Search Results (436)

Background/Objectives: Anterior dental trauma in adolescents presents complex restorative challenges due to ongoing craniofacial development and high aesthetic expectations. This study evaluated the long-term clinical performance of feldspathic ceramic veneers and lithium disilicate crowns used in the anterior region following dental trauma in adolescents. Methods: A total of 209 restorations were placed in 85 adolescents (50 females, 35 males), aged 11.1–17.9 years (mean age: 15.1 years). Of these, 144 were lithium disilicate crowns, and 65 were feldspathic ceramic veneers. All restorations were fabricated using minimally invasive protocols and followed up for periods ranging from 3 to 60 months. Outcomes were assessed based on standardized clinical criteria for success and failure. Results: Lithium disilicate crowns exhibited superior long-term performance, with the majority of failures occurring in feldspathic veneers (p < 0.001), primarily due to chipping or structural fracture. Age and gender had no statistically significant influence on failure rates. Conclusions: Both feldspathic and lithium disilicate ceramic restorations represent viable treatment options for anterior dental trauma in adolescents. However, lithium disilicate demonstrates greater mechanical reliability, particularly in teeth with significant hard tissue loss. These results support the use of durable ceramic materials in adolescent restorative protocols involving dental trauma. Full article

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

Urban wetlands are increasingly recognized for their ecological and cultural benefits, yet remain underutilized due to limited public awareness and environmental literacy. This study investigates how visitors’ perceptions of wetland ecosystem services influence their motivations to engage with a constructed wetland in Putrajaya, Malaysia. By integrating the ecosystem services framework with push-pull motivation theory, the research aims to bridge knowledge gaps and inform sustainable wetland tourism planning. A structured questionnaire was administered to 420 visitors, with 385 valid responses (response rate: 91.7%). Data were analyzed using non-parametric tests (Kruskal–Wallis, Spearman correlation) and multiple regression analysis. Results show that cultural and regulating services are perceived most positively, while emotional restoration and aesthetic appreciation emerged as key motivational drivers. Regression findings reveal that push factors are stronger predictors of ecosystem service engagement than pull factors. These insights highlight the importance of emotional and psychological connections to nature, offering practical implications for urban wetland management, visitor education and environmental communication strategies. Full article

The rapid development of generative artificial intelligence has paved the way for a new approach to reproduce and intelligently generate traditional patterns digitally. This paper focuses on the traditional Chinese phoenix pattern and constructs a “Phoenix Pattern Multidimensional Cultural Gene Model” based on the grounded theory. It summarises seven semantic dimensions covering composition pattern, pixel configuration, colour system, media technology, semantic implication, theme context, and application scenario and divides them into explicit and implicit cultural genes. The study further proposes a control mechanism of “semantic label–prompt–image generation”, constructs a cross-platform prompt structure system suitable for Midjourney and Dreamina AI, and completes 28 groups of prompt combinations and six rounds of iterative experiments. The analysis of the results from 64 user questionnaires and 10 expert ratings reveals that Dreamina AI excels in cultural semantic restoration and context recognition. In contrast, Midjourney has an advantage in composition coordination and aesthetic consistency. Overall, the study verified the effectiveness of the cultural gene model in generating AIGC control. It proposed a framework for generating innovative traditional patterns, providing a theoretical basis and practical support for the intelligent expression of cultural heritage. Full article

Background and Clinical Significance: The retreatment of failed dental implants remains a challenging clinical scenario, particularly when complicated by peri-implantitis and as sociated bone loss. Successful management requires a comprehensive and predictable approach that addresses both hard and soft tissue deficiencies. Case Presentation: This case report illustrates a fully digital, prosthetically driven workflow for the rehabilitation of a posterior mandibular site following implant failure. A 44-year-old female patient underwent removal of a failing implant and adjacent tooth due to advanced peri-implantitis and periodontitis. After healing, a digital workflow—including intraoral scanning, cone-beam computed tomography (CBCT), and virtual planning—was employed to design and fabricate a customized CAD/CAM titanium mesh for vertical guided bone regeneration. The grafting procedure utilized a composite mixture of autogenous bone and anorganic bovine bone (A-Oss). After nine months of healing, two implants with a hydrophilic surface (SOI) were placed using a fully guided surgical protocol (OneGuide system). Subsequent soft tissue grafting and final prosthetic rehabilitation with monolithic zirconia restorations resulted in stable functional and aesthetic outcomes. Conclusions: This case highlights how the integration of modern digital technologies with advanced regenerative procedures and innovative implant surfaces can enhance the predictability and long-term success of implant retreatment in compromised posterior sites. 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

The restoration of gold leaf on sandstone sculptures requires structural stability, aesthetic considerations, and compliance with the principles of cultural heritage preservation. A primary issue is achieving visual and material compatibility between newly restored and original areas. Based on the “Diagnosis–Analysis–Selection–Restoration” methodology, the research team developed a targeted restoration approach for gilded stone sculptures, using the Shakyamuni sculpture at Erfo Temple in Chongqing as a case study. Assessment of the current situation revealed that over 70% of the sculpture’s surface exhibited gold leaf delamination. The composition and structure of the gold-sizing lacquer, lacquer plaster filler, ground layers, and pigments were investigated using SEM-EDS, XRD, Raman spectroscopy, and THM-Py-GC/MS techniques. The results confirmed that the sculpture featured a typical multilayer gilding structure with clear evidence of historical restorations. Considering both material performance and interfacial compatibility, an NHL2/SiO₂/SF016 composite emulsion and traditional lacquer plaster were selected as the optimal materials for reattachment and infill, respectively. A scientific restoration protocol was developed, encompassing gentle cleaning, targeted reattachment and reinforcement, and region-specific repair methods. Principal Component Analysis (PCA) was used to evaluate the influence of temperature and humidity on the curing behavior of lacquer layers. Additionally, a non-invasive gold leaf color-matching technique was developed by controlling the surface roughness of the gold-sizing lacquer, effectively avoiding the damage caused by traditional color-matching methods. Full article

This study evaluated the effects of conventional cigarette smoke compared to aerosol from a heat-non-burn tobacco product on the color stability of two UDMA-based dental composite resins, namely a monochromatic (Omnichroma) and a polychromatic (Vittra APS) resin. Twenty disc-shaped specimens were prepared, divided into two groups of ten, and exposed to 105 cigarettes or 105 aerosol tobacco sticks via a custom-made smoking chamber. Puff duration was 2 s, with a 60 s interval between puffs in which smoke saturated the chamber for 30 s; then, clean air was introduced into the chamber for 30 s. Six puffs and six intervals were simulated. Color parameters were measured before and after exposure and following brushing of each specimen with 15 strokes. Color differences were determined based on the CIEDE2000 formula. Significant color change was found in all specimens exposed to cigarette and tobacco aerosol. The highest color-change mean value was obtained from composite resin exposed to cigarette smoke. Although both cigarette and thermal heating systems cause discoloration, the aerosol causes reduced composite resin discoloration, which compromises aesthetics and increases patient dissatisfaction, impacting the overall dental care. Color stability is the hallmark of success, as it is the main reason for replacing dental restorations. 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

Oncoplastic breast-conserving surgery (OBCS), or oncoplastic surgery, has revolutionized the surgical management of breast cancer by integrating oncologic principles with reconstructive techniques to optimize both cancer control and aesthetic outcomes following breast-conserving surgery (BCS). Since its inception in the 1980s, the field has evolved significantly, incorporating a range of volume displacement and volume replacement strategies to restore breast contour after partial mastectomy. This review explores the current practices and key surgical considerations of OBCS. It highlights the role of preoperative multidisciplinary planning, patient selection, anatomical and vascular knowledge, and intraoperative technique in optimizing results. Barriers to access—including disparities in training, insurance, and geographic availability—are addressed, alongside efforts by professional societies like the American Society of Breast Surgeons (ASBS) to standardize definitions and practices. The review also outlines strategies for minimizing complications and enhancing oncologic, reconstructive, and patient-reported outcomes. By offering a comprehensive framework for clinical decision-making, this paper aims to support broader adoption and refinement of OBCS as a standard component of breast cancer care. Full article

Facial reconstruction presents complex challenges due to the intricate nature of craniofacial anatomy and the necessity for individualized treatment. Conventional reconstructive methods—such as autologous bone grafts and prefabricated alloplastic implants—pose limitations, including donor site morbidity, implant rejection, and suboptimal aesthetic results. The emergence of 3D printing technology has introduced patient-specific implants (PSIs) that enhance anatomical fit, functional restoration, and biocompatibility. This review outlines the evolution of 3D-printed implants, key materials, computer-assisted design (CAD), and their applications across trauma, oncology, congenital conditions, and aesthetics. It also addresses current challenges and explores future directions, such as bioprinting, smart implants, and drug-eluting coatings. Full article

The crystallization of soluble salts is one of the most significant agents of deterioration affecting porous building materials in historical architecture. This process not only compromises the physical integrity of the materials but also results in considerable aesthetic, structural, and economic consequences. Soluble salts involved in these processes may originate from geogenic sources—including soil leachate, marine aerosols, and the natural weathering of parent rocks—or from anthropogenic factors such as air pollution, wastewater infiltration, and the use of incompatible restoration materials. This study examines the role of capillary rise as a primary mechanism responsible for the vertical migration of saline solutions from the soil profile into historic masonry structures, especially those constructed with calcareous stones. It describes how water retained or sustained within the soil matrix ascends via capillarity, carrying dissolved salts that eventually crystallize within the pore network of the stone. This phenomenon leads to a variety of damage types, ranging from superficial staining and efflorescence to more severe forms such as subflorescence, microfracturing, and progressive mass loss. By adopting a multidisciplinary approach that integrates concepts and methods from soil physics, hydrology, petrophysics, and conservation science, this paper examines the mechanisms that govern saline water movement, salt precipitation patterns, and their cumulative effects on stone durability. It highlights the influence of key variables such as soil texture and structure, matric potential, hydraulic conductivity, climatic conditions, and stone porosity on the severity and progression of deterioration. This paper also addresses regional considerations by focusing on the context of Spain, which holds one of the highest concentrations of World Heritage Sites globally and where many monuments are constructed from vulnerable calcareous materials such as fossiliferous calcarenites and marly limestones. Special attention is given to the types of salts most commonly encountered in Spanish soils—particularly chlorides and sulfates—and their thermodynamic behavior under fluctuating environmental conditions. Ultimately, this study underscores the pressing need for integrated, preventive conservation strategies. These include the implementation of drainage systems, capillary barriers, and the use of compatible materials in restoration, as well as the application of non-destructive diagnostic techniques such as electrical resistivity tomography and hyperspectral imaging. Understanding the interplay between soil moisture dynamics, salt crystallization, and material degradation is essential for safeguarding the cultural and structural value of historic buildings in the face of ongoing environmental challenges and climate variability. Full article

Background: Intercostal artery perforator (ICAP) flaps are a reliable option for volume replacement in breast-conserving surgery (BCS), particularly for lower pole defects. However, limited flap volume may reduce their applicability in selected patients. Autologous fat grafting has been proposed to enhance both volume and aesthetic outcomes. Methods: This retrospective study evaluated 10 patients undergoing BCS with immediate reconstruction using fat-graft-augmented ICAP flaps. Nine anterior ICAP (AICAP) flaps and one lateral ICAP (LICAP) flap were employed. The outcomes included flap viability, complications, and aesthetic results over a 6-month follow-up. Results: Partial flap resorption occurred in 2 patients (20%), both of whom were active smokers. No cases of skin necrosis were observed. Fat grafting volumes ranged from 20 to 60 cc. Aesthetic outcomes were satisfactory, with good restoration of the breast contour and stable integration of the flap and grafted fat. Conclusions: The combined use of ICAP flaps and autologous fat grafting is a feasible and effective technique for immediate reconstruction after BCS. It allows volume enhancement, maintains natural contour, and shows low complication rates in properly selected patients. Smoking remains a significant risk factor. Full article

The relationship between natural environments and psychological well-being has gained increasing attention in environmental and health sciences. However, there is still a lack of robust quantitative instruments to assess the restorative potential of different environments. This study aimed to adapt and validate the Portuguese version of the Perceived Restorativeness Scale (PRS), an instrument based on Attention Restoration Theory that evaluates the perceived restorative qualities of environments. In Study 1, exploratory and confirmatory factor analyses were conducted on data from 410 participants. The results supported a refined 20-item version of the scale, comprising four factors—being away, fascination, compatibility, and legibility—with good internal consistency and acceptable model fit. Measurement invariance analysis confirmed configural, metric, and scalar invariance across gender. In Study 2, a separate sample of 212 participants completed the PRS along with additional validated measures: the Sublime Emotion toward Nature Scale (SEN), an aesthetic evaluation of landscapes, and the Positive and Negative Affect Schedule (PANAS). The PRS showed strong convergent and discriminant validity and significantly predicted restorative outcomes. These findings support the psychometric adequacy of the Portuguese PRS and its relevance as a valid tool for assessing perceived restorativeness in both natural and built environments. The scale may inform future research and public policies aimed at designing spaces that promote psychological restoration and mental well-being. Full article