Geometrical modeling of complete dental shapes by using panoramic X-ray, digital mouth data and anatomical templates

In the field of orthodontic planning, the creation of a complete digital dental model to simulate and predict treatments is of utmost importance. Nowadays, orthodontists use panoramic radiographs (PAN) and dental crown representations obtained by optical scanning. However, these data do not contain any 3D information regarding tooth root geometries. A reliable orthodontic treatment should instead take into account entire geometrical models of dental shapes in order to better predict tooth movements. This paper presents a methodology to create complete 3D patient dental anatomies by combining digital mouth models and panoramic radiographs. The modeling process is based on using crown surfaces, reconstructed by optical scanning, and root geometries, obtained by adapting anatomical CAD templates over patient specific information extracted from radiographic data. The radiographic process is virtually replicated on crown digital geometries through the Discrete Radon Transform (DRT). The resulting virtual PAN image is used to integrate the actual radiographic data and the digital mouth model. This procedure provides the root references on the 3D digital crown models, which guide a shape adjustment of the dental CAD templates. The entire geometrical models are finally created by merging dental crowns, captured by optical scanning, and root geometries, obtained from the CAD templates

ToothInpaintor: Tooth Inpainting from Partial 3D Dental Model and 2D Panoramic Image

In orthodontic treatment, a full tooth model consisting of both the crown and root is indispensable in making the treatment plan. However, acquiring tooth root information to obtain the full tooth model from CBCT images is sometimes restricted due to the massive radiation of CBCT scanning. Thus, reconstructing the full tooth shape from the ready-to-use input, e.g., the partial intra-oral scan and the 2D panoramic image, is an applicable and valuable solution. In this paper, we propose a neural network, called ToothInpaintor, that takes as input a partial 3D dental model and a 2D panoramic image and reconstructs the full tooth model with high-quality root(s). Technically, we utilize the implicit representation for both the 3D and 2D inputs, and learn a latent space of the full tooth shapes. At test time, given an input, we successfully project it to the learned latent space via neural optimization to obtain the full tooth model conditioned on the input. To help find the robust projection, a novel adversarial learning module is exploited in our pipeline. We extensively evaluate our method on a dataset collected from real-world clinics. The evaluation, comparison, and comprehensive ablation studies demonstrate that our approach produces accurate complete tooth models robustly and outperforms the state-of-the-art methods

Computer aided modelling to simulate the biomechanical behaviour of customised orthodontic removable appliances

In the field of orthodontics, the use of Removable Thermoplastic Appliances (RTAs) to treat moderate malocclusion problems is progressively replacing traditional fixed brackets. Generally, these orthodontic devices are designed on the basis of individual anatomies and customised requirements. However, many elements may affect the effectiveness of a RTA-based therapy: accuracies of anatomical reference models, clinical treatment strategies, shape features and mechanical properties of the appliances. In this paper, a numerical model for customised orthodontic treatments planning is proposed by means of the finite element method. The model integrates individual patient’s teeth, periodontal ligaments, bone tissue with structural and geometrical attributes of the appliances. The anatomical tissues are reconstructed by a multi-modality imaging technique, which combines 3D data obtained by an optical scanner (visible tissues) and a computerised tomography system (internal tissues). The mechanical interactions between anatomical shapes and appliance models are simulated through finite element analyses. The numerical approach allows a dental technician to predict how the RTA attributes affect tooth movements. In this work, treatments considering rotation movements for a maxillary incisor and a maxillary canine have been analysed by using multi-tooth models

Computational design and engineering of polymeric orthodontic aligners

Transparent and removable aligners represent an effective solution to correct various orthodontic malocclusions through minimally invasive procedures. An aligner-based treatment requires patients to sequentially wear dentition-mating shells obtained by thermoforming polymeric disks on reference dental models. An aligner is shaped introducing a geometrical mismatch with respect to the actual tooth positions to induce a loading system, which moves the target teeth toward the correct positions. The common practice is based on selecting the aligner features (material, thickness, and auxiliary elements) by only considering clinician's subjective assessments. In this article, a computational design and engineering methodology has been developed to reconstruct anatomical tissues, to model parametric aligner shapes, to simulate orthodontic movements, and to enhance the aligner design. The proposed approach integrates computer-aided technologies, from tomographic imaging to optical scanning, from parametric modeling to finite element analyses, within a 3-dimensional digital framework. The anatomical modeling provides anatomies, including teeth (roots and crowns), jaw bones, and periodontal ligaments, which are the references for the down streaming parametric aligner shaping. The biomechanical interactions between anatomical models and aligner geometries are virtually reproduced using a finite element analysis software. The methodology allows numerical simulations of patient-specific conditions and the comparative analyses of different aligner configurations. In this article, the digital framework has been used to study the influence of various auxiliary elements on the loading system delivered to a maxillary and a mandibular central incisor during an orthodontic tipping movement. Numerical simulations have shown a high dependency of the orthodontic tooth movement on the auxiliary element configuration, which should then be accurately selected to maximize the aligner's effectiveness

Bonding Strength to Teeth with Amelogenesis Imperfecta

Background Amelogenesis Imperfecta (AI) is an inherited dental condition of enamel, which can cause increased tooth sensitivity, difficulties maintaining oral hygiene, rapid tooth loss or enamel fractures, as well as defects in enamel thickness, colour, and shape. All these factors may impair aesthetic appearance and masticatory ability, requiring dental treatment for a lifetime which may affect their overall quality of life. Aim: 1. To assess the burden of care for children with AI attending the Paediatric Dental Department at the Eastman Dental Hospital (EDH). 2. To review the available scientific evidence on the adhesive interface between AI affected teeth and restorative materials. 3. To analyze different AI classifications quoted in the literature, to determine the consistency and standardization of reporting on AI classifications. Material and method: A service evaluation of AI patients being treated in the department from 2002- 2019. Two systematic searches were conducted using search terms in both electronic and hand search journals. Results: The burden and impact of care audit showed the average number of appointments per year was 5, (SD=2.5). The average distance travelled to the hospital was 33.7 miles (SD =30 miles) and the treatment provided included: • Extractions - majority in hypoplastic group (78%, n=10). • Composite restorations - hypoplastic (66%, n=18), mixed (16%, n=4). • Indirect coronal restorations – hypoplastic (67%, n=17), mixed (12%, n=3). • Bleaching and microabrasion - most performed in hypomature group (56%, n= 8 and 67%, n=5 respectively). • More failed composite restorations occurred in hypocalcified (25%, n=4) and mixed type (23%, n=40) with debonding being the most common reason. In the systematic review of bonding strength to AI affected teeth, studies showed a lower bonding strength of AI affected teeth in comparison to sound teeth. The bonding strength of composite was not significantly different when using self-etch compared with etch and rinse adhesives and deproteinization with sodium hypochlorite had no effect on shear bond strength, but chlorine dioxide and sodium fluoride showed better values in enhancing bonding strength. In the review of classification of AI papers did not use or cite a classification (n=12, 36%) and 43% only described the phenotype with no information regarding the basic genetic information if known. Those results are elaborated in each chapter in detail. Conclusion: The service evaluation provides data on the burden of care for children with AI. The high number of appointments, treatment needs, and miles travelled illustrate the scope of complications that can occur and stress the need for comprehensive management of this condition. Lower bonding strength values and durability of restorations to AI affected teeth requires further laboratory studies. There are variations and inconsistencies of classification used for studies published from 2015

Management of bone defects with Bio-oss

Introduction: The defects in the alveolar bone might appear as a result of congenital malformations, traumatic injuries, periodontal disease, surgical traumas, chronic periapical changes and tumors from benign or malignant origin. The aim of this study was to provide solid and healthy area with application of Bio-Oss in the defect. Materials and methods: Based on the clinical diagnosisestablished by previously taken history, clinical examination and radiographic images oral-surgery interventions was made. To realize the aim of this work, augmentative material was implicated in the bone defects made in the patients after removal of follicular cyst, chronic periapical lesion, and parodontopathia. During the first and seventh day of the interventions, the patients have been followed through from aspect of possible development of local and general complications after the oral-surgery intervention. After period of one, three and six mount control x-ray was made. Results: Obtained results confirmed that: volume of the socket and defect of the bone was kept, fast revascularization was achieved, bone formation and slow resorption of the augmentative material was achieved, and period of normal healing without infection was also achieved. Conclusions: The augmentative materials used for treatment of bone defects besides their basic chemical and physical characteristics referring to their solubility in the body fluids, the transformation, modulation and resorption must be completely safe or secure, i.e. not to bring any risk of infection, immunological risk, physiological intolerance or inhibition of the process of restitutio ad integrum. In our study Bio-Oss was confirmed as augmentative material who had this characteristics. Keywords: bone defect, resorption of the bone, augmentative material, Bio-Os

Advanced Applications of Rapid Prototyping Technology in Modern Engineering

Rapid prototyping (RP) technology has been widely known and appreciated due to its flexible and customized manufacturing capabilities. The widely studied RP techniques include stereolithography apparatus (SLA), selective laser sintering (SLS), three-dimensional printing (3DP), fused deposition modeling (FDM), 3D plotting, solid ground curing (SGC), multiphase jet solidification (MJS), laminated object manufacturing (LOM). Different techniques are associated with different materials and/or processing principles and thus are devoted to specific applications. RP technology has no longer been only for prototype building rather has been extended for real industrial manufacturing solutions. Today, the RP technology has contributed to almost all engineering areas that include mechanical, materials, industrial, aerospace, electrical and most recently biomedical engineering. This book aims to present the advanced development of RP technologies in various engineering areas as the solutions to the real world engineering problems

3D Innovations in Personalized Surgery

Current practice involves the use of 3D surgical planning and patient-specific solutions in multiple surgical areas of expertise. Patient-specific solutions have been endorsed for several years in numerous publications due to their associated benefits around accuracy, safety, and predictability of surgical outcome. The basis of 3D surgical planning is the use of high-quality medical images (e.g., CT, MRI, or PET-scans). The translation from 3D digital planning toward surgical applications was developed hand in hand with a rise in 3D printing applications of multiple biocompatible materials. These technical aspects of medical care require engineers’ or technical physicians’ expertise for optimal safe and effective implementation in daily clinical routines.The aim and scope of this Special Issue is high-tech solutions in personalized surgery, based on 3D technology and, more specifically, bone-related surgery. Full-papers or highly innovative technical notes or (systematic) reviews that relate to innovative personalized surgery are invited. This can include optimization of imaging for 3D VSP, optimization of 3D VSP workflow and its translation toward the surgical procedure, or optimization of personalized implants or devices in relation to bone surgery

A Textbook of Advanced Oral and Maxillofacial Surgery

The scope of OMF surgery has expanded; encompassing treatment of diseases, disorders, defects and injuries of the head, face, jaws and oral cavity. This internationally-recognized specialty is evolving with advancements in technology and instrumentation. Specialists of this discipline treat patients with impacted teeth, facial pain, misaligned jaws, facial trauma, oral cancer, cysts and tumors; they also perform facial cosmetic surgery and place dental implants. The contents of this volume essentially complements the volume 1; with chapters that cover both basic and advanced concepts on complex topics in oral and maxillofacial surgery