Search Results (534)

Objective: Due to the increasing esthetic demand among pediatric patients and different restorative materials, we focused on analyzing which of the options of restorations may provide superior clinical outcomes. Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) using PubMed and Cochrane databases. Results: Five articles met all inclusion criteria from an initial pool of 359 articles identified in the initial search. Greater bond strength was observed when pulpotomized teeth were restored with Biodentine^® and resin composites compared to resin-modified glass ionomer cements (RMGICs). When comparing pulpotomies in primary teeth with MTA and Biodentine^®, the fracture resistance values were higher in the pulpotomized teeth with Biodentine^® than with MTA. Additionally, following a narrative synthesis in MTA-treated teeth, a higher risk of failure was observed using RMGICs or composite instead of stainless-steel crowns (SCCs) as the final restorative material. Conclusions: Variables such as the type of final restoration can affect the survival of primary teeth after pulpotomy reconstruction. Regardless of the pulp material, survival with SSCs is higher, but resin composites appear to be a viable restorative material after Biodentine^® application. Full article

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

Recently, 3D-printed resins have been introduced as materials for definitive indirect restorations. Herein, a comparative assessment of the bond strengths of 3D-printed resins to a resin cement was performed. Methods: four definitive restorative materials were selected, i.e., a Feldspar ceramic (VITA Mark II, VM), a polymer-infiltrated ceramic network (VITA Enamic, VE), a nanohybrid resin composite (Grandio Bloc, GB), and one 3D-printed resin (Crown Permanent, CP). VM and VE were etched and silanized, GB was sandblasted, and CP was glass bead blasted; for one further experimental group, this was followed by sandblasting (CPs). A resin cement (RelyX Unicem) was then used for bonding, and then a notched shear bond strength test (nSBS) was performed. Failure modes were observed and classified as adhesive, cohesive, or mixed, and SEM representative images were taken. Data were statistically analyzed with one-way ANOVA, Tukey, and Chi-square tests. Significant differences were detected in nSBS among materials (p < 0.001). The highest nSBS was found in VM (30.3 ± 1.8 MPa) a, followed by CP^b, GB^bc, CP^bc, and VE^c. Failure modes were significantly different (p < 0.001), and with different prevalent failure modes. The bond strength for 3D-printed permanent resin materials was shown to be lower than that of the felspathic ceramic but comparable to that of the resin block and PICN substrates. Full article

Primary teeth play a crucial role in a child’s development, particularly in maintaining space for permanent teeth. The premature loss of a primary tooth can lead to orthodontic issues, making the use of space maintainers essential to ensure proper growth and development of permanent teeth. To preserve space, the fabrication of a space maintainer is necessary. Since conventional space maintainers do not restore masticatory function, this study presents an innovative solution for space preservation following the extraction of the first primary molar through the design of the functional space maintainer KOS&MET (Key Orthodontic System and Materials Enhanced Therapy). The space maintainer was designed using the 3Shape Dental Designer 2023 version software tool and manufactured via additive 3D printing, utilizing a metal alloy with high resistance to masticatory forces. The crown is supported by the primary canine, while an intraoral window is created to monitor the eruption of the successor tooth. This design does not interfere with occlusion and enables bilateral chewing. Masticatory performance was assessed using two-color chewing gum, and the results showed improvement after cementing the space maintainer. This innovative approach not only preserves space for permanent teeth but also enhances masticatory function, contributing to the proper growth and development of the jaws and teeth. Full article

Additive manufacturing (AM) has emerged as a transformative technology in dentistry, enabling the production of patient-specific dental applications with reduced costs and fabrication times. Despite the growth of applications, a consolidated understanding of current 3D printing technologies, materials, and performance in dental settings remains fragmented. Here, we perform a Systematic Literature Review (SLR) using the PRISMA protocol, retrieving 19 closely related primary studies. The evidence is synthesized across three axes: application domain, AM technology, and critical quality parameters. Dental restorations, prosthetics, crowns, and implants are the most common applications, while fused deposition modeling, stereolithography, digital light processing, selective laser sintering, and laser-directed energy deposition are the most used technologies. AM materials include polymers, metals, and emerging biomaterials. Key quality determinants include dimensional accuracy, wear and corrosion resistance, and photosensitivity. Notably, biocompatibility and cytotoxicity remain underexplored yet critical factors for ensuring long-term clinical safety. The evidence also suggests a lack of in vivo studies, insufficient tribological and microbiological testing, including limited data degradation pathways of AM materials under oral conditions. Understanding that there are disconnects between the realization of the clinical and the economic benefits of 3D printing in dentistry, future research requires standardized testing frameworks and long-term biocompatibility validation. Full article

Deep margin elevation (DME) is a widely adopted technique for managing subgingival cervical proximal margins by repositioning them to a supragingival location. This approach enhances access, visibility, and control in these anatomically challenging areas. This narrative review aimed to evaluate current evidence on the indications, materials, clinical protocols, and outcomes of DME. A structured search was conducted in PubMed, the Cochrane Library and Scopus up to February 2025, using keywords such as “deep margin elevation”, “proximal box elevation” and “subgingival margin.” Clinical studies, in vitro investigations, relevant reviews and reports in English were included. A total of 59 articles were selected based on eligibility criteria. The hypothesis was that DME can serve as a reliable alternative to surgical crown lengthening in appropriate cases. A variety of materials have been investigated for use as the intermediate layer, with composite resins of varying viscosities and filler compositions being preferred due to their favorable long-term mechanical properties. DME may reduce the need for surgical intervention while maintaining periodontal health; however further randomized clinical trials are needed to clarify the material selection, establish long-term outcomes, and standardize clinical protocols. Understanding the indications, limitations, and protocol of DME is critical for achieving biologically sound and predictably functional restorations. Full article

Background: Monolithic zirconia has attracted considerable interest in dentistry due to its favorable physical and mechanical properties, making it a promising alternative for crown fabrication. Nonetheless, a standardized finishing protocol for this material has yet to be established. Objective: This study aimed to evaluate the surface characteristics and in vitro biofilm formation of zirconia finished by either polishing or glazing. Methods: A total of 72 zirconia specimens were fabricated and divided into control, glazing, and polishing groups. Surface analysis included roughness, wettability, and surface free energy. Microbiological analysis included CFU (colony-forming units per mL) counts, microbial adhesion at 2, 4, 6, and 8 h, biofilm biovolume, and qualitative biofilm assessment via scanning electron microscopy (sEm). Results: The glazing group showed significantly greater roughness than the polishing (p = 0.006) and control (p = 0.016) groups, along with a lower contact angle (polishing—p = 0.002; control—p < 0.001) and higher surface energy (polishing—p = 0.005; control—p < 0.001). No significant differences were observed in CFU counts for the tested microorganisms (C. albicans, p = 0.158; L. casei, p = 0.610; S. mutans, p = 0.904). Regarding microbial adhesion, the polishing group showed a smaller biofilm-covered area compared to the control group for both total biofilm (p = 0.008) and viable biofilm (p = 0.005). no statistically significant difference was observed in biofilm biovolume (p = 0.082). Conclusions: These findings suggest that, despite the surface differences among the groups, biofilm formation was not significantly affected. Full article

Purpose: This pilot study aimed to evaluate how deviations in X-ray tube head angulation and digital sensor alignment affect the radiographic measurement of the profile angle in CAD-CAM abutments. Materials and Methods: A mandibular model was used with five implant positions (central, buccal, and lingual offsets). Custom CAD-CAM abutments were designed with identical bucco-lingual direction contours and varying mesio-distal asymmetry for the corresponding implant positions. Periapical radiographs were acquired under controlled conditions by systematically varying vertical tube angulation, horizontal tube angulation, and horizontal sensor rotation from 0° to 20° in 5° increments for each parameter. Profile angles, interthread distances, and proximal overlaps were measured and compared with baseline STL data. Results: Profile angle measurements were significantly affected by both X-ray tube and sensor deviations. Horizontal tube angulation produced the greatest profile angle distortion, particularly in buccally positioned implants. Vertical x-ray tube angulations beyond 15° led to progressive underestimation of profile angles, while horizontal tube head rotation introduced asymmetric mesial–distal variation. Sensor rotation also caused marked interthread elongation, in some cases exceeding 100%, despite vertical projection being maintained. Profile angle deviations greater than 5° occurred in multiple conditions. Conclusions: X-ray tube angulation and sensor alignment influence the reliability of profile angle measurements. Radiographs with > 10% interthread elongation or crown overlap may be inaccurate and warrant re-acquisition. Special attention is needed when imaging buccally positioned implants. Full article

Dens invaginatus is a developmental dental anomaly characterized by the infolding of the enamel organ into the dental papilla during early odontogenesis. This process leads to a broad spectrum of anatomical variations, ranging from minor enamel-lined pits confined to the crown to deep invaginations extending through the root, occasionally communicating with periodontal or periapical tissues. The internal complexity of affected teeth presents diagnostic and therapeutic challenges, particularly in severe forms that mimic root canal systems or are associated with pulpal or periapical pathology. Maxillary lateral incisors are most frequently affected, likely due to their unique developmental timeline and morphological susceptibility. Although various classification systems have been proposed, Oehlers’ classification remains the most clinically relevant due to its simplicity and correlation with treatment complexity. Recent advances in diagnostic imaging, especially cone beam computed tomography (CBCT), have revolutionized the identification and classification of these anomalies. CBCT-based adaptations of Oehlers’ classification allow for the precise assessment of invagination extent and pulpal involvement, facilitating improved treatment planning. Contemporary therapeutic strategies now include calcium-silicate-based cement sealing materials, endodontic microsurgery for inaccessible anatomy, and regenerative endodontic procedures for immature teeth with necrotic pulps. Emerging developments in artificial intelligence, genetic research, and tissue engineering promise to further refine diagnostic capabilities and treatment options. Early detection remains critical to prevent complications such as pulpal necrosis or apical disease. A multidisciplinary, image-guided, and patient-centered approach is essential for optimizing clinical outcomes in cases of dens invaginatus. Full article

The aim of this study was to evaluate and compare the surface roughness and gloss—both initially and after simulated toothbrushing—of three 3D-printed crown materials subjected to different surface treatments: varnishing, polishing with diamond-impregnated rubber polishers, and polishing with a bristle brush and paste. Disc-shaped specimens (n = 90) were 3D-printed using three commercially available crown resins (Rodin Sculpture, VarseoSmile TriniQ, and OnX Tough 2) and post-processed per manufacturers’ instructions. Specimens were divided into three surface treatment groups: application of a light-cured varnish, polishing with a two-step diamond-impregnated rubber polisher, or polishing with a bristle brush and abrasive paste. Surface roughness and gloss were measured after treatment and again following 20,000 cycles of simulated toothbrushing. Additional specimens were prepared for Vickers microhardness testing and determination of filler weight percentage (wt%). Statistical comparisons were performed using two-way ANOVA with significance set at p < 0.05. Results: The varnish provided the statistically lowest roughness of all surface treatments for all materials. The bristle brush and abrasive paste polishing protocol produced the greatest gloss for the softest material (VarseoSmile TriniQ) and lowest gloss for the hardest material (Rodin Sculpture), whereas the two-step diamond-impregnated rubber polisher produced an equivalent gloss on all materials. Following toothbrushing, roughness was minimally affected; however, gloss was considerably reduced. Conclusions: All tested polishing and varnishing methods achieved clinically acceptable surface roughness (Ra < 0.2 µm) that persisted after simulated toothbrushing. Notably, the two-step diamond-impregnated rubber polisher produced consistent gloss across all materials, while the bristle brush and abrasive paste polishing protocol performed better on softer materials, and varnish application resulted in equal or superior gloss and roughness retention compared to polishing. Full article

Background: Acrylic resin-based materials are a versatile category used extensively in various dental applications. Processed by current modern technologies, such as CAD/CAM technologies or 3D printing, these materials have revolutionized the field of dentistry for the efficient creation of dental devices. However, despite their extensive use, a limited number of comparative studies exist that investigate how different processing methods—such as traditional techniques, 3D printing, and CAD/CAM milling—impact the nano-mechanical behavior and internal porosity of these materials, which are critical for their long-term clinical performance. Objectives: The purpose of this study is to evaluate the nanomechanical properties (hardness, elasticity, and stiffness) and micro-porosity of acrylic resin-based materials indicated for temporary prosthodontic appliances manufactured by new technologies (milling, 3D printing) compared to traditional methods. Methods: The hardness, elasticity, and stiffness measurements were performed by the nano-metric indentation method (nanoindentation), and the quantitative morphological characterization of the porosity of the acrylic resin samples obtained by 3D printing and CAD/CAM milling was performed by micro-computed tomography. Results: According to nanomechanical investigations, CAD/CAM milling restorative specimens exhibited the greatest mechanical performances (E~5.233 GPa and H~0.315 GPa), followed by 3D printed samples, while the lowest mechanical properties were registered for the specimen fabricated by the traditional method (E~3.552 GPa, H~0.142 GPa). At the same time, the results of porosity studies (micro-CT) suggested that 3D printed specimens demonstrated a superior degree of porosity (temporary crown—22.93% and splints—8.94%) compared to CAD/CAM milling restorative samples (5.73%). Conclusions: The comparative analysis of these results allows for the optimal selection of the processing method in order to ensure the specific requirements of the various clinical applications. Full article

Background/Objectives: Digital prosthodontics increasingly utilize both additive (3D printing) and subtractive Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), yet comprehensive comparisons remain limited. This scoping review evaluates their relative performance across prosthodontic applications. Methods: Systematic searches (PubMed, Scopus, Web of Science, Embase, 2015–2025) identified 28 studies (27 in vitro, 1 retrospective). Data were extracted on accuracy, efficiency, materials, and outcomes. Results: CAD/CAM milling demonstrated superior accuracy for fixed prostheses, with marginal gaps for milled zirconia (123.89 ± 56.89 µm), comparable to optimized 3D-printed interim crowns (123.87 ± 67.42 µm, p = 0.760). For removable prostheses, milled denture bases achieved a trueness of 65 ± 6 µm, while SLA-printed dentures post-processed at 40 °C for 30 min showed the lowest root mean square error (RMSE) (30 min/40 °C group). Three-dimensional printing excelled in material efficiency (<5% waste vs. milling > 30–40%) and complex geometries, such as hollow-pontic fixed dental prostheses (FDPs) (2.0 mm wall thickness reduced gaps by 33%). Build orientation (45° for crowns, 30–45° for veneers) and post-processing protocols significantly influenced accuracy. Milled resins exhibited superior color stability (ΔE00: 1.2 ± 0.3 vs. 3D-printed: 4.5 ± 1.1, p < 0.05), while 3D-printed Co-Cr frameworks (SLM) showed marginal fits of 8.4 ± 3.2 µm, surpassing milling (130.3 ± 13.8 µm). Digital workflows reduced chairside time by 29% (154.31 ± 13.19 min vs. 218.00 ± 20.75 min). All methods met clinical thresholds (<120 µm gaps). Conclusions: Milling remains preferred for high-precision fixed prostheses, while 3D printing offers advantages in material efficiency, complex designs, and removable applications. Critical gaps include long-term clinical data and standardized protocols. Future research should prioritize hybrid workflows, advanced materials, and AI-driven optimization to bridge technical and clinical gaps. Full article

Phalaenopsis is a widely cultivated ornamental plant of considerable economic value worldwide. However, traditional growing medium, sphagnum moss, is limited and non-renewable. It also decomposes slowly and is prone to environmental issues. Therefore, there is an urgent need to identify more environmentally friendly and efficient alternatives. Biochar, a sustainable material with excellent physical and chemical properties, has been recognized as an effective promoter of plant growth. In this study, we investigated the influence of biochar derived from three raw materials (corn straw, bamboo, and walnut) mixed1 with coconut shell at ratios of 1:2, 1:10, and 4:1, on the growth of Phalaenopsis ‘Big Chili’. Over a 150-day controlled experiment, we evaluated multiple growth parameters, including plant height, crown width, total root length, total projected area, total surface area, and root volume. Compared to the traditional growing medium, the optimal biochar-coconut shell mixture (maize straw biochar: coconut shell = 1:2) increased plant height and crown width by 7.55% and 6.68%, respectively. Root metrics improved substantially, with total root length increasing by 10.96%, total projected area by 22.82%, total surface area by 22.14%, and root volume by 38.49%. Root biomass in the optimal treatment group increased by 42.47%, while aboveground and belowground dry weights increased by 6.16% and 77.11%, respectively. These improvements were closely associated with favorable substrate characteristics, including low bulk density, high total and water-holding porosity, moderate aeration, and adequate nutrient availability. These findings demonstrate that substrate characteristics critically influence plant performance and that biochar–coconut shell mixtures, particularly at a 1:2 ratio, represent a viable and sustainable alternative to sphagnum moss for commercial cultivation of Phalaenopsis. Full article

In practical engineering applications, the use of low-carbon concrete materials is in line with the principles of sustainable development and helps to reduce the impact on the environment. Creep effects are particularly critical in the research on such materials. However, traditional characterization methods are time-consuming and often fail to account for the interactions of multiple factors. This study constructs a time-series database capturing the behavioral characteristics of low-carbon concrete materials over time. Three temporal prediction models—Artificial Neural Network (ANN), Random Forest (RF), and Long Short-Term Memory (LSTM) networks—were retrained for creep prediction. To address limitations in model architecture and algorithmic frameworks, an enhanced Adaptive Crowned Porcupine Optimization algorithm (ACCPO) was implemented. The improved performance of the ACCPO was validated using four diverse benchmark test functions. Post-optimization results showed remarkable improvements. For ANN, RF, and LSTM, single-metric accuracies increased by 20%, 19%, and 6%, reaching final values of 95.9%, 93.9%, and 97.8%, respectively. Comprehensive evaluation metrics revealed error reductions of 22.6%, 7.9%, and 8% across the respective models. These results confirm the rationality of the proposed temporal modeling framework and the effectiveness of the ACCPO algorithm. Among them, the ACCPO-LSTM time series model is the best choice. Full article

Biomimetic restorative protocols aim to preserve natural tooth structure while enhancing restoration longevity. This in vitro study aimed to evaluate the shear bond strength (SBS) in the repair of additively and subtractively manufactured CAD/CAM materials using bulk-fill resin composites and to assess the effect of thermocycling. Forty rectangular specimens (14.5 × 7 × 3 mm) were prepared from Grandio Blocs (GB, VOCO) and VarseoSmile Crown^Plus (VS, BEGO), and thermocycled (5000 cycles, 5–55 °C, 20 s dwell time). All surfaces were roughened with 50 μm Al₂O₃. Samples were repaired using VisCalor (VCB, VOCO) and Charisma Bulk Flow One (CBO, Kulzer) composites (n = 10 per group) with their respective adhesives. Each group was further divided into immediate and post-thermocycling subgroups. All specimens were tested under shear force until failure, and failure types were examined under a stereomicroscope. Representative samples were examined by SEM to evaluate filler morphology. Statistical analysis was performed with SPSS v23 (p < 0.05). No statistically significant differences in SBS were found between groups (p > 0.05). Mean SBS values were highest in VS-CBO and lowest in GB-CBO. Cohesive failures were more frequent in immediate groups, while adhesive failures predominated after thermocycling. Bulk-fill composites did not influence the repair bond strength of indirect materials. Thermocycling affected the failure type, though not the SBS values. Full article