Abdulaziz AlHelal

Comparison of retention between maxillary milled and conventional denture bases: A clinical study.

Statement of problem Clinical studies comparing the retention values of milled denture bases with those of conventionally processed denture bases are lacking. Purpose The purpose of this clinical study was to compare the retention values of conventional heat‐polymerized denture bases with those of digitally milled maxillary denture bases. Material and methods Twenty individuals with completely edentulous maxillary arches participated in this study. Definitive polyvinyl siloxane impressions were scanned (iSeries; Dental Wings), and the standard tessellation language files were sent to Global Dental Science for the fabrication of a computer‐aided design and computer‐aided manufacturing (CAD‐CAM) milled denture base (group MB) (AvaDent). The impression was then poured to obtain a definitive cast that was used to fabricate a heat‐polymerized acrylic resin denture base resin (group HB). A custom‐designed testing device was used to measure denture retention (N). Each denture base was subjected to a vertical pulling force by using an advanced digital force gauge 3 times at 10‐minute intervals. The average retention of the 2 fabrication methods was compared using repeated ANOVA (&agr;=.05). Results Significantly increased retention was observed for the milled denture bases compared with that of the conventional heat‐polymerized denture bases (P<.001). Conclusions The retention offered by milled complete denture bases from prepolymerized poly(methyl methacrylate) resin was significantly higher than that offered by conventional heat‐ polymerized denture bases.

An update on computer-engineered complete dentures: A systematic review on clinical outcomes

STATEMENT OF PROBLEM Reports on computer-engineered complete dentures (CECDs) continue to increase. Systematic reviews on clinical outcomes and applications associated with CECDs are lacking in the literature. PURPOSE The purpose of this systematic review was to determine the clinical outcomes and applications of CECDs. MATERIAL AND METHODS Electronic searches of the English literature from January 1984 to May 2016 were performed in MEDLINE and Cochrane databases, with the results enriched by hand searches and citation mining to address 2 relevant population intervention comparison outcome (PICO) questions: What are the clinical outcomes associated with CECDs? Are there specific applications and significant advantages for CECDs? RESULTS A review of the selected articles on CECDs revealed significantly better retention and reduced clinical time for the milled CECDs compared with conventional complete dentures. An advantage associated with CECDs is the possibility of electronically archiving data using digital technology for rapid fabrication. Applications reported in the literature with CECDs were also identified. CONCLUSIONS A positive trend was seen in the outcomes with CECDs, although patient selection might have also contributed to favorable outcomes. Significantly reduced clinical time, improved retention, and digital archiving were the main advantages associated with CECDs.

Clinical complications and quality assessments with computer-engineered complete dentures: A systematic review

Statement of problem Computer‐engineered complete dentures (CECDs) have significant potential as shown by recent reports of outcomes and specific applications. An understanding of complications and quality assessment factors associated with CECDs from compiled data is lacking in published reports. Purpose The purpose of this systematic review was to determine the clinical complications and quality assessments related to CECDs. Material and methods Electronic searches of publications in English from January 1984 to September 2016 were performed in MEDLINE and Cochrane databases, with the results enriched by manual searches and citation mining to address 2 population intervention comparison outcome (PICO) questions: what are the clinical complications associated with CECDs, and what are the quality assessments with CECDs? Results A review of 5 selected articles (limited data) on CECDs revealed patient dissatisfaction related to overall outcome (25.49%), inadequate retention (20.73%), and esthetic concerns (15.09%) as common complications. Quality assessment factors that were used to report complications were identified. Conclusions Patient dissatisfaction, inadequate retention, and inadequate esthetics were the most common complications with CECDs. The addition of a trial placement option for CECDs could result in a better clinical outcome, reducing the incidence of other complications related to occlusal vertical dimension, centric relationship, tooth arrangement, and esthetics, improving patient satisfaction, and reducing remakes. The difficulty in reading the digital preview for an objective assessment before fabrication is a unique but not a common, complication for CECDs.

Three-dimensional printing in contemporary fixed prosthodontics: A technique article

Digital dentistry has gained in popularity among clinicians and laboratory technicians because of its versatile applications. Three-dimensional (3D) printing has been applied in many areas of dentistry as it offers efficiency, affordability, accessibility, reproducibility, speed, and accuracy. This article describes a technique where 3D printing is used to fabricate a die-trimmed cast and to replicate gingival tissue and implant analogs. The digital workflow that replaces the conventional laboratory procedure is outlined.

Obstructive Sleep Apnea Management: An Overview of the Literature

PURPOSE Different approaches have been proposed to treat obstructive sleep apnea (OSA). This article reviews a synopsis of the available literature regarding the management of OSA. METHODS A comprehensive review of the literature on the management of OSA began with a search of English-language peer-reviewed manuscripts using PubMed and MEDLINE. The focus was on clinical research articles published between 1996 and 2016. A search of relevant dental journals was also completed. RESULTS OSA can be managed through behavior management, continuous positive airway pressure (CPAP), oral appliances, and other therapies. Clinicians may select treatment modalities based on the severity of clinical presentation and the patients symptoms. CONCLUSION Studies showed an enhancement in the quality of life in many patients who have been treated with oral appliances, and patients in general prefer oral appliances over CPAP therapy or any other treatments for OSA because of its convenience.Purpose Different approaches have been proposed to treat obstructive sleep apnea (OSA). This article reviews a synopsis of the available literature regarding the management of OSA. Methods A comprehensive review of the literature on the management of OSA began with a search of English-language peer-reviewed manuscripts using PubMed and MEDLINE. The focus was on clinical research articles published between 1996 and 2016. A search of relevant dental journals was also completed. Results OSA can be managed through behavior management, continuous positive airway pressure (CPAP), oral appliances, and other therapies. Clinicians may select treatment modalities based on the severity of clinical presentation and the patients symptoms. Conclusion Studies showed an enhancement in the quality of life in many patients who have been treated with oral appliances, and patients in general prefer oral appliances over CPAP therapy or any other treatments for OSA because of its convenience.

Obstructive Sleep Apnea Management: An Overview of the Literature: Obstructive Sleep Apnea Management: Overview

PURPOSE Different approaches have been proposed to treat obstructive sleep apnea (OSA). This article reviews a synopsis of the available literature regarding the management of OSA. METHODS A comprehensive review of the literature on the management of OSA began with a search of English-language peer-reviewed manuscripts using PubMed and MEDLINE. The focus was on clinical research articles published between 1996 and 2016. A search of relevant dental journals was also completed. RESULTS OSA can be managed through behavior management, continuous positive airway pressure (CPAP), oral appliances, and other therapies. Clinicians may select treatment modalities based on the severity of clinical presentation and the patients symptoms. CONCLUSION Studies showed an enhancement in the quality of life in many patients who have been treated with oral appliances, and patients in general prefer oral appliances over CPAP therapy or any other treatments for OSA because of its convenience.Purpose Different approaches have been proposed to treat obstructive sleep apnea (OSA). This article reviews a synopsis of the available literature regarding the management of OSA. Methods A comprehensive review of the literature on the management of OSA began with a search of English-language peer-reviewed manuscripts using PubMed and MEDLINE. The focus was on clinical research articles published between 1996 and 2016. A search of relevant dental journals was also completed. Results OSA can be managed through behavior management, continuous positive airway pressure (CPAP), oral appliances, and other therapies. Clinicians may select treatment modalities based on the severity of clinical presentation and the patients symptoms. Conclusion Studies showed an enhancement in the quality of life in many patients who have been treated with oral appliances, and patients in general prefer oral appliances over CPAP therapy or any other treatments for OSA because of its convenience.

Digital technology for performing a nasopalatine and greater palatine nerve block with a modified implant surgical guide: A technique article

This article describes a computer-aided design and computer-aided manufacturing (CAD-CAM) technique to perform a precise nerve block of the nasopalatine and greater palatine nerves by using an implant surgical guide. The technique uses additional guide anchor pins planned and positioned for specific anatomic landmarks during guided implant surgical guide planning. A relief modification virtually designed on the intaglio surface of the surgical guide allows for palatal soft tissue distension following administration of local anesthetic. This information is then transferred to the guide manufacturer to order the modified guided implant surgical guide. The purpose of this procedure is to provide precise delivery of local anesthetic and to prevent any discrepancy in surgical guide seating following injection.

Effects of denture adhesive on the retention of milled and heat-activated maxillary denture bases: A clinical study

Statement of problem. Clinical studies have identified advantages of digital complete denture technology including patient satisfaction, improved mastication, increased retention, and technique efficiency. However, studies that focus on the effect of denture adhesive on the retention of milled and heat‐activated denture bases are lacking. Purpose. The purpose of this clinical study was to evaluate the effectiveness of denture adhesive on the retention of milled and heat‐activated denture bases. Material and methods. Twenty participants with complete maxillary edentulism were selected for this study (11 men and 9 women). Definitive impressions were obtained and scanned (iSeries impression scanner; Dental Wings). Digital data were sent to Global Dental Science for the fabrication of computer‐aided design and computer‐aided manufacturing (CAD‐CAM) milled denture bases (MB condition). The physical impressions were poured in stone to produce casts for the fabrication of heat‐activated acrylic resin denture bases (HB condition). A portable clinical motorized test stand and advance digital force gauge were modified to measure the amount of denture base retention in newtons. The denture bases were seated over the edentulous maxillary ridge and pulled 3 times vertically at 10‐minute intervals without denture adhesive (MB and HB control conditions) and with denture adhesive (MBA and HBA test conditions). For statistical analysis, a repeated‐measures ANOVA was performed (&agr;=.05). Results. The control MB condition had significantly higher retention values compared with all other conditions (P<.001). However, the use of adhesive significantly decreased the retention of the milled bases. No significant differences were found with or without the use of denture adhesive among heat‐activated denture bases (P>.05). Conclusions. Significantly higher retention values were recorded with milled denture bases than heat‐activated resin bases without the use of denture adhesive. However, denture adhesive did negatively affect the retention of milled complete dentures.

Using Virtual Ridge Augmentation and 3-Dimensional Printing to Fabricate a Titanium Mesh Positioning Device: A Novel Technique Letter

This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.

A technique for immediately restoring single dental implants with a CAD-CAM implant-supported crown milled from a poly(methyl methacrylate) block

This technique is used when a single dental implant is placed. A stent made of autopolymerized acrylic resin was used to transfer the implant position to the laboratory. Once the implant position was transferred, the stone cast was scanned, and a computer-aided design and computer-aided manufacturing (CAD-CAM) interim implant-supported crown was milled from a poly(methyl methacrylate) (PMMA) block. A titanium insert, in contact with the implant platform and not the PMMA material, was used to support the crown. The interim prosthesis was then placed intraorally. The soft tissues were sutured, and the interim prosthesis was left for a period of at least 3 months to confirm osseointegration and allow the soft tissue to heal. A CAD-CAM titanium impression coping was made and used for the definitive impression. The contours of the impression coping were identical to the contours of the interim restoration. The data of the digital design of the interim prosthesis were saved, and the definitive prosthesis was fabricated with contours identical to those of the interim prosthesis.