The paper is a comprehensive but compact review of the literature on the state of illnesses of the human stomatognathic system, related consequences in the form of dental deficiencies, and the resulting need for prosthetic treatment. Types of prosthetic restorations, including implants, as well as new classes of implantable devices called implant-scaffolds with a porous part integrated with a solid core, as well as biological engineering materials with the use of living cells, have been characterized. A review of works on current trends in the technical development of dental prosthetics aiding, called Dentistry 4.0, analogous to the concept of the highest stage of Industry 4.0 of the industrial revolution, has been presented. Authors’ own augmented holistic model of Industry 4.0 has been developed and presented. The studies on the significance of cone-beam computed tomography (CBCT) in planning prosthetic treatment, as well as in the design and manufacture of prosthetic restorations, have been described. The presented and fully digital approach is a radical turnaround in both clinical procedures and the technologies of implant preparation using computer-aided design and manufacturing methods (CAD/CAM) and additive manufacturing (AM) technologies, including selective laser sintering (SLS). The authors’ research illustrates the practical application of the Dentistry 4.0 approach for several types of prosthetic restorations. The development process of the modern approach is being observed all over the world. The use of the principles of the augmented holistic model of Industry 4.0 in advanced dental engineering indicates a change in the traditional relationship between a dentist and a dental engineer. The overall conclusion demonstrates that it is inevitable and extremely beneficial to implement the idea of Dentistry 4.0 following the assumptions of the authors’ own, holistic Industry 4.0 model.
This paper concerns the assessment of the current state of dentistry in the world and the prospects of its sustainable development. A traditional Chinese censer was adopted as the pattern, with a strong and stable support on three legs. The dominant diseases of the oral cavity are caries and periodontal diseases, with the inevitable consequence of toothlessness. From the caries 3.5–5 billion people suffer. Moreover, each of these diseases has a wide influence on the development of systemic complications. The territorial range of these diseases and their significant differentiation in severity in different countries and their impact on disability-adjusted life years index are presented (DALY). Edentulousness has a significant impact on the oral health-related quality of life (OHRQoL). The etiology of these diseases is presented, as well as the preventive and therapeutic strategies undertaken as a result of modifying the Deming circle through the fives’ rules idea. The state of development of Dentistry 4.0 is an element of the current stage of the industrial revolution Industry 4.0 and the great achievements of modern dental engineering. Dental treatment examples from the authors’ own clinical practice are given. The systemic safety of a huge number of dentists in the world is discussed, in place of the passive strategy of using more and more advanced personal protective equipment (PPE), introducing our own strategy for the active prevention of the spread of pathogenic microorganisms, including SARS-CoV-2. The ethical aspects of dentists’ activity towards their own patients and the ethical obligations of the dentist community towards society are discussed in detail. This paper is a polemic arguing against the view presented by a group of eminent specialists in the middle of last year in The Lancet. It is impossible to disagree with these views when it comes to waiting for egalitarianism in dental care, increasing the scope of prevention and eliminating discrimination in this area on the basis of scarcity and poverty. The views on the discrimination of dentistry in relation to other branches of medicine are far more debatable. Therefore, relevant world statistics for other branches of medicine are presented. The authors of this paper do not agree with the thesis that interventional dental treatment can be replaced with properly implemented prophylaxis. The final remarks, therefore, present a discussion of the prospects for the development of dentistry based on three pillars, analogous to the traditional Chinese censer obtaining a stable balance thanks to its three legs. The Dentistry Sustainable Development (DSD) > 2020 model, consisting of Global Dental Prevention (GDP), Advanced Interventionist Dentistry 4.0 (AID 4.0), and Dentistry Safety System (DSS), is presented.
The importance of endodontics is presented within our own concept of Dentistry Sustainable Development (DSD) consisting of three inseparable elements; i.e., Advanced Interventionist Dentistry 4.0 (AID 4.0), Global Dental Prevention (GDP), and the Dentistry Safety System (DSS) as a polemic, with the hypothesis of the need to abandon interventionist dentistry in favour of the domination of dental prevention. In view of the numerous systemic complications of caries that affect 3−5 billion people globally, endodontic treatment effectively counteracts them. Regardless of this, the prevention of oral diseases should be developed very widely, and in many countries dental care should reach the poorest sections of society. The materials and methods of clinical management in endodontic procedures are characterized. The progress in the field of filling materials and techniques for the development and obturation of root canals is presented. The endodontics market is forecast to reach USD 2.1 billion in 2026, with a CAGR of 4.1%. The most widely used and recognized material for filling root canals is gutta-percha, recognized as the “gold standard”. An alternative is a synthetic thermoplastic filler material based on polyester materials, known mainly under the trade name Resilon. There are still sceptical opinions about the need to replace gutta-percha with this synthetic material, and many dentists still believe that this material cannot compete with gutta-percha. The results of studies carried out so far do not allow for the formulation of a substantively and ethically unambiguous view that gutta-percha should be replaced with another material. There is still insufficient clinical evidence to formulate firm opinions in this regard. In essence, materials and technologies used in endodontics do not differ from other groups of materials, which justifies using material engineering methodology for their research. Therefore, a detailed methodological approach is presented to objectify the assessment of endodontic treatment. Theoretical analysis was carried out using the methods of procedural benchmarking and comparative analysis with the use of contextual matrices to virtually optimize the selection of materials, techniques for the development and obturation of root canals, and methods for assessing the effectiveness of filling, which methods are usually used, e.g., in management science, and especially in foresight research as part of knowledge management. The results of these analyses are presented in the form of appropriate context matrices. The full usefulness of the research on the effectiveness and tightness of root canal filling using scanning electron microscopy is indicated. The analysis results are a practical application of the so-called “digital twins” approach concerning the virtual comparative analysis of biomaterials used in endodontic treatment.
The aim of the research, the results of which are presented in the paper, is to fabricate, by Selective Laser Melting (SLM), a metallic scaffold with Ti6Al4V powder based on a virtual model corresponding to the actual loss of a patient's craniofacial bone. A plaster cast was made for a patient with a palate recess, and the cast was then scanned with a 3D scanner to create a virtual 3D model of a palate recess, according to which a 3D model of a solid implant was created using specialist software. The virtual 3D solid implant model was converted into a 3D porous implant model after designing an individual shape of the unit cell conditioning the size and three-dimensional shape of the scaffold pores by multiplication of unit cells. The data concerning a virtual 3D porous implant model was transferred into a selective laser melting (SLM) device and a metallic scaffold was produced from Ti6Al4V powder with this machine, which was subjected to surface treatment by chemical etching. An object with certain initially adopted assumptions, i.e. shape and geometric dimensions, was finally achieved, which perfectly matches the patient bone recesses. The scaffold created was subjected to micro-and spectroscopic examinations.Keywords: biomimetic materials, CAMD, scaffolds, SLM, Ti6Al4V powders, SEM, EDS Celem badań, których wyniki zaprezentowano w artykule jest wytworzenie, metodą selektywnego topienia laserowego (SLM), scaffoldu metalowego z proszku Ti6Al4V na podstawie wirtualnego modelu odpowiadającego rzeczywistemu ubytkowi kości twarzoczaszki pacjenta. Od pacjenta z ubytkiem podniebienia pobierano wycisk gipsowy, który następnie zeskanowano za pomocą skanera 3D, w celu uzyskania wirtualnego modelu 3D ubytku podniebienia, na podstawie którego z użyciem specjalistycznego oprogramowania utworzono model 3D litego implantu. Po zaprojektowaniu indywidualnego kształtu komórki jednostkowej, determinującej wielkość i trójwymiarowy kształt porów scaffoldu, poprzez multiplikację komórek jednostkowych przekształcono wirtualny model 3D implantu litego w model 3D implantu porowatego. Dane dotyczące wirtualnego modelu 3D implantu porowatego przetransferowano do urządzenia służącego do selektywnego topienia laserowego (SLM) i z użyciem tej maszyny z proszku Ti6Al4V wytworzono metalowy scaffold, który poddano obróbce powierzchniowej poprzez trawienie chemiczne. Finalnie otrzymano obiekt o założonych na wstępie: kształcie i wymiarach geometrycznych, które idealnie odpowiadają ubytkowi kości pacjenta. Wytworzony scaffold poddano badaniom mikroi spektroskopowym.
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