Search Results (250)

Background: A bidirectional association between diabetes and oral health is well established, yet oral self-care is overlooked in diabetes management. Health Belief Model (HBM)-guided oral care interventions have exhibited promising outcomes in the literature but have not been used to guide oral self-care interventions designed for people with diabetes (PWD). Positioned at the early conceptualization and design stage of such a program, this developmental study was to identify self-perceived needs in oral self-care practices and to obtain preliminary feedback among PWD about the blueprint of a new program—DiaOral^©. Methods: We conducted semi-structured interviews with 15 PWD recruited from a large healthcare system, with a goal to recruit patients from racially/ethnically diverse urban/suburban zip codes. Interviews explored participants’ oral self-care practices in relation to diabetes. Sample DiaOral^© content and images on a blueprint were presented and feedback was solicited. Braun and Clarke’s reflexive thematic analysis was used to code and interpret transcripts, aligning emerging themes with HBM constructs through team-based consensus. Results: Three major themes and 27 sub-themes emerged: (1) lack of knowledge on optimal oral care, (2) low perceived importance of preventive care and oral health in diabetes, and (3) low self-efficacy for performing effective oral self-care. Participants expressed satisfaction with the content and their perceived confidence and interest potentially in using the DiaOral^© program based on their preliminary review of the blueprint. Conclusions: Findings support the relevance of HBM constructs in shaping oral self-care among PWD. This developmental study suggests that the DiaOral^© blueprint is ready to move forward to website prototype development. Future work will finalize the program and evaluate its efficacy among PWD. Full article

Dental implant placement has evolved from conventional freehand techniques toward digitally guided workflows integrating cone-beam computed tomography (CBCT), computer-aided design/computer-aided manufacturing (CAD/CAM), and dynamic navigation systems. Although guided surgery improves positional accuracy, its clinical relevance compared with freehand placement remains debated. This narrative review, based on a systematic and structured literature search following predefined selection criteria, analyzes studies published between 2000 and 2025 comparing guided and freehand implant placement regarding accuracy, survival, complications, biological outcomes, and workflow efficiency. Searches of PubMed/MEDLINE, Embase, and Web of Science identified 40 eligible human clinical studies for qualitative synthesis. Guided placement consistently demonstrated greater positional accuracy, with angular deviations of approximately 2–4° versus 5–9° for freehand placement and linear deviations reduced by about 1 mm. Nevertheless, implant survival rates were high and comparable for both techniques, generally exceeding 95% across short- and medium-term follow-up. Overall complication rates were low; guided approaches reduced anatomical risk and improved prosthetic predictability in complex or multi-implant cases, while freehand placement allowed greater intraoperative flexibility and tactile feedback, potentially optimizing primary stability in variable bone conditions. Marginal bone loss and peri-implant tissue outcomes were similar between approaches. Guided workflows required additional planning time and costs but enhanced reproducibility in complex rehabilitations. Guided and freehand implant placement should therefore be considered complementary strategies, with optimal outcomes depending on case selection, surgical expertise, and the balanced integration of digital technologies into contemporary implant practice. Full article

Objectives. This study evaluated the performance of three intraoral scanners with different acquisition technologies in detecting early signs of tooth wear, using micro-computed tomography (micro-CT) as the reference standard. Methods and Materials. Three IOS were examined, including an active triangulation scanner, a structured-light triangulation scanner, and a parallel confocal technology scanner. Ten extracted unrestored and caries-free premolars were placed in the maxillary left second premolar position of a dental mannequin and scanned at baseline, generating quadrant digital models. Micro-CT scans were also obtained at baseline. Wear was simulated by immersion in a 1% citric acid solution followed by brushing of the buccal surfaces. All specimens were rescanned with IOS and micro-CT. Micro-CT datasets were reconstructed into stereolithography models and compared with IOS models using mesh analysis software. Statistical analysis was performed in R using linear mixed-effects models to account for repeated measurements across teeth. RMS values and absolute errors relative to the micro-CT reference were analysed with device as a fixed effect and tooth as a random effect, with Tukey-adjusted pairwise comparisons. Repeatability was additionally assessed from the repeated scans using within-tooth variability. Results. Significant differences were observed among the evaluated systems in the detection of changes related to tooth wear (p < 0.001). The micro-CT reference showed the lowest RMS value, followed by Trios 3, Primescan, and Omnicam. Model-based analyses confirmed significant differences among the evaluated systems, while the magnitude and statistical support of pairwise contrasts depended on the specific outcome considered. Repeatability analysis showed that Trios 3 had the lowest within-tooth standard deviation and repeatability coefficient (0.0215 mm and 0.0595 mm, respectively), followed by Primescan (0.0290 mm and 0.0802 mm), whereas Omnicam showed the highest within-tooth variability and repeatability coefficient (0.0624 mm and 0.173 mm). Conclusions. The parallel confocal and structured-light triangulation intraoral scanners produced RMS values numerically closer to the micro-CT reference than the active triangulation scanner. However, none of the evaluated intraoral scanners demonstrated quantitative agreement sufficient to be considered interchangeable with the reference standard. Full article

This case report describes a digital workflow for the aesthetic rehabilitation of a 30-year-old male patient with unaesthetic anterior teeth. The treatment incorporated AI-assisted smile design software (SmileCloud Biometrics) for 2D/3D digital planning and patient communication. Six lithium disilicate veneers (IPS e.max CAD) were fabricated using CAD/CAM technology following mock-up-guided minimally invasive preparation (0.2–0.9 mm reduction). The restorations were adhesively cemented under rubber dam isolation. One-week follow-up confirmed aesthetic integration, occlusal harmony, and patient satisfaction. This case illustrates how digital workflows with AI-assisted tools can support veneer rehabilitation through data-informed planning and conservative preparation while maintaining aesthetic outcomes. Full article

Objective: This narrative review synthesizes current evidence on materials and manufacturing technologies for customized dental implants, highlighting their comparative advantages and limitations. Methods: A structured literature search (December 2024–January 2025) was conducted using PubMed, Web of Science, Scopus, and Google Scholar. Peer-reviewed English-language articles (mainly 2015–2025) addressing implant materials, manufacturing methods, and surface modifications were included. Data were critically analyzed and thematically organized without meta-analysis. Results: Digital workflows are advancing implantology toward patient-specific solutions. Subtractive manufacturing (SM) ensures high precision and surface quality but is limited by material waste and geometric constraints. In contrast, additive manufacturing (AM) enables complex, porous, and customized designs, though often requires post-processing. Titanium and its alloys remain the gold standard due to strength and biocompatibility, while TiZr and β-type alloys may reduce stress shielding. Zirconia offers aesthetic benefits but is brittle, whereas PEEK shows favorable elasticity but limited bioactivity. Surface modifications enhance osseointegration and long-term performance. Conclusions: Combining digital workflows with SM and AM supports development of optimized, patient-specific implants. While titanium dominates clinical use, emerging materials offer specific advantages. Further clinical validation and standardization are required. Full article

Background and Objectives: Severe alveolar atrophy may pose significant challenges for dental rehabilitation. Recent advances in digital planning and CAD/CAM technology have renewed the interest in patient-specific subperiosteal implants as a treatment option for anatomically challenging cases. This cohort study evaluated changes in oral health-related quality of life and patient satisfaction following rehabilitation with customized subperiosteal implants in severe alveolar atrophy. Materials and Methods: This cohort study included all consecutive adult patients with severe alveolar atrophy who underwent reconstruction with patient-specific subperiosteal implants at the Department of Oral and Maxillofacial Surgery of “Evangelismos” General Hospital, Athens, Greece, in 2025. Oral health-related quality of life was assessed using the validated OHIP-14 questionnaire preoperatively and 12 months postoperatively. Patient satisfaction was evaluated using a numerical rating scale (NRS). Secondary outcomes included postoperative complications, implant exposure, implant stability, and need for reoperation. Comparisons between baseline and 12-month scores were performed using the Wilcoxon signed-rank test. Results: Nine patients who had completed 12-month follow-up were included. Five were male, and all implants were placed in the maxilla. Significant improvement was observed in oral health-related quality of life, with the median OHIP-14 total score decreasing from 41 preoperatively to 1 at the 12-month follow-up. Patient satisfaction also improved significantly, with the median NRS total score increasing from 17 to 58. Improvements were consistent across all OHIP-14 domains and all NRS items. No major complications were recorded. One patient developed early wound dehiscence, and one patient presented with implant exposure at the anterior palate. At the final follow-up twelve months postoperatively, all implants remained clinically and radiographically stable. Conclusions: These preliminary short-term findings suggest that customized subperiosteal implants may be a promising option for selected patients with severe alveolar atrophy in whom placement of conventional endosseous implants is not feasible; however, the results should be interpreted cautiously given the very small sample size and observational design. Full article

Despite advances in dental materials and digital color registration systems, esthetic matching remains a clinical challenge for both dental students and experienced professionals. A comprehensive narrative review was conducted through bibliographic searches in PubMed, Scopus, Web of Science, and PsycINFO databases from January 2015 to January 2026. The evidence was synthesized using a four-dimensional analytical framework encompassing technological, cognitive–psychological, educational, and clinical-contextual factors. Quantitative synthesis revealed substantial variability in shade matching success rates, with intraoral scanners demonstrating pass rates ranging from 31.3% to 78.2% across devices, while spectrophotometers achieved superior repeatability (ICC > 0.9) but faced interpretive barriers. Cognitive load theory explains the performance deterioration, with novices being particularly susceptible to retinal fatigue and metamerism under non-standardized lighting conditions. The proposed paradigm shift involves redefining shade selection from a purely technical task to a cognitive skill that requires deliberate perceptual calibration, structured educational protocols, and hybrid digital visual workflows. To improve esthetic predictability, educational programs need to integrate longitudinal training in color science with objective feedback mechanisms. Clinical workflows should adopt hybrid calibration-centric protocols that position technology as a verification tool, rather than a replacement for clinical judgment. Understanding the multidimensional nature of shade matching difficulty enables the development of evidence-based educational protocols and clinical workflows, ultimately improving esthetic outcomes. Full article

This systematic review critically examines the use of 2D and 3D digital imaging technologies of the face and teeth, with and without integration of artificial intelligence, for human identification in forensic and medicolegal contexts. Following PRISMA 2020 guidelines, Scopus, PubMed and Web of Science were systematically searched, identifying 26 studies published between 2011 and 2025 that met predefined eligibility criteria framed by a PECO-style question. Eighteen studies focused on facial imaging, six on dental imaging and two on integrated orofacial workflows, using digital photography, CCTV/video, 3D surface imaging, intraoral scanners, and three-dimensional superimposition methods, sometimes combined with classical algorithms and deep learning models. In controlled or semi-controlled settings, state-of-the-art facial algorithms often reported very high accuracy, with values up to 99.85%. By contrast, studies using real CCTV or other challenging forensic imagery showed more variable performance, with accuracies ranging from about 72.8% to 96.6%. Dental and orofacial studies reported 100% correct identifications for 3D superimposition of intraoral scans in small samples, and around 83% accuracy for automated AI-based dental identification. Crucially, fulfilling the promise of a true orofacial approach, this review proposes a structured research agenda focused on creating realistic multi-modal databases, standardizing protocols, and implementing probabilistic reporting (likelihood ratios) to guide future validation and legal admissibility. Full article

Background/Objectives: Modern dentistry focuses on the ongoing development of digital alternative technologies and the study of the properties of these innovative materials is deemed essential. Therefore, the objectives of this study were to evaluate the optical and surface characteristics of six computer-aided design/Computer-Aided Manufacturing (CAD-CAM) dental materials, both subtractive and additive, in relation to in vitro degradation. Methods: CAD-CAM dental materials, subtractively processed (Vita Enamic, Cerasmart, Brilliant and Tetric) and additively manufactured (Saremco Crowntec and Voco C&B), were prepared to standard dimensions of 14 × 10 × 1 mm, with baseline measurements taken prior to, and after, the degradation procedures, consisting of immersion in an ADA-recommended staining broth, artificial aging (thermocycling), and the combined effects of staining and in vitro aging. Additionally, two different surface treatments were investigated (polished and glazed). Results: The poorest color stability was observed for Tetric glazed specimens (mean value 25.585) subjected to staining, while the best performance was recorded for Brilliant polished Control (average value of 0.781). The staining procedure produced the most pronounced color changes. Surface treatment did not significantly affect color stability, and surface roughness was not influenced by either the degradation method or the surface treatment (p > 0.05). Atomic Force Microscopy (AFM) evaluation revealed superior performance of the glazed surfaces, characterized by lower nanoroughness values compared with polished surfaces and a smoother surface appearance. Conclusions: The staining potential of staining broth was demonstrated in this study, with the highest values recorded after the staining procedures. In addition, the influence of artificial aging alone and artificial aging combined with staining was investigated, providing relevant results for a better clinical approach. Moreover, surface treatment demonstrated reliability and therefore clinical applicability. Full article

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

Three-dimensional (3D) printing, also known as additive manufacturing (AM), has become increasingly integrated into dentistry because of its high precision, efficiency, and ability to fabricate patient-specific devices. This review comprehensively discusses the historical development of 3D printing and outlines the fundamental principles of the most widely used technologies in dentistry, including stereolithography (SLA), digital light processing (DLP), and liquid crystal display (LCD). These technologies enable the accurate and efficient fabrication of dental models, crowns, bridges, dentures, surgical guides, orthodontic appliances, and tissue engineering scaffolds. Current clinical applications are systematically summarized across major dental disciplines, including prosthodontics, orthodontics, oral and maxillofacial surgery, endodontics, periodontics, and pediatric dentistry. Despite existing challenges, such as limited long-term clinical data for certain materials, high initial equipment costs, and post-processing requirements, 3D printing offers substantial advantages in terms of customization, workflow efficiency, and clinical predictability of the final product. Future developments in advanced biomaterials, artificial intelligence-assisted workflows, bioprinting, and four-dimensional (4D) printing are expected to further expand the role of additive manufacturing in personalized and regenerative dentistry. Full article

Background: Dental anxiety remains a prevalent and persistent challenge in pediatric dentistry, significantly affecting children’s cooperation, treatment outcomes, and long-term oral health behaviors. Despite advances in minimally invasive care, anxiety continues to act as a barrier to effective clinical management. This narrative review aims to synthesize current evidence on validated assessment tools for pediatric dental anxiety and to examine contemporary non-pharmacological management strategies applicable in routine clinical practice. Methods: A structured literature search was conducted in major electronic databases to identify relevant studies, systematic reviews, and clinical guidelines addressing dental anxiety assessment and behavioral management in children. Particular emphasis was placed on validated anxiety scales, communication strategies, environmental adaptations, and emerging digital interventions such as immersive distraction technologies. Results: Multiple validated instruments are available to assess pediatric dental anxiety; however, their applicability varies by age, cognitive development, and clinical context. Non-pharmacological approaches including tell–show–do, modeling, parental guidance, audiovisual distraction, and virtual reality-based techniques demonstrate consistent effectiveness in reducing anxiety and improving behavioral cooperation. Recent trends emphasize multimodal, patient-centered strategies integrating communication, environmental modification, and digital tools. Conclusions: Structured anxiety assessment combined with contemporary multimodal management strategies can enhance clinical efficiency, improve child cooperation, and promote positive dental experiences. The integration of emerging digital technologies represents a promising advancement in pediatric anxiety management and supports a more individualized approach to care. Furthermore, a structured multimodal clinical framework is proposed to facilitate chairside decision-making and practical implementation. Full article

Background: The clinical translation of natural nanomaterials and smart delivery systems in regenerative dentistry relies heavily on practitioner acceptance; however, end-user perspectives remain under-investigated. Objective: This study evaluated dental practitioners’ self-reported knowledge, attitudes, and perceived barriers regarding these innovations. The questionnaire examined stated intention and self-reported willingness, not clinical behaviour. Methods: A cross-sectional survey using convenience sampling was conducted among 713 Romanian dentists. Statistical analysis included Chi-square tests and odds ratio estimation to identify factors associated with willingness to adopt nano-formulations. Results: Self-reported familiarity was moderate, with only 19.1% of respondents describing themselves as “very familiar” with nanodentistry; nevertheless, 77.3% believed natural nano-formulations could match synthetic efficacy. High costs (36.5%), lack of long-term evidence (35.9%), and staining concerns (46.0%) were identified as primary perceived barriers. Experience with digital technologies (CAD/CAM) was significantly associated with a positive attitude toward adoption (OR = 2.05, 95% CI: 1.41–2.98, p < 0.001). Conclusions: Respondents demonstrated a generally positive attitude toward integrating bioactive nanomaterials, though widespread adoption is currently limited by economic, educational, and evidentiary gaps. Future strategies should focus on establishing clear clinical protocols, providing robust long-term safety data, and improving the aesthetic stability of natural biomaterials. Full article

Background/Objectives: Digital technologies and generative artificial intelligence (AI) are increasingly used in undergraduate dental education, yet international variations in adoption and governance remain insufficiently described. This study aimed to characterise cross-national patterns of educational software use, perceived importance for curriculum delivery, and institutional readiness for AI governance. Methods: A cross-sectional online survey of educators and academic administrators involved in undergraduate dental education captured institutional software use across teaching delivery, learning management, assessment, clinical record systems, imaging, simulation, digital workflows, and generative AI. Results: A total of 97 respondents from 38 countries completed the survey, with most institutions delivering both undergraduate and postgraduate dental education (66.0%). Videoconferencing platforms were widely adopted. LMS provision varied, with Google Classroom, Moodle, and Blackboard most frequently reported. Paper-based clinical records remained in use in 32% of institutions. Among digital PMS/EDR platforms, axiUm, Salud/Titanium, and Carestream Dental were the most prevalent. Adoption of simulation software, CAD/CAM systems, and 3D printing was inconsistent. LMS and videoconferencing were most often rated as essential, whereas simulation, scanners, CAD/CAM, and 3D printing were generally considered useful but not essential. Generative AI use was commonly reported, while formal institutional guidance and policies were frequently absent. Conclusions: Although digital integration in undergraduate dental education is widespread, its distribution is uneven across different regions and technology domains. The combination of rapid generative AI uptake and limited governance highlights an urgent need for institution-level guidance, staff development, and strategic investment to support responsible and equitable integration. Full article

Effective dentist-patient communication underpins care, empowering informed decisions, reducing anxiety, improving efficiency, and fostering trust through clear, accurate, cohesive exchanges. This narrative review used a structured Medline search of literature, employing key terms to select and synthesize relevant English-language publications on dentist-patient communication without strict inclusion criteria. Key strategies include active listening, empathetic dialogue, patient-centred approaches, and the use of plain language and visual aids to demystify complex information. Additionally, integrating technology for appointment reminders, virtual consultations, and feedback mechanisms can streamline interactions. Crucially, cultural competency and sensitivity to individual needs ensure inclusivity and personalized care. Building on these findings, the study outlines ten actionable pillars for effective communication: (1) Initial Consultation: Establish rapport and gather comprehensive medical/dental histories. (2) Treatment Explanation: Simplify diagnoses and options using layman’s terms. (3) Informed Consent: Transparently discuss risks/benefits and invite questions. (4) Patient Education: Clarify oral hygiene practices and post-treatment expectations. (5) Anxiety Management: Address fears through reassurance and tailored coping strategies. (6) Follow-Up Care: Maintain post-treatment engagement to resolve concerns. (7) Feedback Systems: Leverage patient insights for service improvement. (8) Cultural Sensitivity: Adapt communication to diverse backgrounds. (9) Non-Verbal Cues: Employ positive body language and active listening. (10) Technology Integration: Utilize digital tools for efficiency and accessibility. By prioritizing empathy, clarity, and adaptability, clinicians can transform dental visits from anxiety-inducing encounters into collaborative partnerships. This approach not only elevates patient satisfaction and adherence but also redefines the standard of care, aligning clinical practice with the evolving needs of modern dentistry. Full article