paper presentation in prosthodontics

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Abstract and Digital Poster Presentation Program

The American Prosthodontic Society invites applications for the 2022 Digital Poster Presentation Program at its 93rd Annual Meeting, February 24-25, 2022, at the Swissôtel Chicago. Designed to showcase new research and innovative ideas from up-and-coming prosthodontists, the Digital Poster Program is the best place to exhibit your findings and engage in conversation with fellow dental professionals.

The Poster Program will be held in conjunction with the meeting on Thursday, February 24th.

Guidelines for Digital Poster Presenters:  Click Here

All submissions are due by January 17, 2022 .

Approval notifications will be sent by January 21, 2022.

Abstract Submission Guidelines

All submissions must include an abstract of the presentation that will be reviewed by the Poster Program Committee for consideration.

All abstracts should include the following :

Categories of Poster Presentations

All presentations must be directly related to the clinical practice of prosthodontics. Poster submissions should include one of the following:

Presentations of a commercial nature will not be allowed.

Posters may be presented by :

Other categories of presenters may be considered on an individual basis.

All presenters must be registered and pay the fee applicable to their registration category in order to attend the 93rd Annual Meeting. Poster presenters will not be reimbursed for any expenses.

For additional meeting information contact us at  [email protected]

ABSTRACT SUBMISSION IS CLOSED... 

HOW TO SUBMIT AN ABSTRACT

First, if you are not already a member of APS , there is a 2 step process. You will need to set up a Guest User account before making your poster submission. If you are already a member, please log in and follow the links in the instructions further below for APS members.

• As part of the Guest User signup process, you will receive an email to confirm your Guest User account creation. The Guest User link expires after an hour, so you must click the link in the confirmation email within one hour  to complete Guest User signup and to gain access to the poster abstract submission form. 

Research Poster Abstract Submission Form for non-members

Case Study Poster Abstract Submission Form for non-members

Technology Poster Abstract Submission Form for non-members

• Note: Remember your user name and password! You will use this same login information to access your abstract record and upload your poster image if your abstract is accepted.
• Return to this page to submit your abstract. * There is a 15 maximum word count on the title of the abstract * There is a 400 maximum word count on the body of the abstract

HOW TO SUBMIT AN ABSTRACT FOR MEMBERS OF APS

Research Poster Abstract Submission Form for Members

Case Study Poster Abstract Submission Form for Members

Technology Poster Abstract Submission Form for Members

HOW TO EDIT YOUR ABSTRACT

• Last day to make edits to your abstract is January 17, 2022.

DIGITAL POSTERS

*All presenters are required to submit a digital version of their poster. Specifications: PDF format / size 16:9 ratio (landscape orientation)or JPG format at least 2000 pixels wide. Submissions are due by January 17, 2022.

GENERAL INFORMATION

Use PowerPoint and set the dimensions of your poster to 16:9 in landscape orientation. You can do this opening PowerPoint, selecting “Design”, “Slide Size” and “Custom Slide Size”.

Before submitting, save your poster as a PDF file. All recent versions of PowerPoint and most other software applications allow you to save your poster as a PDF file from the “File > Save as” menu or through the “File > Print > as .PDF” option.

SLIDE DESIGN

Your digital poster should include the following information:

• Title and Presenter/Author Names
• Purpose/Aim, Materials & Methods, Results and Conclusions – where applicable
• Graphs, Charts or Photos that support your case/research

Text: The text should be concise and to the point, with key facts emphasized. Minimum suggested font size: 24 (20 for references).

Colors: Choose color combinations that make your text easy to read on a monitor and have a large contrast (dark lettering on a light background or the reverse).

Layout: Keep data simple and ensure a logical order of the content.

Images and Effects: For embedded images, use .jpeg or .png file formats in a resolution of 72 or 96 dpi. Do not use animated effects, “animations” or videos.

Posters will be made available for viewing under the APS members only section of the website

2020 Digital Poster Award Recipients

Thank you to all of our digital poster presenters who participated at the 92nd Annual Meeting of the American Prosthodontic Society.

View the Poster Presentations from the 92nd Annual Meeting

• 1st Place "DIGITAL PLANNING AND GUIDED IMPLANT SURGERY IN FULL ARCH IMMEDIATE LOAD" Juan Arellano Benemérita Universidad Autónoma de Puebla (BUAP)
• 2nd Place "MULTIDISCIPLINARY TREATMENT OF A PATIENT WITH CLASS III MALOCCLUSION: A MINIMAL INVASIVE TECHNIQUE " Lourdes Paola Hernández Rivera Benemérita Universidad Autónoma de Puebla (BUAP)
• 3rd Place "MAXILLARY REHABILITATION WITH CROWN LENGTHENING, DENTAL IMPLANTS AND PFZ CROWNS ON NATURAL TEETH " Kristen Frantz University of Rochester Eastman Institute for Oral Health
• Honorary Mention "PREDICTABLE ESTHETIC IN FULL ARCH IMPLANT RESTORATION" Eduardo Gonzalez de la Torre New York University College of Dentistry
• 1st Place "SILVER NANO PARTICLES DEPOSITED ON COLLAGE MEMBRANE VIA ATOMIC LAYER DEPOSITION: CHARACTERIZATION AND BIOCOMPABILITY" Sarah Hashemi Astaneh University of Illinois at Chicago
• 2nd Place "INTERCHANGEABILITY OF THE IVOCLAR STRATOS 300 SEMI-ADJUSTABLE ARTICULATOR" Venkata Mohan Mutnuri New York University College Of Dentistry
• 3rd Place "ARTIFICIAL CARIES MODEL FOR BIOACTIVE CEMENTS" Chan-Te Huang University of Alabama at Birmingham

Maxillofacial

• 1st Place (tie) "NASOALVEOLAR MOLDING: NAM AT 25 YEARS" Charmaine Ip New York University College of Dentistry

Graduate Research Competition

• 1st Place "LIGHT TRANSMISSION AND WEAR OF TRANSLUCENT ZIRCONIA AFTER CONVENTIONAL AND FAST SINTERING CYCLE" Anvita Maharishi University of Alabama at Birmingham
• 2nd Place "ACCURACY OF INTRA-ORAL SCANNER COMPARED TO LAB SCANNER IN FULL-ARCH IMPLANT PROSTHESIS" Davide Romeo Eastman Institute for Oral Health
• 3rd Place "DECONTAMINATION PROTOCOLS: CONVENTIONAL AND 3D PRINTED SURGICAL GUIDES IN DENTAL IMPLANT SURGERY" David Remiszewski University of Connecticut

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• Corpus ID: 79263497

TRENDS IN PROSTHODONTICS: AN OVERVIEW

• C. Kumar , M. Shahid
• Published 2016

4 Citations

Trends in prosthodontics - a review, a paradigm shift in prosthodontics: analog to digital, esthetic smile rehabilitation of enamel hypomineralized teeth with e-max prosthesis: case report, a novel optimization aspect of osseointegrated dental implant, 28 references, prosthodontics--past, present, and future., trends in prosthodontics, the future value of prosthodontics, prosthodontics: a past with a future, prosthodontic research: breaking traditional barriers., the future of complete dentures in oral rehabilitation. a critical review., research in prosthodontics: a 10-year observation of trends in topics, collaboration, and funding., shortened dental arches and oral function., prosthodontics: have we misjudged the cause and lost direction, turning points in removable partial denture philosophy., related papers.

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Hot Topics in Clinical Oral Implants Research: Recent Trends in Literature Coverage

Vesela valkova.

1 Medical University of Vienna, Bernhard Gottlieb School of Dentistry, Sensengasse 2a, A-1090 Vienna, Austria; [email protected] (V.V.); moc.oohay@aneeneec (C.U.M.)

Ceeneena Ubaidha Maheen

Bernhard pommer.

2 Academy for Oral Implantology, Lazarettgasse 19/DG, A-1090 Vienna, Austria

Xiaohui Rausch-Fan

3 Medical University of Vienna, Rausch-Fan Laboratory, Sensengasse 2a, A-1090 Vienna, Austria; [email protected]

Rudolf Seemann

4 Medical University of Vienna, Department of Oral and Maxillofacial Surgery, Währinger Gürtel 18-20, A-1090 Vienna, Austria; [email protected]

This systematic review looks at thematic trends in clinical research publications on dental implants. For this purpose, MEDLINE electronic searches as well as additional hand searches of six main journals in the field were conducted. A total of 2875 clinical studies published between 2001 and 2012 met the inclusion criteria and were subjected to statistical analysis. Hot topics in dental implant literature included immediate loading (14.3%), bone substitutes (11.6%), cross-arch full bridges (8.0%), and immediate implant placement (7.5%). A significant increase in scientific interest for immediate loading (+6.3%, p = 0.001), platform switching (+2.9%, p = 0.001), guided implant surgery (+1.9%, p = 0.011), growth factors ( p = 0.014, +1.4%), piezoelectric surgery (+1.3%, p = 0.015), and restorative materials (+0.7%, p = 0.011) was found. A declining scientific interest in onlay grafting (−0.3%, p = 0.042) was recorded. The findings regarding current clinical oral implants research tie in with better-informed consumers and increased patient demands. Our results demonstrate an increasing interest in techniques that avoid complicated procedures such as bone grafting and that reduce treatment duration.

1. Introduction

The present special issue of Dentistry Journal deals with “Advances in Implant Dentistry,” and the following keywords denote hot topics in this field: template-guided implant placement, minimally invasive techniques, short lengths and reduced implant diameters, novel bone grafting techniques, medically compromised patients, peri-implantitis treatment, immediate placement and restoration, transition from a failing dentition, CAD/CAM prosthetics, and optical intraoral impressions. As the first paper in this special issue, the following review aims to provide the background to recent trends and “hot topics” in advanced and minimally invasive oral implant treatment [ 1 ].

The concept of osseointegration of oral implants was introduced by Branemark 40 years ago and set the precedent for new knowledge in oral medicine. Since then, oral implantology has become one of the most investigated topics in dental medicine, with exponential growth in the use of implant products [ 2 ]. Data shows that the number of implants used for oral rehabilitation in the USA increased ten-fold between 1983 and 2002 and also ten-fold from 2000 to 2010 [ 3 ]. While previously the primary aim of research on oral implantology was to find ways to rehabilitate function [ 4 ], many efforts nowadays are focused on the shortening of treatment procedures, simplifying surgical techniques, and esthetic improvement [ 5 ]. It is well known that oral implantology is a prosthetically driven field with a major surgical component [ 6 ]. Therefore, the current state of the art in implant dentistry represents advances in both surgical and prosthodontic techniques [ 5 ].

Keeping pace with research development, the aim of this systematic review was to investigate contemporary issues in oral implantology research and to perform a topical trend analysis of clinical studies published in the time period from 2001 to 2012.

2. Material and Methods

2.1. search strategy.

A MEDLINE electronic literature search was conducted, limited to clinical studies on dental implants published between 2001 and 2012. The search term “dental implant,” sorted by “year of publication” was used in order to capture all relevant articles [ 7 ]. Additional hand searching was performed to examine six main journals in the field: The International Journal of Maxillofacial Implants , Journal of Oral Implantology , Clinical Oral Implant Related Research , Implant Dentistry , European Journal of Oral Implantology , and Clinical Oral Implant Research . Two reviewers independently identified all trials [ 8 ]. The PubMed search initially identified 15,695 publications, and 5048 additional results were identified by hand search. These studies were screened for their relevance based upon a threshold set [ 9 ]:

• inclusion criteria: prospective and retrospective studies, cross-sectional studies, case-control studies, case reports with at least 10 patients
• exclusion criteria: non-English publications, statistical studies, animal studies, finite element analyses, in vitro studies, review articles, and case series with fewer than 10 patients.

A total number of 3695 articles were subjected to abstract review. Where the abstract provided little information, a full text analysis was performed. Authors of potentially relevant publications, which were not available or lacked data, were contacted and asked for cooperation. Ultimately, 2875 clinical studies were identified as meeting the inclusion criteria. Our goal was to investigate how trends change over time as regards the topics examined in modern implant dentistry research. In this respect, we have determined that 31 topics were appropriate: 23 of them concerned surgical issues and 8 dealt with prosthodontic issues ( Table 1 ). First, all relevant publications were screened for the topics listed in Table 1 independently by two reviewers. Thereafter, the results were verified, and all doubtful publications were discussed before the final decision was taken.

Topics sorted by literature coverage. Absolute numbers of publications per year as well as the total percentage of all clinical papers 2001–2012 (* indicates prosthodontic topics).

2.2. Statistical Analysis

As mentioned above, 2875 publications were analyzed. In order to find statistical trends in respect to the relevant topics between 2001 and 2012, Poisson regression analysis was performed, taking the level of significance as p ≤ 0.05, using R-project statistical software version 3.1.0. This statistical test was used to model count data, which in this case was the number of publications. p -values were calculated for every topic, taking into account the relative number publications per topic from the total number of publications.

The surgical and prosthodontic topics of interest were computed as percentages of the total number of publications ( Table 1 ). Among the most covered surgical topics in the literature were immediate loading (14.3%), bone substitutes (11.6%), immediate implant placement (7.5%), simultaneous implant placement with bone augmentation (6.4%), onlay grafting (4.3%), medically compromised patients (4.0%), healing modality (3.7%), transcrestal sinus floor elevation (3.0%), flapless surgery (2.7%), socket grafting (2.6%), and guided surgery (2.4%). Immediate loading (14.3%), cross-arch implant bridges (8.0%), early loading (4.5%), and platform switching (1.7%) were ranked as the most prevalent prosthodontic issues in current oral implant research.

The surgical issues were the more prevalent topics, demonstrating an increasing rate of publications over the time in terms of mean coverage (0.53 ± 0.01) per publication ( Figure 1 ), as compared to prosthodontic issues (0.33 ± 0.05 hits). The mean coverage values were estimated based on yearly ratios: the number of prosthodontic/surgical publications per year in relation to the total number of publications per year. The significant increase in publications on surgical issues over the years was demonstrated by Poisson regression analysis ( p = 0.002).

Literature coverage of surgical (s) versus prosthodontic (p) issues: x-axis indicates year of publication, y-axis indicates the ratio of numbers of publications (surgical/prosthodontic) to the total number of publications per year.

A total of eight topics showed significant trends ( p < 0.05) over the years 2001 to 2012 ( Table 2 ). Immediate loading demonstrated the highest increase with a positive change of +6.3% and p = 0.001 ( Figure 2 a). Platform switching (+2.9%, p = 0.001) was the second topic showing a significant increase; however, only one relevant article was detected between 2001 and 2006 ( Figure 2 b). These topics were followed by guided implant surgery (+1.9%, p = 0.011), growth factors (+1.4%, p = 0.014), piezoelectric surgery (+1.3%, p = 0.015), and restorative materials (+0.7%, p = 0.011). The green line represents the percentage of the total number of publications for every year. The black trend line reveals the relationship between the year of publication (x-variable) and the percentage of the total number of publications (y-variable). Since there were no publications on platform switching between 2002 and 2005, there is a negative trend line intercept starting from 2001 ( Figure 2 b). Decreasing scientific interest and a corresponding downward trend were recorded for the topic onlay grafting (−0.3%, p = 0.042).

Trend curves (percentage out of the total number of publications per year) for ( a ) immediate loading; ( b ) platform switching; ( c ) flapless implant surgery; ( d ) guided implant surgery; ( e ) growth factors; ( f ) piezoelectric surgery; ( g )restorative materials; and ( h ) onlay grafting.

Topics demonstrating a significant increase (positive) or decrease (negative change) of scientific interest in the years 2001–2012.

4. Discussion

Comparisons of published clinical trials per year revealed a trend of increasing interest in conducting clinical trials, starting with 137 relevant articles in the year 2001 and reaching the number of 446 publications in the year 2012. However, even the total number of 3695 articles is smaller than the total number of 4655 clinical studies published between 1989 and 1999 reported by Russo et al. [ 10 ]. Given that the number of publications increased with every year, it was considered more appropriate to perform Poisson regression analysis related to percentage-based values rather than related to absolute values for all topics.

Immediate loading proved to be the most studied topic in the last decade ( Figure 2 a). This avid scientific interest can be explained by several advantages it offers, such as shortened treatment protocols, immediate rehabilitation of the function, and high patient satisfaction. Meta-analyses on single-tooth implant placement have shown encouraging results for the immediate loading protocol as a promising alternative to conventional loading, as it may be equally successful and may not significantly affect marginal bone resorption and implant success rates [ 11 , 12 , 13 ]. Another meta-analysis by Papaspyridakos et al. [ 14 ] reported that there was no significant difference between immediate, early, and conventional loading in edentulous patients with fixed prostheses, and all three protocols showed a high level of success. However, other reviewers disagree with this assessment of the unimpaired success of the immediate loading protocol. A meta-analysis of clinical studies comparing the immediate and conventional loading of single tooth implants discovered that immediate loading has a significantly higher risk of implant failure [ 15 ]. Schimmel and coworkers [ 16 ] concluded that, despite the high implant survival rates, the conventional and early loading protocols are superior to immediate loading as better documented protocols, providing better results in the first year of loading. A survey among implantologists from 16 countries all over the world stated that immediate loading was the treatment protocol most accepted by dentists in Australia and Europe [ 17 ]. Based on these controversial statements in the literature, it can be concluded that there is still a lack of well-designed RCTs concerning loading protocol [ 18 ] and immediate loading may well retain its place as a hot topic of discussion over the coming years.

The platform-switching concept arose in 1980 with the introduction of the wide diameter implants. Due to the lack of commercially available matching components for wide diameter implants, the standard-diameter abutments were used. Later, it was found that “platform-switched” implants demonstrated osseointegration with less initial crestal bone loss and were thus superior to the “platform-matched implants” [ 19 ]. However, the first introduction of this concept appeared in 2005 [ 20 ]. Radiographic observation over a period of 13 years demonstrated that platform switching resulted in little or no crestal bone loss as compared to the conventional implants, whereas marginal bone resorption of 1.5 mm on average was accepted as one of the criteria for success of the dental implant [ 21 ]. Our study shows that the increasing publication rate of clinical studies happened to coincide with the first official introduction of this concept, with a positive linear trend for this topic starting in 2005 ( Figure 2 b). Since guided surgery is performed in combination with the flapless procedure in most cases, [ 22 ] the similarity in literature coverage, illustrated in both scatter plots, does not come as a surprise ( Figure 2 c,d).

In contrast to the last decade of the 20th century, when the main progress in the field of oral implant research was made in alveolar bone resorption management to refine the different graft techniques [ 23 ], our findings show that in the 21st century there has been increasing interest in methods developed to overcome the grafting procedures and even a loss of interest in one of the most used augmentation techniques, i.e. , onlay bone grafting. It seems that dental implant scientific work is inspired more by the patient’s appraisals [ 24 ], seeking to improve minimally invasive surgical techniques [ 25 ], diminish patient morbidity, and shorten the treatment time. However, the role of industrial funding for conducting clinical studies should be taken into consideration. 32.4% of the clinical trials are supported by industry as a source of funding, which is a suitable way for companies not only to comply with safety and efficacy standards, but also to introduce their new products to the market [ 26 ]. This industry sponsorship may lead to biased reporting and pro-industry conclusions [ 27 ]. This does have the potential to reflect on ongoing trends in clinical research. In this connection for instance, the relatively innovative technique of guided implant surgery provides less painful and invasive treatment but at the same time is a more difficult and expensive procedure than conventional implant placement, demonstrating the same survival rate. However, a survey by Hof and coworkers [ 28 ] showed that the main priority for the patients when it comes to implant therapy remains the predictability of treatment success. The achievements brought about by ongoing clinical research, such as improved quality, ease of use of implant systems, as well as shorter treatment duration [ 29 ] may provide grounds for future researchers to face the challenge of preserving the perspectives of clinical implant research, and specifically, to enhance the relationship between private practice and science without involving marketing.

In order to adhere to ethical rules on explicit reporting, including also the disadvantages of any study, the researchers are obligated to report their study’s limitations. Undoubtedly, meta-analysis is the “gold standard” for performing any systematic review aiming at assessing treatment effects. Given that the variable investigated in the present study was the number of publications, the Poisson regression was selected as a statistical tool. The Poisson regression is used to model count data (in the present case this is the number of publications) and is an appropriate statistical method for predicting trends. Therefore, no methods estimating risk of bias, quality design, or heterogeneity of the studies provided by the meta-analysis were applied in this study.

A further limitation is presented by the use of only one database source. The findings in the present work are based on analysis, including studies from MEDLINE, and an additional hand search of six journals. However, the search strategy did not consider other databases such as EMBASE and the Cochrane Central Register of Controlled Trials.

In conclusion, the analysis of scientific literature on dental implants revealed several hot topics in the time period between 2001 and 2012. The most frequently covered surgical issues were bone substitutes (11.6%) and immediate implant placement, (7.5%), while the most prevalent prosthodontic topics involved immediate loading (14.3%) and cross-arch full bridges (8.0%). Given that the topics demonstrating the highest increase in interest were prosthodontic topics, i.e. , immediate loading (+6.3%) and platform switching (+2.9%), the interest in researching prosthodontic topics will most likely continue to increase.

Acknowledgments

No funding was received to support the study.

Author Contributions

Bernhard Pommer conceived and designed the experiments; Vesela Valkova and Ceeneena Ubaidha Maheen performed the experiments; Rudolf Seemann analyzed the data; Xiaohui Rausch-Fan contributed analysis tools; Vesela Valkova wrote the paper.

Conflicts of Interest

The authors declare no conflict of interest.

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Purpose: This study aimed to investigate the effects of the age and sex of tooth donors on dentin bond strength.

Methods: A total of 38 extracted teeth (12 male and 26 female donors; age range: 17–82 years) were used in this study. In addition to donor age and sex, four other microtensile bond strength (μTBS) test specimen factors were evaluated: dentin position, bonding area, presence of voids at the interface, and computed tomography (CT) values of dentin. The μTBS was measured immediately (24 h) and 6 months after storage in water. After the μTBS testing, linear mixed and nonlinear regression models were used to analyze the effects of these factors on the μTBS data.

Results: The results from the linear mixed model revealed that the bonding area ( P = 0.02), presence of voids at the interface ( P = 0.04), and storage time ( P < 0.001) significantly affected bond strength. In contrast, no correlation was observed between the μ TBS and dentin position ( P = 0.08) or sex ( P = 0.07). The results of the nonlinear regression model with robust variance–covariance estimators revealed that age significantly affected bond strength ( P < 0.001). In addition, a significant positive correlation was found between μTBS and age ( P < 0.001), with nonlinearity ( P = 0.002). However, no correlation was observed between the μTBS and CT values ( P = 0.69) without nonlinearity ( P = 0.39).

Conclusions: These findings suggest that bond strength increases with age until 60 years but not afterward.

This study offers valuable insights into the factors influencing dentin bond strength, particularly highlighting the significant impact of donor age. By meticulously analyzing a wide range of variables, including bonding area, void presence, and CT values, the researchers have provided a comprehensive understanding of how these elements interact with age to affect bond strength. The finding that bond strength increases with age up to the age of 60 is particularly noteworthy, offering practical implications for optimizing adhesive dentistry procedures. This research not only advances our knowledge in the field but also underscores the importance of considering donor characteristics in clinical applications. Overall, this study is a commendable contribution to the field of adhesive dentistry.

Purpose: This systematic review examined the effectiveness of soft denture relining (SDR) materials.

Study selection: A comprehensive search of MEDLINE, Cochrane Library, and ICHUSHI was conducted up to July 26, 2020. Target outcomes were patient satisfaction, oral health-related quality of life (OHRQOL), masticatory ability (MA), denture functional duration, residual ridge resorption (RRR), and microbial contamination. An organization specializing in literature searches performed the reference searches, and two reviewers independently selected the literature sources, extracted the data, and assessed the risk of bias. The reviewers resolved any disagreements concerning the assortment of literature sources through discussion. SDR included acrylic- and silicone-based materials, which were evaluated separately.

Results: Reviewers selected 7, 5, 11, 1, 4, and 6 studies to assess patient satisfaction, OHRQOL, MA, functional duration, RRR, and microbial contamination, respectively. The results confirmed that SDR improved patient satisfaction, OHRQOL, MA, and RRR. However, the functional duration of SDR material is shorter than that of hard denture relining (HDR) or acrylic resin material. Furthermore, SDR material is more susceptible to microbial contamination in the long term. The risk of bias for the included studies tended to be high because of specific issues (difficulty in blinding SDR versus HDR).

Conclusions: For patients who wear complete dentures, SDR often provides beneficial outcomes such as pain reduction and recovery from MA. However, caution should be exercised regarding their use owing to insufficient functional duration and the possibility of microbial contamination during long-term use.

This study systematically reviewed clinical studies to examine the effectiveness of soft denture relining (SDR) materials used for removable dentures and found that SDR often provides beneficial outcomes such as pain reduction and recovery of chewing ability with dentures. However, caution should be exercised regarding their use, owing to insufficient functional duration and the possibility of microbial contamination during long-term use. This review highlights the clinical significance and limitations of SDR in maintaining the quality of life of individuals using removable dentures.

Purpose: Depression is a leading cause of disability. Although tooth loss increases the risk of depressive symptoms, it is unclear whether dental prosthesis use moderates this risk. This study aimed to investigate whether dental prosthesis use moderates the association between tooth loss and new depressive symptoms in older adults.

Methods: This cohort study used data from the 2016 and 2019 Japan Gerontological Evaluation Study (JAGES). The participants were independent older adults aged ≥65 years without depressive symptoms in 2016. The onset of depressive symptoms in 2019 was the outcome variable. The explanatory variables were dental status (≥20 teeth, 10–19 teeth with or without dental prostheses, and 0–9 teeth with or without dental prostheses) in 2016. Risk ratios (RRs) and 95% confidence intervals (CIs) were estimated using Poisson regression models with potential confounders as covariates.

Results: The analysis included 50,169 participants (mean age: 72.8 [standard deviation, 5.4] years). During follow-up, the incidence of depressive symptoms was 11.3%. Compared to those who had ≥20 teeth, the RR of depressive symptom onset was highest among those who had 0–9 teeth without dental prostheses (RR, 1.27; 95% CI, 1.04–1.56), after the adjustment for confounders. However, this risk was lower in those with 0–9 teeth and dental prostheses (RR, 1.08; 95% CI, 1.01–1.15).

Conclusions: These data highlight the potential of dental prostheses as an important factor in reducing the risk of depressive symptoms among individuals with severe tooth loss.

This article provides a compelling investigation into the moderating role of dental prostheses in the risk of depressive symptoms developing due to tooth loss among older adults. Utilizing data from the Japan Gerontological Evaluation Study, the authors conducted a robust cohort analysis of over 50,000 participants, identifying that those with severe tooth loss and no prostheses experienced the highest risk of depressive symptoms. The use of dental prostheses may mitigate this risk of depression linked to severe tooth loss. These findings emphasize the importance of dental interventions in mental health strategies for older adults.

Purpose: To investigate whether depth-gauge burs in veneer preparations influence preparation depth in a randomized, controlled, single-blinded trial and whether inexperienced operators can perform adequate veneer preparations.

Methods: Participants were 20 undergraduate dental students with no prior veneer preparation experience. The instruments used were the “Laminate Veneer System” (LVS), “Keramik-Veneers. de” (KVD), and a “Freehand” group (FH) for reference. All participants prepared three educational acrylic resin maxillae and three mandibular central incisors mounted in typodonts in patient simulators. The objectives were to achieve a preparation depth of 0.6 mm (tooth 11) and 0.4 mm (tooth 31). The sequences of the instruments used and prepared teeth were randomized. The measurements were performed using a laser triangulation coordinate-measuring machine. The data were stratified according to tooth location.

Results: The preparation depths of both depth-gauge-instrument-groups LVS and KVD achieved the objectives significantly better than did the instruments from the “Freehand” group ( P < 0.001). The differences between the depth gauge groups were insignificant, although the maximum preparation depths were smaller in the KVD group. Regarding the prepared teeth, the preparation depths in the mandibular incisors were lower, and the differences were smaller.

Conclusions: The use of special depth-gauge burs for initial veneer preparation leads to significantly lower preparation depths than “Freehand” preparations. The tapered instruments resulted in a lower incidence of extreme preparation depths. The inexperienced operators performed veneer preparation remarkably well.

Currently, depth gauge instruments are considered the standard of care for veneer preparation. This study involved preparing maxillary and mandibular incisors and typodont teeth mounted in dental treatment simulators, aiming to simulate a clinical setting as closely as possible. It was conducted as a randomized controlled trial with blinded measurements and independent statistical evaluation. 

Purpose: In this narrative review, we present the current applications and performances of artificial intelligence (AI) models in different phases of the removable prosthodontic workflow and related research topics.

Study selection: A literature search was conducted using PubMed, Scopus, Web of Science, and Google Scholar databases between January 2010 and January 2023. Search terms related to AI were combined with terms related to removable prosthodontics. Articles reporting the structure and performance of the developed AI model were selected for this literature review.

Results: A total of 15 articles were relevant to the application of AI in removable prosthodontics, including maxillofacial prosthetics. These applications included the design of removable partial dentures, classification of partially edentulous arches, functional evaluation and outcome prediction in complete denture treatment, early prosthetic management of patients with cleft lip and palate, coloration of maxillofacial prostheses, and prediction of the material properties of denture teeth. Various AI models with reliable prediction accuracy have been developed using supervised learning.

Conclusions: The current applications of AI in removable prosthodontics exhibit significant potential for improving the prosthodontic workflow, with high accuracy levels reported in most of the reviewed studies. However, the focus has been predominantly on the diagnostic phase, with few studies addressing treatment planning and implementation. Because the number of AI-related studies in removable prosthodontics is limited, more models targeting different prosthodontic disciplines are required.

This literature review provides a comprehensive overview of the applications of artificial intelligence (AI) in removable prosthodontics, offering significant insights into the current state and prospects of this field. The authors have adeptly highlighted AI’s potential to revolutionize diagnostic processes and treatment planning, while also emphasizing the need for more comprehensive research and collaboration to fully integrate AI into prosthodontic workflows. This paper is recommended for readers interested in understanding the impact of AI on prosthodontics and the convergence of dental sciences with technological innovation.

• In vitro study of optimal removable partial denture clasp design made from novel high-performance polyetherketoneketone Pei-Wen Peng, May-Show Chen, Tzu-Yu Peng, Peng-Chien Huang, Hiroki Nikawa, Wei-Fang Lee
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Digitization in prosthodontics: A futuristic approach

Jain, Vaibhav; Caroline, Hazel

INDC Danteshwari, INHS Asvini Campus, Mumbai, Maharashtra, India

Address for correspondence: Dr. Vaibhav Jain, INDC Danteshwari, INHS Asvini Campus, Colaba, Mumbai - 400 005, Maharashtra, India. E-mail: [email protected]

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Digitization has become an imperative element in contemporary prosthodontics. It is now more pertinent than ever, post the COVID-19 pandemic. Digital dentistry has enabled the clinician’s momentum, as well as the ability to integrate the myriad options that are available into their armamentarium to ensure the highest standards of patient care. Digitization ensures safer procedures and staff protection, whereas restricting the number of patient visits to the treatment facility to a minimum. During the COVID-19 pandemic, digitization played a crucial role in prosthetic dentistry. It enabled clinicians to adopt necessary precautions, reduced the number of appointments, enhanced digital communication with the laboratory, and enabled several other procedures that eliminated the possibility of cross infections between the practitioners, patients, and dental technicians. The availability of technology in prosthodontics such as computer-aided design-computer-aided manufacturing, stereolithography, rapid prototyping, use of virtual articulators, digital face bows, and digital radiographs have revolutionized treatment protocols. Developments in cross-sectional imaging techniques such as spiral tomography and reformatted computerized tomograms have become increasingly popular in preoperative assessment and planning for dental implant treatment. The three-dimensional (3D) optical digitizing technology allows images to be scanned with a 3D scanner and these can be coupled with computerized milling machines for processing prosthetic restorations. The pace of digitization in dental practice is expected to revolutionize the future of dentistry. Continuous research in material science, equipment, and treatment techniques can be expected to improve treatment outcomes in the specialty. Further, digitization permits many newer and effective methods of research.

INTRODUCTION

The constant upgradation of technology is revolutionizing dentistry as it is practiced and the manner in which dental laboratories are fabricating various prostheses. The various aspects of dentistry such as diagnosis, rehabilitation, and patients’ maintenance with complex clinical conditions have been drastically improved through the digitalized techniques vis-a-vis conventional procedures. Digitalization in dentistry also influences various factors such as clinical examination, patient education, motivation of the patient, laboratory procedures, practice management, and research in dentistry. The availability of software has also amplified the role of chairside computers by successfully integrating clinical features with corresponding administrative functions and financial management.

Under many circumstances, digital dentistry, specifically digital prosthodontics, has emerged as an important tool in the management of cases. During widespread transmission of SARS-CoV-2 and the unique characteristics of a dental operatory such as proximity to the oropharyngeal region and generation of aerosol during dental procedures, dental practitioners and patients were subjected to an increased risk of contracting COVID-19 infection. Although the mortality associated with COVID-19 has reduced substantially, it has taught us lessons on how we could move forward. The patients requiring dental prostheses are often in the senior age group. Factors such as high concentration of copious saliva in impression trays and dentures, exposure to blood during preprosthetic surgeries such as implant placement and exposure to aerosols during tooth preparation for crown and bridge make infection control a challenging task.

The dental laboratory and its capabilities are of cardinal importance in the practice of prosthetic dentistry. It is very important to consider the fact that laboratory work involves multiple people in a human chain beginning from the practitioner, the dental assistant, the laboratory supervisor, the laboratory technician, and then the practitioner once again. Since impressions, models, and prostheses are handled by several people in the operatory and the laboratory, the possibility of cross-infections is substantially high. The advent of digitization has helped us to reduce these to a large extent.

The term “digitization” refers to the conversion of an image or signal into digital code by scanning using a graphic tablet (indirect technique) or using an analog (direct technique) to a digital conversion device. [ 1 ] Over the years, digitization has seamlessly blended with contemporary prosthodontics. Routine procedures such as making impressions, recording jaw movements, fabricating prostheses, educating and training new dentists, and patient motivation for practice buildup have incorporated a digital component. [ 2 ]

The digital tools in clinical and laboratory procedures include computer-aided design-computer-aided manufacture (CAD-CAM) machines, stereolithography, rapid prototyping, [ 2 ] use of virtual articulators, digital facebow, and digital radiographs. Digital tools in the field of training include [ 3 ] three-dimensional (3D) photographic imaging system, [ 4 ] optoelectronic recording of jaw motion, digital Instron machine, retention testing device, and audio-visual aids. [ 5 ]

This paper reviews various aspects of prosthodontics where digitization has completely modified conventional procedures.

ROLE OF DIGITIZATION

Role of digitization in patient motivation and practice management.

Building a good rapport with the patient before treatment is as elemental as the treatment itself. Educating them regarding their oral health and the need for professional help can be done by employing various digital aids such as intraoral camera, educational software, videos, two-dimensional (2D), and 3D images of dental procedures. This helps the patients to understand the interrelation of dental health with general health and weans away the fear of dental treatment procedures. Software such as XCPT, Dentrix, and Bite FX can be used for a better understanding of treatment plans and portrayed in a visually convincing manner. [ 6 , 7 ] This software digitizes analog radiographs or captures digital radiographs (panoramic, periapical, or computed tomography [CT] scan) and gives the clinician the ability to annotate the image and place a variety of objects, crowns, implants, abutments, and bone grafts to explain to the patient the course of treatment. They can serve as on-the-spot consultation tools, build trust, and save time because it enables patients to grasp the view that is being conveyed. In this manner, treatment results can be visualized in a 3D form to motivate patients. [ 8 ]

Role of digitization in training and research

Learning through the World Wide Web and visualizing many dental procedural videos on YouTube is just a click away for the present generation. A big leap in the field of education is with virtual software such as virtual dental patient (CANDIDETM, PERIOSLIMTM) which allows learning with the true feel of working on a patient. Surgical training has traditionally been one of apprenticeship, where the trainee learns to perform surgery under the supervision of a trained surgeon. This is time-consuming, expensive, and of variable efficacy. Training using a virtual reality simulator is available as an option to supplement standard training and for assessing the competency of a surgeon in an ethical manner. [ 9–11 ] This can prove to be beneficial for teaching restorative procedures, tooth preparation, suture placement, and implant-related surgeries since it offers the virtual simulation of working on a patients without harm or risk to them. [ 12 , 13 ] In the field of research, software such as CorelDraw and Adobe Photoshop allows the evaluation of photographs for anthropometric and tooth ratios. Laser digitization of casts is carried out using 3D optical digitizing technology and evaluated for accuracy to see the effect of tray selection and cast formation technique. Hence, the method paved the way for an accurate technique for measuring the dimensions of the dental cast as an alternative to manual measurements.

Digitization in diagnosis

Digital radiography offers immediate viewing of images which are highly desirable during implant procedures, postimplant placement, and patient education. It makes the use and maintenance of chemicals and dark rooms redundant. Images can be enhanced by the intuitive software for easier reading and diagnosis, comparison, and subsequent viewing. The storage and electronic distribution of digital images allow better communication with other practitioners and insurance companies. Errors are also minimized in this manner and it decreases the radiation exposure because of fewer retakes. 3D radiographs have been called the fourth dimension of endodontic treatment planning as they improve the preoperative visibility of lateral canals, presence/absence of additional canals, and provide clues about the tooth anatomy before performing invasive procedure. [ 14–16 ] Further, software-related barriers need to be overcome for the use of computers in dental radiography. The alteration of images to remove artifacts or scratches needs to be documented and cannot be relied as evidence for legal purpose. Besides, its high cost does not encourage many of the practitioners. However, some reasonably priced newly introduced equipment has aided in a transition from traditional to computerized radiography. [ 17 ]

Radiovisiography (RVG) was first introduced by Dr. Mouyen et al . [ 18 ] in 1989. It enables the clinician to capture radiographs from the patient’s mouth through an RVG sensor on the chair itself and transfer the images to the screen. The images on the screen can be zoomed, rotated, cropped, edited, or further manipulated with enhancement, contrast, and reversing. The newer versions of intraoral cameras have minimal weight (<50 g) and the illumination for image capture is no longer the fiber-optic cord that is affected by aging. They have been replaced by light-emitting diodes which give adequate white illumination to compensate for darkness inside the mouth. Radiation exposure is reduced with RVG when compared to conventional radiography, cone beam CT further helps in the reduction of radiation exposure by 10–30 times less than that of a conventional CT radiograph. [ 19–21 ]

Contemporary options available for TMJ imaging are CT with cone-beam technology, MRI, and nuclear imaging including single-photon emission CT and positron emission tomography. These advancements improve the understanding of this complex joint and its pathology, ultimately lead to improved treatment outcomes. [ 19–21 ]

Diagnostic imaging is an essential component of implant treatment planning and a variety of advanced imaging modalities has been recommended to assist the dentist in assessing potential sites for implants. Developments in cross-sectional imaging techniques such as spiral tomography and reformatted computerized tomograms have become increasingly popular in the preoperative assessment and planning for a dental implant. Radiographs are used to evaluate bone quantity, quality, density, and esthetic site assessment for implant placement. Digital panoramic imaging is one of the earliest and most sought-after modes as it is a noninvasive procedure. Authors suggest considering risk–benefit analysis before applying newer imaging methods, for example, radiation exposure which also makes the latter most relevant. [ 22 , 23 ]

Dental photography has always been an aid for patient education and esthetic treatment planning. Intuitive software makes it possible to visualize posttreatment effect, variation of tooth size and form, etc. It is utilized for many web-based studies to survey opinions of dentists and nondentist population. [ 24 , 25 ] Photographic records are easier to store, can be viewed at various angulations and dimensions can be easily measured. A series of photographic records of dental visits could be a big help examine age changes such as occlusal vertical dimension, tooth color, and facial changes. This can redefine the practice of prosthodontics with their ability of visual communication and aid in the medicolegal documentation in contemporary practice. The use of digital photographs has also been explored in areas of maxillofacial restoration to replicate the iris, whereas fabricating a custom ocular prosthesis for an anophthalmic patient or orbital prosthesis and for restoring other maxillofacial defects. [ 6 , 26 ] Software such as Adobe Photoshop and CorelDraw allows for digital subtraction photography, which improves the detection of caries, periapical lesions, bone changes, and progress of periapical healing. [ 27 ]

Diagnosing and treating occlusal errors

Analyzing the problems arising from the occlusal origin is difficult to constitute a great difficulty due to the complex nature of the human occlusal system. An atraumatic dental occlusion is an area of growing demand in the fields of restorative and reconstructive dentistry. [ 28 , 29 ] Systems such as Tekscan (T scan) and MatScan permit a precise study of occlusal contacts and the forces created detecting even the slightest of occlusal interferences which are significant in full mouth rehabilitation and implant-protected occlusion. In 1988 Dr. William Maness [ 30 ] working at Tufts University introduced an automated computerized sensor for analysis of the dental occlusion. The record is transferred to a computing system that can make an actual simulation of the patient’s occlusion on a monitor, assuming the different situations possible during centric, eccentric, and functional movements. This provides both qualitative and quantitative assessment of occlusion. The system was termed T-scan and was accepted well due to its advantages such as simple operation, dynamic viewing of occlusion, and timed analysis of force during various positions of teeth contact. In addition, it also accommodates the possibility of permanent documentation and monitoring of the occlusal condition after performing the various treatment protocols. There have been many improvements in the system up to the 4 th generation permitting the use of a thin 100 µ thin sensor and software to analyze and display the timing and force of the patients bite in 2D and 3D graphics.

Mandibular kinematics permits the detection and assessment of TMJ functional irregularities due to internal obstacles such as a displaced articular disc. Jaw tracking devices (K6 diagnostics) would be helpful in studying jaw movements and hence occlusion which may result in microtrauma in temporomandibular disorders. [ 31 , 32 ] The elevated muscle activity associated with malocclusion-directed nociception can be detected with surface electromyography (EMG). An EMG device named BITE STRIP™ can record muscle activity for 6 h and provides useful information in nocturnal bruxism. All these techniques mainly revolve around studying the stomatognathic system accurately and precisely. Computerized pantographs such as DENTAL HOBY FF (DHF-030) Articulator can be used for the restoration of deteriorated dentitions, thereby relating the stomatognathic system accurately.

Role of digitization in treatment planning

Impression-making is an indispensable part of prosthodontics, and digital impressions have revolutionized this task during the COVID-19 pandemic. They overcome the use of materials and their related inaccuracies. This historical development in making impressions has been aptly called bites to bytes. [ 33 ] Digital recording allows multiple uses without loss of accuracy, helps avoid the need for disinfection, and could be beneficial in patients with a hypersensitive palate. The advent of digital impressions has aided in further shortening the chairside time for CAD-CAM restorations which offered a significant advantage during COVID-19. [ 34–36 ]

3D optical digitizing technology allows 3D images to be scanned with a 3D scanner and these can be coupled with computerized milling machines for processing restorations. CEREC AC gives dentists the choice of implementing in office, fabrication, or sending the digital images with CEREC CONNECT directly to the laboratory where the restoration can either be milled or a model can be created for traditional fabrication of the restoration. The optical impressions and other digital records provide useful information in prosthetic dentistry. Digital impressions with LAVA™ Chairside Oral Scanner have been used for the assessment of gingival contour and compared with traditional clinical indices such as modified gingival index and bleeding index. [ 37 , 38 ]

Another area of digital application has been the replication of shades/color as this has always been prone for inter- and intraoperator variability. Visual shade matching is now being replaced by methods such as photography, colorimeters, and spectrophotometers (shade match, shade vision, shade eye, and clear match) they give a more consistent shade and a near-life effect with color mapping of the teeth. Digital imaging and shade matching decrease the interoperator and intraoperator variability and facilitate accurate communication with the laboratory. [ 39 ]

CAD-CAM-aided implant surgeries help in proper planning and execution of treatment and result in biomechanically sound prosthesis, through minimally invasive flapless procedures. [ 40 ] A tactile registration-based implant locating system has been proposed as a simple method for accurate implant design and placement requiring only basic computer experience, minimal operational space, and infrastructure. [ 41 ] Computer-assisted surgery helps to improve oral implant planning and intraoral bone-sounding device maps the surface of the jaw through the soft tissue. Bone contour data are registered over the computerized tomographic image. Guided by treatment preplanning software, a chairside robotic manipulator fabricates guiding sleeves that direct the drill and implant during the osteotomy and implant placement, respectively. Construction of CAD/CAM bilateral ear prostheses has been described using laser scanning of the defective regions of a patient’s face and rapid prototyping using 3D anatomic models from a digital ear library. [ 8 ]

Another important technological application is the use of virtual articulators. Treating occlusion and restoring oral health needs a good articulator simulating the oral environment. There have been extensive developments in the design of articulators to evaluate the near-accurate simulation of the mouth. Considering the limitations of existing articulators, Bernard Frank said “Mouth is the best articulator.” The application of virtual technology to articulator design aims to reproduce close to real-life situation. The virtual articulators have been designed for the exhaustive analysis of static and dynamic occlusion with the purpose of substituting mechanical articulators and avoiding their errors. They can simulate a specific masticatory movement of patient and the program calculates the sites where the opposing teeth come into contact during mandibular animation. Mechanical articulators are different from real-life biological settings. They cannot simulate masticatory movements that are dependent upon the muscle patterns and resilience of the soft tissues and joint discs. Moreover, tooth mobility cannot be simulated by plaster models. As a result, the latter are unable to reproduce real-life dynamic conditions of occlusion. [ 42–44 ]

Future scope of digitization

The pace at which digitization is encompassing dental practice will revolutionize the future of dentistry. Research in areas such as optical coherence tomography (D4D Technologies) would enable the creation of sliced images of the teeth or other structures. At present, digital impressions are extremely sensitive to face movements which makes it difficult to scan preparations intraorally. The newer developments are expected to give more consistent results. The evolution 4D system, currently under development by D4D Technologies (Richardson, Texas) is expected to have intraoral data capture capabilities. Other commercially available CAD/CAM systems capture data from models using mechanical or optical digitizers of various types. After the evolution of intraoral scanner, the use of data can be captured directly without models with high precision. The complete edentulous arches, if recorded directly using the intaoral scanner, can be treated without the discrepancy of REALEFF factor. Other areas to be explored include the use of virtual articulators and digital face bows to facilitate the automatic design of the occlusal surface.

Advances in digital imaging, CAD, internet communication, digital manufacturing, and new materials have simplified diagnostic processes, improved treatment outcomes and reduced patient visits while minimizing the chances of infection. Digital technology influences patient motivation, practice management, and clinical treatment procedures. Digital radiographs aid in diagnosis. CAD-CAM ceramics provide better esthetics and function. Rapid prototyping and stereolithography aid in the fabrication of maxillofacial prostheses. These digital aids provide a high level of predictability and convenience with a minimum number of visits to the dental operatory. Research has to progress in the fields of equipment, material science, and treatment procedures. Digitization permits many newer and effective methods of research. Increasing patient safety and controlling crosscontamination will be a top priority for patient services and staff protection in the post-COVID-19 era.

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section " Dentistry, Oral Surgery and Oral Medicine ".

Deadline for manuscript submissions: closed (30 November 2021) | Viewed by 28486

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Dear Colleagues,

We are well aware that both patients and clinicians expect that prosthodontic treatments (often preceded by a variety of surgical, periodontal, and restorative treatments) have a positive impact on oral health and wellbeing. However, since prostheses are directed towards influencing oral function and patient aesthetics, the patient´s perception may be the key parameter in assessing treatment outcomes because those relevant dimensions (oral function and aesthetics) can only be subjectively estimated by the patient.

Over the past two decades, the importance of measuring so-called patient-centered outcomes has been increasingly reported in the literature as a complementary but recommended tool for assessing prosthetic treatments. The outcomes of prosthodontic procedures are variable and cannot be assessed reliably using clinical measures alone. For example, the improvement of masticatory function after replacing missing teeth may be assessed simultaneously by subjective and objective methods to effectively quantify changes in mastication.

The focus of this Special Issue is to review what is currently known about the effect of prosthetic treatments on patient functioning and wellbeing by measuring patient-centered outcomes.

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