Digitization in Dentistry: Clinical Applications

Foreword
Preface
Acknowledgments
Contents
1: Artificial Intelligence and Big Data in Dentistry
	1.1	 Introduction
	1.2	 Recent Trends in Digitization
		1.2.1	 Rapid Prototyping (RP)
		1.2.2	 Big Data
			1.2.2.1	 Electronic Health Records (EHR) and Data Analytics
			1.2.2.2	 Personalized Medicine and Data Linkages
			1.2.2.3	 Mobile Health (mHealth) and Teledentistry
		1.2.3	 Artificial Intelligence (AI)
			1.2.3.1	 How Are Artificial Intelligence (AI) and Big Data Intertwined?
			1.2.3.2	 AI and its Applications in Dentistry
	1.3	 Conclusion
	References
2: Digital Diagnosis and Treatment Planning
	2.1	 Introduction
	2.2	 Caries Detection Methods
		2.2.1	 Intraoral Television Camera (IOTV)
		2.2.2	 Visible Light
		2.2.3	 Fiber-Optic Transillumination (FOTI)
		2.2.4	 Digital Imaging Fiber-Optic Transillumination
		2.2.5	 Electrical Caries Monitor (ECM)
	2.3	 Lasers
		2.3.1	 Quantitative Light-Induced Fluorescence (QLF)
		2.3.2	 DIAGNOdent Laser System
		2.3.3	 Ultrasonography
	2.4	 Diagnosis in Endodontics: Pulp Vitality Tests
		2.4.1	 Laser Doppler Flowmetry (LDF)
		2.4.2	 Pulse Oximetry
		2.4.3	 Other Noninvasive Experimental Tests for Pulp Vitality
	2.5	 Diagnosing Periodontal Disease
		2.5.1	 Periodontal Pocket Probes
	2.6	 Other Devices (Non-periodontal Probes)
		2.6.1	 Detecting Calculus
		2.6.2	 Periodontal Disease Evaluation System
		2.6.3	 Gingival Temperature Detection
		2.6.4	 Periodontal Imaging Technologies
	2.7	 Digital Prosthodontics
		2.7.1	 Assessing Occlusion
			2.7.1.1	 T-Scan System
			2.7.1.2	 Virtual Articulators Digital Facebows
			2.7.1.3	 Assessing Temporomandibular Joint Disorders
	2.8	 Digital Diagnosis in Orthodontics
		2.8.1	 3D Face Scanner
		2.8.2	 Digital Study Models
		2.8.3	 Sure Smile
		2.8.4	 DentaScan
		2.8.5	 3D Printing
			2.8.5.1	 Rapid Prototyping
	2.9	 Conclusion
	References
3: Digital Oral Radiography
	3.1	 Introduction
	3.2	 Digital Radiograph
	3.3	 Digital Image Acquisition
		3.3.1	 Indirect Digital Acquisition
		3.3.2	 Direct Digital Acquisition
		3.3.3	 Semi-Direct Digital Acquisition
	3.4	 Digital Radiographic Processing
		3.4.1	 Pre-Processing of Digital Images
		3.4.2	 Post-Processing of Digital Images
	3.5	 Digital Subtraction Radiography
	3.6	 Cone Beam Computed Tomography (CBCT)
	3.7	 Clinical Applications of CBCT
		3.7.1	 Dental Implant Treatment Planning
		3.7.2	 Endodontics
			3.7.2.1	 Canal Morphology
			3.7.2.2	 Inflammatory Lesions
			3.7.2.3	 Root Vertical Fractures
		3.7.3	 Maxillofacial Surgery
			3.7.3.1	 Impacted Teeth and Third Molars Evaluation
			3.7.3.2	 TMJ Bone Assessment
		3.7.4	 Types of Artifacts
	References
4: Digitalization in Endodontics
	4.1	 Introduction
	4.2	 Digital Radiography
	4.3	 Optical Coherence Tomography (OCT)
	4.4	 Cone Beam Computed Tomography (CBCT)
	4.5	 Ultrasound (US) Imaging
	4.6	 Magnetic Resonance Imaging (MRI)
	4.7	 Electrical/Digital Pulp Testers
		4.7.1	 Clinical Considerations
	4.8	 Apex Locators
		4.8.1	 Development of Electronic Apex Locators
		4.8.2	 How Do Apex Locators Work?
		4.8.3	 Generations of Apex Locators
		4.8.4	 Clinical Tips to Avoid False Reading
	4.9	 Sonics and Ultrasonic
		4.9.1	 Types of Sonic Devices
		4.9.2	 Note on Active and Passive Root Canal Irrigation
	4.10	 Digital Delivery of Local Anesthetics
	4.11	 Automated Instrumentation Systems (Endodontic Electric Motors)
		4.11.1	 Conventional Endodontic Motors
		4.11.2	 New Endodontic Motors
	4.12	 Obturation
	4.13	 Surgical Operating Microscope (SOM)
		4.13.1	 Components of SOM
			4.13.1.1	 Eyepieces
			4.13.1.2	 Binoculars
			4.13.1.3	 Magnification Changer (MC)
			4.13.1.4	 Objective Lens
		4.13.2	 Total Magnification (TM)
		4.13.3	 Light Source Housing
		4.13.4	 Supporting Structure
		4.13.5	 Documentation Components
		4.13.6	 Advantages and Disadvantages of SOM
	4.14	 How to Use Dental Microscope
		4.14.1	 Patient Positioning
		4.14.2	 Operator Positioning
		4.14.3	 Microscope Positioning
		4.14.4	 Assistant Role
	4.15	 3D Guided Endodontics
	4.16	 Static Guidance (3D Printed Surgical Guidance)
	4.17	 Dynamic Guidance (Live 3D Navigation)
	4.18	 3D Guided Surgical Endodontics
	4.19	 See Footnote
	4.20	 The Assistive Augmented Reality (AR) Technology
	4.21	 Conclusion
	References
5: Digitization and Dental Lasers
	5.1	 Introduction
	5.2	 Laser and its Components
	5.3	 Laser Delivery Systems and Laser Emission Modes
	5.4	 Types of Tissue Interactions
	5.5	 Lasers in Dentistry
	5.6	 Lasers Generally Practiced in Dentistry
		5.6.1	 Carbon Dioxide Laser
		5.6.2	 Neodymium Yttrium Aluminum Garnet Lasers
		5.6.3	 Erbium Laser
		5.6.4	 Diode Laser
	5.7	 Soft Tissue Application
		5.7.1	 Photobiomodulation
		5.7.2	 Photodynamic Therapy for Malignancies
		5.7.3	 Soft Tissue Surgery
		5.7.4	 Frenectomies
	5.8	 Hard Tissue Applications
	5.9	 Laser Fluorescence
	5.10	 Cavity Preparation, Caries, and Restorative Removal
	5.11	 Treatment of Dentinal Hypersensitivity
	5.12	 Research
	5.13	 3D Laser Scanner for E-Model Preparation
	5.14	 Benefits and Drawbacks of Dental Lasers
	5.15	 Laser Safety
	5.16	 Conclusion
	References
6: Digital Impressions
	6.1	 Introduction
	6.2	 History
	6.3	 Comparison between Conventional and Digital Impressions
	6.4	 Technology of Digital Impression Systems
	6.5	 Advantages of Digital Impressions
	6.6	 Disadvantages of Digital Impressions
	6.7	 Clinical Indications and Contraindications of Digital Impressions and IOS
	6.8	 Accuracy of Intraoral Scanners
	6.9	 Comparison of Accuracy between Intraoral Scanners and Extraoral Scanners
	6.10	 Common Commercially Available Intraoral Scanning Systems (Table 6.3)
		6.10.1	 CEREC
		6.10.2	 Midmark Mobile True Definition Scanner
		6.10.3	 Trios®4 Scanner
		6.10.4	 iTero Element 5D
		6.10.5	 Planmeca PlanScan®
		6.10.6	 Emerald™
		6.10.7	 Emerald™ S
			6.10.7.1	 Carestream CS 3700® (Carestream Health, Rochester, NY, US)
			6.10.7.2	 Medit i500
			6.10.7.3	 Virtuo Vivo (Dental Wings)
	6.11	 Conclusion
	References
7: Digital Orthodontics
	7.1	 Digital Imaging
		7.1.1	 History
	7.2	 Cone Beam Computed Tomography (CBCT)
		7.2.1	 Additional Benefits of CBCT in the Orthodontic Practice
	7.3	 3D Facial Photography
	7.4	 4D Facial Photography
	7.5	 Digital Model Acquisition
		7.5.1	 Extraoral Scanners
			7.5.1.1	 History
				How to Choose an Appropriate EO Scanner
	7.6	 Intraoral Scanner
		7.6.1	 Scanners in Orthodontics Today
			7.6.1.1	 Precision and Accuracy
			7.6.1.2	 Advantages
			7.6.1.3	 Disadvantages
	7.7	 CBCT
	7.8	 3D Printing
		7.8.1	 History
		7.8.2	 3D Printing Technologies
	7.9	 Digitization and Direct Appliance Manufacture
	7.10	 Study Models
	7.11	 Aligners
	7.12	 Custom Brackets
		7.12.1	 Lingual Brackets
		7.12.2	 Labial Brackets
	7.13	 Custom Wires
	7.14	 Indirect Bonding
	7.15	 Removable and Functional Appliances
	7.16	 Metallic Appliances
	7.17	 Bone-Borne Devices
	7.18	 Fixed Retainers
	7.19	 Digital Workflow
	7.20	 Apps
	7.21	 Tele-Orthodontics and Remote Monitoring
	7.22	 Do Yourself (DIY) Orthodontics
	7.23	 Look into the Future
	7.24	 Conclusion
	References
8: Digital Occlusal Analysis and Force Finishing
	8.1	 Introduction
	8.2	 Dental Occlusion: The Foundation of Vedic Smile Dentistry (VSD) Approach
	8.3	 Occlusal Forces: Key to Occlusal Harmony
	8.4	 Mastication and Occlusal Forces
	8.5	 Swallowing and Occlusal Forces
	8.6	 Speech and Occlusal Forces
	8.7	 Parafunctional and Occlusal Forces
	8.8	 Occlusal Force Harmony, Disharmony, and Disorders
	8.9	 Dental Occlusion Analysis: The Digital Vs Nondigital Approach
	8.10	 The Nondigital Approach in Occlusion Analysis
	8.11	 The Digital Approach to Occlusion Analysis
	8.12	 Force Finishing Concept and Protocol
	8.13	 Clinical Cases
	8.14	 Summary
	8.15	 Disclaimer
	References
9: Digitization in Management of Temporomandibular Disorders
	9.1	 Introduction
		9.1.1	 Temporomandibular Disorders (TMD)
			9.1.1.1	 Classification of Temporomandibular Disorders
			9.1.1.2	 Prevalence of Temporomandibular Disorders
	9.2	 Diagnosis of Temporomandibular Disorders
		9.2.1	 The Conventional Diagnostic Approach
	9.3	 Digitization in the Diagnosis of Temporomandibular Disorders
		9.3.1	 Cone Beam Computed Tomography
		9.3.2	 Analysis of Occlusion and Occlusal Forces
		9.3.3	 Real-Time Jaw Movement Tracking
		9.3.4	 Real-Time Magnetic Resonance Imaging (MRI) of the TMJ
		9.3.5	 Artificial Intelligence (AI)
	9.4	 Treatment of Temporomandibular Disorders
		9.4.1	 The Conventional Treatment Approach for Temporomandibular Disorders
	9.5	 Digitization in the Treatment of Temporomandibular Disorders
		9.5.1	 Computer-Assisted Arthroscopy of the TMJ
		9.5.2	 Customized Design: Total TMJ Prosthesis
	9.6	 Clinical Applications
	9.7	 Conclusions
	References
10: Digitization in Operative Dentistry
	10.1	 Introduction
	10.2	 Digital Caries Diagnosis and Assessment
	10.3	 Electrical Current Measurement
		10.3.1 Electronic Caries Monitor (ECM)
	10.4	 Radiographic Techniques
		10.4.1 Digital Radiographs
			10.4.1.1	 Subtraction Radiography
			10.4.1.2	 DiFOTI
	10.5	 Fluorescent Techniques
		10.5.1 QLF (Quantitative Laser Fluorescence)
			10.5.1.1	 Working Principle
			10.5.1.2	 Uses
			10.5.1.3	 DIAGNOdent
	10.6	 Digital Restoration Workflow- the CAD/CAM Technique
		10.6.1	 Tooth Preparation for Digital Restorations/CAD/CAM Inlay or Onlay
		10.6.2	 Principle of Inlay and Onlay
			10.6.2.1	 Outline Form
			10.6.2.2	 Margin Design
			10.6.2.3	 Occlusal Clearance
		10.6.3	 Guidelines for Digital Impressions
		10.6.4	 Intraoral Scanners
		10.6.5	 Digital Impression Workflow
		10.6.6	 Types of CAD/CAM Systems
		10.6.7	 Data Processing of the Digital Impression
	10.7	 Chair-Side CAD/CAM Systems
	10.8	 Clinical Workflow
	10.9	 Chair-Side Restorative Materials
	10.10	 Computer-Assisted Manufacturing
		10.10.1 Open and Closed Systems
	10.11	 Subtractive and Additive Processes
		10.11.1 Subtractive Process
		10.11.2 Additive Process
	10.12	 Conclusion
	References
11: Digitization in Periodontics
	11.1	 Introduction
	11.2	 Digital Aids in Clinical Periodontics
	11.3	 Periodontal Probes
	11.4	 Detection of Sub-Gingival Calculus
		11.4.1	 Fibre-Optic Endoscopy
		11.4.2	 Spectro-Optical Technology (Differential Reflectometry)
		11.4.3	 Autofluorescence-Based Technology
		11.4.4	 Keylaser3
		11.4.5	 Ultrasonic Technology
	11.5	 Measurement of Tooth Mobility
	11.6	 Digital Occlusal Analysis in Periodontal Therapy
	11.7	 Digital Periodontal Treatment Planning and Database Maintenance
	11.8	 Digital Advances in Periodontal Therapy
	11.9	 Minimally Invasive Periodontal Surgery
	11.10	 Three-Dimensional Imaging and Scaffolds
	11.11	 Exploring Digital Solutions to Periodontal Research Problems
	11.12	 Advances in Periodontal Care at Home
	11.13	 Future Prospects and Conclusion
	References
12: Dental Implants and Digitization
	12.1	 Introduction
	12.2	 History and Development
	12.3	 Implant Manufacturing
	12.4	 Restorative Componentry
	12.5	 Digital Impression in Implant Dentistry
		12.5.1	 Scan Bodies
		12.5.2	 Photogrammetry
	12.6	 Guided Implant Surgery
	12.7	 Navigational Surgery
	12.8	 Clinical Cases
	12.9	 Conclusion
	References
13: Digital Smile Design
	13.1	 Introduction
	13.2	 Historical Perspective
	13.3	 Principles of Smile Design
	13.4	 Facial Composition
	13.5	 Dental Composition
	13.6	 Tooth Components
		13.6.1	 Dental Midline
		13.6.2 Incisal Length
		13.6.3 Tooth Dimensions
		13.6.4 Axial Inclinations
		13.6.5 Zenith Points
		13.6.6 Incisal Embrasures
		13.6.7 Interproximal Contact (ICA) Area and Interproximal Contact Points (ICP)
		13.6.8 Sex, Age and Personality
	13.7	 Soft Tissue Components
		13.7.1	 Gingival Health
		13.7.2 Gingival Level
		13.7.3 Smile Line
	13.8	 Shade Selection
	13.9	 Digital Shade Analysis
	13.10	 Digital Smile Designing Process (DSD)
		13.10.1 Requirements for DSD
		13.10.2 Photography
		13.10.3 Videography
		13.10.4 DSD Software
	13.11	 Steps in Smile Designing Treatment
	13.12	 Advantages of DSD [34]
		13.12.1 Aesthetic Diagnosis
		13.12.2 Communication
		13.12.3 Feedback
		13.12.4 Patient Management
		13.12.5 Education
	13.13	 Limitations of DSD
	13.14	 Advances in DSD
	13.15	 Conclusion
	References
14: Virtual Reality in Dentistry
	14.1	 Introduction
	14.2	 A Virtual Patient
	14.3	 Understanding the Difference between “Virtual Reality” (VR) and “Augmented Reality” (AR)
	14.4	 Uses of VR
		14.4.1	 Education and Training (Preclinical and Clinical)
			14.4.1.1	 DentSim
			14.4.1.2	 PerioSim©
			14.4.1.3	 MOOG Simodont Dental Trainer
		14.4.2	 Clinical Applications
			14.4.2.1	 VR in Implantology
			14.4.2.2	 VR in Oral and Maxillo-Facial Surgery and Orthognathic Surgery
			14.4.2.3	 VR in Reducing Pain and Anxiety during Dental Procedures
		14.4.3	 Robotic Patients for Simulation
		14.4.4	 Future Prospects
	References