Accuracy and Precision of Occlusal Contacts of Stereolithographic Casts Mounted by Digital Interocclusal Registrations

Statement of problem Little peer-reviewed information is available regarding the accuracy and precision of the occlusal contact reproduction of digitally mounted stereolithographic casts. Purpose The purpose of this in vitro study was to evaluate the accuracy and precision of occlusal contacts among stereolithographic casts mounted by digital occlusal registrations. Material and methods Four complete anatomic dentoforms were arbitrarily mounted on a semi-adjustable articulator in maximal intercuspal position and served as the 4 different simulated patients (SP). A total of 60 digital impressions and digital interocclusal registrations were made with a digital intraoral scanner to fabricate 15 sets of mounted stereolithographic (SLA) definitive casts for each dentoform. After receiving a total of 60 SLA casts, polyvinyl siloxane (PVS) interocclusal records were made for each set. The occlusal contacts for each set of SLA casts were measured by recording the amount of light transmitted through the interocclusal records. To evaluate the accuracy between the SP and their respective SLA casts, the areas of actual contact (AC) and near contact (NC) were calculated. For precision analysis, the coefficient of variation (CoV) was used. The data was analyzed with t tests for accuracy and the McKay and Vangel test for precision (α=.05). Results The accuracy analysis showed a statistically significant difference between the SP and the SLA cast of each dentoform (PPP Conclusions For the accuracy evaluation, statistically significant differences were found between the occlusal contacts of all digitally mounted SLA casts groups, with an increase in AC values and a decrease in NC values. For the precision assessment, the CoV values of the AC and NC showed the digitally articulated cast’s inability to reproduce the uniform occlusal contacts

Accuracy, Prosthetic Outcomes, and Patient-related Outcomes with Immediate Loading of 4-Guided Implants Supporting an Unsplinted Maxillary Implant-Retained Overdenture

Aim: Assess the accuracy of implant placement using a mucosa-supported surgical guide relative to the planned implant position and examine patient-related outcomes associated with immediately-loaded Mx IOD using a single-attachment abutment system. The secondary aim of the study is to examine the prosthetic complications associated with this treatment. Materials and methods: Fifteen individuals with edentulous maxillae were included. Each participant received 4 Straumann BLX implants through a stereolithic mucosa-supported surgical guide distributed in the Mx arch to maximize AP spread. Implant lengths ranged from 10 to 14 mm. A post-op CBCT was taken after the surgery to compare the accuracy of the implant placement with the planned position using the Treatment Evaluation Module in CoDiagnostix. Primary outcome variables were 3D offset at apex and platform along with global angular deviation and patient-related outcomes. Results: Fifteen participants had 60 implants placed. Fifty-nine of those implants were suitable for assessment. The mean global deviation of the implants was 3.28±1.929º, the 3D offset of the implants was 0.86±0.484 mm at the platform and 1.036±0.59 mm at the apex. Statistically significant higher 3D offset was observed for the implant platform and apex between posterior and anterior implants at 0.762 vs. 0.984 and 0.862 vs. 1.203 mm respectively. Conclusion: The accuracy of mucosa-supported surgical guides for Mx IODs is within the acceptable range of error when compared to planned position. Posterior implants show greater deviation than anterior implants. Patient-related outcomes improve immediately after the prosthesis is loaded and continue to improve over the follow-up period

Integration of 3D anatomical data obtained by CT imaging and 3D optical scanning for computer aided implant surgery

<p>Abstract</p> <p>Background</p> <p>A precise placement of dental implants is a crucial step to optimize both prosthetic aspects and functional constraints. In this context, the use of virtual guiding systems has been recognized as a fundamental tool to control the ideal implant position. In particular, complex periodontal surgeries can be performed using preoperative planning based on CT data. The critical point of the procedure relies on the lack of accuracy in transferring CT planning information to surgical field through custom-made stereo-lithographic surgical guides.</p> <p>Methods</p> <p>In this work, a novel methodology is proposed for monitoring loss of accuracy in transferring CT dental information into periodontal surgical field. The methodology is based on integrating 3D data of anatomical (impression and cast) and preoperative (radiographic template) models, obtained by both CT and optical scanning processes.</p> <p>Results</p> <p>A clinical case, relative to a fully edentulous jaw patient, has been used as test case to assess the accuracy of the various steps concurring in manufacturing surgical guides. In particular, a surgical guide has been designed to place implants in the bone structure of the patient. The analysis of the results has allowed the clinician to monitor all the errors, which have been occurring step by step manufacturing the physical templates.</p> <p>Conclusions</p> <p>The use of an optical scanner, which has a higher resolution and accuracy than CT scanning, has demonstrated to be a valid support to control the precision of the various physical models adopted and to point out possible error sources. A case study regarding a fully edentulous patient has confirmed the feasibility of the proposed methodology.</p

Comparison of Accuracy and Reproducibility of Casts Made by Digital and Conventional Methods

Statement of problem Little peer-reviewed information is available regarding the accuracy and reproducibility of digitally fabricated casts compared to conventional nondigital methods. Purpose The purpose of this in vitro study was to compare the accuracy and reproducibility of a digital impression and cast fabrication with a conventional impression and cast fabrication. Material and methods Conventional impressions were made via a 1-step single viscosity technique with vinyl siloxanether material of a typodont master model, and conventional casts were cast from dental stone. Digital impressions were obtained with a digital scanner, and digital stereolithographic models were printed. The typodont and fabricated casts were digitized with a structured light scanner and saved in surface tessellation language (STL) format. All STL records were superimposed via a best-fit method. The digital impression and cast fabrication method was compared with the conventional impression and cast fabrication method for discrepancy, accuracy, and reproducibility. The Levene test was used to determine equality of variances, and a 1-way ANOVA was conducted to assess the overall statistical significance of differences among the groups (n=5, α=.05). Results No significant statistical difference was found between the digital cast and conventional casts in the internal area or finish line area (P\u3e.05). In addition, there was no statistically significant difference between these 2 techniques for a fixed dental prosthesis or single crown (P\u3e.05). However, statistically significant differences were observed for overall areas of the casts in terms of accuracy (PP Conclusions No statistically significant difference was found between the digital cast and conventional cast groups in the internal and finish line areas. However, in terms of the reproducibility and accuracy of the entire cast area, the conventional cast was significantly better than the digital cast

Clinical value of patient-specific three-dimensional printing of congenital heart disease: Quantitative and qualitative assessments

Objective: Current diagnostic assessment tools remain suboptimal in demonstrating complex morphology of congenital heart disease (CHD). This limitation has posed several challenges in preoperative planning, communication in medical practice, and medical education. This study aims to investigate the dimensional accuracy and the clinical value of 3D printed model of CHD in the above three areas. Methods: Using cardiac computed tomography angiography (CCTA) data, a patient-specific 3D model of a 20-month-old boy with double outlet right ventricle was printed in Tango Plus material. Pearson correlation coefficient was used to evaluate correlation of the quantitative measurements taken at analogous anatomical locations between the CCTA images pre- and post-3D printing. Qualitative analysis was conducted by distributing surveys to six health professionals (two radiologists, two cardiologists and two cardiac surgeons) and three medical academics to assess the clinical value of the 3D printed model in these three areas. Results: Excellent correlation (r = 0.99) was noted in the measurements between CCTA and 3D printed model, with a mean difference of 0.23 mm. Four out of six health professionals found the model to be useful in facilitating preoperative planning, while all of them thought that the model would be invaluable in enhancing patient-doctor communication. All three medical academics found the model to be helpful in teaching, and thought that the students will be able to learn the pathology quicker with better understanding. Conclusion: The complex cardiac anatomy can be accurately replicated in flexible material using 3D printing technology. 3D printed heart models could serve as an excellent tool in facilitating preoperative planning, communication in medical practice, and medical education, although further studies with inclusion of more clinical cases are needed