Search Results (3,257)

CoCrMo alloys are widely used as orthopedic and dental implants, owing to their superior mechanical properties, wear resistance, and biocompatibility. Copper (Cu) ion exhibits strong antibacterial activity, making it a promising alloying element. A systematic study was conducted on the corrosion resistance and ion release behavior of CoCrMo-xCu (Co-xCu) alloys in both as-cast and heat-treated states in different simulated solutions. The results indicated that the corrosion resistance of Co-xCu alloys decreased with the increasing Cu content, which was mainly attributed to the formation of micro-galvanic couples between the alloy matrix and Cu-rich phases. The synergistic effect of heat treatment and an appropriate Cu content can effectively improve the corrosion resistance of the alloys, and the corrosion current density (i_corr) of Cu-containing cobalt alloys was comparable to that of Cu-free cobalt alloys. Maximum concentrations of Co, Cr, and Cu ions released from Co-xCu alloys were lower than the corresponding recommended safety limits. Through the combined optimization of Cu content and heat treatment, the metal ion release levels of Cu-containing cobalt alloys can be reduced to values even lower than those of Cu-free cobalt alloys. Full article

Background: Primary stability and long-term osseointegration depend on bone healing surrounding dental implants. Implant macrogeometry is crucial for controlling insertion torque and the biological reaction of peri-implant bone. This study assessed the impact of an implant design meant to lessen cortical bone compression on early bone healing. Methods: Forty titanium prototype implants (3 × 6 mm) were equally divided into Control (standard macrogeometry) and Test (macrogeometry with healing chambers) groups. Initial insertion torque was measured in vitro using synthetic bone blocks. Subsequently, an in vivo rabbit tibia model was used (n = 10 implants per group) to assess early healing. At 21 days, histological sections were analyzed for bone-to-implant contact (BIC%) at three cervical positions (C1, C2, and C3). Additionally, digital radiographs of the cervical region were evaluated using RGB color mapping, where distinct color channels quantified varying degrees of bone density. Results: The in vitro insertion torque for the Control group was significantly greater than the Test group (8.01 vs. 5.70 Ncm). The in vivo histomorphometric analysis indicated improved integration for the Test design, showing substantially higher BIC% at the C2 (59.30% vs. 40.30%) and C3 (42.10% vs. 17.90%) positions. Furthermore, radiographic RGB analysis revealed that the Test group possessed a higher blue channel contribution, indicating greater mineralized tissue density. Conclusions: These results imply that modifying implant macrogeometry to lower insertion torque and minimize cortical bone compression favorably enhances early cervical bone healing and osseointegration. Full article

Aim: This study aimed to compare two-piece zirconia and two-piece titanium implants inserted into the anterior mandible for removable overdentures in a 3-year randomized split-mouth clinical trial. Methods: Twenty fully edentulous mandibular patients received two zirconia and two titanium implants allocated by computer-generated randomization. The primary endpoint was bleeding-on-probing (BOP) at 12 months. Secondary outcomes included implant survival and success (Albrektsson criteria), marginal bone level changes, peri-implant cytokines (IL-1β, IL-6, and TNFα), prosthetic complications, and patient-reported outcomes (PROMs). Results: After 3 years, overall survival was 98.61% and overall success was 84.72%. Titanium implants showed higher success compared with zirconia implants (91.70% vs. 77.78%), while survival was 100% and 97.22%, respectively. Marginal bone loss was significantly greater around zirconia implants at 36 months (p < 0.01). No significant differences were observed in IL-1β, IL-6, or TNFα levels up to 12 months. PROMs revealed a trade-off, with zirconia favored for esthetics and cleaning perception, while titanium was rated superior for stability. Conclusions: Within the limitations of this split-mouth RCT, zirconia implants demonstrated reduced success and inferior marginal bone stability compared with titanium implants in overdenture therapy. Careful case selection and close follow-up appear essential when zirconia implants are used in this indication. Full article

Dental implants are widely used to replace missing teeth, but peri-implantitis remains a major biological complication associated with bacterial biofilm formation on implant surfaces. The increasing incidence of peri-implant infections underscores the need for alternative antimicrobial strategies that effectively decontaminate complex titanium implant surfaces. This study evaluated the inhibitory effect of low-temperature microwave argon plasma on bacteria in an experimental model simulating peri-implant conditions and compared the responses of microorganisms with different biological characteristics. A 3D-printed mandibular bone segment model with an inserted Straumann BLX Roxolid^® dental implant was used to reproduce the peri-implant environment. Bacterial suspensions of Streptococcus mutans NBIMCC 1786 and the extremophilic bacterium Chromohalobacter canadensis NBIMCC 9077 have been exposed to a microwave non-equilibrium argon plasma jet (2.45 GHz, atmospheric pressure) for 1–7 min. Optical density measurements and colony growth analysis were used to assess antimicrobial effects. Plasma treatment induced a pronounced reduction in bacterial growth during the early post-treatment period. In C. canadensis, growth inhibition reached a plateau (~47–55% at 24 h) regardless of exposure time. In contrast, S. mutans showed a nonlinear response, with stable inhibition after short exposures (1–3 min) and partial recovery after longer treatments (5–7 min). These findings indicate that microwave argon plasma exhibits significant antimicrobial activity under controlled in vitro conditions, although its effectiveness depends on microorganism-specific biological characteristics. Because the present model was based on simplified single-species systems, direct clinical extrapolation remains limited and should be addressed in future studies using polymicrobial peri-implant biofilm models. Full article

Poly(lactic-co-glycolic acid) (PLGA) is one of the most extensively investigated biodegradable polymers for biomedical applications, owing to its tunable degradation kinetics, established biocompatibility, and regulatory approval. In implantology, PLGA-based systems have emerged as versatile platforms for scaffolds, coatings, and localized drug delivery, aimed at enhancing osseointegration and tissue regeneration. This review provides a focused and up-to-date analysis of PLGA applications in dental and orthopedic implantology, with particular emphasis on advances reported over the past decade. Unlike previous reviews that predominantly address general drug delivery or broad tissue engineering applications, this work establishes a direct correlation between polymer composition (LA:GA ratio), processing strategies, and biological outcomes, including degradation behavior, mechanical performance, and host response. Special attention is given to multifunctional PLGA systems incorporating antibiotics, growth factors, and bioactive nanoparticles, highlighting their role in improving antibacterial efficacy and osteogenesis. Emerging technologies such as nanostructured composites, additive manufacturing, and stimuli-responsive delivery platforms are critically evaluated. Key limitations—including acidic degradation by-products, burst release kinetics, and translational barriers—are discussed in the context of clinical applicability. By integrating physicochemical design with biological performance and recent clinical trends (2024–2025), this review proposes a framework for the rational development of next-generation PLGA-based implant systems. Full article

Background: Maxillary sinus lift is among the most common preprosthetic procedures in the posterior maxilla due to alveolar ridge resorption and the maxillary sinus pneumatization. It often extends treatment duration, significantly increases costs, and is not without complications. Objective: To explore the prevalence and morphology of the palatal bone reservoir as a viable site for dental implant insertion, offering a conservative alternative to avoid maxillary sinus lift. Methods: DICOM data sets from helical CT of maxillofacial trauma patients aged 50 years and older were used to perform virtual dental implant positioning in the edentulous second premolar, first molar, or second molar areas using ImplaStation software (version 5.3.2; ProDigiDent, Inc., Scottsdale, AZ, USA). A 3D Slicer software (version 5.3.2; ProDigiDent, Inc., Scottsdale, AZ, USA) was used to calculate the volume of the palatal bone reservoir and identify its mean density. The density of the residual alveolar process was also identified and compared with that of the previous one. Results: A total of 1822 maxillofacial trauma cases with helical CT between 2015 and 2025 were retrieved. After exclusion, 305 cases were analyzed. A total of 65 implants were virtually positioned in 50 patients. The mean volume of the palatal bone reservoir was 229 ± 139.2 mm³ with a mean radiodensity of 546.7 ± 159.6 HU. The mean radiodensity of the residual alveolar process was 286.3 ± 118.0 HU. The palatal bone reservoir was significantly denser than the residual alveolar process (95% CI [184.2, 336.6]; p < 0.01). Conclusions: The presence of a palatal bone reservoir is not uncommon and can offer a more conservative alternative for implant placement, potentially increasing primary stability and facilitating immediate loading. Full article

The long-term success of dental implants is significantly influenced by primary stability, which is commonly assessed through insertion torque (IT) and removal torque (RT) measurements in vitro. While polyurethane (PU) blocks are accepted by the American Society for Testing and Materials (ASTM) as the standard bone analog material for biomechanical testing, the use of polyethylene (PE) as a bone model material for dental implant research remains limited and not well established. This operator-blinded, in vitro study compared the IT and RT values of dental implants placed in PE and PU blocks of identical density (60 pounds per cubic foot [pcf]; 0.96 g/cm³). A total of 60 tapered dental implants (4.2 × 12 mm, RBM surface, platform switching) were placed into PE (n = 30) and PU (n = 30) blocks by a calibrated operator blinded to the material type. Implant sockets were prepared by an independent surgeon following the manufacturer’s drilling protocol. IT and RT values were recorded using a physiodispenser with torque measurement capability (5–80 N·cm). Statistical analysis was performed using Student’s t-test (α = 0.05), with Mann–Whitney U tests reported as a sensitivity analysis for non-normally distributed variables. No statistically significant difference was observed in IT between PE and PU groups (58.50 ± 8.42 vs. 58.17 ± 9.60 N·cm; p = 0.887; Cohen’s d = 0.04; 95% CI of mean difference: −4.33 to 5.00 N·cm). However, RT was significantly higher in the PU group compared to the PE group (71.17 ± 7.15 vs. 64.33 ± 9.17 N·cm; p = 0.002; Cohen’s d = 0.83; 95% CI: −11.08 to −2.58 N·cm; Mann–Whitney U sensitivity analysis p = 0.004). Under the specific high-density (60 pcf) conditions tested, the absence of a statistically significant IT difference does not constitute formal evidence of equivalence or non-inferiority, and the significantly higher RT in PU indicates that PE and PU are not interchangeable bone analogs. Further studies across a range of densities, implant macrogeometries, and using formal equivalence testing are required before PE can be considered for in vitro dental implant stability research. Full article

Background/Objectives: Peri-implant inflammatory complications remain a major cause of late implant failure and are closely associated with the condition of peri-implant soft tissues. Insufficient keratinized attached mucosa has been identified as a potential risk factor for peri-implant inflammation; however, morphological and immunohistochemical validation of soft tissue remodeling following corrective interventions remains limited. The aim of this study was to perform a morphological and immunohistochemical evaluation of a reproducible surgical approach for increasing keratinized attached mucosa around dental implants. Methods: A comparative clinical–morphological study included 25 patients undergoing implant-supported prosthetic treatment. Patients were divided into a control group (standard prosthetic protocol without soft tissue augmentation, n = 10) and a study group (soft tissue correction using a previously developed technique, n = 15). Punch biopsies of peri-implant mucosa were obtained at baseline and prior to definitive prosthetic restoration. Histological examination and immunohistochemical analysis were performed using the semi-quantitative Astaldi–Verga method. Expression of inflammatory markers (MPO, CD3, CD20, CD68), vascular marker CD31, and remodeling markers MMP-9 and TIMP-2 was evaluated. Data were analyzed using the Mann–Whitney U test (p < 0.05). Results: The study group demonstrated significantly lower expression of inflammatory markers, including MPO, CD68, CD3, and CD20 (p < 0.001), and reduced MMP-9 expression (p = 0.001) compared with controls. The MMP-9/TIMP-2 balance was more favorable in the study group, suggesting more regulated extracellular matrix remodeling. Histologically, the control group exhibited epithelial disruption and microcirculatory alterations, whereas the study group showed preserved epithelial architecture and reduced inflammatory infiltration. Conclusions: Morphological and immunohistochemical assessment suggests that soft tissue correction of keratinized mucosa deficiency may be associated with more favorable early peri-implant soft tissue characteristics, including reduced inflammatory activity and modulation of matrix remodeling. Immunohistochemical markers such as MMP-9 and TIMP-2 may provide additional insight into early soft tissue integration around dental implants. However, these findings should be interpreted with caution due to the exploratory design and short follow-up period. Full article

Objectives: To evaluate the influence of two surface finishing procedures—mechanical polishing and glaze firing—on the color stability and wear behavior of lithium aluminium disilicate (LAD) hybrid abutment crowns over a three-year clinical observation period. Methods: Twenty-four patients requiring 34 implant-supported single crowns were included in this prospective clinical study. LAD abutment crowns were fabricated using n!ce ceramic and a CAD/CAM workflow and finished either by mechanical polishing (P, n = 17) or glaze firing (G, n = 17). After insertion as well as after one and three years (P: n = 9, G: n = 9) of clinical use color measurements were performed using spectrophotometry, and color differences (ΔE00) were calculated. Wear was assessed by digital surface comparison of baseline and the two follow-up scans using three-dimensional analysis software. Reference teeth (R) were defined and evaluated comparable to the P and F groups. Biological and technical complications were recorded throughout the observation period. Results: Color deviations increased over time in all groups (P, G, R). After three years, G showed lower mean color differences (ΔE00 ≈ 2.77) compared with F (ΔE00 ≈ 5.40), although the difference was not statistically significant. No significant differences in vertical height loss were observed between P and G. One adhesive fracture occurred both in the P and G group, five crowns (P: n = 3, G: n = 2) developed periimplantitis. Conclusions: Both polishing and glazing resulted in comparable clinical outcomes regarding color stability, wear behavior, and complication rates. Clinical Significance: Both finishing protocols might be a reliable option for LAD hybrid abutment crowns. Full article

Robotic technologies are increasingly investigated for craniofacial and dental surgical procedures where sub-millimeter positional accuracy and stable instrument trajectories are essential. This structured review evaluates the current landscape of robotic systems applied to craniofacial surgical interventions and analyzes their technical architectures, validation approaches, and reported surgical accuracy. A structured literature search of PubMed and IEEE Xplore identified 27 studies published between 2015 and 2025 that met predefined inclusion criteria. The included systems were analyzed with respect to robotic control architecture, surgical application domain, validation model, and quantitative performance metrics. To facilitate cross-study interpretation, the review introduces a unified engineering classification framework linking robotic control paradigms, mechanical configurations, and clinical application domains. Most platforms employed master–slave teleoperation, image-guided hybrid control, task-autonomous execution, or cooperative haptic-guided architectures designed to stabilize surgical trajectories and reduce surgeon-dependent variability. Across representative investigations, robotic systems demonstrated entry-point deviations typically ranging from approximately 0.6–1.5 mm and angular deviations between 1.2° and 3.5°, indicating improved reproducibility compared with conventional freehand techniques. Dental implant robotics currently represents the most clinically mature application, whereas sinus, skull base, and microsurgical systems remain largely in experimental or early translational stages. Overall, craniofacial surgical robotics demonstrates substantial potential to enhance surgical precision and procedural standardization; however, broader clinical validation and improved workflow integration remain necessary for widespread clinical adoption. Full article

Background/Objectives: The clinical decision between preserving periodontally compromised teeth and replacing them with dental implants represents a complex clinical dilemma influenced by biological, prosthetic, economic, and professional factors. The aim of this pilot study was to develop and preliminarily validate a questionnaire designed to assess dentists’ attitudes and therapeutic preferences regarding the use of periodontally compromised teeth as prosthetic abutments versus extraction and implant-supported rehabilitation. Methods: An observational cross-sectional study was conducted, among Romanian dentists, using a structured self-administered questionnaire consisting of 43 items organized into seven sections addressing clinical attitudes, decision-making factors, professional competence, prosthetic treatment preferences, and implant-related clinical practices. A total of 111 Romanian dentists completed the questionnaire. Responses were recorded using a five-point Likert scale. Statistical analysis was performed using IBM SPSS Statistics software. Internal consistency was evaluated using Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC). Construct validity was assessed using exploratory factor analysis based on Principal Component Analysis with Varimax rotation. Results: The questionnaire demonstrated good internal consistency across most sections, with Cronbach’s alpha values ranging between 0.795 and 0.859 after scale optimization. Item–total correlations indicated adequate contribution of individual items to overall scale reliability. Intraclass correlation coefficients confirmed moderate reliability for individual items and good reliability for average section scores. Exploratory factor analysis showed satisfactory sampling adequacy (KMO = 0.709) and statistically significant Bartlett’s test of sphericity (p < 0.001), supporting the suitability of the data for factor analysis. The sample population was predominantly composed of early-career dentists with limited clinical experience, which should be considered when interpreting the findings. Conclusions: The developed questionnaire demonstrated satisfactory psychometric properties, including good internal consistency and acceptable construct validity, supporting its use as a research instrument for assessing Romanian dentists’ self-reported attitudes, therapeutic preferences, and perception-based decision patterns regarding the preservation of periodontally compromised teeth and implant-supported prosthetic rehabilitation. Full article

This research presents an artificial intelligence (AI)-driven 3D scanning and printing system for the fabrication of personalized dental prosthetics, implants, and orthodontic appliances. The proposed system integrates high-resolution intraoral scanning, AI-based data analysis, and additive manufacturing to enhance precision, customization, and treatment efficiency. Patient-specific anatomical data and medical history are incorporated to optimize implant design, material selection, and functional performance. Nano-enhanced biocompatible materials are utilized to improve mechanical strength, durability, and antibacterial properties. Specifically, these materials demonstrate a 30% increase in overall precision and a 50% improvement in durability compared to traditional dental materials. In addition, the system adopts a zero-waste manufacturing strategy by recycling excess materials, supporting sustainable dental practices. The results demonstrate significant improvements in accuracy, patient comfort, and environmental responsibility in modern digital dentistry. 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

Additive manufacturing enables the fabrication of patient-specific zirconia devices with integrated surface features; however, the biological effects of meso-scale topographies remain insufficiently understood. This in vitro study evaluated the influence of defined meso-scale surface modifications on osteoblast behavior using Digital Light Processing (DLP)-fabricated 3Y tetragonal zirconia polycrystal (3Y-TZP) and 5Y partially stabilized zirconia (5Y-PSZ). Planar control specimens and surfaces incorporating regularly distributed columnar structures (height: 100 µm; width: 40 µm; center-to-center spacing: 80, 120, and 160 µm; Mod-80, Mod-120, Mod-160) were fabricated and characterized after sintering. Cytotoxicity was assessed by elution testing and showed cell viability >98% for all groups. Osteoblast adhesion and proliferation (hFOB 1.19) were quantified using metabolic assays. Meso-scale modifications significantly increased early cell adhesion compared to planar controls (p < 0.05), with the strongest effect observed for Mod-160. No significant differences in proliferation rates were detected between groups (p > 0.05). Osteogenic differentiation was evaluated by RT-qPCR (RUNX2, ALPL, COL1A1, BGLAP), revealing material- and geometry-dependent responses. On 3Y-TZP, meso-scale structures, particularly Mod-160, were associated with sustained upregulation of BGLAP, whereas 5Y-PSZ exhibited less pronounced effects. Within the limitations of this in vitro study, meso-scale surface structuring of additively manufactured zirconia enhances early osteoblast adhesion without affecting proliferation and may influence osteogenic differentiation in a material-dependent manner. Full article

Background: Artificial intelligence (AI) is increasingly being integrated into dental implantology, particularly in treatment planning, a critical phase for implant success. Traditionally dependent on clinician expertise, planning can now be supported by AI-assisted systems that aim to improve diagnostic accuracy, precision, and efficiency. Objective: To synthesise recent evidence on the use of AI in dental implant planning, particularly its ability to analyse cone beam computed tomography (CBCT) imaging to identify edentulous regions and assess bone dimensions compared with conventional planning methods. Methods: A systematic search was conducted across PubMed, Scopus, Google Scholar, and the Cochrane Library, with additional manual searches from October 2024 to July 2025. Eligibility was defined using the Population, Intervention, Comparison, Outcome (PICO) framework, focusing on adults undergoing implant procedures planned using AI-assisted CBCT imaging and deep learning (DL) models, particularly U-Net architectures, for CBCT segmentation. Results: Ten studies were included, AI systems demonstrated high accuracy (92–99.7%) in detecting teeth and edentulous regions, with precision and recall frequently exceeding 90%. AI-assisted planning also showed improved efficiency, and, in one study, higher implant success rates compared with traditional planning (92% vs. 78%). However, variability in study design, inconsistent reporting, and limited ethical oversight were noted. Conclusions: AI, particularly DL models applied to CBCT imaging, shows strong potential to enhance diagnostic precision and efficiency in dental implant planning. Nevertheless, the field requires standardised evaluation metrics, larger datasets, and well-designed clinical trials before widespread clinical implementation. Full article