Research Spotlight

Schneiderman, E., Schramm, P., Hui, J., Wilson, P.D., Moura, P., German, Z., McCann, A. and Newton, M. (2020). “Randomized Trial of 2 Self-Titrated Oral Appliances for Airway Management.” J Dent Res Sep 18;22034520956977. [Epub ahead of print.].

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The effectiveness and predictability of 2 different oral appliance (OA) designs to reduce the respiratory event index (REI) in moderate and severe obstructive sleep apnea (OSA) patients requires elucidation. The primary aim of the trial was to determine if 2 widely used midline-traction and bilateral-thrust OA designs differ in effectiveness to reduce the REI within a single test population categorized by OSA severity. Moderate and severe adult OSA patients, who were previously prescribed continuous positive airway pressure therapy (CPAP) but were dissatisfied with it (n = 56), were studied by home-polygraphy in a randomized crossover trial using either midline-traction with restricted mouth opening (MR) or bilateral thrust with opening permitted (BP) design OAs. OAs were used nightly for 4 wk (T2) followed by a 1-wk washout period, then 4 wk (T4) using the alternate OA. REI and oxygen saturation (SaO(2)) were primary outcomes, while predictability and efficacy comparison of the 2 OAs were secondary outcomes. Thirty-six participants had used MR and BP OAs during both 4-wk study legs. Twenty (55.6%) MR OA-using participants, 25 (69.4%) BP OA-using participants, and 16 (44.4%) participants using both OAs had significant REI reductions. Overall baseline (T0) median REI (interquartile range) of 33.7 (20.7-54.9) was reduced to 18.0 (8.5-19.4) at T2 and to 12.5 (8.2-15.9) at T4 (P < 0.001). Comparison of the 2 sequence groups' (MR-BP and BP-MR) REI showed the median differences between T0 and T2 and T4 were highly significant (P < 0.001). Regression analysis predicted about half of all users will have REIs between 8 and 16 after 2 mo. Baseline overjet measures >2.9 mm predicted greater OA advancement at T4. Mean and minimum SaO(2) did not change significantly from T0 to T2 or T4. MR and BP OA designs similarly attenuated REI in moderate and severe OSA individuals who completed the 8-wk study protocol with greater REI reduction in those with severe OSA (ClinicalTrials.gov NCT03219034).

Revilla-León, M., Methani, M.M. and Özcan, M. (2020). “Impact of the ambient light illuminance conditions on the shade matching capabilities of an intraoral scanner.” J Esthet Restor Dent Sep 21. [Epub ahead of print.].

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PURPOSE: To compare the shade matching capabilities between an intraoral scanner (IOS) and a spectrophotometer under different ambient light illuminance conditions. MATERIAL AND METHODS: The shade of three teeth of a patient was obtained using an IOS (IOS group) (TRIOS 3; 3Shape) and a spectrophotometer (DS group) (EasyShade V; Vita Zahnfabrik) at 4 ambient illuminances: 10000-, 1000-, 500-, and 0-lx. Ten shade measurements were documented using Vita Classical and 3D-Master guides per tooth at each lighting condition. Data was analyzed using the Kruskal-Wallis and Mann Whitney U tests (α = .05). RESULTS: Significant shade discrepancies were obtained between the groups in different lighting conditions (P < .05). The IOS group presented significant shade discrepancies in different lighting conditions when evaluated using either shade guide, with lower variation under the 0-lx condition. However, the DS group did not present significant shade discrepancies among the different lighting conditions with either shade guide, except for the maxillary lateral incisor measured under 10 000-lx condition using the 3D-Master guide. CONCLUSIONS: Lighting conditions influenced the shade matching competency of an IOS. The IOS tested obtained high variation in the different lighting conditions evaluated and provided a lower shade value than the spectrophotometer. The spectrophotometer revealed high consistency amongst the various lighting conditions evaluated. CLINICAL IMPLICATIONS: Ambient light illuminance conditions can impact the shade matching capabilities of IOSs. The results of this investigation suggest the use of a supplementary instrumental method for assessment of tooth shade.

Piedra-Cascón, W., Sadeghpour, M., Att, W. and Revilla-León, M. (2020). “A vat-polymerized 3-dimensionally printed dual-material occlusal device: A dental technique.” J Prosthet Dent Sep 17;S0022-3913(20)30438-8. [Epub ahead of print.].

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A technique to additively manufacture an occlusal device by using a completely digital workflow is described. Using a computer-aided design program, information captured with an intraoral scanner was used to additively manufacture a dual-material occlusal device by using a vat-polymerization printer. This technique allows for the combination of 2 different materials, resulting in an occlusal device with a resilient intaglio and a hard resin exterior surface. Advantages of the resulting occlusal device compared with a single-material device include improved patient acceptance and comfort, better fit, and minimal adjustments to ensure fit.

Pérez-Giugovaz, M.G., Park, S.H. and Revilla-León, M. (2020). “Three-dimensional virtual representation by superimposing facial and intraoral digital scans with an additively manufactured intraoral scan body.” J Prosthet Dent Sep 24;S0022-3913(20)30439-X. [Epub ahead of print.].

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A technique to merge facial and intraoral digital scans guided by an additively manufactured intraoral scan body is described. The technique facilitates facially driven treatment planning of restorative procedures in situations where a cone beam computed tomography scan is not indicated. Furthermore, the intraoral scan body can be customized to the size of the patient’s arch to improve patient comfort and simplify the digitalization procedures.

Azarpazhooh, A., Diogenes, A.R., Fouad, A.F., Glickman, G.N., Kishen, A., Levin, L., Roda, R.S., Sedgley, C.M., Tay, F.R. and Hargreaves, K.M. (2020). “Insights into the October 2020 Issue of the JOE.” J Endod 46(10): 1369-1370.

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Welcome to the October 2020 issue of the JOE. Here, we share some of our favorite articles that are published in this issue of the Journal. We hope you look forward to reading these and other articles in the JOE. [No abstract; excerpt from Editorial.].