Functional Removable Prosthetic Rehabilitation Using the Electronic Condylograph: A Case Report

This article describes the design of complete removable prostheses following the Slavicek philosophy, which involves the integration between condylographic data and an individual cephalometric study of the patient. The electronic condylograph is a device that records the mandibular movements made by the patient. This case report shows how condylography data are useful not only in the individual articulator setting, but also for diagnostic completion and for planning a functional prosthetic rehabilitation.

Construction of a Removable Partial Denture (RPD): Comparison between the Analog Procedure and the Selective Laser Melting Procedure

A partial removable denture is a device that allows the patient to recover from a partial edentulism. This case report describes the realization of a chrome–cobalt partial removable denture by using two different realization methods: (1) analogic framework and (2) hybrid framework. This allowed us to compare the stability, retention as well as clasp quality of both the products and to highlight their respective advantages, disadvantages, and limitations.

Conceptualization of a Sensory Feedback System in an Anthropomorphic Replacement Hand

(1) Background: This paper presents a conceptual design for an anthropomorphic replacement hand made of silicone that integrates a sensory feedback system. In combination with a motorized orthosis, it allows performing movements and registering information on the flexion and the pressure of the fingers. (2) Methods: To create the replacement hand, a three-dimensional (3D) scanner was used to scan the hand of the test person. With computer-aided design (CAD), a mold was created from the hand, then 3D-printed. Bending and force sensors were attached to the mold before silicone casting to implement the sensory feedback system. To achieve a functional and anthropomorphic appearance of the replacement hand, a material analysis was carried out. In two different test series, the properties of the used silicones were analyzed regarding their mechanical properties and the manufacturing process. (3) Results: Individual fingers and an entire hand with integrated sensors were realized, which demonstrated in several tests that sensory feedback in such an anthropomorphic replacement hand can be realized. Nevertheless, the choice of silicone material remains an open challenge, as there is a trade-off between the hardness of the material and the maximum mechanical force of the orthosis. (4) Conclusion: Apart from manufacturing-related issues, it is possible to cost-effectively create a personalized, anthropomorphic replacement hand, including sensory feedback, by using 3D scanning and 3D printing techniques.

Endodontic Irrigants and Their Activation Efficacy on Cleansing Post-Space Root Canal Walls

The aim of this study was to evaluate the efficacy of activated irrigants (EDTA e NaOCL) during the cleansing of root walls, of the smear layer, of the debris, and gutta-percha after the preparation of the restorative space. Twenty single and multi-rooted (n = 20) have been collected. All samples were prepared by the same operator, using Nickel-titanium rotating instruments (Mtwo) through the Simultaneous Shaping Technique. The continuous-wave of condensation technique of obturation was used. To all specimens, the restorative space has been made, leaving 5 mm of apical gutta-percha, and postoperative periapical X-rays were performed. The samples were randomly divided into two groups: Group (A): cleansing of the root walls with ultrasonic activation of the irrigants (NEWTRON P5 XS; Satelec Acteon); Group (B): radicular walls wash without ultrasonic activation of endodontic irrigants (NaOCl 5.25% and EDTA 17%). Both dental sample groups were cut longitudinally with a low-speed saw (Isomet); the samples were observed by using a scanning electron microscope (Jeol, Jsm-6060LV) in order to evaluate: (1) the amount of debris/smear layer; (2) the mount of obstruction of dentinal tubules found in the two groups; and (3) evaluation of the presence of gutta-percha. Then, the other five samples each group (with and without ultrasonic activation) were prepared following the same protocol. Then, a universal bonding system (G-Praemio Bond, GC) and a layer of a flowable resin composite (Gaenial Flow, GC) were light-cured and used on top of the prepared root canal walls. The samples were cut in two pieces along the long axis of the root. Then, half sample teeth were kept in an acidic solution (37% HCl) for 48 h in order to completely dissolve dental structures and to have a direct view of resin tags formation under SEM. The other half was prepared to observe the adhesive interface under SEM. The amount of debris was not satisfactory in 9 out of 10 cases in Group B, while in Group A, which has been treated with ultrasounds, the result was either good or great in most of the samples. For the sample group treated with ultrasound, the tubules were evaluated as perfectly clean in 9 out of 10 cases, instead, the results are unsatisfactory for 9 out of 10 cases of group B not treated with ultrasound. Differences between Group A and B were statistically significant. With respect to the presence of debris and tubules obstruction treatment with ultrasonic activation, it offers with no doubt better results. When ultrasonic activation is used in combination with endodontic irrigants, a clean dentin substrate is be obtained for the adhesion of restorative materials, but in order to confirm the findings of this study, further in vivo trials are needed.

A Visual Feedback Tool for Quantitative Pressure Monitoring in Lower-Limb Prosthetic Sockets

Obtaining a good socket fit is an iterative process dependent on the skill and experience of the prosthetist creating it and requires individualisation based on the size and shape. There is no standard measurement system used to aid prosthetic socket creation despite the severe impacts on physical health and quality of life if one is ill fitting. Pressure sensors embedded in a prosthetic socket were used to collect data at the socket–residuum interface. To choose an interpolation method, the sensor array was simplified to a 2D grid with a border for extrapolation and tested using previously collected walking test pressure data. Four multivariable interpolation methods were evaluated to create a colour map of the pressure data. Radial basis function interpolation was chosen, as it produced a clear image with a graduated interpolation between data points, and was used to create a colour map across the surface of a 3D prosthetic socket model. For the model to be accessible to clinical audiences, a desktop application was created using PyQt to view the model. The application allowed for connection to the sensors via Bluetooth, with the pressure data updating on the 3D model in real time. Clinician feedback on the application showed the potential for a clinical product; however, further development informed by feedback from rehabilitation clinicians and prosthesis users is required.

Prosthetic Rehabilitation of an Unusually Self-Obturated Cleft Palate Defect in an Adult Edentulous Patient Living in a Remote Rural Area. A Clinical Report

Patients with unrepaired cleft palate defects still exist within remote rural areas. The prosthodontic rehabilitation of an adult edentulous cleft patient could be very demanding for treating maxillofacial prosthodontist, since most of them are edentulous, challenging the retention and the stability of the maxillary prosthesis. It is therefore highly important that cleft palate patients seek dental and prosthodontic care as early in their life as possible. In this report, an unusual case of a patient self-obturated cleft palate defect is presented. The patient’s self-made prosthesis was replaced by an appropriately fabricated pharyngeal obturator prosthesis in order to improve speech and swallowing.

Regulating Environmental Impact of Medical Devices in the United Kingdom—A Scoping Review

Medical devices are highly regulated to ensure safety and efficacy of the products and minimize the risk of harm to users and patients. However, the broader impacts of these devices on the environment have scarcely been questioned until recently. The United Kingdom National Health Service intends to achieve a “net zero” emissions service by 2040 and has identified specific targets to achieve through this process. However, medical device manufacturers do not see sufficient incentives to invest in reducing greenhouse gas emissions unless enforced by legislation. Furthermore, there is little evidence on the legislation required to reduce emissions from medical devices. This study addresses the relationship of medical device regulations and the environmental impact of the devices throughout their lifecycle. A scoping review was conducted on academic literature on the topic, followed by a critical review of the current medical device regulations and associated guidelines in the United Kingdom. The challenges to regulating environmental impact of medical devices were identified under seven themes. These challenges were contextualized with the National Health Service target of achieving zero emissions by 2040. The review indicates that current guidelines support single-use disposal of devices and equipment as the best approach to prevent pathogen transmission and landfilling and incineration are the most used waste management strategies. Manufacturers need to be guided and educated on reducing their emissions while ensuring the development of safe and effective devices.

Traditional Removable Partial Dentures versus Implant-Supported Removable Partial Dentures: A Retrospective, Observational Oral Health-Related Quality-of-Life Study

Removable partial dentures (RPD) are still a valid alternative for the restoration of missing teeth. Additionally, implant-supported removable partial dentures (ISRPD) represent a valid alternative as it allows to avoid the use of clasps and increase stability. The objective of this study was to evaluate through an OHIP-14 questionnaire the level of satisfaction and quality of life (QoL) of patients treated before RPD and then with ISRPD. Twenty patients were rehabilitated with traditional RPDs, and after one year the prosthesis was modified into ISRPD, by inserting an implant and a ball or locator attachment. At the end of both phases, patients completed the Oral Health Impact Profile (OHIP-14) questionnaire. The collected data were statistically analyzed through the Wilcoxon U test, as overall OHIP score and difference between treatments. The mean of the OHIP summary (range from 0 to 56) in the RPD Group was 20.95 (±5.27). In the ISRPD Group it was 13.95 (±3.91), with a statistically significant difference (p < 0.05) between the two Groups. The same findings were highlighted for the differences between groups in every domain question. Patients showed significant improvements after rehabilitation in all areas of investigation, stating how the transformation of a removable prosthesis into an implant-supported one can improve patients’ QoL with benefits in chewing ability, aesthetics and self-satisfaction.

Qualitative and Quantitative Evaluation of Different Types of Orthodontic Brackets and Archwires by Optical Microscopy and X-ray Fluorescence Spectroscopy

The wear behaviour and chemical composition of orthodontic components influence the mechanical characteristics of a fixed orthodontic treatment. The purpose of this paper is to evaluate the surface alterations of different types of brackets (aesthetic, metallic, and conventional self-ligating) and archwires (superelastic and thermal) subjected to wear tests through optical microscopy and, subsequently, to identify the chemical elements of accessories by X-ray fluorescence. The cycles (5000 for each bracket and 10,000 for each wire) of the tribological test were carried out in dry conditions inside a machine that allows alternating sliding. The results of the study highlighted different wear behaviours even within the same type of brackets and archwires. The monocrystalline sapphire brackets maintain their aesthetic properties despite traces of wear inside the slots and contain minimal amounts of nickel. Superelastic NiTi archwires have a better overall rating than thermal wires, as they do not show significant surface wear alterations.

Faculty versus Student Repeatability on Evaluating Translucency of the Anterior Dentition

The objective was to compare the repeatability between dental faculty, whose clinical practice was primarily restorative dentistry, and final year dental students in categorizing the inherent translucency of images selected at random using either a 3- or 7-point scale (translucent to opaque). Digital images of anterior dentition were randomly selected based on inherent translucency. Thirty images (five were repeated) were randomized and categorized by 20 dental students and 20 faculty on their inherent translucency. Statistical analysis was performed using an F test for analysis of variance at 95% confidence interval. A covariance parameter estimate (CPE) was accomplished to compare the inter-rater variability of the dental faculty and dental students. Statistically, more variability occurred between Slides (CPE of 0.185 (p = 0.001)) and between Subject and Slide (CPE of 0.122 (p = 0.0002)) than within subjects (CPE of 0.021 (p = 0.083)). Viewing repeat Slides, Students (CPE = 0.16) were more consistent (p < 0.05) than faculty (CPE = 1.8) using the 3- point scale, while the CPE was the same (CPE = 0.669) using 7-point scale. Dental students and faculty were consistent using the 7-point scale to judge repeat slides, while dental students in this limited pilot study were more consistent when viewing a repeat slide using the 3-point scale.