Cleft lip and palate are one of the most common congenital craniofacial malformations. As an initial treatment, presurgical orthopedics is considered standard treatment at many cleft centers. Digital impressions are becoming feasible in cleft care. Computer-aided design (CAD) and three-dimensional (3D) printing are manufacturing standards in dentistry. The assimilation of these technologies has the potential to alter the traditional workflow for the fabrication of customized presurgical orthopedic plates. We present a digital workflow comprising three steps: 3D digital image acquisition with an intraoral scanner, open-source CAD modeling, and point-of-care 3D printing for the fabrication of personalized passive presurgical plates for newborns with cleft lip and palate. The digital workflow resulted in patient-related benefits, such as no risk of airway obstruction with quicker data acquisition (range 1–2.5 min). Throughput time was higher in the digital workflow 260–350 min compared to 135 min in the conventional workflow. The manual and personal intervention time was reduced from 135 min to 60 min. We show a clinically useful digital workflow for presurgical plates in cleft treatment. Once care providers overcome procurement costs, digital impressions, and point-of-care 3D printing will simplify these workflows and have the potential to become standard for cleft care.
Background. Internal bleaching is a choice of treatment in discolored endodontically treated teeth. Cervical root resorption is one of the important complications of this treatment. A suggested procedure to prevent this type of resorption is using a coronal barrier under the bleaching materials. The aim of the study was to compare the microleakage of mineral trioxide aggregate (MTA), calcium-enriched mixture (CEM) cement, and Biodentine. Materials and Methods. In this in vitro study, a total of 60 single canal incisors were included. They were randomly divided into three experimental groups (n = 16), one positive control group (n = 6), and one negative control group (n = 6). Coronal portion of the canals in the experimental groups was sealed with 3 mm of MTA, CEM cement, or Biodentine as a coronal barrier. After 3 days, specimens were bleached. A fresh Enterococcus faecalis suspension was added to the samples. The culture tubes were observed for 45 days, and the daily turbidity was recorded. Statistical analysis was accomplished by the Kaplan–Meier test and SPSS 22. Results. All positive samples showed turbidity, whereas none of the negative samples allowed bacterial leakage. Results showed no significant difference between MTA, CEM cement, and Biodentine groups. ( P value = 0.304, 0.695, and 0.217). The bacterial microleakage for the two groups also did not show significant differences. Conclusions. CEM cement and Biodentine showed promising results as coronal plug, and clinical studies are needed to test these materials with MTA for avoiding microleakage in internal bleaching treatment.
Additive manufacturing (AM) of polyetheretherketone (PEEK) biomaterials using the material-extrusion (MEX) method has been studied for years. Because of the challenging manufacturing process, precisely controlling printing parameters is crucial. This study aimed to investigate the effects of printing parameters such as orientation and position of printing on mechanical properties. Thus, 34 samples were printed using PEEK filament and the MEX process. Samples were divided into two main groups (A,B) according to their printing orientations (A: groups 1–3) and positions on the build plate (B: groups 4–8). Mechanical tensile tests were performed to evaluate the effects of different printing orientations and positions on mechanical properties. The means of the tensile modulus in samples 3D-printed in XY (group 1), XZ (group 2), and ZX (group 3) orientations were not significantly different (p-value = 0.063). Groups 1 and 2 had smaller distributions than group 3 in the means of tensile strength. The t-test showed that the overall means of the measurements in groups 4–8 did not differ significantly (p-value = 0.315). The tensile tests indicated that printing in vertical and horizontal orientations had no significant influence on mechanical properties. There were no significant differences in mechanical strength between top/bottom printed samples in five different lateral positions. Reliability of printing with good mechanical properties could be a step forward to manufacturing patient-specific implants.
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