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The aim of this study was to evaluate the validity and reliability of volume determinations using the commercially available Seattle ShapeMaker CAD/CAM system for production of prosthetic sockets and to compare it with the commercially available CAPOD system. We used three types of reference objects for volumetric determinations: steel tubes, plaster of Paris casts, and residual limb models. Three different sizes were examined for each type of object. Volume measurements with the two CAD/CAM systems were compared with measurements obtained by water filling, water immersion, or mathematical calculation (tubes only). We found an inconsistent systematic error of less than 3.1% for ShapeMaker and no systematic error for CAPOD. Random errors, represented by the coefficient of variation, were below 1.3% for the ShapeMaker and, in most cases, below 0.4% for the CAPOD. Theoretical changes in volume of 2.6% and 0.8% are possible to detect with these CAD/CAM systems. In our opinion, both systems have sufficient precision for routine clinical use in prosthetics and orthotics. However, in our study, the ShapeMaker committed larger random and systematic errors than CAPOD. This means that, according to our study, CAPOD offers the best possibility to determine and detect small changes in residual limb volume as a function of time.
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PMID:Accuracy and precision of volumetric determinations using two commercial CAD systems for prosthetics: a technical note. 950 50

The number of dental computer-aided design/computer-aided manufacture (CAD/CAM) systems commercially available is growing. These systems range in complexity and application, from manual copy milling of inlays to full computer-controlled systems with a complex library of tooth forms enabling the automated production of crowns and bridges. All CAD/CAM systems permit the production of restorations at the chairside and, at least in theory, eliminate potential inaccuracies associated with the traditional, multistage production of indirect restorations. Their use also minimizes cross-infection. However, the capital costs of these systems are great and a high throughput of restorations is required in order to achieve financial viability. Long-term clinical studies are required before a final judgement may be made of the use of these relatively new systems.
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PMID:Dental CAD/CAM: a millstone or a milestone? 960 Dec 23

The aim of this investigation was to evaluate clinically and histologically a new custom-made, root analogue titanium implant placed into extraction sockets in monkeys (Macaca fascicularis). Three adult monkeys were used in this investigation. After raising full thickness flaps on the buccal and lingual side, the upper central and lateral incisors were extracted. Each tooth root was machine copied to 1 titanium analogue using a new CAD/CAM-system. The implants were installed in the respective extraction sockets and the flaps sutured back. After 6 months of healing biopsies were taken and processed according to the cutting-grinding technique. The percentage of mineralized bone-to-implant contact was measured as a fraction of the rough implant surface using computer-assisted analysis. The main clinical problem that occurred during implant placement was the fracture of the buccal alveolar wall. The histometric evaluation showed a mean mineralized bone-to-implant contact of 41.2 +/- 20.6%. In this investigation it could be shown that implants fabricated by laser copying will osseointegrate. The presented data encourage the performance of clinical and experimental trials evaluating the new system utilizing improved second generation CAD/CAM equipment. Such studies are currently underway.
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PMID:Custom-made root analogue titanium implants placed into extraction sockets. An experimental study in monkeys. 961 43

Three-dimensional registration of the facial surface by methods which are currently in use is difficult because of the long measuring times required by point-based imaging systems. Artifacts caused by movement appear, e.g., blinking. Also the production of a facial plaster-cast model for measuring is not an adequate solution. In order to acquire data of the facial surface in a contact-free manner, a system is needed that has short measuring times, is able to record data of complex surfaces and at the same time does no harm to the open eyes. The method described here represents a new development of an industrial high tech CAD/CAM system. Unlike customary point-based imaging systems, the stripe projection method works using entire planes. Structured light is aimed at the surface to be measured, recorded by videocamera and calculated by triangulation; then the different views are combined by computer. The system has an optic sensor that can record approximately 500,000 measuring points within seconds (ca. 1.7s). Test persons' faces and plaster-cast models of them (n = 15) were measured comparatively and serially (n = 5) to test the validity and reliability of the method for maxillofacial procedures. These investigations show that this method is appropriate for recording three-dimensional soft-tissue profiles. First studies on patients before and after dysgnathia operations were undertaken. A prospective long-term study for collecting data on pre- and postoperative dysgnathia patients has been begun. Initially, it will record the changes in facial soft tissue on the basis of skeletal displacement. Later, predictions about the soft-tissue changes subsequent to dysgnathia surgery can be worked out on the basis of stored data matched with three-dimensional bone data.
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PMID:[3-D imaging of the facial surface by topometry using projected white light strips]. 965 39

The design and development of a simulator for endovascular repair of abdominal aortic aneurysm (AAA) is described. The simulator consists of an interchangeable model of a human AAA based on computed tomography data and is produced by means of computer-aided design and manufacture (CAD/CAM) techniques. The model has renal, iliac, and femoral arteries, and is perfused with a temperature controlled blood-analog fluid under simulated physiological flow conditions. "Fluoroscopic imaging" is simulated by a computerized imaging system that uses visible light. A movable video camera relays images in the antero-posterior and lateral planes of the AAA to a monitor. The imaging system allows "arteriography" and "road-mapping" to be performed so as to facilitate accurate deployment of endovascular stent-grafts. The system has been used for teaching and demonstrating endovascular techniques to clinicians, as well as the evaluation of new stent-graft devices. Its successful incorporation into endovascular workshops has demonstrated its role in the training of clinicians in endovascular repair of AAA.
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PMID:Development of a simulator for endovascular repair of abdominal aortic aneurysms. 977 52

Titanium is used in dentistry for implants and frame work because of its sufficient chemical, physical and biological properties. The corrosion behaviour is from high interest to value biocompatibility. A static immersion test was undertaken with a titanium test specimen (30 mm x 10 mm x 1 mm, immersion time = 4 x 1 w, n = 3 for each series). The following parameters were investigated: specimen preparation, grinding, pH-value, different casting systems, comparison with CAD/CAM, influence of: chloride, thiocyanate, fluoride, lactate, citrate, oxalate, acetate. Atomic absorption spectroscopy was used to analyse the solutions weekly. The course of corrosion was investigated photometrically. Titanium reveals ion releases [(0.01-0.1) microg/(cm2 x d)] in the magnitude of gold alloys. There is little influence of grinding and casting systems in comparison with organic acids or pH value. The ion release increases extreme (up to 500 microg/(cm2 x d)) in the presence of fluoride. Low pH values accelerate this effect even more. Clinically, no corrosion effects were observed. Nevertheless it is recommended that it is best to avoid the presence of fluoride or to reduce contact time. In prophylactic fluoridation of teeth, a varnish should be used.
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PMID:In vitro corrosion of titanium. 979 25

Subperiosteal implants are currently fabricated by using the classic two-stage direct bone impression technique or by the use of the one-stage computer tomography/computer-assisted design-computer-assisted manufacture (CT/CAD-CAM) method. This study compares the accuracy of the two techniques by using cadaver maxillae and mandibles as the models for fabrication of casts. Seven cadaver jaw specimens were collected and subjected to direct bone impressions and to CT scans. Those derived from the direct bone impressions were poured in die stone, while the CT scans were sent for fabrication of CAD-CAM-generated casts. On each of the 14 models so produced, a cast grid was fabricated that was designed as a measuring device. The preciseness of fit of each grid was subjected to analyses that presented levels of accuracy. Statistical evaluation of these levels, reduced to numerical indices, revealed that the direct bone techniques resulted in acceptable castings in seven of seven cases, whereas the CAD-CAM method yielded adequate castings in five of seven cases.
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PMID:An in vitro comparison of the computerized tomography/CAD-CAM and direct bone impression techniques for subperiosteal implant model generation. 983 33

Sixty-six class-II CAD/CAM-manufactured ceramic inlays (Cerec) were placed in 27 patients. Each patient received at least one inlay luted with a dual-cured resin composite and one inlay luted with a chemically cured resin composite. The inlays were examined 5 years after luting using the California Dental Association (CDA) criteria. Eighty-nine percent of the 66 inlays were rated 'satisfactory'. During the follow-up period replacement was required for 3 inlays because of inlay fractures (4.5%) and 1 inlay because of fracture of the tooth substance (1.5%). All those inlays were luted with the dual-cured resin composite luting agent. Of the remaining 62 inlays the CDA rating 'excellent' was given to 84% for color, 97% for surface, and 81% for anatomic form. 'Excellent' margin integrity was seen in 52% of the dual-cured resin composite luted inlays and in 61% of the chemically cured resin composite luted inlays. No statistically significant (P> 0.05) difference was observed between the two luting agents.
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PMID:A 5-year clinical evaluation of ceramic inlays (Cerec) cemented with a dual-cured or chemically cured resin composite luting agent. 986 93

Even though you will never find a dental management system that will do exactly what you want, there are a tremendous variety of systems out there with some incredibly powerful features. Look for a system that can handle most of the tasks you need. Keep your eye on other technologies that you may want in your practice. The system you purchase now should be able to handle whatever technologies you decide to add on in the next 3 to 4 years. Once you have made the decision to purchase, the transition to automated management begins. It will be necessary to train you and your staff on how to use the system. Depending on the system chosen, it may be necessary to adjust your management strategies in a number of areas to take advantage of the system's features. This may cause a few adjustment problems at first, but things will work out with a little time and effort. In the next few years, advances in technology integration will allow you to seamlessly blend practice management, voice charting, intraoral cameras, CAD/CAM, lasers, EDI, video imaging, etc., into a single potent system for complete clinical and practice management. A dental practice management system is the first step to realizing that future. Shop wisely and invest your time in learning the terminology and techniques of automated information management.
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PMID:Selecting office management computer equipment. 992 50

Technology is creating customer choice, and choice is altering the marketplace. Gone are the days of the marketer as salesperson. Gone as well is marketing that tries to trick the customer into buying whatever the company makes. There is a new paradigm for marketing, a model that depends on the marketer's knowledge, experience, and ability to integrate the customer and the company. Six principles are at the heart of the new marketing. The first, "Marketing is everything and everything is marketing," suggests that marketing is like quality. It is not a function but an all-pervasive way of doing business. The second, "The goal of marketing is to own the market, not just to sell the product," is a remedy for companies that adopt a limiting "market-share mentality." When you own a market, you lead the market. The third principle says that "marketing evolves as technology evolves." Programmable technology means that companies can promise customers "any thing, any way, any time." Now marketing is evolving to deliver on that promise. The fourth principle, "Marketing moves from monologue to dialogue," argues that advertising is obsolete. Talking at customers is no longer useful. The new marketing requires a feedback loop--a dialogue between company and customer. The fifth principle says that "marketing a product is marketing a service is marketing a product." The line between the categories is fast eroding: the best manufacturing companies provide great service, the best service companies think of themselves as offering high-quality products. The sixth principle, "Technology markets technology," points out the inevitable marriage of marketing and technology and predicts the emergence of marketing workstations, a marketing counterpart to engineers' CAD/CAM systems.
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PMID:Marketing is everything. 1010 73


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