Prosthesis, Volume 7, Issue 4 (August 2025) – 18 articles

Background. Digital dentistry continues to evolve, offering improved accuracy, efficiency, and patient experience across various prosthodontic procedures. Many previous reviews have focused on digital applications in prosthodontics. But the use of a fully digital workflow for full-arch implant-supported prostheses in edentulous patients remains an emerging and underexplored area in the literature. Objective. This article presents a comprehensive methodological review of the digital workflow in full-arch implant-supported rehabilitation. It follows a structured literature exploration and synthesizes relevant technological processes from patient assessment to prosthetic delivery. Methods. The relevant literature was retrieved from the PubMed database on 20 June 2024, to identify the most recent and relevant studies. A total of 22 articles met the eligibility criteria and were included in the review. The majority included case and technical reports. Results. The review illustrates the integration and application of digital tools in implant dentistry, including cone-beam computed tomography (CBCT) exposure, intraoral scanning, digital smile design, virtual patients, guided surgery, and digital scanning. The key findings demonstrate multiple advantages of a fully digital workflow, such as reduced treatment time and cost, increased patient satisfaction, and improved interdisciplinary communication. Conclusions. Despite these benefits, limitations persist due to the low level of evidence, technological challenges, and the lack of standardized protocols. Further randomized controlled trials and long-term clinical evaluations are essential to validate the effectiveness and feasibility of a fully digital workflow for full-arch implant-supported rehabilitation. Full article

Background/Objectives: Dental cavity preparation is a critical procedure in restorative dentistry that involves the removal of decayed tissue while preserving a healthy tooth structure. Excessive stress during tooth preparation leads to enamel cracking, dentin damage, and long term compressive pulp health. This study employed finite element analysis (FEA) to investigate the stress distribution in dental structures during cavity preparation using round diamond burs of varying diameters and depths of cut (DOC). Methods: A three-dimensional human maxillary first molar was generated from computed tomography (CT) scan data using 3D Slicer, Fusion 360, and ANSYS Space Claim 2024 R-2. Finite element analysis (FEA) was conducted using ANSYS Workbench 2024. Round diamond burs with diameters of 1, 2, and 3 mm were modeled. Cutting simulations were performed for DOC of 1 mm and 2 mm. The burs were treated as rigid bodies, whereas the dental structures were modeled as deformable bodies using the Cowper–Symonds model. Results: The simulations revealed that larger bur diameters and deeper cuts led to higher stress magnitudes, particularly in the enamel and dentin. The maximum von Mises stress was reached at 136.98 MPa, and dentin 140.33 MPa. Smaller burs (≤2 mm) and lower depths of cut (≤1 mm) produced lower stress values and were optimal for minimizing dental structural damage. Pulpal stress remained low but showed an increasing trend with increased DOC and bur size. Conclusions: This study provides clinically relevant guidance for reducing mechanical damage during cavity preparation by recommending the use of smaller burs and controlled cutting depths. The originality of this study lies in its integration of CT-based anatomy with dynamic FEA modeling, enabling a realistic simulation of tool–tissue interaction in dentistry. These insights can inform bur selection, cutting protocols, and future experimental validations. Full article

Background/Objectives: the precise application of torque during prosthetic screw tightening is essential to the long-term success and mechanical stability of implant-supported restorations. This study aimed to evaluate the influence of practitioner experience, glove material, screwdriver length, and hand moisture on the maximum torque value (MTV) generated during manual tightening. Methods: thirty participants, comprising 10 experienced professors and 20 senior dental students, performed tightening tasks under six hand conditions (nitrile gloves, latex gloves, and bare hands, each in dry and wet environments) using two screwdriver lengths (21 mm and 27 mm). The torque values were measured using a calibrated digital torque meter, and the results were analyzed using a linear mixed model. Results: professors applied significantly higher torque than students (16.92 Ncm vs. 15.03 Ncm; p = 0.008). Nitrile gloves yielded the highest torque (17.11 Ncm), surpassing bare hands significantly (p = 0.003). No statistically significant differences were found for screwdriver length (p = 0.12) or hand moisture (p = 0.11). Conclusions: these findings underscore the importance of clinical proficiency and glove material in torque delivery, providing evidence-based insights to enhance procedural reliability and training standards in implant prosthodontics. Full article

Background/Objectives: The projected rise in limb amputations highlights the need for advancements in prosthetic technology. Current transtibial prosthetic designs primarily focus on sagittal plane kinematics but often neglect both the ankle kinematics and kinetics in the coronal plane, and the metatarsophalangeal joint, which play critical roles in gait stability and efficiency. This study aims to evaluate the combined effects of compliance in the coronal plane and a flexible toe joint on prosthetic gait using non-amputated participants as a model. Methods: We conducted gait trials on ten non-amputated individuals in the presence and absence of compliance in the coronal plane and toe compliance, using a previously developed three-degree-of-freedom (DOF) prosthetic foot with a prosthetic simulator. We recorded and analyzed sagittal and coronal kinematic data, ground reaction forces, and electromyographic signals from muscles involved in the control of gait. Results: The addition of compliance in the coronal plane and toe compliance had significant kinematic and muscular effects. Notably, this compliance combination reduced peak pelvis obliquity by 27%, preserved the swing stance/ratio, and decreased gluteus medius’ activation by 34% on the non-prosthetic side, compared to the laterally rigid version of the prosthesis without toe compliance. Conclusions: The results underscore the importance of integrating compliance in the coronal plane and toe compliance in prosthetic feet designs as they show potential in improving gait metrics related to mediolateral movements and balance, while also decreasing muscle activation. Still, these findings remain to be validated in people with transtibial amputations. Full article

Background/Objectives: The aim of this systematic review was to identify the role of orthodontics in patients undergoing tumor-ablative surgery, in collaboration with maxillofacial prosthodontic rehabilitation in a multidisciplinary fashion. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024582050). The focused question was constructed using the PICO (participant, intervention, comparison, and outcome) approach. A three-stage search was performed in PubMed, Scopus, and Web of Science using Medical Subject Heading (MeSH) terms. To assess the risk of bias, the National Institute of Health (NIH) “Quality Assessment Tool for case series/reports” was used. All data was synthesized qualitatively, according to the Synthesis Without Meta-analysis (SWiM) reporting guideline. Results: The initial search yielded 624 articles, of which 22 met the inclusion criteria after screening and eligibility assessment, with most being single-patient case reports and one case series involving 12 patients. The included studies primarily involved tumors in the mandible (64.5%) and maxilla (32.3%). Orthodontic treatment was initiated at various time points, ranging from one month pre-surgery to 19 years post-surgery, primarily utilizing fixed appliances (77.8%). In some studies, orthodontic appliances were used to enhance the stability of maxillofacial prostheses. The results of this study indicate that orthodontic treatment may facilitate prosthetic rehabilitation by improving conditions prior to prosthetic intervention and increasing the retention of the obturator prosthesis. Conclusions: Orthodontic treatment can enhance maxillofacial prosthetic rehabilitation after tumor-ablative surgery by optimizing jaw growth, improving occlusion, and facilitating prosthetic retention or space creation. Further research is needed to establish treatment guidelines. Orthodontic miniscrews may improve temporary prosthesis retention before final implant placement, when indicated. Full article

Background/Objectives: Partial maxillectomy frequently results in severe impairments of oral functions, such as difficulties in chewing, speech, swallowing, and facial appearance. Immediate prosthetic rehabilitation is challenging because soft tissue healing is typically required before impression taking. This study aimed to (1) develop a comprehensive digital workflow for fabricating immediate obturator prostheses using preoperative data and (2) assess their early clinical effectiveness in restoring oral functions after surgery. Methods: In this prospective clinical study, 20 patients undergoing partial maxillectomy from January 2023 to January 2025 were enrolled. A digital workflow combining cone-beam computed tomography (CBCT), intraoral scanning, CAD/CAM design, and 3D metal printing was implemented. Obturator prostheses were digitally designed preoperatively and inserted immediately post-resection. Functional outcomes were postoperatively evaluated after one month using the Obturator Functioning Scale (OFS), which measures functional, speech, esthetic, and psychosocial aspects. Results: The digitally fabricated immediate obturator prostheses were successfully placed intraoperatively in all patients. Most participants reported mild to moderate difficulties, with speech-related issues being the most common, while esthetic concerns were minimal. Masticatory function was satisfactorily restored in 75% of cases, and 60% of patients experienced minimal fluid leakage during swallowing. No significant differences were found between genders. Patients with larger defects tended to report greater functional challenges. Conclusions: The digitally planned immediate obturator prosthesis provides a practical and effective solution for early rehabilitation following partial maxillectomy. This digital workflow reduces patient discomfort, restores key oral functions, and facilitates psychosocial recovery. Full article

Background/Objectives: Autopolymerizing poly (methyl methacrylate) (PMMA) resin is widely used in provisional restorations; however, its inadequate mechanical properties represent a significant limitation. This study aimed to develop electrospun fibers with chemically reduced graphene oxide (rGO) and to evaluate the effect of fiber reinforcement on the mechanical and physical properties of a commercially available PMMA resin. Methods: Electrospinning was employed to produce nanofibers containing 0.02 wt% and 0.05 wt% rGO within a PMMA matrix. Fiber characterization was performed using SEM-EDS, XRD, TGA/DTG, and FTIR. Following characterization, the fibers were blended into PMMA resin at 1%, 2.5%, and 5% (by weight). The resulting fiber-reinforced composites were tested for flexural strength, elastic modulus, surface roughness, and Vickers microhardness. Results: The addition of 1% and 2.5% PMMA/rGO-0.02 fibers and 1% PMMA/rGO-0.05 fibers significantly improved the flexural strength of PMMA compared with the control group (p < 0.05). A statistically significant increase in elastic modulus was observed only in the group containing 1% PMMA/rGO-0.02 fibers (p < 0.05). However, there were no significant differences in surface roughness or microhardness between the control and experimental groups (p > 0.05). Conclusions: Incorporating electrospun PMMA-rGO fibers into PMMA resin enhances flexural properties at low concentrations without altering surface characteristics. These findings suggest that such fiber-reinforced systems hold promises for improving the mechanical performance and functional longevity of provisional dental restorations under clinical conditions. Full article

Objectives: This systematic review aimed to evaluate the cost, production time, clinical performance, and patient satisfaction of 3D printing workflows in prosthodontics compared to conventional and subtractive methods. Methods: Following PRISMA guidelines, a systematic search of electronic databases was performed to identify studies published between 2015 and 2025 that directly compared digital additive workflows with analogue or subtractive workflows. Studies were eligible if they included prosthodontic treatments such as dentures, crowns, or implant-supported prostheses and reported at least one relevant outcome. The primary outcomes were cost, time efficiency, clinical accuracy (e.g., marginal adaptation, fit), and patient satisfaction. Included studies were methodologically evaluated using MINORS scale and the risk of bias was assessed using ROBINS-I and RoB 2 tools. Results: Seven studies met the inclusion criteria. Overall, 3D printing workflows demonstrated reduced production time and cost in comparison to conventional or subtractive methods. Clinical outcomes were generally comparable or superior, particularly regarding adaptation and fit. Patient satisfaction was favourable in most studies, although reporting varied. Long-term follow-up was limited, which constrains the interpretation of sustained clinical performance. Conclusions: These findings suggest that 3D printing can serve as an efficient and cost-effective alternative in prosthodontic fabrication, with clinical results comparable to those already established. Further research is needed to assess long-term clinical performance and cost-effectiveness in various clinical scenarios. Full article

Background: Digital dental photography is increasingly essential for documentation and smile design. This study aimed to compare the linear measurement accuracy of various smartphones and a Digital Single-Lens Reflex (DSLR) camera against digital models obtained by intraoral and desktop scanners. Methods: Tooth height and width from six different casts were measured and compared using images acquired with a Canon EOS 250D DSLR, six smartphone models (iPhone 13, iPhone 15, Samsung Galaxy S22 Ultra, Samsung Galaxy S23 Ultra, Samsung Galaxy S24, and Vivo T2), and digital scans obtained from the Helios 500 intraoral scanner and the Ceramill Map 600 desktop scanner. All image measurements were performed using ImageJ software (National Institutes of Health, Bethesda, MD, USA), and statistical analysis was conducted using one-way analysis of variance (ANOVA) with Tukey’s post hoc test (α = 0.05). Results: The results showed no significant differences in measurements across most imaging methods (p > 0.05), except for the Vivo T2, which showed a significant deviation (p < 0.05). The other smartphones produced measurements comparable to those of the DSLR, even at distances as close as 16 cm. Conclusions: These findings preliminary support the clinical use of smartphones for accurate dental documentation and two-dimensional smile design, including the posterior areas, and challenge the previously recommended 24 cm minimum distance for mobile dental photography (MDP). This provides clinicians with a simplified and accessible alternative for high-accuracy dental imaging, advancing the everyday use of MDP in clinical practice. Full article

Background/Objectives: Guided implant surgery relies on the use of surgical templates to direct osteotomy drills, but guide design may influence irrigation efficiency, hence bone overheating, a critical factor in preventing thermal necrosis. This ex vivo study compared temperature changes when drilling using two guide designs: a closed-frame (occlusive structure) and an open-frame (non-occlusive design), evaluating their clinical relevance in mitigating overheating. Methods: Sixteen pig ribs were scanned, and implant osteotomies were planned via a guided surgery software. Two 3D-printed resin templates, one with a closed-frame design and one with an open-frame design, were tested (8 ribs per group, 24 implants per group). Drilling was performed sequentially (diameter of 1.9 mm, 3.25 mm, and 4.1 mm) at 800 rpm, while bone temperatures were recorded at depths of 3 mm and 10 mm using K-type thermo§s. Results: Significantly higher temperature rises were observed with the closed-frame guide. Drilling depth had also a significant influence, with higher temperatures at 3 mm than 10 mm (p < 0.001), suggesting that cortical bone density may amplify frictional heat. No significant effect of drill diameter was detected. Conclusions: Within the limitations of this ex vivo model, the open-frame design kept the maximal temperature rise about 0.67 °C lower than the closed-frame guide (1.22 °C vs. 0.55 °C), i.e., a 2.2-fold relative reduction was observed during the most demanding drilling step. This suggests a more efficient cooling capacity, especially in dense cortical bone, which offers a potential benefit for minimizing thermal risk in guided implant procedures. Full article

Purpose: The aim of this study was to compare the effect of rotary (air-driven, electric-driven) and oscillating (piezoelectric ultrasonic) handpieces on the quality of crown preparation, marginal integrity, and internal adaptation of monolithic zirconia crowns. Materials and Methods: Seventy-two standardized premolar preparations were performed using the air-driven handpiece with a guide pin-ended tapered fissure diamond bur on a modified dental surveyor. The finishing process utilized three handpiece types (n = 24/group) with fine/superfine diamond burs under controlled force with a fixed number of rotations and controlled advancement time. Marginal/internal adaptation was evaluated via the triple-scan technique; defects (marginal, axial, and occlusal) were quantified based on predefined criteria through the inspection of the Standard Tessellation Language (STL) file. Results: One-way ANOVA with Tukey HSD and Kruskal–Wallis with Dunn–Bonferroni tests were utilized. The marginal gap showed no significant differences (p > 0.05, η² = 0.04). The electric handpiece outperformed the ultrasonic (p = 0.023, η² = 0.105) in internal adaptation, while the air-driven showed no differences (p > 0.05). The ultrasonic handpiece produced fewer marginal defects than the air-driven (p = 0.039, ε² = 0.132), but more axial defects (median 9 vs. 6, p = 0.014, ε² = 0.168) than the electric handpiece and occlusal defects (5 vs. 3, 4 p = 0.007, p = 0.015, ε² = 0.227) than rotary handpieces. The air-driven handpiece exhibited comparable defect numbers to the electric handpiece without statistical significance (p > 0.05). Conclusions: Handpiece selection had a small effect on marginal adaptation but more pronounced effects on overall defect formations and internal adaptation. The ultrasonic handpiece’s decreased marginal defects but variable axial/occlusal results reveal technological constraints, whereas rotary handpieces’ consistency reflects their operator-dependent nature. Full article

Background: The increasing adoption of digital workflows in implant dentistry necessitates rigorous assessment of intraoral scanning, particularly for complex full-arch rehabilitations like All-on-Four prostheses, where posterior implant angulation may impact the accuracy of optical data acquisition. Objectives: This in vitro study aimed to assess the accuracy of digital intraoral scanners in scanning All-on-Four implant models with different posterior implant angulations. Methods: Two epoxy resin All-on-Four implant models were fabricated with two posterior implant angulations (30-degree and 45-degree). Both models were digitized to obtain control datasets using a Smart Optics reference scanner (REF). Four intraoral scanners were comparatively assessed: Cerec Omnicam AC (OMN), Trios 4 (TRI), Cerec Primescan AC (PRI), and Medit i700 (MED), with nine scans per each scanner (n = 9). All STL files were exported and analyzed using Geomagic Control X with root mean square (RMS) values computed for trueness and precision assessments. Results: The comparison between IOS types in terms of trueness revealed that with 30° angulation, the MED group showed the statistically significant least deviation (p = 402). With 45° angulation, both PRI and OMN scanners showed the statistically significant highest deviation values (p = 0.047 and 0.007, respectively). MED again showed the statistically significant least deviation (p = 402). For precision evaluation in 30° angulation models, PRI and OMN scanners showed the statistically significant least deviation values (p = 402 and <0.001, respectively). While, in 45° angulation models, no statistically significant inter-scanner differences were observed. Conclusions: While MED, PRI, and OMN scanners demonstrated clinical validity for 30° angled posterior implants, only the MED system achieved sufficient accuracy for 45° tilt. These findings emphasize the critical relationship between scanner selection and extreme implant angulations in full-arch digital workflows. Full article

Background: Patients awaiting total hip arthroplasty (THA), particularly those with hip osteoarthritis (OA), face an elevated risk of osteoporosis due to age and gender-related factors. Osteoporosis, indicated by low bone mineral density (BMD), can affect implant osteointegration, long-term stability, and increase the likelihood of periprosthetic fractures. Despite these risks, osteoporosis is often underdiagnosed and undertreated in THA candidates. While several studies have addressed this issue in Northern populations, data on Southern European cohorts, particularly Italian patients, remain limited. This study aims to evaluate the prevalence of osteoporosis and vitamin D deficiency, as well as the rates of related treatments, in patients with hip osteoarthritis scheduled for THA. Methods: This single-center, retrospective study was conducted at Policlinico Universitario di TorVergata, Italy, involving 66 hip OA patients (35 men, 31 women; mean age 67.5 years). BMD was assessed at the femoral neck, total femur, and lumbar spine via DEXA, alongside vitamin D and PTH levels. Demographic data, ongoing anti-osteoporotic therapies, Harris Hip Score (HHS), and handgrip strength were recorded. Statistical analysis included t-tests and Pearson’s correlation. Osteoporosis was defined per WHO criteria, with significance set at p < 0.05. Results: In this study of 66 patients with hip osteoarthritis (35 men, 31 women; mean age 67.5 years), women exhibited significantly lower bone mineral density (BMD) at the total femur (−0.98 ± 1.42 vs. −0.08 ± 1.04; p < 0.05) and lumbar spine (−0.66 ± 1.74 vs. 0.67 ± 1.59; p < 0.05) compared to men. Handgrip strength was also significantly reduced in females (17.1 ± 8.2 kg) versus males (27.3 ± 10.3 kg; p < 0.05). Vitamin D levels were below 30 ng/mL in 89.4% of patients, and 63.6% had levels below 20 ng/mL; PTH levels were elevated (>65 pg/mL) in 54.5% of cases, indicating frequent secondary hyperparathyroidism. Only 9 patients were receiving vitamin D supplementation and none were on anti-osteoporotic treatment. Conclusions: These findings highlight the frequent coexistence of low BMD, vitamin D deficiency, and reduced muscle strength in THA candidates, suggesting a pattern of musculoskeletal vulnerability that warrants clinical attention. Full article

Introduction: Pediatric prosthetic knee joints must be appropriately scaled from adult designs to ensure proper gait biomechanics. However, direct dimensional scaling without considering the biomechanical implications may lead to functional discrepancies. This study aimed to evaluate whether using a linear scaling factor can effectively adapt a knee for pediatric use. The study assessed whether such an approach yields a viable pediatric prosthetic knee joint by applying a fixed scaling factor and analyzing the resultant knee geometry. Methods: The linear scaling factor was determined based on the pylon tube diameter, a key constraint in compact pediatric knee design. Given a pediatric pylon diameter of 22 mm, the length of the tibial link was set to 22 mm, yielding a scaling factor of 0.6875 when compared to the adult-sized knee. This scaling factor was used to determine the dimensions of the pediatric four-bar (scaled) knee joint. Static geometric analysis was conducted using GeoGebra^® to model the lower-body segment lengths. The knee joint’s performance was evaluated based on stance and swing phase parameters. These metrics were compared between the scaled knee and a commercial pediatric knee. Results: The geometric analysis revealed that while using the linear scaling factor maintained proportional relationships, certain biomechanical parameters deviated from the expected pediatric norms. The scaled knee achieved a toe clearance of 13.5 mm compared to 19.7 mm in the commercial design and demonstrated a swing-phase heel clearance of 11.6 mm versus 13.3 mm, maintaining negative x/y ratios at heel contact and showing significant stability in push-off moments, while the stance flexion angle remained within an acceptable range. The heel contact and push-off ratios (x/y) were found to be comparable, with the scaled model achieving values of −1.21 and −0.59, respectively. The stance flexion angle measured 10.6°, closely aligning with the commercial reference. Conclusions: Using a linear scaling factor provides a straightforward method for adapting adult prosthetic knee designs to pediatric use. However, deviations in key biomechanical parameters indicate that further experimental study may be required to validate the applicability of the scaled knee joint for pediatric users. Future work should explore dynamic simulations and experimental validations to refine the design further and ensure optimal gait performance. Full article

Transcatheter aortic valve replacement (TAVR) is now established as a safe and effective treatment for severe aortic stenosis across all surgical risk categories. Nevertheless, periprocedural conduction disturbances—including new-onset left bundle branch block (LBBB), right bundle branch block (RBBB), and other intraventricular blocks—remain among the most frequent complications, often resulting in permanent pacemaker (PPM) implantation and impacting left ventricular remodeling. A review was conducted using the PubMed/MEDLINE database. Relevant clinical trials, observational studies, and meta-analyses addressing post-TAVR LBBB were included and analysed with a focus on frequency, risk factors, and association with adverse outcomes. We describe the incidence of post-TAVR conduction disturbances and identify key predictors: pre-existing RBBB, membranous septum length, valve oversizing, implantation depth, infra-annular leaflet extension, compression ratio, and valve type/generation. New-onset LBBB is a frequent complication after TAVR and may negatively affect patient outcomes. Accurate risk stratification and standardised post-procedural monitoring protocols are essential. Further prospective studies are needed to better define management strategies for patients developing LBBB after TAVR. Full article

Background: Dental implants enhance masticatory efficiency in edentulous patients, yet discrepancies exist between objective assessments and patient perceptions. This study evaluated masticatory efficiency before and after implant rehabilitation using the two-color mixing test (Hue-Check Gum^®) and Viewgum^® software Version 1.4. 32-bit, correlating objective data with patient-reported outcomes. Methods: In a prospective study of 30 patients receiving implant-supported prostheses, masticatory efficiency was assessed objectively (VOH values via Viewgum^®) and subjectively (10 cm VAS). Statistical analysis included Shapiro–Wilk, paired t-tests (VAS), and Wilcoxon tests (VOH). Correlation and regression analyses examined subjective–objective relationships. Results: Significant improvements occurred post-rehabilitation. VAS scores rose from 3.46 (95% CI: 2.54–4.39) to 7.29 (6.55–8.02; p < 0.001). VOH values decreased from 0.462 (0.426–0.497) to 0.438 (0.403–0.473; p = 0.001), confirming better chewing performance. No correlation was found between VAS and VOH, pre- (p > 0.346) or post-treatment (p > 0.980). Conclusion: Implant rehabilitation improves masticatory function objectively and subjectively. However, the lack of correlation underscores the need for dual assessment in clinical practice. Future studies should explore factors influencing satisfaction and performance to optimize outcomes. Full article

Background: Soft liners offer a cushioning effect that aids in the healing of inflamed mucosa and allocates the relevant load in the support area of prostheses, enhancing their fit and stability. This study looks at how strontium-infused phosphate bioactive glass affects a heat-cured acrylic-based soft liner, focusing on the surface hardness and the surface roughness of the material. Methods: One hundred soft liner specimens were produced, with fifty specimens being designated for surface hardness testing and fifty specimens for surface roughness testing. PBG*Sr was incorporated into the soft liner at the concentrations of 1 wt.%, 3 wt.%, 5 wt.%, and 7 wt.%. Surface hardness and surface roughness were evaluated with a digital durometer for Shore A hardness and a profilometer, respectively. Fourier transform infrared spectroscopy analysis and field emission scanning electron microscopy were employed. Results: The Shapiro–Wilk test demonstrated that the data adhered to a normal distribution, as the p-values were not statistically significant. Subsequently, for statistical analyses following the one-way ANOVA, Dunnett’s T3 post hoc test was employed for surface hardness, while Tukey’s post hoc test was used for surface roughness. The lowest hardness value was documented in the 7 wt.% subgroup (29.040 ± 0.070), followed by the 5 wt.% subgroup (30.97 ± 0.231), and the control (40.880 ± 0.473) had the highest hardness mean value. The 7 wt.% subgroup displayed the lowest value of Ra recorded, 0.489 ± 0.077 μm, while the control subgroup showed the highest, 1.994 ± 0.168 μm. FTIR analysis suggested that the domination of physical interactions according to the analyses with the FESEM led to improved surface morphology for the 7 wt.% PBG*Sr specimens. Conclusions: The 7 wt.% PBG*Sr specimens exhibited the lowest surface hardness, suitable for soft lining material, and improved the surface morphology of acrylic soft liners compared with the control and other concentrations. Full article

Background: Aesthetic dentistry increasingly demands minimally invasive, predictable, and patient-centered solutions. Digital technologies and AI-driven planning tools are now integral to interdisciplinary treatments. Aim: To evaluate, by means of a 16-item questionnaire, patients’ perceptions of smile aesthetics and oral function before and after receiving clear aligner therapy followed by minimally invasive ceramic veneers, using digital planning and Smile Creator software. Materials and Methods: Five adult patients underwent digital smile design, clear aligner therapy, and feldspathic veneer placement. Pre- and post-treatment perceptions of smile aesthetics and function were assessed using a structured questionnaire. AI-based simulation tools (2D and 4 K TruSmile video previews) were incorporated. Paired t-tests were used to compare outcomes before and after treatment. Results: Mean pre-treatment scores were 4.8 for smile aesthetics and 6.6 for function. Post-treatment scores significantly improved to 9.8 (p = 0.001) and 9.4 (p = 0.002), respectively. Patients rated AI-generated smile previews more favorably than 2D designs and acknowledged the value of digital tools in understanding and accepting treatment. Conclusions: The integration of digital and AI-based tools in aesthetic dentistry enhances patient communication, improves predictability, and enables minimally invasive treatment. Patient satisfaction was high, underscoring the effectiveness of the combined orthodontic and prosthetic approach. Full article