Comparing the clinical acceptability of innovatedly made transpalatal arch (TPA) from 3D reconstructed model and conventionally-made TPA / Azanee-Nur Mohd Arif Fadzillah
Introduction: Digital workflow have been widely implemented in dental clinics for easier data management and reduction of physical storage of dental records. However, the need for physical model supersedes the sophistication of virtual model in dental appliances fabrication. Thus, there is a n...
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| Format: | Thesis |
| Published: |
2019
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| Online Access: | http://studentsrepo.um.edu.my/12606/4/azanee.pdf http://studentsrepo.um.edu.my/12606/ |
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| Summary: | Introduction: Digital workflow have been widely implemented in dental clinics for
easier data management and reduction of physical storage of dental records. However,
the need for physical model supersedes the sophistication of virtual model in dental
appliances fabrication. Thus, there is a need to investigate whether the 3D reconstructed
model is clinically applicable for the construction of orthodontic appliances. Aim and
objectives: The study aimed to investigate whether transpalatal arch (TPA) directly
fabricated from 3D reconstructed model is a feasible alternative to conventionally
constructed TPA for clinical practice, by assessing the patients� oral health related quality
of life (OHRQoL), pain level and clinicians� preferences. Materials and methods: This
is a two-part study comprising quantitative and qualitative methods. Part 1 comprised of
a parallel group randomized clinical trial study on 52 subjects who were recruited from
patients receiving orthodontic fixed appliances treatment at Faculty of Dentistry,
University of Malaya. Twenty-six subjects were allocated into two groups each (CG and
3DG) by block randomization. TPAs (0.9mm stainless steel with midpalatal semi loop)
were constructed on conventional stone model and 3D reconstructed model (ABS
material printed by UP! Plus 3D Printer). Two outcomes were measured: (1) self?administered questionnaire of the modified short version of Malaysian Oral Health
Impact Profile-14 (OHIP-14[M]) to assess the oral health related quality of life
(OHRQoL). (2) self-administered pain level by visual analogue score. Data were
collected at baseline (T0), and one week (T1), one month (T2) and three months (T3)
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after insertion of TPA. Part 2 is a qualitative study involving a Focus Group Discussion
(FGD) among five clinicians who treated all the subjects to explore clinicians� preference
of clinical application. Result: All 52 subjects were analysed and there was no drop out
in this study. Severity of OHRQoL among the patients was highest at first week insertion
of TPA (10.08; S.D. 6.69) and improved after one month (8.37; S.D. 5.85) and three
months (7.56; S.D. 4.97) of wear. There was no significant difference in OHRQoL
between the two types of TPA (p>0.05) at all measured time points (T0, T1, T2 and T3).
The most affected domain after wearing TPA was psychological discomfort and the least
was social disability. There was no significant difference in pain level between the two
types of TPA (p>0.05) at all measured time points (T1, T2 and T3). Four out of five
clinicians preferred the TPA fabricated on 3D reconstructed model than the conventional
TPA with three emerged themes (1) time factor, (2) molar band selection (3) cost factor.
Conclusion: There was no significant difference of OHRQoL and pain level between the
two types of TPA. Majority of clinicians preferred the TPA fabricated on 3D
reconstructed model rather than the conventional TPA. The 3D reconstructed models are
clinically acceptable as working models in replacing conventional stone models for TPA
fabrication.
Keywords: Transpalatal Arch (TPA), 3D printing, Oral Health Related Quality of Life
(OHRQoL, orthodontic pain, focus group discussion (FGD) |
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