Search Results (25)

This narrative review examines contemporary applications of polymeric materials in dentistry from 2020 to 2025, spanning prosthodontics, restorative dentistry, orthodontics, endodontics, implantology, diagnostics, and emerging technologies. We searched PubMed, Scopus, Web of Science, and Embase for peer reviewed English language articles and synthesized evidence on polymer classes, processing routes, mechanical and chemical behavior, and clinical performance. Approximately 116 articles were included. Polymers remain central to clinical practice: poly methyl methacrylate (PMMA) is still widely used for dentures, high performance systems such as polyether ether ketone (PEEK) are expanding framework and implant-related indications, and resin composites and adhesives continue to evolve through nanofillers and bioactive formulations aimed at improved durability and reduced secondary caries. Thermoplastic polyurethane and copolyester systems drive clear aligner therapy, while polymer-based obturation materials and fiber-reinforced posts support endodontic rehabilitation. Additive manufacturing and computer aided design computer aided manufacturing (CAD CAM) enable customized prostheses and surgical guides, and sustainability trends are accelerating interest in biodegradable or recyclable dental polymers. Across domains, evidence remains heterogeneous and clinical translation depends on balancing strength, esthetics, biocompatibility, aging behavior, and workflow constraints. Full article

Background/Objectives: The accurate and prosthetically driven placement of dental implants is crucial for long-term clinical success. While computer-aided static navigation enhances precision, the comparative accuracy of different surgical guide support types (teeth-, mucosa-, and bone-supported) under identical clinical conditions remains a critical and less explored variable. This study aimed to compare the accuracy of these three guide types. Methods: This clinical study evaluated the precision of computer-aided implant placement by comparing planned versus actual implant positions in fifty participants who received 140 implants. Discrepancies were measured in 3D using STL files in Exocad^® DentalCAD software (exocad Elefsina 3.2, Darmstadt, Germany). Results: In the maxilla, mean total deviation was 0.443 mm at the implant neck and 0.562 mm at the apex. In the mandible, deviations were higher: 0.755 mm at the neck and 0.981 mm at the apex. Teeth-supported guides demonstrated the highest accuracy. Mucosa-supported guides showed the least precision, particularly in the mandible, while bone-supported guides provided clinically acceptable results. Conclusions: Computer-aided static navigation is highly accurate for implant placement. Guide selection should be tailored to anatomical conditions, with bone-supported guides preferred for edentulous mandibles. Full article

Successful dental implant therapy relies on accurate planning and placement, e.g., through static, computer-aided implant surgery using CAD/CAM-fabricated surgical guides. This study examined production methods’ influence on surgical guide sleeve housing geometry. A model with two edentulous spaces was digitized using intraoral scanning and CBCT, and two virtually positioned implants were planned. Ten guides per group were produced using milling (MCX5), DLP printing (ASIGA and SHERA), and SLA printing (FORM), printing with 50 µm and 100 µm layers each. Each guide (n = 70) was then digitized using an industrial scanner before and after sterilization. Superimposition of the actual guide data with the reference data allowed for evaluation of deviations at the drill sleeve housing along the x-, y-, z-, and dxyz-axes. Descriptive and statistical evaluation was performed (significance level: p ≤ 0.0125). Significant differences existed among the production methods: Milling and SLA showed higher deviations than the DLP group (p < 0.001). Milled guides post-sterilization showed the highest deviations (0.352 ± 0.08 mm), while one DLP printer at 50 μm layer thickness showed lowest deviations (0.091 ± 0.04 mm). The layer thickness was insignificant, whereas sterilization increased deviation (p < 0.001). DLP produced the most precise implant surgical guides. All 3D printers were suitable for fabricating clinically acceptable surgical guides. Full article

Background: Dynamic computer-aided navigation systems are a real-time motion tracking technology widely applied in oral implantology and endodontics to enhance precision and reduce complications. However, their reliability, accuracy, and usability in dentoalveolar surgery and maxillary bone augmentation remain underinvestigated. Methods: A systematic review following PRISMA guidelines was conducted and registered on PROSPERO (CRD42024610153). PubMed, Scopus, Web of Science, and Cochrane Library databases were searched until October 2024 to retrieve English eligible studies, without restrictions on the publication year, on dynamic computer-assisted navigation systems in dentoalveolar and bone augmentation surgeries. Exclusion criteria were surgery performed without dynamic computer-assisted navigation systems; dental implant placement; endodontic surgery; and maxillo-facial surgery. The outcomes were reliability, accuracy, post-operative course, surgical duration, complications, patient- and clinician-reported usability, acceptability, and satisfaction. Included studies were qualitatively synthetized and judged using dedicated tools for the different study designs. Results: Twenty-nine studies with 214 patients were included, showing high reliability in dentoalveolar and bone augmentation surgeries comparable to or superior to freehand surgeries, higher accuracy in dentoalveolar surgery compared to maxillary bone augmentation, and reduced complication rates across all surgeries. While overall surgical duration slightly increased due to technology installation, operative time was reduced in third molar extractions. Patient-reported outcomes were poorly investigated. Clinician-reported outcomes were mixed, but difficulties in the differentiation of soft tissue from hard tissue were recorded, especially in sinus floor elevation. Conclusions: Dynamic computer-assisted navigation systems enhance accuracy and safety in dentoalveolar and bone augmentation surgery. Further studies are needed to assess the underinvestigated patient-reported outcomes and standardize protocols. Full article

Background: The following case report presents the treatment of a patient with severe maxillary atrophy and failing residual dentition. The patient has been diagnosed with stage IV grade C periodontitis, making this case challenging from the very beginning. Methods: The treatment plan was based on collecting and merging digital data: CBCT, a face scan, and an intraoral scan. Due to the advancement of the periodontal disease, the treatment was divided into three stages. The entire process was conducted in a digital manner, based on the concept of prosthetically driven implantology. Additionally, all prosthetic temporaries were planned via digital smile design. Stage I included extracting the residual dentition, placing four implants in the mandible, and the delivery of a 3D-printed upper removable denture. Stage II included placing two zygomatic implants, two anchored piriform rims, and one midline implant. Both arches were immediately loaded with the intraoral welding of abutments screwed to multiunit abutments and 3D-printed shells. Subsequently, in stage III, two milled ceramic superstructures combined with a titanium milled bar were delivered as a final screw-retained restoration with the application of scan flags (horizontal scan bodies) for intraoral scanning. Results: The aforementioned technologies can all be implemented and merged into one complex treatment plan combining high predictability, successful esthetics, and a reliable and accurate end result. Even though the concept of scan flags is relatively new, this case shows its potential and merit. Conclusions: This case represents the power of the digital approach as a helpful tool in the recreation of functional and esthetic smiles in compromised conditions in periodontal patients. Full article

Background: Advanced manufacturing techniques, such as three-dimensional (3D) printing, use digital models from computer-aided design to produce 3D objects. They are frequently employed in different areas of dentistry, such as orthodontics, oral implantology, and prosthodontics. Purpose: The aim of this review was to provide a comprehensive overview of 3D-printing technology for denture bases and explore the influence of incorporating different fillers into 3D-printed denture base resins on their physical, mechanical, and biological characteristics. Methods: Relevant studies were identified by searching papers published between 2010 and 2023 in several online databases, such as Scopus, PubMed, Cochrane library, and Google Scholar. The main inclusion criteria used during the search was identifying the papers which added nanoparticles in the resin as an agent to bring different functional characteristics within the 3D-printed denture base resin. Furthermore, even though the search criteria were set for finding papers from the past 10 years, development in this field has accelerated in the past 4–5 years. Findings: Various fillers have exhibited promising results in terms of their ability to improve the functional properties of the 3D-printed denture base resins. However, such improvements come at a higher cost with careful resin preparation when considering the filler particles, the fabrication complexities and the extensive post-processing that is required. Conclusions: The use of 3D-printing approaches and fillers to fabricate dentures is associated with significant benefits in terms of imparting functional properties, consistency in fabrication and opportunities for innovation. However, further research is required to acquire a better understanding of the holistic, long-term performance of various filler materials, concentrations, their clinical relevance and particularly the potential health risks from the fillers. Full article

In implantology, among the key choices, to obtain predictable results, it is essential to establish, using cone beam computed tomography (CBCT), the bone site and where to insert the implants; during the surgical phase, these sites must be identified on the oral mucosa. Surgical templates are a valid aid, especially in complex cases which require the insertion of more than three or four implants. In cases of a single implant, on the other hand, surgical guides are rarely used, and the implant is often inserted freehand; therefore, the identification of the implant site on the oral mucosa (after choosing the location on the CBCT) is more difficult. For this reason, the clinician uses the teeth in the arch as a reference. This study evaluates the ability of the human eye to identify, on the oral mucosa, where the implant collars will be positioned, the position of which has previously been chosen on the CBCT, in cases where the hands-free surgical technique (without surgical guides) is used. The verification of this precision is carried out using particular thermo-printed templates which contain radiopaque metal spheres. The results show that, in the freehand technique, it is difficult to precisely identify the implant sites (chosen via X-ray) on the mucosa, especially when they are far from natural teeth adjacent to the edentulous area. In case of monoedentulism, the freehand implant technique seems to be applicable by expert implantologists with a reduced risk of error; in fact, clinical experience helps to find the correct correspondence between the implant site chosen on the CBCT and its identification on the mucosa. The level of experience is fundamental in the clinician’s decision about whether or not to use surgical guides; in fact, doctors with little experience should use surgical guides even in the simplest cases to reduce the risk of error. Full article

Bone augmentation prior to dental implant placement is a common scenario in the dental implantology field. Among the important intraoral harvesting sites to obtain bone blocks is the ramus/retromolar region that has a high success rate and long-lasting alveolar ridge augmentation. Preserving the bone volume and quality at the donor site is crucial for preventing further complications or to serve as a site for re-harvesting. Healing of the intraoral donor sites has been described in the maxillofacial field. This study aimed to evaluate the spontaneous healing of the mandibular retromolar donor site utilizing computer-assisted quantification 6 and 12 months after bone harvesting. Materials and methods: The study was conducted on patients who underwent an alveolar ridge augmentation using an intraoral retromolar bone graft. Three CBCT scans were performed—intraoperative, and at six months and one year after the surgical procedure. By using the Materialise Mimics Innovation Suite software 26.0 features segmentation by thresholding, Hounsfield unit averaging, and superimposition of the tomographies, we could precisely quantify the healing process utilizing spatial and characteristic measures. Results: In all cases, the computer-aided quantification showed that six months following surgery, the donor site had recovered up to 64.5% ± 4.24 of its initial volume, and this recovery increased to 89.2% ± 2.6 after one year. Moreover, the Hounsfield unit averaging confirmed dynamic bone quality healing, starting at 690.3 ± 81 HU for the bone block, decreasing to 102 ± 27.8 HU at six months postoperatively, and improving to 453.9 ± 91.4 HU at the donor site after a year. Conclusions: This study demonstrates that there is no need for additional replanting at the donor site following retromolar bone block harvesting, whether autogenous or allograft, since spontaneous healing occurs 12 months following the surgery. Full article

Background: Complex implant reconstructions in patients with residual dentition due to periodontitis is a challenging task in many aspects. Methods: This study shows a full digital workflow combining 3D printing, guided implant placement, intraoral scanning and welding with immediate loading and digital smile design. An analog impression was taken to validate the passive fit of final restorations. The whole treatment plan was divided into three stages. The first stage included an intraoral scan of baseline dentition, and then the extraction of all teeth was performed, implanting four temporary implants and providing the patient with removable temporary prosthesis. The second stage was to scan the removable temporaries, implanting 10 implants and multi-unit abutments (MUA), and create a rigid construction via the intraoral welding of titanium bar and by fixing it to the 3D-printed temporary reconstructions (designed with DSD) as a form of immediate loading. The third stage included the scanning of screw-retained temporary reconstructions, then scanning from the MUA level and creating final reconstruction. Results: The presented workflow enabled the delivery of some sort of restoration to the patient at every moment of the treatment and to sustain the required esthetic effect with decent comfort of use even in the early stages. Conclusions: A full digital workflow is a reliable treatment method even in complex cases. Full article

Oral rehabilitation after maxillary oncological resection is challenging. This case report presents the rehabilitation of a 65-year-old Caucasian male adenoid cystic carcinoma patient using a myo-cutaneous thigh flap, zygomatic implant placement, and an immediate fixed provisional prosthesis made with computer-aided technologies. The patient presented complaints of asymptomatic enlarged swelling of 5-mm on the right hard hemi-palate. There was an oro-antral communication deriving from a previous local excision. Preoperative radiographs showed the involvement of the right maxilla, maxillary sinus, and nose with a suspect involvement of the maxillary division of the trigeminal nerve. Treatment was planned through a fully digital workflow. A partial maxillectomy was performed endoscopically, and maxilla was reconstructed using an anterolateral thigh free flap. Two zygomatic implants were inserted simultaneously. A provisional fix full-arch prosthesis was manufactured preoperatively through a fully digital workflow and was placed in the operating room. Following post-operative radiotherapy, the patient received a final hybrid prosthesis. During the follow-up period of two years, the patient reported good function, aesthetics, and significant enhancement in quality of life. According to the results of this case, the protocol represented can be a promising alternative for oral cancer patients with large defects, and can lead to an improved quality of life. Full article

Implant abutment selection is an important step in implant treatment to restore one or more lost teeth. The aim of this study was to compare stock and individual CAD/CAM full-form abutments after one year in function. A total of 64 subjects with one missing tooth were divided into two groups according to the type of abutment: 34 patients were given a stock abutment, and 30 an individual CAD/CAM abutment. Patients were scheduled for check-ups seven days after functional loading and after four, eight, and twelve months. Peri-implant soft tissue status was checked at every check-up by monitoring parameters traditionally used in similar studies: plaque index; bleeding on probing; and probing depth. To assess the stability of the bone tissue, radiological methods of measuring the amount of bone level compared to the implant shoulder were used. When needed, data were analysed by χ² test or by Fisher’s exact test. The normality of the distribution of quantitative measurements (properties) was tested by the Shapiro–Wilk test. Differences in the distribution of quantitative variables frequencies were analysed by Student’s t-test. Student’s t-test was used for repeated measurements, Mann–Whitney’s U test and ANOVA test for repeated measurements, and Friedmann’s two-way analysis of variance for repeated measurements. The predictive values of the chosen variables on the ABI index were assessed by the logistic regression model (Enter method). The results of this study showed that the impact of the abutment type (individual CAD/CAM or stock) on the average bleeding on probing was significant, especially after eight or twelve months. However, the abutment type did not show a significant correlation with the total crestal bone loss. The level of oral hygiene showed a significant correlation with the average bleeding on probing. The influence of smoking cigarettes on the total crestal bone loss evaluation was also significant. Overall, from a clinical perspective, custom CAD/CAM abutment performed slightly better than stock abutments during the one-year follow-up. Full article

The present study aimed to evaluate the influence of manual expertise on static computer-aided implantology (s-CAI) in terms of accuracy and operative timings. After the cone-beam CT (CBCT) scanning of eleven mandibular models, a full-arch rehabilitation was planned, and two different skilled operators performed s-CAI. The distances between the virtual and actual implant positions were calculated considering the three spatial vectorial axes and the three-dimensional Euclidean value for the entry (E) and apical (A) points, along with the axis orientation differences (Ax). These values emerged from the overlapping of the pre-op CBCT to post-op CBCT data (method 1), from scanning the data from the laboratory scanner (method 2), and from the intra-oral scanner (method 3) and were correlated with the operators’ expertise and operative timings. The mean values for accuracy from the three methods were: E = 0.57 (0.8, 0.45, 0.47) mm, A = 0.6 (0.8, 0.48, 0.49) mm, and Ax 1.04 (1.05,1.03,1.05) ° for the expert operator; and E = 0.8 (0.9, 0.87, 0.77), A = 0.95 (1.02, 0.95, 0.89), and Ax =1.64 (1.78, 1.58, 1.58) for the novice. The mean value of the operative timings was statistically inferior for the expert operator (p < 0.05), with an improved accuracy over time for both operators. A significant difference (p < 0.05) emerged between method 1 and methods 2 and 3 for seven of the nine variables, without differences between the evaluations from the two scanners. The support from digital surgical guides does not eliminate the importance of manual expertise for the reliability and the shortening of the surgical procedure, and it requires a learning pathway over time. Full article

Background and Objectives: Alveolar ridge augmentation in the complex bone defect is a popular topic in implantology. Guided bone regeneration (GBR) is one of the most commonly applied methods to reconstruct alveolar bone. The application of a membrane is the fundamental principle of GBR. There are many membrane types used in oral surgery, but the advantage of the titanium mesh is the rigidity which provides space maintenance and prevents contour collapse. The smooth surface also reduces bacterial contamination. Using computer-aided design (CAD) and computer-aided manufacturing (CAM) in dentistry allows us to obtain the perfect architecture form of the mesh, which covers and protects the bone reconstruction. Case presentation: We present a surgical case of a 27-year-old female patient with severe aesthetic bone atrophy after a deficient odontectomy. Based on the GBR clinical applications, the technique consists of bone reconstruction and a customized titanium mesh application. Using mesh titanium in this case presentation was a reliable alternative to perform a lateral alveolar bone augmentation and reconstruct ridge deformities before reaching an ideal implant placement. Conclusions: According to our case report, the customized titanium mesh could be a valuable option for guided bone regeneration in aesthetic maxillary defects. Full article

A digital workflow by means of intraoral scanners and computer tomography has been used in dental implantology, allowing clinicians to be potentially more accurate and precise. Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM) and 3D models facilitate the process from treatment planning to the surgical procedure, up to the implant placement and final prosthesis. The aim of the present retrospective study was to evaluate a fully digital workflow for single-tooth implant rehabilitation. A total of 19 patients (22 implants) were included in the present study, with a mean follow-up time of 2 years. A fully digital workflow was performed on each patient through the planning, design and printing of a surgical guide, following a digital impression made with an intraoral scanner, computer-tomography-guided implant placement and, finally, with the delivery of a CAD-CAM crown. The two-year follow-up results were satisfactory in terms of the aesthetic yield and precision of the prosthesis. In single-implant-supported restorations, due to digital protocols and digital planning, a reduced number of clinical sessions was registered and the treatment plan results were more predictable. Future studies are needed to understand the application of fully digital protocols in cases of partially or totally edentulous patients. Full article

(1) Background: The achievement of an optimal implant position is still a critical consideration in implantology, especially in the aesthetic area. Dynamic navigation is a computer-aided procedure that allows the surgeon to follow on a screen the three-dimensional position of instruments in real time during implant site preparation. The aim of this proof-of-concept study was to assess the clinical and radiographical performance and accuracy of the surgical workflow during maxillary immediate implant placement assisted by DTX studio Implant software planning and X-Guide Navigation. (2) Methods: Twelve consecutive patients requiring at least one implant in the maxillary aesthetic region were treated. Clinical outcome measures were biological complications and implant or prosthetic success rate. The accuracy was measured by calculating the deviation between the real implant position obtained from the postoperative cone beam computed tomography (CBCT) scan and the planned implant position. (3) Results: The average deviation at the implant shoulder was 0.77 ± 0.25 mm and at the apical point was 1.2 ± 0.61 mm. The depth error was 0.5 ± 0.21 mm. The axis deviation was 2.5 ± 0.41 degrees. No biological complications or implant and prosthetic failures occurred after mean 6-month follow-up. (4) Conclusions: Within the limitations of this study, it seems that the dynamic navigation system for implant placement in the maxillary aesthetic region is accurate for prosthetically driven implant placement. Full article