Dental quadrants
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Dental Quadrants: Insights from Recent Research
Precision of Digital vs. Conventional Quadrant Dental Impressions
Digital Quadrant Impressions: Recent studies have shown that digital quadrant impressions can achieve precision levels comparable to conventional methods. The precision of digital systems like the Lava True Definition Scanner, 3Shape Trios, and CEREC Bluecam was found to be on par with traditional metal full-arch trays, although the deviation patterns varied depending on the method used. Digital systems with single-shot capture showed greater deviations at the tooth surface, while high-frame rate systems differed more in gingival areas.
Dental Wear Scoring Using Quadrant Systems
Quadrant-Based Scoring: A novel dental wear scoring technique divides molar teeth into four quadrants, scoring each section on a 1-10 scale based on enamel wear. This method has proven reliable and produces data with lower variances compared to older systems, making it a recommended approach for analyzing dental wear.
Efficiency of Quadrant Dentistry
Chairtime Savings: Quadrant dentistry, where multiple restorations are performed in the same quadrant during a single sitting, has been shown to save between 30% and 50% of chairtime compared to treating each restoration separately. This efficiency is consistent regardless of the individual speed of the dentists.
Prevalence of Good Dental Quadrants
Age-Related Decline: Data from the 1988 UK adult dental health survey revealed that the proportion of individuals with four good dental quadrants decreases significantly with age. While 90% of individuals aged 16-24 had four good quadrants, this number dropped to just 2% among those aged 65-74. Overall, 54% of the sample had four good quadrants, highlighting the importance of maintaining dental health across all quadrants.
Patient Experiences with Quadrant-Based Periodontal Treatments
Fear, Anxiety, and Pain: In a study comparing scaling and root planing per quadrant (SRP-Q) with one-stage full-mouth disinfection (FMD), both treatments resulted in significant improvements in periodontal health. Patients reported similar levels of fear, anxiety, and pain for both methods, indicating that quadrant-based treatments are as effective and tolerable as full-mouth approaches.
Gingival Health Assessment via Digital Impressions
Novel Measurement Techniques: Digital impressions can be used to measure gingival contour and volume, providing a new method for assessing gingival health. This technique has shown significant improvements in gingivitis following dental prophylaxis, comparable to traditional clinical indices.
Comparative Effectiveness of Metronidazole Gel and Subgingival Scaling
Clinical and Microbiological Outcomes: The application of a 25% metronidazole dental gel in specific quadrants was found to be as effective as subgingival scaling in reducing pocket probing depths and bleeding on probing. Both treatments led to a healthier subgingival microflora over a six-month period.
Quadrant Tray and Bite Registration for Fixed Prosthetics
Alternative Techniques: For fixed prosthodontic procedures, using a quadrant tray and separate interocclusal record offers several advantages over the traditional dual-arch impression method. This approach can improve the accuracy and efficiency of crown fabrication.
Ergonomic Risks in Dental Quadrant Treatments
Musculoskeletal Strain: Oral and maxillofacial surgeons experience high ergonomic risks, particularly when working on the first dental quadrant. The Rapid Upper Limb Assessment (RULA) scores indicate significant strain on the wrists, hands, elbows, lower arms, and neck, emphasizing the need for ergonomic interventions in dental practice.
Cantilevered Fixed Dental Prostheses in Shortened Dental Arches
Medium-Term Prognosis: Cantilevered fixed dental prostheses (CFDPs) used to replace second premolars in shortened dental arches do not negatively impact the prognosis of abutment teeth over a five-year period. This makes CFDPs a viable treatment option without compromising the health of supporting teeth.
Conclusion
Research on dental quadrants spans various aspects of dental practice, from impression techniques and wear scoring to treatment efficiency and ergonomic risks. Digital impressions and quadrant-based treatments offer significant benefits in terms of precision, efficiency, and patient comfort. However, maintaining good dental health across all quadrants remains a challenge, particularly with age. Continued advancements in digital technology and ergonomic practices are essential for improving dental care outcomes.
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