Amirali Zandinejad

Use of digital data acquisition and CAD/CAM technology for the fabrication of a fixed complete dental prosthesis on dental implants

The work flow in this report describes a metal-resin fixed complete dental prosthesis fabricated by using digital data acquisition at the implant fixture level with a computer-aided design and computer-aided manufacturing (CAD/CAM) fabricated tissue-colored anodized titanium framework.

The influence of digital fabrication options on the accuracy of dental implant-based single units and complete-arch frameworks.

PURPOSE To compare the accuracy and reproducibility of digital versus conventional dental impressions and fabrication techniques for single units and full-arch implant frameworks. MATERIALS AND METHODS A total of 24 samples, divided into four groups, were created using conventional and digital implant impression/fabrication techniques: group 1 (conventional single implant), group 2 (digital single implant), group 3 (conventional complete arch), and group 4 (digital complete arch). All impressions were made at the abutment level. Marginal fit measurements were made using an optical microscope at two points (buccal and lingual) for each sample. Statistical analysis was performed using F and t tests (α = .05). RESULTS For single implants, the conventional impression/fabrication pathway resulted in a mean marginal discrepancy of 24.1 μm compared to 61.43 μm for the digital impression/fabrication pathway. For full-arch frameworks, the conventional impression/fabrication pathway resulted in a mean marginal discrepancy of 135.1 μm compared to 63.14 μm for the digital technique. CONCLUSION The conventional pathway resulted in a smaller marginal discrepancy for single-implant frameworks. In contrast, the digital pathway resulted in a smaller marginal discrepancy for full-arch implant frameworks.

Use of prefabricated titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone.

This report describes the fabrication of customized abutments consisting of prefabricated 2-piece titanium abutments and customized anatomic lithium disilicate structures for cement-retained implant restorations in the esthetic zone. The heat-pressed lithium disilicate provides esthetic customized anatomic structures and crowns independently of the computer-aided design and computer-aided manufacturing process.

Predictable Restorative Work Flow for Computer-Aided Design/Computer-Aided Manufacture–Fabricated Ceramic Veneers Utilizing a Virtual Smile Design Principle

The purpose of this case report was to present the use of a contemporary digital photograph-assisted virtual smile design principle, an intraoral digital impression, and computer-aided design/computer-aided manufacture-fabricated lithium disilicate ceramic veneers to treat a patient with esthetic needs in the maxillary anterior region. By using the proposed digital restorative work flow, this case report demonstrated an effective communication pathway between the patient, clinician, and dental laboratory technician. Effective communication can help to achieve a more predictable and satisfactory esthetic outcome.

Digital workflow for virtually designing and milling ceramic lithium disilicate veneers: a clinical report.

Laminate veneers have been routinely used to restore and enhance the appearance of natural dentition. The traditional pathway for fabricating veneers consisted of making conventional polyvinyl siloxane impressions, producing stone casts, and fabricating final porcelain prostheses on stone dies. Pressed ceramics have successfully been used for laminate veneer fabrication for several years. Recently, digital computer-aided design/computer-aided manufacturing scanning has become commercially available to make a digital impression that is sent electronically to a dental laboratory or a chairside milling machine. However, technology has been developed to allow digital data acquisition in conjunction with electronically transmitted data that enables virtual design of restorations and milling at a remote production center. Following the aforementioned workflow will provide the opportunity to fabricate a physical cast-free restoration. This new technique has been reported recently for all-ceramic IPS e.max full-coverage pressed-ceramic restorations. However, laminate veneers are very delicate and technique-sensitive restorations when compared with all-ceramic full-coverage ones made from the same material. Complete digital design and fabrication of multiple consecutive laminate veneers seems to be very challenging. This clinical report presents the digital workflow for the virtual design and fabrication of multiple laminate veneers in a patient for enhancing the esthetics of his maxillary anterior teeth. A step-by-step process is presented with a discussion of the advantages and disadvantages of this novel technique. Additionally, the use of lithium disilicate ceramic as the material of choice and the rationale for such a decision is discussed.

Virtually designed and CAD/CAM-fabricated lithium disilicate prostheses for an esthetic maxillary rehabilitation: A senior dental student clinical report

During their education, dental students seek to be involved in comprehensive esthetic treatment for the rehabilitation of lost, damaged, or discolored tooth structure. Due to technological advances and patient exposure to dental advertising, recent dental school graduates can find themselves under great expectations with limited clinical experience. With the implementation of an oral health and rehabilitation department at the University of Louisville Dental School, dental students have the opportunity to plan treatment and treat such patients under the supervision of faculty with advanced training in prosthodontics and restorative dentistry. The work flow of multiple consecutive lithium disilicate ceramic prostheses using a digital impression, virtual CAD/CAM design, and milled fabrication as planned and executed by a senior dental student is presented.

Maxillary and Mandibular Rehabilitation in the Esthetic Zone Using a Digital Impression Technique and CAD/CAM-fabricated Prostheses: A Multidisciplinary Clinical Report.

Interdisciplinary treatment planning is necessary in certain clinical situations to optimize esthetic treatment outcomes. Patients presenting with severe wear of their anterior teeth from iatrogenic influences pose a particularly difficult problem in terms of esthetic treatment planning. Collaboration of practitioners from the disciplines of orthodontics, periodontics, and restorative dentistry is essential for the treatment of patients with complex esthetic dental needs. Careful assessment of clinical situations and corresponding specialty consultations are of utmost importance to achieve more predictable and esthetic treatment outcomes. The purpose of this clinical case is to report to the readership a novel digital fabrication of computer-aided design/computer-aided manufacturing milled acrylic provisional restorations and final lithium disilicate definitive restorations after orthodontic and periodontal therapy with virtual master impressions, casts, and articulation.

Complete oral rehabilitation of a patient with hereditary gingival fibromatosis: a clinical report.

Hereditary gingival fibromatosis is a rare disease that has several debilitating oral and psychological manifestations, especially with young children and adolescents. The complexity of the treatment as well as the timing relative to the growth and maturation of the patient present a challenge. Few treatment options have been reported in the literature. This clinical report presents a multidisciplinary approach to treating a young patient with hereditary gingival fibromatosis by using implant-supported prostheses. The treatment steps and its outcome are discussed.

Dental student perception and assessment of their clinical knowledge in educating patients about preventive dentistry

In todays dental school curricula, an increasing amount of time is dedicated to technological advances, and preventive dentistry topics may not be adequately addressed. Freshman (D1) students participated in a new Introduction to Preventive Dentistry course, which consisted of didactic lectures, active learning breakout sessions and case-based studies. The goal of this study was to determine if D1 dental students completing the course had a better knowledge and comfort level with basic preventive dentistry concepts and caries risk assessment than the upcoming graduating senior dental students. Following the completion of the course, D1 students were administered a survey that assessed their comfort level describing preventive dentistry topics to patients. This was immediately followed by an unannounced examination over the same topics. Senior (D4) students, who had not taken a formal course, reported statistically significant higher comfort levels than D1 students. However, the D4s scored significantly lower in all of the examination areas than the D1 students. Higher scores in D1s may have been due to recent exposure to the course material. However, the basic nature of the content-specific questions should be easily answered by novice practitioners educating their patients on oral disease prevention. As the current data shows lower content-specific scores of basic preventive dentistry knowledge amongst graduating D4 students, this may indicate a need for more guidance and education of students during the patient care. This study showed that implementation of a formalised course for D1 students can successfully ameliorate deficiencies in knowledge of preventive dentistry topics.

Fabrication of a fixed multipurpose template retained by existing dental implants

This report describes the use of a multipurpose template stabilized with existing implants to provide accurate information for immediate implant placement, to facilitate impression making, and to record maxillomandibular relationships for the fabrication of an interim immediate implant-supported fixed prosthesis.