Search Results (227)

Dental implant components are typically fabricated using subtractive manufacturing, often involving metal materials that can be costly, inefficient, and time-consuming. This study explores the use of additive manufacturing (AM) with zirconia for dental implant overdenture bars, focusing on mechanical performance, stress distribution, and fit. Solid and lattice-structured bars were designed in Fusion 360 and produced using LithaCon 210 3Y-TZP zirconia (Lithoz GmbH, Vienna, Austria) on a CeraFab 8500 printer. Post-processing included cleaning, debinding, and sintering. A 3D-printed denture was also fabricated to evaluate fit. Thermography and optical imaging were used to assess adaptation. Custom fixtures were developed for flexural testing, and fracture loads were recorded to calculate stress distribution using finite element analysis (ANSYS R2025). The FEA model assumed isotropic, homogeneous, linear-elastic material behavior. Bars were torqued to 15 Ncm on implant analogs. The average fracture loads were 1.2240 kN (solid, n = 12) and 1.1132 kN (lattice, n = 5), with corresponding stress values of 147 MPa and 143 MPa, respectively. No statistically significant difference was observed (p = 0.578; α = 0.05). The fracture occurred near high-stress regions at fixture support points. All bars demonstrated a clinically acceptable fit on the model; however, further validation and clinical evaluation are still needed. Additively manufactured zirconia bars, including lattice structures, show promise as alternatives to conventional superstructures, potentially offering reduced material use and faster production without compromising mechanical performance. Full article

Background/Objectives: The growing demand for biocompatible and fluoride-free alternatives in oral care has led to the development of formulations containing nano-hydroxyapatite (nanoHAP). This study aimed to evaluate the antimicrobial, antibiofilm, antioxidant, and anti-inflammatory properties of a novel mouthwash containing nanoHAP, zinc lactate, D-panthenol, licorice extract, and cetylpyridinium chloride, with particular focus on its efficacy against Staphylococcus aureus and its biofilm on various dental materials. Methods: The antimicrobial activities of the mouthwash KWT0000 and control product ELM were assessed via minimal inhibitory concentration (MIC) testing against selected Gram-positive and Gram-negative bacteria and Candida fungi. Antibiofilm activity was evaluated using fluorescence and digital microscopy following 1-h exposure to biofilms of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The efficacy was compared across multiple dental materials, including titanium, zirconia, and PMMA. Antioxidant capacity was determined using the 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) assay, and anti-inflammatory potential via hyaluronidase inhibition. Results: KWT0000 exhibited strong antimicrobial activity against S. aureus and C. albicans (MICs: 0.2–1.6%) and moderate activity against Gram-negative strains. Fluorescence imaging revealed significant biofilm disruption and bacterial death after 1 h. On metallic surfaces, especially polished titanium and zirconia, KWT0000 reduced S. aureus biofilm density considerably. The formulation also demonstrated superior antioxidant (55.33 ± 3.34%) and anti-inflammatory (23.33 ± 3.67%) activity compared to a fluoride-based comparator. Conclusions: The tested nanoHAP-based mouthwash shows promising potential in antimicrobial and antibiofilm oral care, particularly for patients with dental implants. Its multifunctional effects may support not only plaque control but also soft tissue health. Full article

Objectives: The aim of this study was to determine the differential temperature produced on ceramic implants using laser irradiation on a pulsed setting of intrabony defects in vitro. Methods: A ceramic (Zr) dental implant (Zeramex, 4.8 × 12 mm) was placed into a bovine bone block. A three-wall intrabony defect (6 × 4 × 3 mm) was created to mimic an osseous peri-implant defect. Thermocouples were placed on the apical and coronal areas to measure temperature changes (∆T) during 60 s of laser irradiation. The bovine block was heated to 37 °C, and the defect walls were irradiated with the CO₂ and Er,Cr:YSGG laser. The settings used were pulsed mode for both lasers, with 30 Hz and 1.5 W for the Er,Cr:YSGG laser and 70 Hz and 2 W for the CO₂ laser. The same laser settings were repeated at room temperature (RT, 23 °C). Twenty trials were performed for each experimental group at room and body temperature for assessment of ∆T. Paired t-test were used to compare the measurements between 37 °C and 23 °C for the Er,Cr:YSGG, and CO₂ laser, respectively. Results: The CO₂ laser resulted in the highest ∆T (°C) at the coronal (15.22 ± 0.28/8.82 ± 0.21) and apical (5.84 ± 0.14/2.30 ± 0.28) level when this laser was used in both room temperature and body temperature, respectively. The highest ∆T (°C) for the Er,Cr:YSGG laser at body temperature at the coronal thermocouple was 7.64 ± 0.55, while for the CO₂ laser, at body temperature was 8.82 ± 0.21. Conclusion: Within the limitations of our study, the use of CO₂ laser and Er,Cr:YSGG laser on peri-implant defects generally appears to be safe in treating peri-implant defects around zirconia implants in vitro. Full article

Background and Clinical Significance: The retreatment of failed dental implants remains a challenging clinical scenario, particularly when complicated by peri-implantitis and as sociated bone loss. Successful management requires a comprehensive and predictable approach that addresses both hard and soft tissue deficiencies. Case Presentation: This case report illustrates a fully digital, prosthetically driven workflow for the rehabilitation of a posterior mandibular site following implant failure. A 44-year-old female patient underwent removal of a failing implant and adjacent tooth due to advanced peri-implantitis and periodontitis. After healing, a digital workflow—including intraoral scanning, cone-beam computed tomography (CBCT), and virtual planning—was employed to design and fabricate a customized CAD/CAM titanium mesh for vertical guided bone regeneration. The grafting procedure utilized a composite mixture of autogenous bone and anorganic bovine bone (A-Oss). After nine months of healing, two implants with a hydrophilic surface (SOI) were placed using a fully guided surgical protocol (OneGuide system). Subsequent soft tissue grafting and final prosthetic rehabilitation with monolithic zirconia restorations resulted in stable functional and aesthetic outcomes. Conclusions: This case highlights how the integration of modern digital technologies with advanced regenerative procedures and innovative implant surfaces can enhance the predictability and long-term success of implant retreatment in compromised posterior sites. Full article

This study investigated the radiation attenuation characteristics of commonly used dental implant materials across an energy spectrum relevant to dental radiology. Two titanium implants were examined, with densities of 4.428 g/cm³ and 4.51 g/cm³, respectively. The first consisted of 90.39% titanium, 5.40% aluminum, and 4.21% vanadium, while the second comprised 58% titanium, 33% oxygen, 7% iron, 1% carbon, and 1% nitrogen. The third material was a zirconia implant (5Y form) composed of 94.75% zirconium dioxide, 5.00% yttrium oxide, and 0.25% aluminum oxide, exhibiting a higher density of 6.05 g/cm³. Monte Carlo simulations (MCNP6) and XCOM data were utilized to estimate photon source parameters, geometric configuration, and interactions with biological materials to calculate the half-value layer, mean free path, and tenth-value layer at varying photon energies. The results indicated that titanium alloys are well suited for low-energy imaging modalities such as CBCT and panoramic radiography due to their reduced artifact production. While zirconia implants demonstrated superior attenuation at higher energies (e.g., CT), their higher density may induce beam-hardening artifacts in low-energy systems. Future research should validate these simulation results through in vitro and clinical imaging and further explore the correlation between material-specific attenuation and CBCT image artifacts. Full article

The stability of yttria-stabilized zirconia (YSZ) as a dental implant material is highly dependent on its resistance to low-temperature degradation (LTD) and surface dissolution, particularly in acidic oral environments. This study investigates the effects of yttrium ion (Y³⁺) release on the phase stability of zirconia during constant immersion and pH cycling tests, simulating oral conditions. Zirconia disks were immersed in acidic (pH 2), neutral (pH 7), and basic (pH 10) solutions over a 27-day period. Inductively coupled plasma (ICP) analysis revealed significant yttrium ion release during acidic phases, while zirconium ion (Zr⁴⁺) release remained minimal. X-ray photoelectron spectroscopy (XPS) showed a shift in zirconium 3d binding energies, indicating a transformation from the tetragonal to the monoclinic phase, driven by yttrium leaching. X-ray diffraction (XRD) confirmed this phase change, with the appearance of the monoclinic (111) peak after exposure to acidic conditions. This study concludes that yttrium ion depletion under acidic conditions destabilizes the tetragonal phase, promoting LTD and compromising the material’s long-term performance as a dental implant or restorative material. Full article

Background/Objectives: This in vitro study investigated the retention of three different geometrical designs of short titanium base (Ti-base) abutments used in implant-supported zirconia crowns. The advent of digital technology has facilitated the integration of Ti-base abutments into implant dentistry by improving time efficiency, precision, and patient comfort. Methods: Three types of short Ti-base abutments were evaluated: Geo SRN multibase^® (Group A), Herilink^® (Group B), and TS Link^® (Group C), each with a height of 4 mm and gingival height of 1 mm (n = 20 per group). Zirconia crowns (LUXEN^® Smile S2, DentalMax, Republic of Korea) were modified for the testing setup and fabricated using CAD/CAM technology, then bonded to the abutments with RelyX^® Luting 2 resin-modified glass ionomer cement. Pull-out tests were conducted at a crosshead speed of 1 mm/min to assess retention. Results: One-way ANOVA and post hoc Tukey tests revealed significant differences in retention values among the different abutment shapes (p < 0.05). The mean retention forces were 194.65 N for Group A, 241.33 N for Group C, and 360.20 N for Group B. Conclusions: The geometrical design of Ti-base short abutments significantly affects the retention of CAD/CAM zirconia crowns, with hexagonal shapes (Group B) demonstrating superior retention. Clinically, selecting an abutment design with enhanced mechanical retention may improve the long-term success of implant-supported restorations. Full article

This study aimed to evaluate prosthetic complications, implant survival rates, and marginal bone loss in implant-supported monolithic restorations compared to metal-ceramic restorations. The study was registered in PROSPERO (CRD420251022336) and conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. A systematic search was conducted in the electronic databases MEDLINE/PubMed, Web of Science, Scopus, Embase, and ProQuest for articles published up to December 2024. The inclusion criteria comprised studies evaluating only randomized clinical trials that evaluated implant-supported monolithic restorations directly compared to metal-ceramic restorations, considering any type of ceramic material and regardless of the fixation system (screw-retained or cemented), with a minimum follow-up of one year. A meta-analysis was performed using RevMan 5.4 software, and the risk of bias and certainty of evidence were assessed using the RoB 2.0 and GRADE tools, respectively. A total of six studies were included, all of which exclusively evaluated monolithic zirconia single crowns over follow-up periods ranging from 1 to 3 years. None of the included studies evaluated fixed partial dentures or restorative materials other than monolithic zirconia. In total, 267 patients (mean age range: 18–57 years) were analyzed, with a total of 174 implant-supported monolithic zirconia crowns and 165 metal-ceramic single crowns in the posterior region (premolars and molars). The meta-analysis revealed that implant-supported monolithic zirconia single crowns exhibited significantly fewer prosthetic complications compared to metal-ceramic single crowns (p < 0.0001; Risk Ratio [RR]: 0.26; Confidence Interval [CI]: 0.14–0.47). However, no statistically significant differences were observed between implant-supported monolithic zirconia and metal-ceramic single crowns regarding implant survival rates (p = 0.36; RR: 1.66; CI: 0.56–4.94) or marginal bone loss (p = 0.15; Mean Difference [MD]: −0.05; CI: −0.11–0.02). The risk of bias assessment indicated that four studies had a low risk of bias. However, the certainty of evidence was classified as low for prosthetic complications and implant survival rates and very low for marginal bone loss. Within the limitations of this review, it can be concluded that implant-supported monolithic zirconia single crowns can be considered a favorable treatment option as they show comparable implant survival and bone stability to metal-ceramic crowns, with a potential reduction in short-term prosthetic complications such as screw loosening and ceramic chipping. However, due to the limited number of studies included and low certainty of evidence, further long-term research is still needed to confirm their clinical performance over time. Full article

Zirconia dental implants have emerged as a transformative material in implantology, offering a biocompatible, esthetic, and durable alternative to traditional titanium implants. This comprehensive review explores the key properties of zirconia, including high fracture resistance, esthetic superiority, and low bacterial affinity. The ability of zirconia to integrate with bone through osseointegration, coupled with its resistance to plaque and inflammation, results in a product that is particularly suitable for patients with metal sensitivities or high esthetic demands. However, challenges such as brittleness and complex manufacturing processes persist. Advances in surface modification techniques and material optimization are poised to address these limitations, paving the way for broader applications. The purpose of this descriptive review was to emphasize the mechanical, antibacterial, osteointegration and survival rates of zirconia implants. This paper also summarizes findings from recent empirical studies, highlighting zirconia’s clinical performance, biological responses, and future potential as a mainstream implant material. Full article

The development of advanced biomaterials for dental applications has gained significant attention due to the need for enhanced mechanical properties, biocompatibility, and antibacterial activity. Hydroxyapatite (HA) is widely used in bone tissue engineering owing to its chemical similarities to bone. However, biofilm formation and bacterial infection on HA may lead to implant failure and revision surgery. Tannic acid, a polyphenolic compound with strong antibacterial and antioxidant properties, was incorporated into the composite to provide antimicrobial effects, that may address the challenge of biofilm formation on dental surfaces. In this study, the biomedical potential of tannic acid (TA)-loaded hydroxyapatite-zirconia composites were analyzed. The crystallization characteristics, functional groups, and morphology were analyzed using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and field emission scanning electron microscopy (FESEM) analysis. The biocompatibility of composite samples was analyzed through in vitro cell culture studies. The combined effect of TA and zirconia showed antibacterial efficacy against Staphylococcus aureus (S. aureus) after 24 h of sample–bacterial interactions. The results demonstrate that this tannic acid-loaded hydroxyapatite-zirconia composite holds significant promise for improving the performance of dental materials and preventing infections in oral healthcare applications. Full article

Guided bone regeneration (GBR) is a procedure used for the treatment of bone deficiencies. Computer-Aided Designed–Computer-Aided Manufacturing (CAD-CAM) allows us to design a titanium mesh (TM) for GBR directly on a 3D bone defect model (3DBM). The design and printing of TMs are often delegated to specialized 3D printing centers, thus preventing the surgeon from controlling surgical parameters such as the thickness, pore width, texture, and stiffness. Therefore, we have here proposed a personalized digital workflow for designing a TM. The 3DBM was uploaded to an open-source CAD-CAM software. Following a GBR simulation, a TM was designed as a Standard Tesselation Language (STL) file and 3D laser-printed. The TM was applied to a graft of 50/50% autologous/xenogenic bone, fixed with a bone screw, and covered with a dermal membrane. No TM exposure was observed during the healing phase. The regenerated bone volume was 970 cc, and pseudoperiosteum was class 1. At the 6-month reentry, a 4.1 × 10 standard dental implant with a primary stability of 40 N/cm was placed and after 3 months a zirconia crown screw-on implant was placed. This proposed digital workflow enabled us to successfully tackle this clinical case. However, further clinical investigations will be necessary to confirm the long-term benefits of this procedure. Full article

One of the key factors influencing osseointegration is the hydrophilicity of the surface of dental implants; high hydrophilicity is more advantageous than low hydrophilicity. This study aimed to compare the hydrophilic properties of titanium and zirconia implants from different manufacturers. An in vitro analysis was conducted on 15 implants—13 titanium and 2 zirconia—each featuring distinct compositions and surface treatments. Their hydrophilicity was assessed using the contact angle method, where a drop of saline solution was pipetted onto the apical part of the implant. For each implant, 30 contact angle measurements were taken at three different surface wetting time intervals. The contact angle is defined as the internal angle between the tangent to the surface of the liquid and the surface at the point of tangency; a smaller angle means a higher hydrophilicity. The results show that titanium implants from BTI UniCa, Nobel TiUltra, and Straumann Roxolid SLActive—which are classified as premium implants—exhibited the highest hydrophilicity. In contrast, zirconia implants demonstrated significantly lower hydrophilicity. Within this group, the Nobel Pearl implant exhibited smaller contact angles than the Bredent WhiteSKY implant. Our findings confirm that high-quality titanium implants show superior hydrophilicity, potentially improving clinical outcomes by accelerating healing and facilitating immediate loading protocols, but this could only be proven with an in vivo animal study. Conversely, the relatively lower hydrophilicity of zirconia implants highlights the need for continued advancements in zirconia composition and surface modification to optimize their osseointegration potential. Full article

Background and Clinical Significance: Dental implants are widely used; however, tooth extraction often results in alveolar bone loss and gingival recession, necessitating bone and connective tissue reconstruction, especially in the esthetic anterior regions. To address these issues, implants are occasionally connected to adjacent teeth, but this remains controversial, as complications (e.g., intrusion of natural teeth) have been observed. This report demonstrates the long-term success of implants replaced after removing maxillary bilateral central incisors and connecting them to lateral incisors with reduced supportive bone due to periodontitis. Case Presentation: A 57-year-old woman with root fractures in maxillary bilateral central incisors, periodontitis, and malocclusion was treated with connecting implants and natural teeth. Bone levels surrounding maxillary bilateral lateral incisors were diminished due to root fractures in adjacent central incisors and periodontitis. After initial periodontal therapy, hopeless maxillary central incisors were extracted, replaced with implants using a digitally simulated surgical guide, and guided bone regeneration and connective tissue grafting were performed. Implants were connected to lateral incisors with provisional restorations, and orthodontic treatment was initiated following digital set-ups incorporating implants into the overall strategy. Final porcelain-fused-to-zirconia restorations were placed after orthodontic treatment. At the 5-year follow-up, gingival morphology, coloration, and position of lateral incisors remained stable. Conclusions: This case demonstrates that connecting implants to natural teeth in the anterior region can effectively maintain periodontal tissues around natural teeth and allow for minimally invasive, short-term, and esthetic treatment. However, careful long-term observation through maintenance is necessary due to limited evidence for this approach in the anterior region. Full article

This review summarizes the development of surface treatments applied to dental implants with the aim of improving their clinical performance. It covers the advancement of various techniques, from the conventional to the more advanced ones. Among the recent advancements, surface texturing has enabled atomic and structural modifications of implant surfaces at the micro- and nanoscales, improving tissue–material interactions. Acid etching and atomic layer deposition applied onto implant surfaces results in optimized osseointegration by stimulating the deposition and proliferation of osteoblasts and fibroblasts. The atomic layer deposition of TiO₂, ZnO, ZrO₂, and CaCO₃ has proven effective in improving osseointegration and tackling corrosion. Corrosion is still an important issue, whereby metals released from titanium implants and their associated degradation products cause local and systemic side effects, leaving a wide avenue for future research. The development of hybrid dental implants is envisaged through new materials and technologies, such as additive manufacturing, which may play a critical role in the fabrication of patient-specific implants with tailored nano-topography capable of enhancing such properties as antibacterial activity and osseointegration. Full article

Titanium (Ti) thin films deposited on insulated substrates were progressively anodized and formed titanium dioxide (TiO₂) nanotube arrays on the surface through a customized anodization tool designed to improve the uniformity and diameters of the nanotubes. With a motorized vertical moving arm attached to the anode, the sample was gradually submerged into the electrolyte at a controlled speed alongside the continuous anodization from the edge to the center to prevent the discontinuation of the conductive Ti layer and its nanotube surface. The effects of Ti deposition rate, anodization voltage, NH₄F concentration, and post-etching conditions on nanotube morphology were also explored. Scanning electron microscopy (SEM) analysis revealed that smaller Ti grain sizes, higher anodization voltages, higher electrolyte concentrations, and optimized post-etching times produce uniform, mature nanotubes with larger diameters, which are crucial for practical applications. This work enhances the applicability of nanotube surfaces with non-conductive substrates, such as Zirconia dental implants, and establishes a foundation for future process optimizations. Full article