Clinical comparison of conventional and additive manufactured stabilization splints

Liu

et al. 2019

Sensors

Bruxism is a masticatory muscle activity characterized by high prevalence, widespread complications, and serious consequences but without specific guidelines for its diagnosis and treatment. Although occlusal force-based biofeedback therapy is proven to be safe, effective, and with few side effects in improving bruxism, its mechanism and key technologies remain unclear. The purpose of this study was to research a real-time, quantitative, intelligent, and precise force-based biofeedback detection device based on artificial intelligence (AI) algorithms for the diagnosis and treatment of bruxism. Stress sensors were integrated and embedded into a resin-based occlusion stabilization splint by using a layering technique (sandwich method). The sensor system mainly consisted of a pressure signal acquisition module, a main control module, and a server terminal. A machine learning algorithm was leveraged for occlusal force data processing and parameter configuration. This study implemented a sensor prototype system from scratch to fully evaluate each component of the intelligent splint. Experiment results showed reasonable parameter metrics for the sensors system and demonstrated the feasibility of the proposed scheme for bruxism treatment. The intelligent occlusion stabilization splint with a stress sensor system is a promising approach to bruxism diagnosis and treatment.Sensors 2020, 20, 89 2 of 15 discussion summary, the existing assessment of bruxism could also be classified into three main aspects: (1) noninstrumental approaches, (2) instrumental approaches, and (3) cut-off points grading [6]. Self-report and clinical examination are considered as noninstrumental approaches, which are also the primary choices in the clinical assessment of bruxism. However, their reliability and validity need further improvement [6]. EMG may provide good evidence of both sleep and awake bruxism, but there is also a risk of overestimating the number of true SB events [7]. PSG could be regarded as a reference standard for SB assessment; however, it is expensive and time-consuming [2]. To date, the reliability and validity of all the common techniques remain debatable, and consensus has yet to be established regarding the best method to diagnose bruxism. Therefore, exploring some new methods of bruxism diagnosis and management is a necessary and meaningful research topic.The use of biofeedback technologies (electrical, auditory, vibratory stimulus, etc.) as behavioral techniques of bruxism diagnosis and treatment has been considered a promising approach in both clinical and scientific fields in recent years [8]. Various biofeedback modalities have been reported in previous papers, and most of these are based on EMG recordings, except two studies that described force-based devices [8,9]. An intra-splint force detector (ISFD) for SB force detection was described in 2003 [10]. A detailed description of this SB inhibition system has been presented in a recently published paper [11]. This inhibition system consisted of ISFD, vibration, and co...

Section: Embedding Challengesmentioning

confidence: 99%

Intelligent Occlusion Stabilization Splint with Stress-Sensor System for Bruxism Diagnosis and Treatment

Liu

et al. 2019

Sensors

“…It would take approximately another 2 decades to introduce digital IOS in mainstream clinical dentistry [ 2 ]. Since then, the range of IOS applications has expanded from single tooth or implant-supported restorations [ 3 – 5 ] to fixed dental prostheses [ 6 ], occlusal devices [ 7 ], removable partial dental prostheses [ 8 , 9 ] or complete dentures [ 10 – 12 ] and maxillofacial prostheses [ 13 , 14 ]. Nevertheless, a consensus regarding the implementation of IOS in complete-arch edentulous patients rehabilitated with multiple dental implants has not yet, been established [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

The direct digital workflow in fixed implant prosthodontics: a narrative review

Michelinakis¹,

Apostolakis²,

Kamposiora

et al. 2021

BMC Oral Health

Background The purpose of this narrative review was to examine the applicability of IOS procedures regarding single and multiple fixed implant restorations. Clinical outcomes for monolithic zirconia and lithium disilicate restorations produced through a direct digital workflow were reported. Methods A MEDLINE (Pubmed) search of the relevant English-language literature spanning from January 1st 2015 until March 31st 2020 was conducted. In vitro studies comparing digital implant impression accuracy by different IOS devices or in vitro studies examining differences in accuracy between digital and conventional impression procedures were included. Also, RCTs, clinical trials and case series on the success and/or survival of monolithic zirconia and lithium disilicate restorations on implants, manufactured completely digitally were included. In vitro and in vivo studies reporting on restorations produced through an indirect digital workflow, case reports and non-English language articles were excluded. The aim was to investigate the accuracy of IOS for single and multiple fixed implant restorations compared to the conventional impression methods and report on the variables that influence it. Finally, this study aimed to report on the survival and success of fixed implant-retained restorations fabricated using the direct digital workflow. Results For the single and short-span implant sites, IOS accuracy was high and the deviations in the position of the virtual implant fell within the acceptable clinical limits. In the complete edentulous arch with multiple implants, no consensus regarding the superiority of the conventional, splinted, custom tray impression procedure compared to the IOS impression was identified. Moreover, complete-arch IOS impressions were more accurate than conventional, non-splinted, open or close tray impressions. Factors related to scanbody design as well as scanner generation, scanning range and interimplant distance were found to influence complete-arch scanning accuracy. Single implant-retained monolithic restorations exhibited high success and survival rates and minor complications for short to medium follow-up periods. Conclusions The vast majority of identified studies were in vitro and this limited their clinical significance. Nevertheless, intraoral scanning exhibited high accuracy both for single and multiple implant restorations. Available literature on single-implant monolithic restorations manufactured through a complete digital workflow shows promising results for a follow-up of 3–5 years.

“…Intraoral scanning represents a more precise and comfortable alternative for the patient. In terms of processing time, studies show that the digital technique depends on the skills of the operator, the position and region of the teeth to be faster than conventional (Berntsen, et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Reverse planning for making an occlusal splint before restorative treatment: case report of rehabilitation of a patient with bruxism

Dias

Veras

Barbosa

et al. 2020

RSD

Recovery of worn tooth surfaces using composite resin has been increasingly accepted by clinicians, since rehabilitation through additive techniques aims at minimal or no intervention and preserves healthy dental structure, ensuring longevity to the treatment. Adhesive dentistry can afford promising results through a correct diagnosis and treatment plan. Planning can offer not only dental rehabilitation, but also controlling cause of the wear process. Strategies that seek to prevent the progression of muscle activities such as bruxism, should be established. This article aims to present a clinical case report of a rehabilitation treatment planned and executed through the digital flow, in which the patient presents wear and tear caused by the habit of bruxism. The rehabilitation of the anterior upper teeth was carried out in direct composite resin, associated with the preparation and installation of an occlusal splint, used before, during and after the restorative treatment, ensuring the reestablishment of the shape, function and dental aesthetics.