Search Results (175)

Background/Objectives: The present study aimed to evaluate the oral health and patient satisfaction of flexible and non-metal clasp dentures (NMCD) compared to removable partial dentures (RPD) using a systematic review. Methods: The PICOS framework of this review was as follows: Do rehabilitations involving flexible dentures or NMCD have a similar success rate to those using RPD? Thus, the PICOS approach involves the following topics: (P) Population/Problem: partial edentulous adult patients; (I) Intervention: patients rehabilitated with flexible dentures or NMCD; (C) Comparison: patients rehabilitated with standard RPD; (O) Outcome: clinical parameters such as oral health, masticatory function, and patient satisfaction; and (S) Study Type: clinical trials and observational studies (cohort, case–control, and cross-sectional). No language restrictions were applied to the studies. The search strategy consisted of the following keywords in different databases: ((flexible) OR (nonmetal) OR (non-metal) OR (thermoplastic)) AND (denture). Only clinical trials and observational studies (cohort, case–control, and cross-sectional studies) from the last 15 years were included, and no language restrictions were applied. Studies that did not describe the denture material were excluded. Results: Of the 2197 potentially relevant records, 14 studies were included in the present review. Two studies reported retrospective results, while twelve reported a prospective evaluation. Considering the thermoplastic materials, five studies evaluated polyester, five polyamides, three polyacetals, and only one study evaluated polyetheretherketone (PEEK). Flexible dentures and NMCD demonstrated similar periodontal status and bone levels on abutment teeth to RPD after up to 12 months. Flexible dentures exhibited a higher degree of redness of the mucosa after 12 months. One study showed a lower maximum bite force for flexible dentures compared to RPD. No study has performed a clinical evaluation of mastication and chewing ability. Conclusions: Despite increased short-term patient satisfaction for flexible dentures and NMCD, there is weak evidence to support a similar clinical performance of flexible dentures and NMCD to RPD. Full article

Background and Objectives: We wished to evaluate the effect of antiresorptive agents (ARAs) on peri-implant tissues and to examine the risk factors for peri-implant medication-related osteonecrosis of the jaw (MRONJ). Materials and Methods: The study cohort consisted of patients who underwent implant surgery or maintenance treatment between March 2012 and December 2024. The patients were divided into two groups: those in whom bisphosphonates (BPs) or denosumab (Dmab) was used to treat osteoporosis after implant treatment (the ARA group) and a control group. Peri-implant clinical parameters (implant probing depth (iPPD), implant bleeding on probing (iBoP), marginal bone loss (MBL), and mandibular cortical index (MCI)) measured at the baseline and at the final visit were statistically evaluated and compared in both groups. Risk factors were examined using a multivariate analysis of adjusted odds ratios (aORs). Results: A total of 192 implants in 61 patients (52 female, 9 male) were included in this study. The ARA group consisted of 89 implants (22 patients). A comparison of the clinical parameters showed that the ARA group had significantly higher variations in their maximum iPPD and iBoP values over time than those in the control group. Risk factors for peri-implantitis as objective variables were the use of ARAs (aOR: 3.91; 95% confidence interval [CI]: 1.29–11.9) and the change in the maximum iPPD over time (aOR: 1.86; 95% CI: 0.754–4.58). Conclusions: During long-term implant maintenance treatment, patients’ health and medication status change. Monitoring peri-implantitis, the presumed cause of peri-implant MRONJ, is essential, especially in patients who started ARA treatment after implant placement, and special attention should be paid to changes in implant pocket depth. Full article

Background: Limited data are available regarding the mechanical performance of 3D-printed fixed partial dentures (FPDs) fabricated from different materials and connector geometries. The purpose of this in vitro study was to evaluate the influence of connector size and material type on the fracture resistance of three-unit posterior FPDs fabricated with two commercially available 3D-printable dental resins. Methods: A standardized metal model with two cylindrical abutments was used to design three-unit FPDs. A total of sixty samples were produced, considering three connector sizes (3 × 3 mm, 4 × 4 mm, and 5 × 5 mm) and two different resins: Temp Print (GC Corp., Tokyo, Japan) and V-Print c&b temp (Voco GmbH, Cuxhaven, Germany) (n = 10). Specimens were fabricated with a DLP printer (Asiga MAX UV), post-processed per manufacturer recommendations, and tested for fracture resistance under occlusal loading using a universal testing machine. Data were analyzed using nonparametric tests (Mann–Whitney U and Kruskal–Wallis; α = 0.05). Results: Significant differences were found between material and connector size groups (p < 0.001). Temp Print (GC Corp., Tokyo, Japan) demonstrated higher mean fracture loads (792.34 ± 578.36 N) compared to V-Print c&b temp (Voco GmbH, Cuxhaven, Germany) (359.74 ± 131.64 N), with statistically significant differences at 4 × 4 and 5 × 5 mm connectors. Fracture strength proportionally increased with connector size. FPDs with 5 × 5 mm connectors showed the highest resistance, reaching values above 1500 N. Conclusions: Both connector geometry and material composition significantly affected the fracture resistance of 3D-printed FPDs. Larger connector dimensions and the use of Temp Print (GC Corp., Tokyo, Japan) resin enhanced mechanical performance. Full article

Polymers are essential materials in the fabrication of partial and complete dentures, where their mechanical properties directly impact durability, comfort, and clinical performance. This study examines the influence of different manufacturing temperatures on the surface hardness of polymeric materials used in dental applications. A total of 60 experimental samples with a rectangular shape of Vertex ThermoSens polymer (Vertex Dental, 3D Systems, Soesterberg, The Netherlands) were fabricated through injection molding at 280 °C and 300 °C and analyzed over time to assess changes in their properties. Hardness measurements, conducted using the EQUOTIP Shore D hardness tester (Proceq SA, Schwerzenbach, Canton of Zürich, Switzerland), indicated increased hardness over time, with higher values observed in samples fabricated at 300 °C. A two-way ANOVA was performed to evaluate the statistical significance of temperature and time on hardness, revealing a significant effect (F = 14.73, p = 0.0185). These findings suggest that processing polymers at elevated temperatures improves surface hardness, significant for denture longevity and patient comfort. Increased hardness contributes to greater wear resistance. Optimizing polymer manufacturing conditions can thus lead to improved clinical outcomes, ensuring more durable and biocompatible dental prostheses. Full article

Aim: This in vitro study aimed to evaluate the adhesive performance of zirconia and lithium disilicate Maryland cantilever restorations on prepared and non-prepared anterior abutment teeth. While conventional clinical protocols involve abutment tooth preparation, no-preparation (no-prep) restorations have emerged as a viable, minimally invasive alternative. This study compared the adhesion fracture resistance (N) of zirconia restorations on non-prepared enamel surfaces with those on prepared surfaces exposing the dentin. Additionally, the zirconia restorations were compared with lithium disilicate Maryland cantilever restorations, a more common yet costly alternative. Materials and Methods: Forty extracted anterior teeth were allocated into four groups based on preparation type (prepared vs. non-prepared) and material (zirconia vs. lithium disilicate). Each group received cantilevered single-unit FPDs fabricated via CAD/CAM and adhesively cemented using Variolink^® Esthetic DC. Standardized loading was applied using a universal testing machine, and the fracture resistance was recorded. Results: The fracture resistance ranged from 190 to 447 N in the zirconia groups and from 219 to 412 N in the lithium disilicate groups. When comparing all the zirconia versus all the lithium disilicate ceramic restorations, regardless of tooth preparation, no statistically significant difference was found (p = 0.752). However, the non-prepared restorations exhibited significantly higher fracture resistance than their prepared counterparts (p = 0.004 for zirconia; p = 0.012 for lithium disilicate ceramic). All the failures were attributed to tooth fracture, except one zirconia restoration, with no debonding observed. Conclusions: Both zirconia and lithium disilicate Maryland cantilever restorations demonstrated reliable adhesive performance when bonded using appropriate surface conditioning and adhesive protocols. Interestingly, the non-prepared designs exhibited higher fracture resistance than the prepared abutments, highlighting their potential advantage in minimally invasive restorative dentistry. Zirconia Maryland bridges, in particular, represent a cost-effective and mechanically resilient option for anterior single-tooth replacement. 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

This study demonstrates that effervescent denture cleansers can influence the electrochemical behavior of cobalt–chromium (Co-Cr) alloys, with a particular focus on their corrosion resistance. The findings underscore the importance for dental professionals of selecting cleansers compatible with Co-Cr prostheses to minimize material degradation and enhance clinical durability. Corrosion resistance was evaluated using open-circuit potential (OCP), corrosion current density (i_corr), and passivation current density (i_pass). Surface morphology and elemental composition were analyzed through scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS). Forty specimens (n = 5 per group) were individually immersed in one of ten test solutions: distilled water (DW), artificial saliva (AS), and eight commercial denture cleansers—Polident 3 minutes™ (P3M), Steradent™ (St), Polident for Partials™ (PP), Efferdent™ (Ef), Corega Tabs™ (CT), NitrAdine™ (Ni), Fixodent™ (Fi), and Kukident™ (Ku). Each specimen was exposed a single solution to avoid cross-contamination. Results showed St, Ef, and Ku had higher OCP values than DW and Ni (p < 0.05), indicating better corrosion resistance. AS exhibited lower OCP values compared to St (p = 0.034), Ku (p = 0.023), and P3M (p = 0.050). DW had higher i_corr than PP (p = 0.030), CT (p = 0.005), and P3M (p = 0.003). For i_pass, DW had lower values than Ef (p = 0.025) and Ku (p = 0.016). SEM and EDS revealed no significant surface alterations. Understanding the underlying corrosion mechanisms in different solutions provides valuable insights into optimizing material performance and ensuring durability in clinical applications. The corrosion resistance of Co-Cr depends on the stability of the passive oxide layer, which can be degraded by chloride ions, reinforced by sulfate ions, and influenced by active ingredients in denture cleansers. Overall, the Co-Cr alloy demonstrated acceptable corrosion resistance, underscoring the importance of selecting suitable cleansers for prosthesis longevity. Full article

This study aimed to evaluate the effect of different manufacturing techniques and thermal aging on the fracture resistance of provisional crowns and fixed partial dentures. Methods: A total of 60 provisional crowns and 60 provisional fixed partial dentures were fabricated using three manufacturing techniques: conventional manufacturing (CM), subtractive manufacturing (SM), and additive manufacturing (AM). An index created from SM-manufactured restorations was used to produce the CM group. Artificial abutments were created by duplicating scanned phantom teeth using model resin. Half of the restorations (n = 10 per group) were subjected to thermal aging (5–55 °C, 5000 cycles). The fracture resistance values of the specimens were tested using a universal testing machine. Data were analyzed using a two-way ANOVA and Tukey’s post hoc tests (α = 0.05). The highest mean fracture resistance was observed in the SM group without aging, both for crowns (1645.4 ± 346.8 N) and fixed partial dentures (1291.13 ± 564.15 N). The two-way ANOVA revealed statistically significant differences among the groups, and thermal aging significantly reduced the fracture resistance (p < 0.05). Both the manufacturing method and thermal aging significantly influenced the fracture resistance of provisional crowns and fixed partial dentures. In fixed partial dentures, a significant effect of aging was associated with the reduced durability of restorations fabricated using the subtractive manufacturing method. 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

Background/Objectives: Conservative options for single-tooth replacements in the anterior region include all-ceramic one-retainer resin-bonded fixed dental prostheses (RBFDPs) and three-unit fixed partial dentures (FPDs). Methods: This systematic review assessed their clinical outcomes. Following the PRISMA 2020 guidelines, an electronic search of MEDLINE/PubMed was conducted from November 1991 to March 2025 for randomized clinical trials (RCTs), prospective cohort studies (PCSs), and retrospective cohort studies (RCSs). Keywords included dental prosthesis, fixed prosthesis, resin-bonded prosthesis, single-tooth replacement, anterior teeth, all-ceramic, lithium disilicate, monolithic, zirconia, survival rate, and success rate. Failures and complications were analyzed to determine long-term outcomes. Results: The search identified 990 articles, and the full-text review of 54 articles was performed, resulting in 23 studies meeting the inclusion criteria. This review revealed that one-retainer RBFDPs and three-unit FPDs in the anterior region demonstrated high survival and success rates. However, debonding was a common complication in RBFDPs, while framework design issues were noted in FPDs. Conclusions: These outcomes highlight the reliability of both approaches as conservative, all-ceramic, prosthodontic interventions for anterior single-tooth replacements. The consideration of one-retainer RBFDPs and three-unit FPDs is advisable due to their favorable clinical performance and minimal invasiveness. 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

Mature adipocyte-derived dedifferentiated fat (DFAT) cells show proliferative capabilities and multipotency. Given that the buccal fat pad (BFP) serves as a readily available resource for DFAT cell isolation, BFP-derived DFAT (BFP-DFAT) cells are a promising candidate in orofacial tissue engineering. In this research, we assessed the regenerative capacity of the periodontium through autologous BFP-DFAT cell transplantation in adult swine (micro-minipigs; MMPs). The BFP-DFAT cells were transplanted into inflammation-inducing two-walled infrabony periodontal defects located on the mesial of the second mandibular premolar (n = 6). Twelve weeks post-transplantation, a remarkable attachment gain was noted in the DFAT group, based on probing depths and clinical attachment levels. Histological and immunohistochemical analyses indicated new continuous cellular cementum and alveolar bone formation within the created infrabony defect. Well-organized periodontal ligament-like fibers were embedded between newly formed cementum and the alveolar bone. Histometric analysis demonstrated that the DFAT group had a 2.2-fold increase in new alveolar bone length and a 2.2-fold enhancement in vascularization than those in the control group. Except for minor inflammation in the lungs, no teratomas were detected in the recipient MMPs. BFP-DFAT cells significantly enhanced periodontal tissue regeneration, thus representing an optimal source for tissue engineering applications in dentistry. Full article

Objectives: This study aimed to establish reference values for bite force in individuals with various prosthetic restorations and to examine the relationship between prosthetic treatment groups (PTGs) and bite force as an indicator of masticatory muscle function. Materials and Methods: In a cross-sectional study from November 2021 to March 2023, 198 participants aged 18 to 95 years were recruited from multiple dental and geriatric centers. The participants were assigned to seven PTGs based on their dental and prosthetic statuses. Bite force was measured using the Occlusal Force Meter GM10, with three recordings on each side of the jaw, and analyzed using ANOVA. Results: The bite force decreased with fewer teeth and the transition from fixed to removable dentures. Fully dentate participants exhibited the highest bite forces, differing significantly from the other groups (p < 0.001). For the fully dentate individuals (547 ± 240 N), the bite force decreased progressively with the extent of prosthetic restoration, reaching 55 ± 45 N in edentulous individuals with complete dentures in both jaws. However, edentulous participants with two interforaminal implants demonstrated higher bite forces than those with partial dentures. Conclusions: Bite force is significantly impacted by prosthetic restoration type. Fully dentate individuals have the highest bite forces, while edentulous patients with implant-supported dentures also show considerable bite forces, similar to those with partial dentures. Full article

Background: Resin-bonded fixed dental prostheses (RBFDPs) have become an increasingly popular minimally invasive solution for replacing missing anterior teeth. However, their long-term success is influenced by factors such as bridge design and material selection. Methods: This systematic review and meta-analysis aimed to assess the impact of different bridge designs on the clinical performance and failure risks of anterior ceramic RBFDPs. A comprehensive search of electronic databases was conducted to identify clinical studies published in English up to January 2025. Nine studies, including randomized controlled trials, cohort studies, and clinical trials, met the inclusion criteria. Results: The analysis revealed that single-retainer RBFDPs demonstrated lower failure rates than two-retainer models (RR: 0.36, 95% CI: 0.17–0.75). Among failure types, fractures were significantly less common in cantilever designs compared to two-retainer designs (RR: 0.25, 95% CI: 0.09–0.73), while no significant differences were observed in debonding rates (OR: 0.40, 95% CI: 0.015–1.10). Conclusions: In terms of material selection, all-ceramic RBFDPs in cantilever designs exhibited significantly lower failure rates (RR: 0.12, 95% CI: 0.03–0.43), whereas metal-ceramic RBFDPs showed no significant difference in failure rates based on bridge design (RR: 0.56, 95% CI: 0.21–1.53). These findings suggest that all-ceramic cantilever RBFDPs may offer superior long-term outcomes, highlighting the importance of precise preparation and cementation protocols for clinical success. Full article

Objective: This study aims to evaluate the influence of pontic length and design on the fracture resistance of zirconia fixed dental prostheses (FDPs). By assessing different span lengths under controlled mechanical loading conditions, the research seeks to provide insights into optimizing the structural integrity of zirconia dental bridges. Materials and Methods: A total of 20 zirconia bridges were fabricated and tested in vitro. Ten bridges were designed to replace a single missing molar (tooth 46), with a pontic span of 11 mm, while the remaining ten were crafted for two missing teeth (35 and 36), featuring a longer pontic span of 17 mm. The zirconia frameworks were milled using the Wieland Zenotec^® Select Hybrid system and cemented onto metal abutments with Voco Meron Plus QM resin-reinforced glass ionomer cement. The specimens were subjected to occlusal loading using a ZwickRoell ProLine Z005 testing machine at a crosshead speed of 1 mm/min until fracture occurred. Results: The mechanical testing revealed a significant correlation between pontic length and fracture resistance. The mean fracture resistance for three-unit bridges (single pontic) was 3703 N, whereas four-unit bridges (double pontic) exhibited a significantly lower resistance of 1713 N. These findings indicate that increased span length reduces the fracture resistance of zirconia restorations due to higher stress accumulation and reduced rigidity. Conclusions: This study underscores the importance of pontic length and design in determining the fracture resistance of zirconia restorations. Shorter spans exhibit greater structural stability, reinforcing the need for careful treatment planning when designing multi-unit zirconia bridges. By optimizing bridge parameters, clinicians can improve clinical outcomes and extend the longevity of zirconia prostheses in restorative dentistry. Full article