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Fabrication of a complete-arch implant-supported fixed interim prosthesis by using a cone beam computed tomography digital scan for a patient with primordial dwarfism: A dental technique

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JOURNAL OF PROSTHETIC DENTISTRY 2022年第6期128卷 1179-1183页

作者： Zandinejad, Amirali Liang, Hui Fisher, Nicole A. Revilla-Leon, Marta Texas A&M Univ Coll Dent Comprehens Dent Dept AEGD Residency Program Dallas TX USA Texas A&M Univ Coll Dent Dept Diagnost Sci Oral Radiol Dallas TX USA Texas A&M Univ Coll Dent Comprehens Dent Dept Dallas TX USA Univ Washington Sch Dent Restorat Dent Dept Affiliate Fac Grad Prosthodont Seattle WA 98195 USA Revilla Res Ctr Madrid Spain

A complete-arch implant-supported interim prosthesis was fabricated from a cone beam computed tomography digital scan of the implant abutments for a patient with primordial dwarfism. The patient presented with limited mouth opening, which hindered the use of a conventional impression technique. The described technique provided an alternative digital procedure to obtain a virtual implant definitive cast. (J Prosthet Dent 2022;128:1179-83)

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An educational model for special patient care in dentistry

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SPECIAL CARE IN DENTISTRY 2023年第6期43卷 772-775页

作者： Risner-Bauman, Alicia Henschel, Marc Robbins, Miriam R. Univ Penn Sch Dent Med Care Ctr Persons Disabil Philadelphia PA USA Univ Penn Sch Dent Med Clin Oral Med & Clin Restorat Dent Philadelphia PA USA Univ Penn Sch Dent Med AEGD Program Div Community Hlth Philadelphia PA USA Univ Penn Sch Dent Med Clin Community Oral Hlth Philadelphia PA USA Univ Penn Sch Dent Med Care Ctr Persons Disabil 240 South 20th St Philadelphia PA 19104 USA

Dental school graduates often have a basic knowledge in the management of patients with specialized healthcare needs. As of August 2019, CODA amended their accreditation standard 2-25: dental school graduates must be competent in the assessment and management of treatment of patients with specialized healthcare needs and disabilities. While the majority of these patients require modified dental care, many dental schools lack the facilities to provide both the proper care and education. This paper identifies improvements to dental education brought on by the innovations at Penn Dental Medicines' Personalized Care Suite for Persons with Disabilities (PCARE). Patient centered care is the emphasis of the PCARE curriculum. Although the clinic has special rooms and equipment to assist in accommodating the special needs of the patients, the program focuses on teaching dental students how to provide comfortable, safe, and effective care in a typical office setting. Detailed patient assessment, non-pharmacological management techniques, and treatment plans designed to meet the needs and abilities of the patients and caregivers are taught through lecture and direct patient care. Teaching assessment and management of this population is of great importance. Including treatment in Standard 2-25 creates another challenge to dental education. Penn Dental's facility allows multidisciplinary care in a cohesive and timely manner. The experience in PCARE offers unique opportunities to educate dental professionals in developing a patient centered approach in the treatment and maintenance of oral health in those patients who require accommodation.

关键词： access barriers to care dental education developmental disability

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Digital workflow for an esthetic rehabilitation using a facial and intraoral scanner and an additive manufactured silicone index: A dental technique

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JOURNAL OF PROSTHETIC DENTISTRY 2020年第4期123卷 564-570页

作者： Revilla-Leon, Marta Raney, Lara Piedra-Cascon, Wenceslao Barrington, Jennifer Zandinejad, Amirali Oezcan, Mutlu Texas A&M Univ Coll Dent AEGD Residency Dallas TX 75246 USA Univ Washington Sch Dent Grad Prosthodont Seattle WA 98195 USA Revilla Res Ctr Madrid Spain Texas A&M Univ Coll Dent AEGD Program Dallas TX 75246 USA Univ Complutense Madrid Esthet Dent Program Madrid Spain Texas A&M Univ Coll Dent Dept Gen Dent Comprehens Care Program Dallas TX 75246 USA Univ Zurich Ctr Dent & Oral Med Dent Mat Unit Zurich Switzerland

The present article describes a digital workflow for planning an esthetic treatment by using a facial and intraoral scanner, the dental and open-source software design of a facially generated diagnostic waxing, and additive manufactured (AM) clear silicone indices. A virtual design was created to fabricate a unique 3-piece AM index composed of flexible, clear silicone at the labial and lingual aspects and a rigid clear custom tray. The 3-piece AM clear indexes provided advantages compared with conventional procedures, including accurate reproduction of the digital diagnostic waxing, control of index thickness, various insertion paths of the silicone indices, flexibility of the indices, and online storage of the designs.

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From Restraint to Medical Immobilization/Protective Stabilization

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Dental Clinics of North America 2022年第2期66卷 261-275页

作者： Perlman, Steven P. Wong, Allen Waldman, H. Barry Friedman, Clive Webb, Jessica Rader, Rick Lyons, Ray A. Special Olympics Special Smiles Boston University Goldman School of Dental Medicine Penn Dental Medicine AEGD Program University of the Pacific Arthur A. Dugoni School of Dentistry San Francisco 94116 CA United States Department of General Dentistry School of Dental Medicine Stony Brook University NY United States Cert. Pediatric Dentistry/ Diplomate AAPD Schulich School of Medicine and Dentistry Department of Pediatric Dentistry University of Washington Advanced Education in Pediatric Dentistry Postdoctoral Residency Programs NYU Langone Dental Medicine Human Development University of Tennessee/ Chattanooga Dental Hygiene and Residency Program University of New Mexico

Clinical dental treatment is the most exacting and demanding medical procedure that persons with special needs undergo on a regular basis throughout their lifetime. Dental treatment is surgical in nature, usually requiring controlled placement of sharpened instrumentation in intimate proximity to the face, airway, and highly vascularized and inner aged oral tissues. Although approximately 90% of patients with special needs can and should be mainstreamed through any general dental practice, without significant behavioral guidance, techniques, or medical immobilization/protective stabilization, there has been a drastic shift toward pharmacologic management of these patients using various forms of sedation and general anesthesia.

关键词： Behavior guidance Medical immobilization/protective stabilization Restraint

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A vat-polymerized 3-dimensionally printed dual-material occlusal device: A dental technique

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JOURNAL OF PROSTHETIC DENTISTRY 2021年第3期126卷 271-275页

作者： Piedra-Cascon, Wenceslao Sadeghpour, Mehrad Att, Wael Revilla-Leon, Marta Univ Complutense Madrid Fac Odontol Dept Restorat Dent Esthet Dent Program Madrid Spain Revilla Res Ctr Madrid Spain Tufts Univ Sch Dent Med Dept Prosthodont Boston MA 02111 USA Texas A&M Univ Coll Dent Comprehens Dent Dept AEGD Residency Dallas TX USA Univ Washington Sch Dent Dept Restorat Dent Grad Prosthodont Seattle WA 98195 USA

A technique to additively manufacture an occlusal device by using a completely digital workflow is described. Using a computer-aided design program, information captured with an intraoral scanner was used to additively manufacture a dual-material occlusal device by using a vat-polymerization printer. This technique allows for the combination of 2 different materials, resulting in an occlusal device with a resilient intaglio and a hard resin exterior surface. Advantages of the resulting occlusal device compared with a single-material device include improved patient acceptance and comfort, better fit, and minimal adjustments to ensure fit. (J Prosthet Dent 2021;126:271-5)

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2D and 3D patient's representation of simulated restorative esthetic outcomes using different computer-aided design software programs: A systematic review

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JOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY 2021年第1期33卷 143-151页

作者： Piedra-Cascon, Wenceslao Fountain, Joshua Att, Wael Revilla-Leon, Marta Univ Complutense Madrid Esthet Dent Program Madrid Spain Revilla Res Ctr Madrid Spain Tufts Univ Sch Dent Med Dept Prosthodont Boston MA 02111 USA Texas A&M Univ Coll Dent AEGD Residency Comprehens Dent Dept 3302 Gaston AveRoom 713 Dallas TX 75246 USA Univ Washington Sch Dent Restorat Dent Dept Prosthodont Seattle WA 98195 USA

Objective To review the techniques and available 2D and 3D computer-aided design (CAD) software programs to perform a diagnostic waxing for restorative procedures when cone beam computed tomography is not indicated. Overview An electronic review was performed in Medline, Embase, and Scopus search engines. A manual search was also conducted. The articles evaluating methods to obtain a 2D or 3D patient's representation for restorative dental procedures were included. A total of 33 articles were included for full text review. CAD programs provide the capability to integrate facial features from 2D photographs or 3D facial scans and facilitate facially driven digital diagnostic waxing procedures. Diagnostic and design tools varied among the programs, and multiple technique descriptions were found. However, the literature evaluating the accuracy of virtual patients and the perception variations between the 2D and 3D dimensional representations is limited. Conclusions The integration of digital technologies into treatment planning procedures introduce variation into the conventional interfaces;however, the concepts remain the same. Further studies are needed to evaluate the accuracy of the virtual representations and the influence of the type of dimensional representation on the esthetic perceptions among dental professionals. Clinical significance The 2D and 3D CAD software programs facilitate the integration of facial features into digital diagnostic waxing procedures;however, the esthetic perception of the patient's virtual representation might vary among the different systems.

关键词： 3D virtual patient CAD‐ CAM computational superimposition diagnostic waxing prosthodontics

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Accuracy (trueness and precision) of a dual-structured light facial scanner and interexaminer reliability

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JOURNAL OF PROSTHETIC DENTISTRY 2020年第5期124卷 567-574页

作者： Piedra-Cascon, Wenceslao Meyer, Matthew J. Methani, Mohammad M. Revilla-Leon, Marta Univ Complutense Madrid Esthet Dent Program Madrid Spain Revilla Res Ctr Madrid Spain Texas A&M Univ Coll Dent Dallas TX USA Rutgers Sch Dent Med Newark NJ USA Texas A&M Univ Coll Dent AEGD Program Dallas TX USA Univ Washington Prosthodont Sch Dent Seattle WA USA

Statement of problem. Digital waxing procedures should be guided by facial references to improve the esthetic outcome of a restoration. The development of facial scanners has allowed the digitalization of the extraoral soft tissues of the patient's face. However, the reliability of facial digitizers is questionable. Purpose. The purpose of this study was to evaluate the accuracy (trueness and precision) of extraoral 3D facial reconstructions performed by using a dual-structured light facial scanner and to measure the interexaminer variability. Material and methods. Ten participants were included. Six soft-tissue landmarks were determined on each participant, specifically reference (Ref), glabella (Gb), subnasal (Sn), menton (Me), chelion right (ChR), and chelion left (ChL). Interlandmark distances Ref-Sn, Sn-Gb, Ref-Gb, Sn-Me, and ChR-ChL (intercommissural) were measured by 2 different operators by using 2 different methods: directly on the participant' face (manual group) and digitally (digital group) on the 3D facial reconstruction of the participant (n=20). For the manual group, interlandmark measurements were made by using digital calipers. For the digital group, 10 three-dimensional facial reconstructions were acquired for each participant by using a dual-structured light facial scanner (Face Camera Pro Bellus;Bellus3D). Interlandmark measurements were made by using an open-source software program (Meshlab;Meshlab). Both operators were used to note 10 measurements for each manual and digital interlandmark distance per participant. The intraclass correlation coefficient between the 2 operators was calculated. The Shapiro-Wilk test revealed that the data were not normally distributed. The data were analyzed by using the Mann-Whitney U test. Results. Significant differences were found between manual and digital interlandmark measurements in all participants. The mean value of the manual and digital group discrepancy was 0.91 +/- 0.32 mm. The dual-structured light

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Influence of printing angulation on the surface roughness of additive manufactured clear silicone indices: An in vitro study

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JOURNAL OF PROSTHETIC DENTISTRY 2021年第3期125卷 462-468页

作者： Revilla-Leon, Marta Jordan, David Methani, Mohammed M. Piedra-Cascon, Wenceslao Ozcan, Mutlu Zandinejad, Amirali Texas A&M Univ Coll Dent AEGD Residency Dallas TX USA Univ Washington Sch Dent Fac Grad Prosthodont Seattle WA 98195 USA Revilla Res Ctr Madrid Spain Addit Mfg MedCAD Dallas TX USA Rutgers Sch Dent Med Grad Prosthodont Resident Piscataway NJ USA Univ Complutense Madrid Esthet Dent Program Madrid Spain Univ Zurich Ctr Dent & Oral Med Dent Mat Unit Zurich Switzerland

Statement of problem. Vat-polymerization additive manufacturing (AM) technologies can be used to fabricate clear silicone indices for diagnostic trial restorations, interim restorations, and direct composite resin restorations. Different support parameters, including print orientation of the virtual design of the silicone index, need to be determined when a dental device is fabricated with AM. However, the optimal printing angulation for minimal surface texture remains unclear. Purpose. The purpose of this in vitro study was to measure the surface roughness of the AM clear silicone indices manufactured by using a vat-polymerization 3D printer with different print orientations. Material and methods. A virtual design of a facial silicone index was obtained, and the standard tessellation language file was exported and used to manufacture all the specimens using a vat-polymerization 3D printer. All the specimens were placed on the build platform with the same parameters, except for the print orientation which was selected as the only manufacturing variable. Therefore, the 5 different groups were 0, 25, 45, 75, and 90 degrees. To minimize variation in the procedure, all the specimens (N=50) were manufactured at the same time in the selected printer at a constant room temperature of 23 degrees C. The printer had been previously calibrated following the manufacturer's recommendations. Surface roughness was measured in the intaglio of the left central maxillary incisor using an optical profilometer with a magnification of x20 and an array size of 640x480. Three measurements per specimen were recorded. The Shapiro-Wilk test revealed that the data were normally distributed, and the data were analyzed by using 1-way ANOVA, followed by the post hoc Sidak test (alpha=.05). Results. The 0-degree angulation printing group reported the least mean +/- standard deviation surface roughness (0.9 +/- 0.3 mu m), followed by the 90-degree group (3.0 +/- 0.6 mu m), the 75-degree group (12.

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Does sandblasting improve bond strength in resin composite repair?

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Dentistry Review 2024年第1期4卷 100077-100077页

作者： Zimmer, Roberto Mantelli, Aveline Ribeiro Montagna, Kelin Reston, Eduardo Galia Arossi, Guilherme Anziliero School of Dentistry Universidade Luterana do Brasil (ULBRA) Brazil FEEVALE University School of Dentistry Brazil AEGD Program Department of Comprehensive Dentistry University of Maryland School of Dentistry United States of America

AbstractThere are many studies investigating the application of air abrasion as a surface treatment for resin-based composite (RBC) repair, some with conflicting results, which makes it difficult for the dentist to know whether to use it or not. The aim of this study is to produce an integrative literature review to identify the scientific evidence on the use of air abrasion for repairing direct RBC restorations. A PICO question was elaborated to guide the selection of literature in a database following the PRISMA statement. The keywords used in Medical Literature Analysis and Retrieval System Online (PubMed) and Service Scopus (SCOPUS) were “composite resin*" AND "air abrasion" OR sandblasting AND repair* OR "composite repair". In Web of Science (WoS), the search strategy was "composite resins" AND "air abrasion" OR sandblasting AND "composite repair". Papers published in peer-reviewed journals since 2010, in English, and related to the aim of this study were the goal of this search. After applying inclusion and exclusion criteria to titles, abstracts, and full text, forty-nine scientific papers were selected for this study. This literature review focused on in vitro studies evaluating bond strength. The most common methodology found in the literature to evaluate bond strength in composite repair were shear and microshear bond strength tests (23 studies), as well as tensile and microtensile bond strength tests (24 studies). Several studies evidence air abrasion as an efficient mechanical surface treatment for composite repair, leading to a greater bond strength when compared to no preparation, diamond bur preparation alone, or distinct types of lasers.

关键词： Air abrasion Sandblasting Composite resins Repair

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Marginal and internal discrepancies associated with carbon digital light synthesis additively manufactured interim crowns

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JOURNAL OF PROSTHETIC DENTISTRY 2023年第1期130卷 108.e1-108.e6页

作者： Khanlar, Leila Nasiry Barmak, Abdul Basir Oh, Youngju Mendha, Umar Yared, Sami Zandinejad, Amirali Texas A&M Univ Sch Dent Dept Comprehens Dent AEGD Residency Program Dallas TX USA Univ Rochester EIOH Med Ctr Clin Res & Biostat Rochester NY USA Texas A&M Univ Sch Dent Dallas TX USA YDL Dent Lab Dallas TX USA Texas A&M Univ Sch Dent Dept Comprehens Dent Arlington TX USA Sch Dent Dept Comprehens Dent 3302 Gaston Ave Dallas TX 75246 USA

Statement of problem. The carbon digital light synthesis (DLS) or continuous liquid interface production (CLIP) technology is an innovative additive manufacturing technology using oxygen-inhibited photopolymerization to create a continuous liquid interface of unpolymerized resin between the growing component and the exposure window. This interface eliminates the need for an incremental layer-by-layer approach, allowing for continuous creation and increased printing speed. However, the internal and marginal discrepancies associated with this new technology remain ***. The purpose of this in vitro study was to evaluate the marginal and internal discrepancies by using the silicone replica technique of interim crowns fabricated by 3 different manufacturing technologies: direct light processing (DLP), DLS, and *** and methods. A mandibular first molar was prepared, and a crown was designed with a computer-aided design (CAD) software program. The standard tessellation language (STL) file was used to create 30 crowns from the DLP, DLS, milling technologies (n=10). The gap discrepancy was determined using the silicone replica approach, with 50 measurements made with a x70 microscope for each specimen for the marginal and internal gaps. The data were analyzed using 1-way ANOVA, followed by the Tukey HSD post hoc test (a=.05). Results. The DLS group had the least marginal discrepancy compared with the DLP and milling groups (P<.001). The DLP group showed the highest internal discrepancy followed by the DLS and milling groups (P=.038). No significant difference was found between DLS and milling in terms of internal discrepancy (P>.05).Conclusions. The manufacturing technique had a significant effect on both internal and marginal discrepancies. The DLS technology showed the smallest marginal discrepancies. (J Prosthet Dent 2023;130:108.e1-e6)

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