Search Results (228)

Background/Objective: Accurate digital recording of implant position is essential for achieving passive fit and predictable outcomes in complete-arch implant-supported prostheses. However, complete-arch cases remain challenging because of increased inter-implant distances, limited anatomical landmarks, soft tissue mobility, scan body-related variables, and cumulative errors during data acquisition and file registration. This narrative review aims to evaluate current intraoral and extraoral digital implant position recording techniques from a clinical decision-making perspective. Methods: A structured narrative literature search was conducted in PubMed from database inception to 15 May 2026 and was supplemented by manual screening of reference lists of key systematic reviews and eligible articles. Systematic reviews, meta-analyses, clinical studies, comparative in vitro studies, dental technique articles, and clinical reports relevant to complete-arch digital implant position recording were considered. Higher-level and clinically relevant evidence was prioritized, whereas technique reports were included primarily for emerging workflows with limited clinical evidence. Results: Intraoral techniques include non-splinted and splinted scan body protocols, calibrated implant scan bodies, calibrated frameworks, and auxiliary reference strategies. These methods may be clinically efficient but remain sensitive to scan path, scanner technology, landmark availability, scan body design, implant distribution, and operator-related factors. Extraoral techniques include stereophotogrammetry, camera- or smartphone-assisted photogrammetric systems, reverse impression workflows, and laboratory scanner-based digitization. These approaches may reduce intraoral stitching errors in complex edentulous arches, but usually require complementary datasets for soft tissue morphology, prosthetic contours, antagonist dentition, and maxillomandibular relationships. Conclusions: Direct intraoral scanner (IOS) protocols may be appropriate in favorable complete-arch situations with accessible scan bodies, limited inter-implant distances, and stable reference geometry. In clinically demanding cases requiring greater cross-arch accuracy, stereophotogrammetry, intraoral photogrammetry, or calibrated scanning approaches may provide more controlled implant position recording. Reverse impression and model-based workflows are particularly useful when a verified interim prosthesis, verification jig, or cast-based reference is available. Regardless of the selected technique, accurate integration of implant coordinates with soft tissue, prosthetic contour, antagonist arch, and occlusal data remains essential. Full article

Objectives: This study aimed to identify the oral health conditions of homeless individuals in Rome, the most frequently required dental treatments, and to describe a standardized, replicable clinical protocol tailored to the specific needs and access barriers of this vulnerable population. Methods: Five hundred homeless individuals received comprehensive dental examinations at the Primary Care Services of the Dicastery for the Charity Services (Vatican City) between September 2023 and January 2026. Clinical assessments included oral hygiene status, periodontal health, caries prevalence, and degree of edentulism. Treatment interventions were programmed by scheduling subsequent appointments. For patients requiring prosthetic rehabilitation, treatment was sequenced into distinct steps: preparatory treatments (hygiene, extractions, conservative procedures), impression taking, prosthesis try-in, and delivery. Results: Oral health assessment revealed poor or absent hygiene (85.4%), high DMFT scores (63.0%), and root residues (22.4%). Periodontal disease affected 94.0% of participants (gingivitis 73.0%, periodontitis 21.0%). Tooth loss patterns included partial edentulism (12.0%) and complete edentulism (24.0%). A total of 440 appointments were scheduled, with an attendance rate of 78.4%. Prosthetic rehabilitation was completed in 150 patients: 50 received partial dentures (33.3%) and 100 complete dentures (66.7%). Conclusions: The examined homeless individuals experienced severe oral health deterioration characterized by extensive tooth loss and advanced periodontal disease. A substantial prosthetic rehabilitation was needed in this sample. The proposed sequential treatment protocol demonstrated high feasibility and patient adherence in this vulnerable population. Comprehensive dental services that address both immediate emergency needs and long-term rehabilitative care are crucial for improving oral health-related quality of life and facilitating social reintegration. Patient-reported outcomes indicated meaningful improvements in digestive function, aesthetic satisfaction, and employment opportunities following prosthetic rehabilitation. Full article

Objectives: Digital impression-taking techniques are widely used due to their many advantages. However, the accuracy of intraoral scanning in full-arch cases remains a matter of debate. The reliability of different digital implant impression techniques remains questionable in completely edentulous, full-arch cases. This review investigated the accuracy of digital implant impression techniques for full-arch use. Methods: Our study protocol was registered in the PROSPERO database (CRD42023393091). Data reporting was based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, by the Cochrane Handbook. Comparative in vitro studies matching the PICO framework were included. A systematic search was conducted in four databases: PubMed (MEDLINE), EMBASE, Web of Science and the Cochrane Library (Cochrane Central Register of Controlled Trials [CENTRAL]). Results: Thirty-four papers were included in analyzing trueness and precision of root mean square (RMS) deviations. No significant differences were observed between test groups. The overall RMS trueness deviation was 53.36 μm [18.44; 88.28] in the extraoral stereophotogrammetry group, 73.88 μm [36.68; 111.09] in the conventional impression group, 99.54 μm [56.22; 142.86] in the IOS plain group, 104.88 μm [36.86; 172.90] in the IOS scanaid group, and 65.58 μm [5.24; 125.92] in the IOS splinted group. Substantial heterogeneity was observed across studies (I² ≈ 100%) Conclusions: In case of completely edentulous jaws restored with four to eight implants, digital techniques showed comparable accuracy to the conventional method with no statistically significant differences detected. Full article

Background/Objectives: The biologically oriented preparation technique (BOPT) is a vertical tooth preparation approach that eliminates a conventional finish line and positions the prosthetic margin within the gingival sulcus, aiming to promote peri-restorative soft tissue adaptation through controlled gingival remodeling. This article describes a clinical case report of a hybrid impression protocol combined with a digital workflow intended to address some of the main clinical limitations of BOPT, particularly the recording of deep subgingival margins and the transfer of the emergence profile from the provisional to the definitive restoration. Methods: The proposed technique combined a conventional silicone impression to obtain a complete reading of the gingival sulcus with intraoral digital scanning, complemented by extraoral scanning of the provisional restoration to reproduce its subgingival morphology within the definitive prosthetic workflow. Results: Within the limitations of a single clinical case with short-term follow-up, this hybrid approach showed a satisfactory esthetic outcome and favorable short-term peri-coronal soft tissue behavior. Conclusions: This hybrid workflow may represent a feasible clinical option for transferring the cervical contour and emergence profile to the definitive prosthesis in anterior BOPT restorations. Full article

Background and Objectives: To evaluate and compare the accuracy (trueness and precision) and scanning speed of three intraoral scanners: Medit i700, Primescan 1, and COXO DL-300P, under standardized clinical conditions, using a digitized high-precision analog impression as the reference. Materials and Methods: A patient requiring fixed prosthetic treatment on natural abutments (2.5, 2.7, 3.5, 3.8) was selected. Ten sequential full-arch scans were performed with each scanner in rotating order. Scanning time was recorded for each full-arch acquisition. Accuracy analysis focused on regions of interest: the upper jaw included abutments with adjacent mucosa, the lower jaw included only abutment surfaces. A VPS impression was taken, poured in type IV stone, and digitized with a high-accuracy desktop scanner to serve as the reference. All datasets were analyzed in Geomagic Control X, and statistics were performed using MedCalc (α = 0.05). Results: Upper Jaw (Abutments and Mucosa): The Medit i700 achieved the highest trueness (100.3 ± 6.6 µm), outperforming Primescan and COXO (p = 0.008). COXO showed the best precision, while Primescan demonstrated the greatest variability (p < 0.0001). Primescan produced the fastest scans (72.5 ± 3.8 s) (p = 0.001). Lower Jaw: (Abutment Surface Only): Medit yielded superior trueness (193.1 ± 63.4 µm) compared with Primescan and COXO (p = 0.005). Precision varied significantly among devices, with COXO presenting the greatest inconsistency (p = 0.0004). Scan times did not differ significantly (p = 0.068). Conclusions: Medit i700 demonstrated the highest trueness, Primescan delivered the fastest scans but variable results, and COXO showed acceptable but inconsistent precision. Full article

Background/Objectives: This technical report introduces an innovative hybrid digital workflow that integrates diagnostic plaster-cast scanning with intraoral scanning to produce an accurate 3D-printed model for fabricating distal-extension removable dental prostheses (RDPs). Methods: The technique aims to overcome the challenges of reproducing the mobile mucosa in free-end saddles, a critical factor for denture base accuracy and stability. The workflow began with conventional clinical procedures, including clinical examination, impression-making, and cast surveying. After performing the required mouth preparations according to the prosthetic design, the diagnostic cast was digitized and selectively modified to allow intraoral rescanning. The prepared teeth were then scanned intraorally and merged with the digitalized cast, producing a refined virtual model for CAD-based metal framework design. The framework was digitally designed, 3D-printed to verify adaptation, and cast in cobalt–chromium. Standard RDP fabrication steps were followed, including intraoral framework try-in, fabrication of acrylic bases, occlusal registration, tooth arrangement, and functional and esthetic try-in. The final prosthesis was installed and adjusted without the need for an additional impression. Results: This hybrid workflow enabled a highly accurate reproduction of the distal extension region, outperforming models derived solely from direct intraoral scanning. By digitally capturing the physiological morphology of the mobile mucosa, the method eliminates the need for the traditional altered-cast technique, reducing clinical time, technical sensitivity, and material costs. Conclusions: The proposed approach enhances denture base accuracy, improves adaptation, and promotes more uniform occlusal load distribution in free-end RDPs. This streamlined and reproducible digital protocol offers a clinically relevant advancement, with potential to improve prosthesis stability and long-term outcomes. Full article

Background/Objectives: Lithium disilicate (LD) veneers are widely used for minimally invasive anterior rehabilitation because of their favorable optical and mechanical properties. Fully digital workflows have been proposed as alternatives to conventional milling. These approaches combine computer-aided design and manufacturing (CAD/CAM) with 3D-printed burn-out patterns and subsequent heat pressing of LD ingots. However, clinical documentation of multi-unit anterior cases fabricated exclusively through this additive-plus-pressing route remains scarce. This case report aims to describe a fully digital additive-plus-pressing workflow for four maxillary anterior LD veneers and to report 48-month clinical outcomes. Case Presentation: A 52-year-old female presented with esthetic concerns involving the maxillary central and lateral incisors (teeth 11, 12, 21, and 22). After clinical and radiographic evaluation, a minimally invasive veneer-based rehabilitation was planned. Preparations were performed under magnification, and immediate dentin sealing was applied. Digital impressions were obtained with an intraoral scanner, and veneers were designed using CAD software(Exocad DentalDB 3.0 Galway (Exocad GmbH, Darmstadt, Germany). Castable resin patterns were 3D-printed, invested, and heat-pressed using LD ingots, followed by finishing and glazing. Adhesive cementation was performed under rubber dam isolation after hydrofluoric acid etching and silanization of the intaglio surfaces and conditioning of the tooth substrates according to the adhesive protocol, using a dual-cure resin cement. At the 48-month follow-up, all veneers remained intact, with clinically acceptable marginal adaptation, stable color and surface gloss, and no signs of secondary caries or marginal discoloration. The patient reported sustained esthetic satisfaction and comfortable function without postoperative sensitivity. Conclusions: This single-patient report suggests that a fully digital additive-plus-pressing workflow may be clinically viable for high-demand anterior LD veneers, providing favorable medium-term esthetics and patient-centered outcomes with no technical or biological complications. The reproducible protocol described may facilitate the integration of 3D printing and heat pressing into digital veneer rehabilitation and supports further controlled clinical investigations. Full article

Background/Objectives: This in vitro study investigated the trueness of digital impressions (DIs) obtained using an intraoral scanner (IOS) compared to conventional impressions (CIs) on resin model replicas of mandibulectomy defects. Methods: Mandibulectomy resin models from 20 patients were used, including 10 partially edentulous (PE) and 10 completely edentulous (CE) patients. All models were scanned using an industrial scanner to obtain reference datasets. For CIs, silicone impressions were made in custom trays, poured into stone models, and subsequently scanned with the industrial scanner to create the test groups (n = 10 each): CI-PE and CI-CE. For the DI, an IOS (True Definition; TD) was used to directly scan the 20 models, yielding the groups DI-PE and DI-CE (n = 10 each). All test scans were superimposed on their corresponding reference scans, and trueness was assessed by calculating the mean absolute deviations (µm). Statistical analysis was performed to compare trueness across groups. Results: The mean deviations (µm) in CI-PE, CI-CE, DI-PE, and DI-CE were 26.49 ± 6.39, 23.10 ± 8.94, 76.64 ± 31.75, and 80.93 ± 33.21, respectively. Impression technique significantly affected the trueness results, with DIs showing higher overall deviations (78.78 ± 31.69 µm) than the CIs (25.24 ± 7.67 µm). No significant difference in trueness was found between partially and completely edentulous models. Conclusions: Digital impressions of mandibulectomy models made with a TD scanner had significantly lower trueness than CIs. However, the observed deviations remained within clinically acceptable limits (around 300 µm in 99.5% of the model scans), demonstrating the feasibility of TD for scanning mandibulectomy models. Full article

Background/Objectives: This study evaluates the level of knowledge among dental students regarding infection prevention and control measures in dental practice. Methods: A total of 225 students from the Medical University of Plovdiv participated in an anonymous survey between November 2024 and March 2025. The survey assessed knowledge about epidemiological factors, disinfection protocols, and procedures for infection prevention and control. Results: The survey results revealed that while most students demonstrated a high level of knowledge of the importance of protective equipment and impression disinfection, a few students reported incorrect or inconsistent practices. Gender differences were observed in adherence to disinfection procedures. Conclusions: The findings highlight the need for enhanced training in infection control within dental curricula to ensure safe clinical practice and minimize cross-infection risks. Full article

Despite the significant environmental impact of the healthcare sector, with Germany’s system accounting for a large proportion of national emissions, quantitative sustainability research on specific medical procedures, such as those in dentistry, is critically scarce. This study aimed to address this issue by conducting a Life Cycle Assessment to quantify and compare the Global Warming Potential of the conventional analog and the digital (intraoral scanner) impression techniques for the manufacturing of single-tooth crowns in a German dental practice. The methodology employed a cradle-to-grave approach, defining a positive dental model as the functional unit and focusing on material consumption, waste streams, and equipment usage while excluding patient travel and facility energy. The results revealed that the digital impression procedure offers significant environmental advantages, with its average carbon footprint (approx. 550 CO₂-eq) being nearly threefold lower than the analog impression (approx. 1620 g CO₂-eq). This difference is primarily driven by the analog impression technique’s intensive use of disposable materials and the generation of contaminated waste requiring incineration. In contrast, the digital impression’s burden shifts to the manufacturing of the intraoral scanner, highlighting the importance of high clinical utilization to achieve the ecological benefit. This work concludes that the adoption of digital impression taking is a critical step towards more sustainable dentistry by promoting material avoidance and waste reduction, provided that high equipment utilization rates can be ensured. It should be noted that these results are specific to the regional context, particularly the German energy mix and national waste management standards, and may vary in different geographical settings Full article

Pediatric odontogenic tumors are rare but are frequently overlooked because they often mimic simple cysts on routine radiographic examinations. The radiographic appearance on panoramic imaging and cone-beam computed tomography (CBCT) frequently does not correlate with the true biological nature of these lesions. On CBCT, classic odontogenic tumors often demonstrate mixed radiolucent–radiopaque patterns with ill-defined borders, internal calcifications, septations, or other structural features. The diagnostic challenge arises when an odontogenic tumor mimics a unilateral, well-defined radiolucent area or a cystic lesion with clear borders and no associated tooth displacement, erosion, root resorption, or cortical bone dehiscence. Panoramic radiography has inherent diagnostic limitations but remains widely used for routine dental screening. CBCT provides enhanced three-dimensional assessment and improves diagnostic accuracy in the evaluation of jaw lesions. A marked increase in dental follicle diameter necessitates differentiation between cystic transformation, inflammatory processes, and other odontogenic pathologies. Cortical swelling and bone asymmetry warrant careful evaluation. In this context, an atypical cyst-like lesion detected on routine panoramic radiography prompted a needle aspiration biopsy, which revealed a dry tap and suggested a solid lesion. This prompted CBCT evaluation. Two juvenile cases are presented in which clinical findings, panoramic radiography, and CBCT provided discordant diagnostic impressions of cystic-appearing lesions with well-defined borders and bone expansion. These cases illustrate a diagnostic pathway in which imaging demonstrates a cyst-like appearance with benign radiological features, fine-needle aspiration biopsy reveals the absence of cystic fluid, and histopathology confirms that radiology alone cannot reliably distinguish true cysts from solid odontogenic tumors in pediatric patients. Full article

Background: Digital intraoral scanning has become an essential component of modern restorative dentistry, offering enhanced accuracy, workflow efficiency, and patient comfort compared to conventional impression techniques. Despite these advantages, the accuracy of intraoral scanners (IOS) can be affected by multiple parameters, among which scanning strategy and device design are particularly influential. Purpose: This study aimed to investigate the effect of different scanning strategies on scan accuracy and precision, focusing on two widely used intraoral scanners (Medit i700 and Trios 5) in a controlled in vitro environment. Materials and Methods: A standardized digital test object was created according to ISO 20896-1 specifications to ensure uniformity and comparability. The object was printed using a high-precision 3D printer and scanned multiple times with both IOS systems, employing distinct scanning strategies under identical environmental conditions. Data analysis was performed using descriptive and comparative statistics, including Mean, Median, Mean Absolute Deviation (MAD), Root Mean Square Error (RMSE), Standard Deviation (SD), and Variance, to evaluate trueness and precision. Results: The Medit i700 consistently exhibited lower deviation values and greater precision compared with the Trios 5, reflecting higher trueness and precision. Scanning strategy influenced scan outcomes; structured, systematic scanning paths produced more stable and accurate datasets. The Trios 5 demonstrated higher variability, suggesting increased sensitivity to operator motion and scanning trajectory. Conclusions: Both the scanner type and scanning strategy substantially affect intraoral scan accuracy. The superior performance of the Medit i700 indicates greater robustness and operator-independent stability. Clinically, these results underscore the importance of standardized scanning protocols, as operator consistency may be a key determinant of digital impression accuracy and, consequently, of clinical outcomes. Full article

This narrative review examines contemporary applications of polymeric materials in dentistry from 2020 to 2025, spanning prosthodontics, restorative dentistry, orthodontics, endodontics, implantology, diagnostics, and emerging technologies. We searched PubMed, Scopus, Web of Science, and Embase for peer reviewed English language articles and synthesized evidence on polymer classes, processing routes, mechanical and chemical behavior, and clinical performance. Approximately 116 articles were included. Polymers remain central to clinical practice: poly methyl methacrylate (PMMA) is still widely used for dentures, high performance systems such as polyether ether ketone (PEEK) are expanding framework and implant-related indications, and resin composites and adhesives continue to evolve through nanofillers and bioactive formulations aimed at improved durability and reduced secondary caries. Thermoplastic polyurethane and copolyester systems drive clear aligner therapy, while polymer-based obturation materials and fiber-reinforced posts support endodontic rehabilitation. Additive manufacturing and computer aided design computer aided manufacturing (CAD CAM) enable customized prostheses and surgical guides, and sustainability trends are accelerating interest in biodegradable or recyclable dental polymers. Across domains, evidence remains heterogeneous and clinical translation depends on balancing strength, esthetics, biocompatibility, aging behavior, and workflow constraints. Full article

Background/Objectives: This study aimed to evaluate the clinical feasibility of a novel desktop micro-computed tomography (micro-CT) scanner for digital impressions through comprehensively assessing its dimensional trueness and morphological accuracy in comparison with other optical-based scanners. Methods: A modified reference model was used to create ten silicone impressions and corresponding plaster models. Four digitization protocols were evaluated: (1) direct scanning of impressions via micro-CT scanner (MCTI), (2) extraoral scanning of impressions via F8 scanner (F8I), (3) extraoral scanning of plaster models via F8 scanner (F8PM), and (4) intraoral scanning of plaster models using Trios 5 scanner (IOSPM). Dimensional trueness was quantified via six linear measurements, and morphological accuracy (trueness and precision) was assessed by 3D surface deviation analysis. Results: Statistically significant differences in linear measurements between the digital impressions and the reference model were observed (p < 0.05). MCTI, F8PM and IOSPM demonstrated higher dimensional trueness than F8I. Although all methods showed high morphological precision, F8I (398.5 ± 43.0 µm) exhibited significantly greater root mean square (RMS) deviations for morphological trueness than MCTI (114.8 ± 42.2 µm), F8PM (142.1 ± 27.7 µm) and IOSPM (134.6 ± 12.0 µm) (p < 0.01). MCTI also demonstrated the highest reliability for morphological trueness according to relative standard deviation (RSD) analysis, with RSD values of 30.83% for MCTI, 41.80% for F8I, 37.26% for F8PM, and 42.55% for IOSPM. Conclusions: The novel micro-CT scanner enables accurate and reliable direct digitization of dental impressions. Its performance is comparable to scanning plaster models with high-end scanners and significantly superior to direct optical scanning of impressions, making it a promising alternative in digital dental workflow. Full article

Objectives: The aim of the current study was to evaluate changes in olfactory sensitivity with Sniffin’ Sticks^® (Burghart Messtechnik, Germany) in patients undergoing palatal expansion. Methods: The study sample consisted of 20 patients enrolled from the Department of Paediatric Dentistry (0–14 years old) at the Policlinico of Rome “Tor Vergata”, according to the following inclusion criteria: negative posterior transverse interarch discrepancy ≥ 4 mm, mixed dentition phase with first permanent molars erupted and prepubertal skeletal maturation stage (CS1-2), evaluated on a lateral radiograph through the Cervical Vertebral Maturation (CVM) method. Each patient underwent a dental examination, orthopantomography and lateral cephalometric X-rays were requested, and dental impressions were taken using digital scanner. Every patient was treated with maxillary rapid expander and underwent ear, nose, and throat (ENT) assessment before and after treatment. Moreover, questionnaires before and after treatment to obtain a subjective assessment of their olfactory perception were given to all participants. Results: About odor identification, the analyses revealed an increase in mean scores of 1.28; however, this change, although slight, did not reach statistical significance (Z = −1.85; p = 0.064). In contrast, about odor discrimination, the test results indicated a statistically significant increase in the children’s scores of 3.41 (Z = −2.87; p < 0.001). Conclusions: This study supports the hypothesis that rapid maxillary expansion (RME) can improve olfactory function by enhancing nasal airway dimensions and airflow. Further studies are required to confirm these results. Full article