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The Role of Three-Dimensional Diagnostic and Planning Tools in the Quality of Clinical Outcomes in Dentistry

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Oral Health".

Deadline for manuscript submissions: closed (10 April 2023) | Viewed by 41251

Special Issue Editors

School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, 80131 Naples, Italy
Interests: orthodontics; dental materials; archwires properties; functional appliances; temporomandibular disorders; class III; digital dentistry; soft tissue
Special Issues, Collections and Topics in MDPI journals
Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Naples 80131, Italy
Interests: dental materials; dental surgery; restorative dentistry and endodontics
Department of Oral Sciences, University of Otago, Dunedin 9054, New Zealand
Interests: craniofacial biology and genetics; clinical orthodontics

Special Issue Information

Dear Colleagues,

The use of three-dimensional (3D) technologies in clinical practice has led to significant improvements in diagnosis, treatment planning and outcome evaluation in dentistry. The ability to simulate various treatment options in a totally digital environment is rather enticing, with potentially important benefits to both patient communication and clinical planning. Current examples of 3D technology in dentistry include the use of guided-implant placement, and CAD-CAM production in prosthodontics and orthodontics. The recent rise of 3D technologies in dentistry raises an important question, however: how do current digitalization processes impact our clinical activity?

In this Special Issue, we invite researchers in all the branches of dentistry, engineering and other sciences to submit high quality clinical and research papers or systematic reviews on the impact of digitalization in clinical practice.

Dr. Roberto Rongo
Prof. Gianrico Spagnuolo
Dr. Joseph Antoun
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Dentistry
  • Three-dimensional imaging
  • Computer-aided design
  • Comprehensive health care
  • Analytical, diagnostic and therapeutic techniques and equipment categories

Published Papers (14 papers)

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Research

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11 pages, 1257 KiB  
Article
Predictability of Maxillary Molar Distalization and Derotation with Clear Aligners: A Prospective Study
by Vincenzo D’Antò, Rosa Valletta, Roberto Ferretti, Rosaria Bucci, Robertas Kirlis and Roberto Rongo
Int. J. Environ. Res. Public Health 2023, 20(4), 2941; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20042941 - 08 Feb 2023
Cited by 9 | Viewed by 2415
Abstract
Clear aligners are employed daily for the treatment of Class II malocclusions, when a valid option involves distalization and derotation of the upper first and second molars. Evidence regarding the predictability of these movements is slight, and the treatment outcome that clinicians plan [...] Read more.
Clear aligners are employed daily for the treatment of Class II malocclusions, when a valid option involves distalization and derotation of the upper first and second molars. Evidence regarding the predictability of these movements is slight, and the treatment outcome that clinicians plan may not be achieved. Therefore, the purpose of this study is to assess the accuracy of distalization and derotation with clear aligners. Geomagic Control X, a 3D quality control software, was used to superimpose digital models of the pre-treatment, post-treatment, and virtual plan (ideal post-treatment) measurements of 16 patients (4 M, 12 F; mean age 25.7 ± 8.8 years). Linear and angular measurement tools were used to calculate the amount of tooth movement prescribed and achieved. Distal displacement of the buccal cusps had an overall accuracy of 69% for the first molar and 75% for the second molar. The accuracy of molar derotation was higher for the first molar (77.5%) than for the second molar (62.7%). The aligners were not able to achieve 100% of the ideal post-treatment result; thus, planning of refinements is often needed. However, clear aligners can be regarded as a valuable option for the distalization of first and second molars. Full article
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10 pages, 28601 KiB  
Article
Accuracy of Endodontic Access Cavities Performed Using an Augmented Reality Appliance: An In Vitro Study
by Vicente Faus-Matoses, Vicente Faus-Llácer, Tanaz Moradian, Elena Riad Deglow, Celia Ruiz-Sánchez, Nirmine Hamoud-Kharrat, Álvaro Zubizarreta-Macho and Ignacio Faus-Matoses
Int. J. Environ. Res. Public Health 2022, 19(18), 11167; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191811167 - 06 Sep 2022
Cited by 5 | Viewed by 1494
Abstract
Introduction: The purpose of this study was to compare and contrast the accuracy of endodontic access cavities created using an augmented reality appliance to those performed using the conventional technique. Materials and Methods: 60 single-rooted anterior teeth were chosen for study and randomly [...] Read more.
Introduction: The purpose of this study was to compare and contrast the accuracy of endodontic access cavities created using an augmented reality appliance to those performed using the conventional technique. Materials and Methods: 60 single-rooted anterior teeth were chosen for study and randomly divided between two study groups: Group A—endodontic access cavities created using an augmented reality appliance as a guide (n = 30) (AR); and Group B—endodontic access cavities performed with the manual (freehand) technique (n = 30) (MN). A 3D implant planning software was used to plan the endodontic access cavities for the AR group, with a cone-beam computed tomography (CBCT) and 3D intraoral surface scan taken preoperatively and subsequently transferred to the augmented reality device. A second CBCT scan was taken after performing the endodontic access cavities to compare the planned and performed endodontic access for accuracy. Therapeutic planning software and Student’s t-test were used to analyze the cavities at the apical, coronal, and angular levels. The repeatability and reproducibility of the digital measurement technique were analyzed using Gage R&R statistical analysis. Results: The paired t-test found statistically significant differences between the study groups at the coronal (p = 0.0029) and apical (p = 0.0063) levels; no statistically significant differences were found between the AR and MN groups at the angular (p = 0.6596) level. Conclusions: Augmented reality devices enable the safer and more accurate performance of endodontic access cavities when compared with the conventional freehand technique. Full article
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12 pages, 1920 KiB  
Article
Assessment of Growth Changes in the Width of Dental Arches Caused by Removable Appliances over a Period of 10 Months in Children with Malocclusion
by Justyna Pałka, Joanna Gawda, Aleksandra Byś, Magdalena Zawadka and Piotr Gawda
Int. J. Environ. Res. Public Health 2022, 19(6), 3442; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19063442 - 15 Mar 2022
Cited by 2 | Viewed by 2381
Abstract
(1) Background: A large number of patients of orthodontic clinics are diagnosed with improper jaw relationships. Intraoral scanners have become an important part of orthodontic practice and provide an opportunity to measure the changes in the width of dental arches. The purpose of [...] Read more.
(1) Background: A large number of patients of orthodontic clinics are diagnosed with improper jaw relationships. Intraoral scanners have become an important part of orthodontic practice and provide an opportunity to measure the changes in the width of dental arches. The purpose of the study was to evaluate the impact of removable appliances used over a 10-month period on growth changes in children with narrowed jaw dimensions. (2) Methods: Twenty four patients were included in the study (a study group—patients, treated with removable appliances in the upper dental arch for a minimum of 10 months; a control group—patients with no craniofacial abnormalities and who did not require orthodontic treatment). A panoramic radiograph and digital intraoral scan were taken, followed by palatal width measurements in Ortho-CAD before treatment, and after a period of 10 months of treatment with removable appliances. (3) Results: After a period of 10 months of the treatment, the study group had a statistically significantly greater mean change in the anterior width of the upper dental arch than the control group. (4) Conclusions: The use of removable appliances in children with narrowed maxillary transverse dimension contributes to offsetting growth changes in comparison to children with normal occlusion. Full article
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11 pages, 2081 KiB  
Article
Effect of CAD/CAM Ceramic Thickness on Shade Masking Ability of Discolored Teeth: In Vitro Study
by Passent Ellakany, Marwa Madi, Nourhan M. Aly, Zainb S. Al-Aql, Maher AlGhamdi, Abdulrahman AlJeraisy and Adel S. Alagl
Int. J. Environ. Res. Public Health 2021, 18(24), 13359; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182413359 - 18 Dec 2021
Cited by 7 | Viewed by 2309
Abstract
Shade matching is a common challenge that dentists face during fabrication of esthetic dental restoration. Thus, the aim of the current study was to assess the masking ability of two types of CAD/CAM ceramics for gaining high esthetic prosthesis. This in vitro study [...] Read more.
Shade matching is a common challenge that dentists face during fabrication of esthetic dental restoration. Thus, the aim of the current study was to assess the masking ability of two types of CAD/CAM ceramics for gaining high esthetic prosthesis. This in vitro study used a total sample size of 66 lithium disilicate (LD) and leucite reinforced (LR) CAD/CAM ceramics sub-grouped into three thicknesses: 0.5, 1, and 1.5 mm. Nine shades of natural dentin die materials were prepared as a replica of the underlying tooth structure. The difference in color (ΔE) and translucency parameter (TP) were assessed for both tested ceramics at the three thicknesses. One-way ANOVA was performed to compare the three thicknesses of each ceramic, followed by multiple pairwise comparisons between both ceramics. LR had significantly higher ΔE than LD at all thicknesses used unlike the case in TP. Thickness of 0.5 mm exhibited the highest ΔE and TP, while 1.5 mm thickness showed the lowest ΔE and TP in both ceramics. Increase in ceramic thickness had a great impact on both color masking ability of the underlying tooth structure and its translucency. The higher the ceramic thickness, the better the masking ability and the lower the translucency was reported. Full article
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10 pages, 1836 KiB  
Article
Digital Quantification of Occlusal Contacts: A Methodological Study
by Jacob Sigvardsson, Samuel Nilsson, Maria Ransjö and Anna Westerlund
Int. J. Environ. Res. Public Health 2021, 18(10), 5297; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105297 - 16 May 2021
Cited by 8 | Viewed by 2664
Abstract
Objective: To compare the reliability of digital occlusal contacts quantification and the validity of digital occlusal contacts quantification with traditional methods used for occlusal contact determination. Subjects and Methods: Thirty participants, all of whom were students at the Sahlgrenska Academy, University of Gothenburg [...] Read more.
Objective: To compare the reliability of digital occlusal contacts quantification and the validity of digital occlusal contacts quantification with traditional methods used for occlusal contact determination. Subjects and Methods: Thirty participants, all of whom were students at the Sahlgrenska Academy, University of Gothenburg in Gothenburg, Sweden, were included in the study. Three different methods were used to evaluate occlusal contacts: (I) a digital examination of the patients’ casts, using the Ortho 3D Models (O3DM) software and measuring the total occlusal contact area in square millimeters (DE); (II) an examination involving the measurement of the total number of occlusal contacts on stone casts mounted in an articulator (AE); and (III) a clinical examination with the measurement of the total number of occlusal contacts with 8 μm-thick articulating foil (CE). Results: The repeated digital measurements (same casts scanned multiple times) showed a significant correlation of 0.85 (p < 0.01), which shows a diagnostic consistency. Furthermore, there was a significant correlation between the results obtained with the DE method and the AE of 0.41 (p < 0.05), and between those acquired with the AE method and the CE of 0.37 (p < 0.05). However, no significant correlation was found between the DE method and the CE method with a correlation coefficient of 0.10 (p > 0.05). Conclusions: Digital casts can be used for quantification of the total occlusal contact area (in mm2) owing to the high reliability of repeated measurements and the strong validity of the method compared to traditionally employed stone cast measurements. Full article
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11 pages, 3080 KiB  
Article
The Effects of Orthodontic Brackets on the Time and Accuracy of Digital Impression Taking
by Hyojin Heo and Minji Kim
Int. J. Environ. Res. Public Health 2021, 18(10), 5282; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18105282 - 16 May 2021
Cited by 6 | Viewed by 1854
Abstract
Background: The aim of the study was to study how the presence or the type of the orthodontic brackets influence the time measurement and accuracy of impressions using a digital oral scanner. Methods: The same models were divided into the control group (the [...] Read more.
Background: The aim of the study was to study how the presence or the type of the orthodontic brackets influence the time measurement and accuracy of impressions using a digital oral scanner. Methods: The same models were divided into the control group (the model without a bracket), MB group (the model with a metal bracket), and CB group (the model with a monocrystalline bracket). Subsequently, scanning was conducted five times for each model using the Trios Pod 2®. Simultaneously, the duration for taking the digital impression was measured. The degree of accuracy was compared among the three groups. Results: As compared with the control group, scanning took 53.3 s longer in the MB group and 194.23 s longer in the CB group. In the canine and the first molar, the mean values of errors were compared between the left and right sides; in both the canine and the first molar, errors between the control group and the CB group were the greatest. Conclusions: Following a comparison of the duration and accuracy of the impressions between the three groups, our results suggest that its degree was the highest in the CB group where a monocrystalline bracket was attached. Full article
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11 pages, 2683 KiB  
Article
Buccal Bone Changes Around First Permanent Molars and Second Primary Molars after Maxillary Expansion with a Low Compliance Ni–Ti Leaf Spring Expander
by Valentina Lanteri, Davide Cavagnetto, Andrea Abate, Eleonora Mainardi, Francesca Gaffuri, Alessandro Ugolini and Cinzia Maspero
Int. J. Environ. Res. Public Health 2020, 17(23), 9104; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17239104 - 06 Dec 2020
Cited by 26 | Viewed by 4315
Abstract
Background: Vestibular bone thickness changes and dento-alveolar buccal tipping of second primary molars and of first molars after maxillary expansion performed with a slow maxillary expansion protocol was investigated. Methods: Twenty patients (mean age 7.3 ± 0.9 years old; 9 male and 11 [...] Read more.
Background: Vestibular bone thickness changes and dento-alveolar buccal tipping of second primary molars and of first molars after maxillary expansion performed with a slow maxillary expansion protocol was investigated. Methods: Twenty patients (mean age 7.3 ± 0.9 years old; 9 male and 11 female) were treated according to the Leaf Expander protocol. Buccal alveolar bone thickness (BT), buccal alveolar bone height (BH), inter-dental angle (TIP), and inter-molar width (IW) regarding first molars and second primary molars were calculated before and after expansion on cone beam computed tomography (CBCT) images. Descriptive statistics and paired t-tests were used to assess changes between the pre-treatment and post-treatment measurements. Results: Bone thickness vestibular to second primary molars and intermolar width of both teeth were the only variables that showed statistically significant changes. Conclusions: It appears that buccal bone thickness vestibular to first molars was not significantly reduced after maxillary expansion with the Leaf Expander. The clinical use of a slow maxillary expander with Ni–Ti springs appears efficient and safe in in the correction of maxillary hypoplasia during mixed dentition. Full article
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9 pages, 675 KiB  
Article
Frontal and Axial Evaluation of Craniofacial Morphology in Repaired Unilateral Cleft Lip and Palate Patients Utilizing Cone Beam Computed Tomography; An Observational Study
by Anuraj Singh Kochhar, Maninder Singh Sidhu, Mona Prabhakar, Ritasha Bhasin, Gulsheen Kaur Kochhar, Himanshu Dadlani and Gianrico Spagnuolo
Int. J. Environ. Res. Public Health 2020, 17(21), 7786; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17217786 - 24 Oct 2020
Cited by 5 | Viewed by 2187
Abstract
The current study was conducted to assess the extent of maxillary arch collapse on the cleft vis-a-vis non-cleft sides in the same individual presenting withunilateral cleft lip and palate (UCLP), using cone-beam computed tomography (CBCT). Thirty-one children (eighteen boys andthirteen girls) with surgically [...] Read more.
The current study was conducted to assess the extent of maxillary arch collapse on the cleft vis-a-vis non-cleft sides in the same individual presenting withunilateral cleft lip and palate (UCLP), using cone-beam computed tomography (CBCT). Thirty-one children (eighteen boys andthirteen girls) with surgically repaired UCLP, who met the inclusion criteria, were selected. Following the acquisition of CBCT scans, fourteen bilateral landmarks were selected. The distance of the bilateral landmark was calculated from the midsagittal plane on the cleft and non-cleft sides for both frontal and axial views. Tracings were done;the data obtained was subjected to statistical analysis;and intra-observer variability was checked with intraclass correlation coefficient (ICC) and two-way ANOVA. Subsequently, the measurements were subjected to paired t-tests at the 95% level of significance with Bonferroni correction. A significant reduction of pyriforme and an alveolar crest above the maxillary 1st molar were discerned in frontal analysis on the cleft side. In the axial view, the zygomatic arch, malar, porion and alveolar crest at the molar region were non-significant, but the alveolar crest at the premolar region (p < 0.004)) was significantly decreased. In the frontal analysis, pyriforme and the alveolar crest above the maxillary 1st molar, and, in the axial view, premolar widths, showed significant reduction when comparing the cleft vis-a-vis non-cleft sides. Full article
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10 pages, 6614 KiB  
Article
Feasibility of 3-Dimensional Visual Guides for Preparing Pediatric Zirconia Crowns: An In Vitro Study
by Ho Yeon Kang, Hyeonjong Lee, Yong Kwon Chae, Seoung-Jin Hong, Yun Yeong Jeong, Ko Eun Lee, Mi Sun Kim, Hyo-Seol Lee, Sung Chul Choi and Ok Hyung Nam
Int. J. Environ. Res. Public Health 2020, 17(16), 5732; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17165732 - 08 Aug 2020
Cited by 9 | Viewed by 2817
Abstract
This study evaluated the feasibility of a tooth preparation guide for prefabricated zirconia crowns (PZCs). Three-dimensional surface data for PZCs of the left maxillary primary first molar and left mandibular primary second molar were obtained using a model scanner. The tooth preparation data [...] Read more.
This study evaluated the feasibility of a tooth preparation guide for prefabricated zirconia crowns (PZCs). Three-dimensional surface data for PZCs of the left maxillary primary first molar and left mandibular primary second molar were obtained using a model scanner. The tooth preparation data were digitally designed to harmonize with the adjacent teeth on the mixed dentition model and visualized using a color-coded map, which presents the required amount of tooth reduction. Twenty participants were recruited for preparing teeth with and without using the tooth preparation guide. The following three parameters were evaluated: tooth preparation time, harmony score, and amount of tooth reduction. The preparation time when using the guide was significantly reduced (p < 0.05), and a significant difference was observed in the harmony scores for the maxillary primary first molar preparation. Furthermore, the amount of tooth reduction was significantly different for both maxillary and mandibular primary molars (p < 0.05) in terms of the occlusal distal surface and buccal line angle in the maxillary primary first molars, and the smooth surfaces, proximal surfaces, and mesial line angles in the mandibular primary second molars. Thus, the results suggest that a tooth preparation guide could facilitate better tooth preparation for PZCs. Full article
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Review

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10 pages, 916 KiB  
Review
The Effectiveness of Semi-Automated and Fully Automatic Segmentation for Inferior Alveolar Canal Localization on CBCT Scans: A Systematic Review
by Julien Issa, Raphael Olszewski and Marta Dyszkiewicz-Konwińska
Int. J. Environ. Res. Public Health 2022, 19(1), 560; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19010560 - 04 Jan 2022
Cited by 10 | Viewed by 2919
Abstract
This systematic review aims to identify the available semi-automatic and fully automatic algorithms for inferior alveolar canal localization as well as to present their diagnostic accuracy. Articles related to inferior alveolar nerve/canal localization using methods based on artificial intelligence (semi-automated and fully automated) [...] Read more.
This systematic review aims to identify the available semi-automatic and fully automatic algorithms for inferior alveolar canal localization as well as to present their diagnostic accuracy. Articles related to inferior alveolar nerve/canal localization using methods based on artificial intelligence (semi-automated and fully automated) were collected electronically from five different databases (PubMed, Medline, Web of Science, Cochrane, and Scopus). Two independent reviewers screened the titles and abstracts of the collected data, stored in EndnoteX7, against the inclusion criteria. Afterward, the included articles have been critically appraised to assess the quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Seven studies were included following the deduplication and screening against exclusion criteria of the 990 initially collected articles. In total, 1288 human cone-beam computed tomography (CBCT) scans were investigated for inferior alveolar canal localization using different algorithms and compared to the results obtained from manual tracing executed by experts in the field. The reported values for diagnostic accuracy of the used algorithms were extracted. A wide range of testing measures was implemented in the analyzed studies, while some of the expected indexes were still missing in the results. Future studies should consider the new artificial intelligence guidelines to ensure proper methodology, reporting, results, and validation. Full article
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18 pages, 1115 KiB  
Review
3D Scanners in Orthodontics—Current Knowledge and Future Perspectives—A Systematic Review
by Maciej Jedliński, Marta Mazur, Katarzyna Grocholewicz and Joanna Janiszewska-Olszowska
Int. J. Environ. Res. Public Health 2021, 18(3), 1121; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031121 - 27 Jan 2021
Cited by 21 | Viewed by 5310
Abstract
Background: Nowadays the use of intraoral scanners has become a routine practice in orthodontics. It allows the introduction of many treatment innovations. One should consider to what extent intraoral scanners have influenced the everyday orthodontic practice and in what direction should the [...] Read more.
Background: Nowadays the use of intraoral scanners has become a routine practice in orthodontics. It allows the introduction of many treatment innovations. One should consider to what extent intraoral scanners have influenced the everyday orthodontic practice and in what direction should the further research in this field be conducted. This study is aimed to systematically review and synthesize available controlled trials investigating the accuracy and efficacy of intraoral scanners for orthodontic purpose to provide clinically useful information and to direct further research in this field. Methods: A literature search of free text and MeSH terms was performed by using MedLine (PubMed), Scopus, Web of Science and Embase. The search engines were used to find studies on application of intraoral scanners in orthodontics (from 1950 to 30 September 2020). The following keywords were used: “intraoral scanners AND efficiency AND accuracy AND orthodontics”. Results: The number of potential identified articles was 71, including 61 from PubMed, two from Scopus, three from Web of Science and five from Embase. After removal of duplicates, 67 full-text articles were analyzed for inclusion criteria, 16 of them were selected and finally included in the qualitative synthesis. Conclusions: There are plenty of data available on accuracy and efficacy of different scanners. Scanners of the same generation from different manufacturers have almost identical accuracy. This is the reason why future similar research will not introduce much to the orthodontics. The challenge for the coming years is to find new applications of digital impressions in the orthodontic practice. Full article
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13 pages, 9871 KiB  
Review
Radiographic Assessment of Pediatric Condylar Fractures after Conservative Treatment with Functional Appliances—A Systematic Review
by Edoardo Staderini, Romeo Patini, Michele Tepedino, Giulio Gasparini, Maria Antonietta Zimbalatti, Francesca Marradi and Patrizia Gallenzi
Int. J. Environ. Res. Public Health 2020, 17(24), 9204; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249204 - 09 Dec 2020
Cited by 6 | Viewed by 4291
Abstract
Background: To evaluate the effectiveness of conservative treatment with functional appliances for condylar fractures in pediatric age. Methods: Four electronic databases (PubMed, EBSCO, Scopus, and Web of Science) were consulted with no restriction of publication status or year, up to 31 August 2020. [...] Read more.
Background: To evaluate the effectiveness of conservative treatment with functional appliances for condylar fractures in pediatric age. Methods: Four electronic databases (PubMed, EBSCO, Scopus, and Web of Science) were consulted with no restriction of publication status or year, up to 31 August 2020. Selection criteria: based on the PICOS criteria, the selection criteria were set for observational human studies, with at least 10 patients and six months of follow-up. The study population included pediatric patients (aged 5–16 years), with unilateral or bilateral condylar fracture, treated with functional appliances. Condylar remodeling and mandibular growth were analyzed through sequential radiographic examinations. Data collection and analysis: Two independent reviewers carried out title-abstract screening, and a senior investigator was involved to solve any disagreement. The quality of the evidence was assessed through the Canada Institute of Health Economics (IHE) quality appraisal checklist, and the National Institutes of Health (NIH) quality assessment tool. Results: A total of 971 articles were retrieved from the electronic search; among them, three studies met the eligibility criteria. A moderate risk of bias was detected in all the studies, due to common limitations (absence of multicenter studies, prospective design, blindness of the investigators, patients’ drop-out). At follow-up examinations (between 6 months and 4.9 years), the difference of condylar neck length between the “injured” and “healthy” side was approximately 2 mm, while the anteroposterior condylar width discrepancy was recorded up to 1 mm. Conclusions: Short- and long-term data revealed that conservative treatment with functional appliances led to partial or full radiological recovery of the joint morphology, along with good to excellent functional results. Patients’ age has a crucial role on the treatment choice, and the type of fracture (presence of condylar displacement, or dislocation) is also a major prognostic indicator of the radiologic outcome. Limitation: To confirm the effectiveness of functional appliances, more prospective clinical long-term follow-up studies with homogeneous samples of condylar fractures are deemed necessary. Registration: The study protocol was registered on PROSPERO (CRD42020205650). Full article
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Other

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9 pages, 10735 KiB  
Case Report
Clear Aligners Treatment of Class III Subdivision with an Extraction of a Lower Bicuspid
by Vincenzo D’Antò, Rosa Valletta, Vittoria De Simone, Massimo Pisano and Stefano Martina
Int. J. Environ. Res. Public Health 2023, 20(4), 3550; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20043550 - 17 Feb 2023
Cited by 5 | Viewed by 1781
Abstract
The aim of this study was to show a case of a Class III subdivision adult patient treated with clear aligners (CA) and the extraction of a lower bicuspid. A 19-year-old male with a class III canine and molar relationship on the right [...] Read more.
The aim of this study was to show a case of a Class III subdivision adult patient treated with clear aligners (CA) and the extraction of a lower bicuspid. A 19-year-old male with a class III canine and molar relationship on the right side and a deviation of lower dental midline to the left asked for an aesthetic treatment. He refused orthognathic surgical procedures, so he was offered a camouflage orthodontic treatment with the extraction of lower right first premolar to achieve a canine Class I relationship and to center the lower midline. The treatment was performed with clear aligners and the use of Class III elastics to maintain distal anchorage on the right side during the canine distalization. At the end of the treatment, the occlusal objectives were achieved. Full article
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10 pages, 3110 KiB  
Case Report
New Conservative Approach for the Management of Recurrent Sublingual Ranula—A Case Report
by Antonino Fiorino, Edoardo Staderini, Rosalba Diana, Carlo Rengo and Patrizia Gallenzi
Int. J. Environ. Res. Public Health 2023, 20(3), 2398; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20032398 - 29 Jan 2023
Viewed by 3046
Abstract
Ranula is a rare and benign extravasation mucocele that is clinically characterized by asymptomatic sublingual or submandibular masses. Surgical excision is considered the most effective treatment approach, but it has been associated with high invasiveness and several complications (hemorrhage, damage to Wharton’s duct, [...] Read more.
Ranula is a rare and benign extravasation mucocele that is clinically characterized by asymptomatic sublingual or submandibular masses. Surgical excision is considered the most effective treatment approach, but it has been associated with high invasiveness and several complications (hemorrhage, damage to Wharton’s duct, and lingual nerve injury). Over the past decade, more conservative therapies have been rapidly disseminated into clinical practice to seek a more effective and less traumatic approach for young patients. In this report, an 8-year-old female with an asymptomatic, recurrent sublingual ranula was treated using a conservative approach with marsupialization and an intracystic injection of a plaque remover (Hybenx® gel). After incision of the cystic dome, Hybenx® gel was applied into the cystic lumen for 20 seconds and then aspirated; next, the area was rinsed thoroughly with sterile saline solution before suturing. Ultrasound re-evaluation at 10 months and intraoral clinical examination at 24 months confirmed the absence of relapse. Our results support the hypothesis that marsupialization combined with intracystic injection of Hybenx® gel could be an encouraging conservative treatment alternative for recurrent sublingual ranula in children. Further randomized controlled trials are needed to test this hypothesis. Full article
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