Background: The purpose of this study was to evaluate some of the clinical variables that influence the accuracy of reproducing the planned attachment shape. The following clinical variables were considered: the template material, type of composite, and pressure application on the template during attachment curing. Methods: In this study, the evaluated materials for the thermoplastic transfer template construction are Erkolen 0.8 (polyethylene: PE) and Erkodur 0.8 (polyethylene terephthalate glycol—PET-G), and two types of composite resins: Enaflow (light-curing low-viscosity composite resin) and Enamel plus dentina HRI (light-curing high-viscosity composite resin). Two different light-curing lamps were used: Valo cordless color with no pressure and push light pressure (SCS). The 26 models included in the study were imported into the 3 Shape Ortho System 2022 (ver. 85.0.20 3 Shape, Denmark), and attachments were virtually placed on the dental elements of the first premolar and on both sides of the first upper molars. The accuracy of the attachment reproduction was evaluated through linear and angular evaluations against the reference model (MCAD). Three physical models were obtained: model A (MA), which was printed with attachments; model B (MB) with attachments made with a PE template; and model C (MC) with attachments made with a PET-G template. Results: The results showed statistically significant differences (p < 0.05) between the PE and PET-G templates with greater precision using the PET-G template. Statistically significant differences (p < 0.05) were found among the high-viscosity composite and low-viscosity composite with pressure curing. Conclusions: In light of the obtained data, using a PET-G template is recommended. The pressure application during composite curing reduces the reproduction accuracy with a low-viscosity composite.
Background: The aim of this study was to propose a new 3D printing method for attachment production and compare the reproduction accuracy of traditional attachments with the proposed 3D-printed attachments. Methods: A standardized 3D model attachment was created with the dimensions of 3, 2, and 2 mm for the apico-coronal, mesio-distal, and vestibulo-lingual dimensions, respectively. A 3D ideal model of the maxillary arch was used to apply four standardized attachments on the vestibular surface of selected teeth. The obtained model with placed attachments was used to reproduce composite attachments via the conventional method. A transfer template was used to bond with the flow composite resin 3D-printed attachment on a new arch model without attachments. The models with traditional attachments and 3D-printed attachments were scanned and overlapped with the original CAD model with attachments. To assess the attachment precision, vertical and horizontal cutting planes were used on the overlapped models. The outcome selection focused on puff analysis (excess composite material evaluation) and shape analysis (attachment accuracy evaluation). Results: The results indicated that the 3D-printed attachments showed significant differences (p < 0.05) compared to the traditional attachments. The descriptive statistics showed the higher discrepancies compared to the CAD model of the traditionally created attachments in the shape (0.85 mm) and puff dimension (1.02 mm). Conclusion: Custom 3D-printed attachment production is an effective method for achieving greater attachment precision.
Background: The aim of this study was to evaluate the correlation between caries, body mass index (BMI) and occlusion in a sample of pediatric patients. Methods: The study group included 127 patients (72 female, 55 male) aged between 6 and 16 years (mean age 10.2) and selected between January and June 2019 at the Department of Pediatric Dentistry, University of Messina. Caries incidence was evaluated using the decayed, missing and filled teeth (DMFT) index. On the basis of BMI values, using a table adjusted for age and gender, patients were grouped into four categories (underweight, normal weight, risk of overweight, overweight). Results: There was no significant correlation between BMI and DMFT in the whole sample. The study of the correlation between BMI and DMFT in patients with different types of malocclusion showed a significant inverse correlation for patients affected by II class and deepbite malocclusion. Conclusions: The incidence of caries does not seem to be significantly related to BMI and occlusal patterns, but it decreases with increasing age.
Background: Obstructive sleep apnea syndrome (OSAS) is a prevalent sleep-related breathing disorder associated with significant systemic complications and reduced quality of life. Mandibular advancement devices (MADs) represent an established alternative therapy for patients who cannot tolerate continuous positive airway pressure (CPAP). However, concerns remain regarding their potential effects on temporomandibular disorders (TMD). Materials and Methods: This retrospective exploratory study analyzed clinical records of 26 patients (mean age 55.4 ± 5.8 years) with polysomnography-confirmed OSAS and baseline TMD-related symptoms treated with a custom-made monobloc MAD. Clinical parameters were evaluated at baseline (T0) and after approximately 6 months of therapy (T1). Outcomes included apnea–hypopnea index (AHI), Epworth Sleepiness Scale (ESS), Fonseca Anamnestic Index, and health-related quality of life assessed using the SF-36 questionnaire. Repeated measures ANOVA and linear regression analyses were performed. Results: After six months of MAD therapy, a significant reduction in AHI was observed (30 ± 13.76 vs. 10.87 ± 3.9; p < 0.00001). Daytime sleepiness significantly decreased (ESS: 9.31 ± 3.53 vs. 3.38 ± 1.77; p < 0.00001). TMD symptom severity also decreased significantly according to the Fonseca Index (33.85 ± 17.74 vs. 10.00 ± 8.94; p < 0.00001). Quality of life scores improved significantly (SF-36: 41.15 ± 9.52 vs. 65.38 ± 5.82; p < 0.00001). Linear regression analysis showed no significant association between changes in AHI and changes in TMD symptoms, ESS scores, or quality of life. Conclusions: Within the limitations of this retrospective study, MAD therapy was not associated with symptom aggravation of temporomandibular disorders in patients with pre-existing TMD symptoms. Significant improvements in respiratory parameters, daytime sleepiness, and quality of life were observed after six months of therapy.