Search Results (163)

The integration of artificial intelligence (AI) and advanced digital workflows is revolutionising full-arch implant dentistry, particularly for geriatric patients with edentulous and atrophic arches, for whom achieving both prosthetic passivity and optimal aesthetic outcomes is critical. This narrative review evaluates current challenges in intraoral scanning accuracy—such as scan distortion, angular deviation, and cross-arch misalignment—and presents how innovations like the Medit SmartX AI-guided workflow and the Scan Ladder system can significantly enhance precision in implant position registration. These technologies mitigate stitching errors by using real-time scan body recognition and auxiliary geometric references, yielding mean RMS trueness values as low as 11–13 µm, comparable to dedicated photogrammetry systems. AI-driven prosthetic design further aligns implant-supported restorations with facial symmetry and smile aesthetics, prioritising predictable midline and occlusal plane control. Early clinical data indicate that such tools can reduce prosthetic misfits to under 20 µm and lower complication rates related to passive fit, while shortening scan times by up to 30% compared to conventional workflows. This is especially valuable for elderly individuals who may not tolerate multiple lengthy adjustments. Additionally, emerging AI applications in design automation, scan validation, and patient-specific workflow adaptation continue to evolve, supporting more efficient and personalised digital prosthodontics. In summary, AI-enhanced scanning and prosthetic workflows do not merely meet functional demands but also elevate aesthetic standards in complex full-arch rehabilitations. The synergy of AI and digital dentistry presents a transformative opportunity to consistently deliver superior precision, passivity, and facial harmony for edentulous implant patients. Full article

Introduction: Digital planning and evolution of technology is allowing dentistry to be more efficient in time than before. In orthodontics the main purpose is to obtain fewer patient visits and to reduce the bonding time. For that, indirect bonding planned with CAD-CAM softwares is used to obtain a shorter treatment period, in general, and less chair-time. This waste of chair-time should also be reduced in other fields of dentistry such as endodontics, surgery, prosthodontics, and aesthetics. Methods: A total of 504 teeth were embedded into epoxy resin models mounted as a dental arch. Customized lingual multibracket appliances were bonded by a current adhesion protocol. After that, they were debonded, the polishing of cement remnants was performed with three different burs and two drills. The polishing time of each group was recorded by an iPhone 14 chronometer. Results: Descriptive and comparative statistical analyses were performed with the different study groups. Statistical differences (p < 0.005) between diamond bur and tungsten carbide and white stone burs and turbine were obtained, with the first being the slowest of them. Discussion: Enamel roughness was widely studied in orthodontics polishing protocol as the main variable for protocols establishment. However, in lingual orthodontics, due the difficulty of the access to the enamel surfaces, the protocol is not clear and efficiency should be considered. It was observed that the tungsten carbide bur is the safest bur. It was also recommended that a two-step protocol of polishing by tungsten carbide bur be followed by polishers. Conclusions: A tungsten carbide bur mounted in a turbine was the most efficient protocol for polishing after lingual bracket debonding. Full article

Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This study aimed to evaluate the remineralization potential and aesthetic effects of novel, green-synthesized nano-silver fluoride (NSF) on artificial white spot lesions in primary teeth in comparison to 38% silver diamine fluoride (SDF) and silver diamine fluoride/potassium iodide (SDF/KI). Materials and Methods: NSF was synthesized using green tea extract. Sixty primary teeth specimens with artificial enamel lesions were randomly divided into five groups depending on the applied material: 38% SDF, 38% SDF/KI, single and double application of NSF, and control group. Treatments were followed by pH cycling. Surface microhardness and photographic analysis were conducted to assess remineralization and staining. Statistical analysis was conducted using non-parametric tests including Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Results: The greatest increase in microhardness was observed in the group receiving double NSF application. Its remineralizing potential was comparable to that of 38% SDF/KI, with no statistically significant difference (p = 1.000). Importantly, NSF-treated samples exhibited no teeth discoloration, unlike the black staining observed in SDF and SDF/KI groups. Conclusions: Green-synthesized NSF is a promising alternative to conventional SDF and SDF/KI, offering remineralization benefits without compromising aesthetics. The eco-friendly formulation and non-staining properties support its potential for clinical use in pediatric dentistry. Full article

Background and Objectives: This is the first systematic review to focus exclusively on in vivo randomized controlled trials that compare bulk-fill and conventional incremental composite restorations in primary teeth. Our aim was to synthesize current evidence on their clinical performance, including retention, two-year survival rates, marginal integrity, and procedural efficiency. Methods: A comprehensive literature search was conducted in PubMed, Scopus, and the Elicit AI platform up to March 2025. Eligible studies were in vivo randomized controlled trials involving children aged 3–12 years with carious primary teeth, directly comparing bulk-fill and incremental composite restorations. Primary outcomes included retention rates, two-year survival, and marginal integrity, while secondary outcomes were postoperative sensitivity, secondary caries, and aesthetic outcomes. Two reviewers independently performed study selection, data extraction, and risk-of-bias assessments using the Cochrane RoB 2.0 tool. A narrative synthesis was undertaken due to substantial heterogeneity in study design and outcome reporting. The review protocol was registered in PROSPERO (CRD420251021433). Results: Thirteen randomized controlled trials met the inclusion criteria. Both restoration techniques demonstrated high short-term retention rates (>90%) and comparable two-year survival (85–90%). Marginal integrity was generally equivalent, though incremental techniques showed modest advantages in complex cavities. Secondary outcomes were inconsistently reported, with no significant group differences. Bulk-fill restorations consistently reduced the procedural time by 2–4 min per restoration, representing a meaningful advantage in pediatric clinical settings. Conclusions: Bulk-fill composites offer a clinically effective and time-efficient alternative to incremental layering in the restoration of primary teeth. This focused synthesis addresses a gap in existing reviews by concentrating solely on primary dentition and in vivo evidence. Despite similar clinical outcomes, the time savings associated with bulk-fill techniques may enhance their utility in pediatric dentistry. Further standardized and long-term trials are warranted to confirm these findings and inform clinical guidelines. Full article

Background/Objectives: The increasing demand for aesthetics in dentistry has driven significant advancements in both materials and techniques. The primary cause of ceramic detachment in dental restorations is extensive mechanical stress, which often results in detachment and clinical complications. This study aims to improve the bond strength between NiCr-based metal frameworks and ceramic coatings by introducing biocompatible inorganic MeSiON thin films (Me = Cr or Zr) as interlayers. Methods: MeSiON coatings with a thickness of ~2 μm were deposited on NiCr alloy using cathodic arc evaporation. To tailor the stoichiometry, morphology, and mechanical properties of the coatings, the substrate bias voltage was varied: −50 V, −100 V, −150 V, −200 V. Structural and surface characterization was performed using SEM/EDS, XRD, profilometry, and contact angle analysis. The coating adhesion was evaluated by using standardized scratch testing, while the bond strength was evaluated using a three-point bending test. Results: The NiCr alloy exhibited a dendritic microstructure, and the ceramic layer consisted mainly of quartz, feldspar, kaolin, and ZrO₂. ZrSiON coatings showed superior roughness, elemental incorporation, and adhesion compared to Cr-based coatings, these properties being further improved by increasing the substrate bias. The highest bond strength was achieved with a ZrSiON coating deposited at −200 V, a result we attributed to increased surface roughness and mechanical interlocking at the ceramic-metal interface. Conclusions: CrSiON and ZrSiON interlayers enhanced ceramic-to-metal adhesion in NiCr-based dental restorations. The enhancement in bond strength is primarily ascribed to substrate bias-induced modifications in the coating’s stoichiometry, roughness, and adhesion. Full article

Background and Clinical Significance: Prosthetic rehabilitation in the aesthetic zone of periodontally compromised patients presents a complex clinical challenge, requiring a careful coordination of aesthetic, functional, and biological demands. This case highlights the benefits of digital dentistry, interdisciplinary collaboration, and regular maintenance in achieving long-term success in complex rehabilitations of periodontally compromised patients. Case Presentation: This case report describes the digital minimally invasive rehabilitation of a 39-year-old male patient with Stage III periodontitis, occlusal discrepancies, tooth mobility, and an interincisal diastema. A fully digital workflow—including intraoral scanning, aesthetic previewing, and mandibular motion analysis—was employed to guide diagnosis, treatment planning, and prosthetic execution. Conservative tooth preparations using a biologically oriented approach (BOPT) were combined with customised provisional restorations to support soft tissue conditioning and functional control throughout the provisional phases. Mandibular motion tracking facilitated the design of a personalised anterior guidance to improve occlusion and correct the deep bite. The interincisal diastema was initially maintained then closed during the advanced phase of treatment based on aesthetic simulations and patient preference. One unplanned endodontic treatment was required during the provisional phase, but no other complications occurred. Conclusions: At the four-year follow-up, the patient demonstrated stable periodontal and occlusal conditions, improved clinical indices, and high satisfaction with the aesthetic outcome. Full article

Background/Objectives: Tooth bleaching is a widely requested aesthetic procedure in modern dentistry. However, the structural effects of high-concentration peroxide-based bleaching agents on enamel remain insufficiently understood. This study aims to evaluate and compare the effects of three in-office bleaching agents—Opalescence Boost (40% hydrogen peroxide [HP]), Opalescence Quick (45% carbamide peroxide [CP]), and BlancOne Ultra + (35% hydrogen peroxide [HP])—on enamel surface characteristics and color change using confocal laser scanning microscopy (CLSM) and spectrophotometric analysis. Methods: Forty-two extracted human teeth were sectioned and divided into experimental and control halves. Each experimental specimen underwent bleaching according to the manufacturer’s protocol. Color measurements were conducted at baseline, immediately post-treatment, at 3 days, 7 days, and 6 months following treatment using the Vita Easyshade^® spectrophotometer. Color differences were calculated using the CIEDE2000 (ΔE₀₀) formula. Enamel surface morphology was assessed by CLSM. Data were analyzed using Wilcoxon and Kruskal–Wallis tests (p < 0.05), performed with SPSS v23. Results: All bleaching agents produced clinically perceptible color changes (ΔE₀₀ > 3.3). Opalescence Boost achieved the highest and most consistent whitening effect (mean ΔE₀₀ > 11), while Opalescence Quick showed moderate efficacy (ΔE₀₀ ~6–8), and BlancOne Ultra+ induced milder changes (ΔE₀₀ ~4–5). CLSM imaging revealed surface alterations in all bleached samples, with more pronounced changes observed in specimens treated with higher peroxide concentrations. Conclusions: All three bleaching systems were effective in improving enamel color, with Opalescence Boost delivering the most substantial and durable effect. CLSM analysis confirmed morphological changes in enamel without evidence of severe damage. These results underscore the importance of selecting bleaching protocols that balance efficacy with enamel safety. Further in vivo studies are recommended to validate long-term structural effects and support clinical decision-making. 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

Cosmetic restorative dentistry focuses on restoring teeth affected by caries or trauma using materials that mimic natural teeth in shape, texture, and color. Composite resins, particularly nanofilled composites, are widely used due to their superior mechanical and aesthetic properties. Accurate tooth color selection is crucial, and methods include visual (shade guides) and instrumental (spectrophotometers, colorimeters, and intraoral scanners). Newer biomimetic composites, such as Admira Fusion 5 and Clearfil Majesty ES-2 Universal, simplify shade selection through advanced optical technologies. A randomized clinical study involving 30 patients compared the color-matching accuracy of two biomimetic composite resins: Admira Fusion 5 (Voco) and Clearfil Majesty ES-2 Universal (Kuraray). The study utilized the Vita Easyshade spectrophotometer and the Primescan intraoral scanner. Patients were treated following standardized protocols, and shade accuracy was evaluated pre- and post-restoration using Cohen’s Kappa index. Admira Fusion 5 showed higher shade-matching accuracy, with good agreement between pre- and post-restoration measurements using both instruments. Clearfil Majesty ES-2 Universal demonstrated lower reproducibility in shade matching, particularly in posterior teeth, with lower agreement in pre- and post-tests. Instrumentation Comparison: Primescan showed slightly better performance than Easyshade, but both provided comparable results. In conclusions, universal composites may not always achieve optimal shade matching in posterior teeth. Layered composites provide better color adaptability. While digital instruments enhance shade accuracy, combining them with visual methods yields the best clinical outcomes. Further research with larger sample sizes is needed to improve shade-matching techniques in aesthetic restorative dentistry. Full article

Lithium disilicate ceramics (LDSs) are widely used in restorative dentistry for their excellent aesthetic and mechanical properties. Variants like zirconia-reinforced lithium silicate (ZLS) and advanced lithium disilicate (ALD) were developed to enhance these characteristics. However, differences in their physical and optical properties, as well as the influence of processing techniques (heat pressing vs. CAD-CAM), remain unclear. This study aimed to evaluate the physical and aesthetic properties of LDS, ZLS, and ALD ceramics. A systematic review and meta-analysis following PRISMA guidelines were conducted. Studies published in the last ten years were retrieved from PubMed, Web of Science, Scopus, Cochrane, and Scielo. The inclusion criteria encompassed in vitro studies analyzing LDS, ZLS, and ALD ceramics with quantitative data on mechanical and aesthetic properties. Meta-analyses were performed using a random-effects model, with subgroup analyses based on ceramic type and processing technique. Twenty-two studies met the inclusion criteria. Meta-analyses showed significant differences in flexural strength, hardness, surface roughness, wear, and translucency. The processing technique influenced these properties, with CAD-CAM materials exhibiting distinct performance compared to heat-pressed ceramics. Publication bias was assessed using Egger’s test and the Trim and Fill method, and heterogeneity via meta-regression. LDS showed the highest fracture resistance and least wear, while ALD had greater roughness depth. Heat pressing enhanced hardness and reduced roughness, whereas CAD-CAM improved flexural strength. Considering these findings and study limitations, LDS appears the most suitable option for clinical use due to its superior mechanical performance. Full article

Background/purpose: Fiber-reinforced materials are commonly used as biobases beneath indirect restorations, potentially affecting the seating and marginal accuracy of the restorations. This study intended to assess the impact of various biobase techniques on the marginal adaptation of lithium disilicate overlay restorations. Methods: Fifty sound maxillary first premolar teeth of comparable dimensions were prepared using a full-bevel overlay design (3 mm occlusal reduction) and allocated randomly to five groups as follows (n = 10): Group A, delayed dentin sealing; Group B, immediate dentin sealing using Optibond FL; Group C, immediate dentin sealing with a 1 mm flowable composite layer (Clearfil AP-X Flow); Group D, immediate dentin sealing followed by a 1 mm short-fiber-reinforced composite layer (everX Flow); and Group E, immediate dentin sealing coated with a 1 mm flowable composite layer reinforced with polyethylene Ribbond fibers. Digital impressions were obtained using a Medit i700 intraoral scanner, and the overlays were digitally designed via the Sirona inLab CAD software and milled via a four-axis milling machine. The overlays were luted with a preheated composite (Clearfil AP-X). Marginal gap assessments were conducted pre- and post-cementation via a digital microscope at 230× magnification. The data were statistically analyzed using a one-way analysis of variance and paired t-tests. Results: The one-way ANOVA disclosed no significant differences among the groups before or after cementation (p > 0.05). Conclusions: The presence or absence of fiber-reinforced biobases did not impact the marginal adaptation of the restorations; these biobases can be incorporated to optimize the mechanical behavior of indirect restorations without adversely affecting their seating accuracy. These findings suggest that fiber-reinforced and non-reinforced biobase techniques can be safely integrated into clinical adhesive protocols to enhance the mechanical performance of restorations without comprising their marginal adaptation. Full article

All-ceramic restorations are the foundation of modern restorative aesthetic dentistry. The industry for dental materials now provides a large selection of biomaterials with a range of constantly improving qualities. Although this is undoubtedly advantageous, the vast array of materials may confuse even experienced dentists. Even if recently the demand of digital dentistry in daily dental practice has significantly increased, due to a lack of understanding concerning cementation techniques, which are different for each type of ceramic used, dentists are continuing to be hesitant to utilise these various CAD/CAM materials. This study analysed 58 articles from 2008 to 2025, focusing on narrative, comprehensive, and systematic reviews and in vitro studies on dental dentistry materials. English articles were included, but non-English articles and case reports were excluded. The analysis included articles from all journal categories, ensuring adherence to inclusion and exclusion criteria. The aim of the research is to assess material classifications and properties that guide practices concerning the adhesive cementation of all-ceramic restorations. In order to provide a clear overview of the composition, characteristics, clinical considerations, and current trends of contemporary dental materials, as well as some recommendations for future research in this area that would be relevant to dentists and the scientific community, the authors of the paper were guided by this structure when writing the article content. The key is to ensure the aesthetics, resistance, and long-term clinical success of the treatment plan by providing dental professionals with clear, accurate information and instructions about resin-luting materials and indirect restoration materials. Full article

Background/Objective: Diagnostic trial restorations play a crucial role in restorative dentistry by allowing clinicians to evaluate aesthetics, function, and phonetics before finalizing definitive restorations. These restorations facilitate communication between patients, clinicians, and dental technicians, ensuring treatment alignment and predictable outcomes. The accuracy of transferring diagnostic trial restorations to the oral cavity is essential to maintain the integrity of the planned design. Various fabrication techniques, including conventional silicone matrices and computer-aided design/computer-aided manufacturing (CAD-CAM)-based methods, have been developed to improve transfer precision. However, there is limited evidence directly comparing their dimensional accuracy. This randomized in vivo study aimed to evaluate and compare the accuracy of four commonly used techniques—condensation silicone, addition PVS silicone, transparent PVS silicone, and CAD-CAM combination matrices—by assessing their linear and volumetric discrepancies. Methods: Twenty patients requiring aesthetic rehabilitation of their anterior maxillary teeth participated. The sequence of matrix usage was determined through randomization. Four techniques for transferring diagnostic trial restorations were evaluated: (1) condensation silicone matrix, (2) addition polyvinyl siloxane (PVS) silicone matrix, (3) transparent PVS silicone matrix, and (4) CAD-CAM combination matrix. Dimensional accuracy was assessed by comparing intraoral scans (IOSs) of the transferred restorations to the original diagnostic wax-up. Linear discrepancies were measured at four buccal landmarks (cervical, medial, lower medial, and incisal), and volumetric deviation was evaluated using reverse engineering alignment software. Results: Significant differences were observed among the groups in both linear and volumetric discrepancies (p < 0.05). The CAD-CAM combination matrix showed superior volumetric accuracy, with minimal deviations from the diagnostic wax-up. The addition PVS silicone matrix demonstrated consistent linear accuracy, particularly at the cervical and medial landmarks. The condensation silicone matrix exhibited moderate performance across both linear and volumetric accuracy. The transparent PVS silicone matrix showed the highest variability, with greater volumetric deviations. Conclusions: The study highlights that the choice of matrix material and technique significantly impacts the dimensional accuracy of diagnostic trial restoration transfers. The CAD-CAM combination matrix and the addition PVS silicone matrix demonstrated superior advantages compared to the other techniques. Clinicians should consider the specific requirements of each case, including accuracy and ease of use, when selecting a transfer technique for aesthetic rehabilitations. Full article

Acid-etched zirconia has emerged as a high-strength alternative to traditional glass ceramics for laminate veneers in aesthetic dentistry. This randomized, double-blind controlled clinical trial aimed to evaluate the one-year clinical performance of zirconia veneers etched with a hydrofluoric-nitric acid mixture and bonded using a 10-methacryloyloxydecyl dihydrogen phosphate (MDP) containing polymeric adhesive system, compared to lithium disilicate veneers. Fifty-two patients were treated with either translucent zirconia or lithium disilicate veneers, and restorations were bonded using light-cured resin-based adhesives. Clinical parameters, including veneer survival, esthetics, marginal adaptation, postoperative sensitivity, and periodontal health, were assessed using modified United States Public Health Service (USPHS) criteria and periodontal indexes at 2 weeks, 6 months, and 12 months. Both materials showed high survival rates with no statistically significant differences in clinical outcomes. One zirconia veneer debonded early but was successfully rebonded without fracture, while one lithium disilicate veneer fractured upon debonding. The findings support the viability of acid-etched zirconia veneers bonded with polymer-based adhesives as a durable and esthetic restorative option. The study highlights the clinical relevance of polymeric bonding systems in enhancing zirconia veneer performance and reinforces their role in modern adhesive dentistry. Full article

Anterior lip/palate cleft is a congenital deformity affecting the upper lip and palate, posing significant challenges in both aesthetic and functional aspects for children. Effective management of this condition is crucial for improving quality of life and ensuring normal development. This review aims to highlight the regenerative treatment options available for children with anterior lip/palate cleft, focusing on the use of bone grafts and other advanced dental procedures. A review of the current literature and clinical practices was conducted to identify and evaluate the most effective treatment options. Emphasis was placed on regenerative techniques, particularly the use of bone grafts. Advancements in regenerative dentistry offer promising outcomes for children with anterior lip/palate cleft. Bone grafts, combined with innovative techniques such as growth factors, stem cell therapy, and distraction osteogenesis, provide effective solutions for restoring function and aesthetics. A multidisciplinary approach is essential to ensure comprehensive care and optimal results for these patients. Full article