ablation method based on a dual-wedges path ablation system, and explore the efficiency of tooth hard tissue and dental restorative materials ablation. Materials and methods: Extracted third molars, pure titanium, cobalt-chromium alloy, gold alloy, and 3Y-zirconia were prepared into samples. These samples were rotary ablated by an fs-laser with dual-wedges. The wavelength was 1030 nm and the pulse duration was 250 fsec. Laser parameters were set as a repetition frequency of 25 kHz, the power percentages as 50% for dental tissues, and 60% for restorative materials. The optical wedge angle was set as 0°, 20°, 40°, 60°, and 80° for restorative materials, 0°, 20°, 30°, 40°, and 60° for enamel, and 0°, 10°, 20°, 30°, and 40°for dentin. Three times of ablation was processed at each parameter to obtain total 90 ablation microcavities of 6 kinds of materials. The diameter, depth, and volume of microcavities were measured by confocal laser microscopy and plotted against optical-wedge-angle in curves of different materials. One-way analysis of variance (ANOVA) was used to test whether the ablation efficiency between different angles was statistically significant. Results: The ablation efficiency of each material at different optical-wedge-angle was statistically significant ( p  < 0.05) and tends to be correlated. For dental hard tissue, the enamel ablation efficiency was 208.1 times and dentin ablation efficiency were 65.2 times than before when the wedge angle was 40°. For pure titanium, zirconia, cobalt-chromium, and gold alloys, the ablation efficiencies were 3.1, 10.7, 81.5, and 128.8 times than before when the rotation angle was 80°. Conclusions: The ablation efficiency of dental hard tissues and restorative materials was significantly increased with the increase of laser oblique incidence angle. Clinical Trial Registration number: PKUSSIRB-201949124.

Purpose: To compare the accuracies of three intraoral scanners for shade determination function in vitro, and to preliminarily investigate the shade-matching characteristics of the three intraoral scanners., Materials and Methods: The shade of the middle third region of each shade tab on the Vita Classical A1-D4 shade guide (VC) was measured with a spectrophotometer (Vita Easyshade V, VE) and three intraoral scanners, including CEREC Omnicam (OM), 3Shape TRIOS 3 (T3), and TRIOS 4 (T4). A conversion table between VC values and CIELAB values was established from the database of VE to analyze the trueness. The reproducibility of the instruments was then compared by repeating the measurements five times., Results: The mean color difference for each instrument was highest in the OM, followed by the T4, and lowest in the T3 and VE, respectively. The L * and a * value for OM, and the b * value for T4, were significantly different from those for VE (p <0.05). The reproducibility of the instrument was highest in the VE (Fleiss' kappa: 0.95), followed by the T3 (Fleiss' kappa: 0.89), T4 (Fleiss' kappa: 0.87), and OM (Fleiss' kappa: 0.78)., Conclusions: Of the three intraoral scanners, the trueness was best on the T3. The reproducibility of all the instruments was excellent., (© 2022 by the American College of Prosthodontists.)

Purpose: To compare the accuracy of occlusal wear facet morphology designed using different bite registration methods for mandibular first molar crowns., Materials and Methods: The posterior teeth and intraoral intercuspal occlusions of 12 participants were scanned. The abutment shape of the mandibular first molars for complete crowns was virtually designed, and the anatomic coping design method was used to design crowns. In the anatomic coping design, digital wax patterns were constructed by elevating the wear facets on the original surface of the first molars and then adjusting the facets with 2 types of virtual occlusions determined by buccal bite registration (BBR) or segmented tooth registration (STR) methods, where the displacement of teeth under bite force was considered (STR) or not (BBR). The occlusal distance between the original wear facets and the antagonists as well as 3D deviations between the facets on the designed crowns and on the surfaces of the original teeth were measured. Paired-samples t-test was used to analyze the results (α = 0.05)., Results: Regarding occlusal distance, the mean 3D deviation and the root mean square (RMS) values of BBR were greater than those of the STR groups (p < 0.001 and p = 0.008). The mean 3D deviations of the crowns of the BBR and STR groups were 0.19 ±0.04 mm and 0.14 ±0.06 mm, respectively and the RMS values were 0.22 ±0.03 mm and 0.18 ±0.04 mm (p < 0.001), respectively., Conclusions: The morphology of occlusal wear facets of mandibular first molar crowns designed with the occlusion constructed using the segmented tooth registration method are more coincident with the original morphology., (© 2022 by the American College of Prosthodontists.)

Objectives: To evaluate the effect of a nanosilica-lithium spray coating on the internal and marginal fit of high translucent zirconia crowns using a digital evaluation method., Methods: A three-dimensional analysis model of a zirconia abutment was digitally scanned using a dental scanner, and 30 monolithic high translucent zirconia crowns were designed and fabricated. They were divided into groups (n = 10) according to the surface treatment method: (1) no treatment: as-sintered zirconia; (2) airborne-particle abrasion with 50 μm Al 2 O 3 particles; and (3) nanosilica-lithium spray coating. Three-dimensional data for the abutment, crown, and crown seated on the abutment were obtained using a dental scanner. The three-dimensional seated fit between the crown and abutment was reconstructed using registration technology, and a three-dimensional (3D) deviation analysis was used to evaluate the effect of different modification methods on the internal and marginal fit of the crowns using root mean square (RMS) values., Results: The 3D deviation analysis of all groups conformed to a normal distribution (P > 0.05), and the variance was homogeneous (P > 0.05). The different surface treatments had no significant effect on the RMS values in the occlusal, axial, and marginal regions of the high translucent zirconia crowns (P > 0.05)., Conclusions: Nanosilica-lithium spray coating for the modification of as-sintered zirconia is clinically feasible and does not affect the internal or marginal fit of high translucent zirconia crowns., Clinical Significance: Nanosilica-lithium spray coating does not affect the adaptation of zirconia crowns and is a clinically feasible surface treatment method for zirconia. It is unnecessary to add the setting values of the internal and marginal fit when fabricating nanosilica-lithium-sprayed zirconia crowns., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Background and Objective: The retention of selective laser melting (SLM)-built denture clasps is inferior to that of cast cobalt-chromium (Co-Cr) clasps engaging 0.01-in undercuts, which are commonly used in clinical practice. Either the clasps engage in excessively deep undercuts or inappropriate printing process parameters are applied. With appropriate undercut engagement and levels of process parameters, the retention of SLM-built clasps (including Co-Cr, commercially pure titanium [CP Ti], and Ti alloy [Ti-6Al-4V] ones) may be comparable to that of cast Co-Cr clasps. Therefore, this feasibility study aimed to evaluate their retention to guide dentists during material selection for the powder-bed fusion process during the printing of denture clasps., Methods: We engaged the clasp arm at an appropriate undercut depth (0.01 or 0.02 in), built clasps at the orientation of their longitudinal axes approximately parallel to the build platform, generated square prism support structures at a critical overhang angle of 30°, applied optimized laser parameters (laser power, scan speed, and hatch space), and adopted annealing treatment for Co-Cr, CP Ti, and Ti-6Al-4V clasps. After postprocessing and accuracy measurement, an insertion/removal test of the clasps for 15,000 cycles was performed to simulate 10 years of clinical use, and the retentive force was recorded every 1500 cycles. Permanent deformation of the retentive arms of the clasps was measured. Cast Co-Cr clasps engaging 0.01-in undercuts were designated the control group., Results: The initial retentive forces of the SLM-built Co-Cr clasps engaging 0.01-in undercuts and CP Ti and Ti-6Al-4V clasps engaging 0.02-in undercuts were comparable to those of the control group. SLM-built Co-Cr clasps engaging 0.01-in undercuts and Ti-6Al-4V clasps engaging 0.02-in undercuts had similar final retentive force and less permanent deformation compared with those of the control group; SLM-built CP Ti clasps engaging 0.02-in undercuts had lower final retentive force and greater permanent deformation., Conclusions: Considering the long-term retention and permanent deformation of the retentive arms, Co-Cr and Ti-6Al-4V alloys, except CP Ti, are recommended for printing denture clasps. SLM-built Co-Cr clasps should engage 0.01-in undercuts, and Ti-6Al-4V clasps should engage 0.02-in undercuts., Competing Interests: Declaration of competing interest None Declared., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Statement of Problem: Although computer-aided design has become popular, restorations are typically designed from static occlusion and dynamically by using an average-value virtual articulator. Patient-specific motion recorded by using an intraoral scanner has rarely been used to design restorations, and its design ability has not been analyzed., Purpose: The purpose of this clinical study was to record patient-specific motion by using an intraoral scanner and to analyze its ability to design the morphology of the wear facets on mandibular first molar crowns., Material and Methods: An intraoral scanner was used to scan complete arch digital casts and to record patient-specific motion of 11 participants. Right and left mandibular first molars were selected as the target teeth. The complete crown preparations of the target teeth were virtually prepared on the digital mandibular casts by using the Geomagic Studio 2013 software program. High points were created by elevating the wear facets of the target teeth by 0.3 mm in the occlusal direction to generate digital wax patterns. The Dental System software program was used to design crowns with the anatomic coping design method. Occlusal adjustment with static occlusion (STA crown), with the average-value virtual articulator (DYN crown), and with patient-specific motion (FUN crown) was carried out. The crowns adjusted with these 3 methods were compared with the original wear facets. The mean value and root mean square (RMS) of 3D deviation were measured. One-way ANOVA was used to analyze the influence of the occlusal surface design methods on the morphology of the wear facets (α=.05)., Results: The STA crowns had the poorest results with the mean ±standard deviation 3D deviation value of 0.15 ±0.05 mm and RMS value of 0.19 ±0.04 mm. The best results occurred in the FUN group, with the mean ±standard deviation 3D deviation value of 0.05 ±0.06 mm and RMS value of 0.13 ±0.03 mm. Significant differences were found among the 3 groups (P<.01). Except for the RMS value between the STA and DYN groups, significant differences were found between groups from the pairwise comparisons., Conclusions: The occlusal surface of the crowns designed by using the patient-specific motion recorded with the intraoral scanner had the best coincidence with the morphology of the wear facets on the original teeth., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Purpose: In this study, we propose a 3D printing-aided method for manufacturing complete dentures and evaluate its accuracy of artificial tooth positioning., Methods: Complete dentures were designed and 3D printed and put on a plaster cast; and pack and press technique was used to fabricate the final denture during which artificial teeth were inserted in the teeth holes formed by the printed denture. In this study, fused deposition moulding (FDM) and stereolithography (SLA) techniques were used to fabricate complete dentures (10 pairs of maxillary and mandibular dentures each). After 3D scanning the final dentures, 3D comparison between the scanned teeth on the denture and its computer-aided design (CAD) data was made and single-tooth deflection angles were measured to evaluate the tooth position. Values were compared using independent-sample t-tests or the Mann-Whitney U test., Results: In the result of 3D comparison, the root mean square values of artificial teeth were 0.107 ± 0.018 mm (SLA group) and 0.136 ± 0.023 mm (FDM group; P < 0.05). In the result of single-tooth deflection angles, the mandibular anterior teeth demonstrated the maximum deflection angle, followed by the molars, premolars, and maxillary anterior teeth., Conclusions: It is feasible to fabricate complete dentures using 3D-printed complete dentures as prototypes and combine conventional methods. The accuracy of the final denture fabricated using SLA printing was better than that of dentures produced using the FDM method., Clinical Significance: The 3D printing-aided manufacturing for complete dentures refers to using the 3D-printed dentures as a prototype along with the traditional process to fabricate final dentures and is an effective alternative when the dentures cannot be directly processed using computer-aided manufacturing (CAM)., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Precise occlusal design of implant-supported fixed prostheses is difficult to achieve by the conventional wax-up method, often requiring chairside adjustments. The computer-aided design (CAD) method is promising. This study aims to compare the occlusal contacts and clearance of posterior implant-supported single crowns designed by the CAD and conventional methods., Methods: Sample size calculation indicated fourteen samples per group. Two sets of type-IV plaster casts with a single implant analog inserted in the posterior teeth region were mounted as master casts in a mechanical articulator in maximal intercuspal position (MIP). Seven working cast sets were obtained from each master cast by a closed tray technique, and mounted in MIP. Two implant-supported single crowns were designed with an occlusal clearance to achieve light occlusal contact in each working cast set by CAD and conventional method, separately. For the CAD group, the crown was designed in digital models obtained by scanning the working casts. For the conventional group, wax-up of the crown was prepared on the working casts and scanned to generate a STL file. In the working and master casts, mean and minimum occlusal clearances in the designed occlusal contact area of the both finished prostheses were calculated using the occlusal clearance (OC) and occlusal record (OR) method. The prostheses' occlusion was evaluated in master casts., Results: For the evaluation in the working casts, both design methods had similar mean occlusal clearances by the OC method (195.4 ± 43.8 vs. 179.8 ± 41.8 μm; P = 0.300), while CAD group resulted in a significantly larger minimum occlusal clearance in the designed occlusal contact area (139.5 ± 52.3 vs. 99.8 ± 43.8 μm; P = 0.043). Both design methods had similar mean and minimum occlusal clearances by the OR method (P > 0.05). For the evaluation in the master casts, both design techniques had similar mean and minimum occlusal clearances, number and distribution of occlusal contacts, and lateral interference ratios (P > 0.05)., Conclusion: Occlusal contact and clearance of posterior implant-supported single crowns designed by the CAD method can be at least as good as those designed by the conventional wax-up method., (© 2023. The Author(s).)

Tumor grading and interpretability of laryngeal cancer is a key yet challenging task in the clinical diagnosis, mainly because of the commonly used low-magnification pathological images lack fine cellular structure information and accurate localization, the diagnosis results of pathologists are different from those of attentional convolutional network -based methods, and the gradient-weighted class activation mapping method cannot be optimized to create the best visualization map. To address this problem, we propose an end-to-end depth domain adaptive network (DDANet) with integration gradient CAM and priori experience-guided attention to improve the tumor grading performance and interpretability by introducing the pathologist's a priori experience in high-magnification into the depth model. Specifically, a novel priori experience-guided attention (PE-GA) method is developed to solve the traditional unsupervised attention optimization problem. Besides, a novel integration gradient CAM is proposed to mitigate overfitting, information redundancies and low sparsity of the Grad-CAM graphs generated by the PE-GA method. Furthermore, we establish a set of quantitative evaluation metric systems for model visual interpretation. Extensive experimental results show that compared with the state-of-the-art methods, the average grading accuracy is increased to 88.43% (↑4.04%), the effective interpretable rate is increased to 52.73% (↑11.45%). Additionally, it effectively reduces the difference between CV-based method and pathology in diagnosis results. Importantly, the visualized interpretive maps are closer to the region of interest of concern by pathologists, and our model outperforms pathologists with different levels of experience., Competing Interests: Declaration of competing interest The authors declared no conflict of interest., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Purpose: This study proposes a method for improving the accuracy of three-dimensional (3D) models generated through cone-beam computed tomography (CBCT)., Methods: A 3D cuboid model fitted with a ¼-scale dentition on its top surface was constructed to simulate an alveolar bone with teeth. A physical specimen of the model was printed and the distance between its opposite sides was measured using a vernier caliper. The physical model was light-scanned, and the surface data of the generated 3D model were corrected by calibrating the distance between opposite sides against the vernier caliper measurements. The physical model was also scanned using CBCT to reconstruct a second 3D model. The overall deviation between the two models and the distance deviation in each direction of the cuboid and dentition were quantified and statistically analyzed., Results: The overall deviation between the reconstructed CBCT model and the calibrated structured light-scanned model was 0.098 ± 0.001 mm. Following calibration, the overall deviation was 0.010 ± 0.006 mm. A one-way variance analysis suggested that the overall deviations' differences were not statistically significant (P < 0.05)., Conclusion: This study lays a solid foundation for accurate dental implantation., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Statement of Problem: Restorations with knife-edge margins are more prone to margin chipping during the manufacturing process. Three-dimensional gel deposition shows potential for fabricating zirconia restorations with good margin quality, but studies on its performance in fabricating knife-edged crowns are lacking., Purpose: The purpose of this in vitro study was to compare the 3-dimensional trueness, surface morphology, and margin quality of self-glazed zirconia and soft-milled zirconia crowns with knife-edge margins., Material and Methods: An abutment with a knife-edge finish line design was prepared and scanned with a laboratory scanner. Anatomic contour crowns were designed and fabricated by 3-dimensional gel deposition and soft milling (n=5). The crowns were digitalized, and the scan data were superimposed on the computer-aided design (CAD) data for 3-dimensional deviation analysis. Surface morphology and margin quality were characterized with microscopic examination., Results: The self-glazed zirconia crowns showed a smooth and glossy appearance. The soft-milled crowns showed traces left by the removal of support bars and numerous micropits of various sizes. In internal areas, no significant difference was found in root mean square values between the 2 groups (P＞.05). For the external surface, self-glazed zirconia showed statistically lower root mean square values than the soft-milled crowns (P＜.05). When observed at ×5 magnification, all the self-glazed zirconia crowns showed smooth edges with no defects, whereas small or large margin defects were found in the soft-milled crowns. When characterized at ×200 magnification, minor margin flaws were observed in the self-glazed zirconia crowns. More and larger margin defects were found in the soft-milled crowns., Conclusions: Three-dimensional gel deposition forms a smoother and more homogeneous surface than soft milling. Knife-edged self-glazed zirconia crowns have good dimensional accuracy and margin quality., (Copyright © 2021 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

The purpose of this study was to compare the accuracy of digital dental casts from plaster cast scanning (PCS), impression scanning (IPS), intraoral scanning (IOS), and cone-beam computed tomography (CBCT) scanning (CCS) methods. The maxillary and mandibular dental casts of 15 patients who needed CBCT scans for oral examination or treatment were digitized via four methods. 12 linear distance measurements of all digital dental casts were selected and acquired with software and compared to those of the reference plaster cast to evaluate the dimensional accuracy. Three-dimensional deviation analysis of the IPS, IOS and CCS groups with respect to the reference PCS group was performed to evaluate the morphological accuracy. The discrepancy in linear distances between the digital dental casts and reference plaster casts was statistically significant (p < 0.01). The dimensional accuracies of the PCS (0.06 ± 0.12 mm) and IPS (0.03 ± 0.05 mm) casts were better than those of the IOS (0.37 ± 0.30 mm) and CCS (0.54 ± 0.40 mm) casts. The one-sample t test showed that there were statistically significant differences between the discrepancies in 8 of the linear distances for the PCS group and 9 of the linear distances for the IPS group between the digital dental casts and reference plaster casts, with an ideal error of 0.00 (p < 0.05). The sequence of morphological accuracy from good to poor was maxillary and mandibular IPS, mandibular IOS; maxillary IOS; and maxillary and mandibular CCS. The accuracy of the digital dental casts from the PCS and IPS methods was greater than that of IOS and CCS methods. Although accuracy of the digital dental cast from IOS was low, it satisfied the clinical requirements for fixed restorations in small units. The accuracy of the digital dental cast from CCS was poorest and could only be used for procedures with lower accuracy requirements., (© 2022. The Author(s), under exclusive licence to The Society of The Nippon Dental University.)

Introduction: Endodontic microsurgery is a very important technique for preserving the natural teeth. The outcomes of endodontic microsurgery largely depend on the skill and experience of the operators, especially for cases in which the apices are located far away from the labial/buccal cortical bone. A dynamic navigation system (DNS) could provide a more accurate and efficient way to carry out endodontic microsurgery. This study is devoted to comparing the clinical outcomes of the DNS technique with those of the freehand technique., Methods and Analysis: Sixteen patients will be randomly assigned to one of two groups. For the experimental group, the osteotomy and root-end resection will be performed under the guidance of dynamic navigation. For the control group, these procedures will be performed freehand by an endodontist. The required time to perform these procedures will be used to evaluate the efficiency of the DNS technique. A Visual Analogue Scale will be used to evaluate pain at 1, 3 and 7 days after endodontic microsurgery. Preoperative and postoperative cone beam CT scans will be obtained to evaluate the accuracy of the DNS technique. The global coronal deviations, the apical deviations and the angular deflection will be measured. The root-end resection length deviation, the root-end resection angle deviations, the extent of the osteotomy and the volume change of the buccal cortical bone will also be measured. Periapical radiographs will be obtained to evaluate the outcome at 1 year after microsurgery. The time to execute the study, including follow-ups, will last from 1 June 2022 to 31 December 2025., Ethics and Dissemination: The present study has received approval from the Ethics Committee of Peking University School and Hospital of Stomatology. The results will be disseminated through scientific journals., Trial Registration Number: ChiCTR2200059389., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: The purpose of this study was to evaluate a novel 3D-printed custom tray for impressions of edentulous jaws, and to compare it with conventional impression trays., Methods: Fifteen edentulous patients were enroled to evaluate the accuracy and border extension of a novel custom tray in the shape of a complete denture. Four impressions were made for each patient. Impressions made using novel custom trays were considered the experimental group, impressions made using conventional custom trays were considered the control group, and impressions made using final dentures and non-pressure custom trays were considered the reference groups. The experimental and control groups were compared with the reference groups using three-dimensional (3D) comparison analysis, and the impressions were further divided into regions. The root mean square (RMS) value was calculated to analyse the differences in impression morphology. Additionally, the experimental and control groups were compared to analyse border extension at standard locations., Results: Compared to the final denture impression as a reference, the diagnostic denture impression (RMS:0.146 ± 0.024 mm) was closer to the reference than the conventional impression (RMS:0.176 ± 0.047 mm), with a significant difference only in the secondary stress-bearing area. The border extension of the diagnostic denture impression was slightly longer than the conventional impression; however, the difference was not statistically significant., Conclusions: The impressions made using the novel custom tray were similar to those made with a definitive complete denture. However, no significant differences were noted when compared with the conventional impressions., Competing Interests: Declaration of Competing Interest The authors have no financial conflicts of interest., (Copyright © 2022. Published by Elsevier Ltd.)

To compare the accuracy of visual and instrumental methods for tooth-color matching based on three attributes in the Munsell color system and to investigate the characteristics of intraoral scanners for tooth-color matching. Shades of the cervical, middle, and incisal third region of 130 maxillary anterior teeth were matched visually by an experienced prosthodontist (EP) using Vita classical A1-D4 (VC) and Vita System 3D-Master (V3D) shade guides, and digitally by a spectrophotometer (Vita Easyshade V, VE) and two intraoral scanners (3Shape TRIOS 3, T3; TRIOS 4, T4). VE was used as a reference. The reproducibility of the three test groups was examined by repeating the measurements in triplicate. The overall trueness of the three test groups (from high to low) was T3 > EP > T4 for VC values (p < 0.01), and T3, EP > T4 (p < 0.01) for V3D. The trueness of T3 in incisal regions was lower than cervical and middle regions. When hue or lightness was correct, the mismatched chroma in test groups was smaller than VE (p < 0.01). The repeatability of EP was the poorest (p < 0.01). The color-matching trueness of T3 was higher than EP and T4. The reproducibility of intraoral scanners was better than visual methodology., (© 2022. The Author(s), under exclusive licence to The Society of The Nippon Dental University.)

The objective of this study was to reconstruct the envelope surface of the condyle and the four-dimensional trajectory model in mandibular border movement in normal adults. Eleven healthy subjects were selected as volunteers. Cone-beam computed tomographic (CBCT) scanning was performed on the volunteers. The three-dimensional (3D) movement path of the mandible was recorded using a virtual articulator (PN-300), which was based on a 3D model of the mandible. We used Proplan CMF 3.0 (Materialise) software to perform this from the DICOM data generated by CBCT scans. The distance of condylar movement was measured in this model during volunteers' mouth opening, protrusion, and lateral excursions. The envelope surface of the condyle was reconstructed by merging a functional condylar surface at each recording moment during the movement of the whole border. In the mandibular digital models, the condyle moved downward firstly, and moved upward to the position of maximum mouth opening. The condyle moved forward and downward during protrusion. The working condyle rotated slightly and the non-working condyle moved forward, downward, and inward during lateral excursions. The mean (SD) movement distance of 11 subjects was 19.04 (4.37) mm during mouth opening (including downward and upward) and 9.75 (2.38) mm during protrusion. During lateral excursions the mean (SD) movement distance of the working condyle was 2.87 (1.13) mm, the mean (SD) movement distance of the non-working condyle was 10.85 (3.25) mm. The envelope surface of healthy volunteers showed a double-peak pattern. The envelope surface of the condyle and four-dimensional movement model can be reconstructed by merging the trajectory of the mandible recorded from the novel virtual articulator PN300 and a 3D image of the mandible., (Copyright © 2021. Published by Elsevier Ltd.)

Objectives: To compare the trueness of computer-aided design and computer-aided manufacturing (CAD-CAM) assisted procedure and freehand procedure for preparing guiding planes for removable partial dentures (RPDs)., Methods: Forty identical mandibular resin casts were divided into two groups in which the guiding planes of two abutment teeth were prepared freehand (control group, n = 20) and using rigidly constrained templates (test group, n = 20). The template was designed on a digital cast of virtually prepared guiding planes and fabricated by selective laser melting using cobalt-chromium alloy. To assess the 3D trueness, all prepared guiding planes (Test data) were digitized using a laboratory scanner and compared to the virtually designed guiding planes (Reference data). The angle deviation between the Test data and the designed direction of the path of placement was measured for assessing the direction trueness of guiding plane preparation., Results: The 3D trueness of guiding plane preparation was significantly better in the Test group (48.4 ± 12.9 μm) than in the Control group (128.5 ± 37.6 μm, p < 0.01). The direction trueness of guiding plane preparation was also significantly better in the Test group (1.20 ± 0.55°) than in the Control group (7.68 ± 3.00°, p < 0.01)., Conclusions: The CAD-CAM template assisted procedure can significantly improve tooth preparation of the guiding planes compared to the freehand preparation. The CAD-CAM template could help clinicians prepare parallel guiding planes in a predictable manner., (Copyright © 2022. Published by Elsevier Ltd.)

Statement of Problem: Existing virtual articulators simulate mandibular movement by using various parameters and are used to design restorations. However, they are not able to reproduce actual patient movements, and the designs of occlusal wear facets by them and by personalized mandibular movement have not been compared., Purpose: The purpose of this clinical study was to establish a clinical application protocol for a virtual articulator based on previous research and to evaluate the accuracy of the occlusal wear facets designed by it., Material and Methods: The gypsum casts of 12 participants were scanned with a cast scanner as the original data. A single crown, 3-unit splinted crowns, a 5-unit fixed partial denture, and a fixed complete denture were virtually prepared on the digital mandibular casts by using the Geomagic Studio 2013 software program. High points were created at the wear facets, and corresponding digital wax patterns with occlusal interferences were generated. The exocad software program was used to design corresponding restorations with the copy method. Static (STA restoration) and dynamic (DYN restoration) occlusal adjustments were carried out with the built-in virtual articulator. The mandibular movements of participants were recorded by the novel virtual articulator system, and the occlusal surfaces of the digital wax patterns were adjusted (FUN restoration). The restorations adjusted with the 3 methods were compared with the original data. The mean value and root mean square (RMS) of 3D deviation and positive volumes (V+) in the occlusal direction were measured. Depending on the normality, 1-way ANOVA and the Kruskal-Wallis test were used to analyze the influence of occlusal surface design methods on the morphology of occlusal wear facets (α=.05)., Results: The mean deviation of the 4 kinds of STA restorations ranged from 0.19 mm to 0.22 mm, the DYN restorations from 0.13 mm to 0.17 mm, and the FUN restorations from 0.03 mm to 0.09 mm. A significant difference was found between the STA and FUN restorations of the 3-unit splinted crowns and 5-unit fixed partial dentures (Ρ=.013, Ρ=.021). The mean values of 3D deviation and V+ decreased from the STA group to the DYN group and then to the FUN group. The RMS and V+ were statistically similar (Ρ>.05)., Conclusions: The preliminary results of the study indicate that the FUN 3-unit splinted crowns and 5-unit fixed partial dentures designed with the self-developed virtual articulator were better than the STA restorations. The FUN restorations were more coincident with the morphology of the wear facets on the original teeth., (Copyright © 2020 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background and Objective: To evaluate the effect of guiding structure and 3D-printing material of CAD-CAM guides on the accuracy of guiding planes preparation., Methods: Four types of computer-aided design and computer-aided manufacturing (CAD-CAM) guides for preparing guiding planes of removable partial denture (RPD) were designed in two types of guiding structures (triple-constraint and single-plane constraint) and were 3D printed using resin and cobalt-chromium (Co-Cr) alloy. Guiding plane preparation of identical resin casts was performed using CAD-CAM guides (resin template, metal template, resin guided device, and metal guide device) in four test groups and by freehand in the control group (n = 22 per group). All prepared casts were then scanned (Test) and aligned to the reference cast with designed guiding planes. 3D compare analysis was performed and root-mean-square (RMS) values were calculated for assessing the 3D trueness and 3D precision of guiding plane preparation. The angle between the prepared guiding plane (Test) and the designed path of placement of RPD (Reference) was measured for evaluating the direction trueness., Results: RMS values of the metal template group for 3D trueness (39.7 ± 14.6 μm) and 3D precision (28.6 ± 6.8 μm) were significantly lower than that of other groups (p < .05). For direction trueness, the metal template group showed the least angle deviation (1.09 ± 0.56°), and the freehand group demonstrated the largest angle deviation (7.03 ± 2.83°)., Conclusions: The Co-Cr alloy guides with triple-constraint guiding structure can assist to prepare accurate guiding planes of RPD., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: To establish a recording method for edentulous jaw relations and to perform quantitative accuracy evaluation in vitro., Materials and Methods: Maxillary and mandibular edentulous arch models and complete dentures were mounted on an articulator, simulating protrusion (A), left and right laterotrusion (B and C), and small opening jaw relations (D), aided by metal foil wax record. Using the tracking system, 3D trajectories of targets were recorded from intercuspation to A, B, C, and D, then used to rehabilitate digital arch relations of A, B, C, and D in the test group. Axial model surfaces were pasted with six pairs of positioning cylinders. The center points of the bottom surfaces of the cylinders in A, B, C, and D were measured to rehabilitate digital arch relations in the control group. With the maxilla as the common area, arch relations of the test group were registered in the control group; 3D deviations of the mandible were calculated, and displacements in horizontal left/right, horizontal anterior/posterior, and vertical directions were analyzed., Results: 3D deviations of the mandible in A, B, C, and D were 131 ± 39 μm, 133 ± 44 μm, 120 ± 51 μm, and 112 ± 52 μm, respectively. Mean absolute values of displacements of the mandible were less than 200 μm., Conclusion: By using the optical jaw tracking system, the accuracy of jaw relation records as measured on an articulator was acceptable for clinical demand. Further investigations among patients are required to clinically verify the results of this study.

Purpose: The scanning of plaster models for three-dimensional (3D) construction requires their rigid fixation in the intercuspal position. Factors such as installation, motion, and scanning procedures influenced the accuracy of this method, which ultimately influence the results. Therefore, the present study attempted to provide an optimal and accurate method with less complex procedures and a more accessible equipment for determining the intercuspal relation in the 3D occlusal construction of dental models., Methods: A pair of plastic mounting plates that could be directly attached to a mechanical articulator was designed and 3D printed. Nine axial hemispherical concaves were introduced on the axial surface of each plate. The rigidly fixed maxillary and mandibular dental models were scanned directly. The distances D R between nine pairs of concaves on both mounting plates adhered to the maxillary and mandibular sections of the articulator were measured using the three-coordinate measuring machine Faro Edge as the reference. The present study comprised seven test groups varying in number and location. Assessing the reference points from each of the seven groups performed the 3D construction. The Geomagic Studio software was used to construct the concaves of digital casts, and the distances D M between the pairs of concaves were measured as test values. Variable differences between D R and D M were analyzed., Results: An optimum distribution scheme was obtained for reference point registration by quantitatively evaluating accuracy levels of the 3D constructions of different reference point distribution patterns. This scheme can serve as a reference for related studies and dental clinic operations., Conclusions: Three-dimensional construction of the intercuspal relation during scanning of the maxillary and mandibular models with an accuracy of 0.046 mm ± 0.009 mm can be achieved using the improved design of mounting plates., (© 2021. The Author(s).)