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Abstract Introduction This study aims to compare sagittal condylar inclination (SCI) measurements derived from three workflows: intraoral scan (IOS) aligned with cone-beam computed tomography (CBCT), IOS aligned with facial scan (FS), and a jaw motion analyzer (JMA) system, in a cohort of young individuals with established normal occlusion. Additionally, the study aims to identify sources contributing to variance in these measurement approaches. Methods Twenty-four healthy individuals exhibiting normal occlusion were enrolled in this clinical trial. The SCI was delineated using a virtual articulator (VA) by aligning IOS with both CBCT and FS, creating two distinct workflows labeled CBCT-IOS and FS-IOS, respectively. Concurrently, SCI measurements were also acquired using a JMA. The normality of data distribution for the difference in bilateral SCI measurements within each workflow was tested using the Shapiro-Wilk test. Depending on the outcomes of this test, we utilized either a paired-sample T-test or Wilcoxon test for bilateral SCI comparisons. The inter-workflow differences were assessed using the Kruskal-Wallis H test. Bland-Altman plots were assess the interchangeability and consistency across each pair of digital methods and to evaluate the aggregate consistency among the trio of digital approaches. Results The analysis revealed that the CBCT-IOS workflow yielded the lowest average SCI measurements, whereas the JMA workflow produced the highest values. No significant differences were found in the SCI measurements between the left and right sides obtained by CBCT-IOS and JMA (P > .05), with the exception of the FS-IOS workflow (P = .002). Additionally, inter-flow comparisons revealed no significant differences in SCI measurements (P > .05), except when contrasting the SCI as measured by CBCT-IOS and JMA (P = .0131). The Bland-Altman plots demonstrated a high degree of consistency and 95% limits of agreement across the three digital workflows. Conclusion SCI measurements obtained from the three digital workflows exhibit a high degree of consistency and are interchangeable, affirming their clinical applicability for precise SCI assessment in young individuals with normal occlusion.

Introduction: This study aims to compare sagittal condylar inclination (SCI) measurements derived from three workflows: intraoral scan (IOS) aligned with cone-beam computed tomography (CBCT), IOS aligned with facial scan (FS), and a jaw motion analyzer (JMA) system, in a cohort of young individuals with established normal occlusion. Additionally, the study aims to identify sources contributing to variance in these measurement approaches. Methods: Twenty-four healthy individuals exhibiting normal occlusion were enrolled in this clinical trial. The SCI was delineated using a virtual articulator (VA) by aligning IOS with both CBCT and FS, creating two distinct workflows labeled CBCT-IOS and FS-IOS, respectively. Concurrently, SCI measurements were also acquired using a JMA. The normality of data distribution for the difference in bilateral SCI measurements within each workflow was tested using the Shapiro-Wilk test. Depending on the outcomes of this test, we utilized either a paired-sample T-test or Wilcoxon test for bilateral SCI comparisons. The inter-workflow differences were assessed using the Kruskal-Wallis H test. Bland-Altman plots were assess the interchangeability and consistency across each pair of digital methods and to evaluate the aggregate consistency among the trio of digital approaches. Results: The analysis revealed that the CBCT-IOS workflow yielded the lowest average SCI measurements, whereas the JMA workflow produced the highest values. No significant differences were found in the SCI measurements between the left and right sides obtained by CBCT-IOS and JMA (P >.05), with the exception of the FS-IOS workflow (P =.002). Additionally, inter-flow comparisons revealed no significant differences in SCI measurements (P >.05), except when contrasting the SCI as measured by CBCT-IOS and JMA (P =.0131). The Bland-Altman plots demonstrated a high degree of consistency and 95% limits of agreement across the three digital workflows. Conclusion: SCI measurements obtained from the three digital workflows exhibit a high degree of consistency and are interchangeable, affirming their clinical applicability for precise SCI assessment in young individuals with normal occlusion. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this article was to introduce a method for the digital application of three‐dimensional (3D) diagnosis and treatment with a virtual articulator and 3D data. Clinical Consideration: With the use of cone‐beam computed tomography (CBCT) and intraoral and facial scans, we can create a virtual articulator and evaluate the mandibular position in maximum intercuspation and centric‐related occlusion for the patient with an unstable occlusion and temporomandibular disorders (TMD). Based on this, we treated a case using a digital mandibular position indicator (MPI) and fabricated a stabilization splint using a 3D printer. This approach eliminates the traditional impression or model mounting process and the analog face bow transfer. Furthermore, the design of the stabilization splint is accomplished using software. Conclusions: The approach outlined in this article offers the potential for a digital diagnosis and treatment process by seamlessly integrating CBCT, intraoral scans, and facial scans with a high degree of accuracy. This may enhance precision in diagnosis and treatment planning, especially for patients with complicated TMD, in addition to facilitating effective communication with orthodontic patients who require thorough attention. Clinical Significance: Utilizing a virtual articulator and digital MPI for the occlusal evaluation of patients with TMD and unstable occlusion makes it possible to diagnose and analyze the occlusal condition accurately. This approach also allows for precision and efficiency in treatment. [ABSTRACT FROM AUTHOR]

The advent of digital technology has revolutionized the field of prosthodontics, ushering in an era of unprecedented precision, efficiency, and patient-centered care. This abstract explores the impact of digital dentistry on prosthodontic practices, focusing on the advancements that have transformed traditional approaches to restorative dentistry. Digital impressions, aided by intraoral scanners, have replaced conventional impression materials, offering improved accuracy and patient comfort. Computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies have streamlined the prosthetic fabrication process, allowing for precise and reproducible restorations. The utilization of three-dimensional (3D) printing in prosthodontics further extends the possibilities, enabling the fabrication of complex and patient-specific prostheses with enhanced material options. Virtual articulation and dynamic occlusal analysis have empowered prosthodontists to refine treatment planning, ensuring optimal function and esthetics in the final prosthetic outcomes. The integration of digital smile design tools has enhanced communication between clinicians and patients, fostering a collaborative approach in treatment decision-making. Additionally, the incorporation of digital workflows facilitates seamless interdisciplinary collaboration among dental professionals, promoting a comprehensive and integrated approach to patient care. Teledentistry platforms further expand accessibility to prosthodontic consultations, enhancing patient engagement and satisfaction. Despite these advancements, challenges such as initial setup costs, learning curves, and ongoing technological developments persist. Nevertheless, the undeniable benefits of digital dentistry in prosthodontics underscore its potential to redefine the standard of care in restorative dentistry, ultimately improving patient outcomes and shaping the future of prosthodontic practice. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Craniomandibular Function is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper presents a method for the digital transfer of the upper maxillary arch position using a facebow, a transfer table, and a reference block with a CAD application without requiring physical casts mounted with articulating gypsum. This technique facilitates the prosthetic digital workflow when the impression is made via intraoral scanning, to obtain the placement of the maxillary arch in the anatomical reference planes and in relation to the axes of rotation of the mandibular movements [ABSTRACT FROM AUTHOR]

Objective: Complete arch implant rehabilitation necessitates meticulous treatment planning and high‐level collaboration between surgical and prosthetic dental teams. Emerging virtual technologies hold considerable promise in streamlining this process. The aim of this article is to extend recommendations to clinicians venturing into the virtual patient‐assisted esthetic implant rehabilitation workflow. Overview: This article summarizes recommendations for virtual patient‐assisted esthetic implant rehabilitation in the following five aspects: three‐dimensional data handling and superimposition, occlusion and virtual articulator integration in creating virtual patients, streamlined face‐ and prosthetic‐driven surgical planning, reuse of presurgical data ("Copy & Paste"), and final impression for passive fitting of final restoration. To illustrate these principles, a case with complete‐mouth implant rehabilitation completed within six visits using this virtual patient workflow is presented. Conclusion: The virtual patient workflow serves as an invaluable tool to perform treatment planning, enhance efficiency, and ensure predictable outcomes in esthetic complete arch implant rehabilitation. Clinical Significance: Virtual workflows are increasingly prevalent in esthetic implant rehabilitation. Nevertheless, these workflows necessitate a distinct set of knowledge and tools divergent from conventional dentistry practices. This article offers guidelines and recommendations for dental clinicians who are new to this field. [ABSTRACT FROM AUTHOR]

"The Virtual Articulator in Aligner Orthodontics" explores the use of a virtual articulator in aligner orthodontics, which allows for accurate recording and matching of real jaw movements in virtual treatment simulations. The article highlights the technical procedure involved in digital joint recording and emphasizes the importance of matching real movement patterns in virtual treatment simulations. Additionally, the article discusses the use of digital technology in diagnosing and treating temporomandibular joint (TMJ) disorders, showcasing a case study where a patient with TMJ disorder experienced pain relief and improved movement patterns after using the virtual articulator. The text also discusses the use of digital joint recording in orthodontic treatment and the importance of determining a physiological condylar position for successful orthodontic treatment. [Extracted from the article]

Jaw motion tracking, which is introduced in recent case reports, is a method which records the patient’s individualized pathway of the mandibular movements along with facebow transfer, and reproduces the information in the virtual space of computer-aided-design/computer-aided-manufacturing (CAD-CAM) software. In this present case, a collapse of the occlusal plane was observed, due the loss of posterior teeth for a long period. Full-mouth rehabilitation with an increase in the occlusal vertical dimension was planned. First, the patient’s mandibular movements were recorded on the newly established jaw relation by jaw tracking, and this information was assembled with the patient’s intraoral data to create a virtual patient. Implant planning and diagnostic wax-up was done on the virtual patient, leading the fabrication of the provisional prosthesis. On the newly established jaw relation with an increase in the occlusal vertical dimension, canine guidance of the provisional prosthesis was checked. Finally, the provisional prosthesis was carried out to the definitive prosthesis. Using the advantages of the technologies in the digital dentistry, the patient was satisfied with the function and the esthetics after the treatment. [ABSTRACT FROM AUTHOR]

The progressive wear of teeth is a physiologic process of aging, but excessive wear can lead to occlusal disharmony, tooth sensitivity and pulp exposure, decreased masticatory efficiency, and aesthetic problems. It should be treated by evaluating the cause of tooth wear and establishing a stable centric relation with appropriate vertical dimension of occlusion and occlusal plane. The present case report successfully rehabilitated a full-mouth case of a severely worn dentition with the use of digital facebow transfer and virtual articulator. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to investigate a possible relation between skeletal phenotypes and virtual mounting data in orthognathic surgery patients. A retrospective cohort study including 323 female (26.1 ± 8.7 years) and 191 male (27.9 ± 8.3 years) orthognathic surgery patients was conducted. A k-means cluster analysis was performed on the mounting parameters: the angle α between the upper occlusal plane (uOP) and the axis orbital plane (AOP); the perpendicular distance (AxV) from the uOP to the hinge axis; and the horizontal length (AxH) of the uOP from upper incisor edge to AxV, with subsequent statistical analysis of related cepalometric values. Three clusters of mounting data were identified, representing three skeletal phenotypes: (1) balanced face with marginal skeletal class II or III and α = 8 ∘ , AxV = 36 mm and AxH = 99 mm; (2) vertical face with skeletal class II and α = 11 ∘ , AxV = 27 mm and AxH = 88 mm; (3) horizontal face with class III and α = 2 ∘ , AxV = 36 mm and AxH = 86 mm. The obtained data on the position of the hinge axis can be applied to any digital planning in orthognathic surgery using CBCT or a virtual articulator, provided that the case can be clearly assigned to one of the calculated clusters. [ABSTRACT FROM AUTHOR]

Purpose: To assess the influence of the number of teeth (2, 3, or 4) and location (molars, molar and premolar, or premolars and canines) of the bilateral virtual occlusal record on the accuracy of the virtual maxillo‐mandibular relationship acquired by an intraoral scanner (IOS). Material and methods: Diagnostic casts mounted on a semi‐adjustable articulator were obtained. Four markers were adhered on the facial surfaces of the first molars and canines. The mounted casts were digitized using an extraoral scanner. Maxillary and mandibular intraoral digital scans were obtained using an intraoral scanner (TRIOS 4). The maxillary and mandibular digital scans were duplicated 105 times and divided into 7 groups based on the number of teeth (2, 3, or 4) and location (molar, molar and premolar, or premolars and canines) of the bilateral virtual occlusal records (n = 15). The alignment of the scans was automatically performed after the acquisition of the corresponding occlusal records by the IOS program. Eight linear distances between the gauge balls were computed on the reference scan and on the 105 digital scans. The distances obtained on the reference scan were used to calculate the discrepancies with the distances obtained on each experimental scan. The Shapiro‐Wilk test showed that the data was normally distributed. The trueness and precision data were analyzed using 2‐way ANOVA followed by pairwise comparison Tukey tests (α = 0.05). Results: Two‐way ANOVA showed that the number of teeth (p < 0.001) and the position of the virtual occlusal record (p < 0.001) were significant factors on the accuracy of the maxillo‐mandibular relationship. Tukey test showed significant overall mean differences between the different groups tested: the 4‐teeth group obtained the highest trueness, and the 2‐teeth group showed the lowest trueness values (p < 0.001). Tukey test showed significant trueness differences between the virtual occlusal record locations. The 2‐teeth record located more posteriorly obtained the lowest trueness. Significant differences in precision values were found among the subgroups tested (p < 0.001). The 2‐teeth group obtained significantly more precision values than the 3‐ and 4‐teeth groups. Additionally, there was a significant difference in precision values between the subgroup tested in which the first molar and second premolar location had the highest precision, while the first and second premolar's location obtained the lowest precision. Conclusions: The number of teeth and the location of the bilateral virtual occlusal record influenced the accuracy of the virtual maxillo‐mandibular relationship obtained by the intraoral scanner tested. The more teeth included in the bilateral virtual occlusal record, the higher the accuracy of the maxillo‐mandibular relationship. Additionally, the more anteriorly located the virtual bilateral occlusal record involving 2 or 3 teeth was, the higher the accuracy mean value. [ABSTRACT FROM AUTHOR]

With the widespread application of digital impression techniques in prosthetic dentistry, accurate intraoral scan mounting, and virtual articulator parameters setting as per patients' anatomic structures are essential for treatment planning and restoration fabrication, especially for complex rehabilitation cases; meanwhile, marginal fit checking, occlusal adjustment, and porcelain layering of restorations are also crucial procedures in all cases in which the analog procedure to mount maxillary arches on a mechanical articulator is still required. This technique article presents an indirect digital approach that can first achieve virtual intraoral scan mounting and sagittal condylar inclination value setting of an Artex virtual articulator based on bony structures provided by a single cone beam computed tomography scan. It then facilitates the transfer of virtually mounted intraoral scans from the virtual articulator to the matched Artex mechanical articulator by relating a digitally scanned mounting plate of the Artex mechanical articulator to the virtual articulator, printing the intraoral scan and mounting plate scan assembly, and then mounting the printed casts on the mechanical articulator based on the printed mounting plate. This technique eliminates the conventional facebow transfer and protrusive bite registration procedures and offers a straightforward approach for the seamless integration of virtual environments and analog workflows into clinical practice. It aids in the design of restorations that are harmonious with the mandibular movements and reduces chairside adjustment time. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Craniomandibular Function is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The accuracy with which virtual articulators are able to simulate centric and eccentric movements when fabricating definitive restorations has not yet been proven to be on par with mechanical articulators which have been reliably used in restorative dentistry for decades. This may be an issue when working on complex restorative cases utilizing a digital workflow and could result in considerable chairside adjustment time and subsequent loss of occlusal anatomy and morphology. Interchanging between digital and analog workflows is a challenge as accurate cross-mounting is difficult due to the changes that occur as the digital and analog workflows progress. This technique article provides a method for the fabrication of simple digital mounting jigs that enable clinicians and laboratory technicians to mount printed digital wax-ups and working casts back onto a programmed mechanical articulator, opposing diagnostic casts that have originally been mounted by means of a facebow transfer. This allows for the positioning of printed digital wax-ups and working casts to be in the correct 3-dimensional spatial relationship on the mechanical articulator for any necessary occlusal adjustments of the digitally designed wax-ups and/or definitive restorations before they are moved chairside. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the accuracy of transferring casts in maximal intercuspal position to a virtual articulator by using transfer plates in the laboratory scanner before and after occlusal optimization. Material and methods: Five sets of standard dental casts were mounted on a mechanical articulator in maximal intercuspal position. The number and position of occlusal contacts were determined with 12‐μm articulating foil. After a calibration process according to the manufacturer's instructions, the mountings were transferred to a virtual articulator using the transfer plates in a laboratory scanner. The occlusion of the digital casts was determined before and after the occlusal optimization process. Then, the sensitivity and positive predictive value were determined by comparing the occlusal contact points in the virtual articulator with those in the mechanical articulator. To evaluate trueness, the occlusal surface of the maxillary teeth in the mechanical articulator was recorded by polyvinyl siloxane occlusal record in maximal intercuspal position and retained on the mandibular arch. The trueness was calculated as the deviation between the occlusal surface of the maxillary teeth in the mechanical articulator and the virtual articulator. To evaluate precision, one set of the casts was scanned 10 times. And the deviation of the interarch position of the maxillary arches when superimposing the mandibular arches of every 2 different scans was calculated. Results: The sensitivity before occlusal optimization (0.14 ± 0.15) was significantly lower than that after occlusal optimization (0.82 ± 0.10) (p = 0.003). However, there was no significant difference between the positive predictive value before (0.80 ± 0.45) and after (0.81 ± 0.09) occlusal optimization (p = 0.952). The trueness before (91.0 ± 10.7 µm) and after (75.4 ± 25.2 µm) occlusal optimization had no significant difference (p = 0.249). The precision before occlusal optimization (11.6 ± 3.8 µm) was significantly superior to that after occlusal optimization (75.6 ± 39.2 µm) (p < 0.001). Conclusions: The accuracy of transferring casts in maximal intercuspal position to a virtual articulator using transfer plates in the laboratory scanner could be improved after occlusal optimization and can meet the clinical needs for occlusal design and analysis of prostheses. [ABSTRACT FROM AUTHOR]

The paper presents the results of examination of patients with articulation disorders of the lower jaw caused by internal pathology of the TMJ. The purpose of the presented work: to study the effectiveness of the use of mechanical and virtual articulators in the functional diagnosis of patients with internal TMJ disorders. All patients underwent comprehensive clinical and instrumental examination including cone-beam computed tomography (CT) and axiographic examination (optical axiograph Dentograf Prosystom, Russia). CBCT was used to assess the state of the TMJ and determine the individual ratio of jaw and joint models. When axiography was recorded and analyzed articular trajectories of the lower jaw. In the first group of patients dynamic occlusion was evaluated using a mechanical articulator, in the second group a virtual articulator was used. It was revealed that the use of mechanical articulators in functional diagnostics to assess dynamic occlusion is limited and does not allow to obtain individualized patient data, their efficiency was 75%. The use of virtual articulators allows to evaluate the dynamic occlusion during opening and closing of the mouth, protrusion and laterotrusion, as well as the continuous movement of the lower jaw with the registration of all possible dental contacts. Due to the combination of CT data of the patient’s head and virtual models, the highest accuracy of placing models in the virtual articulator in accordance with the individual characteristics of patients was achieved.

Copyright of International Journal of Computerized Dentistry is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Customized cast orientations and parameter settings of the virtual articulator according to the patient's condyles are indispensable parts of today's digital workflows in prosthodontics. This article describes a digital technique to align the intraoral scans to a virtual articulator by using a facial scanner to locate the patient's cutaneous landmarks of the arbitrary hinge axis and the reference plane, and to customize the sagittal condylar inclination of the virtual articulator through a digital protrusive interocclusal record and a dental computer‐aided design software program. It enables individual cast orientations and virtual articulator parameter settings without conventional facebow transferring and bite registration procedures and can be easily integrated with most virtual articulator systems on the market to allow clinicians and technicians to work in a complete digital workflow and facilitate customized treatment planning and dental prosthesis fabrication. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the trueness and precision of virtual facebow records using a smartphone as a three‐dimensional (3D) face scanner. Material and Methods: Twenty repeated virtual facebow records were performed on two subjects using a smartphone as a 3D face scanner. For each subject, a virtual facebow was attached to his/her maxillary arch, and face scans were performed using a smartphone with a 3D scan application. The subject's maxillary arch intraoral scan was aligned to the face scan by the virtual facebow fork. This procedure was repeated 10 times for each subject. To investigate if the maxillary scan is located at the right position to the face, these virtual facebow records were superimposed to a cone‐beam computed tomography (CBCT) head scan from the same subject by matching the face scan to the 3D face reconstruction from CBCT images. The location of maxillary arch in virtual facebow records was compared with its position in CBCT. The "trueness" of the proposed procedure is defined as the deviation between maxilla arch position in virtual facebow records and the CBCT images. The "precision" is defined as the deviation between each virtual facebow record. The linear deviation at left central incisor (#9), left first molar (#14), and right first molar (#3), as well as angular deviation of occlusal plane were analyzed with descriptive statistics. Differences between two objects were also explored with Mann Whitney U test. Results: The 20 virtual facebow records using the smartphone 3D scanner deviated from the CBCT measurements (trueness) by 1.14 ± 0.40 mm at #9, 1.20 ± 0.50 mm at #14, 1.12 ± 0.51 mm at the #3, and 1.48 ± 0.56° in the occlusal plane. The VFTs deviated from each other by 1.06 ± 0.50 mm at #9, 1.09 ± 0.49 mm at #14, 1.11 ± 0.58 mm at #3, and 0.81 ± 0.58° in the occlusal plane. When all sites combined, the trueness was 1.14 ± 0.40 mm, and the precision was 1.08 ± 0.52 mm. Out of eight measurements, three measurements were significantly different between subjects. Nevertheless, the mean difference was small. Conclusions: Virtual facebow records made using smartphone‐based face scan can capture the maxilla position with high trueness and precision. The deviation can be anticipated as around 1 mm in linear distance and 1° in angulation. [ABSTRACT FROM AUTHOR]

Full mouth rehabilitation is re-organizing the occlusion of the remaining teeth and missing teeth considering the functions, esthetics, and neuromuscular harmony. With the loss of multiple teeth, the patient's occlusal plane gradually collapses and the vertical dimension can be reduced. Since reduced vertical dimension can be a potential etiology of the temporomandibular joint and masticatory muscles, prosthetic restoration with increased vertical dimension is required. This case report is about a 68 years old patient with vertical dimension loss due to worn dentition and multiple loss of teeth. In this case, the loss of vertical dimension is assessed carefully using the digital dentistry technology. Using CAD software in digital analysis step, the occlusal plane was established and evaluated using several criteria. Orienting the position of the bone and teeth using CBCT image, patient's condition was visualized in 3 dimension and treatment planning was possible virtually. The information that matches the patient's condylar position with the articulator, which is the virtual face bow, is reproduced on the actual articulator, and evaluated again. After the evaluation, provisional prosthesis was fabricated and it was confirmed that the patient adapts without any abnormality. This was implemented as a final prosthesis. As a result, the patient obtained satisfying results, utilizing the benefits of digital dentistry technology and traditional methods. [ABSTRACT FROM AUTHOR]

The provisional prosthesis is a prerequisite for prosthodontic rehabilitation. The purpose of this technique was to register facial and intraoral scans predictably. A 3D virtual patient was created through facial scans, intraoral scans, digital face‐bow transfer, and digital cross‐articulation technique. This virtual patient allowed predictable positioning of intraoral scans to a virtual articulator by using digital face‐bow transfer. The resulting virtual patient facilitated the design of definitive prostheses following a facially generated treatment planning principle. In addition, the virtual articulator was used to improve occlusal design on the definitive prostheses and reduce the need for intraoral adjustment. [ABSTRACT FROM AUTHOR]

Digital technology is broadly used in almost every part of medicine. As tools of digital technology, augmented reality and virtual reality have been adopted in all disciplines of dentistry and dental education. In particular, virtual articulators have allowed for a full analysis of occlusion with dental models that can simulate all mandibular movements in static and dynamic positions. When combined with additional software, virtual articulators can also enhance education and practice, allow for quicker and more precise individualized diagnoses and enable discussions of dental treatment planning options with patients during their first appointment. This article reviews the requirements for virtual articulators and occlusal recordings and assesses their advantages and disadvantages in various aspects. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of different residual dentitions on the dynamic adjustment of wear facet morphology on a single mandibular first molar crown with a virtual articulator. Materials and Methods: Gypsum casts (N = 12) of natural full dentitions were mounted on an articulator and scanned. The mandibular right first molar (#46) was prepared and a copy of the tooth before it was prepared and used to design the crown. The wear facets on the original #46 were selected and elevated by 0.3 mm in the occlusal direction to generate high points. The #46 with high points was segmented to create a digital wax pattern. Then different teeth were virtually removed to generate 4 types of residual dentitions: Type I (no teeth), Type II (adjacent teeth), Type III (ipsilateral posterior teeth and canine), and Type IV (all teeth). The crowns were adjusted dynamically with different residual teeth to guide mandibular movement of the virtual articulator. Three‐dimensional deviations, negative and positive volumes between crowns and wear facets on the original #46 were analyzed. The Kruskal‐Wallis test was used to analyze the results. Results: The mean deviation values and positive volumes decreased with the decrease in residual teeth, and the negative volumes showed an opposite trend. The mean deviation values, root mean square, and positive volumes were not significantly different. The negative volume of the crowns of Type I was different from that of Type IV (p = 0.031). Conclusions: Residual dentition affects the dynamic adjustment of wear facet morphology. When there are insufficient residual teeth, mandibular movements should be accurately measured. [ABSTRACT FROM AUTHOR]

Accurately mounting dental casts on an articulator is an essential step in prosthetic treatments. In digital dentistry, virtual articulator mounting procedures rely on virtual facebow records. However, virtual facebow records usually require devices like face scanners or jaw motion tracking systems that are not commonly available in most dental practices. The present technique report describes a straightforward intraoral scanner-based virtual facebow transfer approach. In this technique, a reference facebow joint support was first scanned and aligned with a virtual articulator. Then, a patient's facebow joint support and bite fork assembly were scanned chairside with an intraoral scanner and aligned with the virtual articulator by matching common features with the reference facebow joint support. After aligning the patient's intraoral scans with the patient's bite fork scan that was already superimposed on the virtual articulator, a virtual mounting process was achieved. Once the corresponding reference facebow joint supports have been generated, this technique can be easily implemented with most facebow systems and be seamlessly integrated into daily clinical practice as only an intraoral scanner and a conventional facebow were required., (© 2024 The Author(s). Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.)

The virtual patient, a unique computer simulation of the patient's face, teeth, oral mucosa, and bone, provides an extraordinary mechanism for digital dental implant surgery planning and prosthetic design. However, the seamless registration of digital scans with functional information in the context of a virtual articulator remains a challenge. This report describes the treatment of a 47‐year‐old male with full‐mouth guided immediate implant placement and immediate loading of CAD/CAM interim prostheses. Utilizing a novel digital workflow, a multifactorial registration of the vertical dimension of occlusion, centric occlusion, and facebow record were completed digitally and paired within a digital articulator. Utilizing this innovative approach, a complex treatment plan and procedure was executed smoothly with a successful prosthetic outcome demonstrating good fit, occlusion, esthetics, and patient reported satisfaction. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the effectiveness of patient-specific motion in restoring anterior guidance and to investigate the influence of occlusal plane position within a virtual articulator on the design of the anterior guide slope for incisors., Methods: Twenty participants' intraoral scan, occlusal plane position, and jaw motion data were recorded. The maxillary anterior teeth were virtually prepared, and the crowns were designed based on average virtual articulator (AVR), personalized virtual articulator (ART), and patient-specific motion (PSM). The anterior guide slope of maxillary central incisors (S 1 , S 2 , S c , S p ) and the mesio-distal angle (MDA) of the canine of prostheses were compared to that of natural teeth (NAT). One-Way ANOVA was utilized to evaluate the effectiveness of the three methods in restoring the anterior guidance of maxillary anterior teeth., Results: The comparison of S p and MDA showed no significant difference between the PSM and NAT groups (p > 0.05). However, S p of the ART group was significantly smaller, while MDA was higher than that of the NAT group (p < 0.05). S p did not differ significantly (p > 0.05) when the angle of the occlusal plane (AOP) was small. As the AOP increased, S p of the ART and AVR groups were significantly smaller than that of the NAT group (p < 0.05). With a large AOP, S p of the ART group was notably smaller than that of the NAT group (p < 0.05), while there was no significant difference between the AVR and NAT groups (p > 0.05)., Conclusions: Occlusal design based on patient-specific motion proved more effective in restoring natural anterior guidance. The anterior guidance of prostheses designed using a virtual articulator was influenced by occlusal plane position., Clinical Significance: The utilization of a jaw motion tracer facilitated the transfer of personalized occlusal plane positions and recorded jaw motion, which can be integrated into the digital prosthetic workflow for virtual occlusion adjustment. Occlusal design based on patient-specific motion more effectively restored lingual guidance of maxillary anterior crowns., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest, either directly or indirectly, in the information or products listed in the paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The articulator is a prerequisite device for the analysis of occlusion and prosthodontic treatment, and it is required to simulate patient jaw movements. This article describes the technique to obtain sagittal condylar inclination (SCI) using cone beam computed tomography (CBCT) data and intraoral scan of the protrusive interocclusal position. The SCI can be used on a virtual articulator in a computer‐aided design software, and it can assist in the fabrication of prosthesis which is harmonious with the mandibular movement of individual patient. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Computerized Dentistry is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. The aim of the study was to evaluate the use of 3D printed muscle relaxation splints made with EXOCAD software using a virtual articulator module for the treatment of disfunctional disorders of the temporomandibular joint (TMJ). Materials and methods. We examined 38 patients with disorders of the occlusal ratios of the jaws and clinical manifestations of TMJ disfunction (ventral dislocation of the articular disk of the TMJ with reposition). All patients underwent axiographic investigation before, during every 3 weeks, and also after the treatment. In group 1 (n=24) we used muscle relaxation splints made in a mechanical articulator, while in group 2 (n=14) the splints were modeled in a virtual articulator in accordance with axiographic findings. Results and discussion. The results of treating patients with subluxation of the TMJ articular disc with muscle relaxation splints made with mechanical and virtual articulators shown that the use of a virtual articulator resulted in minimal frequency of positioning errors in the articulator interframe space. We developed a method of occlusal surface modeling using a virtual articulator with loaded individual parameters of the lower jaw movements. It helped to considerably reduce inaccuracies of splint modeling occurring when a standard mechanical face bow with mechanical articulators is used. Conclusions. In patients with TMJ disfunction (ventral dislocation of the articular disc with reposition), the treatment is better with the use of printed tires made in the virtual articulator. The algorithm of the analysis of individual joint trajectories of the mandibular movements according to the axiography data and occlusal contacts in the modeling of muscle relaxing splints allows improving the quality of treatment of patients with disfunction conditions of TMJ. [ABSTRACT FROM AUTHOR]

Purpose: To study the effects of altering condylar settings and pin openings on the trueness and precision of virtual articulators vs. mechanical articulators. Materials and Methods: Maxillary and mandibular typodonts with fiducial markers were mounted on a mechanical Artex‐CR articulator, and the mandibular teeth were prepared to allow guidance solely by the posterior determinants of the articulator and the incisal table. The relationship of the mounted typodonts was preserved digitally by scanning using manufacturer transfer plate adaptors. On the mechanical articulator, pattern resin was allowed to set between the maxillary and mandibular occlusal surfaces (area #25‐30) at the endpoints of dynamic movements at 3 condylar inclinations (SCI): 10°, 30°, and 45°, n = 12/inclination, or at 3 incisal pin openings (2, 5, and 10 mm, n = 12/opening). All other articulator settings were kept constant. Resin specimens attached to the typodonts were scanned within 5 minutes of setting, then removed, and the articulated typodonts rescanned. Fixed dental prostheses (FDPs) #25‐30 were designed on the virtual articulator using identical parameters to the mechanical articulator. Dynamic virtual movements were used to sculpt the design, and a file of the design was saved. The files of both types of samples were aligned and overlaid. Interocclusal separation was measured in triplicate at the indentation created by the mesiolabioincisal point angle on the incisal edge of #8 and the mesiobucco‐occlusal point angle of #3. Trueness and precision of both types of articulators were calculated and compared using one‐way ANOVA, followed by the Tukey HSD test (α = 0.05). Results: There was no statistically significant difference at altered pin openings in either trueness (F = 0.202, p = 0.37) or precision (F = 3.134, p = 0.09) for the majority of measurements. The only significant difference was in the precision between the 2 types of articulators at 5 mm incisal opening, and only at the anterior measurement point (F = 15.134, p = 0.0008); however, these differences were less than 100 μm. When the SCI was altered, there was no statistically significant difference (F = 3.624, p > 0.05) between the virtual and mechanical articulators in trueness for 5 of the 6 measurements obtained (F = 3.624, p = 0.07) or for all of the precision measurements (F = 3.529, p = 0.07). The one trueness measurement that was significantly different (F = 9.237, p = 0.006) occurred at SCI of 10°, and it was less than 100 µm. Conclusions: Dynamic movements on the virtual articulator were shown to be as true and precise as to the mechanical articulator. When there were deviations, these deviations were less than 100 µm and thus, these deviations may not be clinically relevant. [ABSTRACT FROM AUTHOR]

Objectives: This clinical study aimed to evaluate the accuracy of a fully digital technique for measuring sagittal condylar inclination (SCI), as well as validating whether differences existed between the left and right SCI values of the same participant, to provide a reference for clinical practice., Methods: Ten participants with good occlusal relationship and normal temporomandibular joint were recruited. Three methods were used to measure the SCI values of the participants, namely, A (mechanical facebow transferring and mechanical articulator-based measuring method with physical protrusive interocclusal registration), B (face scan-based virtual facebow and virtual articulator-based measuring method with digital protrusive interocclusal registration), and C (jaw motion tracking system-based measuring method). With the group subjected to methods A and C as the control, the SCI values obtained by the three methods were statistically analyzed. The left and right SCI values of the same participant were also compared., Results: The left and right SCI values measured by method A were 41.70°±7.09° and 42.80°±8.62°, those by method B were 35.09°±12.49° and 37.63°±12.10°, and those by method C were 39.43°±8.72° and 38.45°±6.91°. No significant difference existed among the SCI values measured by the three methods ( P >0.05). Meanwhile, no statistical difference existed between the SCI values on the left and right sides of the same participant ( P >0.05)., Conclusions: The accuracy of the virtual facebow and digital protrusive occlusal registration based SCI measuring method was the same as that of mechanical facebow based and jaw motion tracking system-based methods. The SCI values on the left and right sides of the same participant were similar. Clinically, an appropriate SCI measurement and setting strategy can be selected based on the actual situations.

The virtual articulator (VA) is a technology that simulates the jaw relation in a computer-generated setting. Augmented and virtual reality have been utilized as digital technology, which aids in many areas of dentistry and dental education. Today, a practicing dentist must keep up with the newer technologies, but with technology evolving so quickly it becomes challenging. In dentistry, the possibilities for digitization and technological advancements are limitless. Virtual articulators (VAs) allow a complete occlusion analysis using dental models that replicate all mandibular motions in static and dynamic scenarios. VA when executed in addition to other software enhances treatment planning and patient education, allowing quicker and more precise individualized diagnoses. The main objective of this study was to describe and evaluate the study outcomes in the available research on VAs, assess their needs, and evaluate their advantages and limitations in various aspects. A PubMed Central search was made of dental journals, with the identification of 135 articles out of which 30 were finally selected. The investigations conducted to evaluate the VA's dependability provide good visualization of the quantity and location of the dynamic interactions. A precise instrument for fully analyzing occlusion in a real patient is the virtual articulator., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Doshi et al.)

Abstract Purpose To introduce a new and simple digital workflow to record dynamic occlusion, and apply it to occlusal analysis and prosthetic treatment in a virtual environment. Methods A table-top scanner (Identica hybrid) was used to transfer fabricated casts into a virtual environment. A facial scanner (Rexcan CS2) was used for facial scanning and target tracking. Four targets were attached to each of the four incisors in the maxilla and mandible to track jaw movement. Target position data were recorded in real time during eccentric movement. The targets were replaced with maxilla and mandible cast scan data, and mandibular movement relative to the maxilla was reconstructed. Four types of antagonist meshes were reconstructed in computer-aided design (CAD) software (EzScan8). The CAD software (Exocad) enabled checking of occlusal contacts in the maximal intercuspation position during eccentric movement. Conclusions Target tracking data were transformed into video clips of dental cast scan data, which showed jaw movements in real time. Occlusal contact information was produced by the CAD software. Both dynamic and static occlusion analyses were performed with reconstructed eccentric movement antagonist meshes. Our new method for reconstructing eccentric movements of the mandible can reveal the occlusal dynamics of a patient within a virtual environment. [ABSTRACT FROM AUTHOR]

Association between tooth morphology, occlusal relations and mandibular condyle/glenoid fossa morphology is still a controversial issue in dentistry. The aim of the present study was to examine the influence of three important articular parameters on the dental morphology and the crown volume, quantifying the variation for each tooth group: incisor, canine, premolar and molar. Materials and methods All maxillary teeth from a set of basic study models were prepared for zirconia single crowns. The models were scanned and then, using a computer aided design software, they were mounted in a virtual articulator and specific mandibular movements were defined. The crown morphology was designed and statically adapted. Ten models were obtained by dynamical adjustment of the basic model for successively modified articular parameters: sagittal condylar inclination (SCI) = 30°, Bennett angle (BA) = 10°, Immediate side shift (ISS) = 0.5 mm — for control and SCI: 40°, 50° and 60° with BA and ISS as control, BA: 15°, 20° and 25° with SCI and ISS as control, ISS: 1.5 mm, 1.0 mm and 0.0 mm with SCI and BA as control — for the nine test models. The following measurements were performed three times on the right side of each model: volume for each tooth group, slope (S) for the central incisor, S and mesio-distal angle (MDA) for canine, S, MDA and vestibulo-oral angle (VOA) for the first premolar and molar. Results When SCI was varied, statistically significant changes as compared to the controls were found for incisor’s and premolar’s S, premolar’s VOA and, for 50° and 60°, MDA and molar’s MDA (for 50°) and VOA (for 60°). When BA was varied, significant changes were found for S (canine) and, in certain models, MDA (premolar, molar). Variations of ISS significantly changed mainly MDA for molars and, in two models, premolars. Conclusions Within the limits of this study, among the articular parameters, SCI mostly influenced the dynamic tooth morphology, but canine and molar morphology was stronger influenced by BA and/or ISS. [ABSTRACT FROM AUTHOR]

To date, the traditional methods of instrumental diagnosis of occlusion and TMJ - quite time consuming and difficult to perform.Requires a very high qualification of experts capable of conducting such a diagnosis. In this regard, the existing and evolving digital technologycan not only producevarious removable and nonremovableorthodonticand orthopedicdesign, but also allow for a precise and easier to perform, diagnoseocclusion of dentition with the biomechanicsof the temporomandibular joint and the aesthetics of the patient's face.

Objectives: The aim of this study was to clinically evaluate the accuracy of a digital axiographic recording system in tracing the sagittal condylar inclination., Methods: An axiographic examination that records the sagittal condylar path during protrusive/retrusive movement was performed on ten patients. Each subject was registered five different times by two different systems: 1) the Cadiax Gamma Diagnostic 4 computerized system as the control; 2) the Zebris Jaw Motion Analyser+  Optic System as the tested digital axiographic recording system. The records obtained allow to calculate the kinematic terminal transverse horizontal axis and the sagittal condylar inclination (SCI) at 3 and 5 mm along the pro-retrusive path. A linear mixed model was used to analyze if there was a statistically significant difference between the two systems., Results: The mean left SCI value recorded by Zebris system were 49.81 ± 10.64° at 3 mm, 48.10 ± 11.04° at 5 mm, while the values recorded by Gamma system were 55.16° at 3 mm, 52.18° at 5 mm. The mean right SCI value recorded by Zebris system were 54.53 ± 10.26° at 3 mm, 51.85 ± 8.55° at 5 mm, while the values recorded by Gamma system were 49.68° at 3 mm, 48.23° at 5 mm. Linear mixed model showed no significant statistical difference between the two systems., Conclusions: Based on preliminary results, the Zebris Jaw Motion Analyzer+ Optic System demonstrates comparable accuracy to the Cadiax Gamma Diagnostic 4 when measuring sagittal condylar inclination., Clinical Significance: The digital axiographic recording system enables to evaluate sagittal condylar inclination and to adjust virtual articulators in a digital workflow., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Objectives: This study aimed to compare the effects of virtual adjustment on occlusal interferences in mandibular posterior single crown and three-unit bridge restorations by using the mandibular movement track and the movement parameters of a virtual articulator., Methods: Twenty-two participants were recruited. Digital casts of the maxillary and mandibular arches were obtained using an intraoral scanner, and the jaw registration system was used to record the data of the mandibular movement track and the movement parameters of the articulator. Four kinds of restorations with 0.3 mm occlusal interferences were designed with dental design software. In particular, single crowns were designed for teeth 44 and 46, whereas three-unit bridges were designed for teeth 44-46 and 45-47, and the corresponding natural teeth were virtually extracted. Virtual adjustment of the restorations was performed using two dynamic occlusal recordings, namely, the mandibular movement track and the movement parameters of the virtual articulator. A reverse-engineering software was used to measure the root-mean-square of the three-dimensional deviation of the occlusal surfaces between natural teeth and the adjusted restorations. The differences between the two methods of virtual-occlusion adjustment were compared and analyzed., Results: For the same group of restorations, the three-dimensional deviation of the mandibular movement track group were lower than those of the virtual articulator group, and the differences were statistically significant ( P <0.05). For the four groups of restorations adjusted by the same method, the three-dimensional deviation of the 46-tooth single crown was the largest and the smallest three-dimensional deviation was that of the 44-tooth single crown. Statistical differences existed between the 44-tooth single crown and the other groups ( P <0.05)., Conclusions: For the occlusal design of posterior single crown and three-unit bridge, the mandibular movement track could be a more effective approach to virtual occlusal adjustment than the movement parameters of the virtual articulator.

Today, virtual reality has a broad spectrum of applications in fields as diverse as architecture, sports, arts or medicine. One of the applications of virtual reality in medicine is the virtual articulator, a digital instrument that was designed as a tool for comprehensive analysis of static and dynamic occlusal relations, the purpose being to substitute the use of mechanical articulators and consequently, of the mechanical errors involved by their use. This paper is a systematic review of the literature on published studies about the functionality and application of the virtual articulators in the analysis of dental occlusion. An electronic search was conducted based on a combination of keywords, using the search engines of Pubmed/Medline and ScienceDirect. Most of the identified studies show that the reproduction of occlusal contacts using virtual articulators has superior, or at least similar, fidelity compared to the conventional techniques, both in static or dynamic manners. [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Computerized Dentistry is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose The purpose of this review is to present a comprehensive review of the current published literature investigating the various methods and techniques for scanning, designing, and fabrication of CAD/CAM generated restorations along with detailing the new classifications of CAD/CAM technology. Study selection I performed a review of a PubMed using the following search terms “CAD/CAM, 3D printing, scanner, digital impression, and zirconia”. The articles were screened for further relevant investigations. The search was limited to articles written in English, published from 2001 to 2015. In addition, a manual search was also conducted through articles and reference lists retrieved from the electronic search and peer-reviewed journals. Results CAD/CAM technology has advantages including digital impressions and models, and use of virtual articulators. However, the implementation of this technology is still considered expensive and requires highly trained personnel. Currently, the design software has more applications including complete dentures and removable partial denture frameworks. The accuracy of restoration fabrication can be best attained with 5 axes milling units. The 3D printing technology has been incorporated into dentistry, but does not include ceramics and is limited to polymers. In the future, optical impressions will be replaced with ultrasound impressions using ultrasonic waves, which have the capability to penetrate the gingiva non-invasively without retraction cords and not be affected by fluids. Conclusion The coming trend for most practitioners will be the use of an acquisition camera attached to a computer with the appropriate software and the capability of forwarding the image to the laboratory. [ABSTRACT FROM AUTHOR]

Virtual reality is a computer based technology linked with the future of dentistry and dental practice. The virtual articulator is one such application in prosthetic and restorative dentistry based on virtual reality that will significantly reduce the limitations of the mechanical articulator, and by simulation of real patient data, allow analyses with regard to static and dynamic occlusion as well as to jaw relation. It is the purpose of this article to present the concepts and strategies for a future replacement of the mechanical articulator by a virtual one. Also, a brief note on virtual reality haptic system has been highlighted along with newly developed touch enabled virtual articulator.