Search Results (3,361)

Polyetheretherketone (PEEK) has emerged as a promising biomaterial for orthopedic and craniofacial implants due to its favorable mechanical properties and fatigue resistance; however, its inherent chemical inertness limits effective osseointegration. In this study, femtosecond laser surface modification is explored as a strategy to enhance the bioactivity of PEEK. Based on a previously performed parametric study, controlled micro- and nanoscale surface textures were fabricated using femtosecond laser processing, enabling precise tuning of surface roughness and wettability without the need for additional chemical treatment. The modified surfaces were systematically characterized in terms of morphology, composition, and topography using scanning electron microscopy (SEM), 3D profilometry, and water contact angle measurements. Four optimized femtosecond laser-generated surface architectures were selected for the present investigation and comprehensively characterized, followed by in vitro evaluation of dental pulp stem cell adhesion, morphology, and proliferation. The results indicate that laser-induced micro/nanostructuring enhances the surface properties of PEEK, while supporting cellular attachment and favorable cell–surface interaction. Differences in the biological response were observed among the optimized laser-textured surfaces. These findings highlight the feasibility of femtosecond laser texturing as a clean, reproducible, and scalable approach for the development of next-generation, personalized orthopedic implants. Full article

Background: Finite element analysis (FEA) has become a cornerstone of dental biomechanics, supporting the simulation of stress, strain, and displacement in biological structures and biomaterials. Methods: This combined bibliometric and narrative review examines the development, geographic and disciplinary distribution, and methodological state of FEA-based dental research by analysing 3379 publications indexed in Scopus between 1969 and 2024. Results: The dataset shows continued exponential growth in annual output, particularly after 2000, with China, the United States, and India as the leading contributors. Journal articles account for the bulk of the literature, and implant dentistry remains the most prominent focus area. The 100 most-cited works concentrate on implant biomechanics, prosthodontics, and scaffold design, while interdisciplinary contributions linking FEA to regenerative biomaterials, orthodontics, and endodontics are increasing. Conclusions: FEA in dentistry is a mature but still rapidly expanding field. Persistent methodological gaps remain, including the routine use of isotropic and linear-elastic bone, idealised osseointegration, static loading, limited patient-specific variability, and scarce in vivo validation. Future work should converge on patient-specific multiscale models, fatigue and contact-aware formulations, standardised validation pipelines, and the integration of artificial intelligence into both pre-processing (mesh generation, parameter identification) and post-processing (surrogate models, outcome prediction). The wider relevance of FEA across orthopaedic, thoracic, and reconstructive biomechanics confirms its role as a unifying computational tool for clinical translation. Full article

Background/Objectives: Accurate estimation of augmentation volume is essential for successful maxillary sinus augmentation planning. Manual CBCT-derived volumetric calculations remain time-consuming and operator-dependent. Artificial intelligence (AI)-assisted volumetric estimation may provide a standardized and reproducible alternative. This study evaluated the agreement and reliability of an AI-assisted volumetric estimation tool compared with CBCT-derived manually calculated augmentation volumes for sinus augmentation planning. Methods: A retrospective comparative study was conducted on 60 CBCT scans obtained from patients undergoing implant treatment planning. Radiographic measurements included bone width (A), residual alveolar bone height (B), sinus lift height (C), sinus lift width (D), and sinus lift depth (E). Manual augmentation volume was calculated using a geometric ellipsoid approximation formula derived from standardized linear measurements. AI-assisted volumetric estimation was performed using the volumetric analysis tool integrated within Planmeca Romexis 6.3 software. Two calibrated periodontists repeated both manual and AI-assisted measurements twice with a two-week interval. Reliability was assessed using intraclass correlation coefficients (ICC), while agreement between methods was evaluated using ICC and Bland–Altman analysis. Results: The mean manually calculated planned augmentation volume per implant site was 0.47 ± 0.11 cm³, whereas the mean AI-assisted planned augmentation volume was 0.52 ± 0.10 cm³. AI-assisted measurements were significantly greater than manual measurements (p < 0.001). Manual measurements demonstrated moderate intra- and inter-examiner reliability (ICC = 0.722, 0.701, and 0.649), whereas AI-assisted measurements demonstrated excellent reliability (ICC = 0.917, 0.924, and 0.903). Agreement between AI-assisted and manual volumetric estimation was good (ICC = 0.847). Bland–Altman analysis demonstrated a mean bias of 0.061 cm³ with limits of agreement ranging from 0.028 to 0.094 cm³. No significant associations were observed between augmentation volume and age, sex, or number of missing teeth after normalization per implant site (p > 0.05). Conclusions: AI-assisted volumetric estimation demonstrated excellent reproducibility and good agreement with manually calculated augmentation volumes while producing slightly higher volume estimates. AI-assisted volumetric estimation may serve as a reliable adjunctive tool for sinus augmentation planning by improving standardization and reducing operator-dependent variability. Full article

Background: The aim of this study was to analyze the success of dental implants in patients with functional diversity by comparing success rates and marginal bone loss with those observed in patients without functional diversity, with both groups being subjected to a strict implant maintenance and hygiene protocol. Methods: A retrospective observational case–control study was designed. Two main study groups were established: one comprising patients with functional diversity (case group) and another including patients without functional diversity (control group), all of whom had received dental implants. Implant success rates were evaluated 12 months after prosthetic loading. Marginal bone loss was quantified according to the classification proposed by Lagervall and Jansson, later modified and validated by Corcuera-Flores et al. In addition, the Silness and Löe plaque index, presence of bruxism, implant characteristics, and rehabilitation techniques were recorded at each follow-up visit. Results: A total of 63 dental implants were placed in 20 patients included in the present study. The case group consisted of 9 patients who received 31 implants, whereas the control group comprised 11 patients who received 32 implants. No statistically significant differences were observed between groups in terms of implant success and MBL. Oral hygiene was assessed showed a statistically significant difference between groups (p = 0.001). Significant differences were also found regarding bruxism prevalence between groups, which was higher in the case group. Conclusions: The results obtained in the present study indicate that implant therapy in patients with functional diversity can achieve success rates comparable to those observed in patients without disabilities despite the higher prevalence of bruxism and a greater amount of dental plaque. These findings reinforce the importance of individualized treatment planning, adequate oral hygiene control, and periodic clinical follow-up in order to ensure long-term implant stability and peri-implant health. Full article

Biofilm-associated infections present a significant but insufficiently acknowledged problem in veterinary medicine because they result in persistent infections that lead to unsuccessful treatments and drive the growth of antimicrobial resistance throughout animal healthcare systems. The extracellular matrix of biofilms together with their resistance mechanisms make traditional antimicrobial methods ineffective against these structures. The development of combination-based biomaterial coatings represents an effective solution for biofilm control since these coatings combine different antimicrobial capabilities into one surface treatment. This review offers an in-depth evaluation of veterinary-focused combination-based coating systems which scientists developed to create solutions for catheterization, orthopedic, dental implant procedures, wound treatment and aquaculture infrastructure. This review also examines various coating methods to determine their effectiveness in creating surfaces that optimize antimicrobial delivery. However, the development of veterinary medical solutions faces major obstacles because the technology needs to overcome some key issues, which include maintaining stability through time, protecting animal health, preventing environmental harm and meeting regulatory standards. Overall, the use of multifunctional biomaterial functional coatings provides veterinary medicine with a revolutionary method to handle biofilm-related infections in animals, which decreases the need for antibiotics while improving infection control according to One Health principles. Full article

This paper studies the effects of price-cap regulation in an oral healthcare market by developing a duopoly model of price–quality competition between a public provider and a private provider. The results show that, in the absence of regulation, the public provider charges a high price and offers high quality, whereas the private provider adopts a low-price, low-quality strategy. This vertical differentiation softens price competition but leaves some highly price-sensitive patients untreated. Under price-cap regulation, market outcomes depend critically on the stringency of the cap. An intermediate price cap narrows the quality gap by inducing the private provider to improve quality while only weakly reducing the public provider’s quality, thereby expanding the market from partial to full coverage. A high price cap generates heterogeneous quality responses depending on the public provider’s unregulated quality level but does not improve market coverage. By contrast, a low price cap expands coverage but compresses profit margins, leading both providers to reduce quality and resulting in a low-price, low-quality equilibrium. These findings highlight the trade-offs between affordability, access, and quality in healthcare price regulation and suggest that intermediate price caps may achieve a better balance between these objectives. Full article

Objectives: To evaluate the influence of implant–abutment connection design, implant diameter, and simulated marginal bone loss on fracture resistance and failure patterns of dental implant systems. Materials and Methods: A total of 180 implant–abutment assemblies were tested, including Morse taper (MT) and internal hex (IH) connections with diameters of 3.5, 4.0, and 5.0 mm. Implants were embedded at two simulated bone levels (0 and 3 mm) and loaded at 30° until failure, in accordance with ISO 14801:2015. Fracture resistance (N) was analyzed using three-way ANOVA. Results: Connection type, implant diameter, bone level, and their interactions significantly affected fracture resistance (p < 0.001). Internal hex implants showed a marked diameter-dependent increase in resistance and greater reduction under simulated bone loss, particularly in reduced diameters. In contrast, Morse taper implants demonstrated similar resistance values regardless of implant diameter or bone level. Failure patterns also differed between systems: internal hex implants exhibited cervical implant fractures in reduced diameters, whereas Morse taper implants showed progressive abutment deformation and/or abutment fracture without implant body fracture. Conclusions: Implant fracture resistance is strongly influenced by implant–abutment connection geometry. Within the limitations of this static in vitro study, MT systems demonstrated diameter-independent mechanical stability and prosthetic-controlled failure patterns, whereas IH systems were highly sensitive to diameter reduction and simulated bone loss. Full article

Background: To compare the short-term clinical and radiographic outcomes of electrolytic versus conventional mechanical implant surface decontamination during surgical treatment of peri-implantitis. Methods: This retrospective cohort study included 20 implants affected by peri-implantitis in 20 patients. Ten implants were treated using electrolytic implant surface decontamination, while 10 implants received conventional mechanical decontamination with titanium curettes, chitosan brushes, and glycine powder air-polishing. In addition, regenerative therapy of the peri-implant defect was performed in 8 of the 20 treated sites, equally distributed between the two groups (4 sites per group). Clinical and radiographic parameters, including probing depth (PD) and radiographic bone loss, were assessed at baseline and after 6 months. Intragroup and intergroup comparisons were performed using parametric statistical analyses (α = 0.05). Results: Both treatment protocols resulted in statistically significant improvements in probing depth reduction and radiographic bone fill after 6 months (p < 0.001). In the electrolytic group, mean PD decreased from 6.7 ± 0.95 mm to 4.0 ± 0.2 mm, while in the conventional group, PD decreased from 6.8 ± 1.03 mm to 3.3 ± 0.3 mm. Radiographic bone loss decreased from 4.88 ± 0.70 mm to 0.94 ± 0.70 mm in the electrolytic group and from 4.88 ± 1.83 mm to 0.94 ± 1.14 mm in the conventional group. No statistically significant intergroup differences were observed for probing depth reduction or radiographic bone level changes. No implant losses occurred during the observation period. Conclusions: Within the limitations of this retrospective study, both electrolytic and conventional mechanical implant surface decontamination protocols resulted in significant short-term clinical and radiographic improvements following peri-implantitis surgery. Electrolytic cleaning demonstrated outcomes comparable to conventional therapy and may represent a viable alternative for implant surface decontamination. Full article

Objectives: The aim of this study was to compare insertion torque (IT) and primary stability, assessed by resonance frequency analysis (RFA), between two implant systems with a shared macrodesign but different surface morphology and titanium grade in a standardized ex vivo porcine bone model. Methods: Sixty implants (OmniTaper EV and Xive; n = 30 per group) were inserted into standardized porcine rib bone blocks using identical osteotomy protocols. Peak insertion torque and primary stability, assessed by resonance frequency analysis (RFA), were recorded immediately after placement. Between-group differences were evaluated using appropriate statistical methods. Results: Bone density did not differ significantly between groups. OmniTaper EV implants demonstrated significantly higher insertion torque (28.2 ± 6.5 Ncm vs. 24.2 ± 6.2 Ncm; p = 0.020) and higher ISQ values (74.1 ± 6.0 vs. 69.8 ± 6.9; p = 0.013) than Xive implants. Mixed-effects analyses confirmed both findings after adjustment for clustering. No significant correlation was found between insertion torque and ISQ. Conclusions: Despite sharing a common implant design concept and standardized osteotomy preparation, the investigated implant systems demonstrated significant differences in insertion torque and primary stability. The findings indicate that implant-specific characteristics, including surface morphology and titanium grade, may influence implant–bone interface mechanics during insertion. However, their individual contributions cannot be distinguished within the present study design and should therefore be interpreted as the combined influence of implant-specific characteristics. Full article

This work presents a systematic methodology for generating bi-sinusoidal surface topographies with controlled and reproducible characteristics on Ti-6Al-4V using a progressive 1D–2D–3D framework. Such deterministic topographies are of interest for dental implants, where surface micro-texture can influence an early biological response and osseointegration. Single-pulse ablation thresholds were first determined to be 0.175 J/cm² at a 1031 nm wavelength using 306 fs pulses, with no polarization dependence. Studies were then carried out to identify fundamental ablation parameters, optimize scanning conditions for planar texturing, and extend the process to controlled three-dimensional surface architectures. During the 1D stage, increasing the fluence from 0.26 to 6.52 J/cm² enlarged the crater diameter from approximately 7 to 32 µm and increased the areal roughness Sa from 0.012 to 0.020 µm. With an increasing pulse number, the crater diameter continued to grow up to 25 pulses before stabilizing. Multi-pulse tests below the threshold showed that repeated exposures caused ablation, highlighting incubation and energy accumulation, with an incubation factor of S = 0.84. In the 2D stage, scanned irradiation was used to quantify how fluence and pulse overlap affect the ablated depth and areal roughness, with depth increasing linearly with the number of passes, and roughness strongly governed by overlap and fluence. Finally, 3D texturing combining x–y scanning with a z-axis focal adjustment enabled reproducible bi-sinusoidal topographies. Full article

Background: This study aimed to assess cone-beam computed tomography (CBCT) knowledge, adherence to justification criteria, field-of-view (FOV) selection practices, and awareness of radiation protection guidelines among dental practitioners in the Asir region. In Saudi Arabia, the Saudi Food and Drug Authority (SFDA) and the Nuclear and Radiological Regulatory Commission are the regulatory bodies responsible for radiation protection and the safe use of dental imaging; limited awareness of their roles may undermine regulatory compliance and patient safety. Accordingly, the specific objectives of this study were: (i) to assess knowledge of CBCT justification criteria and radiation-dose magnitudes; (ii) to evaluate adherence to the requirement for a prior 2D radiograph; (iii) to examine FOV selection across standardized clinical vignettes; (iv) to explore factors associated with knowledge scores; and (v) to identify perceived barriers to appropriate CBCT prescribing. Methods: A cross-sectional descriptive-analytical survey targeted 73 dental practitioners in Abha, Saudi Arabia. A validated 30-item questionnaire was distributed via Google Forms using snowball convenience sampling. The effective target population comprised dental practitioners and interns working in Abha during the study period. Because recruitment used open snowball distribution without a fixed sampling frame, a formal response rate could not be calculated. Results: The mean knowledge score was 5.47/10 (standard deviation: 1.86). Item-level correct rates were 82.2% for caries detection, 80.8% for the requirement for a prior 2D radiograph, and 58.9% for paediatric CBCT justification. FOV selection across four clinical vignettes ranged from 27.4% to 68.5% correct, with the lower-left-molar implant vignette showing the lowest rate (27.4%) and the six-unit anterior implant bridge vignette also poorly answered (37.0%), reflecting a frequent tendency to select an inappropriately large FOV. Guideline awareness was low: 65.8% were completely unaware of the Safety and Efficacy of a New and Emerging Dental X-ray Modality Computed Tomography (SEDENTEX CT) 2012 guidelines, while 54.8% did not know that the American Dental Association publishes specific radiation guidelines. In an exploratory multivariable model, no factor was a statistically significant predictor of the knowledge score; formal CBCT training showed a small, non-significant association (B = 0.585; 95% confidence interval [−0.27, 1.44]; p = 0.175). Conclusions: In this preliminary survey, CBCT knowledge among dental practitioners in Abha was moderate but suboptimal, with almost half of respondents scoring below the satisfactory threshold and with significant gaps in FOV optimisation and guideline awareness. Given the small, non-probability sample, these findings should be regarded as preliminary and hypothesis-generating. Full article

Background/Objectives: Thermal injury during implant osteotomy is a recognized complication of guided surgery. Closed guide architectures and metallic sleeves restrict coolant access to the drill–bone interface, reducing the effectiveness of conventional external irrigation. This study aimed to describe the design and fabrication of a 3D-printed surgical guide system with integrated internal irrigation channels and to evaluate its technical and clinical feasibility in guided implant surgery. Methods: The system was developed by integrating CBCT and IOS data into BlueSky Bio planning software. Irrigation channels were generated by CAD subtraction. Guides were fabricated by additive manufacturing—digital light processing (DLP) in biocompatible Asiga DentaGuide resin and, in one case, selective laser melting (SLM) in Mediloy metal—with metal auxiliary components incorporated where required. Channel patency was confirmed by flow equivalence testing and visual inspection. The design was evaluated for compatibility with the BioHorizons Pro Surgical Guide Kit and the Ticare Fidelis Kit. Clinical feasibility was assessed in two cases: maxillary All-on-6 rehabilitation and immediate implant placement in the esthetic zone. Results: Both guides were successfully fabricated with confirmed patent irrigation channels. Guide seating was verified through occlusal fenestrations and secured with fixation pins. Irrigation flow remained unobstructed throughout all osteotomy steps, and no guide-related or irrigation-related complications were observed. The system was integrated into standard drilling protocols without modification for either implant platform. Conclusions: This proof-of-concept study demonstrates the technical feasibility of an internally irrigated surgical guide across two implant systems and distinct clinical scenarios. The proposed design was successfully integrated into standard guided surgery workflows and maintained functional irrigation. Further in vitro thermal studies and prospective clinical investigations are required to evaluate its effect on temperature control. Full article

Background/Objectives: One-piece (monoblock) dental implants are increasingly used, particularly in patients with limited bone availability. Prosthetic alignment is often achieved via plastic deformation of the titanium implant. This study aimed to evaluate the impact of such deformation-induced residual stress on the corrosion resistance of these implants. Methods: Two types of monoblock dental implants (spherical “S” and Mag-Conical “M”) were subjected to controlled plastic deformation. Residual stress was quantified by X-ray diffraction using the Bragg–Brentano method. Electrochemical behavior was evaluated by measuring the open-circuit potential (E_OCP) and performing potentiodynamic polarization tests in phosphate-buffered saline (PBS) at 37 °C. Metal ion release (Ti, V, Al) was quantified by inductively coupled plasma mass spectrometry (ICP-MS) at specific immersion time points. Surface morphology and corrosion features were examined by scanning electron microscopy (SEM). Results: Residual stress values increased significantly after plastic deformation. The open-circuit potential (E_OCP) shifted towards more electronegative values in both implant designs as deformation-induced residual stresses increased. The E_OCP values shifted from −0.099 V to −0.227 V in the S design and from −0.115 V to −0.141 V in the M design, comparing the as-received condition with the deformed state, respectively. Potentiodynamic tests showed an increase in corrosion rate from 0.0021 mm/year for the original implants to 0.0156 mm/year for the deformed ones. Surfaces in the stressed regions exhibited a high density of corrosion pits, indicating localized electrochemical degradation. Deformed dental implants also exhibited higher ion release, particularly of titanium and vanadium, with higher levels observed in implants with greater residual stress and lower corrosion resistance. In the deformed regions, the release of titanium and vanadium ions into the surrounding medium was nearly five-fold higher. Conclusions: Plastic deformation of monoblock dental implants is associated with reduced corrosion resistance. Increased residual stress correlates with enhanced electrochemical degradation and ion release, which may have relevant implications for implant selection and clinical placement. Full article

Objectives: The aim of the study was to compare CBCT (Cone Beam Computed Tomography)-derived radiographic hard tissue gain after hydraulic transcrestal sinus floor elevation performed with versus without cross-linked hyaluronic acid (HA) and to assess associated clinical, radiographic, and patient-reported outcomes. Materials and Methods: This single-center, prospective clinical study enrolled 58 patients with 2–6 mm residual bone height in the posterior maxilla, assigned in a non-randomized parallel-group design to HA (n = 29) or No Graft (n = 29). The primary endpoint was CBCT-based 3D CBCT-derived radiographic hard-tissue volume gain at 12 months; secondary endpoints included vertical bone gain, marginal bone loss (MBL) at 12 and 24 months, implant stability quotient (ISQ), implant survival/success, complications, and patient-reported outcomes (VAS pain, OHIP-14). Analyses used ANCOVA and appropriate comparative statistics. Results: At 12 months, mean CBCT-derived radiographic hard-tissue volume gain was higher with HA (1210 +/− 610 mm³) than with No Graft (858 +/− 605 mm³; adjusted difference +352 mm³, 95% CI: 140–564; p = 0.002). ISQ at 12 months was greater with HA (p = 0.028), while MBL at 12/24 months did not differ significantly. Twenty-four-month implant survival was 98.1% (HA) vs. 94.3% (No Graft; p = 0.041). Complication rates were low and comparable; VAS pain at 72 h was modestly lower with HA. Conclusions: In this non-randomized prospective clinical study, cross-linked hyaluronic acid was associated with greater CBCT-derived radiographic hard-tissue volume gain and vertical radiographic gain after hydraulic transcrestal sinus floor elevation compared with clot stabilization alone. Clinical outcomes were favorable in both groups during the 24-month observation period. These findings support the interpretation of cross-linked hyaluronic acid as a potential space-maintaining adjunct in posterior maxillary sites with limited residual bone height; however, because no histological or histomorphometric assessment was performed, they should not be interpreted as proof of vital mature bone regeneration or superior bone quality. Full article

Macrophage membrane-coated nanoparticles (MMNPs) are an emerging class of biomimetic nanoplatforms that combine the immune-regulatory functions of macrophages with the structural versatility of synthetic nanoparticles (NPs). By retaining key membrane proteins and receptors, MMNPs exhibit natural targeting capabilities, immune interactions, and inflammatory site homing, making them promising tools for immunomodulation and targeted therapy. This review summarizes macrophage biology relevant to immune regulation and discusses how nanoparticle core properties, including size, surface charge, composition, and mechanical characteristics, influence membrane coating efficiency, stability, and biological performance. Current fabrication and characterization strategies for MMNPs are also discussed. Particular emphasis is placed on the therapeutic applications of MMNPs in inflammatory disorders, tissue regeneration, and oral and dental implant-related applications. Recent studies demonstrate that MMNPs can modulate macrophage polarization, sequester pro-inflammatory cytokines, remodel the immune microenvironment, and promote tissue repair and bone regeneration, highlighting their potential to improve implant integration and reduce inflammation-associated implant failure. Despite these promising advances, challenges remain regarding large-scale manufacturing, membrane preservation, reproducibility, and long-term biosafety. Continued interdisciplinary research in nanotechnology, immunology, and biomaterials engineering is expected to accelerate the clinical translation of MMNPs for regenerative and immunomodulatory therapies. Full article