Search Results (1,137)

Background: The aim of this in vitro study was to examine the effect of the sterilization process on two different two-piece intra-oral scan bodies (ISBs) using three-dimensional (3D) analysis. Methods: Two identical 3D-printed models with three analogs in positions #12, #13, and 14# were used: two-piece titanium (Ti-Ti) and two-piece poly-ether-ether-ketone (PEEK) and Ti (PEEK-Ti) ISBs. Each model was scanned once before sterilization. A laboratory scanner (LBS) produced a reference stereolithography (STL) file, followed by 30 scans with an intra-oral scanner (IOS), producing 30 STL files. Both ISBs underwent three cycles of sterilization followed by thirty scans using an IOS, producing another 30 STL files. Each STL file was superimposed on the LBS reference STL file using 3D analyzing software, and the following parameters were calculated: inter-implant distance, intra-implant distance, inter-implant angle, and intra-implant angle. The Kolmogorov–Smirnov test indicated non-normal distribution; therefore, Wilcoxon signed-rank tests and Mann–Whitney tests were performed (p < 0.05). Results: Within groups, after sterilization, the mean errors of the Ti-Ti ISB were significantly increased regarding inter-implant distance 12_13 (p < 0.05), intra-implant distance 14 (p = 0.0005), inter-implant angle 12_13 (p = 0.0005), inter-implant angle 13_14 (p = 0.001), intra-implant angle 13 (p = 0.005), and intra-implant angle 14 (p < 0.05). Within groups, after sterilization, the mean errors of the PEEK-Ti ISB were significantly increased regarding inter-implant distance 12_13, 13_14, and 12_14 (p = 0.0005), intra-implant distance 12 (p < 0.05), intra-implant distance 13 and 14 (p = 0.0005), inter-implant angle 12_13 (p = 0.0005), and inter-implant angle 13_14 (p = 0.005). Between groups, after sterilization, the mean errors for the PEEK-Ti ISB were significantly higher (p < 0.0005) regarding all parameters compared to the Ti-Ti ISB. Conclusions: Both PEEK-Ti and Ti-Ti ISBs showed significant changes in most parameters after three cycles of sterilization, with the PEEK-Ti ISB exhibiting greater changes compared to the Ti-Ti ISB. Therefore, three cycles of sterilization affect axes and distances for both PEEK-Ti and Ti-Ti ISBs. Full article

Background and Clinical Significance: Implant rehabilitation of patients with acquired maxillofacial defects remains challenging, particularly following high-energy war-related trauma. Gunshot and mine blast injuries frequently result in extensive hard and soft tissue loss, often requiring complex reconstructive procedures. Although cortically anchored implants have been successfully used in patients with severe maxillary atrophy and selected traumatic defects, evidence supporting their use for the immediate rehabilitation of critical-size war-related maxillary defects remains limited. Cortically anchored single-piece implants used in conjunction with an immediate loading protocol may provide an alternative rehabilitation strategy for selected patients who decline, or are unsuitable for, conventional implants and bone-grafting procedures. Case Presentation: Two patients with critical-size maxillary defects (approximately 3 cm) resulting from gunshot and mine blast injuries are presented. Treatment consisted of extraction of non-restorable teeth, placement of cortically anchored single-piece implants, including tubero-pterygoid implants, followed by immediate loading with fixed hybrid metal–acrylic hybrid prostheses. Clinical and radiological evaluation was performed using panoramic radiography and cone-beam computed tomography. Conclusion: Successful implant-supported prosthetic rehabilitation was achieved in both patients. Cortically anchored implants engaging the basal bone of the maxilla provided stable support for immediately loaded fixed prostheses despite substantial hard and soft tissue loss. Functional and aesthetic outcomes were satisfactory. Immediate prosthetic rehabilitation was successfully completed in both patients. A 12-month clinical and radiographic follow-up was available for one patient and demonstrated stable implant function without biological or prosthetic complications. Long-term follow-up of the second patient was not available because of active military service. Cortically anchored implant-supported hybrid prostheses may represent a viable treatment option for selected patients with critical-size maxillary defects resulting from gunshot or mine blast injuries, enabling rapid restoration of oral function and facial aesthetics while avoiding extensive bone-grafting procedures. Full article

This narrative review aimed to summarize the contemporary evidence regarding the integration of periodontal and prosthodontic treatment. A narrative literature review was conducted using PubMed, Scopus, Web of Science, and Google Scholar, including studies published between January 1990 and May 2026. Relevant studies, systematic reviews, meta-analyses, consensus reports, and clinical guidelines published in English were analyzed. Current evidence highlights the importance of comprehensive periodontal assessment before prosthodontic treatment, including evaluation of probing depth, attachment loss, furcation involvement, tooth mobility, periodontal phenotype, and oral hygiene status. Appropriate periodontal preparation and supportive periodontal care contribute significantly to the long-term success of both tooth-supported and implant-supported restorations. Successful oral rehabilitation requires close interdisciplinary collaboration between periodontology and prosthodontics. Periodontal stability, patient compliance, and long-term maintenance remain key factors for predictable treatment outcomes. Full article

Contemporary patient-specific subperiosteal implants (SPIs) have re-emerged as digitally planned, additively manufactured solutions for oral and maxillofacial rehabilitation when conventional endosseous implants are limited by severe atrophy, anatomical constraints, or reconstructive defects. Unlike conventional implants, SPIs behave as fixation-based skeletal frameworks whose performance depends on passive fit, screw fixation, anchorage, framework architecture, material properties, manufacturing accuracy, and prosthetic load transfer. This scoping review evaluated the maturity of mechanical design and validation evidence for contemporary SPIs. Following a predefined internal protocol and PRISMA-ScR, MEDLINE/PubMed, Scopus, Web of Science, Embase, and the Cochrane Library were searched from inception to 13 June 2026. Reference-list screening and citation tracking supplemented the electronic search. Two reviewers independently screened records against predefined eligibility criteria. Data were charted using a predefined extraction form and synthesized descriptively by evidence type, engineering domain, validation stage, and translational status. No meta-analysis was undertaken because of methodological heterogeneity, and no formal risk-of-bias grading was applied. Across 65 included records, the evidence was dominated by descriptive technical studies and comparative computational analyses, whereas direct mechanical testing, fatigue assessment, manufacturing verification, and clinical correlation were limited. Finite element analysis was useful for comparing design alternatives and identifying stress concentrations, but models were heterogeneous and often insufficiently validated. Design modifications generally redistributed stress across the implant–prosthesis–bone system rather than reducing it globally. Titanium and Ti6Al4V were the most established framework materials, whereas polymeric, ceramic, and scaffold-assisted strategies remained preliminary. The principal contribution of this review is a cross-domain appraisal of progression from anatomical feasibility and comparative modeling to manufacturing verification, experimental testing, and clinical validation. An evidence map, minimum reporting checklist, and integrated validation pathway are provided to support reproducible device development. Full article

Tooth loss and bone resorption of the alveolar cavity caused by dental caries and periodontal disease remain major clinical challenges that compromise oral function. Tissue engineering approaches based on biocompatible scaffolds have emerged as promising strategies for bone regeneration; however, the influence of fabrication methods on scaffold performance remains unclear. This study developed hydroxyapatite/poly (lactic-coglycolic acid)/chitosan scaffolds (HAp/PLGA/CS) using freeze-drying and 3D-printing techniques and evaluated their physicochemical, biological, and biomechanical properties. The morphology, porosity, elemental composition, and mechanical properties of the scaffold were characterized, while the biocompatibility and osteogenic potential were evaluated using human dental pulp stem cells (hDPSCs). Finite element analysis (FEA) using COMSOL Multiphysics^® Version 6.2. was performed to evaluate scaffold behavior under simulated dental implant loading conditions. The 3D-printed scaffolds exhibited significantly higher cell viability than the freeze-dried scaffolds, reaching approximately 85% in the 50% filling group compared with 50% in the freeze-dried group. Microstructural analysis revealed interconnected hierarchical porosity, including macro-, micro-, and submicrometer scale pores. Although the 50% infill scaffold showed the highest cell viability, the 70% infill scaffold demonstrated the most favorable osteogenic profile, with enhanced expression of RUNX2 and OSX. Both types exhibited degradation profiles compatible with early bone regeneration. FEA simulations indicated that further mechanical optimization is required to improve load transfer and reduce deformation at the implant–scaffold interface. Overall, HAp/PLGA/CS scaffolds showed potential as experimental bioactive platforms for bone tissue engineering, with 3D-printed scaffolds providing greater architectural control and favorable early osteogenic responses. However, the translational relevance of these findings remains preliminary and requires validation through long-term degradation studies, in vivo bone regeneration and osseointegration models, cyclic mechanical testing, and implant fixation experiments. Full article

Bacterial biofilm formations on dental implant–bone borders risk the development of periimplantitis (PI). Treatment, ranging from conservative to invasive options, is effective but associated with significant patient burden. In vitro Photodynamic Inactivation (PDI) waveguided by zirconium dioxide ceramic (ZrO₂) dental implants shows promising bactericidal effects and is envisioned to function as an additive treatment reducing patient burden while maintaining therapy outcomes. To facilitate clinical application, this study mathematically quantified the expected waveguiding abilities of ZrO₂ implants in a computed tomography (CT)-based Monte Carlo Simulation of Radiation Transport (MCRT). The latter implemented previously photographically determined optical properties from human and porcine jawbone tissues. ZrO₂ implants displayed effective light propagation beyond the implant–bone border, with power-per-area values above a minimum baseline for effective PDI of 10 mW/cm², thus delivering enough light power to reach bactericidal levels in a standard PDI regimen. Modifying the implant design and light-source placement influenced the topographic distribution of the light power around the implant, eventually allowing to target case-specific changes in biofilm distribution. No major interspecies difference was observed, which fosters the transferability of potential mammal testing. All findings therefore support the envisioned application of waveguiding ZrO₂ dental implants in PDI to target oral health issues. Full article

People with diabetes often have a high rate of oral implant failure and unstable long-term treatment effects. It is urgent to find the potential mechanisms and effective cure methods to address the increasing demand for dental restoration in recent years. This paper aims to find an influential factor, and a probable treatment resulting from it, to improve poor osseointegration and achieve favorable bone regeneration. To find out the influential factor of poor diabetic osseointegration, we compared marginal bone loss among patients taking different hypoglycemic drugs. To verify our pre-clinical findings, we performed in vitro experiments as well as micro-CT, fluorescence intensity, and histopathological analysis methods after establishing a diabetic rat model controlled by different systemic hypoglycemic drugs. To enhance implant osseointegration and find out the underlying mechanism, we proposed the GelMA–alogliptin hydrogel system and tested the scratch wound healing, cell adhesion, CCK-8, live-dead cell staining, osteogenesis, qPCR, and Western blot methods based on diabetic rat-derived BMSCs, HUVECs and BMMS, as well as the in vivo experiments in diabetic rats. People with diabetes under DPP4i (alogliptin) exhibit the lowest marginal bone loss. The systemic alogliptin and locally delivered peri-implant GelMA–alogliptin hydrogel treatment promoted bone regeneration around diabetic implants, enhanced diabetic-derived BMSC activity and migration through GLP1R/GSK3β/β-catenin and induced osteogenic differentiation, and promoted vascular regeneration and inflammation control. Alogliptin has positive effects on the oral implant health of people with diabetes. A locally delivered GelMA–alogliptin hydrogel system exhibits competitive ability to improve diabetic bone microenvironment and enhance implant osseointegration. Full article

The oral cavity represents one of the most demanding operating environments for biomedical coatings, subjecting materials to constant masticatory shear and tribological stress, dynamic temperature fluctuations, salivary enzymatic activity, and continuous fluid turnover that collectively challenge coating adhesion, durability, and longevity. Thermosensitive hydrogels that undergo reversible sol–gel transitions near body temperature offer a uniquely versatile platform for in situ coating formation on complex oral surfaces, enabling minimally invasive application and conformal coverage of irregular anatomical structures—from periodontal pockets and root canal systems to extraction sockets and bone defects. This review examines the application of thermo-sensitive hydrogel coatings across six major oral disease categories: periodontitis, peri-implantitis, bone defects, endodontic diseases, extraction wounds, and oral cancer. We further discuss practical hurdles facing clinical translation, noting that sterilization often degrades these materials, mechanical properties may prove inadequate under masticatory loads, and long-term biosafety data remains limited. This review critically evaluates how these smart coatings can bridge the gap between laboratory innovation and clinical application, offering insights to guide the development of next-generation precision therapies for oral diseases. Full article

Peri-implantitis, a biofilm-driven inflammatory disease that causes progressive loss of the bone supporting dental implants, is common and difficult to treat: mechanical debridement cannot fully decontaminate the implant surface, and antibiotic adjuncts act non-selectively while promoting resistance. Antimicrobial peptides (AMPs) have emerged as a promising preventive strategy. As cationic, membrane-disrupting molecules they kill a broad spectrum of organisms with a low propensity to select for resistance, and as host-defense peptides they additionally modulate inflammation and promote epithelial and connective-tissue repair. This review examines AMP-functionalized titanium as a prospective strategy against peri-implantitis through a dermatological lens, drawing on the established roles of the cathelicidin LL-37 and the β-defensins in cutaneous and oral wound healing. We argue that the peri-implant transmucosal interface behaves as a healing epithelial barrier, so that a single class of host-defense peptides can address two goals usually pursued separately—suppressing the peri-implant biofilm and reinforcing the soft-tissue seal. Because peri-implant disease initiates at the transmucosal region, we give particular attention to the abutment or transmucosal collar as the primary sealing target, and we consider how the concept extends to zirconia and hybrid components. The evidence assembled here, however, is predominantly preclinical, derived from in vitro and animal studies, and does not yet demonstrate clinical prevention of peri-implantitis in patients. After surveying peri-implant epidemiology, microbiology, AMP biology, surface-engineering strategies, and the in vivo evidence, we appraise the translational barriers—stability, cytotoxicity, cost, regulation, and the absence of human trials—that remain. We conclude that biologically intelligent, multifunctional peptide coatings represent a rational direction for next-generation implant surfaces. Full article

Background: Coronary stenting remains the cornerstone of interventional cardiology. Drug-eluting stents (DES) have reduced restenosis compared to bare-metal stents (BMS), but their high cost and need for prolonged dual antiplatelet therapy (DAPT) limit accessibility in many regions. Recent evidence has revisited the potential role of systemic pharmacologic adjuncts—oral sirolimus (rapamycin), prednisone and colchicine—as cost-effective therapies to mitigate restenosis and adverse events following BMS implantation. Objective: This review critically evaluates the clinical and mechanistic evidence supporting the use of oral immunosuppressive or anti-inflammatory drugs following BMS implantation, with emphasis on their applicability in both resource-limited and general cardiology settings. Three randomized clinical trials comparing this strategy against DES are analyzed and discussed in this review. Conclusions: Oral sirolimus, prednisone, and colchicine demonstrate promising anti-inflammatory and antiproliferative effects that translate into clinical outcomes comparable to DES in a highly select population. Their systemic administration following BMS implantation may provide a feasible, cost-effective alternative where DES use is restricted by cost or clinical contraindications. Larger-scale, long-term trials are warranted to confirm safety, optimize dosing, and identify ideal patient populations for this “pharmacologic stent hybrid” strategy. Full article

Background/Objectives: Oral healthcare succeeds not only when treatment is biologically sound but when its outcome meets patient expectations, making expectation management a measurable component of care quality. Patient satisfaction in dental implant therapy is strongly influenced by pre-treatment expectations, yet differences between patient expectations and dentists’ perceptions of those expectations remain poorly characterized. This study compared the two using a mirror-design survey. Methods: A cross-sectional survey was administered to adult patients (n = 250) and dentists involved in implant therapy (n = 200). A 16-item questionnaire was developed in two parallel versions covering two domains, outcome expectations and surgical process apprehension, rated on a 5-point Likert scale. Internal consistency, item- and subscale-level differences, and signed and absolute between-group difference scores were analyzed. Results: Significant between-group differences were identified in 13 of the 16 items, while total scale scores did not differ between groups, producing a cancel-out effect at the aggregate level. Within the surgical process apprehension domain, patients were more optimistic than dentists perceived, with procedural pain showing the largest between-group difference (Cliff’s δ = 0.437). The opposite pattern emerged for long-term outcomes, where concern about implant loss yielded the largest difference across the entire instrument (δ = 0.645). Dentists’ clinical experience was negatively correlated with the signed total gap score (ρ = −0.342, p < 0.001), indicating reduced directional bias among more experienced clinicians. Conclusion: Patients’ expectations differed systematically from dentists’ perceptions of those expectations across both domains, but these opposing differences offset at the aggregate level. Aggregate summary scores may therefore obscure clinically relevant item-level differences, and directional item-level analyses may better capture expectation patterns in implant dentistry. Full article

Background: The aim of this study was to analyze the success of dental implants in patients with functional diversity by comparing success rates and marginal bone loss with those observed in patients without functional diversity, with both groups being subjected to a strict implant maintenance and hygiene protocol. Methods: A retrospective observational case–control study was designed. Two main study groups were established: one comprising patients with functional diversity (case group) and another including patients without functional diversity (control group), all of whom had received dental implants. Implant success rates were evaluated 12 months after prosthetic loading. Marginal bone loss was quantified according to the classification proposed by Lagervall and Jansson, later modified and validated by Corcuera-Flores et al. In addition, the Silness and Löe plaque index, presence of bruxism, implant characteristics, and rehabilitation techniques were recorded at each follow-up visit. Results: A total of 63 dental implants were placed in 20 patients included in the present study. The case group consisted of 9 patients who received 31 implants, whereas the control group comprised 11 patients who received 32 implants. No statistically significant differences were observed between groups in terms of implant success and MBL. Oral hygiene was assessed showed a statistically significant difference between groups (p = 0.001). Significant differences were also found regarding bruxism prevalence between groups, which was higher in the case group. Conclusions: The results obtained in the present study indicate that implant therapy in patients with functional diversity can achieve success rates comparable to those observed in patients without disabilities despite the higher prevalence of bruxism and a greater amount of dental plaque. These findings reinforce the importance of individualized treatment planning, adequate oral hygiene control, and periodic clinical follow-up in order to ensure long-term implant stability and peri-implant health. Full article

Background: Atrial fibrillation (AF) is a common but frequently undiagnosed cause of ischemic stroke, particularly among patients with cryptogenic stroke and embolic stroke of undetermined source (ESUS). Implantable cardiac monitors (ICMs) enable prolonged continuous rhythm monitoring and may improve AF detection following ischemic stroke or transient ischemic attack (TIA). This systematic review and meta-analysis aimed to evaluate the diagnostic yield, clinical impact, and safety of prolonged ICM monitoring in patients with ischemic stroke or TIA. Methods: This systematic review and meta-analysis was conducted in accordance with the PRISMA 2020 guidelines and registered with PROSPERO (CRD42024573913). PubMed, Google Scholar, and the Cochrane Library were systematically searched. Randomized controlled trials and observational studies evaluating the use of ICMs after ischemic stroke or TIA were included. Randomized evidence was synthesized narratively, whereas single-arm random-effects meta-analyses of observational studies were performed to estimate pooled proportions for AF detection, oral anticoagulation initiation, recurrent ischemic stroke or TIA, and device-related adverse events. Results: Twelve completed studies involving 4563 participants met the inclusion criteria, including two randomized controlled trials and ten observational studies. One additional ongoing randomized controlled trial (Find-AF 2) involving a planned enrollment of 5200 participants was identified and is described narratively. Across the observational studies, the pooled AF detection rate during prolonged ICM monitoring was 25.9% (95% CI, 18.9–33.5%), although substantial heterogeneity was observed (I² = 95%). Oral anticoagulation was initiated in 94.2% (95% CI, 79.4–100.0%) of patients diagnosed with AF. Device-related complications were uncommon, with a pooled incidence of 3.7% (95% CI, 2.0–6.0%; I² = 0%), while the pooled rate of recurrent ischemic stroke or TIA during follow-up was 6.2% (95% CI, 3.9–9.2%). Narrative synthesis of the randomized evidence demonstrated that ICMs significantly increased AF detection compared with conventional monitoring but did not demonstrate a significant reduction in recurrent stroke during the available follow-up period. Conclusions: Prolonged implantable cardiac monitoring identifies AF in approximately one-quarter of patients following ischemic stroke or TIA and frequently leads to the initiation of oral anticoagulation, with a favorable safety profile. Although ICMs substantially improve AF detection, current evidence remains insufficient to confirm that increased detection translates into a reduction in recurrent stroke. Large, adequately powered randomized controlled trials are needed to determine the long-term clinical benefits of ICM-guided management and to define the optimal monitoring strategy for patients following ischemic stroke. Full article

Background: To compare the short-term clinical and radiographic outcomes of electrolytic versus conventional mechanical implant surface decontamination during surgical treatment of peri-implantitis. Methods: This retrospective cohort study included 20 implants affected by peri-implantitis in 20 patients. Ten implants were treated using electrolytic implant surface decontamination, while 10 implants received conventional mechanical decontamination with titanium curettes, chitosan brushes, and glycine powder air-polishing. In addition, regenerative therapy of the peri-implant defect was performed in 8 of the 20 treated sites, equally distributed between the two groups (4 sites per group). Clinical and radiographic parameters, including probing depth (PD) and radiographic bone loss, were assessed at baseline and after 6 months. Intragroup and intergroup comparisons were performed using parametric statistical analyses (α = 0.05). Results: Both treatment protocols resulted in statistically significant improvements in probing depth reduction and radiographic bone fill after 6 months (p < 0.001). In the electrolytic group, mean PD decreased from 6.7 ± 0.95 mm to 4.0 ± 0.2 mm, while in the conventional group, PD decreased from 6.8 ± 1.03 mm to 3.3 ± 0.3 mm. Radiographic bone loss decreased from 4.88 ± 0.70 mm to 0.94 ± 0.70 mm in the electrolytic group and from 4.88 ± 1.83 mm to 0.94 ± 1.14 mm in the conventional group. No statistically significant intergroup differences were observed for probing depth reduction or radiographic bone level changes. No implant losses occurred during the observation period. Conclusions: Within the limitations of this retrospective study, both electrolytic and conventional mechanical implant surface decontamination protocols resulted in significant short-term clinical and radiographic improvements following peri-implantitis surgery. Electrolytic cleaning demonstrated outcomes comparable to conventional therapy and may represent a viable alternative for implant surface decontamination. Full article

Background/Objectives: Children with congenital long QT syndrome (cLQTS) are at extremely high risk of torsades de pointes (TdP) and sudden cardiac death (SCD). Although the implantable cardioverter-defibrillator (ICD) is a cornerstone in SCD prevention, traditional transvenous ICDs are associated with venous access occupation, lead wear or fracture due to somatic growth, and difficulties with long-term lead revision or extraction. The extravascular ICD, which places the lead in the substernal extravascular space, has the potential to circumvent these lead-related complications. We report the experience of successful extravascular ICD implantation in a young child with drug-refractory cLQTS type 2 (cLQTS2). Methods: The clinical data of a 9-year-old boy with cLQTS2 were retrospectively analyzed. The patient carried a heterozygous KCNH2 variant (c.1810G>A, p.Gly604Ser) and had been on long-term oral propranolol and mexiletine. He presented with a cardiac arrest out of hospital during nocturnal sleep, was transferred to our hospital after successful cardiopulmonary resuscitation, and had TdP captured on ambulatory monitoring. Following multidisciplinary discussion, preoperative chest computed tomography (CT) assessment of the substernal anatomy, and informed consent, extravascular ICD implantation was performed on hospital day 11. The procedure involved the creation of a substernal tunnel via a subxiphoid incision, placement of the defibrillation lead in the anterior mediastinum with lead slack reserved for growth, and positioning of the pulse generator in a left axillary subcutaneous pocket. Intraoperative defibrillation testing succeeded with a single 30 J shock. Results: The postoperative recovery was uneventful without procedure-related complications. At the 2-month follow-up, device parameters were satisfactory and no inappropriate shocks had occurred. The corrected QT interval (QTc) decreased from 563 ms on admission to 522 ms. Ambulatory monitoring detected asymptomatic episodes of non-sustained ventricular tachycardia, but no ventricular fibrillation or syncope was observed. Venous access was fully preserved. Conclusions: In children with drug-refractory cLQTS2, the extravascular ICD provides defibrillation and antitachycardia pacing (ATP) while avoiding transvenous lead complications and preserving venous access. This case shows that with precise preoperative planning and lead redundancy, the device appears feasible and can be implanted without short-term complications in young children. Larger studies with longer follow-up are needed to evaluate long-term device performance. Full article