Search Results (74)

Background/Objectives: The increasing demand for aesthetics in dentistry has driven significant advancements in both materials and techniques. The primary cause of ceramic detachment in dental restorations is extensive mechanical stress, which often results in detachment and clinical complications. This study aims to improve the bond strength between NiCr-based metal frameworks and ceramic coatings by introducing biocompatible inorganic MeSiON thin films (Me = Cr or Zr) as interlayers. Methods: MeSiON coatings with a thickness of ~2 μm were deposited on NiCr alloy using cathodic arc evaporation. To tailor the stoichiometry, morphology, and mechanical properties of the coatings, the substrate bias voltage was varied: −50 V, −100 V, −150 V, −200 V. Structural and surface characterization was performed using SEM/EDS, XRD, profilometry, and contact angle analysis. The coating adhesion was evaluated by using standardized scratch testing, while the bond strength was evaluated using a three-point bending test. Results: The NiCr alloy exhibited a dendritic microstructure, and the ceramic layer consisted mainly of quartz, feldspar, kaolin, and ZrO₂. ZrSiON coatings showed superior roughness, elemental incorporation, and adhesion compared to Cr-based coatings, these properties being further improved by increasing the substrate bias. The highest bond strength was achieved with a ZrSiON coating deposited at −200 V, a result we attributed to increased surface roughness and mechanical interlocking at the ceramic-metal interface. Conclusions: CrSiON and ZrSiON interlayers enhanced ceramic-to-metal adhesion in NiCr-based dental restorations. The enhancement in bond strength is primarily ascribed to substrate bias-induced modifications in the coating’s stoichiometry, roughness, and adhesion. Full article

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

Total Hip Arthroplasty (THA) is a widely used surgical procedure to restore mobility and reduce pain in patients with hip joint disorders. Implant success and longevity are influenced by the selection of appropriate materials. This study presents a comprehensive literature review based on structured searches in Scopus and Web of Science, focusing on material selection criteria and methods in THA. The inclusion criteria targeted original studies and reviews addressing material properties, selection techniques, and clinical performance. A bibliometric analysis and keyword co-occurrence network were used to highlight major research themes. The review examines traditional materials such as Metal-on-Polyethylene (MoP), as well as advanced options like ceramics, composites, and Functionally Graded Materials (FGMs). Key challenges discussed include aseptic loosening, wear resistance, and stress shielding. Selection methodologies such as Multi-Criteria Decision-Making (MCDM), Weighted Properties Methods (WPM), and computational tools like Ashby charts and CES Selector are analyzed. The findings from international arthroplasty registries show that more than half of implant failures are linked to material-related factors. This study therefore aims to guide material selection processes in THA by aligning clinical performance with biomechanical and biological requirements, supporting improved implant outcomes and long-term surgical success. Future developments should focus on patient-specific solutions and continuous innovation. Full article

The rapid advancement of materials science has revolutionized total hip arthroplasty (THA), a critical orthopedic procedure aimed at restoring mobility and improving patient quality of life. This review investigates the evolution of biomaterials used in THA, analyzing their mechanical, biological, and chemical properties. The study outlines the transition from early natural materials to modern metals, polymers, and ceramics, highlighting their benefits and limitations in clinical applications. Particular emphasis is placed on the development of advanced materials such as highly cross-linked polyethylene (HXLPE), zirconia-toughened alumina (ZTA), and tantalum alloys (Ta), which demonstrate enhanced biocompatibility, wear resistance, and longevity. By examining emerging trends, including bioactive coatings and nanotechnology, this paper aims to provide a comprehensive understanding of current challenges and future directions in material selection for hip prostheses, ultimately aiming to minimize annual revision rates and improve long-term outcomes. Full article

Zirconia restorations are widely used in dentistry due to their high esthetic expectations and physical durability. However, zirconia’s opaque white color can compromise esthetics. Therefore, zirconia is often veneered with porcelain, but fractures may occur in the veneer layer. Monolithic zirconia restorations, which do not require porcelain veneering and offer higher translucency, have been developed to address this issue. Zirconia exists in three main crystal phases: monoclinic, tetragonal, and cubic. Metal oxides such as yttrium are added to stabilize the tetragonal phase at room temperature. 3Y-TZP contains 3 mol% yttrium and provides high mechanical strength but has poor optical properties. Recently, 4Y-PSZ and 5Y-PSZ ceramics, which offer better optical properties but lower mechanical strength, have been introduced. This review examines the factors affecting the color change in monolithic zirconia ceramics. These factors are categorized into six main groups: cement type and color, restoration thickness, substrate color, sintering, aging, and zirconia type. Cement type and color are crucial in determining the final shade, especially in thin restorations. Increased restoration thickness reduces the influence of the substrate color while the sintering temperature and process improve optical properties. These findings emphasize the importance of material selection and application processes in ensuring esthetic harmony in zirconia restorations. This review aims to bridge gaps in the literature by providing valuable insights that guide clinicians in selecting and applying zirconia materials to meet both esthetic and functional requirements in restorative dentistry. Full article

Objectives: Among modern metal-free materials, zirconia, a high-performance ceramic material that can only be manufactured through CAM procedures, has certainly exponentially gained popularity thanks to its mechanical strength, biocompatibility, esthetic, and versatility. However, one of the main debates that has been raised in relation to zirconia is its usage as an adhesive material. The present case report describes the clinical outcome of a multidisciplinary case finalized with adhesive minimally invasive zirconia veneers for the treatment of discolored teeth after a 24-month follow-up. Methods: A 19-year-old female patient with discolored upper frontal teeth (first premolar to first premolar) negatively affecting her self-esteem and social life was visited by a prosthodontic specialist. The treatment plan included orthodontic treatment, soft and hard tissue management through surgical procedures, and, lastly, minimally invasive adhesive zirconia veneers. The zirconia veneers bonding was performed under a rubber dam by conditioning the dental substrate by sandblasting the enamel with 40-micron aluminum oxide, etching with orthophosphoric acid 37%, and using a proper adhesive system. Monolithic zirconia restorations were sandblasted with 70-micron aluminum oxide at 0.2 MPa, then cleaned with a specific cleaner, and treated with a primer. Results: At the last follow-up (24 months), neither biological nor mechanical complications were observed. The patient anecdotally reported being very satisfied with the functional and esthetic results obtained. Therefore, the case was considered successful. Conclusions: Within the limitations of the present case report, the reported case on the use of minimally invasive resin-bonded zirconia veneers for the treatment of discolored teeth showed excellent outcomes after a 24-month follow-up. The use of zirconia as an adhesive material seems to be emerging. However, more clinical studies are required to validate the procedure. Full article

FRCs (Fiber-Reinforced Composites) are materials that are being used increasingly more often in dentistry as an alternative to traditional restorations made of ceramics or metals. The aim of this study was to carry out a comparative analysis of the strength parameters of a light-curable dental composite reinforced with one single band and two single bands of artificial fibers. The specimens for the strength tests were prepared in accordance with the guidelines of the PN-EN ISO 4049:2019-07 international standard. The test material covered specimens of composite reinforced with single (one or two) bands of fibers. The following bands of fibers were used: carbon (WGL), aramid (AMD) and hybrid carbon–aramid (WGL-AMD). The presence of one single band of aramid fibers caused a three-fold increase in deflection, with a simultaneous increase in the Young’s modulus of over 140%. The flexural strength of specimens reinforced with one single band of aramid fibers was higher by 280% than that control group specimens (KONT). To summarize the performed tests, the incorporation of carbon, aramid and hybrid carbon–aramid fibers into organic matrix has a significant impact on the values of the mechanical parameters of dental composites. The results indicate that particular attention should be paid to aramid fibers, which have rarely been used in dentistry so far. Full article

Choosing an appropriate prosthetic material for the superstructure of an implant-supported or tooth-implant supported fixed partial denture (FPD) is crucial for the success of the prostheses. The objective of this study was to examine the effect of prosthetic material type and tooth-to-implant support on stress distribution of FPDs using three-dimensional finite element analysis (3D FEA). Two FEA models were generated, distinguished by their support configurations: Model I representing an FPD supported by implants, and Model II depicting an FPD supported by both a tooth and an implant. Two different restorative materials, porcelain-fused-to-metal (PFM) and monolithic zirconia, were evaluated for stress distribution under axial and oblique loads of 300 N applied to the pontic. Under both axial and oblique loading conditions, the maximum von Mises stress values were observed to be higher in the implant-abutment complex of both zirconia implant-supported and tooth-implant-supported FPDs compared to PFM FPDs. In the case of axial loading, comparable stress values were found in the cortical bone for PFM (12.65 MPa) and zirconia implant-supported FPDs (12.71 MPa). The zirconia tooth-implant-supported FPD exhibited the highest stress values in the implant-abutment system. Full article

Reconstructive and regenerative medicine are critical disciplines dedicated to restoring tissues and organs affected by injury, disease, or congenital anomalies. These fields rely on biomaterials like synthetic polymers, metals, ceramics, and biological tissues to create substitutes that integrate seamlessly with the body. Personalized implants and prosthetics, designed using advanced imaging and computer-assisted techniques, ensure optimal functionality and fit. Regenerative medicine focuses on stimulating natural healing mechanisms through cellular therapies and biomaterial scaffolds, enhancing tissue regeneration. In bone repair, addressing defects requires advanced solutions such as bone grafts, essential in medical and dental practices worldwide. Bovine bone scaffolds offer advantages over autogenous grafts, reducing surgical risks and costs. Incorporating antimicrobial properties into bone substitutes, particularly with metals like zinc, copper, and silver, shows promise in preventing infections associated with graft procedures. Silver nanoparticles exhibit robust antimicrobial efficacy, while zinc nanoparticles aid in infection prevention and support bone healing; 3D printing technology facilitates the production of customized implants and scaffolds, revolutionizing treatment approaches across medical disciplines. In this review, we discuss the primary biomaterials and their association with antimicrobial agents. Full article

Fracture resistance is an important parameter used to predict the performance of indirect dental restorations. The purpose of this in vitro study was to assess the fracture load of posterior milled nanoceramic crowns, in comparison with the lithium disilicate crowns, after fatigue loading, for two different restoration occlusal thicknesses. Forty test metal dies were fabricated by duplicating a master metal model consisting of an anatomic abutment preparation of the maxillary first premolar for a single crown. The dies were divided into two groups of 20 each for the fabrication of nanoceramic (Lava Ultimate) and lithium disilicate (IPS e.max CAD) single crowns. Each material group was further divided into two sub-groups of 10 dies each, based on crown occlusal thickness, of 0.5-mm and 0.75-mm (n = 10). Dental Type V stone dies poured from polyvinyl siloxane impressions of the test metal dies were laboratory scanned in order to design and mill 40 ceramic crowns. The crowns were cemented on to the test metal dies with a self-adhesive resin luting cement. All crowns were thermocycled (2500 cycles) and mechanically loaded (250,000 cycles) in a chewing simulator followed by static loading until failure, and the values noted. The data were statistically analyzed by 2-way ANOVA and Tukey HSD post-hoc multiple comparison tests (α = 0.05). The mean fracture loads ranged from 1022 to 1322 N for nanoceramic crowns and from 1145 to 1441 N for the lithium disilicate crowns. Two-way ANOVA revealed insignificant differences between the nanoceramic and lithium disilicate crowns (p > 0.05) in terms of fracture load. Significant differences were noted in the fracture resistance of crowns based on occlusal thickness (303 N; p = 0.013) regardless of the material used. Multiple comparisons by Tukey HSD post-hoc test showed insignificant differences between the four material-occlusal thickness groups (p > 0.05). The nanoceramic crowns were found to be comparable with lithium disilicate crowns in terms of fracture load. The mean fracture loads of all of the tested crowns were within the normal physiological masticatory load limits. Based on the fracture-resistance results, nanoceramic crowns seem to be suitable for clinical use for the tested occlusal thicknesses. Full article

Background/Objectives: This research investigates the nuanced factors influencing peri-implant bone resorption in implant-supported fixed prostheses, with a focus on age, gender, implant location, time since prosthetic loading, and material characteristics. Methods: Records from a dental clinic in Oradea, Romania, between 1 January 2017 and 1 January 2023, were scrutinized and were selected by means of purposive sampling. All records were analyzed between 1 May 2023 and 15 June 2023. A total of 160 implants were included, and the prosthetic restorations were either metal-ceramic or zirconia. Implants from a single manufacturer were used, and a standardized loading protocol was followed. The study examined variables such as age, gender, implant location, prosthetic material, and time since prosthetic loading. Results: A total of 160 implants were included, with 78 applied to female patients (48.8%) and 82 to male patients (51.2%). The age range of the patients undergoing dental implant procedures was 30 to 79 years. Implants were distributed between the mandible (51.2%) and maxilla (48.8%), with 49.4% placed in the posterior dental arches and 50.6% in the anterior dental arches. The majority of patients received metal-ceramic prosthetic reconstructions (76.9%). Statistical analysis revealed significant differences in resorption patterns between zirconia and metal-ceramic restorations (p < 0.001), with zirconia restorations exhibiting higher resorption in the mesial-vertical and distal-vertical planes compared to metal-ceramic restorations. Age-related factors showed a significant association with distal-vertical resorption (p = 0.017), with patients aged 60–69 years exhibiting higher resorption values compared to those aged 40–49 years. Gender differences were observed in mesial-horizontal resorption (p = 0.036), with male patients displaying higher resorption values compared to female patients. Implant location and time elapsed since implant loading did not show significant associations with resorption patterns. Conclusions: The study provides insights into the multifactorial nature of peri-implant resorption. Age, gender, and material characteristics contribute to variations, informing personalized treatment approaches. The findings facilitate a comprehensive understanding for clinicians, enhancing treatment planning and post-operative care. Full article

Ensuring a secure bond between a framework structure and layering composite resin veneer is essential for a long-lasting dental restoration. A variety of primer systems are available to facilitate the adhesive bonding. Nevertheless, the growing preference for efficiency and simplicity in dentistry has made the one-bottle universal primers a desirable option. This study aims to compare the effectiveness of universal primers on the shear bond strength (SBS) of base metal alloy (BMA) and zirconia to layering composite resin. Each 160 BMA and zirconia 20 × 10 × 5 mm test specimen was fabricated. Eight different primers (SunCera Metal Primer, Metal Primer Z, Reliance Metal Primer, Alloy Primer, MKZ Primer, Monobond Plus, ArtPrime Plus, and Clearfil Ceramic Primer Plus) were applied to 20 specimens in each group. Subsequently, a 5 × 2 mm composite resin build-up was applied. SBS tests were performed after 24 h of water storage and after thermocycling (25,000 cycles, 5–55 °C). On BMA, after water storage for 24 h, the bond strength values ranged from 26.53 ± 3.28 MPa (Metal Primer Z) to 29.72 ± 2.00 MPa (MKZ Primer), while after thermocycling, bond strength values ranged from 25.19 ± 1.73 MPa (MKZ Primer) to 27.69 ± 2.37 MPa (Clearfil Ceramic Primer Plus). On a zirconia base, after 24 h, the bond strengths values ranged from 22.63 ± 2.28 MPa (Reliance Primer) to 29.96 ± 2.37 MPa (MKZ Primer) and from 23.77 ± 3.86 MPa (Metal Primer Z) to 28.88 ± 3.09 MPa (Monobond Plus) after thermocycling. While no significant difference in bond strength was found between the primers on the BMA base, five primer combinations differed significantly from each other on zirconia (p = 0.002–0.043). All primers achieved a bond strength greater than 23 MPa on both framework materials after thermocycling. Thus, all primers tested can be applied to both framework materials with comparable results. Full article

Ceramic thickness and technicians’ manipulative variables are critical factors affecting the resultant shade of dental ceramo-metallic restorations. This study investigated the effect of the following variables on shade duplication of ceramo-metallic specimens: (a) ceramic thickness; (b) differences between several technicians (inter-technician variability); and (c) the ability of each technician to repeat the resultant shade (intra-technician variability). Ninety ceramo-metallic specimens were prepared and divided into three main groups (n = 30/gp) according to the different technicians who built up the veneering ceramic of the specimens. Each group was further subdivided into three subgroups (n = 10/subgroup) according to the thickness of the ceramic (1, 1.5, and 2 mm built over a 0.5 mm-thick metal substructure). Three different technicians were asked to follow the same protocol as regards the same ceramic batch (Shade 3M2, Vita VM13, Zahnfabrik, Germany), firing temperature, and number of firing cycles. Meanwhile, each technician followed his own protocol with regard to other ceramic manipulative variables. The duplicated shades of the specimens were investigated using the Vita Easyshade spectrophotometer by using the verify shade mode. Color difference (∆E) values were calculated between the target shade (3M2) and the duplicated shades of the specimens automatically by the Vita Easyshade spectrophotometer (Vita, Zahnfabrik, Germany). The effect of ceramic thickness and inter- and intra-technician variability on the duplication of the target shade was investigated. The results showed that the effect of ceramic thickness on the duplicated shades depended on inter-technician variability. High inter-technician variability (∆E = 2–6.4) was noticed in contrast to low intra-technician variability (∆E = 0.2–1.5). It could be concluded that proper shade-duplication of ceramo-metallic restoration was a cumulative technique intimately related to manipulative variables and ceramic thickness. Full article

Dental healthcare plays an important role in the overall health of individuals, and the sector is rapidly growing around the world due to increases in population, healthcare facilities, and improved access for economically weaker sections of society. Dental procedures and oral care generate a significant amount of biomedical waste that should be managed in an environmentally safe and sustainable manner. An overview is presented of the current status of dental solid waste management with a focus on waste composition from traditional and emerging dental treatments, new-generation dental materials, waste treatment procedures, and current options. Dental waste can be broadly divided into three categories: infectious waste, non-infectious waste, and domestic-type waste. Infectious waste contains materials contaminated with blood or other infectious mouth fluids, amalgam, and sharps, whereas non-infectious dental waste is devoid of human fluid contamination but can be potentially toxic due to the presence of amalgams, acids, metal dust, resins, etc. Suspended particulates in dental wastewater are another likely source of contamination. Appropriate segregation of this waste is essential for containing infections during waste processing. New-generation dental materials, such as nanomaterials, resin-based composites, and ceramics, are finding increasing applications in a variety of dental procedures as antimicrobial, restorative, and therapeutic agents. While incineration and landfilling have been used for processing traditional dental waste, the presence of novel materials in dental waste raises several additional concerns. Novel single/multistage recycling approaches need to be developed for dental waste towards resource recovery, thus minimizing incineration and landfilling to the extent possible. Full article

Wirobond^® C is a commercial dental casting alloy suitable for the fabrication of crowns, bridges, and metal ceramic restorations. This study aims to investigate the effect of ready-to-use Listerine^® and Meridol^® mouthwashes and sodium fluoride on the resistance of CoCrMo dental alloys to electrochemical corrosion in artificial saliva at 37 °C. SEM, EDS, SKP, and microhardness investigations were carried out to characterize the material under study. The in vitro corrosion resistance of the CoCrMo alloy was conducted using the open-circuit potential method, electrochemical impedance spectroscopy, and anodic polarization curves. The presence of Co 59.8(8) wt.%, Cr 31.5(4) wt.%, and Mo 8.8(6) wt.% was confirmed. The CoCrMo alloy was characterized by a Vickers microhardness value of 445(31) µHV_0.3. Based on the EIS data, the capacitive behavior and high corrosion resistance of the CoCrMo alloy were revealed. The kinetics of pitting corrosion in the artificial saliva were lower after being modified with NaF, Listerine^®, and Meridol^® mouthwashes. The potentiodynamic characteristics revealed the passive behavior of the CoCrMo alloy in all solutions. Based on the SKP measurements of the CoCrMo alloy after corrosion tests, the effect of artificial saliva modification on the electronic properties of Bego Wirobond^® C dental alloy was found. Full article