Wael Att

Purpose: This study aimed to examine the satisfaction of dental professionals, including dental students, dentists, and dental technicians, with computer‐aided design (CAD) software performance using deep learning (DL) and explainable artificial intelligence (XAI)‐based behavioral analysis concepts.Materials and Methods: This study involved 436 dental professionals with diverse CAD experiences to assess their satisfaction with various dental CAD software programs. Through exploratory factor analysis, latent factors affecting user satisfaction were extracted from the observed variables. A multilayer perceptron artificial neural network (MLP‐ANN) model was developed along with permutation feature importance analysis (PFIA) and the Shapley additive explanation (Shapley) method to gain XAI‐based insights into individual factors' significance and contributions.Results: The MLP‐ANN model outperformed a standard logistic linear regression model, demonstrating high accuracy (95%), precision (84%), and recall rates (84%) in capturing complex psychological problems related to human attitudes. PFIA revealed that design adjustability was the most important factor impacting dental CAD software users' satisfaction. XAI analysis highlighted the positive impacts of features supporting the finish line and crown design, while the number of design steps and installation time had negative impacts. Notably, finish‐line design‐related features and the number of design steps emerged as the most significant factors.Conclusions: This study sheds light on the factors influencing dental professionals' decisions in using and selecting CAD software. This approach can serve as a proof‐of‐concept for applying DL‐XAI‐based behavioral analysis in dentistry and medicine, facilitating informed software selection and development.

The aim of this in vitro study was to investigate the effect of hydrogen peroxide (H₂O₂) on the surface properties of various zirconia-based dental implant materials and the response of human alveolar bone osteoblasts. For this purpose, discs of two zirconia-based materials with smooth and roughened surfaces were immersed in 20% H₂O₂ for two hours. Scanning electron and atomic force microscopy showed no topographic changes after H₂O₂-treatment. Contact angle measurements (1), X-ray photoelectron spectroscopy (2) and X-ray diffraction (3) indicated that H₂O₂-treated surfaces (1) increased in hydrophilicity (p < 0.05) and (2) on three surfaces the carbon content decreased (33–60%), while (3) the monoclinic phase increased on all surfaces. Immunofluorescence analysis of the cell area and DNA-quantification and alkaline phosphatase activity revealed no effect of H₂O₂-treatment on cell behavior. Proliferation activity was significantly higher on three of the four untreated surfaces, especially on the smooth surfaces (p < 0.05). Within the limitations of this study, it can be concluded that exposure of zirconia surfaces to 20% H₂O₂ for 2 h increases the wettability of the surfaces, but also seems to increase the monoclinic phase, especially on roughened surfaces, which can be considered detrimental to material stability. Moreover, the H₂O₂-treatment has no influence on osteoblast behavior.

The digital workflow in implant dentistry aims to provide safer and predictable implant placement. This is facilitated through visualization of the anatomical structures as well as the integration of the prosthetic information to dictate implant placement. Guided surgery is useful in edentulous arches planned for fixed rehabilitations, where the unfavorable position of the implants may limit the possibility to realize such a treatment option. In full-arch immediate implant placement and immediate loading, computer-guided implant surgery gains a significant importance. Here, clinicians rely on either soft tissue or bone to provide support for the surgical guide during implant placement. Due to tooth extraction and the loss of anatomical structures that improve the support of the surgical guide, the correct positioning of the guide can be challenging. Further, the procedure that follows to deliver the immediate temporary rehabilitation can also be challenging due to the lack of workflow integrity between the surgical and restorative phases. The present case report describes a novel digital workflow for immediate implant placement and immediate loading of a full-arch rehabilitation, which aims to improve the accuracy of implant placement surgery and simplify the procedure of delivering immediate provisional restorations.

Purpose: To assess the influence of the number of teeth (2, 3, or 4) and location (molars, molar and premolar, or premolars and canines) of the bilateral virtual occlusal record on the accuracy of the virtual maxillo‐mandibular relationship acquired by an intraoral scanner (IOS).Material and methods: Diagnostic casts mounted on a semi‐adjustable articulator were obtained. Four markers were adhered on the facial surfaces of the first molars and canines. The mounted casts were digitized using an extraoral scanner. Maxillary and mandibular intraoral digital scans were obtained using an intraoral scanner (TRIOS 4). The maxillary and mandibular digital scans were duplicated 105 times and divided into 7 groups based on the number of teeth (2, 3, or 4) and location (molar, molar and premolar, or premolars and canines) of the bilateral virtual occlusal records (n = 15). The alignment of the scans was automatically performed after the acquisition of the corresponding occlusal records by the IOS program. Eight linear distances between the gauge balls were computed on the reference scan and on the 105 digital scans. The distances obtained on the reference scan were used to calculate the discrepancies with the distances obtained on each experimental scan. The Shapiro‐Wilk test showed that the data was normally distributed. The trueness and precision data were analyzed using 2‐way ANOVA followed by pairwise comparison Tukey tests (α = 0.05).Results: Two‐way ANOVA showed that the number of teeth (p < 0.001) and the position of the virtual occlusal record (p < 0.001) were significant factors on the accuracy of the maxillo‐mandibular relationship. Tukey test showed significant overall mean differences between the different groups tested: the 4‐teeth group obtained the highest trueness, and the 2‐teeth group showed the lowest trueness values (p < 0.001). Tukey test showed significant trueness differences between the virtual occlusal record locations. The 2‐teeth record located more posteriorly obtained the lowest trueness. Significant differences in precision values were found among the subgroups tested (p < 0.001). The 2‐teeth group obtained significantly more precision values than the 3‐ and 4‐teeth groups. Additionally, there was a significant difference in precision values between the subgroup tested in which the first molar and second premolar location had the highest precision, while the first and second premolar's location obtained the lowest precision.Conclusions: The number of teeth and the location of the bilateral virtual occlusal record influenced the accuracy of the virtual maxillo‐mandibular relationship obtained by the intraoral scanner tested. The more teeth included in the bilateral virtual occlusal record, the higher the accuracy of the maxillo‐mandibular relationship. Additionally, the more anteriorly located the virtual bilateral occlusal record involving 2 or 3 teeth was, the higher the accuracy mean value.

A review of the main additive manufacturing technologies including vat‐polymerization, material extrusion, material jetting, binder jetting, powder‐based fusion, sheet lamination, and direct energy deposition is provided. Additionally, the dental applications of polymer, metal, and ceramic printing technologies are discussed.