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A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomedical Engineering and Biomaterials".

Deadline for manuscript submissions: closed (28 February 2026) | Viewed by 10140

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Prof. Dr. Gherlone Felice Enrico

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Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita Salute University, Milan, Italy
Interests: oral surgery; maxillofacial surgery; oral pathology; implant; digital dentistry; prosthodontics
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Dr. Giulia Teté

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Guest Editor

Department of Dentistry, IRCCS San Raffaele Hospital, Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
Interests: biomaterials; stem cells; dental implants; periodontal and oral hygiene; systemic disease
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Dear Colleagues,

The average increase in life expectancy is dependent on the effective treatment of a higher incidence of systemic diseases in the overall population.

The progressive and continuous evolution in medical science means that compensation for most pathologies may be achieved, allowing affected patients to lead a lifestyle that is almost comparable to that of healthy individuals.

Additionally, ensuring adequate function and aesthetics from a dental point of view, in combination with the growing average age (also dependent on the increase in partially or fully edentulous individuals), could be an increasingly burning issue.

Although consulting the treating physician may be the condition for proceeding with surgical and prosthetic rehabilitations, it is essential for the dentist to have decision-making guidelines that can enable them, from the very first visit, to provide the patient with concrete answers as to whether or not procedures are feasible.

Moreover, access to prospective and retrospective clinical studies with medium–long follow-up would increase optimism and confidence about the predictability of procedures and long-term results could also be essential in managing possible complications.

Full knowledge of the effect of drugs on implant survival rates, peri-implant parameters, and intra- and post-operative complications is also significant.

These drugs, in addition to individual characteristics, autoimmune and psychiatric diseases, genetic predisposition, and stress, could also play a significant role in oral mucosal diseases.

Further studies concerning the incidence of these pathologies and the possible impact on surgical and prosthetic rehabilitation to restore missing or compromised teeth could be crucial, both for clinicians and patients.

Another key point related to prominent issues in dentistry is the need to reduce clinical time and biological and economic costs for the patient.

From this point of view, the use of digital methods that allow the patient to pre-visualise prosthetic rehabilitations, reduce timing, increase patient comfort, and assist the clinician should be considered the gold standard.

Concerning dental implants, long-term edentulism, especially of the posterior sectors but also of the anterior ones, could be hindered by insufficient residual bone volume and the scarcity of keratinized mucosa; investigating therapeutic alternatives that allow the insertion of implants that adapt to reduced bone height and/or thickness and investigating the role of soft tissue in the success of rehabilitation could be crucial.

Prof. Dr. Gherlone Felice Enrico
Dr. Giulia Teté
Guest Editors

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Keywords

biomaterials
odontoiatria
oral and dental health

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Related Special Issue

Biomaterials and Technology for Oral and Dental Health, 2nd Edition in Bioengineering

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Research

23 pages, 2122 KB

Open AccessArticle

Corrosion Behavior and Ion Release of Co–Cr Dental Alloys Fabricated by Casting, CAD/CAM, SLM and DMLS: Influence of Manufacturing Route and Microstructure

by Lucien Reclaru, Gabriel Buciu, Stelian-Mihai-Sever Petrescu, Raluca Ionela Gheorghe, Daniela Florentina Grecu and Alexandru Florian Grecu

Bioengineering 2026, 13(4), 406; https://doi.org/10.3390/bioengineering13040406 - 31 Mar 2026

Viewed by 504

Abstract

The present study demonstrates that the corrosion behavior of dental cobalt–chromium (Co–Cr) alloys is strongly influenced by the interaction between microstructure, manufacturing technique, and oral chemical environment. A comparative investigation was conducted on Co–Cr specimens fabricated using four technological routes: conventional casting, CAD/CAM machining, Selective Laser Melting (SLM), and Direct Metal Laser Sintering (DMLS). The study included microstructural characterization, evaluation of generalized corrosion behavior using the rotating electrode technique, assessment of localized crevice corrosion, and quantitative analysis of the release of twenty metallic cations. Extraction tests were performed for 168 h in two media simulating aggressive oral environments: 0.07 N HCl (acidic medium) and a fluoride-containing electrolyte (0.1% NaF + 0.1% KF). Electrochemical measurements were recorded in the current density range of 10⁻¹⁰ to 10⁻⁷ A/cm², while released cation concentrations were quantified at the µg/L level. All alloys exhibited very low corrosion current densities (icorr in the 10⁻⁸ to 10⁻⁹ A·cm⁻² range), confirming overall good corrosion resistance. Among all manufacturing routes, CAD/CAM specimens demonstrated the highest electrochemical performance, with a wide passivity domain extending up to approximately 740 mV/SCE. A statistical interaction analysis between extraction media and manufacturing techniques was performed using the non-parametric Mann–Whitney (MW) U test. Among the analyzed elements, only chromium showed a statistically significant difference between media (p < 0.05), with an approximately 25-fold-higher release in acidic conditions compared with the fluoride medium, confirming the predominant role of proton-induced destabilization of the protective Cr₂O₃ passive film. In contrast, fluoride-containing media induced selective release of elements such as Cu (3× higher), W (2.5× higher), and Mo (1.4× higher), associated with complexation phenomena. The manufacturing route significantly influences corrosion behavior. Although additive manufacturing technologies (SLM/DMLS) enable highly accurate and customized prosthetic designs, rapid solidification and microstructural heterogeneities may increase susceptibility to localized corrosion compared with more homogeneous CAD/CAM materials. Clinically, these findings suggest that future restorative strategies should incorporate corrosion-aware material selection within digital workflows. As digital dentistry evolves, predictive models integrating patient-specific oral conditions may assist clinicians in selecting the most appropriate material system for long-term performance. In conclusion, the long-term success of dental Co–Cr prosthetic devices depends not only on mechanical strength and precision of fit, but also on sustained electrochemical stability in the complex oral environment. Full article

(This article belongs to the Special Issue Biomaterials and Technology for Oral and Dental Health)

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18 pages, 1810 KB

Open AccessArticle

Comparative Evaluation of Beverage-Induced Surface Alterations on Dental Enamel: An In Vitro Biomaterial Study

by Ioana Elena Lile, Otilia Stana, Diana Marian, Carolina Cojocariu, Luminiţa Ligia Vaida, Anda Olivia Jesamine Samoilă and Iustin Olariu

Bioengineering 2026, 13(3), 369; https://doi.org/10.3390/bioengineering13030369 - 22 Mar 2026

Viewed by 547

Abstract

Background/Objectives: Despite advances in preventive dental care, tooth enamel erosion remains a relevant concern, and very few comparisons of surface topography have been carried out under controlled conditions in the laboratory. This study primarily aimed to conduct a qualitative morphological evaluation, supported by semi-quantitative image analysis, of the effects of commonly consumed beverages on human enamel morphology and colour, and to explore their relationship with beverage acidity in an in vitro model. Methods: Forty-two human teeth were allocated at random into seven different groups, each containing six molars. These groups were Coca-Cola, orange juice, lemon juice, coffee, chlorhexidine, regular mouthwash without chlorhexidine, and one control group. Following a 24 h exposure to a simulated saliva environment at 37 °C, the test samples were then subjected to a five-day erosion cycle. SEM analysis was used to examine the enamel alterations after evaluating the morphology of the enamel surface and by digital image analysis. Results: Scanning electron microscopy, SEM, showed how erosion of the teeth’s surface increased with the acidity of the drink. The extensive exposure of the crystal prisms, along with the severe loss of intercrystalline material and honeycomb weathering patterns, was all brought about by Coca-Cola and lemon juice. The moderate erosion brought on by orange juice in tests resulted in partially exposed prisms. Both the mouthwashes and the coffee exhibited similar impacts on the tooth enamel in a microscopic view. Minimal enamel prism rods were exposed due to either the coffee or the mouthwash. The surface characteristics were found through a digital image analysis, which indicated alterations in surface texture. Conclusions: Under these immersion conditions, highly acidic beverages produced the most pronounced enamel surface changes, whereas coffee induced mainly staining and neutral mouthwashes caused minimal modification. These results reflect qualitative morphological trends and should not be interpreted as clinical outcomes. Full article

(This article belongs to the Special Issue Biomaterials and Technology for Oral and Dental Health)

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31 pages, 5855 KB

Open AccessArticle

Integrated Characterization by EDS and Roughness as a Diagnostic Tool for Dental Enamel Degradation: An In Vitro Study

by Cosmin Bogdan Licsăndroiu, Mihaela Jana Țuculină, Petre Costin Mărășescu, Felicia Ileana Mărășescu, Cosmin Mihai Mirițoiu, Raluca Ionela Olaru Gheorghe, Bogdan Dimitriu, Maria Cristina Bezna, Elena Verona Licsăndroiu, Mihaela Stan, Cristian-Marius Bacanu and Ionela Teodora Dascălu

Bioengineering 2026, 13(1), 85; https://doi.org/10.3390/bioengineering13010085 - 12 Jan 2026

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Abstract

In fixed orthodontic treatment, brackets are orthodontic attachments bonded to the tooth enamel, and their placement and removal may affect the underlying enamel surface. Enamel degradation is a critical factor for oral health, as it reduces the mechanical strength of teeth and increases susceptibility to caries and erosion. Accurate diagnosis of enamel changes is therefore essential for the evaluation of preventive and restorative treatments. In this study, enamel degradation was investigated via two integrated methods: energy-dispersive X-ray spectroscopy (EDS) and surface roughness measurement. The experimental protocol was performed in three stages: before bracket bonding, after bracket removal, and after applying a remineralization treatment. The experimental design included a repeated-measures structure, with stage (baseline, post-debonding, post-remineralization) as the within-tooth factor and bracket type (sapphire vs. metallic) as the between-tooth factor. Given the violation of the variance homogeneity assumption, group comparisons were ultimately performed using Welch ANOVA followed by Games–Howell post hoc tests, with Bonferroni-adjusted values used for pairwise comparisons. The presence of orthodontic brackets can influence enamel mineralization because the bonding and debonding procedures modify the enamel surface microtopography. These procedures can generate microcracks and surface irregularities, which may affect mineral exchange between enamel and the surrounding environment. In our study, bracket removal led to a significant decrease in the mean atomic percentages of Ca (from 32.65% to 16.37% for sapphire) and P (from 16.35% to 8.60% for sapphire), accompanied by a sharp increase in surface roughness. After remineralization, Ca and P levels increased, while roughness decreased. However, neither the mineral content nor the surface topography fully returned to the initial values, indicating that remineralization achieved only a partial recovery of enamel integrity. These findings highlight that the integrated EDS approach and roughness analysis offer a promising descriptive framework for assessing enamel degradation and monitoring the effectiveness of remineralization therapies. The generated mathematical model provides a powerful descriptive framework for the in vitro data obtained, correlating roughness with mineral composition and treatment stage. However, such a high goodness-of-fit (R² > 0.98) should be interpreted cautiously due to the risk of overfitting. Therefore, rigorous external validation is mandatory before this model can be considered a reliable predictive tool. It also highlights the importance of enamel remineralization therapies after orthodontic treatment, but also the importance of choosing personalized treatment strategies adapted to the enamel type. Full article

(This article belongs to the Special Issue Biomaterials and Technology for Oral and Dental Health)

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19 pages, 4657 KB

Open AccessArticle

Analysis of Extreme Thermal Variations in the Oral Cavity of a Patient with a Fixed Metallic Orthodontic Appliance Using the Finite Element Method

by Stelian-Mihai-Sever Petrescu, Anne-Marie Rauten, Mihai Popescu, Mihai Raul Popescu, Dragoș Laurențiu Popa, Gabriel Buciu, Eduard-Mihai Ciucă, Tiberius-Cătălin Dudan and Marilena Bătăiosu

Bioengineering 2025, 12(9), 901; https://doi.org/10.3390/bioengineering12090901 - 22 Aug 2025

Cited by 1 | Viewed by 1002

Abstract

Several decades after the development of FEM in computer-based form, which is a milestone in the evaluation of mechanical systems, the method has been adopted to analyze the biomechanical response of human skeletal structures. This innovative technique has generated new questions, but also new results, and, at the same time, competitive environments with explosive development, in the recent period. This research is focused on analyzing, using FEM, the extreme thermal variations produced at the level of two oro-facial systems (one control and one subjected to orthodontic therapy using a fixed metallic orthodontic appliance). The objective of the study was to determine the temperature evolution in different dental structures subjected to extreme temperatures given by variations between very cold and very hot foods. Each system was exposed to a succession of extreme thermal regimes (70…−18…70… °C and −18…70…−18… °C). In order to conduct this research, we used the case of a 14-year-old female patient. Following an orthodontic evaluation, we discovered that the patient had dento-alveolar disharmony with crowding. The straight-wire method of applying a fixed metallic orthodontic appliance was chosen. As complementary examinations, the patient was subjected to a bimaxillary CBCT. Using a series of programs (InVesalius, Geomagic, SolidWorks, and AnsysWorkbench), a three-dimensional model was obtained. This model contained jaws and teeth. Also, brackets, tubes, and orthodontic wires can be incorporated into the model. Following the simulations carried out in this study, it was found that thermal variations from the dental pulp are more severe for the oro-facial system with a fixed metallic orthodontic appliance (regardless of the type of thermal stimulus used). Thus, even today, with all the facilities available in the dental materials industry, metallic orthodontic devices present significant thermal conductivity, generating harmful effects on the dental structures. The reading of the results was performed on the virtual model, more precisely, on the internal dental structures (enamel, dentin, and pulp). A statistical study was not performed because it was considered that, in other patients, the results would be similar. Full article

(This article belongs to the Special Issue Biomaterials and Technology for Oral and Dental Health)

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16 pages, 2243 KB

Open AccessArticle

Comparative Effectiveness of Tunneling vs. Coronally Advanced Flap Techniques for Root Coverage: A 6–12-Month Randomized Clinical Trial

by Luis Chauca-Bajaña, Pedro Samuel Vásquez González, María José Alban Guijarro, Carlos Andrés Guim Martínez, Byron Velásquez Ron, Patricio Proaño Yela, Alejandro Ismael Lorenzo-Pouso, Alba Pérez-Jardón and Andrea Ordoñez Balladares

Bioengineering 2025, 12(8), 824; https://doi.org/10.3390/bioengineering12080824 - 30 Jul 2025

Cited by 2 | Viewed by 4647

Abstract

Background: Gingival recession is a common condition involving apical displacement of the gingival margin, leading to root surface exposure and associated complications such as dentin hypersensitivity and root caries. Among the most effective treatment options are the tunneling technique (TUN) and the coronally advanced flap (CAF), both combined with connective tissue grafts (CTGs). This study aimed to evaluate and compare the clinical outcomes of TUN + CTG and CAF + CTG in terms of root coverage and keratinized tissue width (KTW) over a 6–12-month follow-up. Methods: A randomized, double-blind clinical trial was conducted following CONSORT guidelines (ClinicalTrials.gov ID: NCT06228534). Participants were randomly assigned to receive either TUN + CTG or CAF + CTG. Clinical parameters, including gingival recession depth (REC) and KTW, were assessed at baseline as well as 6 months and 12 months postoperatively using a calibrated periodontal probe. Statistical analysis was performed using descriptive statistics and linear mixed models to compare outcomes over time, with a significance level set at 5%. Results: Both techniques demonstrated significant clinical improvements. At 6 months, mean root coverage was 100% in CAF + CTG cases and 97% in TUN + CTG cases, while complete root coverage (REC = 0) was observed in 100% and 89% of cases, respectively. At 12 months, root coverage remained stable, at 99% in the CAF + CTG group and 97% in the TUN + CTG group. KTW increased in both groups, with higher values observed in the CAF + CTG group (3.53 mm vs. 3.11 mm in TUN + CTG at 12 months). No significant postoperative complications were reported. Conclusions: Both TUN + CTG and CAF + CTG are safe and effective techniques for treating RT1 and RT2 gingival recession, offering high percentages of root coverage and increased KTW. While CAF + CTG achieved slightly superior coverage and tissue gain, the TUN was associated with better aesthetic outcomes and faster recovery, making it a valuable alternative in clinical practice. Full article

(This article belongs to the Special Issue Biomaterials and Technology for Oral and Dental Health)

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12 pages, 478 KB

Open AccessArticle

Innovative Approaches in Dental Care: Electrical Impedance Analysis (EIA) for Early Caries Detection

by Liliana Sachelarie, Ioana Romanul, Daniela Domocos, Mihaela Moisa, Emilia-Albinita Cuc, Raluca Iurcov, Carmen Stadoleanu and Loredana Liliana Hurjui

Bioengineering 2025, 12(3), 215; https://doi.org/10.3390/bioengineering12030215 - 20 Feb 2025

Cited by 1 | Viewed by 1953

Abstract

(1) Background: Microcracks and structural fragility in teeth, often undetected by traditional methods until severe complications like fractures or pulp exposure occur, are evaluated in this study using electrical impedance analysis (EIA) as a non-invasive tool for early detection and assessment. (2) Methods: A total of 57 patients were recruited, including individuals with bruxism (n = 20), dental restorations (n = 18), and no significant dental history (control group, n = 19). Electrical impedance measurements were performed on all teeth using a portable device, with data collected from occlusal and proximal surfaces. Patients with abnormal values underwent additional imaging (standard radiographs) to confirm the presence of microcracks. Statistical analyses included ANOVA to compare impedance values between groups and logistic regression to assess the predictors of structural fragility. (3) Results: Teeth with microcracks confirmed by standard radiographs exhibited significantly lower impedance values (mean 50 kΩ) compared to healthy teeth (mean 120 kΩ, p < 0.01). Patients with bruxism showed the highest proportion of teeth with abnormal impedance (45%). Logistic regression identified bruxism as a significant predictor of reduced impedance values (p < 0.05). (4) Conclusions: Electrical impedance analysis demonstrates promise as a non-invasive method for detecting microcracks and assessing structural fragility in teeth. Its application in routine dental check-ups could enable early interventions, particularly for high-risk patients with bruxism or restorations. Full article

(This article belongs to the Special Issue Biomaterials and Technology for Oral and Dental Health)

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