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Item Selection criteria for immediate implant placement and immediate loading for single tooth replacement in the maxillary esthetic zone: A systematic review and meta-analysis(Wiley, 2023-09) Hamilton, Adam; Gonzaga, Luiz; Amorim, Karina; Wittneben, Julia-Gabriela; Martig, Lukas; Morton, Dean; Martin, William; Gallucci, German O.; Wismeijer, Daniel; Prosthodontics, School of DentistryObjectives The aim of this study was to review available evidence for Type 1A (immediate implant placement and immediate loading) of single tooth replacement in the maxillary esthetic zone. Materials and Methods An electronic search was conducted utilizing the databases of MEDLINE, Embase, and Cochrane to identify publications reporting on the outcomes of Type 1A for single tooth replacement in the maxillary esthetic zone. The success and survival rates of the included articles were reported, which were further categorized according to the clinical criteria reported in Type 1A. Mean survival rates were univariately compared between risk groups and additionally between studies published before and since 2012 using bias-corrected and study size-weighed bootstrap tests. A study time-correcting meta-analysis was then performed to obtain an overall effect for the study pool. Results A total of 3118 publications were identified in the search, with a total of 68 articles included. A mean number of implants per study were 37.2 and mean follow-up was 2.8 years. All the included studies utilizing Type 1A report highly selective inclusion and exclusion criteria. Univariate risk group comparison determined that studies before 2012 report a significantly lower mean survival rate (difference of −1.9 percentage points [PP], 95% CI: [−0.3, −4.0], p = .02), facial gap dimension had an impact on survival rates (+3.1 PP [0.2, 5.3] for width >2 mm, p = .04), as well as presence of endodontic infection (+2.6 PP [0.9, 5.1], p = .004). Conclusions Type 1A has a high survival rate in studies reporting strict patient and site selection criteria. Further research is required to assess esthetic and functional success with Type 1A treatments.Item The Effects of Plantago major on the Activation of the Neutrophil Respiratory Burst(Elsevier, 2013) Reina, Elaine; Al‑Shibani, Nouf; Allam, Eman; Gregson, Karen S.; Kowolik, Michael; Windsor, L. Jack; Prosthodontics, School of DentistryPlantago major is a common plant that grows worldwide in temperate zones and is found in fields, lawns, and on the roadsides. Its leaves and seeds have been used in almost all parts of the world for centuries as a wound healer, analgesic, antioxidant, and antibiotic, as well as an immune system modulator, antiviral, antifungal, and anti-inflammatory agent. Baicalein and aucubin are the two most biologically active components of P. major, and both have been shown to have antioxidant, anti-inflammatory, and anticancer properties. Neutrophils have a pivotal role in wound healing and inflammation. Their principal mechanism of host defense is the killing of pathogens via the production of reactive oxygen species (ROS). The aim of the present study was to determine the in vitro effects of P. major extract, baicalein, and aucubin on human neutrophil respiratory burst activity. The cytotoxicity of the agents was assessed by lactate dehydrogenase (LDH) assays. A standard luminol-dependent chemiluminescence (CL) assay was utilized to monitor the respiratory burst of the neutrophils after exposure to P. major extract and its two active ingredients, baicalein and aucubin. Three replicates per group were included in each of the three runs of the experiments and analysis of variance (ANOVA) was used for statistical analysis. P. major and baicalein were not toxic to the cells at any of the concentrations examined. Aucubin was toxic to the cells only at the highest concentration tested (P = 0.0081). However, genistein was toxic to the cells at all of the concentrations examined except for the lowest concentration of 16.9 μg/ml (P = 0.985). P. major (-0.10 ± 0.11), aucubin (0.06 ± 0.16), baicalein (-0.10 ± 0.11), and genistein (-0.18 ± 0.07) all significantly (P < 0.0001) inhibited ROS production from the neutrophils. P. major extract inhibited neutrophil ROS production, as did aucubin and baicalein. Therefore, these components should be investigated further with relation to the regulation of destructive ROS production in conditions such as periodontal disease.Item Performance of the caries diagnosis feature of intraoral scanners and near-infrared imaging technology—A narrative review(Wiley, 2023-12) Lin, Wei-Shao; Alfaraj, Amal; Lippert, Frank; Yang, Chao-Chieh; Prosthodontics, School of DentistryPurpose To describe and discuss the benefits and drawbacks of various dental caries diagnostic techniques, including the use of intraoral scanners for caries diagnosis based on near-infrared imaging (NIR) technology. Material and Methods A MEDLINE search from 1980–2023 focused on dental caries diagnostic techniques, emphasizing intraoral scanners using NIR technology. Alternative caries detection methods were also evaluated for their advantages and limitations, enabling a comparison with NIR. The review included traditional caries tools, the latest detection methods, and NIR's role in intraoral scanners, drawing from case reports and both in vivo and in vitro studies. Keywords like “caries detection,” “intraoral scanners,” and “Near Infrared Imaging (NIRI)” guided the search. After screening titles and abstracts for relevance, full texts with valuable insights were thoroughly analyzed. The data was grouped into three: traditional diagnostics, advanced digital methods, and intraoral scanner-based detection. Results This comprehensive narrative review described and discussed the current state of dental caries diagnostic methods, given the insufficient number of clinical investigations suitable for a systematic review. Traditional caries diagnosis techniques have shown variable accuracy dependent on a dentist's experience and the potential over-removal of healthy tooth structures. Intraoral scanners have emerged as a novel caries detection method, because of their integration of NIR technology. Various studies have confirmed the efficacy of NIR in detecting interproximal caries and in the early diagnosis of non-cavitated caries. Specifically, intraoral scanners have demonstrated promising results, proving comparable to established diagnostic methods like bitewing radiography. Nevertheless, while the integration of NIR into intraoral scanners seems promising, the technology still faces challenges, notably its accuracy in detecting secondary and subgingival cavities. However, with anticipated integrations of AI, NIR in intraoral scanners could revolutionize early caries detection. Conclusions Intraoral scanners with NIR technology offer non-destructive imaging, real-time lesion visuals, and enhanced patient communication. Although comparable to bitewing radiography in some studies, a universally accepted diagnostic tool is lacking. Future research should compare them with existing methods, focusing on clinical outcomes, cost-effectiveness, and patient acceptance.Item 3D‐printed shell complete dentures as a diagnostic aid for implant planning and fabricating interim restorations for complete arch rehabilitations: A case series(Wiley, 2025) Azpiazu-Flores, Francisco X.; Yang, Chao-Chieh; Lin, Wei-Shao; Polido, Waldemar D.; Morton, Dean; Prosthodontics, School of Dentistry3D-printed shell complete dentures generated from a scan of the patient's existing prostheses can simplify and expedite the surgical planning and interim restoration design for complete arch rehabilitations. Three patients were rehabilitated with endosteal implants, and interim restorations were generated from the contours of the 3D-printed shell complete dentures used as diagnostic aids. This case series report presents the recommended protocol and its clinical progression, in addition to clinical and radiographic images of the treatment outcomes.Item Race to the Moon or the Bottom? Applications, Performance, and Ethical Considerations of Artificial Intelligence in Prosthodontics and Implant Dentistry(MDPI, 2024-12-27) Alfaraj, Amal; Nagai, Toshiki; AlQallaf, Hawra; Lin, Wei-Shao; Prosthodontics, School of DentistryObjectives: This review aims to explore the applications of artificial intelligence (AI) in prosthodontics and implant dentistry, focusing on its performance outcomes and associated ethical concerns. Materials and Methods: Following the PRISMA guidelines, a search was conducted across databases such as PubMed, Medline, Web of Science, and Scopus. Studies published between January 2022 and May 2024, in English, were considered. The Population (P) included patients or extracted teeth with AI applications in prosthodontics and implant dentistry; the Intervention (I) was AI-based tools; the Comparison (C) was traditional methods, and the Outcome (O) involved AI performance outcomes and ethical considerations. The Newcastle-Ottawa Scale was used to assess the quality and risk of bias in the studies. Results: Out of 3420 initially identified articles, 18 met the inclusion criteria for AI applications in prosthodontics and implant dentistry. The review highlighted AI's significant role in improving diagnostic accuracy, treatment planning, and prosthesis design. AI models demonstrated high accuracy in classifying dental implants and predicting implant outcomes, although limitations were noted in data diversity and model generalizability. Regarding ethical issues, five studies identified concerns such as data privacy, system bias, and the potential replacement of human roles by AI. While patients generally viewed AI positively, dental professionals expressed hesitancy due to a lack of familiarity and regulatory guidelines, highlighting the need for better education and ethical frameworks. Conclusions: AI has the potential to revolutionize prosthodontics and implant dentistry by enhancing treatment accuracy and efficiency. However, there is a pressing need to address ethical issues through comprehensive training and the development of regulatory frameworks. Future research should focus on broadening AI applications and addressing the identified ethical concerns.Item Influence of exposure protocol, voxel size, and artifact removal algorithm on the trueness of segmentation utilizing an artificial-intelligence-based system(Wiley, 2024-07) Alrashed, Safa; Dutra, Vinicius; Chu, Tien-Min G.; Yang, Chao-Chieh; Lin, Wei-Shao; Prosthodontics, School of DentistryPurpose To evaluate the effects of exposure protocol, voxel sizes, and artifact removal algorithms on the trueness of segmentation in various mandible regions using an artificial intelligence (AI)-based system. Materials and methods Eleven dry human mandibles were scanned using a cone beam computed tomography (CBCT) scanner under differing exposure protocols (standard and ultra-low), voxel sizes (0.15 mm, 0.3 mm, and 0.45 mm), and with or without artifact removal algorithm. The resulting datasets were segmented using an AI-based system, exported as 3D models, and compared to reference files derived from a white-light laboratory scanner. Deviation measurement was performed using a computer-aided design (CAD) program and recorded as root mean square (RMS). The RMS values were used as a representation of the trueness of the AI-segmented 3D models. A 4-way ANOVA was used to assess the impact of voxel size, exposure protocol, artifact removal algorithm, and location on RMS values (α = 0.05). Results Significant effects were found with voxel size (p < 0.001) and location (p < 0.001), but not with exposure protocol (p = 0.259) or artifact removal algorithm (p = 0.752). Standard exposure groups had significantly lower RMS values than the ultra-low exposure groups in the mandible body with 0.3 mm (p = 0.014) or 0.45 mm (p < 0.001) voxel sizes, the symphysis with a 0.45 mm voxel size (p = 0.011), and the whole mandible with a 0.45 mm voxel size (p = 0.001). Exposure protocol did not affect RMS values at teeth and alveolar bone (p = 0.544), mandible angles (p = 0.380), condyles (p = 0.114), and coronoids (p = 0.806) locations. Conclusion This study informs optimal exposure protocol and voxel size choices in CBCT imaging for true AI-based automatic segmentation with minimal radiation. The artifact removal algorithm did not influence the trueness of AI segmentation. When using an ultra-low exposure protocol to minimize patient radiation exposure in AI segmentations, a voxel size of 0.15 mm is recommended, while a voxel size of 0.45 mm should be avoided.Item Initial dental patient assessment appointment: Advancing educational goals during COVID-19(Wiley, 2022) Harrington, Christine; Lang, Lisa; Robinson, Fonda G.; Mallery, Susan R.; Prosthodontics, School of DentistryItem Clinical performance of immediately placed and immediately loaded single implants in the esthetic zone: A systematic review and meta-analysis(Wiley, 2023-09) Wittneben, Julia-Gabriela; Molinero-Mourelle, Pedro; Hamilton, Adam; Alnasser, Muhsen; Obermaier, Barbara; Morton, Dean; Galluci, German O.; Wismeijer, Daniel; Prosthodontics, School of DentistryObjectives The aim of this study was to assess the following PIO question: In adult patients treated with an indication for single tooth extraction in the maxillary esthetic zone (15–25), what is the influence of an immediate implant placement and immediate loading protocol on the clinical performance (primary aim) and esthetic outcomes (secondary aim) focusing on investigations published after 2010. Material and Methods An electronic search in Medline (PubMed), the Cochrane Central Register of Controlled Trials, and EMBASE databases up to April 2022 was performed to identify clinical studies investigating the outcome of single implants subjected to immediate placement with immediate restoration/loading (Type 1A). Results Sixty-three studies (10 randomized controlled trials, 28 prospective and 25 retrospective cohort studies) were included with a follow-up ranging from 12 to 96 months. One thousand nine hundred sixty-one implants reported survival rates of 99.2 (98.6–99.5) % at 1 year, 97.5 (95.9–98.4) % after 3 years, and 95.8 (93.3–97.4) % after 5 years; 1064 immediately loaded restorations presented survival rates of 98.9 (97.8–99.5) % after 1 year, 96.8 (93.6–98.4) % after 2 years, and 94.8 (89.6–97.4) % after 5 years. Comparing baseline to 12-month data using the Hedges' g effect size (95% CI), papilla height presented an overall effect size of −0.71 (−1.25, −0.1) mm, midfacial recession change of −0.15 (−0.66, 0.36) mm, and a 0.82 (0.37, 1.28) gain in PES. Conclusions Immediate implant placement and immediate loading can be considered a predictable and safe treatment option for single maxillary anterior restorations with adequate survival rates and favorable esthetics outcomes for up to 5 years.Item Accelerated denture base festooning using a free 3D modeling computer program: A dental technique(Elsevier, 2024-05) Azpiazu-Flores, Francisco X.; Morton, Dean; Lin, Wei-Shao; Prosthodontics, School of DentistryDenture bases should be contoured to recreate the natural contours of the tissues being replaced to ensure optimum phonetics, esthetics, and function.1 Several suggestions have been made regarding the desired shape and contours of the artificial root eminences, denture base extension contours, and surface characterization of the denture base.2–4 Traditionally, achieving these contours has been a time-consuming process done manually during the waxing stage of denture fabrication and requiring significant skill and artistry.2Item Color reproduction trueness of 3D-printed full-color dental casts with scans derived from an intraoral scanner(Wiley, 2023) Alfaraj, Amal; Lin, Wei-Shao; Prosthodontics, School of DentistryPurpose To investigate the effects of shade tab color variations (tooth-colored vs. gingiva-colored) and surface treatment (application of mineral oil) on the trueness of color reproduction from dental shade tabs to 3D-printed full-color dental casts, using digital scans obtained from an intraoral scanner. Materials and Methods Pristine tooth-colored (with 16 shade tabs) and gingiva-colored (with five shade tabs) shade guides were digitally scanned using an intraoral scanner, and subsequently, 3D-printed replicas were created using a full-color material jetting 3D printer. Three color measurements using a contact type digital spectrophotometer were recorded, including actual shade tabs (R0), dried 3D-printed study samples (RP1), and study samples with mineral oil application (RP2), in this study to calculate color differences between the actual shade tabs and 3D-printed ones. The CIEDE2000 formula was used to calculate the color differences (color reproduction trueness) between reference shade tabs and 3D-printed full-color study samples—without and with mineral oil, ∆E00(RP1), and ∆E00(RP2). ∆E00(RP1) and ∆E00(RP2) were compared with a 50:50% accessibility threshold (AT) and a 50:50% perceptibility threshold (PT). A grading system, based on the relative ranges of AT and PT, was employed. The percentage of samples falling into each color-matching category was then recorded. The data collected were subjected to statistical analysis, utilizing a mixed model ANOVA to evaluate the effects of shade tab color and mineral oil application on color differences, α = 0.05. Results The application of mineral oil significantly affected the ∆E00 [F(1, 378) = 19.1, p = < 0.0001]. However, this effect was only significant for the gingiva-colored study samples; the mineral oil application significantly decreased color difference, showing ∆E00(RP1) of 8.71 ± 3.78 and ∆E00(RP2) of 6.55 ± 2.14 (p < 0.0001). For the tooth-colored groups, the mineral oil application did not yield any color difference, showing ∆E00(RP1) of 7.05 ± 2.35 and ∆E00(RP2) of 6.94 ± 2.35 (p = 0.497). In the absence of mineral oil, gingiva-colored samples revealed a significantly larger ∆E00(RP1) of 8.71 ± 3.78 compared to tooth-colored samples at 7.05 ± 2.35 (p = 0.017). Conversely, mineral oil application rendered comparable ∆E00(RP2) values between gingiva-colored (6.55 ± 2.14) and tooth-colored (6.94 ± 2.35) samples (p = 0.558). All 3D-printed full-color samples showed Grade 1 (extremely unacceptable mismatch) and Grade 2 (clearly unacceptable mismatch), regardless of the shades or the presence of mineral oil. Conclusions Utilizing an intraoral scanner to gather digital color data, along with an MJ 3D printer, offers the potential for producing 3D-printed full-color dental casts for prosthesis characterization in the dental laboratory. While mineral oil improves the color reproduction trueness of gingiva-colored objects, all 3D-printed full-color samples exhibited unacceptable mismatches when compared to their target objects. This underscores the need for future improvement in the digital color data acquisition process and color optimization protocols in 3D printing processes.