Technology in Dentistry by

Image Quality - Nomad vs Wall-Mounted Device

petrichandie — 2021-09-08 17:50:51 UTC

This article compared the quality of images taken by portable x-ray devices (such as the Nomad) and standard wall-mounted devices, like the ones we use in clinic at MSU. The study was done to see if portable x-ray devices are capable of producing the same, better, or worse diagnostic images. The study showed that portable x-ray devices are capable of capturing images that are as diagnostic as those from a wall-mounted device. The only difference is, the operator seems to make a difference. When the dentist is the operator, the images tend to be better in quality vs when dental assistants or hygienists are the operators. Portable x-ray devices are a great choice, but make sure the operator is properly trained so the images are of quality.

Operator's Radiation Dose

petrichandie — 2021-09-08 18:02:25 UTC

This study was conducted to find out the level of operator dose received when using a handheld x-ray device, such as the Nomad, in various positions. A few different positions were used, differing in being parallel/perpendicular to the ground & the distance the device was held out from the operator. The study found that the operator's positioning related to the device has a significant effect on how much radiation is exposed to the operator. The levels of radiation are still well below the recommended levels of the Ionizing Radiation Regulations of 1999, so they are still safe to use however, training should be done before operating.

Handheld X-ray Devices in a Morgue Setting

petrichandie — 2021-09-08 18:12:08 UTC

This article talked about the use of handheld x-ray devices in a morgue setting, and if it is safe for the forensic dental professional to use one. In a morgue setting, x-rays are used, mainly, to identify the victim. It would be very hard to take x-rays in the patient's mouth without the patience compliance. Now that there are handheld x-ray devices, they have found that they work very effectively in taking diagnostic x-rays, while posing no significant health risks to the dental professional in the room.

Advantages vs Disadvantages

petrichandie — 2021-09-08 18:21:46 UTC

Advantages:

•Portable

•Sharp
•Clear images
•Less retakes
•Less chance of patient movement

Disadvantages:
•Operator fatigue - due to weight of device
•Sharing with other clinicians
•Charging the battery
•Disinfection

Cost

petrichandie — 2021-09-08 18:26:15 UTC

There's a wide variety of handheld x-ray devices so there's a wide range in the price. I have found x-ray devices from $1,900-$7,200.

petrichandie — 2021-09-08 18:27:54 UTC

Oral Irrigators + Periodontitis

petrichandie — 2021-09-14 16:45:11 UTC

This study was done to determine the effects of oral irrigators improving periodontal conditions and reducing the recurrence of periodontitis among patients during periodontal maintenance therapy. Over a 6-year cohort study, 142 patients who attended at least 1 periodontal maintenance visit within 12 months were eligible to participate. They were separated into 3 groups: 1.) manual brushing/dental flossing + interdental brushes 2.) manual brushing/dental flossing + oral irrigator and 3.) manual brushing/dental flossing alone. The results show us that manual brushing/dental flossing alone is not as effective as manual brushing/dental flossing + the use of an oral irrigator or interdental brush.

Does Bacteria Accumulate in the Nozzle?

petrichandie — 2021-09-14 16:49:01 UTC

This study was performed with 5 participants over the course of 3 weeks. Saliva samples and water-jet samples of devices used daily with bottled water were collected to test the colony forming units (CFU). The results showed that daily use of a power-driven water flosser for 3 weeks resulted in bacterial colonization in the nozzle of the device. The bacteria from the water jet can be transmitted, so your best bet would be to clean your device after each use.

petrichandie — 2021-09-14 16:51:54 UTC

Advantages vs Disadvantages

petrichandie — 2021-09-14 16:57:52 UTC

Advantages:

•Easy to use

•Gets in hard-to-reach areas
•Clean between tightly spaced teeth
•Gentle on gums = less likely to cause pain and bleeding

Disadvantages:

•Can be costly

•Messier than string floss
•Plaque removal
•Device needs to be cleaned

petrichandie — 2021-09-14 17:00:19 UTC

Oral irrigators have been clinically proven to provide significant oral health benefits to users, including those with implants, crowns, braces, and even diabetes.

Cost

petrichandie — 2021-09-14 17:06:07 UTC

After doing some research, I found oral irrigators as cheap as $29.99, and a few that go for as much as $499.99. I just purchased the Aquarius Professional Waterpik for $44.99, but it was regularly priced as $99.99.

petrichandie — 2021-09-14 17:07:39 UTC

Effectiveness

petrichandie — 2021-09-14 17:16:50 UTC

This study was done to evaluate the effectiveness of water flossers on plaque, calculus, and overall gingival health. 32 patients agreed to participate and 29 patients completed the double blind clinical trial. Prior to the trial, all patients teeth were cleaned, making their plaque, calculus, and gingival indices zero. After the patients used the oral irrigators for X amount of time, their indices were checked again. Results showed that the use of a magnetized water oral irrigator showed 64% less calculus formation.

petrichandie — 2021-09-20 21:45:15 UTC

This article was written about a book written by two dental hygienists. The pair wrote a book about the use of lasers by dental hygienists and was very interesting to read the summary of clinicians who use these devices in practice. The book was in favor for the use of lasers.

petrichandie — 2021-09-20 21:47:13 UTC

petrichandie — 2021-09-20 21:49:46 UTC

The use of lasers in dentistry is fairly new, and this article goes over the ins and outs of diode lasers as if you had no prior knowledge.

petrichandie — 2021-09-20 21:51:18 UTC

This article talks about how versatile diode lasers are when used in dentistry. The 5 following patients reported to an office where diode lasers were used for treatment:
•21-year-old female with ankyloglossia
•65-year-old female with a poor denture fit needing vestibuloplasty and frenectomy
•10-year-old male with pigmented gingiva in mandible and maxilla
•14-year-old female needing exposure of maxillary right canine for bracket bonding
•25-year-old female who has a gingival maxillary frenum with a nodule
All procedures went smoothly using the lasers and are suggested for use for future procedures rather than conventional surgery in the field of oral soft tissue surgery.

petrichandie — 2021-09-20 21:56:57 UTC

Advantages:

•Painless

•Portable & compact
•Minimal swelling
•Less invasive
•Excellent hemostasis

Disadvantages:
•Expensive
•Patient willingness

Cost

petrichandie — 2021-09-20 22:05:28 UTC

The initial investment of a diode laser is most commonly between $3,000-$10,000 but can generate $15,000-$40,000 in added revenue per year.

Uses

petrichandie — 2021-09-20 22:09:13 UTC

•Laser bacterial reduction
•Reduction of inflammation
•Pocket therapy
•Periodontal debridement
•Aphthous ulcers & herpetic lesions
•Hemostasis

Effectiveness with Orthodontic Treatment

petrichandie — 2021-09-29 15:50:31 UTC

This study was done to determine the effectiveness of orofacial myofunctional therapy (OMT) as an adjuvant to orthodontic treatment in individuals with orofacial disorders. The researchers found that the combination of OMT and orthodontic treatment was more successful in correcting lip incompetence than OMT alone. The findings of the present systematic review demonstrate a scarcity of consistent studies and scientific evidence supporting the use of OMT in combination with orthodontic treatment to achieve

better results in the correction of dentofacial disorders in individuals with orofacial abnormalities.

Effectiveness in Closing Anterior Open Bites

petrichandie — 2021-09-29 15:50:45 UTC

In this study, they investigated the efficacy of orofacial myofunctional therapy (OMT) for maintaining closure of open bites in conjunction with orthodontic treatment. 76 subjects with anterior open bites were selected to participate for 2 months to 23 years. The study showed that OMT in conjunction with orthodontic treatment was highly effective in maintaining closure of anterior open bites compared with orthodontic treatment alone.

OMT with Class II Malocclusion

petrichandie — 2021-09-29 15:50:58 UTC

In this study, an adult with a class II division I malocclusion with nonextraction and assisted by lip myofunctional training was followed to determine the success. The patient had problems in both dental tissue and facial soft tissues because of her structure. Her chief complaints were her protrusive upper teeth (10mm overjet) and incompetent lip. After receiving treatment, the results showed that orthodontic treatment assisted by lip myofunctional training is an effective option to achieve optimal facial esthetics and long‐term dentoalveolar stability in adult patients with Class II division 1 malocclusion.

petrichandie — 2021-09-29 15:51:44 UTC

Cost

petrichandie — 2021-09-29 15:55:59 UTC

Cost of therapy can vary based on therapist/provider and region. Sessions are generally charged per visit or as a full myofunctional therapy program consisting of a number of prescribed sessions. Myofunctional Therapy Programs can range from $1400-$3000.

petrichandie — 2021-09-29 16:05:03 UTC

How it works:
MRC has pioneered the use of appliances to correct myofunctional habits in growing children and has proven success in orthodontic correction without braces. This treatment can also lead to better facial development. The key to this treatment is correcting the position and function of the tongue, obtaining correct nose breathing and retraining the oral muscles to function correctly.

Goals of treatment:

•Lips together at all times except when speaking or eating

•Breathe through the nose, to assist the development of the upper and lower jaws, and to achieve the correct bite
•No lip activity when swallowing, allowing the front teeth to develop correctly
•Improved dental alignment
•Improved facial development

For a successful outcome:
The Myobrace appliance must be worn daily for 1-2 hours + overnight while sleeping.

Advantages vs Disadvantages

petrichandie — 2021-09-29 16:30:19 UTC

Advantages:

•Correction of many myofunctional problems

•Assists developing teeth and jaws
•Facial aesthetics

Disadvantages:
•Patient cooperation

petrichandie — 2021-10-07 00:50:39 UTC

Effectiveness during SRP

petrichandie — 2021-10-07 01:43:09 UTC

This study was done to determine the effectiveness of using a periodontal endoscope while performing scaling and root planing. 100 teeth from 15 subjects were chosen to participate, with some receiving treatment with the periodontal endoscope, and the others receiving treatment without the periodontal endoscope for a total of 40 minutes. Results proved that the use of a periodontal endoscope has a significant improvement in removing calculus, especially in areas with deeper pockets. Results also showed that the time the clinician spent in each pocket was significantly less due to actually being able to see the calculus.

Is it painful?

petrichandie — 2021-10-07 01:43:46 UTC

This study was performed in order to determine if periodontal endoscopes inflict any pain on our patients. 30 subjects were used and a periodontal probe was used to compare the feeling of a periodontal endoscope while receiving treatment. Prior to treatment, the subjects completed a survey to determine their level of dental anxiety, to take that into consideration for their pain threshold. The level of perceived pain was significantly higher with the periodontal probe than with the endoscope, meaning that subjects did not find the periodontal endoscope to inflict any pain.

Endoscopy vs Tactile Sensitivity

petrichandie — 2021-10-07 01:45:13 UTC

This study compares the level of subgingival calculus detection when using an 11/12 Explorer alone versus in conjuction with a periodontal endoscope. 26 subjects with moderate periodontitis participated in this study, exploring 1 quadrant alone and 1 with the endoscope. Results concluded the addition of a visual component was extremely beneficial for the clinician, especially during the re-evaluation phase of treatment. The patients who agree to use a periodontal endoscope during their treatment will receive the best care available because the clinician will no longer be working blindly.

View with a Periodontal Endoscope:

petrichandie — 2021-10-07 01:45:38 UTC

CMOS sensor is equivalent to film .65mm in diameter

Cost

petrichandie — 2021-10-07 01:55:44 UTC

The initial cost of a periodontal endoscope is around $31,000, but first-time buyers can get it on discount for 30% off. The sheath that wraps around the cord are to be thrown away after each appointment and cost $79 for the clinician. The patient will pay between $100-$400 per quadrant to use the periodontal endoscope during their treatment.

Advantages vs Disadvantages

petrichandie — 2021-10-07 02:02:32 UTC

Advantages:
•40% of calc is missed without

•Less recession --> less sensitivity
•Non-surgical

•Simple pain management --> no opioids
•Definitive
•Improved oral/systemic health
•Enables detection of other problems
•No gingival flap surgery

Disadvantages:
•Cannot be used in pockets <4mm
•Loss of clarity
•Initial cost
•Cost of individual sheaths

Precision of Impressions

petrichandie — 2021-10-20 17:08:04 UTC

This study was done to evaluate the precision of digital intraoral scanners compared to the standard use of extraoral images. The patients who participated in the study had 10-full arch intraoral scans and took impressions and digitized those 10 times. The intraoral scanners seemed to be less accurate than model scanning because of saliva and the limited space in the mouth.

Accuracy of Full Arch Scans

petrichandie — 2021-10-20 17:08:34 UTC

The accuracy of intraoral scanners in full-arch scans were put to the test in this study. A model with 14 prepared abutments was digitized using an industrial scanner as well as 4 intraoral scanners (iTero, CEREC AC Bluecam, Lava COS, and Zfx Intrascan). The data collected was loaded into 3D evaluation software to compare the accuracy. Results showed that the intraoral scanners were comparably accurate except for the CEREC AC Bluecam.

2 New iTero Scanners

petrichandie — 2021-10-20 17:09:19 UTC

Align Technology is a manufacturing company that specializes in 3D scanners and Invisalign clear aligners used in orthodontics. They have recently came out with two new iTero scanners. The first being iTero Element 2 and the second being iTero Element Flex Scanners. The new additions have even better precision, full-color imaging, and fast scan times.

Advantages vs Disadvantages

petrichandie — 2021-10-20 17:10:20 UTC

Advantages:
•Restorative scanner (replaces alginate)
•Full mouth intraoral photos
•Interproximal caries detection
•3 minute scan
•Time lapse feature
•Outcome simulator
•Patient education
•80% of people learn visually
•Occlusogram

Disadvantages:
•Initial cost
•Patient comfort

Cost

petrichandie — 2021-10-20 17:13:23 UTC

An iTero scanner can cost anywhere from $10,000-$40,000. It is a bit of an investment, but it well worth it from the amount of information it can give you. It costs the patient $0 to use during their appointment.

petrichandie — 2021-10-20 17:14:37 UTC

petrichandie — 2021-11-03 19:59:19 UTC

petrichandie — 2021-11-03 19:59:29 UTC

Dentin-Exposed Incisal/Occlusal Tooth Wear

petrichandie — 2021-11-03 19:59:52 UTC

This study was done to prove that detection of dentin-exposed occlusal/insical tooth wear is important and can be done by using light-induced fluorescence technology. 73 adults (1,949 teeth) were used to conduct this study. Results showed that pathological tooth wear, particularly in posterior teeth, can be detected. To prolong tooth life expectancy, tooth wear resulting in dentin exposure should be detected early.

Benefits in Orthodontic Treatment

petrichandie — 2021-11-03 20:00:07 UTC

During fixed orthodontic therapy, arch-wires, brackets, and elastic modules have been shown to be sites of significant plaque accumulation, making it difficult for a patient to maintain proper oral hygiene. For dentists, it is hard for them to visualize the biofilm accumulation. This study was conducted to determine if fluorescence technology can offer a new method of detection of demineralization during orthodontic treatment.

Dental Plaque in Children (Red Fluorescence)

petrichandie — 2021-11-03 20:00:16 UTC

This study looked at the use of red fluorescent lights and their part in detection of dental caries. The microbial composition of dental plaque from sites with red fluorescent plaque (RFP_ and from sites with no red fluorescent plaque (NFP) was assessed. Fluorescence pictures were taken from 50 children with overnight plaque. There were no clinical relevant correlations in this cross-sectional study between the presence of RFP and early caries lesions.

Cost

petrichandie — 2021-11-03 20:00:30 UTC

To use the Oral ID, there is a $200 fee each month for the dental office, and $125 for extra machines. Most offices perform the screenings at no cost for the patient.

Advantages vs Disadvantages

petrichandie — 2021-11-03 20:00:48 UTC

Advantages:
•Wide variety of uses
•Early detection of oral cancers
•No upfront costs
•Can be used in multiple operatories
•Easy to use
•Battery operated
•Patient's health

Disadvantages:
•Continual cost

What is it and how is it used?

petrichandie — 2021-11-03 20:03:41 UTC

OralID is an adjunctive screening device that uses fluorescence technology to aid clinicians in visualization of oral abnormalities, such as cancer. During the Fluorescence Assessment, we are looking for dark lesions. If you discover any lesions that appear dark, or abnormal, experts suggest you re-assess within 2 weeks. Any trauma due to thermal or mechanical damage will have healed by that time.

Cost

petrichandie — 2021-11-17 14:47:15 UTC

The use of teledentistry helps patients save money and time, as well as the dental team who are saving tools/resources and time. For billing patients for using this resource, there are insurance codes to use, D9995 and D9996, in adjunct to the procedures performed during the online appointment.

Advantages vs Disadvantages

petrichandie — 2021-11-17 14:48:22 UTC

Advantages:
•No travel time/expenses
•Easy to schedule/navigate
•Readily available
•Growing field
•Able to reach a greater population
•Great resource to use during a pandemic

Disadvantages:
•Unavailable to patients without internet
•Cannot receive a cleaning via teledentistry
•Signal strength problems

petrichandie — 2021-11-17 14:50:56 UTC

What is it?

petrichandie — 2021-11-17 15:27:08 UTC

Teledentistry is the use of electronic information, imaging and communication technologies, including interactive audio, video, data communications as well as store and forward technologies, to provide and support dental care delivery, diagnosis, consultation, treatment, transfer of dental information and education.

Teledentistry & COVID-19

petrichandie — 2021-11-17 15:47:39 UTC

This article takes a look at how many people were interested in Teledentistry in the midst of the COVID-19. Data was gained by looking at search engines with the following phrases, "emergency dental care," "oral health," "teledentistry," and a few other words. Teledentistry was a great resource for patients and clinicians to use.

Should dental schools implement Teledentistry?

petrichandie — 2021-11-17 15:59:26 UTC

This article looks at dental schools and the option of whether or not to include teledentistry in their curriculum. One viewpoint discusses how it's a new cutting-edge technology that can improve access to care to underserved populations and provide a cheaper alternative. The other viewpoint discusses how it's too new to show evidence of support. There isn't enough regulations with legal and regulatory requirements, and insurance companies are resistant to pay or reimburse for this service. The authors of the article support that a policy should be developed and all teams should be on the same page (insurance, the state, the government, and dental professionals) and work together in order to try and implement it.

How useful is Teledentistry?

petrichandie — 2021-11-17 16:59:07 UTC

This systematic review, conducted by the British Dental Journal, was performed to determine the effect of teledentistry-based strategies, reported in randomized controlled trials and quasi-randomized trials, with a focus on oral health prevention and promotion-related outcomes in patients of all ages. Teledentistry was successful in helping the patients reach a dentist in their community, but wasn’t as effective in other areas. The author suggests that teledentistry is a promising tool for clinicians to use for preventing, diagnosing, and promoting oral health, but not as effective with treating the conditions.

What is it?

petrichandie — 2021-11-22 23:48:13 UTC

Air polishing involves the use of compressed air, water, and glycine (or sodium bicarbonate) powder to disrupt oral biofilm and remove stain from tooth surfaces. Patients often feel more comfortable when this technique is used.

Advantages vs Disadvantages

petrichandie — 2021-11-22 23:48:55 UTC

Advantages:
•Time efficient
•Stain removal
•Painless
•100% safe
•Can be used on dental implants

Disadvantages:
•Requires careful angulation to avoid trauma to oral soft tissues
•Doesn't remove calculus
•Supragingival polishing only

Cost

petrichandie — 2021-11-22 23:52:49 UTC

Air polishing is often incorporated into the price of a regular prophylaxis as charged by the dental office, typically ranging from $50-$200.

Effects on Restorative Material

petrichandie — 2021-11-23 00:03:18 UTC

This study was done to determine which polishing powder was the least abrasive. Results were collected by comparing the effects of three different polishing powders- sodium bicarbonate, glycine, and erythritol and then testing the surface roughness. Sodium bicarbonate proved to have a stronger detrimental effect on on composite surfaces than glycine or erythritol.

Air Polishing + The Creation of Aerosols

petrichandie — 2021-11-23 00:03:48 UTC

This study was done to determine how much aerosols are created while using air polishers during periodontal therapy. They used two different methods to compare- air polishing with an airflow device, or ultrasonic scaling in the upper and lower anterior front for 5 minutes. The selected periodontal interventions resulted in different contamination levels around the patient's mouth. Both devices showed contamination of the nearby structures, less contamination was detected when using the

ultrasonic.

Subgingival Air Polishing During a Periodontal Maintenance Visit

petrichandie — 2021-11-23 00:04:18 UTC

This study was done to evaluate repeated subgingival air-polishing in residual pockets with a new erythritol powder containing 0.3% chlorhexidine. 50 patients in periodontal maintenance were monitored in 3-month intervals over a 12-month period. Probing depths were measured at each appointment to see how their gingival health has changed whether they are receiving (a) air polishing or (b) ultrasonic debridement. Results showed that repeated subgingival air-polishing reduced the number of pockets >4mm similar to ultrasonic debridement. It was a safer plan because it induces less pain upon the patients.

petrichandie — 2021-11-23 00:22:18 UTC

petrichandie — 2021-11-26 19:05:43 UTC

Advantages vs Disadvantages

petrichandie — 2021-11-26 19:06:46 UTC

Advantages:
•Safe & easy to use
•Faster scan time
•Boost of diagnostic confidence
•Substitute for expensive & evasive diagnostic procedures
•Facilitates planning for non-invasive procedures

Disadvantages:
•Initial cost of equipment
•Poor contrast resolution
•Artifacts

Cost

petrichandie — 2021-11-26 19:08:18 UTC

Purchasing the equipment for 3D Imaging can be anywhere from $50,000-$100,000. In order to use it on a patient, they would pay anywhere from $100-$500. While submitting CBCT scans for dental insurance reimbursement is a relatively new concept, more and more insurance carriers are recognizing 3D teeth imaging as the standard of care for many dental procedures and diagnoses, and thus are providing reimbursement for some patients.

What is it?

petrichandie — 2021-11-26 19:21:06 UTC

CBCT is a variation of traditional computed tomography (CT) systems. In conventional CT scanners, an x-ray tube that emits a finely collimated fan-shaped x-ray beam directed through the patients to a series of scintillation detectors. The detectors form a continuous ring around the patient, and the x-ray tube moves in a circle within the fixed detector ring, taking 2D images. 3D images can be created by stacking all 2D slices together.

Detecting Dental Trauma with 2D vs 3D Images

petrichandie — 2021-11-29 02:46:15 UTC

This study was done to determine a dentist's ability to detect and diagnose dental trauma while using 2D and 3D imaging, to see the difference between the two. 20 children with dental trauma received a set of intraoral x-rays as well as a CBCT (3D) scan and 13 pediatric dentists assessed them. Performance of individual observers showed some variation, but mainly favored the 3D images, with only one of the dentists favoring the 2D images to detect dental trauma.

3D imaging & Dental Cavities

petrichandie — 2021-11-29 02:49:41 UTC

This study was performed to determine how 3D imaging helps visualize dental problems. The topography of the root canals was visualized and the canals volume was calculated. The presented technique may be used for quantitative analysis of the root canal cavities shape and volume. The results of such an analysis may be applied for estimation of the quality of the impressional mapping methods in restorative dentistry or as an alternative non-impressional 3D mapping method.

Basic Training Requirements for the Use of CBCT

petrichandie — 2021-11-29 02:54:26 UTC

This study was published to show what types of training one must go through in order to be able to perform CBCT (or 3D imaging) on their patients. The European Academy of

DentoMaxilloFacial Radiology (EADMFR) recognizes that dentists receive training in 2D dental imaging as undergraduates, but most of them have received little or no training in the application and interpretation of cross-sectional 3D imaging. Two levels of training are recognized. Level 1 is intended to train dentists who prescribe CBCT imaging, such that they may request appropriately and understand the resultant reported images. Level 2 is intended to train to a more advanced level and covers the understanding and skills needed to justify, carry out and interpret a CBCT examination. These recommendations are not intended to create specialists in CBCT imaging but to offer guidance on the training of all dentists to enable the safe use of CBCT in the dentoalveolar region. This study represents expert opinion developed by a dedicated panel within EADMFR established for thhis purpose.