Search Results (3,146)

Interactions between the chemical compounds contained in mouthwashes and the components of dental composites may significantly influence their functional properties. The study investigated the effect of mouthwashes on the mechanical properties and color stability of a restorative nanocomposite. Twelve mouthwashes characterized by different chemical compositions were selected and distilled water was used as a control. Composite specimens were conditioned for 24 h, 48 h, and 72 h. Changes in microhardness (HV), compressive strength (CS) and diametral tensile strength (DTS) were evaluated. In addition, color changes were analyzed using spectrophotometric measurements. The results demonstrated a significant decrease in both HV and CS after exposure to mouthwashes, depending on their composition and immersion time. DTS values remained stable. Color changes were statistically significant; however, the values observed remained within clinically acceptable limits from an esthetic standpoint. The loss of mechanical properties was generally most pronounced during the initial period of contact between the mouthwashes and the tested material, which should be considered as unfavorable. The influence of ethanol molecules on mechanical properties was not stronger than that of many ethanol-free solutions. The frequently suggested correlation between changes in composite material hardness and the pH values of mouthwashes was not confirmed. Full article

Background and Objectives: To evaluate and compare the accuracy (trueness and precision) and scanning speed of three intraoral scanners: Medit i700, Primescan 1, and COXO DL-300P, under standardized clinical conditions, using a digitized high-precision analog impression as the reference. Materials and Methods: A patient requiring fixed prosthetic treatment on natural abutments (2.5, 2.7, 3.5, 3.8) was selected. Ten sequential full-arch scans were performed with each scanner in rotating order. Scanning time was recorded for each full-arch acquisition. Accuracy analysis focused on regions of interest: the upper jaw included abutments with adjacent mucosa, the lower jaw included only abutment surfaces. A VPS impression was taken, poured in type IV stone, and digitized with a high-accuracy desktop scanner to serve as the reference. All datasets were analyzed in Geomagic Control X, and statistics were performed using MedCalc (α = 0.05). Results: Upper Jaw (Abutments and Mucosa): The Medit i700 achieved the highest trueness (100.3 ± 6.6 µm), outperforming Primescan and COXO (p = 0.008). COXO showed the best precision, while Primescan demonstrated the greatest variability (p < 0.0001). Primescan produced the fastest scans (72.5 ± 3.8 s) (p = 0.001). Lower Jaw: (Abutment Surface Only): Medit yielded superior trueness (193.1 ± 63.4 µm) compared with Primescan and COXO (p = 0.005). Precision varied significantly among devices, with COXO presenting the greatest inconsistency (p = 0.0004). Scan times did not differ significantly (p = 0.068). Conclusions: Medit i700 demonstrated the highest trueness, Primescan delivered the fastest scans but variable results, and COXO showed acceptable but inconsistent precision. Full article

Background: Patients with diabetes mellitus exhibit increased susceptibility to peri-implant inflammation and implant failure due to systemic metabolic dysfunction, impaired immunity, and delayed tissue healing. The oral microbiome is increasingly recognized as a key intermediary in these pathogenic processes. Aims: This review aims to systematically evaluate the available literature examining the relationships among the oral microbiome, biomaterial biocompatibility, and inflammatory changes in peri-prosthetic tissues in insulin-dependent diabetic patients. Methods: A systematic search of PubMed and Scopus databases identified studies published between January 2000 and July 2025. Eligible studies (25 in total) included clinical, histological, microbiological, or immunohistochemical investigations involving diabetic patients rehabilitated with dental implants or prostheses. Study selection and reporting followed PRISMA 2020 guidelines. Results: Diabetic cohorts showed consistent microbial alterations, including a higher relative abundance of periopathogenic species (P. gingivalis, T. forsythia, and F. nucleatum), lower microbial diversity, and greater biofilm-forming potential. Histological analyses frequently described increased inflammatory infiltrates, higher cytokine expression, and reduced soft-tissue integration. Biomaterial surface characteristics were also associated with differences in microbial adhesion, while hyperglycemia was linked to microbial and host-response patterns suggestive of greater pathogenicity and inflammation. Collectively, these findings suggest that diabetes-associated dysbiosis may be associated with increased peri-implant inflammatory changes and altered peri-implant homeostasis. Conclusions: The oral microbiome may be involved in inflammatory activity and biocompatibility at the tissue–implant interface in diabetic patients. A better understanding of host–microbe–material interactions may support risk assessment and help inform future personalized management strategies, such as targeted antimicrobial approaches, probiotic modulation, and biomaterial surface optimization, although these implications should be interpreted cautiously given the predominantly observational and heterogeneous nature of the available evidence. Full article

Flexible and biocompatible sensors are vital for a wide range of biomedical applications, including real-time health monitoring, intracranial pressure monitoring, knee replacement surgeries, wearables, and smart prosthetics. While various highly sensitive and stable pressure sensors have been demonstrated, they often lack the conformability and biocompatibility crucial for their wider application in various bio-integrated electronic systems. Herein, a piezoelectric pressure sensor is proposed using a hybrid polymer composite by leveraging the unique properties of Chitosan and Parylene C. Various material characterisations, such as XRD and FTIR, were performed to reveal structural and chemical characteristics of the novel composite material. Next, electromechanical characterisations of the pressure sensor were performed to reveal its dynamic sensing properties. The pressure sensor exhibits excellent sensitivity for both pressure and frequency, as well as cyclic stability (10³ cycles), wide pressure range (20–70 kPa), and biocompatibility. Full article

Background/Objectives: Half of diagnosed unilateral maxillary sinusitis may have odontogenic origin, and root canal treatment (RCT) can be beneficial as a single-mode treatment for full resolution of maxillary sinusitis of endodontic origin (MSEO) symptoms. The aim of the study was to investigate the influence of passive ultrasonic irrigation (PUI) on the healing of MSEO after non-surgical endodontic treatment. Methods: A single-center, retrospective study was conducted on CBCT data and medical records of 240 patients, who underwent non-surgical endodontic treatment, performed by the same operator between 2016 and 2025. One hundred and thirty-six teeth entered the study due to inclusion/exclusion criteria. Results: Complete healing was observed in 75.74% of the cases (n = 103). The tooth most frequently associated with MSEO was the first upper molar (52.21%, n = 71). PUI was applied in 66.91% of the treatments (n = 91). PUI was an independent predictor of MSEO healing (p = 0.001; 95% CI [1.768; 9.136]). When PUI was introduced in RCT, complete healing of MSEO was observed in 84.62% of the cases (n = 77). PUI was independently associated with higher odds of radiological resolution of MSEO in univariate logistic regression (OR = 4.019) and multiple logistic regression (OR = 12.388) models. Conclusions: PUI application in the irrigation protocol was associated with higher rates of MSEO healing after non-surgical endodontic treatment (p = 0.001; 95% CI [1.768; 9.136]). The rate of MSEO healing after non-surgical RCT is high (75.74%); therefore it should be considered as a single-mode treatment option in cases of unilateral maxillary sinusitis. Full article

Background: Malnutrition and its risk are prevalent in older adults and contribute to frailty, morbidity, and mortality. Poor oral health—particularly tooth loss and inadequate prosthetic rehabilitation—may impair chewing, limit dietary variety, and accelerate nutritional decline. We investigated associations between dentition status, denture use, and nutritional status in a nationally representative sample of Polish older adults. Methods: We analyzed data from 5214 participants aged ≥60 years from the nationwide cross-sectional PolSenior2 study. Dentition status was classified as functional dentition (≥20 teeth), partial dentition (1–19 teeth), or edentulism (0 teeth). Nutritional status was assessed using the Mini Nutritional Assessment—Short Form (MNA-SF); impaired nutritional status was defined as MNA-SF <12 (malnourished or at risk). Additional indicators included hypoalbuminemia (<35 g/L) and small calf circumference (<31 cm). Associations were tested using chi-square and multivariable logistic regression adjusted for age, sex, education, and place of residence. Results: Functional dentition was present in 15.5%, partial dentition in 48.1%, and edentulism in 36.4% of participants. The proportion of edentulous individuals increased across worsening MNA-SF categories (26.2% in well-nourished, 41.8% in at risk, 46.9% in malnourished). In adjusted models, edentulism was associated with higher odds of impaired nutritional status compared with functional dentition (OR: 1.66; 95% CI: 1.32–2.10; p < 0.001), while partial dentition showed a non-significant trend (OR: 1.22; 95% CI: 0.98–1.52; p = 0.077). Among edentulous participants, denture use was more common in well-nourished individuals than in those with impaired nutritional status (93.0% vs. 77.2%), suggesting a possible association between active prosthetic rehabilitation and better nutritional status. Conclusions: In Polish older adults, tooth loss—particularly edentulism—is associated with poorer nutritional status. Screening for malnutrition risk may benefit from incorporating basic oral health and denture-use assessment while improved access to prosthetic rehabilitation may support nutritional resilience in ageing populations. Full article

Background and Objectives: Orbital exenteration performed for advanced malignancies often results in complex defects that are difficult to reconstruct, particularly in patients treated with adjuvant radiotherapy who subsequently develop osteoradionecrosis. This study describes the preliminary results of a surgical technique for secondary orbital reconstruction using a combined scalp flap and temporalis muscle flap (TMF), referred to as the “Pacman flap with tongue,” performed prior to prosthetic rehabilitation. Materials and Methods: Five elderly patients with multiple comorbidities and osteoradionecrosis following orbital exenteration and radiotherapy underwent secondary orbital reconstruction using the “Pacman flap with tongue” technique. The clinical outcomes, flap viability, complications, and feasibility of subsequent prosthetic rehabilitation were assessed. After stabilization of healing, digitally planned ocular epitheses were fabricated using cone-beam computed tomography (CBCT), computer-aided design, and three-dimensional printing. Results: Healing was uneventful in all patients. No flap necrosis, wound dehiscence, or recurrent bone exposure was observed. The reconstructed orbital sockets provided a stable, well-vascularized prosthetic bed, enabling satisfactory prosthetic rehabilitation. Conclusions: The “Pacman flap with tongue” may be considered a feasible option for secondary orbital reconstruction in selected high-risk patients, particularly in the setting of osteoradionecrosis. Full article

Reliable control of robotic hands using residual muscle activity is challenging due to low-amplitude myoelectric signals, susceptibility to noise, and the need for real-time actuation. This paper presents a myoelectric-controlled robotic hand capable of voluntary independent finger motion. Surface myoelectric signals from the forearm are processed via amplification, filtering, and digital analysis to enable accurate detection of muscle activity. The system achieves independent and simultaneous actuation of five fingers using a tendon-driven, servo-actuated mechanism in a lightweight ABS structure. Experimental evaluation demonstrates finger actuation delays ranging from 314 ms to 650 ms, maximum holding strengths between 1.75 N and 4.07 N, and minimum gripping distances between 22 mm and 49 mm across all five fingers, with peak motor currents remaining below 0.7 A. Results validate consistent muscle activity detection, successful execution of individual and combined finger movements, and the robustness of the proposed design. Full article

Background: Implant therapy is a standard of care for long-term tooth replacement. While high survival rates have been reported for implants placed by specialists, data on outcomes achieved by Advanced Education in General Dentistry (AEGD) residents remain limited. Objectives: To evaluate the clinical performance and complication rates of dental implants placed and restored by AEGD residents under faculty supervision, and to identify factors influencing outcomes after at least one year in function. Methods: A retrospective review was conducted for implants placed between April 2012 and December 2021 at the Eastman Institute for Oral Health. Only implants with ≥1-year follow-up were included. Data included demographics, medical history, smoking status, oral hygiene, peri-implant health, and prosthetic outcomes. Logistic regression was used to assess associations between risk factors and complications. Results: Among 262 implants that survived ≥1 year, the complication rate was low: screw loosening occurred in 8.4%, crown issues in 3.4%, abutment or screw fractures in 0.4%, and early peri-implantitis in 11.5%. Examiner satisfaction was high for esthetics (82.8%) and occlusion (85.9%), and over 80% of patients rated their outcomes between 8 and 10 on a 10-point scale. Diabetes and high plaque index were significant predictors of peri-implantitis. Conclusions: Implants placed and restored by AEGD residents under structured faculty supervision achieved low complication frequencies, and strong patient satisfaction comparable to specialist outcomes. Full article

Objective: To evaluate the biomechanical effects of varying posterior implant inclinations and loading protocols on peri-implant stress distribution in full-arch maxillary rehabilitations using the All-on-Four concept. Methodology: A three-dimensional finite element model of an edentulous atrophic maxilla was developed from a digital point cloud. Four implants were placed according to the All-on-Four protocol: two anterior vertical implants and two posterior implants with inclinations of 0°, 15°, 30°, or 45°. Mini-abutments and a titanium bar prosthesis were included. Material properties were assumed as homogeneous, isotropic, and linearly elastic. Immediate loading was simulated using frictional contacts (µ = 0.3), whereas delayed loading assumed complete osseointegration (bonded contacts). The models were meshed using 10-node quadratic tetrahedral elements (SOLID187) in ANSYS^®. Maximum von Mises stress in cortical bone, cancellous bone, implants, abutments, and the prosthetic bar was assessed. Results: Posterior implant tilt significantly reduced peri-implant stress. Under immediate loading, the highest stress occurred at 0° inclination in the posterior left implant (82.36 MPa) and decreased progressively with increasing tilt, reaching 33.63 MPa at 45° (≈59% reduction). Delayed loading generally produces lower stress magnitudes, particularly at extreme tilts. Anterior implants experienced lower stress levels across all configurations. Comparative analysis demonstrated that immediate loading increased stress at lower angulations, while differences between loading protocols were minimal at higher inclinations. Conclusions: Posterior implant angulation and loading protocol critically influence peri-implant stress distribution. Increased posterior tilt combined with appropriate loading reduces peak cortical bone stresses, supporting biomechanical optimization in All-on-Four maxillary rehabilitations. Full article

Custom-made subperiosteal implants are increasingly used in clinical cases where significant bone loss due to trauma or disease renders conventional endosseous implant placement unfeasible. This study investigated how different internal structural designs affect the deformation and stress distribution in mandibular subperiosteal implants under clinically relevant loading conditions. An idealized implant geometry was defined based on average human mandibular dimensions, and four configurations with identical outer shape and connection features were created, differing only in sidewall architecture (solid, top-relieved, top-relieved with lateral perforations, and top-relieved lattice framework). All specimens were manufactured by metal additive manufacturing and evaluated using cone-beam computed tomography (CBCT). Mechanical testing was performed in two stages: (i) cyclic loading consisting of 500 bite cycles at an overall force of ~326–350 N and (ii) a single static high-load event of 2000 N, applied parallel to the fixation pin axes. CT datasets acquired before and after each stage were compared to detect permanent deformation. No measurable residual deformation was identified in any configuration; the only observed macroscopic change was an adhesive-bond limitation in one case, rather than structural yielding of the implant. Finite element analysis further supported these findings by identifying localized stress concentrations mainly at the implant–prosthetic interface and by revealing the load-transfer zones that govern the mechanical response. Overall, the results indicate that lightweight, perforated, and lattice-based internal designs can preserve global structural integrity across physiological and supra-physiological load ranges while enabling design optimization to improve stress distribution. Full article

Background/Objectives: Bone-anchored prostheses provide an alternative to socket prostheses, directly connecting the prosthesis to the residual limb via osseointegration. However, limited evidence exists on how spatiotemporal gait parameters and gait symmetry change over time following osseointegration in individuals with unilateral transfemoral amputation. This study aimed to examine changes in spatiotemporal and gait symmetry parameters before osseointegration and at 6 and 12 months post-surgery. Methods: Common spatiotemporal parameters were collected from six individuals with unilateral transfemoral amputation at baseline (with socket prosthesis) and at 6 and 12 months post-osseointegration using a motion analysis system. Group-level differences were assessed using repeated measures ANOVA. Gait symmetry was evaluated using selected spatiotemporal parameters. Results: Following osseointegration, individuals with unilateral transfemoral amputation experienced significant spatiotemporal changes over time. At the group level, walking velocity and stride length decreased at 6 months, with stride length increasing at 12 months. Step width and prosthetic-side step length increased at 12 months relative to 6 months, while intact-side step length decreased. Prosthetic-side toe-off timing was shorter at 12 months. Gait symmetry responses varied individually: some with poor baseline symmetry improved, while those with better baseline symmetry became more asymmetric, indicating heterogeneous outcomes. Conclusions: This study highlights longitudinal changes in gait biomechanics following osseointegration in individuals with unilateral transfemoral amputation. Gait adaptations were highly variable across individuals and time points. Future research should involve larger, more homogeneous samples and incorporate kinetic, muscle activity, and functional outcome measures to better understand the impact of bone-anchored prostheses on gait and mobility. Full article

CAD/CAM polymer-based dental materials are increasingly used as metal-free alternatives for fixed and implant-supported restorations. High-performance polymers such as polyetheretherketone (PEEK), fiber-reinforced composites, and graphene-reinforced polymers have been introduced to improve material stability; however, evidence regarding the effects of thermal aging on their physicochemical and biological properties remains limited. In this study, PEEK, a fiber-reinforced composite (FRC), and a graphene-reinforced PMMA-based polymer (G-CAM) were evaluated. Twenty-seven disc-shaped specimens (10 × 2 mm; n = 9 per material) were fabricated and subjected to 10,000 thermal cycles between 5 and 55 °C. Color change (ΔE₀₀), surface roughness (Ra), and Vickers microhardness (VHN) were measured before and after aging. Chemical stability was assessed using FTIR and Raman spectroscopy, surface morphology by SEM analysis, and biological safety by cytotoxicity testing. Material-dependent differences were observed in color stability, surface roughness, and microhardness after thermal aging (p < 0.05). Microhardness decreased in the fiber-reinforced and graphene-reinforced materials, whereas PEEK showed no significant change. Spectroscopic analyses indicated preserved chemical structure, and all materials demonstrated acceptable cytocompatibility. Thermal aging influenced material behavior while chemical stability and biological safety were maintained, highlighting the importance of considering aging behavior during material selection for prosthetic restorations. Full article

Degenerative mitral stenosis (MS) secondary to extensive mitral annular calcification (MAC) represents a growing clinical challenge in an aging population. These patients are often elderly, frail, and harbor a significant burden of comorbidities, rendering conventional mitral valve surgery prohibitively high-risk. While transcatheter mitral valve replacement (TMVR) has emerged as a potential alternative, the current evidence is only derived from single-arm observational registries. Therefore, the transition toward randomized controlled trials to define optimal patient selection and long-term prosthetic durability is necessary. This review examines the current landscape of TMVR for degenerative MS, focusing on the role of multimodal pre-procedural planning, procedural technique, and prevention of the principal complications. The integration of echocardiography and multi-slice computed tomography (MSCT) is essential for evaluating anatomical feasibility, particularly in predicting neo left ventricle outflow tract (neo-LVOT) obstruction, the primary determinant of procedural mortality. However, it is limited due to the absence of standardized protocol. We are showing the outcomes of off-label balloon-expandable aortic prostheses and dedicated TMVR system, which are the only two devices which data in patients with MS are available. Despite high technical success rates in specialized centers, complications, including paravalvular leak, valve thrombosis, and device migration, remain more prevalent than in aortic interventions. We present some tips and tricks to prevent and manage adverse events. TMVR represents a transformative frontier for inoperable patients with severe MAC. However, its routine clinical adoption requires further refinement of dedicated technologies and standardized imaging protocols to improve safety and bridge the gap between palliative medical therapy and definitive intervention. Full article

Background and Objectives: When a single missing tooth must be replaced, the best solution is the placement of an implant. In adults, most of the time the space for implant is totally or partially closed due to the shift in the adjacent teeth. The objective of the study was to describe the clinical parameters, treatment choices, and outcomes associated with orthodontic space opening for single-tooth implants in various treatment solutions, as well as to determine their influence on the variation in the dimension of the edentulous space. Materials and Methods: An observational prospective cohort study was designed in which patients with a single missing tooth were selected to be included in the study. After the clinical examination two groups were formed: patients who opted for fixed orthodontic treatment (metallic or sapphire) to open space for implant and patients who opted for alignment to achieve this (with Invisalign or Spark). All subjects received orthodontic treatment. A dental chart was created for each patient which included demographics, clinical data, orthopantomography (OPG), profile cephalograms, and photographs. The potential implant prosthetic space was measured during orthodontic treatment to observe the space dimension evolution in time. Results: In total, 97 patients were included in the study, 60 women and 37 men, with ages between 14 and 60 years. Edentulous spaces dimensions were opened from 1–4 mm to 5–6 mm (39.18% patients), 6–8 mm (48.45%), and >8 mm (12.37%). Both types of orthodontic treatments were effective in opening the potential prosthetic space for implant. Conclusions: Large prosthetic spaces and older edentulism tend to require longer treatments. Older patients had experienced edentulism for a longer period, indicating a correlation between age and the duration of tooth loss. Metal fixed orthodontic appliances were used in exceedingly long treatments, while aligners/sapphire brackets were used in short–medium durations. For the study group, fixed appliances and aligners proved to be effective in opening the space for future implants. Full article