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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Dentistry and Oral Sciences".

Deadline for manuscript submissions: closed (10 June 2023) | Viewed by 17865

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Dr. Antonino Lo Giudice

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Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, Unit of Orthodontics, University of Catania, 95131 Catania, Italy
Interests: 3D imaging; CBCT; digital anatomical segmentation; facial scan; intraoral scan; cephalometry; craniofacial development imaging; CAD-CAM; diagnostic digital workflow; RMI; functional orthodontic appliances; dentofacial orthopedics; interceptive orthodontics; elastodontics
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Dr. Rosanna Guarnieri

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Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy
Interests: interceptive orthodontics; dental anomalies; genetic; dentofacial orthopedics; digital orthodontics
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Dr. Ludovica Nucci

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Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80100 Naples, Italy
Interests: impacted canine; early treatment; dentofacial orthopedics; cleft lip and palate
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The ceaseless research into dental technology has remarkably influenced the conventional clinical workflow involving diagnosis and the treatment plan strategies. In this regard, most newly available technologies and equipment aim to improve both the patients’ and clinicians’ experience. To date, dentists and orthodontists have been able to plan complex rehabilitative treatments involving different aesthetic, functional outcomes and, consequently, different specialists. Additionally, novel technologies are contributing to improving the effectiveness and efficiency of treatments, optimizing the experience at the chairside and streamlining clinical tasks in the dental practice.

In the present Special Issue, topics of interest include (but are not limited to) in vivo and in vitro studies proposing novel technologies and materials for dentists and orthodontists, such as digital equipment, CAD–CAM technologies, robotics, artificial intelligence, applications of laser and photobiomodulation, intraoral and facial scans, modern radiology, natural dental products and advanced materials for functional and aesthetic facial and dental rehabilitations.

Interventional studies aiming to improving the current knowledge regarding novel techniques/advances in dentistry are welcome. Studies incorporating a novel approach or providing novel information are of higher priority. Case reports and reviews, including studies using conceptual frameworks on any of the aforementioned topics, will also be welcomed.

Prof. Dr. Antonino Lo Giudice
Dr. Rosanna Guarnieri
Dr. Ludovica Nucci
Guest Editors

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Keywords

digital orthodontics
digital dentistry
aesthetic rehabilitation
functional rehabilitation
CAD–CAM
custom-made appliance
modern radiology
CBCT
intraoral scanner
facial scanner
dynamic articulators
periodontology
biomaterials
interdisciplinary treatments

Published Papers (11 papers)

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Editorial

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3 pages, 193 KiB

Open AccessEditorial

Modern Approaches in Orthodontics and Orofacial Treatments: An Updated Perspective of Innovative Technologies

by Antonino Lo Giudice

Appl. Sci. 2023, 13(23), 12842; https://doi.org/10.3390/app132312842 - 30 Nov 2023

Viewed by 605

Abstract

The technological advancements in orthodontics and oral rehabilitation are continuous and consistent [...] Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

Research

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14 pages, 3496 KiB

Open AccessArticle

Finite Element Analysis (FEA) of the Stress and Strain Distribution in Cone-Morse Implant–Abutment Connection Implants Placed Equicrestally and Subcrestally

by Natalia Di Pietro, Mario Ceddia, Tea Romasco, Nilton De Bortoli Junior, Bruno Freitas Mello, Margherita Tumedei, Alessandro Specchiulli, Adriano Piattelli and Bartolomeo Trentadue

Appl. Sci. 2023, 13(14), 8147; https://doi.org/10.3390/app13148147 - 13 Jul 2023

Cited by 5 | Viewed by 809

Abstract

Peri-implant bone resorption has been reported around some implants after loading, which could create problems for the peri-implant soft and hard tissues’ long-term stability. The reasons for this are still not known. However, relevant importance could be given to this due to the presence of a bacterial contamination at the micro-gap level between implant and abutment. In this regard, external and internal implant–abutment assemblies have been shown to be much more permeable to bacterial colonization than Cone-Morse or conical connections. The placement of a subcrestal implant could have aesthetic advantages, therefore allowing a better prosthetic emergence profile. In literature, controversial experimental and clinical results have been reported on bone resorption around implants placed equicrestally and subcrestally. Interestingly, Finite Element Analysis (FEA) studies revealed to be extremely useful for assessing the peri-implant bone strain and stress. Thus, this study conducted a FEA evaluation of implants with a Cone-Morse implant–abutment assembly inserted into a bone block model mimicking equicrestal (0 mm) and subcrestal placements (−1 and −2 mm). Results demonstrated that maximum stresses were observed in the cortical bone around equicrestally placed implants, with the lowest in the 2 mm subcrestally placed implant and intermediate stresses within the 1 mm subcrestally placed implant. The cortical bone resulted more stressed under lateral loads than axial loads. In conclusion, this FEA study suggested a subcrestal implant placement ranging between −1 and −2 mm to obtain an adequate peri-implant stress pattern. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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10 pages, 1988 KiB

Open AccessArticle

Proposal of a Full Digital Workflow for a Bite Fork to Assess Mandibular Advancement during Drug-Induced Sleep Endoscopy (DISE) for Obstructive Sleep Apnea

by Cristina Grippaudo, Grazia Rizzotto, Antonino Lo Giudice, Cristina Buccarella, Stefano Negrini, Fabrizio Anelli, Luigi Corina, Jacopo Galli and Antonella Fiorita

Appl. Sci. 2023, 13(11), 6647; https://doi.org/10.3390/app13116647 - 30 May 2023

Viewed by 841

Abstract

(1) Background. Drug-induced sleep endoscopy (DISE) is currently regarded as the gold standard diagnostic procedure to assess the site(s) of upper airway collapse in subjects affected by Obstructive Sleep Apnea Syndrome (OSAS). During DISE, a jaw thrust maneuver is performed to advance the mandible and to predict the effectiveness of outcomes of treatment with mandibular advancement devices (MADs). However, the maneuver is not predictable and could be influenced by specific patients’ anatomical/functional conditions. The aim of this work is to propose a full-digital workflow for customizing an individual mandibular advancement fork, usable by otorhinolaryngologists during DISE. (2) Materials. Two patients with a diagnosis of mild-to-moderate OSAS (AHI ≥ 5 to ≤30/h of sleep) underwent orthodontic examination to verify the usability of the MAD. Intra-oral scans and registration were performed, including bite registration with 65% of mandibular advancement. The latter measurement was used as a reference to design a 3D-printed fork for DISE, as well as for the future MAD. Both patients underwent DISE in the operating room in the presence of an anesthesiologist, otolaryngologist, orthodontic specialist and neurophysiopathology technician. (3) Results. In the intraoperative polysomnography recording, during sleep, the presence of obstructive apnea was confirmed based on respiratory parameters (PNG1, PNG2, PNG3) with associated desaturation and increased muscle activities on PNG4 (mylohyoid muscle), EMG1 (right masseter muscle) and EMG2 (left masseter muscle). With the advancement fork in place, the immediate improvement effect on all respiratory parameters with normal saturation values and the complete suppression of masseter muscles were observed. Accordingly, both patients were considered potential good-responders to the MAD treatment. (4) Conclusions. The preliminary data shown are encouraging and would suggest that the fork represents a stable reference for the otorhinolaryngologist to evaluate the airway patency within the physiological range of movement. The efficiency of the work-flow from data registration to the DISE procedure and laboratory process represent two significant advantages that justify the integration of a digital system in the management of patients affected by OSAS. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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14 pages, 2502 KiB

Open AccessFeature PaperArticle

Dental Anomalies in Maxillary Incisors and Canines among Patients with Total Cleft Lip and Palate

by Anna Paradowska-Stolarz and Beata Kawala

Appl. Sci. 2023, 13(11), 6635; https://doi.org/10.3390/app13116635 - 30 May 2023

Cited by 2 | Viewed by 1125

Abstract

Cleft lip and palate is the most common asymmetric congenital condition of the orofacial region, which also finds its reflection in dental anomalies. The aim of the study was to present the dental asymmetries of the front region of the maxilla in cleft patients. Materials and Methods: We analyzed plaster casts and panoramic X-rays of 154 patients with total clefts and 151 healthy individuals. The cleft patients’ age ranged between 7.1 and 20 years (mean 13.18). The control group had a similar age range (7.1 and 20 years, mean 13.44). The digital caliper was used to measure the width of the teeth. Each measurement was performed three times each. Results: Most of the dental anomalies among cleft patients referred to the lateral incisors and were focused on the cleft side. The asymmetry of the incisors is reflected both in the number of teeth in the cleft region and their width. The lateral incisor was missing twice as frequently on the cleft side of the individual. If present, the lateral incisor was usually ±1.5 mm narrower than the incisor on the opposite side. In bilateral clefts, dental anomalies occurred more frequently on the left side. Conclusions: Dental problems occurred more frequently in patients with total cleft lip and palate than in healthy individuals. The most commonly affected teeth were the lateral incisors. The width of the lateral incisors was reduced in cleft patients—showing a smaller mesiodistal dimension on the cleft side. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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11 pages, 2139 KiB

Open AccessArticle

Equalization of the Occlusal State by Wearing a Mouthguard Contributes to Improving Postural Control Function

by Mutsumi Takahashi, Yogetsu Bando, Takuya Fukui, Akiko Maruyama and Masaaki Sugita

Appl. Sci. 2023, 13(7), 4342; https://doi.org/10.3390/app13074342 - 29 Mar 2023

Cited by 1 | Viewed by 1043

Abstract

The aim of this study was to clarify the effect on the postural control function of equalizing the occlusal contact state by wearing a mouthguard. Method: Participants included 23 untrained adults, 11 gymnasts, and 10 weightlifters. Custom mouthguards were fabricated and adjusted so that all teeth were in even contact with light clenching. The standing postural control function was evaluated by the displacement of the center of foot pressure (COP) measured using a gravity center fluctuation meter. Measurement conditions were with and without a mouthguard. Statistical analyses were performed on the differences in COP displacement among participant groups and between mouthguard conditions and the difference in the reduction rate of COP displacement when wearing a mouthguard among participant groups. Results: COP significantly decreased in the order of untrained adults to weightlifters to gymnasts, irrespective of the mouthguard condition. The reduction rate in COP displacement after wearing a mouthguard was greatest in gymnasts. Conclusions: The effect of the mouthguard on postural control function was more pronounced in gymnasts than in untrained adults and weightlifters, and this study suggests that equalization of the occlusal state by wearing a mouthguard contributes to improving postural control function. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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10 pages, 904 KiB

Open AccessArticle

Patient and Parental Satisfaction following Orthodontic Treatment with Clear Aligners and Elastodontic Appliances during Mixed Dentition: A Cross-Sectional Case–Control Study

by Simona Dianiskova, Rosaria Bucci, Laura Solazzo, Roberto Rongo, Sara Caruso, Silvia Caruso, Roberto Gatto, Fabiana Fiasca, Rosa Valletta and Vincenzo D’Antò

Appl. Sci. 2023, 13(7), 4074; https://doi.org/10.3390/app13074074 - 23 Mar 2023

Cited by 4 | Viewed by 1588

Abstract

The aim of the current study was to assess patient and parental satisfaction following treatment during mixed dentition with two removable orthodontic devices: elastodontic appliances (EAs) and clear aligners (CAs). Consecutive patients below the age of 12 years who had completed the active phase of EA or CA therapy were recruited. A dedicated written questionnaire divided into four sections was used to measure parental and patient satisfaction regarding treatment experiences and treatment outcomes. The total sample included 56 subjects: 28 belonged to the EA group (7 girls and 21 boys; mean age 11 years); 28 belonged to the CA group (12 girls and 16 boys; mean age 9 years). Patients and parents of both the EA and CA groups were satisfied with the treatment experiences and outcomes. According to parental reporting, EA treatment was significantly more painful than CA therapy (p = 0.003), but this was not confirmed by the patients (p = 0.100). Both parents and patients reported EAs being significantly more difficult to wear than CAs (p < 0.001 and p = 0.001, respectively). Functional improvements were reported, including a reduction in grinding sounds in the CA group (p = 0.020) and breathing improvements in the EA group (p = 0.023). According to the parents, school life and social life were significantly improved in the CA group, as compared to the EA group (school life p < 0.001, social life p = 0.001). Finally, parents belonging to the CA group found that their child’s treatment was much shorter than expected (p = 0.003). Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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14 pages, 3312 KiB

Open AccessCommunication

Realistic Facial Three-Dimensional Reconstruction from CT Images and 2D Photographic Images for Surgical-Orthognathic Planning

by Miguel Monteiro, Francisco Vale, Nuno Ferreira, Filipa Marques, Madalena Prata Ribeiro, Mariana Santos, Catarina Oliveira, Mariana McEvoy, Raquel Travassos, Catarina Nunes, Anabela Baptista Paula, Inês Francisco and Francisco Caramelo

Appl. Sci. 2023, 13(2), 1226; https://doi.org/10.3390/app13021226 - 16 Jan 2023

Viewed by 1599

Abstract

Orthognathic surgery is a procedure used to correct intermaxillary discrepancies, thus promoting significant improvements in chewing and breathing. During the surgical planning stage, orthodontists often use two-dimensional imaging techniques. The assessment is based on CBCT images and dental cast models to overcome these limitations; however, the evaluation of soft tissues remains complex. The aim of the present study was to develop a co-registration method of CBCT and photo images that would result in realistic facial image reconstruction. CBCT images were three-dimensionally rendered, and the soft tissues were subsequently segmented resulting in the cranial external surface. A co-registration between the obtained surface and a frontal photo of the subject was then carried out. From this mapping, a photorealistic model capable of replicating the features of the face was generated. To assess the quality of this procedure, seven orthodontists were asked to fill in a survey on the models obtained. The survey results showed that orthodontists consider the three-dimensional model obtained to be realistic and of high quality. This process can automatically obtain a three-dimensional model from CBCT images, which in turn may enhance the predictability of surgical-orthognathic planning. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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11 pages, 1386 KiB

Open AccessArticle

Treatment of Palatally Displaced Canines Using Miniscrews for Direct or Indirect Anchorage: A Three-Dimensional Prospective Cohort Study on Tooth Movement Speed

by Marco Migliorati, Sara Drago, Tecla Bocchino, Ambra Michelotti and Vincenzo D’Antò

Appl. Sci. 2022, 12(21), 10935; https://doi.org/10.3390/app122110935 - 28 Oct 2022

Cited by 3 | Viewed by 3508

Abstract

Palatally impacted canines are usually challenging to treat in terms of both biomechanics and possible side effects. Different therapeutic approaches have been reported with or without the use of temporary anchorage devices, including the canine-first approach. Two groups of patients with palatally impacted canines were compared, observing their canine movement measured on consecutive CBCTs after three months of treatment. In the control group, impacted canines were treated with direct anchorage on miniscrews, and in the test group with indirect anchorage using a miniscrew-supported transpalatal arch. The primary outcome was the canine movement speed; the secondary outcome was the change in the root length of adjacent teeth. The median monthly apex speed was 1.05 mm in the control group (IR [0.74, 1.64]) and 0.72 mm in the test group (IR [0.27, 1.30]). The median monthly cusp displacement was 1.89 mm in the control group (IR [1.04, 2.84]) and 1.08 mm in the test group (IR [0.81, 1.91]). Approximately 50% of teeth adjacent to an impacted canine underwent a negative root length change of less than 1 mm in the majority of cases, but no significant differences were found in root length changes between groups. No statistically significant differences in the reported speeds were found, and no miniscrew failures were observed in either group. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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10 pages, 1216 KiB

Open AccessArticle

In-House 3D-Printed vs. Conventional Bracket: An In Vitro Comparative Analysis of Real and Nominal Bracket Slot Heights

by Luca Brucculeri, Claudia Carpanese, Mario Palone and Luca Lombardo

Appl. Sci. 2022, 12(19), 10120; https://doi.org/10.3390/app121910120 - 08 Oct 2022

Viewed by 1645

Abstract

Aims: The purpose of this study was to evaluate the accuracy of the slot height of in-house 3D-printed resin brackets, comparing them with other types of brackets on the market today, both ceramic and metallic. Methods: Seven different types of bracket systems were selected. For each system, ten brackets for tooth 2.1 with 0.022 × 0.028-inch slots were selected (total n° 70). Considering the whole sample, five types were commercially available and two were in-house 3D-printed. The entire sample was divided into four different groups according to the bracket material and the method of holding the archwire. Precision pin gauges with 0.002-mm increments were inserted inside the slot of each bracket, and the slot heights were measured, microscopically ensuring that the gauge completely filled the slot, with full contact between both the bottom and the top of the slot. Results: With respect to the other five types of brackets on the market, the two types of in-house 3D-printed resin brackets showed great accuracy of slot height (0.558 ± 0.001 mm). There was a statistically significant difference between the real height measured and the nominal height declared by the manufacturers (p < 0.05) of all the samples investigated, with the exception of in-house 3D-printed resin brackets. Furthermore, the difference in slot height accuracy between commercially manufactured and in-house 3D-printed resin brackets was statistically significant. Conclusions: In-house 3D-printed resin brackets have a remarkably precise slot height, unlike commercially available brackets, whose slot heights tend to be significantly oversized with respect to the nominal values declared by the manufacturers. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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14 pages, 15968 KiB

Open AccessCommunication

The Virtual Patient in Daily Orthodontics: Matching Intraoral and Facial Scans without Cone Beam Computed Tomography

by Alessandra Campobasso, Giovanni Battista, Eleonora Lo Muzio and Lorenzo Lo Muzio

Appl. Sci. 2022, 12(19), 9870; https://doi.org/10.3390/app12199870 - 30 Sep 2022

Cited by 3 | Viewed by 1700

Abstract

Aim: The authors provided an accurate, simple, and noninvasive method for matching the intraoral scan with facial scan of a patient, without the need of a cone beam computed tomography (CBCT). Materials and methods: Three different facial scans were acquired: the first one with the mouth closed, the second one with a voluntary “social smile”, and the last one scanned the face with a lip-and-cheek retractor with dental arches in occlusion. The base of this method is to superimpose the area of the dental arches acquired by a face scanner with the same area derived by an intraoral scanner. Result: An accurate matching of intraoral and facial scans can be achieved without the risks of radiation exposure. Conclusions: The virtual patient helps the orthodontist to improve both diagnosis and treatment planning: a three-dimensional digital smile design can be performed, the patient’s smile can then be analyzed in the context of the lips, and the teeth can be moved to achieve a consonant and balanced smile. All this information can be integrated in a clear aligner therapy or an indirect bonding procedure, enhancing outcomes in the facial esthetics. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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25 pages, 8066 KiB

Open AccessPerspective

From Reverse Engineering Software to CAD-CAM Systems: How Digital Environment Has Influenced the Clinical Applications in Modern Dentistry and Orthodontics

by Vincenzo Ronsivalle, Ferdinando Ruiz, Antonino Lo Giudice, Elisabetta Carli, Pietro Venezia, Gaetano Isola, Rosalia Leonardi and Stefano Mummolo

Appl. Sci. 2023, 13(8), 4986; https://doi.org/10.3390/app13084986 - 15 Apr 2023

Cited by 1 | Viewed by 2352

Abstract

Background: Reverse engineering (RE) or back engineering is a process that analyzes a physical object to obtain the primary data of the same project. RE technologies have different applications in industrial settings and productive chains; however, with the advent of digital technologies in dentistry and orthodontic fields, they are involved in the new diagnostic and clinical digital workflow. For example, 3D model scanning, 3D facial scanning, models superimposition, digital orthodontic setup, anatomical volumetric assessment, soft tissue analysis, orthodontic digital guided systems, and prototyped orthodontic appliances represent a few examples of the application of RE in orthodontics. Moreover, clinicians can manipulate the data derived from original digital file to enhance diagnosis and communication with other clinicians and dental technicians; however, RE and digital technologies systems are not exempt from shortcomings, including costs and knowledge curve. In this regard, the aim of the present manuscript was to describe the use of reverse engineering technologies in modern digital orthodontics and provide helpful information for those specialists who are at the beginning of the transition from analogic to digital orthodontic workflow. Full article

(This article belongs to the Special Issue New Technologies for Orthodontic and Dento-Facial Rehabilitations)

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