Wael Att

• DDS. Dr Med Dent. DMD. PhD
• Professor (Full) and Chair at Tufts University

Objective The aim of this in vitro study was to evaluate the accuracy of resin‐based fixed dental restorations, namely veneers, single crowns, and four‐unit fixed partial dental prosthesis (FPDs), using two different 3D printing technologies and polymer‐based materials. Materials and Methods A standard maxillary polyurethane jaw model containing p...

Purpose To evaluate the dimensional stability over time of additively manufactured surgical templates, fabricated by different resins, and stored by different methods. Materials and Methods Using a 3D printer with DLS technology and two different resins (Surgical Guide (SG)‐WhipMix and Key Guide (KG)‐KeystoneIndustries), 96 surgical guides were ad...

Objective This article puts forward consensus recommendations from PROSEC North America regarding single indirect restorations made from ceramic and non-metallic biomaterials in posterior teeth. Overview The consensus process involved a multidisciplinary panel and three consensus workshops. A systematic literature review was conducted across five d...

Objective The aim of the present study was to provide recommendations in order to facilitate communication between dental professionals and surgeons who are collaborating in the field of dentofacial esthetics. Clinical Considerations Smile esthetics are beyond the scope, both of the surgeons who are collaborating with facial esthetics and of the d...

Objectives To investigate the accuracy of conventional and automatic artificial intelligence (AI)‐based registration of cone‐beam computed tomography (CBCT) with intraoral scans and to evaluate the impact of user's experience, restoration artifact, number of missing teeth, and free‐ended edentulous area. Materials and Methods Three initial registr...

Objectives To investigate the accuracy of artificial intelligence (AI)‐based segmentation of the mandibular canal, compared to the conventional manual tracing, implementing implant planning software. Materials and methods Localization of the mandibular canals was performed for 104 randomly selected patients. A localization was performed by three e...

Objective: The aim of this in vitro study was to evaluate the accuracy of resin-based fixed dental restorations, namely veneers, single crowns, and four-unit fixed partial dental prosthesis (FPDs) using two different 3D printers and polymer-based materials. Materials and Methods: A standard maxillary polyurethane jaw model containing prepared teeth...

Purpose: To compare the performance of licensed dentists and two software versions (3.5 legacy and 4.0) of an AI-based chatbot (ChatGPT) answering the exam for the 2022 Certification in Implant Dentistry of the European Association for Osseointegration (EAO). Materials and Methods: The 50 question, multiple-choice exam of the EAO for the 2022 Certi...

Purpose: To measure the impact of the scanning distance on the accuracy of complete-arch implant scans acquired by using a photogrammetry (PG) system. Material and methods: An edentulous cast with 6 implant abutment analogs was obtained. A brand new implant scan body was positioned on each implant abutment and digitized using an extraoral scanner...

Purpose The purpose of the present clinical study was to compare the Ricketts and Steiner cephalometric analysis obtained by two experienced orthodontists and artificial intelligence (AI)‐based software program and measure the orthodontist variability. Materials and Methods A total of 50 lateral cephalometric radiographs from 50 patients were obta...

Objectives: Within the development of digital technologies, dental professionals aim to integrate virtual diagnostic articulated casts obtained by using intraoral scanners (IOSs), the mandibular motion of the patient recorded by using an optical jaw tracking system, and the information provided by computerized occlusal analysis systems. This artic...

Statement of problem: Intraoral scanners (IOSs) provide a digital alternative to conventional implant impression techniques. However, the effect of the supramucosal height of the scan body and implant angulation on the accuracy of IOSs remains unclear. Purpose: The purpose of this in vitro study was to measure the impact of the supramucosal heig...

Objectives: To provide an overview about the current approaches to prevent peri-implant diseases in edentulous patients with complete-arch implant-supported prostheses, and to review the clinical applications of the latest digital technologies for implant prosthodontics. Methods: A review of the guidelines to prevent peri-implant diseases in pat...

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....

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 un...

A step‐by‐step technique for tracking and recording in real‐time the lip dynamics of the patient and for integrating this lip dynamics into the 3D virtual patient representation by using facial trackers and motion engine software programs is described. The main advantage of this technique is that it enables capturing of the lip movements of the pat...

Purpose: To evaluate the mechanical stability of highly translucent zirconia (Zr) cantilevered fixed dental prostheses (cFDPs) and to investigate the influence of the number of implants (one versus two) supporting cFDPs with different restorative materials on their mechanical stability and load-bearing capacity. Materials and methods: Thirty-two...

Purpose: To systematically review all clinical studies focusing on the clinical outcomes of zirconia restorations bonded to different types of tooth or implant abutments and to provide practical clinical guidelines. Materials and methods: A search was performed for English-language articles in dental journals published up to September 2020 using...

Purpose: To assess the influence of the number of posterior teeth (2, 3, or 4) and location (molars, molar and premolar, or premolars) 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...

Statement of problem The accuracy of digital implant scans can be affected by the implant angulation, implant depth, or interimplant distance. However, studies analyzing intraoral scanning accuracy with different implant angulations and different scan body heights are scarce. Purpose The purpose of this in vitro study was to determine the influenc...

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.

Statement of problem Different variables that decrease the accuracy of intraoral scanners (IOSs) have been identified. Ambient temperature changes can occur in the dental environment, but the impact of ambient temperature changes on intraoral scanning accuracy is unknown. Purpose The purpose of this in vitro study was to assess the impact of ambie...

This technique report describes a fully digital workflow to create a prosthetic articulator-based implant rehabilitation (PAIR) virtual patient for complete-arch or complete-mouth implant rehabilitation. This workflow uses a custom gothic arch tracer during the cone beam computed tomography (CBCT) scan and a 3-dimensional virtual facebow when super...

Statement of problem Artificial intelligence applications are increasing in prosthodontics. Still, the current development and performance of artificial intelligence in prosthodontic applications has not yet been systematically documented and analyzed. Purpose The purpose of this systematic review was to assess the performance of the artificial in...

Many studies have evaluated short implants (SIs); however, it is still unclear whether SIs are reliable and can be used to simplify surgical and prosthetic protocols with successful clinical outcomes. The aim of this non-random, conveniently sampled, prospective, split-mouth study was to compare the clinical outcomes when short (SI) (≤8 mm) or regu...

Statement of problem Photogrammetry technology has been used for the digitalization of multiple dental implants, but its trueness and precision remain uncertain. Purpose The purpose of this in vitro investigation was to compare the accuracy (trueness and precision) of multisite implant recordings between the conventional method and a photogrammetr...

Statement of problem Artificial intelligence (AI) applications are growing in dental implant procedures. The current expansion and performance of AI models in implant dentistry applications have not yet been systematically documented and analyzed. Purpose The purpose of this systematic review was to assess the performance of AI models in implant d...

Purpose: To measure the accuracy of the additively manufactured casts with 3 base designs: solid, honeycomb-structure, and hollowed bases. Methods: A virtual cast was used to create different base designs: solid (S Group), honeycomb-structure (HC group), and hollowed (H group). Three standard tessellation language files were used to fabricate the s...

Objectives: To measure the accuracy (trueness and precision) of a facial scanner depending on the alignment method and the digitized surface area location. Methods: Fourteen markers were adhered on a head mannequin and digitized using an industrial scanner (GOM Atos Q 3D 12 M; Carl Zeiss Industrielle Messtechnik GmbH). A control mesh was acquire...

Statement of problem Artificial intelligence (AI) applications are increasing in restorative procedures. However, the current development and performance of AI in restorative dentistry applications has not yet been systematically documented and analyzed. Purpose The purpose of this systematic review was to identify and evaluate the ability of AI m...

Purpose: To measure the influence of postpolymerization condition (dry or submerged in water) and time (2, 10, 20, and 40 minutes) on the accuracy of additively manufactured model material. Materials and methods: A bar standard tessellation language file was used to manufacture the resin specimens (E-Model Light, EnvisionTEC) using a 3D printer...

Objective To review the elements of the vat-polymerization workflow, including the 3D printing parameters, support structures, slicing, and post-processing procedures, as well as how these elements affect the characteristics of the manufactured dental devices. Data Collection of published articles related to vat-polymerization technologies includi...

Purpose: To evaluate the mechanical stability and complication rates of titanium (Ti) or zirconia (Zr) abutments restored with cantilevered fixed dental prostheses (cFDPs) when supported by 1 or 2 implants. Materials and methods: A total of 32 samples were fabricated. Half of the samples received 1 implant, and the other half received 2 implants...

Purpose: To investigate the volumetric facial soft tissue changes associated with wearing complete dentures using 3D face scans. Materials and methods: Forty volunteers, 20 men and 20 women, were recruited for the study and treated with maxillary and mandibular complete dentures. Six facial scans were taken of each subject. Three scans were wear...

Purpose: To systematically review all in vitro studies focusing on the durability of different bonding protocols applied to zirconia restorations with different types of tooth or implant abutments. Materials and methods: English-language articles published in dental journals up to March 2020 were searched using a combination of free text words a...

Statement of problem The properties of dental computer-aided design and computer-aided manufacturing (CAD-CAM) materials vary. Studies regarding the effects of aging on the properties of these materials are lacking. Purpose The purpose of this in vitro study was to evaluate the changes in the mechanical and surface properties of different CAD-CAM...

Objective To review the techniques and available 2D and 3D computer‐aided design (CAD) software programs to perform a diagnostic waxing for restorative procedures when cone beam computed tomography is not indicated. Overview An electronic review was performed in Medline, Embase, and Scopus search engines. A manual search was also conducted. The ar...

Excessively worn dentition is a clinical condition that mainly impacts the esthetic appearance of patients. In many cases, this may even extend to affect their psychologic condition and social interaction, and consequently reduce their quality of life. The treatment steps of such cases involve comprehensive evaluation and diagnosis, a rigid rehabil...

Purpose: To measure the chemical composition, Knoop hardness, surface roughness, and composite bond strength of additive manufactured (AM) and conventional interim materials. Material and methods: Disks were prepared using conventionally (CNV group) and additively manufactured (AM group) materials: CNV-1 (Protemp 4; 3M ESPE), CNV-2 (Anaxdent new o...

This clinical report describes a ceramic complete-mouth rehabilitation with screw-retained implant abutment crowns, optimizing esthetics by combining the properties of ceramic materials. The abutments connected a titanium insert to a computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic zirconia framework, offering improved es...

Purpose: To measure the influence of illuminance of the ambient light between 1000 lux (room light) and 10 000 lux (chair light) on the accuracy of an intraoral scanner (IOS). Material and methods: A typodont was digitized using an extraoral scanner to obtain a reference standard tessellation language (STL) file. Ten groups were created based on t...

Statement of problem: Long-term clinical data on the survival of pressed lithium disilicate glass ceramic when used with partial coverage restorations and the effect that different technical and clinical variables have on survival are sparse. Purpose: The purpose of this clinical study was to determine the 10.9-year survival of pressed lithium d...

Statement of problem The optical properties of esthetic computer-aided design and computer-aided manufacturing (CAD-CAM) materials can change depending on the clinical situation. Studies that compare esthetic CAD-CAM materials based on their optical properties are lacking. Purpose The purpose of this in vitro study was to evaluate the optical prop...

Statement of problem: Long-term clinical data are lacking on the comparison of the survival of adhesively luted pressed e.max lithium disilicate glass ceramic complete and partial coverage restorations in posterior dentitions and the effect that different technical and clinical variables have on their survival. Purpose: The purpose of this clini...

A technique to additively manufacture an occlusal device by using a completely digital workflow is described. Using a computer-aided design program, information captured with an intraoral scanner was used to additively manufacture a dual-material occlusal device by using a vat-polymerization printer. This technique allows for the combination of 2 d...

Statement of problem Conventional implant impressions by using elastomeric impression material have been reported as a more reliable technique for a complete-arch implant record compared with intraoral scanner procedures. Photogrammetry technology may provide a reliable alternative to digital scanning or a conventional impression; however, its accu...

Artificial intelligence (AI) encompasses a broad spectrum of emerging technologies that continue to influence daily life. The evolution of AI makes the analysis of big data possible, which provides reliable information and improves the decision-making process. This article introduces the principles of AI and reviews the development of AI and how it...

The following amendments are made to the published article: Quintessence Int 2020;51(3):248-257; First published 4 February 2020; doi:10.3290/j.qi.a43952 Artificial intelligence in dentistry: current applications and future perspectives Yo-wei Chen, DDS, MSc/Kyle Stanley, DDS/Wael Att, DDS, Dr Med Dent, PhD.

Purpose of Review Implant dentistry is a fast-evolving field and the computer-aided implant placement is becoming an inseparable part of it. There is a vast variety of techniques, workflows, and software making it hard for the dental practitioner to know which technique to apply to which clinical scenario. Therefore, the purpose of this review is t...

The purpose of this study was to evaluate the surface characteristics and optical and mechanical properties of materials through hydrothermal aging using different types of translucent monolithic zirconia. Three conventional materials (LT, KT, and ET) and three multilayered materials (LM, KM, and EM) of translucent monolithic zirconia were investig...

Background: Mucoepidermoid carcinoma (MEC) is a common cancer in the oral salivary gland malignancy, which mainly occurs in the parotid gland. The aim of this study is to identify independent prognostic factors and establish a nomogram model for parotid gland mucoepidermoid carcinoma (P-MEC) patients using the National Cancer Institute's Surveilla...

During complete-arch digital implant scanning, one of the most technique-sensitive steps is the data registration and superimposition or matching of different surface geometry data sets because of the absence of fixed landmarks. This article describes a straightforward technique for facilitating the accurate superimposition or matching of surface s...

Purpose: Evaluating the impact of the prosthetic material on implant- and prosthetic survival of implant-supported fixed complete dentures. Study selection: Electronic and hand searches were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify clinical studies including at least 10 patie...

With the advancement of computer-aided design/computer-aided manufacturing (CAD/CAM) in dentistry, the use of digital technologies is being increasingly adopted by clinicians and laboratory technicians. Clinicians are using intraoral scanners (IOSs) more and more to perform computer-aided impressions. While these are mainly used to digitize dentate...

Purpose: This systematic review aimed to provide an overview of zirconia implants as well as regarding the outcome of the implant-restorative complex in preclinical studies. Study selection: An electronic search of the literature prior to July 2017 was performed to identify all articles related to preclinical research on zirconia implants. The s...

Purpose: This systematic review evaluates the clinical outcome of zirconia implant-associated survival and success rates, marginal bone loss, and implant-restoration complex integrity. Study selection: Using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, studies including ≥10 patients restored with zi...

In many cases, due to anatomical limitations, the placement of regular-length implants cannot be facilitated without the performance of advanced surgical procedures. However, these are associated with morbidity, prolonged treatment time and costs. To overcome such disadvantages, short implants were introduced. The aim of this prospective pilot spli...

Purpose: A single implant can be placed to retain an overdenture in the edentulous mandible. This study aimed at the development of Oral Health-related Quality of Life comparing immediate and delayed implant loading, i.e., loading after 3 months of submerged healing. Methods: In a randomized controlled trial, 158 participants received a single m...

Purpose: To compare the accuracy of implant impressions using computer-aided impression-making technology and a conventional approach in a standardized setting in vitro, and to verify the effect of implant angulation (40 to 45 degrees) on the accuracy of digital and conventional impression-making procedures. Materials and methods: Four different...

It was the aim of this 24-mo randomized controlled clinical trial to investigate whether the survival of a single median implant placed in the edentulous mandible to retain a complete denture is not compromised by immediate loading. Secondary outcomes were differences in prosthetic complications between the loading principles. Each of the 158 patie...

Background : The successful long- term outcome of implant treatment of edentulous jaws has been documented extensively. While different fac-tors have been suggested to affect the outcome of implants, little is known about the impact of the restorative material. So far, studies focused either on the outcome of implants or on the outcome of the prost...

Aim: The impact of prosthetic material selection on implant survival is not clear. The current criteria for choosing a prosthetic material seem to be based on clinician preferences. This systematic review aims to evaluate the impact of restorative materials on the mid- and long-term survival of implants supporting single crowns and fixed partial d...

Objectives This randomized clinical trial compares immediate and delayed loading of single implants to support mandibular overdentures. The aim of this preliminary analysis is to test the hypothesis whether patients with immediate loading will experience less pain and discomfort through the intervention than patients with delayed loading. Materials...

Purpose: The aim of this critical review was to assess the survival and success rates of all-ceramic single crowns manufactured using different ceramic materials with a mean follow-up time of 5 years or longer. Materials and methods: An electronic search of studies published between 1980 and 2014 complemented by manual searching was conducted in...

The innovations of digital technologies in the interdisciplinary reconstructive and implant dentistry have opened new possibilities in the treatment planning and execution. Nowadays, the different virtual data sets can be integrated and fused in software, which leads to more information on the computer screen and enables a multi-layer visualization...

Objectives: To investigate whether there are differences in patients' denture satisfaction when an implant placed in the midline of the edentulous mandible is loaded either immediately or three months later, after second stage surgery. Methods: One hundred and fifty-eight edentulous patients received a single implant in the midline of the mandib...

Objective: Improvements in the bioactivity of zirconia implants for accelerated healing and reduced morbidity have been of continuing interest in the fields of dentistry and orthopedic surgery. The aim of the present study was to examine whether UV treatment increases the osteoconductivity of zirconia-based materials. Materials and methods: Smoo...

Purpose: The digitization of scanbodies on dental implants is required to use computer-aided design/computer-assisted manufacture processes for implant prosthetics. Little is known about the accuracy of scanbody digitization with intraoral scanners and dental lab scanners. This study aimed to examine the precision of different intraoral digital im...

Purpose: The aim of this paper is to provide a concise overview about the principles of pre-implant orthodontic extrusion, describe methods and techniques available and provide the clinicians with guidelines about its application. Study selection: A number of reports describe orthodontic extrusion as a reliable method for pre-implant site enhanc...

Titanium undergoes time-dependent degradation in biological capability, or “biological aging”. It is unknown whether the biological aging of titanium occurs beyond four weeks and whether age-related changes are definitely associated with surface hydrophilicity. We therefore measured multiple biological parameters of bone marrow-derived osteoblasts...

Purpose: Optical transfer is realized with system-specific transfer posts (scan bodies) mounted on dental implants or on implant analogs. This study presents a novel algorithm for creation of geometry on the surface of dental implant scan bodies and examines the precision of the optical acquisition of scan bodies and the precision of the position...

This study assessed the wear behavior of different zirconia substrates with distinct surface roughness against different antagonist materials. Hemisphere-shaped specimens (diameter 5 mm) made out of different materials (VM9, Vintage ZR, IPS e.max Press, and human enamel) were used as antagonists against plates of three zirconia materials (P-NANOZr,...

Abstract: Ultraviolet (UV) light treatment of implant surfaces has been demonstrated to enhance their bioactivity significantly. This study examined the effect of UV treatment of different zirconia surfaces on the response of primary human alveolar bone-derived osteoblasts (PhABO). Disks of two zirconia-based materials with two different surface to...

To examine the effect of ultraviolet light (UV) treatment on the surface characteristics of two acid-etched zirconia-based dental implant materials.Methods Discs of two zirconia-based materials (Zr1 and Zr2) with smooth (m) and roughened (r) surfaces were treated by UV light for 15 min. The surface topography was investigated by scanning electron m...

Background: Little is known about the accuracy of physical dental casts that are based on three-dimensional (3D) data from an intraoral scanner (IOS). Thus, the authors conducted a study to evaluate the accuracy of full-arch stereolithographic (SLA) and milled casts obtained from scans of three IOSs. Methods: The authors digitized a polyurethane...

When planning a prosthetic rehabilitation of a periodontally compromised case, the clinician is often confronted with difficulties and dilemmas related to selecting the appropriate treatment modality that would provide a long-term longevity in terms of function and esthetics. In such cases, a correct diagnosis and prognosis of the intraoral situati...

This study examined the effect of photofunctionalization on bioactivity and osteoconductivity of titanium alloy Ti6Al4V. We also tested a hypothesis that the effect of photofunctionalization is as substantial as the one of surface roughening. Two different surface morphology, a roughened surface (sandblasted and acid-etched surface) and relatively...

Objective: This study aimed to evaluate the wear behavior of different ceramic materials opposing different zirconia ceramics with distinct surface roughness. Method: Sphere-shaped samples (diameter 5 mm) were fabricated out of two different leucite-glass based veneering ceramics (VM9, Vintage ZR), lithium-disilicate ceramic (Emax Press) and...

Background: Although intraoral scanners are known to have good accuracy in computer-aided impression making (CAIM), their effect on time efficiency is not. Little is known about the time required to make a digital impression. The purpose of the authors' in vitro investigation was to evaluate the time efficiency of intraoral scanners. Methods: Th...

The aim of this systematic review was to evaluate the outcomes of flapless surgery for implants placed using either free-hand or guided (with or without 3D navigation) surgical methods. Literature searches were conducted to collect information on survival rate, marginal bone loss, and complications of implants placed with such surgeries. Twenty-thr...

Purpose: To evaluate the long-term clinical performance of prosthetic reconstructions on one-piece implants, with a focus on technical and biological complications. Materials and methods: An electronic MEDLINE search complemented by a manual search was conducted to identify randomized and prospective controlled clinical trials on one-piece impla...

This study aimed to evaluate the accuracy of intraoral scanners in full-arch scans. A representative model with 14 prepared abutments was digitized using an industrial scanner (reference scanner) as well as four intraoral scanners (iTero, CEREC AC Bluecam, Lava C.O.S., and Zfx IntraScan). Datasets obtained from different scans were loaded into 3D e...

Despite the accuracy of intraoral scanners (IOSs) in producing single-unit scans and the possibility of generating complete dentures digitally, little is known about their feasibility and accuracy in digitizing edentulous jaws. The purpose of this in vitro investigation was to evaluate the feasibility and accuracy of digitizing edentulous jaw model...

Zirconia posts can be used as an esthetic alternative to metal posts. Despite their advantages, there is a lack of information about the long-term performance of zirconia posts. This retrospective clinical study examined the survival probability, clinical performance, and reasons for failure of teeth restored with zirconia posts after an observatio...

Objective: The aim of the present systematic review was to determine the peri-implant tissue response to different implant abutment materials and designs available and to assess the impact of tissue biotype. Materials and methods: Relevant literature published between December 2009 and August 2012 was searched to identify studies dealing with di...

Objective: The aim of this clinical study was to compare tooth shade, color rebound, and tooth sensitivity after using either a combined bleaching technique (CBT) or a deep bleaching technique (DBT) to lighten stained teeth. CBT is a two-stage bleaching process consisting of an initial in-office bleaching treatment session using 35% hydrogen perox...

Bone regeneration often requires cues from osteogenesis-inducing factors for successful outcome. N-acetyl cysteine (NAC), an anti-oxidant small molecule, possibly modulates osteoblastic differentiation. This study investigated the potential of NAC as an osteogenesis-enhancing molecule in vitro and in vivo. Various concentrations of NAC (0, 2.5, 5.0...

Objective: This study examined the in vitro and in vivo response of osteoblasts to a novel, acid-etched and sandblasted zirconia surface. Methods: Osteoblastic hFOB 1.19 cells were cultured either on electrochemically anodized titanium (TiUnite(®)), machined titanium (Ti-m), sandblasted and acid-etched zirconia (TZP-proc), and machined zirconia...