PURPOSE: Accuracy of image matching between resting and smiling facial models is affected by the stability of the reference surfaces. This study aimed to investigate the morphometric variations in subdivided facial units during resting, posed and spontaneous smiling. MATERIALS AND METHODS: The posed and spontaneous smiling faces of 33 adults were digitized and registered to the resting faces. The morphological changes of subdivided facial units at the forehead (upper and lower central, upper and lower lateral, and temple), nasal (dorsum, tip, lateral wall, and alar lobules), and chin (central and lateral) regions were assessed by measuring the 3D mesh deviations between the smiling and resting facial models. The one-way analysis of variance, Duncan post hoc tests, and Student’s t-test were used to determine the differences among the groups (α = .05). RESULTS: The smallest morphometric changes were observed at the upper and central forehead and nasal dorsum; meanwhile, the largest deviation was found at the nasal alar lobules in both the posed and spontaneous smiles (P < .001). The spontaneous smile generally resulted in larger facial unit changes than the posed smile, and significant difference was observed at the alar lobules, central chin, and lateral chin units (P < .001). CONCLUSION The upper and central forehead and nasal dorsum are reliable areas for image matching between resting and smiling 3D facial images. The central chin area can be considered an additional reference area for posed smiles; however, special cautions should be taken when selecting this area as references for spontaneous smiles.

PURPOSE: . This study investigated the accuracy of full-arch intraoral scans obtained by various scan strategies with the segmental scan and merge methods. MATERIALS AND METHODS: . Seventy intraoral scans (seven scans per group) were performed using 10 scan strategies that differed in the segmental scan (1, 2, or 3 segments) and the scanning motion (straight, zigzag, or combined). The three-dimensional (3D) geometric accuracy of scan images was evaluated by comparison with a reference image in an image analysis software program, in terms of the arch shape discrepancies. Measurement parameters were the intermolar distance, interpremolar distance, anteroposterior distance, and global surface deviation. One-way analysis of variance and Tukey honestly significance difference post hoc tests were carried out to compare differences among the scan strategy groups (α = .05). RESULTS: . The linear discrepancy values of intraoral scans were not different among scan strategies performed with the single scan and segmental scan methods. In general, differences in the scan motion did not show different accuracies, except for the intermolar distance measured under the scan conditions of a 3-segmental scan and zigzag motion. The global surface deviations were not different among all scan strategies. CONCLUSION . The segmental scan and merge methods using two scan parts appear to be reliable as an alternative to the single scan method for full-arch intraoral scans. When three segmental scans are involved, the accuracy of complete arch scan can be negatively affected.

This case report describes a dynamic digital esthetic rehabilitation procedure that integrates a new three-dimensional augmented reality (3D-AR) technique to treat a patient with multiple missing anterior teeth. The prostheses were designed using computer-aided design (CAD) software and virtually trialed using static and dynamic visualization methods. In the static method, the prostheses were visualized by integrating the CAD model with a 3D face scan of the patient. For the dynamic method, the 3D-AR application was used for real-time tracking and projection of the CAD prostheses in the patient’s mouth. Results of a quick survey on patient satisfaction with the two visualization methods showed that the patient felt more satisfied with the dynamic visualization method because it allowed him to observe the prostheses directly on his face and be more proactive in the treatment process.

Purpose: The purpose of the present study was to investigate the effects of image matching experience of operators on the accuracy and working time of image registration between radiographic and optical scan images. Materials and Methods: Computed tomography and optical scan of a dentate dental arch were obtained. Image matching between the computed tomography and the optical scan (IDC S1, Amann Girrbach, Koblah, Austria) was performed using the point-based automatic registration method in planning software programs (Implant Studio, 3Shape, Copenhagen, Denmark) using two different experience conditions on image registration: experienced group and inexperienced group (n = 15 per group, N = 30). The accuracy of image registration in each group was evaluated by measuring linear discrepancies between matched images, and working time was recorded. Independent t test was used to statistically analyze the result data (α = .05). Results: In the linear deviation, no statistically significant difference was found between the experienced and inexperienced groups. Meanwhile, the working time for image registration was significantly shorter in the experienced group than in the inexperienced group (P = .007). Conclusion Difference in the image matching experience may not influence the accuracy of image registration of optical scan to computed tomography when the point-based automatic registration was used, but affect the working time for the image registration.

Purpose: The purpose of the present study was to investigate the effects of image matching experience of operators on the accuracy and working time of image registration between radiographic and optical scan images. Materials and Methods: Computed tomography and optical scan of a dentate dental arch were obtained. Image matching between the computed tomography and the optical scan (IDC S1, Amann Girrbach, Koblah, Austria) was performed using the point-based automatic registration method in planning software programs (Implant Studio, 3Shape, Copenhagen, Denmark) using two different experience conditions on image registration: experienced group and inexperienced group (n = 15 per group, N = 30). The accuracy of image registration in each group was evaluated by measuring linear discrepancies between matched images, and working time was recorded. Independent t test was used to statistically analyze the result data (α = .05). Results: In the linear deviation, no statistically significant difference was found between the experienced and inexperienced groups. Meanwhile, the working time for image registration was significantly shorter in the experienced group than in the inexperienced group (P = .007). Conclusion Difference in the image matching experience may not influence the accuracy of image registration of optical scan to computed tomography when the point-based automatic registration was used, but affect the working time for the image registration.

Conventionally, when a zirconia fixed dental restoration is planned, the interim restoration is made manually and the final restoration is fabricated by the silicone impression taking at the prosthodontic stage. This conventional workflow does not provide direct relation between interim and final restorations. Moreover, the predictability of the final restoration could be low. Nowadays, the CAD/CAM based restoration fabrication and related digital techniques are developed and being applied in dentistry in multiple ways. This case report introduces a digital workflow for fabricating an optimal gingival adaptation and predictability of monolithic zirconia restoration by using CAD/CAM interim restoration, intra oral scan, and image superimposition technique in a case that required tooth extraction.

PURPOSE: Surface finishing of a zirconia restoration is essential after clinical adjustment. Herein, we investigated the effects of a surface finishing protocol for monolithic zirconia on final roughness and bacterial adherence. MATERIALS AND METHODS: Forty-eight disk-shaped monolithic zirconia specimens were fabricated and divided into four groups (n = 12) based on initial surface treatment, finishing, and polishing protocols: diamond bur+polishing bur (DP group), diamond bur+stone grinding bur+polishing bur (DSP group), no diamond bur+polishing bur (NP group), and no diamond bur+stone grinding bur+polishing bur (NSP group). Initial and final surface roughness was measured with a profilometer, and shown using scanning electron microscope. Bacterial adhesion was evaluated by quantifying Streptococcus mutans in the biofilm. Kruskal-Wallis and Mann-Whitney U tests were used to compare results among groups, and two-way analysis of variance was used to evaluate the effects of grinding burs on final roughness (α=.05). RESULTS: The DP group had the highest final Ra value, followed by the DSP, NP, and NSP groups. Use of the stone grinding bur as a coarse-finishing step significantly decreased final Ra values when a diamond bur was used (P < .001). Omission of the stone grinding bur increased biofilm formation on specimen surfaces. Combining a stone grinding bur with silicone polishing burs produced the smallest final biofilm values, regardless of the use of a diamond bur in initial surface treatment. CONCLUSION: Coarse finishing of monolithic zirconia with a stone grinding bur significantly decreased final Ra values and bacterial biofilm formation when surfaces had been roughened by a diamond bur.
Bacterial Adhesion ; Biofilms ; Dental Instruments ; Dental Polishing ; Diamond ; Silicon ; Silicones ; Streptococcus mutans

PURPOSE: The purpose of this study was to evaluate the effects of various protocols and systems for finishing and polishing monolithic zirconia on surface topography, phase transformation, and bacterial adhesion. MATERIALS AND METHODS: Three hundred monolithic zirconia specimens were fabricated and then treated with three finishing and polishing systems (Jota [JO], Meisinger [ME], and Edenta [ED]) using four surface treatment protocols: coarse finishing alone (C); coarse finishing and medium polishing (CM); coarse finishing and fine polishing (CF); and coarse finishing, medium polishing, and fine polishing (CMF). Surface roughness, crystal phase transformation, and bacterial adhesion were evaluated using atomic force microscopy, X-ray diffraction, and streptococcal biofilm formation assay, respectively. One-way and two-way analysis of variance with Tukey post hoc tests were used to analyze the results (α=.05). RESULTS: In this study, the surface treatment protocols and systems had significant effects on the resulting roughness. The CMF protocol produced the lowest roughness values, followed by CM and CF. Use of the JO system produced the lowest roughness values and the smallest biofilm mass, while the ME system produced the smallest partial transformation ratio. The ED group exhibited the highest roughness values, biofilm mass, and partial transformation ratio. CONCLUSION: Stepwise surface treatment of monolithic zirconia, combined with careful polishing system selection, is essential to obtaining optimal microstructural and biological surface results.
Bacterial Adhesion ; Biofilms ; Clinical Protocols ; Dental Polishing ; Microscopy, Atomic Force ; X-Ray Diffraction

PURPOSE: The present study was designed to examine the clinical fit of fixed dental prosthesis fabricated by the milling-sintering method using a presintered cobalt-chromium alloy. MATERIALS AND METHODS: Two single metal-ceramic crowns were fabricated via milling-sintering method and casting method in each of the twelve consecutive patients who required an implant-supported fixed prosthesis. In the milling-sintering method, the prosthetic coping was designed in computer software, and the design was converted to a non-precious alloy coping using milling and post-sintering process. In the casting method, the conventional manual fabrication process was applied. The absolute marginal discrepancy of the prostheses was evaluated intraorally using the triple-scan technique. Statistical analysis was conducted using Mann-Whitney U test (α=.05). RESULTS: Eight patients (66.7%) showed a lower marginal discrepancy of the prostheses made using the milling-sintering method than that of the prosthesis made by the casting method. Statistically, the misfit of the prosthesis fabricated using the milling-sintering method was not significantly different from that fabricated using the casting method (P=.782). There was no tendency between the amount of marginal discrepancy and the measurement point. CONCLUSION: The overall marginal fit of prosthesis fabricated by milling-sintering using a presintered alloy was comparable to that of the prosthesis fabricated by the conventional casting method in clinical use.
Alloys ; Clinical Study ; Crowns ; Dental Prosthesis ; Humans ; Methods ; Prostheses and Implants

PURPOSE: The purpose of this study was to evaluate the reliability of computer-aided replica technique (CART) by calculating its agreement with the replica technique (RT), using statistical agreement analysis. MATERIALS AND METHODS: A prepared metal die and a metal crown were fabricated. The gap between the restoration and abutment was replicated using silicone indicator paste (n = 25). Gap measurements differed in the control (RT) and experimental (CART) groups. In the RT group, the silicone replica was manually sectioned, and the marginal and occlusal gaps were measured using a microscope. In the CART group, the gap was digitized using optical scanning and image superimposition, and the gaps were measured using a software program. The agreement between the measurement techniques was evaluated by using the 95% Bland-Altman limits of agreement and concordance correlation coefficients (CCC). The least acceptable CCC was 0.90. RESULTS: The RT and CART groups showed linear association, with a strong positive correlation in gap measurements, but without significant differences. The 95% limits of agreement between the paired gap measurements were 3.84% and 7.08% of the mean. The lower 95% confidence limits of CCC were 0.9676 and 0.9188 for the marginal and occlusal gap measurements, respectively, and the values were greater than the allowed limit. CONCLUSION: The CART is a reliable digital approach for evaluating the fit accuracy of fixed dental prostheses.
Crowns ; Dental Prosthesis ; Prostheses and Implants* ; Replica Techniques* ; Silicon ; Silicones