Comparazione di tecniche di impronta digitali e tradizionali in protesi totale su impianti: studio multidisciplinare

Revising the international literature extensively, it’s clear that data regarding the accuracy of the digital dental models generated by an intra-oral scanner for full-arch implant support rehabilitation are few and contradictory. Realistically, the cause of these discordant results has to be identified in inadequate evaluation methods. Thus, the aim of this doctoral research project is the development of a methodology for the evaluation of digital dental models accuracy in accordance with the industrial preparation protocols. Five macro-areas can be identified: a) design and development of the master model; b) calibration of the master model; c) data acquisition; d) meshes elaboration; e) data analysis (3D- distance and position analysis). Once the evaluation methodology has been defined, it will be possible to perform different types of analysis in the implant-prosthetic area. The purpose will be to define the accuracy of: a) three different scanning techniques; b) six different intra-oral scanners; c) traditional versus digital impression techniques. Interestingly, the advantage guaranteed by this evaluation method is twofold. It may provide the clinician a useful a tool to understand the possible critical issues related to the different intra-oral scanner systems currently available; and it will help in the evaluation of the better impression technique to adopt during clinical activity

Peri-Implant Bone Loss and Overload: A Systematic Review Focusing on Occlusal Analysis through Digital and Analogic Methods.

The present review aimed to assess the possible relationship between occlusal overload and peri-implant bone loss. In accordance with the PRISMA guidelines, the MEDLINE, Scopus, and Cochrane databases were searched from January 1985 up to and including December 2021. The search strategy applied was: (dental OR oral) AND implants AND (overload OR excessive load OR occlusal wear) AND (bone loss OR peri-implantitis OR failure). Clinical studies that reported quantitative analysis of occlusal loads through digital contacts and/or occlusal wear were included. The studies were screened for eligibility by two independent reviewers. The quality of the included studies was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool. In total, 492 studies were identified in the search during the initial screening. Of those, 84 were subjected to full-text evaluation, and 7 fulfilled the inclusion criteria (4 cohort studies, 2 cross-sectional, and 1 case-control). Only one study used a digital device to assess excessive occlusal forces. Four out of seven studies reported a positive correlation between the overload and the crestal bone loss. All of the included studies had moderate to serious overall risk of bias, according to the ROBINS-I tool. In conclusion, the reported data relating the occlusal analysis to the peri-implant bone level seem to reveal an association, which must be further investigated using new digital tools that can help to standardize the methodology

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Think Digital—The New Era in the Dentistry Field

In recent years the dental field has evolved incredibly due to the introduction of digital technology [...

Comparazione di tecniche di impronta digitali e tradizionali in protesi totale su impianti: studio multidisciplinare

Revising the international literature extensively, it’s clear that data regarding the accuracy of the digital dental models generated by an intra-oral scanner for full-arch implant support rehabilitation are few and contradictory. Realistically, the cause of these discordant results has to be identified in inadequate evaluation methods. Thus, the aim of this doctoral research project is the development of a methodology for the evaluation of digital dental models accuracy in accordance with the industrial preparation protocols. Five macro-areas can be identified: a) design and development of the master model; b) calibration of the master model; c) data acquisition; d) meshes elaboration; e) data analysis (3D- distance and position analysis). Once the evaluation methodology has been defined, it will be possible to perform different types of analysis in the implant-prosthetic area. The purpose will be to define the accuracy of: a) three different scanning techniques; b) six different intra-oral scanners; c) traditional versus digital impression techniques. Interestingly, the advantage guaranteed by this evaluation method is twofold. It may provide the clinician a useful a tool to understand the possible critical issues related to the different intra-oral scanner systems currently available; and it will help in the evaluation of the better impression technique to adopt during clinical activity.In letteratura mondiale pochi e contradditori sono gli articoli che valutano l’accuratezza delle impronte digitali generate da uno scanner intra-orale utilizzato in casi di riabilitazione full-arch su impianti. Analizzando nel dettaglio tutti gli articoli abbiamo individuato nella metodologia di valutazione la causa dei risultati disomogenei. Lo scopo di questa tesi di dottorato è di sviluppare una metodologia di valutazione dell’accuratezza per le impronte digitali che segua i protocolli ingegneristici utilizzati nei processi di sviluppo dei prodotti industriali. La metodologia di valutazione si suddivide in cinque macro aree: progettazione e realizzazione di un modello master, calibrazione del modello master, acquisizione dei dati, elaborazione delle mesh e analisi dei dati ( analisi 3D delle distanze e analisi 3D delle posizioni).Una volta messa a punto la metodologia di valutazione è possibile condurre diverse sperimentazioni nell’ambito implanto-protesico con differenti obbiettivi: valutazione dell’accuratezza di tre differenti tecniche di scansione ; valutazione dell’accuratezza di sei differenti scanner intra-orali e comparazione dell’accuratezza dell’impronta digitale con l’impronta tradizionale. La progettazione di questa metodologia di valutazione fornisce al clinico uno strumento per capire le possibili criticità dei differenti sistemi di scanner intra-orali presenti in commercio, ma soprattutto nel valutare quale tecnica di impronta presenta le migliori performance da applicare ai pazienti durante l’attività clinica quotidiana

The influence of crown-to-implant ratio on marginal bone loss: a narrative review

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Retrospective clinical study of 1472-unit monolithic zirconia restorations with feather-edge margins realized with digital workflow

Objectives: To evaluate the clinical performance of monolithic zirconia restorations with feather-edge margins fabricated by digital impressions. Materials and methods: All participants that present monolithic zirconia restorations with feather-edge margins realized with digital workflow were evaluated during scheduled periodontal maintenance between February and September 2022 according to predetermined inclusion criteria. Clinical performance was assessed using the modified USPHS and periodontal parameters. Overall survival was calculated for monolithic zirconia restorations. Technical and biologic complications were reported. Descriptive statistical analysis and life-table analyses were performed for all data. Results: A total of 1472 monolithic zirconia FDPs (1279 on abutments and 193 on pontics) placed in 1189 patients (982 males and 490 females) from February 2017 to September 2020 were analyzed. The mean follow-up was 44 months (range 36-61 months), and the overall survival rate was 98.5%. There were 931 single crowns, 96 were 3-unit FDPs, 33 were 4-unit FDPs, 11 were 5-unit FDPs, and 6-unit FDPs. Three single crowns had irreparable cracks, and 6 single crowns and one 4-unit FDP were fractured. One 3-unit FDP failed due to tooth fracture and 5 single crowns failed due to endodontic failure. The loss of retention was noted in 25 monolithic zirconia FDPs and hypersensitivity in 44 single crowns. Biologic complications were uncommon. Conclusions: Based on the results and its limitations, the monolithic zirconia FPDs and digital impressions represent a favorable prosthetic treatment similar to that reported with other margin designs CLINICAL RELEVANCE: Monolithic zirconia restorations on vertical-margin abutments fabricated using a digital workflow demonstrate excellent clinical performance. The digital clinical workflow without the use of a cast means a reduction in costs, steps, and operating time

Disinfection protocols during COVID-19 pandemic and their effects on prosthetic surfaces: a systematic review

To describe the possible adverse effects of sodium hypochlorite (NaOCl) solutions, high-concentration alcohol solutions, and povidone-iodine products, which are indicated for disinfection of inanimate surfaces against human coronavirus of the severe acute respiratory syndrome (SARS-CoV), on prosthesis materials, including zirconia, lithium disilicate, and acrylic resin