ERGONOMIC CONCEPTS IN DENTAL MEDICINE

Dental medicine is an extremely complex medical field, comprising several specialties (orthodontics and dentofacial orthopedics, prosthodontics, dental surgery, endodontics etc.), which in most cases also require the assistance of a dental nurse. Purpose. In this paper, we have tried to present a number of very interesting ergonomic aspects in the dental office, which aim at simplifying work at this level. Material and method. This study was conducted between May and July 2018 using a questionaire applied to a number of 69 dental practitioners from Bucharest. Results and discussions. Results obtained in this study give us an image about how current dental practitioners understand ergonomics in daily practice. Conlclusions. All the aspects discussed in this study have an important role in the ergonomy of daily activity of a dental office. More important is that the majority of dentists involved in the stuty understand and apply the ergonomic concepts underlined by this study

Presurgical Cone Beam Computed Tomography Bone Quality Evaluation for Predictable Immediate Implant Placement and Restoration in Esthetic Zone

Despite numerous advantages over multislice computed tomography (MSCT), including a lower radiation dose to the patient, shorter acquisition times, affordable cost, and sometimes greater detail with isotropic voxels used in reconstruction, allowing precise measurements, cone beam computed tomography (CBCT) is still controversial regarding bone quality evaluation. This paper presents a brief review of the literature on accuracy and reliability of bone quality assessment with CBCT and a case report with step-by-step predictable treatment planning in esthetic zone, based on CBCT scans which enabled the clinician to evaluate, depending on bone volume and quality, whether immediate restoration with CAD-CAM manufactured temporary crown and flapless surgery may be a treatment option

Digital Workflow in Maxillofacial Prosthodontics—An Update on Defect Data Acquisition, Editing and Design Using Open-Source and Commercial Available Software

Background: A maxillofacial prosthesis, an alternative to surgery for the rehabilitation of patients with facial disabilities (congenital or acquired due to malignant disease or trauma), are meant to replace parts of the face or missing areas of bone and soft tissue and restore oral functions such as swallowing, speech and chewing, with the main goal being to improve the quality of life of the patients. The conventional procedures for maxillofacial prosthesis manufacturing involve several complex steps, are very traumatic for the patient and rely on the skills of the maxillofacial team. Computer-aided design and computer-aided manufacturing have opened a new approach to the fabrication of maxillofacial prostheses. Our review aimed to perform an update on the digital design of a maxillofacial prosthesis, emphasizing the available methods of data acquisition for the extraoral, intraoral and complex defects in the maxillofacial region and assessing the software used for data processing and part design. Methods: A search in the PubMed and Scopus databases was done using the predefined MeSH terms. Results: Partially and complete digital workflows were successfully applied for extraoral and intraoral prosthesis manufacturing. Conclusions: To date, the software and interface used to process and design maxillofacial prostheses are expensive, not typical for this purpose and accessible only to very skilled dental professionals or to computer-aided design (CAD) engineers. As the demand for a digital approach to maxillofacial rehabilitation increases, more support from the software designer or manufacturer will be necessary to create user-friendly and accessible modules similar to those used in dental laboratories

A Predictable Approach of a Rare and Frequently Misdiagnosed Entity: Laryngeal Nerve Schwannoma

(1) Background: Schwannoma, a mesenchymal neoplasm derived from Schwann cells that line peripheral nerve sheaths, has a challenging diagnosis, due to the non-specific medical history and clinical examination. Nowadays, virtual reality (VR) is increasingly more used for enhancing diagnosis and for preoperative planning of surgical procedures. With VR, the surgeon can interact, before any surgery, with a virtual environment that is completely generated by a computer, offering them a real experience inside a virtual 3D model. (2) Methods and Results: The aim of the present paper was to present a case of surgically removal of a schwannoma, which originated from the fibers of the superior laryngeal nerve, in a predictable and minimally invasive fashion, upon using VR for diagnosis and surgical procedure planning. (3) Conclusions: The current clinical report attracted the attention of including schwannoma in the possible differential diagnosis of a swelling in the anterior cervical region, mainly when a nonspecific radiological appearance is noticed, even with the use of multiple imaging modalities. Virtual reality can increase the predictability and success rate of the surgical procedure, being in the meantime a good tool for communication with the patient

Noţiuni anatomice privind procesele alveolare şi structurile vecine din perspectiva reabilitării implanto-protetice

Reabilitarea implanto-protetică reprezintă o metodă de tratament extrem de complexă şi în acelaşi timp extrem de completă. Totuşi, pentru abordarea unei soluţii de tratament de reabilitare implanto-protetică este nevoie de o profundă cunoaştere a anatomiei regiunii oro-maxilo-faciale, fără de care această soluţie de tratament poate fi sortită eşecului, încă din faza de debut. De aceea, în continuare, vom încerca o explicitare a noţiunilor de anatomie, care intervin în abordarea acestei soluţii de tratament

Implantologia orală corelată cu reconstrucţia crestelor alveolare deficitare

În general, majoritatea profesioniştilor sunt de acord cu faptul că, implantologia orală reprezintă o mixtură de chirurgie, protetică şi gnatologie, amestec, ce a revoluţionat medicina dentară în general şi protetica dentară în special. Astfel, reconstituirile protetice s-au extins în egală măsură în ultimele trei decenii şi jumătate, atât în Europa, cât şi în S.U.A. Concret, în lume, foarte multe implanturi dentare sunt inserate în clinicile de chirurgie oro-maxilo-facială, dar poate cel mai mare număr de implanturi este inserat de către profesioniştii stomatologi in cabinetele private de medicină dentară

Intraindividual Left–Right Side Differences of Sagittal Condylar Inclination (SCI) in Different Skeletal Classes

(1) Background: The temporomandibular joint (TMJ) is the most complex and one of the most important joints in the human body due to its essential roles in mastication, swallowing, breathing and speech. Several instruments have been used to track mandibular movements and register the characteristic parameters of the TMJ, among which condylography instruments are validated for the accurate clinical registration of the condylar path. Sagittal condylar inclination (SCI) is one of the most important parameters, together with the Bennett angle and the immediate side shift, used for articular settings in the process of oral rehabilitation. The aim of the present study was to evaluate the differences between the left and right SCI and to assess whether the differences were statistically significant for skeletal class, age, gender, dentate status, TMJ pathology or parafunctional habits. (2) Methods: One hundred and forty consecutive patients, fully dentate or partially edentulous, and with angle class I, II and II, were recruited. Their left and right SCIs were determined with an ultrasonic jaw tracking device. Each subject had to make three protrusive movements and three right and left laterotrusive movements. The software calculated the SCI from the mean of the protrusive movements. (3) Results: The mean values obtained for the right and left SCI were 34.68° (±12.44°) and 34.94° (±13.23°), respectively, with no statistically significant differences between the left and right values for gender, dentate status, TMJ disorders or parafunctional habits. Skeletal class III subjects registered lower SCI means, which were statistically significant for the left SCI. (4) Conclusions: For an optimal functionalization of prosthetic restorations and for an ideal treatment plan, the registration of both the left and right paths of the condyles and the articular disc should be taken into consideration

Predictive Model for Occlusal Vertical Dimension Determination and Digital Preservation with Three-Dimensional Facial Scanning

(1) Background: Occlusal vertical dimension (OVD) in the optimal maxillo–mandibular relationship is an important parameter to establish when complex dental rehabilitation has to be done. The optimal method to measure OVD is still a challenge in everyday practice. The aim of the present study was to test the reliability of the correlation between OVD and some anthropometric and cephalometric methods described in the literature. The validity of OVD registration using a facial scanner was also assessed. (2) Materials and Methods: 150 dentate participants, aged 20–25 years, were randomly selected using sealed envelopes. Anthropometric measurements between specific standard points were performed: Subnasion–Prementon (Sn–PM) and Subnasion–Gnation (Sn–Gn) in maximum intercuspation and in the rest mandibular position, right and left pupil to the corresponding chelion. The cephalometric measurements registered were the lower facial angle and the angle between mandibular and Frankfurt planes. The distance Sn–Gn in maximum intercuspation was compared to all other parameters. Facial scanning, with a mobile phone and installed dedicated application, was performed on ten subjects, randomly selected using the same method among the participants, and the obtained 3D files were analyzed. The digital measurements were compared, for validity, to the clinical measurements. Pearson’s correlation coefficient was used, for comparing clinical Sn–Gn in maximum intercuspation position to the other parameters. (3) Results: A strong agreement between all measured anthropometric parameters of the facial scan and clinical contact measurement method was registered. None of the measured parameters could predict the exact OVD. (4) Conclusions: In the limits of our study, the facial scanning could be used for predictable registration of OVD and the stored digital information could be preserved through life and use for oral rehabilitation. However, if OVD needs to be determined, several measurement methods, including cephalometric measurements, need to be used simultaneously to reach a final decision

Survival and mechanical complications of single- and multiple-unit cement-retained posterior implant-supported restorations with custom CAD/CAM Atlantis titanium abutments: An up to 10-year retrospective analysis

Purpose: To evaluate the survival of and incidence of mechanical complications with single- and multiple-unit cement-retained posterior implant-supported restorations with custom CAD/CAM Atlantis titanium abutments (Dentsply Sirona, Charlotte, NC, USA). Materials and methods: This retrospective clinical study analysed 196 Astra Tech OsseoSpeed TX Internal Hexagon implants (Dentsply Sirona) placed in 85 patients between January 2011 and January 2021. Customised Atlantis titanium abutments and cement-retained metal-ceramic crowns were employed. The clinical outcomes recorded were implant and abutment survival rates, and mechanical complications. The results were analysed according to implant length and diameter, arch, implant position and single- or multiple-unit restoration. Results: Over the observation period (up to 10 years), implant and abutment survival rates were 98.5% and 100.0%, respectively. The mean observation period for the single- and multiple-unit implant-supported restorations was 106.00 ± 20.84 months, with a minimum of 41 months and a maximum of 120 months. For the 67 single-unit and 129 multiple-unit posterior implant-supported restorations, four mechanical complications were recorded: two cases of screw loosening, one case of chipping or fracture of veneering materials, and one case of crown decementation. No screw or abutment fractures were observed. Conclusions: According to the results of this retrospective clinical study, cement-retained posterior implant-supported restorations with custom CAD/CAM Atlantis titanium abutments showed high survival rates over a follow-up period of up to 10 years. No statistically significant differences were recorded when comparing implant position, implant diameter, implant length, single- versus multiple-unit restoration and arch