Research Spotlight

Revilla-León, M., Sicilia, E., Agustín-Panadero, R., Gómez-Polo, M. and Kois, J.C. (2022). “Clinical evaluation of the effects of cutting off, overlapping, and rescanning procedures on intraoral scanning accuracy.” J Prosthet Dent Jan 5;S0022-3913(21)00590-4. [Epub ahead of print].

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STATEMENT OF PROBLEM: Cutting off and rescanning procedures have been shown to affect the accuracy of intraoral scanning; however, the clinical impact of tooth cutting off and rescanning of mesh holes on accuracy remains unclear. PURPOSE: The purpose of this clinical study was to evaluate the influence of the tooth location of the rescanned mesh holes (with or without modifying the preexisting intraoral digital mesh with the rescanning procedures) on intraoral scanning accuracy. MATERIAL AND METHODS: A maxillary right quadrant digital scan was acquired (control scan) on a dentate participant by using an intraoral scanner (TRIOS 4). The control scan was duplicated 240 times and distributed among 4 groups depending on the location of the rescanned mesh hole: first molar (M group), second premolar (PM group), canine (C group), and central incisor (I group). Each group was divided into 2 subgroups: one subgroup contained overlapping rescanning modifications (WO subgroup), and the other blocked the preexisting digital scan to avoid further modifications when rescanning (NO subgroup) (n=30). A software program (Geomagic) was used to assess the discrepancy between the control and the experimental meshes by using the root mean square (RMS) error calculation. The Shapiro-Wilk test showed that data were not normally distributed. The Kruskal-Wallis test and post hoc Dunn test with Bonferroni correction were used to analyze the RMS mean discrepancies (α=.05). The Levene test was used to analyze the equality of the variances. RESULTS: Trueness ranged from 15 to 17 μm with a precision of 4 μm among the subgroups in which the existing digital scan was blocked, but the trueness ranged from 42 to 72 μm and the precision ranged from 15 to 47 μm among the subgroups in which the rescanning procedures allowed the modification of the existing digital scan. Significant trueness differences were found among the groups tested (P<.05). Significant differences in the RMS values were computed between the WO and NO subgroups for each group (M (P<.001): PM (P<.001); C (P<.001), and I (P<.001) groups), but the effect of the tooth mesh hole location demonstrated no significant difference either among the WO (P=1.00) or NO subgroups (P=1.00). Furthermore, the NO groups showed markedly better precision than the WO groups for each tooth location. The I-WO group showed better precision than the groups C-WO, PM-WO, and M-WO. However, when no overlapping was allowed, no difference was found in precision between the different tooth locations tested. CONCLUSIONS: Rescanning procedures influenced intraoral scanning accuracy. Allowing further modification of the preexisting intraoral digital scan demonstrated a significantly decreased scanning accuracy. However, tooth location of the rescanned mesh hole did not impact scanning accuracy.

Brennan, M.T., Madsen, L.S., Saunders, D.P., Napenas, J.J., McCreary, C., Ni Riordain, R., Pedersen, A.M.L., Fedele, S., Cook, R.J., Abdelsayed, R., Llopiz, M.T., Sankar, V., Ryan, K., Culton, D.A., Akhlef, Y., Castillo, F., Fernandez, I., Jurge, S., Kerr, A.R., McDuffie, C., McGaw, T., Mighell, A., Sollecito, T.P., Schlieve, T., Carrozzo, M., Papas, A., Bengtsson, T., Al-Hashimi, I., Burke, L., Burkhart, N.W., Culshaw, S., Desai, B., Hansen, J., Jensen, P., Menné, T., Patel, P.B., Thornhill, M., Treister, N. and Ruzicka, T. (2021). “Efficacy and Safety of a Novel Mucoadhesive Clobetasol Patch for Treatment of Erosive Oral Lichen Planus.” J Oral Pathol Med Dec 14. [Epub ahead of print].

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BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disorder of the oral mucosa. Currently there is no approved treatment for oral lichen planus (OLP). We report on the efficacy and safety of a novel mucoadhesive clobetasol patch (Rivelin(®) -CLO) for the treatment of OLP. METHODS: Patients with confirmed OLP and measurable symptomatic ulcer(s) participated in a randomized, double-blind, placebo-controlled, multicenter clinical trial testing a novel mucoadhesive clobetasol patch (Rivelin(®) -CLO) in OLP across Europe, Canada and USA. Patients were randomized to placebo (non-medicated), 1, 5, 20 µg Clobetasol/patch, twice daily, for 4 weeks. The primary endpoint was change in total ulcer area compared to baseline. Secondary endpoints included improvement from baseline in pain, disease activity, and quality of life. RESULTS: Data were analyzed and expressed as mean [SD]. One hundred thirty-eight (138) patients were included in the study; 99 females and 39 males, mean age was 61.1 [11.6] years. Statistical analyses revealed that treatment with 20-μg Rivelin(®) -CLO patches demonstrated significant improvement with ulcer area (P=0.047), symptom severity (P=0.001), disease activity (P=0.022), pain (P=0.012), and quality of life (P=0.003) as compared with placebo. Improvement in OLP symptoms from beginning to the end of the study was reported as very much better (best rating) in the 20-µg group (25/32) patients compared to the placebo group (11/30), (P=0.012). Adverse events were mild/moderate. Candidiasis incidence was low (2%). CONCLUSIONS: Rivelin(®) -CLO patches were superior to placebo demonstrating statistically significant, clinically relevant efficacy in objective and subjective improvement and, with a favorable safety profile.

Harrel, S.K., Cobb, C.M., Sottosanti, J.S., Sheldon, L.N. and Rethman, M.P. (2022). “Clinical Decisions Based on the 2018 Classification of Periodontal Diseases.” Compend Contin Educ Dent 43(1): 52-56.

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The absence of widely accepted treatment decision points for the management of periodontitis can be problematic for the dental profession and patients. After conducting a thorough review of published peer-reviewed studies, the authors developed basic therapeutic decision points for the management of periodontitis based on the 2018 classification of periodontal diseases. These decision points were utilized to outline appropriate treatments, which include: patient commitment to a thorough daily self-care regimen, the definitive elimination of etiological factors, professional treatment that includes the complete removal of residual bacterial biofilm (plaque), the definitive removal of both supragingival and subgingival calculus, and, in advanced disease, possible tissue augmentation and regenerative surgery. Advanced therapies to accomplish an acceptable therapeutic end point are indicated in stage III and stage IV periodontitis. The presented decision points for the treatment of periodontitis offer a basis for the ethical care and management of patients in all stages of periodontitis.

Aminoshariae, A., Azarpazhooh, A., Diogenes, A.R., Fouad, A.F., Glickman, G.N., He, J., Kishen, A., Letra, A.M., Levin, L., Setzer, F.C., Tay, F.R. and Hargreaves, K.M. (2022). “Insights into the January 2022 Issue of the JOE.” J Endod 48(1): 1-3.

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Welcome to the January 2022 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.

Ekhlasmandkermani, M., Amid, R., Kadkhodazadeh, M., Hajizadeh, F., Abed, P.F., Kheiri, L. and Kheiri, A. (2021). “Sinus floor elevation and simultaneous implant placement in fresh extraction sockets: a systematic review of clinical data.” J Korean Assoc Oral Maxillofac Surg 47(6): 411-426.

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Combining different procedures to reduce the number of surgical sessions and patient discomfort in implant placement and sinus floor elevation has been recommended, and evidence supports good outcomes. The aim of this study was to review the results of clinical studies on sinus floor elevation through extraction sockets and simultaneous immediate posterior implant placement. An electronic search was carried out in PubMed, Scopus, and Web of Science to find English articles published in or before August 2020. A manual search was also performed. Titles, abstracts, and the full-text of the retrieved articles were studied. Thirteen studies met our eligibility criteria: 6 retrospective case series, 3 case reports, 2 prospective cohort caseseries, 1 prospective case series, and 1 randomized controlled trial. Overall, 306 implants were placed; 2 studies reported implant survival rates of 91.7% and 98.57%. The others either did not report the survival rate or reported 100% survival. Sinus floor elevation through a fresh extraction socket and simultaneous immediate implant placement appears to be a predictable modality with a high success rate. However, proper case selection and the expertise of the clinician play fundamental roles in the success of such complex procedures.