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Item Accuracy of digital duplication scanning methods for complete dentures(Wiley, 2023) Alehaideb, Abdullah; Lin, Wei-Shao; Levon, John A.; Chu, Tien-Min G.; Yang, Chao-Chieh; Prosthodontics, School of DentistryPurpose To compare the accuracy of four digital scanning methods in duplicating a complete denture. Material and Methods Four scanning methods were used: cone beam computed tomography (CBCT), Straumann desktop scanner (DS), Trios intraoral scanner (TIO), and Virtuo Vivo intraoral scanner (VVIO). Each method was used to duplicate all the surfaces of a printed complete denture. The denture was scanned 10 times in each group. The trueness (in root mean square, RMS) and precision (in standard deviation, SD) were calculated by comparing the combined dentition, denture extension, and intaglio surfaces with the reference file. One-way analysis of variance and F-tests were used to test statistical differences (α = 0.05). Results For the scanning accuracy of the whole denture, CBCT showed the highest RMS (0.249 ± 0.020 mm) and lowest trueness than DS (0.124 ± 0.014 mm p < 0.001), TIO (0.131 ± 0.006 mm p < 0.001), and VVIO (0.227 ± 0.020 mm p = 0.017), while DS and TIO showed smaller RMS than VVIO (p < 0.001). For the trueness of dentition, denture extension, and intaglio surfaces, CBCT also showed the highest mean RMS and lowest trueness among all groups (p < 0.001). DS and TIO had smaller mean RMS and higher trueness among all groups in all surfaces (p < 0.001, except VVIO in intaglio surface, p > 0.05). TIO had significantly lower within-group variability of RMS and highest precision compared to DS (p = 0.013), CBCT (p = 0.001), and VVIO (p < 0.001) in the combined surface. For dentition and denture extension surfaces, TIO showed similar within-group variability of RMS with the DS group (p > 0.05) and lower than CBCT and VVIO (p < 0.001). Conclusion The 7 Series desktop scanner and Trios 4 intraoral scanner can duplicate dentures in higher trueness than CBCT and the Virtuo Vivo intraoral scanner. The Trios 4 intraoral scanner was more precise in the combined surfaces than other scanning methods, while the 7 Series desktop scanner and Trios 4 intraoral scanner were more precise in the denture extension surface.Item Barriers to Dental Care in Individuals with Special Healthcare Needs in Qatif, Saudi Arabia: A Caregiver’s Perspective(Dove Press, 2021-01-22) Alfaraj, Amal; Halawany, Hassan S.; Al-Hinai, Muntasar T.; Al-Badr, Abid H.; Alalshaikh, Marwa; Al-Khalifa, Khalifa S.; Prosthodontics, School of DentistryObjective: Access to dental care is a key factor influencing oral health outcomes. Individuals with special healthcare needs are at risk of not having access to dental care services which they need to maintain their oral health. This study assessed the magnitude of this problem and identified barriers responsible for the difficulties in accessing dental care in Qatif, Saudi Arabia, as reported by caregivers of individuals with special healthcare needs. Methods: This cross-sectional study collected data using a self-administered survey questionnaire from caregivers of individuals with special healthcare needs across 11 centers (eight special needs centers and three schools) in Qatif, Eastern Province of Saudi Arabia, between February and April 2019. Results: A total of 186 caregivers participated in the study, 102 (54.8%) of whom reported difficulties in getting access to dental care. The key barriers included lack of time on the part of caregivers (60.8%), unsuitable clinic environment (53.9%), difficulties with transportation (51.9%), medical/health status of the individual with special healthcare needs (51.0%), and geographically distant dental clinics (51.0%). Caregiver demographics (age, gender, and educational level) had no significant influence on the difficulties reported by caregivers in getting access to dental care for individuals with special healthcare needs (p>0.05). Conclusion: A large proportion of caregivers in Qatif, Saudi Arabia, experience difficulties with access to dental care services for individuals with special healthcare needs. The most common barriers are physical accessibility of dental facilities (for individuals with special healthcare needs), affordability, and lack of skills and knowledge of dental care providers.Item Bead-anchored surgical templates for static computer-assisted implant surgery: A dental technique(Wiley, 2022-10) Orgev, Ahmet; Pellerito, John; Polido, Waldemar; Morton, Dean; Lin, Wei-Shao; Prosthodontics, School of DentistryThis technique report describes an alternative method to stabilize surgical templates throughout full-arch static computer-assisted implant surgery (FA s-CAIS). In FA s-CAIS, remaining teeth, mucosa, existing implants, custom occlusal device, bone, or any combination thereof, could be used as an initial positioning mechanism to position surgical templates. Different anchoring mechanisms are then used to stabilize the surgical templates during surgery. In this report, a novel design of surgical templates using remaining dentition and opposing occlusal surfaces as initial positioning mechanism followed by the combination of bone block fixation screw and stainless-steel beads as secondary anchoring mechanisms is described. The advantages, limitations, and comparisons with surgical templates using other anchoring mechanisms are also discussed.Item CAD-CAM Hollow Obturator Prosthesis: A Technical Report(Wiley, 2022) Alfaraj, Amal; Su, Fang-Yu; Lin, Wei-Shao; Prosthodontics, School of DentistryAn obturator with a hollow bulb can decrease the overall weight of the prosthesis, stress on the underlying tissues, and patient discomfort. Although many techniques and materials have been proposed in the literature for hollowing the obturator prosthesis, they are often time-consuming and technique sensitive. This proposed technique used an open-source software program to hollow digital design of solid obturator base from a commercially available software in one single convenient step. The hollowing process allowed precise control of prosthesis thickness at the hollow space area for desirable hermetic seal and prosthesis strength.Item Caregivers' Perception about the Relationship between Oral Health and Overall Health in Individuals with Disability in Qatif, Saudi Arabia: A Cross-Sectional Study(Hindawi, 2022-10-03) Alalshaikh, Marwa; Alsheikh, Rasha; Alfaraj, Amal; Al-Khalifa, Khalifa S.; Prosthodontics, School of DentistryBackground: In Saudi Arabia, there are many people with disabilities that do not receive adequate healthcare, especially in the field of dentistry. Objective: This study focused on assessing caregivers' perception of the relationship between oral healthcare and the overall health status of individuals with special healthcare needs (SHCN) in Qatif, Saudi Arabia. Methodology Design. This cross-sectional study was conducted using a questionnaire that was divided into two sections. The first part included demographic information such as the age and gender of both the caregiver and the person with a disability and the type of disability. The second part investigated the systemic health of the individual with a disability and the caregivers' perception of the relationship between the management and treatment of systemic health and oral healthcare in relation to the overall health status. The results of descriptive analyses were summarized using frequency distribution tables. Bivariate analyses (chi-square test) were also performed. Significant differences were considered at a p value of 0.05. Setting. Initiated in school setting. Results: A total of 186 caregivers participated in the study. As much as 83.3% agree that oral health affects overall health, and 48.9% agreed that untreated dental problems could affect cardiac health. Age was the only factor found to be significantly associated with caregiver perception as younger caregivers were more likely to rightly understand the relationship between oral health and general health (p < 0.05). Conclusion: This study has shown the extent to which caregivers of individuals with special care needs to understand the role of oral health in the general health of an individual. Three-quarters of the caregivers agree that dental health affects overall health, and age is a factor that might influence this understanding.Item Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review(Wiley, 2018-10) Lin, Wei-Shao; Eckert, Steven E.; Prosthodontics, School of DentistryObjectives The aim of this review was to determine the clinical performance of dental implants that are intentionally tilted when compared with implants that are placed following the long axis of the residual alveolar ridge. Materials and methods A systematic review of the scientific literature using a predefined research question (PICO) and search strategy was undertaken. This search included five electronic databases. Two independent reviewers examined electronic databases and performed a manual review following search strategy to accomplish the item generation and reduction. Included articles were evaluated to determine the level of evidence. Data were extracted only from level I and level II studies, based on the Oxford Centre for Evidence‐based Medicine—Levels of Evidence (March 2009). If included studies were homogeneous in nature, data were to be accumulated. However, if included studies were heterogeneous in nature, only descriptive data would be reviewed and analyzed. Results A total of 811 articles were identified through the PICO question and search strategy. Detailed review of the abstracts and articles resulted in further item reduction, and 46 articles were included for full‐text review. A total of 42 articles were then selected for inclusion in the systematic review. The identified articles included two level I and 20 level II studies. In addition, 15 level IV, one gray literature, and four previous systematic reviews with meta‐analyses were also used in the study. The extracted data from the included studies demonstrated heterogeneity that prevented quantitative assessment, and only one level II study directly compared tilted and axially placed implants. Assessment of the descriptive data demonstrated no differences in implant survival, marginal bone loss, prosthesis survival, or patient‐reported outcome measures (PROMs) whether implants are placed axially or with intentional inclination of the coronal aspect of the implant toward the distal aspect of edentulous jaws. Conclusions Based upon the systematic review of the literature, an analysis of the descriptive data suggested no differences in clinical performance between implants that are placed in an axial position relative to the residual alveolar ridge when compared with implants that are intentionally tilted toward the distal aspect of edentulous jaws.Item Comparison of surface characteristics of denture base resin materials with two surface treatment protocols and simulated brushing(Wiley, 2023) Alouthah, Hesham; Lippert, Frank; Yang, Chao-Chieh; Levon, John A.; Lin, Wei-Shao; Prosthodontics, School of DentistryPurpose To investigate the effects of 4 denture base materials, 2 surface treatment protocols, and simulated brushing (SB) on the surface hardness, surface roughness, surface gloss, and the surface loss of denture base materials. Materials and Methods Four denture base resin material groups (compression-molded, injection-molded, 3D-printed, and milled) with two different surface treatment protocols (polished and glazed) were utilized in this study. A total of 80 samples (n = 10) were evaluated for surface hardness (Vickers) before SB. SB was performed for each sample (custom-built V8 cross brushing machine, 50,000 reciprocal strokes). Surface roughness (Ra) was measured before and after SB with a non-contact optical profilometer. Surface gloss was performed using a glossmeter to determine changes in surface reflectivity of the specimens before and after SB. Surface loss (wear resistance) was measured after SB using optical profilometry. The effects of material, surface treatment, and SB on all surface characteristics were examined with two-way and three-way analysis of variance models (ANOVA) (α = 0.05). Results The polished compression-molded group had significantly higher surface hardness than all other groups. The protective glaze coating significantly increased the surface hardness for all groups (P < 0.001). SB increased the surface roughness of all groups regardless of surface treatments (P < 0.001). The increase in surface roughness after SB was significantly higher with polished surface treatment than with a glazed surface treatment in all groups (P < 0.001). Surface gloss was significantly higher with the glazed surface treatment than with the polished surface treatment for all denture base materials (P < 0.001). After SB, milled denture base material showed the highest, and 3D-printed material showed the second highest surface gloss compared to the other groups (P < 0.001), regardless of surface treatment. In all materials tested, surface glaze significantly decreased surface loss (P < 0.001). With the glaze surface treatment, compression-molded denture base material had significantly less surface loss (more surface gain) than other materials, while with the polished surface treatment, 3D-printed denture base material had the least surface loss when compared with other groups. Conclusions A single layer of nano-filled, light-polymerizing protective glaze coating has displayed potential for enhancing the longevity of denture base materials, as evidenced by increased hardness and wear resistance. Following simulated brushing, the milled denture material exhibited the highest surface gloss and lowest surface roughness among all groups, regardless of the surface treatment protocol. This indicates that milled denture base material possesses favorable surface properties and may serve as a viable alternative to traditional denture base materials.Item Coronavirus disease 2019 (COVID-19): Experiences and protocols from the Department of Prosthodontics at the Wuhan University(Elsevier, 2020-07-10) Sa, Yue; Lin, Wei-Shao; Morton, Dean; Huang, Cui; Prosthodontics, School of DentistryStatement of problem: The novel Coronavirus Disease 2019 (COVID-19) is a global pandemic, and many countries and regions are still currently in the midst of the outbreak. This pandemic has caused prosthodontics units to suspend their clinical and educational operations in academia. Purpose: The purpose of this article was to review the experiences from the Department of Prosthodontics, Wuhan University School and Hospital of Stomatology (DP-WHUSHS) during the COVID-19 outbreak and the protocols DP-WHUSHS utilized to resume clinical activities after the outbreak. Material and methods: The descriptive approach was used in this article to provide a chronological narrative of the experiences and protocols from the DP-WHUSHS during the COVID-19 outbreak and after the outbreak. Results: During the COVID-19 outbreak period, clinical care was provided for patients with dental emergencies using enhanced Grade 2 or Garde 3 personal protective equipment (PPE). Teledentistry was used to provide care for patients with non-emergency needs. Online webinars and lectures were provided for the predoctoral students, residents, and dentists to minimize the interruption in their education and engage the dental community amid the pandemic. Various factors were considered before clinical activities resumed after the outbreak subsided. Additional resources were allocated for facility preparation and management and employee training. New infection control and clinical operation protocols were developed to minimize the healthcare-associated infection of airborne transmission diseases. The psychological health and mental wellness of the employees were emphasized. Distance or online education is still under rapid development to provide students and dentists opportunities to advance their knowledge amid the pandemic. Conclusions: Within the limitation of this descriptive review, the following conclusions were drawn. Patient welfare and emergency needs should be considered amid the pandemic. Enhanced Grade 2 or Grade 3 PPE should be used during the outbreak. Multifactorial considerations for work resumption after the outbreak included facility preparation and management, training for employees, and clinical operation management. In-person psychological consultation and online mental wellness programs were available to employees to improve their mental wellness. Distance or online education was under rapid development to minimize the interruption in education for the students and to engage the dental community amid a pandemic.Item Curcumin—A Natural Medicament for Root Canal Disinfection: Effects of Irrigation, Drug Release, and Photoactivation(Elsevier, 2019-11) Sotomil, Julian M.; Münchow, Eliseu A.; Pankajakshan, Divya; Spolnik, Kenneth J.; Ferreira, Jessica A.; Gregory, Richard L.; Bottino, Marco C.; Prosthodontics, School of DentistryIntroduction Curcumin incorporation into polymeric fibers was tested for its antimicrobial properties and potential use in root canal disinfection. Methods Curcumin-modified fibers were processed via electrospinning and tested against a 7-day old established Actinomyces naeslundii (An) biofilm. The medicaments tested were as follows: curcumin-modified fibers at 2.5 and 5.0 mg/mL, curcumin-based irrigant at 2.5 and 5.0 mg/mL, saline solution (negative control), and the following positive controls: 2% chlorhexidine, 1% NaOCl, and triple antibiotic paste (TAP, 1 mg/mL). All medicaments, except for the positive controls, were allocated according to the light exposure protocol: photoactivation with an LED every 30 s for 4 min or without photoactivation. After treatment, the medicaments were removed and 1 mL of saline solution was added; the biofilm was scraped from the well and used to prepare a 1:2000 dilution. Spiral plating was done using anaerobic blood agar plates. After 24 h, colony-forming units (CFU/mL, n=11/group) were counted to determine the antimicrobial effects. Results Data exhibited significant antimicrobial effects on positive control groups, followed by the curcumin irrigants, and lastly, the photoactivated curcumin-modified fibers. There was a significant reduction of viable bacteria in curcumin-based irrigants, which was greater than the TAP-treated group. Curcumin-free fibers, saline, and the non-photoactivated curcumin-modified fibers did not display antimicrobial activity. Conclusions Curcumin seems to be a potential alternative to TAP when controlling infection, but it requires a minimal concentration (2.5 mg/mL) to be effective. Photoactivation of curcumin-based medicaments seems to be essential to obtain greater antibiofilm activity.Item Delphi Project on the trends in Implant Dentistry in the COVID-19 era: Perspectives from Latin America(Wiley, 2021) Alarcón, Marco Antonio; Sanz‐Sánchez, Ignacio; Shibli, Jamil Awad; Treviño Santos, Alejandro; Caram, Santiago; Lanis, Alejandro; Jiménez, Paola; Dueñas, Ricardo; Torres, Ronald; Alvarado, Jacinto; Avendaño, Adrián; Galindo, Roberto; Umanzor, Vilma; Shedden, Mónica; Invernizzi, Carlos; Yibrin, Caroll; Collins, James; León, Roberto; Contreras, Luis; Bueno, Luis; López‐Pacheco, Andrea; Málaga‐Figueroa, Lilian; Sanz, Mariano; Prosthodontics, School of DentistryAim To establish trends in Implant Dentistry in Latin America in the COVID‐19 pandemic. Material and methods A steering committee and an advisory group of experts in Implant Dentistry were selected among eighteen countries. An open‐ended questionnaire by Delphi methodology was validated including 64 questions, divided in 7 topics, concerning the various trends in dental implantology. The survey was conducted in two rounds, which provided the participants in the second round with the results of the first. The questionnaires were completed on August 2020, and the online meeting conference was held on September 2020. The final prediction was developed through consensus by a selected group of experts. Results A total of 197 experts from Latin America answered the first and second questionnaire. In the first round, the established threshold for consensus (65%) was achieved in 30 questions (46.87%). In the second round, performed on average 45 days later, this level was achieved in 47 questions (73.43%). Consensus was completely reached on the item “Diagnostic” (100%), the field with the lowest consensus was “Demand for treatment with dental implants” (37.5%). Conclusions The present study in Latin America has provided relevant and useful information on the predictions in the education and practice of Implant Dentistry in the COVID‐19 era. The consensus points toward a great confidence of clinicians in the biosecurity protocols used to minimize the risk of SARS‐CoV‐2 transmission. It is foreseen as an important change in education, with introduction of virtual reality and other simulation technologies in implant training.