Search Results (385)

Purpose: This study investigated the surface morphology and roughness of the dental implant platform and abutment at their junction interface, comparing parameters before and after mechanical assembly (screwing). Methods: The experimental specimens comprised 40 implants from the TBR, Bone Level M System (TBR, France) with a diameter of 4.7 mm and a length of 10 mm, and 40 matching abutments from the same system (Titanium Standard Abutment, TBR, France) with a diameter of 4 mm and a gingival height of 3 mm. All components were fabricated from Grade 4 titanium. The implants and abutments were divided into two equal groups. In the first group (control), 20 implants and 20 abutments remained unassembled. In the second group, 20 implants were coupled with 20 abutments and tightened to the manufacturer-recommended torque. To achieve this, the implants were stabilized with pliers to prevent rotation, and the abutments were screwed using a screwdriver and a torque wrench at 30 N.cm. Subsequently, the abutments were unscrewed counterclockwise. Surface evaluations were conducted using scanning electron microscopy (SEM) and 3D surface modeling. Results: The obtained results demonstrate a statistically significant reduction in the parameters reflecting the roughness of the implant platform. Based on the analysis, a pronounced decrease in the average roughness (Ra, Rq) of the abutment was observed (p < 0.001). Furthermore, it was established that the implant platform exhibits nearly twice the surface roughness of the abutment even in its baseline state. Conclusions: Within the limitations of this in vitro study, a single tightening and removal procedure was associated with measurable changes in the roughness parameters and surface morphology of the implant platform and abutment. These findings indicate microtopographic adaptation at the conical interface under the tested conditions; however, biomechanical reliability and resistance to bacterial micro-leakage were not evaluated. Full article

Background: Teledentistry is widely seen as a promising route to widening access to dental care and narrowing social inequalities. For dental implantology—a technically demanding and costly field that unfolds across several treatment steps—it remains largely unclear whether and, if so, how remote approaches actually make care fairer. The aim of this scoping review was to map the available evidence and organise it in accordance with an established access framework. Methods: A systematic search was conducted, covering PubMed, Scopus, and Web of Science, which was complemented by a manual search. After deduplication, 68 records were subjected to title and abstract screening, and 17 reached the full-text stage. Thirteen studies were obtained (two through supplementary searching), while four could not be retrieved and thus remained unevaluated. This retrieval shortfall (24%) is a material limitation, and it is weighed accordingly throughout. Data were charted using the PCC scheme, and the analysis followed the access model developed by Levesque et al. Results: Five primary studies met the criteria, alongside one conceptual perspective paper without clinical data. Four secondary reviews and five background sources supplied context. The clinical studies were methodologically heterogeneous and mostly small, ranging from case reports to a single randomised pilot study. Structured appraisal revealed that none met all five quality criteria, and only three met the majority of them. Only two of the studies examined implant care directly. The remaining conclusions drew on broader teledentistry or general dental evidence. The findings point to high acceptance, shorter travel distances, and comparable clinical assessments; furthermore, they indicate that, while access has improved, disparities between underserved and better-served groups have not been reduced. Not one source linked teledentistry, implantology, and care equity in any measurable way. Conclusions: The evidence base is scarce, indirect, and rarely framed explicitly around equity. Teledentistry can lower access barriers, yet improved access is not the same as reduced inequality and, through the digital divide, remote care may even deepen existing disparities. This scoping review is therefore best interpreted as identifying an important research gap rather than demonstrating an equity benefit. Targeted, equity-sensitive studies on implantology are needed. Until such data exist, the desired equity benefit remains plausible but unproven. Full article

Background/Objectives: Nanotechnology has become a transformative area in modern dentistry, providing new opportunities for better diagnosis, targeted drug delivery, improved restorative materials, antimicrobial treatments, and tissue regeneration. This scoping review outlines the scope, key developments, and future directions of nanotechnology use across all dental specialties, highlights emerging innovations, and identifies major translational challenges and research priorities. Methods: This review followed the Joanna Briggs Institute (JBI) methodology for scoping reviews and adhered to the PRISMA-ScR guidelines. These guidelines, originally by Arksey and O’Malley (2005) and later updated by Levac et al. (2010) and Peters et al. (2020, 2021), guided the process. The Population, Concept, and Context (PCC) framework guided the eligibility criteria. Included studies were primary research or reviews reporting nanotechnology applications in any dental specialty, published in English, with no date restriction. Excluded were non-peer-reviewed sources, conference abstracts without full text, studies unrelated to dental applications, and non-English publications. A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, and Web of Science. After screening titles and abstracts and reviewing full texts, 133 studies were included. Results: The included studies covered a wide range of fields such as restorative dentistry, implantology, periodontology, endodontics, drug delivery, tissue regeneration, oral diagnostics, antimicrobial applications, prosthodontics, orthodontics, and emerging technologies like nanorobotics and graphene-based systems. The most commonly reported nanomaterials were silver nanoparticles (AgNPs), calcium phosphate nanoparticles (CaP NPs), and polymeric nanoparticles such as PLGA and chitosan. Additionally, there was a notable increase in publications starting from 2019. Conclusions: Nanotechnology offers transformative possibilities in every area of dentistry. Nonetheless, challenges such as nanotoxicology safety, regulatory alignment, and effective clinical application need resolution. Essential steps include standardized characterization, gathering long-term safety data, and establishing international regulatory standards to ensure safe adoption of nano dentistry. Full article

Background: Accurate three-dimensional positioning of dental implants is fundamental for long-term prosthetic success. While static guided surgery and traditional dynamic navigation present intrinsic limitations related to physical bulk or hand–eye coordination (the “look-away” phenomenon), Augmented Reality (AR) via Head-Mounted Displays (HMDs) promises to overcome these barriers by superimposing virtual holograms directly onto the surgical field. Objectives: The aim of this scoping review is to map the existing literature to evaluate the positioning accuracy, workflow efficiency, and ergonomic/technical barriers of HMD-based AR navigation systems in implant dentistry. Methods: A systematic search was conducted across the PubMed, Scopus, Web of Science, and Cochrane Library databases, following the PRISMA-ScR guidelines. In vitro, ex vivo, and clinical studies utilizing AR headsets (e.g., HoloLens) for implant guidance, reporting quantitative data on accuracy and/or qualitative data on usability issues, were included. Results: Eleven studies were included (7 in vitro, 1 ex vivo, 3 clinical). Accuracy showed a strong dependence on case complexity: for standard implants, the mean error at the entry point ranged between 0.33 and 1.51 mm, which is comparable to s-CAIS techniques. However, in complex scenarios (zygomatic implants), significant deviations were reported (up to 5.64 mm and 9.60°). The main barriers to routine adoption identified include tracking instability due to line-of-sight interruption, device weight, and the vergence–accommodation conflict. Conclusions: AR dynamic navigation demonstrates promising potential. Nevertheless, current evidence relies predominantly on in vitro studies that fail to fully replicate real-world surgical complexities. Persistent technical and ergonomic barriers, such as tracking instability and hardware limitations, indicate that the technology remains largely in a preclinical phase and is not yet suitable for routine clinical application. Further advancements toward markerless tracking systems, lighter headsets, and rigorous in vivo trials are required. Full article

Introduction: One of the fundamental principles of modern medicine, including dentistry, is prevention. However, if treatment is not initiated, tooth loss can occur, necessitating the use of dental prostheses to restore the function and aesthetics of the stomatognathic system. The oral microbiome is a complex ecosystem that is sensitive to external factors, including the biomaterials used to manufacture dental prostheses. Objectives: This narrative literature review aims to identify and compare the effects of various metal alloys used in dentistry, specifically high-precious (gold), precious (silver–palladium) and base (cobalt–chromium and nickel–chromium) alloys, as well as titanium, on the balance of the oral microbiome and biofilm formation. Results: The analysis indicates that gold, silver and palladium alloys demonstrate the most favourable biocompatibility and antibacterial properties, significantly reducing biofilm accumulation. Titanium and titanium-based alloys generally exhibit neutral properties under healthy conditions, although their biocorrosion products can alter the microbial environment in pathological states such as peri-implantitis. In contrast, base metal alloys (cobalt–chromium and nickel–chromium) are highly susceptible to biocorrosion in acidic environments, which can encourage the growth of bacteria that cause tooth decay and inflammation, potentially exacerbating oral dysbiosis. Conclusions: The selection of materials plays a critical role in maintaining oral microbial homeostasis and preventing plaque-related diseases. High-noble alloys and titanium are more biocompatible than base metal alloys. However, further long-term clinical trials and multi-species biofilm models are needed to fully understand these interactions between materials and microbes. Full article

Smartphone-based augmented reality (AR) may help dentists visualize an implant axis during treatment or training. Before a virtual overlay can be displayed, however, the application must first recognize the real target reliably. This in vitro study tested how five lighting conditions affected recognition of a two-colored, 3D-printed polylactic acid (PLA) dental model by a Unity/Vuforia smartphone application. The application ran on a Samsung Galaxy S22. A GoPro HERO10 recorded the smartphone display at 240 frames per second, and the videos were evaluated frame by frame. Red, green, blue, daylight-like light-emitting diode (LED) and halogen illumination were tested at a central and an eccentric model position, with ten repetitions per condition and position. The model was not recognized under red or blue illumination within the predefined observation interval. Recognition was successful in all repetitions under green, daylight-like and halogen illumination. Recognition speed differed among these successful conditions, and the eccentric position delayed recognition under daylight-like and halogen illumination. A supplementary region-of-interest analysis also showed lighting-dependent differences in image brightness and contrast. These findings indicate that lighting should be standardized and documented when smartphone-based dental AR systems are developed and tested. Full article

Titanium remains the gold standard in dental implantology; however, its clinical drawbacks, such as hypersensitivity reactions, metallic particle release, and aesthetically compromising discoloration, have driven interest in metal-free alternatives. Yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) has emerged as a promising bioceramic candidate, offering favorable aesthetics, mechanical strength, and reduced bacterial plaque affinity. Its pristine surface is nonetheless bioinert, prompting extensive research into surface modification strategies, including sandblasting, acid-etching, femtosecond laser texturing, and bioactive coatings, to enhance osteoconductivity. This comprehensive narrative review synthesizes in vitro evidence on the behavior of key host cell populations—macrophages, mesenchymal stem cells, osteoblasts, fibroblasts, and epithelial cells in response to Y-TZP surface and its modifications, relevant to osseointegration and soft-tissue sealing. A literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library, supplemented by Google Scholar, concluding in March 2026. By integrating findings across multiple cell lineages, this review aims to clarify how engineered zirconia topographies modulate cell-specific pathways, thereby informing the development of next-generation implants optimized for biological integration. 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: The aim of this ex vivo study was to compare the resistance to lateral wall failure during sequential implant site preparation using osseodensification (OD) burs and conventional rotary drills in a standardized narrow ridge model. The primary outcome was the drill diameter at first lateral wall perforation. Secondary outcomes included paired perforation occurrence at a clinically relevant diameter (4.0 mm) and perforation morphology (length and width). Methods: Twenty standardized trabecular bone blocks were prepared in a paired within-specimen design, with each block receiving two osteotomies: one prepared using conventional rotary drills and the other using OD burs. Osteotomy diameter was sequentially increased according to the manufacturers’ protocols until lateral wall perforation occurred. The drill diameter at first perforation was recorded. Perforation morphology (length and width) was quantified using high-resolution extraoral digital scanning and software-based measurements. Statistical analysis was performed using paired non-parametric tests (α = 0.05). Results: OD burs significantly delayed lateral wall perforation compared with conventional drills (median 4.30 vs. 4.00 mm; p = 0.0000171). At the 4.0 mm drill step, perforation occurred in 16/20 (80%) conventional versus 2/20 (10%) OD preparations (p = 0.0013). Perforation length was significantly greater with conventional drilling (p = 0.000681), while no significant difference was observed for perforation width (p = 0.073). Conclusions: Within the limits of this decorticated trabecular ex vivo model, OD increased resistance to lateral wall failure, delayed perforation onset, and reduced perforation length compared with conventional drilling. Full article

Objectives: Patient safety is central to healthcare quality, yet dental practice also involves occupational risks for professionals. This study examined the lifetime prevalence and types of patient- and staff-safety incidents among Korean dental professionals and explored associated demographic, professional, and institutional factors. Methods: A cross-sectional survey was conducted among 439 dental professionals in South Korea. Participants reported lifetime experience of predefined safety incidents, institutional safety factors, and demographic and occupational characteristics. Descriptive statistics, profession-based comparisons, and multivariable logistic regression were applied. Results: Overall, 89.1% of respondents reported at least one safety incident. The most common patient-safety events were aspiration or ingestion of teeth or prosthetic materials and instrument-related injury, whereas sharps injuries and verbal abuse were the leading staff-safety issues. Dentists and dental hygienists differed significantly in response knowledge, liability insurance coverage, and safety education. The presence of institutional safety protocols was associated with higher reported incident experience, which may reflect greater recognition and reporting rather than a causal increase in harm. Conclusions: Safety incidents are highly prevalent in Korean dental practice and represent an underrecognized quality-of-care and workforce-safety issue. Integrated strategies including occupational-hygiene measures, structured safety education, non-punitive reporting, and stronger organizational preparedness are needed to improve dental healthcare delivery. Full article

This research reports on the properties of oxide-ceramic coatings produced by plasma electrolytic oxidation in novel electrolyte solutions for implantology applications. A series of bioactive calcium-phosphate coatings was synthesized on medical-grade Ti-13Zr-13Nb alloy using the plasma electrolytic oxidation (PEO) method. Novel electrolytes enriched with calcium and phosphorus were developed, enabling the formation of coatings with tailored physicochemical and structural characteristics. A correlation was established between the electrolyte composition and the phase composition, thickness, morphology, porosity, and microhardness of the resulting coatings. The optimum coatings exhibited a Ca/P ratio close to that of natural human bone tissue, homogeneity, a well-developed porous surface topography, and controlled resorption behavior. For the first time, a mechanism of calcium-phosphate coating resorption in a biologically active environment has been proposed. It involves partial dissolution, the formation of apatite-like surface structures, and the subsequent controlled release of Ca and P ions. In vitro testing in simulated body fluid indicated the potential bioactivity of the synthesized coatings. The proposed calcium-phosphate coatings may be considered promising candidates for future implant surface modification. The results obtained are significant for the development of advanced orthopedic and dental implants, including those fabricated using additive manufacturing technologies. Full article

Florid cemento-osseous dysplasia (FCOD) is a benign fibro-osseous condition typically presenting as multifocal, sclerotic masses throughout the jaws. While often asymptomatic, the hypovascular nature of the dysplastic bone predisposes it to secondary infection, which can mimic more aggressive pathologies. We present a complex diagnostic challenge involving a 76-year-old female with a history of intravenous ibandronic acid therapy for 18 months. The patient presented with a purulent mandibular fistula and exposed bone, leading to an initial clinical suspicion of Stage 2 Medication-Related Osteonecrosis of the Jaw (MRONJ). Radiographic evaluation, however, revealed generalized “cotton-wool” opacities across all four quadrants, characteristic of FCOD, with multifocal mixed radiolucent–radiopaque changes and a localized demarcated sequestrum in the symptomatic area. Accordingly, the diagnostic reasoning progressed from an initial clinical suspicion of MRONJ, to radiologic consideration of infected FCOD, and finally to exclusion of plasma cell neoplasia by immunohistochemical evaluation. The diagnostic dilemma intensified during histopathological analysis, which revealed an unusually dense, sheet-like infiltration of plasma cells within the fibro-osseous stroma. This striking plasmacytosis initially raised suspicion for a plasma cell neoplasm, such as plasmacytoma or multiple myeloma. To differentiate reactive inflammation from malignancy, immunohistochemical staining for kappa and lambda light chains was performed, demonstrating a polyclonal pattern that confirmed a reactive process. The final diagnosis was determined as FCOD with superimposed secondary osteomyelitis. Following conservative surgical debridement and targeted antibiotic therapy, the patient showed clinical resolution and remained stable at a 6-month follow-up. Recognizing these overlaps is essential for preventing over-treatment and ensuring appropriate management in elderly patients with complex medical backgrounds. Full article

Background: Er:YAG laser (λ = 2940 nm) biomodification of the implant osteotomy site removes the smear layer after rotary preparation and may enhance bone-implant contact. This randomized controlled clinical study evaluated implant stability dynamics following Er:YAG laser biomodification using resonance frequency analysis (RFA). Methods: Ninety patients were randomized 1:1 into a case group (n = 45; rotary osteotomy + Er:YAG biomodification; 400 mJ, 17 Hz) and a control group (n = 45; rotary osteotomy alone). Implant stability quotient (ISQ) was measured by RFA in vestibulo-oral (VO) and mesiodistal (MD) directions at placement, days 10, 20, 30, and month 3. Results: The case group showed significantly higher ISQ values at all time points in both directions (t-test, p < 0.05). Repeated measures ANOVA revealed a significant time × group interaction in the MD direction (F = 14.461, p < 0.001, partial η² = 0.341). Primary VO ISQ: 75.04 ± 4.27 (cases) vs. 72.29 ± 3.38 (controls); primary MD ISQ: 76.49 ± 4.29 vs. 72.89 ± 2.29. The proportion achieving ISQ ≥ 70 was consistently higher in the case group. Conclusions: Er:YAG laser biomodification combined with rotary osteotomy yields higher, more stable ISQ values throughout early healing in mandibular D2/D3 bone, potentially supporting shorter healing intervals and early loading in selected clinical situations. Full article

Background/Objectives: Titanium alloy Ti₆Al₄V remains the gold standard in dental implantology due to its excellent mechanical properties, corrosion resistance, and biocompatibility. However, implant-associated infections and insufficient osseointegration continue to represent major clinical challenges, mainly related to bacterial biofilm formation and suboptimal surface–tissue interactions. Biofilm formation refers to the adhesion, accumulation, and growth of microbial communities embedded within a self-produced extracellular polymeric matrix on implant surfaces, which contributes to bacterial persistence and resistance to host defense mechanisms. This review aims to critically evaluate recent advances in multifunctional bioceramic coatings for dental implants, with a particular focus on zirconia (ZrO₂)-based systems and their antibacterial mechanisms. Methods: A structured literature analysis was conducted using major scientific databases including PubMed, Scopus, and Web of Science, focusing mainly on studies published between 2015 and 2025 related to CaP, Ag, and ZrO₂-based coatings for dental implants. The review examines their physicochemical properties, antibacterial strategies, ion release behavior, and biological responses, including osteogenic activity and biofilm inhibition. Particular attention is given to hybrid systems integrating multiple functional phases. Results: CaP coatings exhibit excellent osteoconductivity and promote early osseointegration but show limited intrinsic antibacterial activity. Ag-based coatings provide strong broad-spectrum antimicrobial effects through controlled Ag⁺ ion release, although concerns regarding cytotoxicity and dose-dependent responses remain. ZrO₂ coatings significantly enhance corrosion resistance and surface stability, while their antibacterial performance can be improved through nanostructuring, laser surface modification, and ionic doping. Hybrid Ag–CaP–ZrO₂ coatings demonstrate improved antibacterial activity, enhanced corrosion resistance, and better regulation of ion release kinetics and osteogenic response compared with single-component coating systems. Conclusions: Multifunctional bioceramic coatings represent a promising strategy for improving the performance of dental implants and addressing the dual challenge of infection control and tissue integration. However, challenges remain regarding long-term stability, controlled ion release, and limited clinical validation. Future research should focus on the development of smart, stimuli-responsive coatings and standardized evaluation protocols to facilitate clinical translation. Full article

Background/Objectives: Immediate-loading interim implant-supported complete-arch fixed dental prostheses (ISCFDPs) are widely used for immediate loading in edentulous patients. Although traditional denture conversion techniques are well established, newer systems aim to improve efficiency and prosthesis integrity. This clinical report aims to describe and compare four chairside conversion techniques for immediate-loading interim ISCFDPs. Methods: Four clinical cases were treated using different conversion techniques, including conventional denture conversion, guided conversion with static computer-assisted implant surgery (s-CAIS), and two closed-mouth pickup systems (SMART Denture Conversion and EasyPro). Clinical workflows, procedural characteristics, and prosthetic considerations were evaluated. Results: All techniques enabled the successful fabrication of immediate-loaded interim ISCFDPs. Conventional conversion was flexible and cost-effective but technique-sensitive and associated with increased risk of prosthesis weakening. Guided conversion improved structural integrity and reduced intraoral adjustment but required precise planning and higher costs. Closed-mouth systems preserved occlusion, minimized denture modification, and reduced chairside time, though they relied on proprietary components and had limited clinical evidence. Conclusions: Each conversion technique presents distinct advantages and limitations. Selection should be based on clinical conditions, available resources, and clinician experience. Further studies are needed to validate the long-term outcomes of emerging conversion systems. Full article