Search Results (432)

Titanium–aluminum–vanadium (Ti6Al4V) is a material chosen for spine, orthopedic, and dental implants due to its combination of desirable mechanical and biological properties. Lasers have been used to modify metal surfaces, enabling the generation of a surface on Ti6Al4V with distinct micro- and nano-scale structures. Studies indicate that topography with micro/nano features of osteoclast resorption pits causes bone marrow stromal cells (MSCs) and osteoprogenitor cells to favor differentiation into an osteoblastic phenotype. This study examined whether the biological response of human MSCs to Ti6Al4V surfaces is sensitive to laser treatment-controlled micro/nano-topography. First, 15 mm diameter Ti6Al4V discs (Spine Wave Inc., Shelton, CT, USA) were either machined (M) or additively manufactured (AM). Surface treatments included no laser treatment (NT), nanosecond laser (Ns), femtosecond laser (Fs), or nanosecond followed by femtosecond laser (Ns+Fs). Surface wettability, roughness, and surface chemistry were determined using sessile drop contact angle, laser confocal microscopy, X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy (SEM). Human MSCs were cultured in growth media on tissue culture polystyrene (TCPS) or test surfaces. On day 7, the levels of osteocalcin (OCN), osteopontin (OPN), osteoprotegerin (OPG), and vascular endothelial growth factor 165 (VEGF) in the conditioned media were measured. M NT, Fs, and Ns+Fs surfaces were hydrophilic; Ns was hydrophobic. AM NT and Fs surfaces were hydrophilic; AM Ns and Ns+Fs were hydrophobic. Roughness (Sa and Sz) increased after Ns and Ns+Fs treatment for both M and AM disks. All surfaces primarily consisted of oxygen, titanium, and carbon; Fs had increased levels of aluminum for both M and AM. SEM images showed that M NT discs had a smooth surface, whereas AM surfaces appeared rough at a higher magnification. Fs surfaces had a similar morphology to their respective NT disc at low magnification, but higher magnification revealed nano-scale bumps not seen on NT surfaces. AM Fs surfaces also had regular interval ridges that were not seen on non-femto laser-ablated surfaces. Surface roughness was increased on M and AM Ns and Ns+Fs disks compared to NT and Fs disks. OCN was enhanced, and DNA was reduced on Ns and Ns+Fs, with no difference between them. OPN, OPG, and VEGF levels for laser-treated M surfaces were unchanged compared to NT, apart from an increase in OPG on Fs. MSCs grown on AM Ns and Ns+Fs surfaces had increased levels of OCN per DNA. These results indicate that MSCs cultured on AM Ns and AM Ns+Fs surfaces, which exhibited unique roughness at the microscale and nanoscale, had enhanced differentiation to an osteoblastic phenotype. The laser treatments of the surface mediated this enhancement of MSC differentiation and warrant further clinical investigation. Full article

This narrative review explores the role of additive manufacturing (AM) technologies in the production of dental implants, focusing on materials and key AM methods. The study discusses several materials used in implant fabrication, including porous titanium, trabecular tantalum, zirconium dioxide, polymers, and composite materials. These materials are evaluated for their mechanical properties, biocompatibility, and suitability for AM processes. Additionally, the review examines the main AM technologies used in dental implant production, such as selective laser melting (SLM), electron beam melting (EBM), stereolithography (SLA), selective laser sintering (SLS), and direct metal laser sintering (DMLS). These technologies are compared based on their accuracy, material limitations, customization potential, and applicability in dental practice. The final section presents a data source analysis of the Web of Science and Scopus databases, based on keyword searches. The analysis evaluates the research trends using three criteria: publication category, document type, and year of publication. This provides an insight into the evolution and current trends in the field of additive manufacturing for dental implants. The findings highlight the growing importance of AM technologies in producing customized and efficient dental implants. Full article

Laser powder bed fusion (LPBF) is an advanced additive manufacturing technology that is gaining increasing interest for biomedical implants because it can produce dense, patient-specific metallic components with controlled microstructures. This study investigated the LPBF fabrication of 316L stainless steel, which is widely used in orthopedic and dental implants, and examined the effects of laser power and scanning speed on the microstructure and mechanical properties relevant to biomedical applications. The study achieved 99.97% density and refined columnar and cellular austenitic grains, with optimized molten pool morphology. The optimal LPBF parameters, 190 W laser power and 700 mm/s, produced a tensile strength of 762.83 MPa and hardness of 253.07 HV_0.2, which exceeded the values of conventional cast 316L stainless steel. These results demonstrated the potential of optimized LPBF 316L stainless steel for functional biomedical applications that require high mechanical integrity and biocompatibility. Full article

Additive manufacturing (AM) has emerged as a transformative technology in dentistry, enabling the production of patient-specific dental applications with reduced costs and fabrication times. Despite the growth of applications, a consolidated understanding of current 3D printing technologies, materials, and performance in dental settings remains fragmented. Here, we perform a Systematic Literature Review (SLR) using the PRISMA protocol, retrieving 19 closely related primary studies. The evidence is synthesized across three axes: application domain, AM technology, and critical quality parameters. Dental restorations, prosthetics, crowns, and implants are the most common applications, while fused deposition modeling, stereolithography, digital light processing, selective laser sintering, and laser-directed energy deposition are the most used technologies. AM materials include polymers, metals, and emerging biomaterials. Key quality determinants include dimensional accuracy, wear and corrosion resistance, and photosensitivity. Notably, biocompatibility and cytotoxicity remain underexplored yet critical factors for ensuring long-term clinical safety. The evidence also suggests a lack of in vivo studies, insufficient tribological and microbiological testing, including limited data degradation pathways of AM materials under oral conditions. Understanding that there are disconnects between the realization of the clinical and the economic benefits of 3D printing in dentistry, future research requires standardized testing frameworks and long-term biocompatibility validation. 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

The aim of translucency-enhancing liquids (TEL) is to locally influence the phase composition of zirconia in order to increase its translucency. This study aimed to determine the influence of TEL on 3Y- and 4Y-TZP zirconia concerning roughness, hardness, wear, flexural strength, dynamic stability and fracture force of fixed dental prostheses after thermal cycling and mechanical loading. Two zirconia materials (4Y-TZP; 3Y-TZP-LA, n = 8 per material and test) were investigated with and without prior application of TEL. Two-body wear tests were performed in a pneumatic pin-on-block design (50 N, 120,000 cycles, 1.6 Hz) with steatite balls (r = 1.5 mm) as antagonists. Mean and maximum vertical loss as well as roughness (Ra, Rz) were measured with a 3D laser-scanning microscope (KJ 3D, Keyence, J). Antagonist wear was determined as percent area of the projected antagonist area. Martens hardness (HM; ISO 14577-1) and biaxial flexural strength (BFS; ISO 6872) were investigated. The flexural fatigue limit BFSdyn was determined under cyclic loading in a staircase approach with a piston-on-three-ball-test. Thermal cycling and mechanical loading (TCML: 2 × 3000 × 5 °C/55 °C, 2 min/cycle, H₂O dist., 1.2 × 10⁶ force á 50 N) was performed on four-unit fixed dental prostheses (FDPs) (n = 8 per group) and the fracture force after TCML was determined. Statistics: ANOVA, Bonferroni test, Kaplan–Meier survival, Pearson correlation; α = 0.05. TEL application significantly influences roughness, hardness, biaxial flexural strength, dynamic performance, as well as fracture force after TCML in 3Y-TZP. For 4Y-TZP, a distinct influence of TEL was only identified for BFS. The application of TEL on 3Y- or 4Y-TZP did not affect wear. TEL application has a strong effect on the mechanical properties of 3Y-TZP and minor effects on 4Y-TZP. All effects of the TEL application are of a magnitude that is unlikely to restrict clinical application. Full article

Background and Objectives: Bone regeneration (BR) is a cornerstone technique in reconstructive dental surgery, traditionally using either barrier membranes, titanium meshes, or perforated non-resorbable membranes to facilitate bone regeneration. Recent advancements in 3D technology, including CAD/CAM and additive manufacturing, have enabled the development of customized scaffolds tailored to patient needs, potentially overcoming the limitations of conventional methods. Materials and Methods: A scoping review was conducted according to the PRISMA guidelines. Electronic searches were performed in MEDLINE (PubMed), the Cochrane Library, Scopus, and Web of Science up to January 2025 to identify studies on digital technologies applied to bone augmentation. Eligible studies encompassed randomized controlled trials, cohort studies, case series, and case reports, all published in English. Data regarding digital workflows, software, materials, printing techniques, and sterilization methods were extracted from 23 studies published between 2015 and 2024. Results: The review highlights a diverse range of digital workflows, beginning with CBCT-based DICOM to STL conversion using software such as Mimics and Btk-3D^®. Customized titanium meshes and other meshes like Poly Ether-Ether Ketone (PEEK) meshes were produced via techniques including direct metal laser sintering (DMLS), selective laser melting (SLM), and five-axis milling. Although titanium remained the predominant material, studies reported variations in mesh design, thickness, and sterilization protocols. The findings underscore that digital customization enhances surgical precision and efficiency in BR, with several studies demonstrating improved bone gain and reduced operative time compared to conventional approaches. Conclusions: This scoping review confirms that 3D techniques represent a promising advancement in BR. Customized digital workflows provide superior accuracy and support for BR procedures, yet variability in protocols and limited high-quality trials underscore the need for further clinical research to standardize techniques and validate long-term outcomes. Full article

Background/Objective: Laser therapy has gained attention in dental practice to minimize bleeding and enhance blood clot formation. This study aimed to explore the utilization and to compare the clinical efficacy of laser-mediated hemostasis for older patients receiving routine dental treatment. Methods: A prospective observational study was conducted across research networks between October 2023 and August 2024, involving 60 patients aged 50 years and older (average = 63.35 years) at risk of postoperative bleeding following dental treatments. Additionally, laser therapy for hemostasis was selected and provided among calibrated operators. A single researcher performed data collection. Before statistical analysis, data verification and clinical assessment were conducted by the operators and researcher. A clinical cut-off for hemostasis was set at 5 min. Two diode laser machines were used namely, an 810 nm and dual wavelengths of 635 nm and 980 nm. Results: There were 94 extraction sockets, 28 procedures of scaling and root planing and 18 procedures of minor oral surgery. Combining laser ablating sulcular fiber and photobiomodulation initiating blood clot formation was a preferable hemostatic technique for extraction socket, while photobiomodulation alone was a preferred technique for soft tissue hemostasis (p < 0.001). All operators confirmed that 97.86 percent of bleeding events achieved more rapid hemostasis. 61.43 percent of bleeding events clinically achieved hemostasis within 5 min by using laser-mediated hemostasis alone (p = 0.092). Full recovery of the extraction socket was significantly observed during the 2- to 4-week follow-up period (p = 0.005). No clinical complications were reported. Conclusions: Laser-mediated hemostasis effectively reduced hemostatic duration, prevented postoperative bleeding and promoted wound healing in older patients undergoing routine dental treatment. Full article

Background: The oral microbiome differs in obese patients compared to normal-weight subjects. Microbiologic shifts very often appear after surgical interventions such as bariatric surgery (BS) and in immunocompromised patients. However, the oral microbiome composition and load in subjects after bariatric surgery are unclear. Aim: The aim of this review is to summarize the current state of the art related to the oral microbiome shift induced by bariatric surgery and to discuss its implications on oral cavity health. Methods: Electronic databases: PubMed/Medline, Web of Science, and Cochrane Library were searched for articles published up to March 30, 2025, describing prospective studies focused on changes in the oral microbiota of patients who underwent bariatric surgery. Results: Eight studies measuring the oral microbiome with different approaches—16S ribosomal RNA (16S rRNA) sequencing, polymerase chain reaction (PCR), culture, and matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI TOF MS)—were included in this review. The following bariatric techniques were used: sleeve gastrectomy, Roux-en-Y gastric bypass, Omega loop gastric bypass, and laparoscopic gastric plication. The follow-up period ranged from 3 to 12 months. The results of microbiologic studies were unequivocal. There was an increment in Streptococcus mutans reported, high levels of Candida species, and increased rates of some periodontitis-associated bacteria (Porphyromonas gingivalis) in the post-bariatric surgery period, though some studies suggested a shift towards non-pathogenic composition of the oral microbiome in prospective observations. Conclusions: The local oral microbial homeostasis becomes strongly impacted by the bariatric surgical treatment itself as well as its consequences in the further post-operative period. Therefore, obese patients undergoing BS require very careful dental observation. Full article

Objectives: In the animal model, we aim to evaluate the bone behavior in two innovative and different laser-treated (L1–L2) titanium implants compared to sandblasted and acid-etched (SBAE) used as control. Materials and Methods: A total of twenty-seven dental implants (8.5 × 3.3 mm) used for the study (Sweden & Martina, Due Carraie Padova-Italy) were placed in three Pelibuey female sheep. Implant surface profilometric, contact angle and EDX analysis were detected. After 15, 30 and 90 days, histological, histomorphometric, SEM-EDX analysis and Bone-to-implant Contact (BIC), Dynamic Osseointegration Index (DOI) and Bone Quality Index (BQI) (as Calcium and Phosphorous atomic percentages ratio) were performed. Results: All surfaces showed relevant profilometric and wettability differences. After 15 days, BIC₁₅ showed great differences in L2 (42.1 ± 2.6) compared to L1 (5.2 ± 3.1) and SBAE (23.3 ± 3.9) as well as after 30 days (L2 (82.4 ± 2.2), L1 (56.2 ± 1.3) and SBAE (77.3 ± 0.4)). After 90 days, relevant lower BIC₉₀ values were detected in L1 (68.4 ± 0.2) compared to L2 (86.4 ± 0.1) and SBAE (86.2 ± 0.6). The DOI showed higher rates of bone growth in L2 after 15 (DOI₁₅ = 2.81) and 30 days (DOI₃₀ = 2.83), compared to L1 (DOI₁₅ = 0.38, DOI₃₀ = 3.40) and SBAE (DOI₁₅ = 1.55, DOI₃₀ = 2.58). The DOI₉₀ drastic slowdown in SBAE (0.96), L1 (0.76), and L2 (0.95) confirmed the Early Osseointegration (EO) as a crucial phase. Moreover, before loading, the lower global BQI in L1 (Ca 44.43 ± 0.08–P 46.14 ± 5.15) and SBAE (Ca 45.31 ± 2.08–P 48.28 ± 1.12) compared to L2 (Ca 79.81 ± 2.08–P 81.85 ± 3.14) allows to assert that osseointegration process and bone healing could not be considered complete if compared to the native bone. Conclusions: The BIC, DOI, and BQI results showed that osseointegration is a dynamic process, confirming the crucial role of surface characteristics able to influence it, especially the early osseointegration (EO) phase. The short-time L2 implants’ higher bone quantity and quality results, compared to L1 and SBAE, suggested the fundamental role of this innovative laser-obtained surface in “secondary stability” and predictable long-term clinical outcomes. Full article

Background: Due to limitations of fluoride (F) treatment as a main caries preventive measure, it is important to consider the use of other dental caries preventive measures to reduce caries prevalence, especially in its early stages. Recently, new remineralizing agents appeared on the market, with their commercial availability in a variety of oral care products. Objectives: The purposes include providing a scoping review that represents caries remineralizing efficacies of only commercially available products and their existing adverse effects (if it is presented) and ensuring that only evidence-based approved products are included. Methods: The following databases were used in searching scientific literature on 28 October 2024: PubMed, PubMed Advanced Search, MeSH database, and PubMed Clinical Queries. The study selection criteria were as follows: for laboratory, in vitro, and/or in situ—remineralization of enamel-scanning electron microscopy, spectroscopy, microhardness test, light microscopy, profilometry, transverse microhardness microradiography, integrated mineral loss, light microscopy, photothermal radiometry; if it was a randomized controlled trial—CONSORT protocol, ICDAS system (to detect dental caries), diagnostic additional devices; antibacterial ability-colony forming units, DNA-based sequencing, scanning electron microscopy, crystal violet staining, and confocal laser scanning microscopy. Results: This review includes 98 papers: 14 of them describing the current status of caries patterns in the world, 60 studies (45 laboratory studies and 15 RCTs), and 24 systematic reviews were analyzed in order to detect whether new remineralizing agents can replace fluoride in further caries prevention. Conclusions: All reviewed new remineralization agents could be used without additives to treat early caries lesions, but the combination with F promotes better remineralization. Only HAP demonstrated its potential to serve as an alternative to fluoride in oral care products. However, further clinical studies are needed to prove its role in the remineralizing process of initial caries lesions. One also needs to ensure that both the clinical trials and in vitro lab studies use the best gold standards to validate any changes in the tooth structure, both remineralization and demineralization. Full article

Background and Objectives: Conventional methods for removing cemented fixed prosthetic restorations (FPRs) are unreliable and lead to unsatisfactory outcomes. At their best, they allow the tooth to be saved at the expense of a laborious process that also wears down rotating tools and handpieces and occasionally results in abutment fractures. Restorations are nearly never reusable in any of these situations. Erbium-doped yttrium-aluminum-garnet (Er:YAG) and erbium-chromium yttrium-scandium-gallium-garnet (Er,Cr:YSGG) lasers casafely and effectively remove FPRs, according to scientific studiesre. This study sets out to examine the impact of Er:YAG laser radiation on the debonding of different ceramic restorations, comparing the behavior of various ceramic prosthetic restoration types under laser radiation action and evaluating the integrity of prosthetic restorations and dental surfaces exposed to laser radiation. Materials and Methods: The study included a total of 16 removed teeth, each prepared on opposite surfaces as abutments.y. Based on the previously defined groups, four types of ceramic restorations were included in the study: feldspathic (F), lithium disilicates (LD), layered zirconia (LZ), and monolithic zirconia (MZ). The thickness of the prosthetic restorations was measured at three points, and two different materials were used for cementation. The Er:YAG Fotona StarWalker MaQX laser was used to debond the ceramic FPR at a distance of 10 mm using an R14 sapphire tip with 275 mJ, 20 Hz, 5.5 W, with air cooling (setting 1 of 9) and water. After debonding, the debonded surface was visualized under electron microscopy. Results: A total of 23 ceramic FPRs were debonded, of which 12 were intact and the others fractured into two or three pieces. The electron microscopy images showed that debonding took place without causing any harm to the tooth structure. The various restoration types had the following success rates: 100% for the LZ and F groups, 87% for the LD group, and 0% for the MZ group. In terms of cement type, debonding ceramic FPRs cemented with RELYX was successful 75% of the time, compared to Variolink DC’s 69% success rate. Conclusions: In summary, the majority of ceramic prosthetic restorations can be successfully and conservatively debonded with Er:YAG radiation. Full article

This study investigates the potential of Selective Laser Melting (SLM) to tailor the surface characteristics of Ti6Al4V directly during fabrication, eliminating the need for post-processing treatments potentially for dental implants. By adjusting the Volumetric Energy Density (VED) through controlled variations in the laser scanning speed, we achieved customized surface textures at both the micro- and nanoscale levels. SLM samples fabricated at moderate VED levels (50–100 W·mm³/s) exhibited optimized dual-scale surface roughness—a macro-roughness of up to 25.5–27.6 µm and micro-roughness of as low as 58.8–64.2 nm—resulting in significantly enhanced hydrophilicity, with water contact angles (WCAs) decreasing to ~62°, compared to ~80° on a standard grade 5 machined Ti6Al4V plate. The XPS analysis revealed that the surface oxygen content remains relatively stable at low VED values, with no significant increase. The surface topography plays a significant role in influencing the WCA, particularly when the VED values are low (below 200 W·mm³/s) during SLM, indicating the dominant effect of surface morphology over chemistry in these conditions. Biological assays using osteoblast-like MG-63 cells demonstrated that these as-built SLM surfaces supported a 1.5-fold-higher proliferation and improved cytoskeletal organization relative to the control, confirming the enhanced early cellular responses. These results highlight the capability of SLM to engineer bioactive implant surfaces through process-controlled morphology and chemistry, presenting a promising strategy for the next generation of dental implants suitable for immediate placement and osseointegration. Full article

Background: The Er:YAG laser has gained attention in dentistry for its potential to enhance microbial disinfection through targeted photothermal and photoacoustic mechanisms. Objective: This systematic review aimed to evaluate the antibacterial and bactericidal efficacy of Er:YAG laser therapy across clinically relevant oral pathogens in in vitro models. Methods: Following the PRISMA 2020 guidelines, a systematic search of PubMed, Embase, Scopus, and the Cochrane Library was conducted for studies published between 2015 and 2025. The review protocol was registered with PROSPERO (CRD420251031368). Eligibility criteria included in vitro or animal studies assessing the bactericidal effects of the Er:YAG laser on oral bacteria or fungi, either alone or in combination with chemical disinfectants. Study selection, data extraction, and quality assessment were conducted independently by multiple reviewers. Results: Ten in vitro studies met inclusion criteria. The Er:YAG laser demonstrated significant antibacterial effects against Enterococcus faecalis, Streptococcus mutans, Porphyromonas gingivalis, Candida albicans, and other species. Greater bacterial reduction was consistently observed when the laser was combined with adjunctive irrigants such as sodium hypochlorite or hydrogen peroxide. The laser was effective in reducing biofilm biomass and viable counts, particularly in complex anatomical settings. Most studies were rated as low risk of bias. Conclusions: Er:YAG laser therapy is a promising adjunctive tool for microbial disinfection in dentistry, particularly in challenging anatomical sites. Further well-designed in vivo and clinical studies are needed to confirm its efficacy and determine optimal treatment parameters. Full article

Laser photobiomodulation (LPMB) is a non-invasive therapy that relies on the use of low-power lasers. The literature supports the positive effect of LPBM on tissue regeneration, since it reduces the timing of the inflammatory phase, promoting the proliferative phase of the process. From a purely clinical point of view, the breadth of lasers currently available for dental use makes it difficult to identify unambiguous parameters that can guarantee the best regenerative effect. Therefore, the aim of the present systematic review is to identify the best irradiation parameters for each type of dental laser that can provide the best effects on fibroblast proliferation and differentiation. The literature was searched through the following electronic databases: Medline, Scopus, Web of Science, Springer, and Cochrane, while respecting the PRISMA 2020 guidelines. In vitro studies conducted on human fibroblast cells, drafted in English between 2004 and 2025, were included. A total of 17 papers assessing the effects of diode lasers at different wavelengths (445 nm, 635 nm, 650 nm, 660 nm, 670 nm, 685 nm, 810 nm, 830 nm, 915 nm, 940 nm), CO2 lasers (10.6 µm), and Er:YAG lasers (2940 nm) were included. What can be concluded from the present review is that, for the same wavelength, the wide variability in the results obtained from each study makes it complicated to identify unambiguous parameters for each laser device that can guarantee the best effect on fibroblast proliferation and differentiation. Full article