Search Results (489)

Stunting is a chronic growth disorder that not only affects height but may also impair craniofacial development. Facial proportions, especially in the vertical dimension, may provide additional anthropometric insight into growth status among children. Objectives: To assess and compare the vertical and horizontal facial proportions of stunted and non-stunted children, and to explore the potential of facial dimensions as supportive indicators for early-stunting detection in community-based settings. Methods: This cross-sectional analytical study involved 266 children aged 7–72 months (mean age 42.63 ± 13.82 months) from several community health centers in Bandung, Indonesia. Children were categorized as stunted or non-stunted based on WHO height-for-age Z-scores. Facial dimensions were measured directly by calibrated pediatric dentistry residents using manual instruments. The vertical dimensions included Nasion–Subnasale (N–SN) and Subnasale–Menton (SN–M), while horizontal dimensions included zygomatic width and intergonion width. Data were analyzed using the Mann–Whitney U test and Spearman correlation. Results: Significant differences were found in vertical facial dimensions between stunted and non-stunted children: median N–SN (32.4 mm vs. 33.6 mm; p = 0.003) and SN–M (42.5 mm vs. 45.1 mm; p < 0.001). No significant differences were observed in horizontal dimensions. All facial parameters showed a positive correlation with age (p < 0.001). No significant differences were found based on sex. Conclusions: Stunted children exhibited shorter vertical facial dimensions compared to their non-stunted peers, while horizontal dimensions remained stable across groups. Vertical facial proportions may serve as supportive indicators in the screening and monitoring of childhood stunting. This method has potential for integration into community-based growth monitoring using simple or digital anthropometric tools. Full article

Objective: With a global prevalence ranging from 50% to 100%, gingivitis is considered the most common oral disease in adults worldwide. It is characterized by clinical signs of inflammation, such as redness, swelling and bleeding, on gentle probing. Although it is considered a milder form of periodontal disease, gingivitis plays an important role in overall oral health. Early detection and treatment are essential to prevent progression to more severe conditions. Typically, diagnosis is performed by dental professionals, as individuals are often unable to accurately assess whether they are affected. Therefore, the aim of the present study was to determine to what degree gingivitis is visually detectable by an easy-to-use camera-based application. Materials and methods: Standardized intraoral photographs were taken using a specialized intraoral camera and processed using a custom-developed filter based on a machine-learning algorithm. The latter was trained to highlight areas suggestive of gingivitis. A total of 110 participants were enrolled through ad hoc sampling, resulting in 320 assessable test sites. A dentist provided two reference standards: the clinical diagnosis based on bleeding on probing of the periodontal sulcus (BOP) and an independent visual assessment of the same images. Agreement between diagnostic methods was measured using Cohen’s kappa statistic. Results: The agreement between the application’s output and the BOP-based clinical diagnosis was low, with a kappa value of 0.055 [p = 0.010]. Similarly, the dentist’s visual assessment of clinical photos showed low agreement with BOP, with a kappa value of 0.087 [p < 0.001]. In contrast, the agreement between the application and the dentist’s photo-based evaluations was higher, with a kappa value of 0.280 [p < 0.001]. Conclusions: In its current form, the camera-based application is not able to reliably detect gingivitis. The low level of agreement between dentists’ visual assessments and the clinical gold standard highlights that gingivitis is difficult to identify merely visually. These results underscore the need to refine visual diagnostic approaches further, which could support future self-assessment or remote screening applications. Full article

This study aimed to develop an innovative resin composite with anti-biofouling properties, tailored to prosthesis fabrication in dentistry using a digital light processing (DLP) 3D-printing technique. The resin composite was formulated using a blend of dental monomers, with the integration of 2-methacryloyloxylethyl phosphorylcholine (MPC) with anti-biofouling behavior and γ-MPS-treated silica-zirconia powder for simultaneous mechanical reinforcement. The overall characterization of the resin composite was carried out using various contents of MPC incorporated into the resin (0–7 wt%) for examining the rheological behavior, photopolymerization, flexural strength/modulus, microstructure and anti-biofouling efficiency. The resin composite demonstrated a significant reduction in bacterial adhesion (97.4% for E. coli and 86.5% for S. aureus) and protein adsorption (reduced OD value from 1.3 ± 0.4 to 0.8 ± 0.2) with 7 wt% of MPC incorporation, without interfering with photopolymerization to demonstrate potential suitability for 3D printing without issues (p < 0.01, and p < 0.05, respectively). The incorporation and optimization of γ-MPS-treated silica-zirconia powder (10–40 vol%) enhanced mechanical properties, leading to a reasonable flexural strength (103.4 ± 6.1 MPa) and a flexural modulus (4.3 ± 0.4 GPa) at 30 vol% (n = 6). However, a further increase to 40 vol% resulted in a reduction in flexural strength and modulus; nevertheless, the results were above ISO 10477 standards for dental materials. Full article

Background/Objectives: Immediate dentin sealing (IDS) has been widely investigated in sound dentin; however, its efficacy on demineralized dentin remains insufficiently explored. This in vitro experimental study aimed to evaluate the shear bond strength (SBS) of indirect composite resin restorations bonded to demineralized dentin using IDS, assessed at 24 h and after 6 months of aging. Methods: Twenty-five extracted premolars were randomly divided into five groups: (1) control (no sealing), (2) IDS applied to sound dentin (sound-IDS), (3) IDS applied to demineralized dentin (carious-IDS), (4) delayed dentin sealing (DDS) on sound dentin (sound-DDS), and (5) DDS on demineralized dentin (carious-DDS). SBS values were analyzed using a three-way analysis of variance (ANOVA) with dentin condition (sound vs. demineralized), aging time (24 h vs. 6 months), and sealing strategy (control, IDS, DDS) as independent variables. Statistical analyses were performed using SigmaPlot 12.0, with significance set at p < 0.05. Results: The results showed that IDS led to significantly higher SBS than DDS (p < 0.05). Bond strength was significantly influenced by dentin condition (p < 0.05), and all interactions between variables—particularly between dentin condition and sealing strategy, and between aging time and treatment—were statistically significant (p < 0.001). Overall, bond strength was higher at 24 h than after 6 months. IDS showed optimal performance in sound dentin, while DDS resulted in better long-term outcomes in demineralized dentin. Conclusions: These findings suggest that DDS may be the more effective approach in cases of carious or demineralized dentin. Full article

Objectives: Digitalization has revolutionized dentistry, introducing advanced technological tools that improve diagnostic accuracy and access to healthcare. This study aims to examine the effects of integrating digital technologies into the dental field, analyzing the associated benefits and risks, with particular paid attention to the therapeutic relationship and decision-making autonomy. Materials and Methods: A literature search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library, complemented by Google Scholar for non-indexed studies. The selection criteria included peer-reviewed studies published in English between 2014 and 2024, focusing on digital dentistry, artificial intelligence, and medical ethics. This is a narrative review. Elements of PRISMA guidelines were applied to enhance transparency in reporting. Results: The analysis highlighted that although digital technologies and AI offer significant benefits, such as more accurate diagnoses and personalized treatments, there are associated risks, including the loss of empathy in the dentist–patient relationship, the risk of overdiagnosis, and the possibility of bias in the data. Conclusions: The balance between technological innovation and the centrality of the dentist is crucial. A human and ethical approach to digital medicine is essential to ensure that technologies improve patient care without compromising the therapeutic relationship. To preserve the quality of dental care, it is necessary to integrate digital technologies in a way that supports, rather than replaces, the therapeutic relationship. Full article

The integration of artificial intelligence (AI) and advanced digital workflows is revolutionising full-arch implant dentistry, particularly for geriatric patients with edentulous and atrophic arches, for whom achieving both prosthetic passivity and optimal aesthetic outcomes is critical. This narrative review evaluates current challenges in intraoral scanning accuracy—such as scan distortion, angular deviation, and cross-arch misalignment—and presents how innovations like the Medit SmartX AI-guided workflow and the Scan Ladder system can significantly enhance precision in implant position registration. These technologies mitigate stitching errors by using real-time scan body recognition and auxiliary geometric references, yielding mean RMS trueness values as low as 11–13 µm, comparable to dedicated photogrammetry systems. AI-driven prosthetic design further aligns implant-supported restorations with facial symmetry and smile aesthetics, prioritising predictable midline and occlusal plane control. Early clinical data indicate that such tools can reduce prosthetic misfits to under 20 µm and lower complication rates related to passive fit, while shortening scan times by up to 30% compared to conventional workflows. This is especially valuable for elderly individuals who may not tolerate multiple lengthy adjustments. Additionally, emerging AI applications in design automation, scan validation, and patient-specific workflow adaptation continue to evolve, supporting more efficient and personalised digital prosthodontics. In summary, AI-enhanced scanning and prosthetic workflows do not merely meet functional demands but also elevate aesthetic standards in complex full-arch rehabilitations. The synergy of AI and digital dentistry presents a transformative opportunity to consistently deliver superior precision, passivity, and facial harmony for edentulous implant patients. Full article

There is insufficient evidence regarding the cytotoxicity of restorative 3D-printing resins, used as part of the digital workflow in dentistry. This study presents a novel comparative evaluation of cell viability and adhesion using human Wharton’s jelly-derived mesenchymal stem cells (WJ-MSCs), a less commonly used but clinically relevant cell line in dental biomaterials research. The aim of this study was to evaluate the cell viability of WJ-MSCs seeded on 3D-printed resins intended for temporary restorations. Resin discs of three commercial 3D-printing resins (NextDent C&B, Leaf Dental C&B, and UNIZ Temp) and a conventional self-curing acrylic resin (NicTone) were used. WJ-MSCs were cultured on the specimens for 1, 4, and 10 days. Cell viability was assessed using the PrestoBlue assay, Live/Dead immunofluorescence staining, and 7AAD/Annexin V staining. Cell adhesion was evaluated using scanning electron microscopy. Direct exposure to the 3D-printed resins and the self-curing acrylic caused slight reductions in cell viability compared to the control group in both microscopic analyses. 7AAD/Annexin V showed the highest percentage of viable WBCs for the conventional acrylic (34%), followed by UNIZ (35%), NextDent (42%), and Leaf Dental (36%) (ANOVA p < 0.05 Tukey’s post-hoc test p < 0.05). These findings suggest that 3D-printed resins could be considered safe for use in temporary restorations. Full article

Background: Graphene oxide (GO) is widely explored as a functional additive in polymer composites; however, its simple physical dispersion in dental resins often leads to poor interfacial stability and limited long-term performance. Covalent functionalization may overcome these limitations by enabling chemical integration into the polymer matrix. This study presents the synthesis and FT-IR/Raman characterization of GRAPHYMERE^®, a novel graphene oxide-based monomer obtained through exfoliation, amine functionalization with 1,6-hexanediamine, and transamidation with methyl methacrylate. Methods: A novel GO-based monomer, GRAPHYMERE^®, was synthesized through a three-step process involving GO exfoliation, amine functionalization with 1,6-hexanediamine, and transamidation with methyl methacrylate to introduce polymerizable acrylic groups. The resulting product was characterized using FT-IR and Raman spectroscopy. Results: Spectroscopic analyses confirmed the presence of aliphatic chains and amine functionalities on the GO surface. Although some expected signals were overlapped, the data suggest successful surface modification and partial insertion of methacrylamide groups. The process is straightforward, uses low-toxicity reagents, and avoids complex reaction steps. Conclusions: GRAPHYMERE^® represents a chemically modified GO monomer potentially suitable for copolymerization within dental resin matrices. While its structural features support compatibility with radical polymerization systems, further studies are required to assess its mechanical performance and functional properties in dental resin applications. Full article

Introduction: Digital planning and evolution of technology is allowing dentistry to be more efficient in time than before. In orthodontics the main purpose is to obtain fewer patient visits and to reduce the bonding time. For that, indirect bonding planned with CAD-CAM softwares is used to obtain a shorter treatment period, in general, and less chair-time. This waste of chair-time should also be reduced in other fields of dentistry such as endodontics, surgery, prosthodontics, and aesthetics. Methods: A total of 504 teeth were embedded into epoxy resin models mounted as a dental arch. Customized lingual multibracket appliances were bonded by a current adhesion protocol. After that, they were debonded, the polishing of cement remnants was performed with three different burs and two drills. The polishing time of each group was recorded by an iPhone 14 chronometer. Results: Descriptive and comparative statistical analyses were performed with the different study groups. Statistical differences (p < 0.005) between diamond bur and tungsten carbide and white stone burs and turbine were obtained, with the first being the slowest of them. Discussion: Enamel roughness was widely studied in orthodontics polishing protocol as the main variable for protocols establishment. However, in lingual orthodontics, due the difficulty of the access to the enamel surfaces, the protocol is not clear and efficiency should be considered. It was observed that the tungsten carbide bur is the safest bur. It was also recommended that a two-step protocol of polishing by tungsten carbide bur be followed by polishers. Conclusions: A tungsten carbide bur mounted in a turbine was the most efficient protocol for polishing after lingual bracket debonding. 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

Successful dental implant therapy relies on accurate planning and placement, e.g., through static, computer-aided implant surgery using CAD/CAM-fabricated surgical guides. This study examined production methods’ influence on surgical guide sleeve housing geometry. A model with two edentulous spaces was digitized using intraoral scanning and CBCT, and two virtually positioned implants were planned. Ten guides per group were produced using milling (MCX5), DLP printing (ASIGA and SHERA), and SLA printing (FORM), printing with 50 µm and 100 µm layers each. Each guide (n = 70) was then digitized using an industrial scanner before and after sterilization. Superimposition of the actual guide data with the reference data allowed for evaluation of deviations at the drill sleeve housing along the x-, y-, z-, and dxyz-axes. Descriptive and statistical evaluation was performed (significance level: p ≤ 0.0125). Significant differences existed among the production methods: Milling and SLA showed higher deviations than the DLP group (p < 0.001). Milled guides post-sterilization showed the highest deviations (0.352 ± 0.08 mm), while one DLP printer at 50 μm layer thickness showed lowest deviations (0.091 ± 0.04 mm). The layer thickness was insignificant, whereas sterilization increased deviation (p < 0.001). DLP produced the most precise implant surgical guides. All 3D printers were suitable for fabricating clinically acceptable surgical guides. Full article

Objectives: The aim of this study was to evaluate the effectiveness of spectrophotometers for objective tooth color measurement, particularly in bleaching procedures enhanced by digital positioning templates. Methods: Tooth color registration was conducted using both subjective methods with shade guides and objective methods with spectrophotometers. Spectrophotometers were chosen for their ability to provide objective, quantifiable, and reproducible results, crucial for monitoring color modifications accurately. Digital workflows were implemented to enhance the registration process further. These workflows included providing a precise positioning matrix for spectrophotometer sensors and optimizing working models to ensure high-quality therapeutic splints. Results: The use of spectrophotometers demonstrated superior performance in registering tooth color objectively compared to subjective shade guides. Digital workflows significantly improved the precision and efficiency of spectrophotometer measurements through a digital matrix, enhancing the quality of therapeutic splints obtained. Conclusions: Spectrophotometers are recommended for objective and precise tooth color registration, particularly in bleaching procedures. Integrating a digital positioning matrix enhances measurement accuracy and reliability, supporting effective monitoring and treatment outcomes. Full article

Background: Accuracy of optical impressions—defined by the intraoral scanner (IOS)’s trueness and precision per International Organization for Standardization (ISO) standards—is influenced by both operator- and patient-related factors. Thus, this in vitro study aimed to (1) evaluate how scanning distance affects the accuracy of three different intraoral scanners (IOSs), and (2) identify the optimal scanning distance for each scanner. Methods: A maxillary arch model was obtained using polyvinyl siloxane impression material and poured with Type IV stone (Octa-rock royal^®, Kulzer, Germany). Using three different types of IOSs—the trios 3 shape (TRIOS ^® cart, 3Shape, Copenhagen, Denmark); the Helios 500 (Eighteeth ^®, Changzhou, China); and the Heron (3Disc ^®, Herndon, VA 20170, USA)—ten scans were performed with each of the IOSs with five predetermined distances: 0 mm, 2.5 mm, 5 mm, 7.5 mm, and 10 mm. Spacers of varying heights were designed using Meshmixer version 3.5 (Autodesk, Inc., Mill Valley, CA, USA) and three-dimensional printed with the Form 2 printer (Formlabs, Somerville, MA, USA). The scanned data was processed using Geomagic Control X (Version 16.0.2.16496, 3D Systems, Wilsonville, OR, USA). Statistical analyses were performed using R Statistical Software (version 4.2.2), with significance set at α = 0.05. Results: Scanning distance significantly influenced scan accuracy for all three scanners. The 3Disc scanner (3Disc, Herndon, VA, USA) demonstrated the highest accuracy at a 7.5 mm distance, while both the Helios 500 (Eighteeth, Changzhou, China) and Trios 3 (3Shape, Copenhagen, Denmark) scanners achieved their best accuracy at a 5 mm distance, as indicated by the lowest root mean square (RMS) values (p < 0.05). Conclusions: To conclude, each IOS has an optimal scanning distance for best accuracy. Trios 3 (3Shape, Copenhagen, Denmark) outperformed the others in both trueness and precision. Future studies should examine these effects under full-arch and clinical conditions. Full article

This study presents a methodology for developing and validating digital models of tooth-inlay systems, aiming to trace the complete workflow from clinical procedures to simulation by involving dental professionals—dentists for manual cavity preparation and dental technicians for restoration modelling—while integrating micro-computed tomography (micro-CT) imaging with finite element analysis (FEA). The proposed workflow includes (1) the acquisition of high-resolution 3D micro-CT scans of a non-restored tooth, (2) image segmentation and reconstruction to create anatomically accurate digital twins and mesh generation, (3) the selection of proper resin and the 3D printing of four typodonts, (4) the manual preparation of cavities on the typodonts, (5) the acquisition of high-resolution 3D micro-CT scans of the typodonts, (6) mesh generation, digital inlay and onlay modelling and material property assignment, and (7) nonlinear FEA simulations under representative masticatory loading. The approach enables the visualisation of stress and deformation patterns, with preliminary results indicating stress concentrations at the tooth-restoration interface integrating different cavity alternatives and restorations on the same tooth. Quantitative outputs include von Mises stress, strain energy density, and displacement distribution. This study demonstrates the feasibility of using image-based, tooth-specific digital twins for biomechanical modelling in dentistry. The developed framework lays the groundwork for future investigations into the optimisation of restoration design and material selection in clinical applications. Full article

Autogenous tooth transplantation offers a biologically favorable approach to tooth replacement, preserving the periodontal ligament, promoting alveolar development, and maintaining proprioception. Background/Objectives: Its broader clinical applicability is limited by variability in techniques and outcome definitions. This systematic review and meta-analysis evaluated the clinical success of autogenous tooth transplantation across donor tooth types, developmental stages, surgical techniques, and fixation methods. Methods: Following PRISMA 2020 guidelines and a PROSPERO-registered protocol (CRD42024625550), five databases and the gray literature were searched through July 2025. Eligible studies reported clinical outcomes for autogenous tooth transplantation. Risk of bias was assessed using the Newcastle–Ottawa Scale. A random-effects meta-analysis of logit-transformed proportions was conducted, with subgroup and sensitivity analyses by tooth type, root development stage, surgical technique, and fixation method. Results: Twenty studies involving 1366 transplanted teeth were included. The pooled success rate was 94.0% (95% CI: 22.5–99.9%) across follow-up periods ranging from one month to twenty-nine years. However, interpretation is limited by distinct heterogeneity (I² = 99.8%) and the wide confidence interval. Subgroup analyses by tooth type, root maturity, surgical technique, and fixation method are, therefore, emphasized to support clinical interpretation. Conclusions: Autogenous tooth transplantation achieves consistently high success across clinical contexts when biologic handling is respected. These findings support its broader use in dental and orthodontic practice and underscore the need for standardized outcome reporting and prospective research. Interpretation is limited by heterogeneity and variation in reporting standards. Full article