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Background: Postoperative resorption of hard and soft tissues occurs as a consequence of tooth extraction. The Benex®-Control extractor allows minimally invasive extraction of the tooth without causing pronounced iatrogenic trauma. The aim of this study was to verify whether the resorption of the tissues after extraction can be reduced by using the Benex® system compared to the conventional extraction method. Methods: Postoperative intraoral scans were superimposed after surgery (t0), after 7 days (t1), after 14 days (t2), after 30 days (t3), after 60 days (t4), and after 90 days (t5) within the two groups (study n = 14, control n = 16), and defined regions of interest (ROIs) (1–8) and volume changes were analyzed. In addition, the influence of gingival thickness and the thickness of the labial cortical plate was investigated. Results: The greatest decrease in volume was observed in both groups in ROI3, although there was no significant difference observed between the groups. In the presence of an adjacent tooth, there was less volume loss in the affected ROIs (1, 2 and 7, 8). The thickness of the gingiva and the bony lamella did not significantly influence the change in volume. Conclusions: Due to the small cohort, the results are limited, and the hypothesis is rejected. [ABSTRACT FROM AUTHOR]

Stress distribution and its magnitude during loading heavily influence the osseointegration of dental implants. Currently, no high-resolution, three-dimensional method of directly measuring these biomechanical processes in the peri-implant bone is available. The aim of this study was to measure the influence of different implant materials on stress distribution in the peri-implant bone. Using the three-dimensional ARAMIS camera system, surface strain in the peri-implant bone area was compared under simulated masticatory forces of 300 N in axial and non-axial directions for titanium implants and zirconia implants. The investigated titanium implants led to a more homogeneous stress distribution than the investigated zirconia implants. Non-axial forces led to greater surface strain on the peri-implant bone than axial forces. Thus, the implant material, implant system, and direction of force could have a significant influence on biomechanical processes and osseointegration within the peri-implant bone. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to determine whether implant surgery procedures can be implemented in the dental curriculum by designing novel courses for students. Additionally, this study assesses the perception of these courses and how they can be established in the future. Materials and Methods: Students from the third to fifth years participated in a programme consisting of 4 modules according to their academic year. The modules taught theoretical and practical content as well as clinical references. After participating, the students completed two questionnaires with research questions (RQ1 = evaluation of the relevance and effects; RQ2 = impact of modules 3 and 4) to evaluate the programme. The questionnaires consisted of 52 statements, each rated on a 6‐point scale (1 'totally disagree' to 6 'totally agree'). Cronbach's alpha analysis was used, and median values, interquartile ranges and Pearson correlations (p‐value) were statistically calculated. Results: In total, 94 students completed the questionnaires. Cronbach's alpha exceeded 0.7 for all constructs except for one (skills training). The highest evaluated median was 6, and the lowest was 4.75. Pearson correlations were significant (<0.05) for perceived importance/lectures, perceived importance/tutor performance, lectures/skills training, skills training/tutor performance and tutor performance/lectures. Seventeen analysed free comments expressed strong interest in implantology courses for the curriculum. 88% of the students wished for more practical exercises in dental implantology during the curriculum or suggested expanding the programme in the future. Conclusion: The programme was highly accepted among dental students. The students wished for more practice in the future to perform supervised procedures on patients. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate intraoral scanners, scannable impression materials, and conventional methods for impression-taking with regard to precision and accuracy. Materials and Methods: Ten impressions per technique were initially taken from a cobalt-chromium (Co-Cr) master model (chamfer preparation for the maxillary right first molar) for fabricating Co-Cr crown copings. The test specimens, their respective metal master model, and the plaster casts from the conventional impressions were then digitized with the lightoptical Atos Triple Scanner. The fit of the dental crown copings was measured in two and three dimensions using computer-aided design software. Global differences between the methods were determined using Kruskal-Wallis test, and pairwise comparisons were performed with Mann-Whitney U test. The significance level was set at .05. Results: The 2D analysis showed that the average absolute marginal distance of the crown copings was 0.026 mm when fabricated with the digital impression method and 0.038 mm when fabricated with the conventional method (P = .028). However, the 3D analysis revealed that the conventional group had a smaller marginal gap (0.028 mm) compared to the digital group (0.06 mm; P = .015). Conclusion: This study showed that, in the field of single-crown prosthetics, digital impressions and the use of scannable impression material could serve as alternatives to conventional methods in the future. [ABSTRACT FROM AUTHOR]

The implementation of CAD software in the digital production of implant prosthetics stands as a pivotal aspect of clinical dentistry, necessitating high precision in the alignment of implant scanbodies. This study investigates the influence of scanbody geometry and the method of superimposing in CAD software when determining 3D implant position. A standardized titanium model with three bone-level implants was digitized to create reference STL files, and 10 intraoral scans were performed on Medentika and NT-Trading scanbodies. To determine implant position, the generated STL files were imported into the Exocad CAD software and superimposed—automatically and manually—with the scanbody geometries stored within the software's shape library. Position accuracy was determined by a comparison of the 3D-defined scanbody points from the STL matching files with those from the reference STL files. The R statistical software was used for the evaluation of the data. In addition, mixed linear models and a significance level of 0.05 were applied to calculate the p-values. The manual overlay method was significantly more accurate than the automatic overlays for both scanbody types. The Medentika scanbodies showed slightly superior precision compared to the NT-Trading scanbodies. Both scanbody geometry and the type of alignment in the CAD software significantly affect digital workflow accuracy. Manual verification and adjustment of the automatic alignment process are essential for precise implant positioning. [ABSTRACT FROM AUTHOR]

Background: With the constantly increasing demand for metal‐free solutions in dental therapy, numerous ceramic restorations have found their way into everyday clinical practice, but long‐term clinical data are limited. Objective: The aim of this prospective clinical study was to evaluate three‐ and four‐unit fixed partial dentures in the posterior region made of zirconium dioxide frameworks veneered with feldspathic porcelain after 10 years in clinical use. Methods: Based on the two studies published in 2009 and 2012, in which the all‐ceramic FDPs were evaluated after 3 and 5 years of function, a clinical evaluation of a total of 17 restorations after 10 years with regard to their condition and long‐term stability was carried out in the course of this study. The restorations were fabricated using feldspathic ceramic‐veneered, yttria‐stabilised, tetragonal zirconium dioxide as the framework material. The data collection was based on modified CDA criteria and included, for example, the shape, shade, surface condition and the success and survival rates of the restorations. Results: The all‐ceramic prostheses embodied excellent biocompatibility and colour reproduction. As a result of an increased incidence of chipping fractures, the success rate was 60%. The survival rate, however, was 88.2%, as 2 of the 17 restorations were lost. Conclusion: All‐ceramic concepts for FDP constructions in the posterior region achieved satisfactory results in terms of durability after 10 years. The main problem was chipping, as has been generally recognised. Nevertheless, the materials were characterised by excellent aesthetics and biocompatibility, which ultimately makes them a good alternative to conventional restorative options. Trial registration: This study is registered in DRKS—German Clinical Trials Register with the register number DRKS00021743. [ABSTRACT FROM AUTHOR]

Purpose: Sufficient data are not currently available on how the various geometries of scan bodies and different scan strategies affect the quality of digital impressions of implants. The purpose of this study was to present new data on these two topics and give clinicians a basis for decision making. Materials and Methods: A titanium master model containing three Nobelreplace Select™ implants (Nobelbiocare Services AG, Zurich, Switzerland) was digitized using an ATOS industrial noncontact scanner. Digitization was repeated three times with different types of scan bodies integrated into the implants: ELOS A/S, nt‐trading GmbH, and TEAMZIEREIS GmbH. These three scans served as virtual master models. The titanium master model was then scanned with the TRIOS3© digital intraoral scanner (ELOS A/S, Copenhagen, Denmark), which was used for two different scanning strategies. Strategy A was a one‐step procedure that included both the titanium master model and the integrated scan bodies. Strategy B comprised two steps. First, a digital overlay was performed with a scan of the titanium master model without integrated scan bodies. A second scan was performed with the titanium master model and integrated scan bodies. By repeating both strategies 10 times for each type of scan body, 60 scans were generated and the corresponding standard tessellation language data sets overlaid with the corresponding virtual master model. Deviations in the resulting superimpositions were calculated and evaluated separately in the individual axes (x, y, z) and in three‐dimensional space (Euclidean distance). Statistical evaluation was performed using the R‐project software. Level of significance was determined at p ≤ 0.05. Results: With regard to the geometry of the scan bodies, strategy A significantly influenced the accuracy of the digital implant impression in regards to Euclidean distance (p = 0.003). No significant difference was found for strategy B in this context. Comparing the two scan strategies revealed that strategy A achieved significantly higher accuracy overall (p = 0.031). Conclusion: The quality of digital intraoral impressions seems to be influenced by both the geometry of the scan body and the scan strategy. For clinical practice, the one‐step scan strategy seems beneficial. Furthermore, the scan bodies of ELOS A/S showed a potential clinical advantage. [ABSTRACT FROM AUTHOR]

Objective: Assessing the level of precision entailed by the virtual fit of dental restorations is a very challenging issue. A cement space between an abutment tooth and a dental restoration is a clinical requisite that precludes the application of conventional best-fit registration protocols routinely applied in industrial precision measurements. Since two-dimensional fit assessment techniques currently used in dentistry miss important information about the third dimension, a new protocol was developed to provide threedimensional information for the virtual registration of the digitized restoration with respect to the abutment. Method and Materials: CAD/CAM was used to produce 10 titanium single crown copings for five gypsum master casts each, representing a molar prepared for a full crown. An industrial noncontact scanner was used for digitizing the components. Registration of surface data sets was achieved by a new triple-scan protocol. For statistical analysis and repeatability testing of the triple-scan protocol, mean distances of the cement space of all copings on their respective abutments were measured three times. Results: The validity of the approach is verified by intraclass correlation coefficients that revealed an almost perfect coefficient for repeatability (ICC = 0.981, P < .001) with a 95% confidence range between 0.970 and 0.989. Conclusion: The triple-scan protocol represents a reliable registration approach for surface data sets in dental applications and eliminates the limitations of conventional best-fit registration protocols when a cement space or gap is present between a restoration and its underlying abutment. Future fit assessment investigations can implement this approach of obtaining detailed information of component precision in all spatial orientation. (Quintessence Int 2011;42:651-657) [ABSTRACT FROM AUTHOR]

Objectives: Artefacts from dental implants in three-dimensional (3D) imaging may lead to incorrect representation of anatomical dimensions and impede virtual planning in navigated implantology. The aim of this study was quantitative assessment of artefacts in 3D STL models from cone beam CT (CBCT) and multislice CT (MSCT) using different scanning protocols and titanium-zirconium (Ti-Zr) and zirconium (ZrO 2 ) implant materials., Methods: Three ZrO 2 and three Ti-Zr implants were respectively placed in the mandibles of two fresh human specimens. Before (baseline) and after implant placement, 3D digital imaging scans were performed (10 repetitions per timepoint: voxel size 0.2 mm³ and 0.3 mm³ for CBCT; 80 and 140 kV in MSCT). DICOM data were converted into 3D STL models and evaluated in computer-aided design software. After precise merging of the baseline and post-op models, the surface deviation was calculated, representing the extent of artefacts in the 3D models., Results: Compared with baseline, ZrO 2 emitted 36.5-37.3% (±0.6-0.8) artefacts in the CBCT and 39.2-50.2% (±0.5-1.2) in the MSCT models. Ti-Zr implants produced 4.1-7.1% (±0.3-3.0) artefacts in CBCT and 5.4-15.7% (±0.5-1.3) in MSCT. Significantly more artefacts were found in the MSCT vs CBCT models for both implant materials ( p < 0.05). Significantly fewer artefacts were visible in the 3D models from scans with higher kilovolts in MSCT and smaller voxel size in CBCT., Conclusions: Among the four applied protocols, the lowest artefact proportion of ZrO 2 and Ti-Zr implants in STL models was observed with CBCT and the 0.3 mm³ voxel size.

Aim: Deformation of the mandible presents a major challenge for many dentists, both in conventional prosthetic supraconstructions and in complex implant restorations. This study aimed to evaluate the three-dimensional (3D) deformation of the mandible in vivo with scannable impression material and an industrial optical scanner., Materials and Methods: In the present study, 20 female and 20 male subjects were examined. In each case, two impressions were made with polyvinylsiloxane: one with the mouth slightly open, and a second with the mouth wide open. The impressions were digitized with an industrial optical scanner and transformed into a virtual model. The two corresponding models were digitally superimposed over all the teeth. Then, an individual local coordinate system was assigned to each individual tooth. Subsequently, a best-fit procedure was performed for each individual tooth. Finally, the open- and closed-mouth models were compared by calculating the differences and rotations in the individual axes. This procedure was performed individually for each tooth., Results: The mean deviations in the x-, y-, and z-coordinates ranged from 0.011 mm at the canines to 0.232 mm at the molars. Larger discrepancies were observed in the female subjects than in the male subjects; however, these differences were not statistically significant., Conclusion: The results demonstrated that the posterior region of the mandible deformed when the mouth was maintained in a wide-open position. Therefore, this position should be avoided when performing dental impressions. Moreover, potential negative consequences of this mandibular deformation should be taken into consideration when planning wide-span fixed dental restorations.