Search Results (117)

Background: The adhesion between artificial teeth and denture bases is crucial for the longevity of complete dentures. This in vitro study evaluated the shear bond strength (SBS) and failure modes between artificial teeth and denture base resins produced with conventional, milled, and 3D-printed techniques. Materials: A total of 105 specimens were fabricated and assigned to 7 groups (n = 15) combining conventional, milled, or printed denture bases with conventional, milled, or printed teeth. SBS was tested using a universal testing machine, and failure modes were classified as adhesive, cohesive, or mixed. Data were analyzed with one-way ANOVA and Tukey’s post hoc test (α = 0.05). Results: SBS significantly varied among groups (p < 0.001). The conventional base–conventional tooth group (CB-CT) showed the highest bond strength (14.9 ± 3.69 MPa), while the printed base–milled tooth group (PB-MT) had the lowest (6.58 ± 3.41 MPa). Milled base groups showed intermediate values (11.7–12.4 MPa). Conclusions: Bond strength between denture teeth and denture bases depends on the fabrication workflow. Conventional heat-cured PMMA bases exhibited the most reliable adhesion, while milled bases demonstrated satisfactory performance with optimized bonding. Printed bases showed reduced and variable adhesion, suggesting the need for improved bonding protocols before their widespread clinical application in definitive prostheses. Full article

Background: Augmented reality (AR) is revolutionizing implant and tooth-supported prosthodontics (ITSP) through enhanced precision, workflow efficiency, and educational outcomes. This scoping review systematically evaluates AR’s clinical applications, educational impacts, and implementation challenges. Methods: Following PRISMA-ScR guidelines, comprehensive searches were conducted in PubMed, Scopus, Web of Science, and Embase (2015–2025) for peer-reviewed studies on AR in ITSP. Eighteen studies met inclusion criteria after dual independent screening. Data extraction focused on clinical outcomes, educational benefits, and technological limitations. Results: AR applications demonstrated: ITSP Practice: Submillimeter implant placement accuracy (0.42–0.69 mm entry deviation; p < 0.001 vs. freehand), 30% faster intraoral scanning (44 s vs. 63 s), and 37% reduction in preparation errors (p < 0.05); ITSP Education: 22–30% faster skill acquisition (p < 0.05) and 99% reduction in assessment time (10.5 s vs. 2 h/case). Key Gaps: Limited to two randomized controlled trials (RCTs), hardware costs ($3500–$10,000), and lack of standardized validation protocols. Conclusions: While AR significantly enhances ITSP precision and training efficiency, widespread adoption requires longitudinal clinical validation, cost-effectiveness analyses, and interoperable digital workflows. Full article

Objective: This article presents a step-by-step digital technique for fabricating a 3D-printed surgical guide to assist in alveoloplasty for immediate denture placement. Methods: The workflow integrates intraoral scanning, virtual tooth extraction, digital soft tissue modeling, and additive manufacturing to produce a customized guide with an occlusal window and buccal slot, along with a verification stent. Results: This method ensures precise ridge recontouring and verification, enhancing surgical predictability and prosthetic fit. Conclusions: Unlike traditional surgical guides based on conventional casts or manual fabrication, this fully digital approach offers a practical and replicable protocol that bridges digital planning and clinical execution. By improving surgical precision, reducing operative time, and ensuring optimal denture fit, this technique represents a significant advancement in guided pre-prosthetic surgery. Full article

Background/Objectives: Digital prosthodontics increasingly utilize both additive (3D printing) and subtractive Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM), yet comprehensive comparisons remain limited. This scoping review evaluates their relative performance across prosthodontic applications. Methods: Systematic searches (PubMed, Scopus, Web of Science, Embase, 2015–2025) identified 28 studies (27 in vitro, 1 retrospective). Data were extracted on accuracy, efficiency, materials, and outcomes. Results: CAD/CAM milling demonstrated superior accuracy for fixed prostheses, with marginal gaps for milled zirconia (123.89 ± 56.89 µm), comparable to optimized 3D-printed interim crowns (123.87 ± 67.42 µm, p = 0.760). For removable prostheses, milled denture bases achieved a trueness of 65 ± 6 µm, while SLA-printed dentures post-processed at 40 °C for 30 min showed the lowest root mean square error (RMSE) (30 min/40 °C group). Three-dimensional printing excelled in material efficiency (<5% waste vs. milling > 30–40%) and complex geometries, such as hollow-pontic fixed dental prostheses (FDPs) (2.0 mm wall thickness reduced gaps by 33%). Build orientation (45° for crowns, 30–45° for veneers) and post-processing protocols significantly influenced accuracy. Milled resins exhibited superior color stability (ΔE00: 1.2 ± 0.3 vs. 3D-printed: 4.5 ± 1.1, p < 0.05), while 3D-printed Co-Cr frameworks (SLM) showed marginal fits of 8.4 ± 3.2 µm, surpassing milling (130.3 ± 13.8 µm). Digital workflows reduced chairside time by 29% (154.31 ± 13.19 min vs. 218.00 ± 20.75 min). All methods met clinical thresholds (<120 µm gaps). Conclusions: Milling remains preferred for high-precision fixed prostheses, while 3D printing offers advantages in material efficiency, complex designs, and removable applications. Critical gaps include long-term clinical data and standardized protocols. Future research should prioritize hybrid workflows, advanced materials, and AI-driven optimization to bridge technical and clinical gaps. Full article

Objectives: This systematic review aimed to evaluate the cost, production time, clinical performance, and patient satisfaction of 3D printing workflows in prosthodontics compared to conventional and subtractive methods. Methods: Following PRISMA guidelines, a systematic search of electronic databases was performed to identify studies published between 2015 and 2025 that directly compared digital additive workflows with analogue or subtractive workflows. Studies were eligible if they included prosthodontic treatments such as dentures, crowns, or implant-supported prostheses and reported at least one relevant outcome. The primary outcomes were cost, time efficiency, clinical accuracy (e.g., marginal adaptation, fit), and patient satisfaction. Included studies were methodologically evaluated using MINORS scale and the risk of bias was assessed using ROBINS-I and RoB 2 tools. Results: Seven studies met the inclusion criteria. Overall, 3D printing workflows demonstrated reduced production time and cost in comparison to conventional or subtractive methods. Clinical outcomes were generally comparable or superior, particularly regarding adaptation and fit. Patient satisfaction was favourable in most studies, although reporting varied. Long-term follow-up was limited, which constrains the interpretation of sustained clinical performance. Conclusions: These findings suggest that 3D printing can serve as an efficient and cost-effective alternative in prosthodontic fabrication, with clinical results comparable to those already established. Further research is needed to assess long-term clinical performance and cost-effectiveness in various clinical scenarios. Full article

Background: In modern dentistry, alveolar socket preservation after tooth extraction plays a critical role in maintaining the alveolar ridge for future dental implants. This retrospective clinical study evaluated bone-level changes 15 years after immediate implant placement, coupled with alveolar ridge preservation. Methods: Fifty non-smoking patients aged 25 to 75 (30 males and 20 females) who underwent single-implant rehabilitation in both anterior and posterior regions of the upper and lower jaws were included. The study examined bone levels and implant survival over time, using standardized intraoral radiographs at 1, 5, and 15 years post-loading. Implants were placed immediately after atraumatic extraction, and the residual gap was grafted with bovine hydroxyapatite and covered with a collagen membrane. The primary outcome was bone-level stability, while secondary outcomes included implant failure. No temporary crowns or removable dentures were provided during healing. Radiographs were digitized for detailed analysis. Results: The results for 50 patients with immediate implant placement showed that bone-resorption levels were significantly higher in the upper jaw than in the lower jaw. Conclusions: Posterior implants exhibited greater bone loss than anterior implants, particularly at 1 year and 15 years, while no implant failures occurred. Full article

Background: Patient satisfaction is a critical outcome in the rehabilitation of edentulous patients. While conventional fabrication methods are widely used, digital workflows are emerging as viable alternatives. However, direct comparative evidence from the patient’s perspective remains limited. Objective: To compare patient satisfaction between conventional complete dentures (C-CD) and digital complete dentures (D-CD) in maxillary edentulous patients, including changes in perceptions over time and final prosthesis preference. Methods: A prospective, randomized crossover clinical trial was conducted in 2023–2024 involving 40 completely maxillary edentulous patients meeting specific inclusion criteria. Participants were randomly allocated into two sequence groups: Group 1 (n = 20) received C-CD first, and Group 2 (n = 20) received D-CD first, each for 6 months (T1), followed by crossover to the alternate denture for another 6 months (T2). Patient satisfaction was measured using a 10-item questionnaire at 6 and 12 months. Statistical analysis: Wilcoxon signed-rank tests were used for within-subject comparisons of denture types, and Mann–Whitney U tests for between-group comparisons, with significance set at p ≤ 0.05. Results: Using the paired crossover analysis, D-CD showed significantly better comfort than C-CD (p < 0.05). D-CD scored significantly higher than C-CD in most satisfaction domains, including comfort, retention, speech, esthetics, and need for adjustments (p ≤ 0.05). Median scores for retention, speech, esthetics, and other domains were slightly higher with D-CD but did not reach statistical significance (p > 0.05). Additionally, the D-CD required fewer post-insertion adjustment visits than the C-CD (p < 0.05). By the end of the trial, 28 patients (70%) preferred the digital denture as their final prosthesis, whereas 12 patients (30%) preferred the conventional denture. Conclusions: Incorporating digital technology in the fabrication of complete dentures significantly enhances patient satisfaction compared to conventional methods. This study highlights the clinical relevance of modern dental prosthesis technology and supports the wider integration of digital workflows. Within the limitations of this pilot study, digitally fabricated complete dentures provided overall patient satisfaction comparable to conventional dentures, with the D-CD offering a notable improvement in comfort. The majority of patients ultimately favored the digital denture, supporting the clinical viability of CAD/CAM workflows. Full article

The development of high-impact denture base formulations that are suitable for digital light processing (DLP) 3D printing is demanding. Indeed, a combination of high flexural strength/modulus and high fracture toughness is required. In this contribution, eight urethane macromonomers (UMs1-8) were synthesized in a one-pot, two-step procedure. Several rigid diols were first reacted with two equivalents of trimethylhexamethylene diisocyanate. The resulting diisocyanates were subsequently end-capped with a free-radically polymerizable monomer bearing a hydroxy group. UMs1-8 were combined with the monofunctional monomer (octahydro-4,7-methano-1H-indenyl)methyl acrylate and a poly(ε-caprolactone)-polydimethylsiloxane-poly(ε-caprolactone) (PCL-PDMS-PCL) triblock copolymer (BCP1) as a toughening agent. The double-bond conversion, glass transition temperature (T_g), and mechanical properties (flexural strength/modulus, fracture toughness) of corresponding light-cured materials were measured (cured in a mold using a light-curing unit). The results showed that the incorporation of BCP1 was highly efficient at significantly increasing the fracture toughness, as long as the obtained networks exhibited a low crosslink density. The structure of the urethane macromonomer (nature of the rigid group in the spacer; nature and number of polymerizable groups) was demonstrated to be crucial to reach the desired properties (balance between flexural strength/modulus and fracture toughness). Amongst the evaluated macromonomers, UM1 and UM2 were particularly promising. By correctly adjusting the BCP1 content, light-cured formulations based on those two urethane dimethacrylates were able to fulfill ISO20795-1:2013 standard requirements regarding high-impact materials. These formulations are therefore suitable for the development of 3D printable high-impact denture bases. Full article

Background/Objectives: Recently, a novel magnetic attachment system was introduced to improve performance. Using the same technology, a new ultra-thin magnetic attachment (UTMA) was possible to produce. This study aimed to evaluate the feasibility of a magnet-retained telescopic partial denture (MTPD) utilizing the new UTMA. Methods: This in vitro study was performed using a titanium master model representing prepared lower first-premolar and second-molar abutment teeth. The inner crowns (ICs) (h: 4 mm, 4° taper) and four-unit MTPDs were fabricated via computer-aided design/computer-aided manufacturing (CAD/CAM) using zirconia. A Ø4 mm UTMA system (magnet assembly and keeper thickness: 0.6 mm and 0.4 mm, respectively) was cemented into the MTPD and the ICs using dual-cure resin cement. A load of 100 N was applied along with 10,000 insertion–removal cycles. The MTPD retentive force was measured before and after every set of 1000 cycles. Stability tests and surface morphology evaluations were conducted before and after cycling. A paired t-test (α = 0.05) was used to observe statistical differences. Results: The average retentive force of the MTPD was 6.86 ± 0.63 N and did not change significantly (p > 0.05) following the load cycles (6.66 ± 0.79 N). The MTPD demonstrated adequate stability under the occlusal load. Minimal deformations were observed on the magnet assemblies, keepers, ICs, and MTPD surfaces after the load tests. Conclusions: Considering the limitations of this study, an MTPD utilizing novel UTMAs fabricated through a digital workflow demonstrated adequate retentive force, stability, and durability for clinical use. Full article

Background and Objectives: Complete dentures remain a primary solution for oral rehabilitation in aging and medically compromised populations. The integration of digital workflows, regenerative materials, and smart technologies is propelling prosthodontics towards a new era, transcending the limitations of traditional static prostheses. Materials and Methods: This narrative review synthesizes historical developments, current practices, and future innovations in complete denture therapy. A comprehensive review of literature from PubMed, Scopus, and Web of Science (2000–2025) was conducted, with a focus on materials science, digital design, patient-centered care, artificial intelligence (AI), and sustainable fabrication. Results: Innovations in the field include high-performance polymers, CAD–CAM systems, digital impressions, smart sensors, and bioactive liners. Recent trends in the field include the development of self-monitoring prostheses, artificial intelligence (AI)-driven design platforms, and bioprinted regenerative bases. These advances have been shown to enhance customization, durability, hygiene, and patient satisfaction. However, challenges persist in terms of accessibility, clinician training, regulatory validation, and ethical integration of digital data. Conclusions: The field of complete denture therapy is undergoing a transition toward a new paradigm of prosthetics that are personalized, intelligent, and sustainable. To ensure the integration of these technologies into standard care, ongoing interdisciplinary research, clinical validation, and equitable implementation are imperative. Full article

Objectives: To examine the effects of surface treatments on the color stability, surface roughness, surface gloss, and wettability of monolithic polychromatic material jetting (MJT) 3D-printed denture material. Material and Methods: Twenty-one color variants of the same denture material (TrueDent; Stratasys, Eden, MN, USA) underwent two surface treatments (polishing only or polishing and glazing), creating 42 study groups with a total of 420 samples (n = 10 per group). The samples were manufactured using a PolyJet 3D printer (J5 DentaJet; Stratasys, Eden, MN, USA), a type of MJT 3D printer. Color measurements were taken with a digital spectrophotometer before and after the surface treatments, and quantitative color differences (ΔE₀₀ and ΔC*) were calculated using the CIE2000 system. Comparisons of ΔE₀₀ were made against the 50%:50% acceptability threshold (AT) of 1.8 and the 50%:50% perceptibility threshold (PT) of 0.8 for tooth shade, as well as the 50%:50% PT of 1.72 and the 50%:50% AT of 4.08 for gingival (pink) shade. After surface treatment, the gloss was measured using a glossmeter, surface roughness was measured with optical profilometry, and wettability was measured by contact angle measurements using an optical tensiometer. The significance of surface treatment on color changes for each color variant was evaluated using one-sided, one-sample t-tests against the AT and PT. The effects of surface treatment on surface gloss, surface roughness, contact angle, and ΔC* were analyzed using t-tests for each color variant. Pairwise comparisons between groups were made using Fisher’s Protected Least Significant Differences (α = 0.05). Results: In most cases, glazing caused the color change (ΔE₀₀) to exceed the AT and PT, with a few exceptions. Most materials exhibited a more vibrant (more saturated) appearance and statistically higher chroma, with glazed surface treatments compared to polished ones, though there were some exceptions. For all materials, the glazed samples had significantly higher gloss units than the polished ones (p < 0.0001). Additionally, all materials showed significantly higher surface roughness in glazed samples compared to polished ones (p < 0.0001 for most). The polished samples had significantly higher contact angles (p < 0.0001 for most). Conclusions: Surface treatments significantly influenced the color, surface gloss, surface roughness, and wettability of MJT 3D-printed denture materials. Glazing led to increased chroma and gloss and produced more hydrophilic surfaces, although it also increased surface roughness. These results highlight the importance of surface treatment selection in optimizing the clinical performance of MJT-fabricated dentures. Full article

The use of 3D printing in the fabrication of immediate prosthetic restorations requires the possibility of sterilization. This study aimed to evaluate the effects of different sterilization methods on the parameters of 3D-printing materials for dental prosthesis plates compared to conventional acrylic material. Forty-four samples were prepared for each tested material: Denture 3D+ (NextDent, The Netherlands), Denturetec (Saremco, Switzerland), Optiprint Laviva (Dentona, Germany), and Rapid Simplified (Vertex Dental, Netherlands). The impact strength of the samples was tested in a HIT 5.5P instrument (Zwick Roell, Germany) after three sterilization methods (pressurized steam, ethylene oxide, and radiation) and without sterilization as a control group. Significantly higher energy and impact strength were recorded for the conventional acrylic material. For Nextdent material, the recommended method of sterilization in terms of impaction is autoclave or ethylene oxide sterilization, Saremco—ethylene oxide sterilization, and Denton—ethylene oxide or radiation sterilization. Conventional acrylic material has a higher impact strength than 3D-printed material, which may encourage the selection of this material for restorations requiring higher fracture strength. The possibility of sterilizing the Nextdent 3D-printed material in the autoclave without worsening its durability makes it a recommended choice for digital clinical practice. Full article

Objectives: This study evaluated the dental and alveolar bone stress distribution of a mandibular Kennedy Class I restored with a bilateral implant-assisted removable partial denture (IARPD) compared with a conventional removable partial denture (CRPD) through the application of finite element analysis (FEA). Methods: Kennedy Class I plaster models were made, including teeth from the lower left first premolar and lower right canine. The models were scanned, resin-based replicated and digitized. Using Solidworks software, internal hexagonal implants (10 mm × 4 mm) were virtually placed at the level of the first molars. Each model was grouped into a unit, and a load of 200 N was applied, simulating masticatory forces. Von Mises stress distributions were calculated via FEA for the vertical, diagonal and combined forces. Results: In the IARPD, the stress generated in the alveolar bone by the vertical (4.2 Mpa), diagonal (12.2 MPa) and combined forces (12.3 MPa) was lower than that of the CRPD (7 MPa, 26.3 MPa and 32 MPa, respectively). Similarly, at the lower central incisor, the IARPD generated less stress than the CRPD due to the action of the vertical, diagonal and combined forces. Conclusions: Our preliminary data suggest that bilateral implant placement may result in less stress on bone and teeth during rehabilitation with a Kennedy Class I IARPD, with different orientations of the forces applied. Full article

Background: Digital impression techniques for edentulous patients present unique challenges due to the absence of stable anatomical landmarks and variable soft tissue morphology. While intraoral scanners have shown promising results in dentate patients, their application in edentulous cases remains problematic, with reported accuracy deviations ranging from 60.6 ± 11.9 μm to 67.2 ± 6.9 μm compared to conventional methods. Material and Methods: This pilot study employed a within-subject, repeated-measures design comparing four scanning protocols in a fully edentulous patient (age: 42, BMI: 24.3 kg/m², Cawood and Howell Class III). Digital scans were performed using iTero Element 5D and Trios 5 scanners (n = 10 scans per group), with and without a modified technique incorporating standardized reference points (1 mm diameter, 5 mm intervals) and systematic soft tissue management. A conventional impression-derived digital model served as the reference standard. Accuracy assessment utilized best-fit alignment and root mean square (RMS) calculations through Geomagic Control X software (version 2020.1.1). Results: The modified technique demonstrated significantly improved accuracy (Groups C/D: 57.8–59.7 μm) compared to standard protocols (Groups A/B: 66.9–68.2 μm) (p < 0.001). Mean scanning times were reduced by 37% with the modified technique (2:10 ± 0:09 min vs. 3:24 ± 0:15 min). Inter-operator reliability showed excellent agreement (ICC = 0.92, 95% CI: 0.88–0.95). Soft tissue management significantly improved vestibular area accuracy (48.7 ± 6.3 μm vs. 72.4 ± 8.9 μm, p < 0.001). Conclusions: The proposed scanning strategy incorporating reference points and systematic soft tissue management significantly improved both accuracy and efficiency in digital impressions of edentulous arches. The technique showed excellent reproducibility and potential clinical applicability across different scanner systems. These findings warrant validation through larger-scale clinical trials to establish definitive protocols for digital impression-taking in edentulous patients. Full article

Background: Mucostatic impressions have been always indicated in thin, sharp, or flabby ridges, and have been addressed for their beneficial effect on long-term residual ridge stability. Nonetheless, a purely mucostatic impression was not possible until intraoral scans became available. This provides an option for digital removable denture which is biologically sensible but might reduce retention in comparison with a mucocompressive impression with border molding. On the other hand, pressure applied to the mucosa may have harmful effects on the long-term residual ridge stability, causing higher resorption and ultimately reduced denture retention. Hence, the possibility to merge mucostatics and mucocompressive philosophies would be a clinically and biologically sensible option for oral rehabilitation in aging populations where patients will potentially wear dentures for longer periods. This possibility is demonstrated in this technical report with a cast-free digital workflow. Technique: Baseplates for occlusion rims, closely adapted to the mucosa, were designed on intraoral scans of edentulous arches and, once 3D-printed, used to register maxillomandibular relations and information for tooth arrangement, as well as to perform border molding. Occlusion rims were then scanned and, within the 3Shape Dental System 2024 software program, the intaglio surfaces of their baseplates were segmented and inverted to obtain the digital master casts which incorporated the precise reproduction of the molded borders. Then, denture design was performed and manufactured; no limitations regarding manufacturing options are applicable to the presented technique. Conclusions: The potential benefits (i.e., improved retention in the initial period after denture delivery and the preservation of tissues) of the presented digital cast-free workflow, based on merging mucostatic and mucocompressive philosophies to obtain dentures with a mucostatic intaglio surface and functional borders, are sensible clinical outcomes which recommend the clinical application of the technique, although further validation, especially in the long term, is required. Full article