Objective
To investigate whether specific predictive profiles for patient-based risk assessment/diagnostics can be applied in different subtypes of peri-implantitis.

Materials and methods
This study included patients with at least two implants (one or more presenting signs of peri-implantitis). Anamnestic, clinical, and implant-related parameters were collected and scored into a single database. Dental implant was chosen as the unit of analysis, and a complete screening protocol was established. The implants affected by peri-implantitis were then clustered into three subtypes in relation to the identified triggering factor: purely plaque-induced or prosthetically or surgically triggered peri-implantitis. Statistical analyses were performed to compare the characteristics and risk factors between peri-implantitis and healthy implants, as well as to compare clinical parameters and distribution of risk factors between plaque, prosthetically and surgically triggered peri-implantitis. The predictive profiles for subtypes of peri-implantitis were estimated using data mining tools including regression methods and C4.5 decision trees.

Results
A total of 926 patients previously treated with 2812 dental implants were screened for eligibility. Fifty-six patients (6.04%) with 332 implants (4.44%) met the study criteria. Data from 125 peri-implantitis and 207 healthy implants were therefore analyzed and included in the statistical analysis. Within peri-implantitis group, 51 were classified as surgically triggered (40.8%), 38 as prosthetically triggered (30.4%), and 36 as plaque-induced (28.8%) peri-implantitis. For peri-implantitis, 51 were associated with surgical risk factor (40.8%), 38 with prosthetic risk factor (30.4%), 36 with purely plaque-induced risk factor (28.8%). The variables identified as predictors of peri-implantitis were female sex (OR = 1.60), malpositioning (OR = 48.2), overloading (OR = 18.70), and bone reconstruction (OR = 2.35). The predictive model showed 82.35% of accuracy and identified distinguishing predictive profiles for plaque, prosthetically and surgically triggered peri-implantitis. The model was in accordance with the results of risk analysis being the external validation for model accuracy.

Conclusions
It can be concluded that plaque induced and prosthetically and surgically triggered peri-implantitis are different entities associated with distinguishing predictive profiles; hence, the appropriate causal treatment approach remains necessary. The advanced data mining model developed in this study seems to be a promising tool for diagnostics of peri-implantitis subtypes.

Distinguishing predictive profiles for patient-based risk assessment and diagnostics of plaque induced, surgically and prosthetically triggered peri-implantitis

Dental occlusion varies among individuals, and achieving correct physiological occlusion after osteotomy is essential for the complex functioning of the stomatognathic system. The T-Scan system records the centre of force, first contact, maximum bite force, and maximum intercuspation. The aim of the present study was to investigate the usefulness and consistency of T-Scan in assessing occlusion before and after orthognathic surgery. Occlusal information was evaluated for 30 healthy adults with normal occlusion and 40 patients undergoing orthognathic surgery. T-Scan had a high degree of reliability for consecutive measurements (Pearson correlation, r = 0.98). For most parameters, occlusal distribution was better after surgery than before surgery. More teeth contributed to occlusion at maximum intercuspation after surgery than before surgery (14 vs. 10). In addition, the difference in the posterior force distribution was reduced after surgery (17.6 ± 13.8 vs. 22.7 ± 21.4 before surgery), indicating better occlusal force distribution after surgery. The maximum percentage force on teeth (p = 0.004) and the number of teeth contributing to occlusion (p < 0.001) also differed significantly. Thus, T-Scan is good for assessing occlusal discrepancies and can be used to portray the pre- and post-operative occlusal contact distribution during treatment planning and follow-up.

Assessment of occlusion with the T-Scan system in patients undergoing orthognathic surgery

PURPOSE To determine the reliability of T-scan and 3D intraoral scan techniques for assessing the occlusal contact area (OCA), compared to occlusal registration and also to assess the validity of the techniques. MATERIALS AND METHODS Thirty-one dentate adults participated in this cross-sectional study. T-scan records were used to measure the OCA at maximum bite force and at 50% of maximum force using the software's bite force selection tool. A second method measured the OCA between 2 virtual models scanned intraorally using a 3D surface scan and considering the occlusal contact at 2 interocclusal distances (0-100 and 0-200 µm). The third method measured OCA using occlusal registration at moderate and maximum occlusal force, and considering contact at the 2 interocclusal distances (0-100 and 0-200 µm). Images obtained using the 3 methods were analyzed using ImageJ software. Test-retest reliability was assessed by the intraclass correlation coefficient (ICC) and validity by Pearson correlations. RESULTS ICCs ranged from 0.56 to 0.79 (p < 0.001) for the T-scan; 0.37 to 0.61 (p < 0.05) for 3D surface scan; and 0.92 to 0.95 (p < 0.0005) for occlusal registration. The highest OCA values were obtained using the T-scan, and the lowest using the 3D surface scan. Occlusal registration measurements had the highest correlations with those of the other techniques. CONCLUSIONS T-scan is a reliable method for measuring the OCA, but the 3D surface scan is not. Occlusal registration showed a high validity.

Reliability and Validity of T-scan and 3D Intraoral Scanning for Measuring the Occlusal Contact Area.

Cavitas sensors and point-of-need sensors capable of providing physical and biochemical information from the oral cavity and saliva have attracted great attention because they offer remarkable advantages for noninvasive sensing systems. Herein, we introduce the basic anatomy and physiology of important body cavities to understand their characteristics as it is a pivotal foundation for the successful development of in-mouth devices. Next, the advanced development in lab-in-a-mouth sensors and point-of-need sensors for analyzing saliva are explained. In addition, we discuss the integrations of artificial intelligence and electronic technologies in smart sensing networks for healthcare systems. This review ends with a discussion of the challenges, future research trends, and opportunities in relevant disciplines. Mouthguard-based sensors and conventional salivary sensing devices will continue to be significant for the progress in the next-generation sensing technologies and smart healthcare systems.

Review—Lab-in-a-Mouth and Advanced Point-of-Care Sensing Systems: Detecting Bioinformation from the Oral Cavity and Saliva

Objective: Published studies indicate that orthodontically treated patients demonstrate increased posterior occlusal friction contributing to temporomandibular disorder (TMD) symptoms. This study investigated measured excursive movement occlusal contact parameters and their association with TMD symptoms between non- and post-orthodontic subjects.Methods: Twenty-five post-orthodontic and 25 non-orthodontic subjects underwent T-Scan® computerized occlusal analysis to determine their disclusion time (DT), the excursive frictional contacts, and occlusal scheme. Each subject answered a TMD questionnaire to determine the presence or absence of TMD symptoms. Statistical analysis compared the within group and between group differences (p < 0.05).Results: Statistically significant differences were observed in the disclusion time: DT = 2.69 s in the post-orthodontic and 1.36 s in the non-orthodontic group. In the non-orthodontic group, 72.7% working and 27.3% non-working side contacts were seen, while in th...

Comparison of excursive occlusal force parameters in post-orthodontic and non-orthodontic subjects using T-Scan® III

Background: All disciplines of dentistry require that clinicians assess the articulation of the teeth/prosthesis with respect to simultaneous contacts, bite force and timing.Aims: This article intends to describe the advantages and limitations of the data acquired when using a computerized occlusal analysis as a dynamic occlusal indicator.Methodology: A search of the literature was completed (Medline, PubMed) using the keywords occlusion, occlusal registration, computerized occlusal analysis and T-Scan for dental.Results: According to the evidence available, the computerized occlusal analysis system is the only occlusal indicator that demonstrates the ability to provide quantifiable force and time variance in a real-time window from the initial tooth contact into maximum intercuspation.Conclusion: The reported advantages to accurately indicate occlusal contacts make the computerized occlusal analysis system a better occlusal indicator when compared with other non-digital convention indicator mater...

Computerized occlusal analysis as an alternative occlusal indicator

Objective: Balanced occlusal force distribution is a critical factor for restorative, prosthetic or orthodontic treatment. It has been postulated that orthodontic treatment may lead to occlusal discrepancies in the arch due to changing the occlusal relationships. This study was conducted to compare the occlusal force parameters between natural dentition patients and a post-orthodontic treatment group.Method and Materials: Fifty Thai subjects were divided into non-orthodontic and post-orthodontic groups comprised of 25 subjects each (mean age 24.8 years). The T-Scan® III computerized occlusal analysis system was used to record a multi-bite closure for each subject. The initial occlusal contact location, the bilateral percentage force distribution, the percentage force in the anterior and posterior quadrants, and the individual tooth force percentages were calculated for both groups. The Student’s Paired t-Test compared the in-group differences, while a one-way ANOVA analyzed the differences between the two...

Comparison of closure occlusal force parameters in post-orthodontic and non-orthodontic subjects using T-Scan® III DMD occlusal analysis

The traditional occlusal indicators used in dental practice are articulation papers, shim-stock foils, elastomeric impression materials, and occlusal wax strips. These static dental materials have been widely believed to have occlusal force descriptive capability. However, modern material studies are challenging the widespread belief that occlusal indicator materials can measure differing occlusal force levels. This chapter evaluates the force reporting limitations of these static occlusal indicators and discusses how clinicians subjectively interpret their appearance characteristics to determine differing occlusal force levels. This chapter then compares these non-digital occlusal indicators to computerized occlusal analysis technology that records and displays precise, quantifiable, relative occlusal force variances and occlusal contact timing sequences. This digital data aids the clinician in making a more accurate occlusal analysis and can guide the clinician in the correction of occlusal contact force and timing abnormalities, thereby eliminating the subjectivity that is inherent in traditional occlusal indicator use.

Sarah Qadeer

Papers

Computerized occlusal analysis as an alternative occlusal indicator

Comparison of closure occlusal force parameters in post-orthodontic and non-orthodontic subjects using T-Scan® III DMD occlusal analysis

Comparison of excursive occlusal force parameters in post-orthodontic and non-orthodontic subjects using T-Scan® III

The Limitations of Traditional Non-Digital Occlusal Indicators When Compared to the T-Scan Computerized Occlusal Analysis Technology