Search Results (656)

Background and Objectives: The integration of digital jaw tracking systems into prosthodontic workflows has created new opportunities for individualized articulator programming. Sagittal condylar inclination (SCI) and Bennett angle (BA) are the key condylar guidance parameters required for this purpose, yet whether these values differ systematically across Angle dental classes remains debated. This study compared condylar guidance parameters recorded with a digital jaw tracking system between Angle Class I and Class II subjects, and assessed inter-session reliability and right-left symmetry of the recordings. Materials and Methods: In this prospective cross-sectional study of a convenience sample, 118 participants were included (109 Angle Class I; 9 Angle Class II; no Angle Class III participants were identified). SCI and BA were recorded with the Modjaw system (Modjaw, Villeurbanne, France) across three separate sessions during protrusion and lateral excursions of the mandible. Inter-session reliability was assessed using the intraclass correlation coefficient [ICC(3,1) and absolute-agreement ICC(A,1)] and the standard error of measurement (SEM); between-group differences with the Mann–Whitney U test; and right–left symmetry with the Wilcoxon signed-rank test (α = 0.05). Results: Inter-session relative reliability was high for all articular parameters (ICC(3,1) 0.953–0.991; ICC(A,1) 0.952–0.991; SEM 0.9–2.2°). No statistically significant differences in SCI or BA were identified between Class I and Class II subjects (all p > 0.05), although the Class II estimates were imprecise (e.g., right BA: Hodges–Lehmann estimate +4.67°, 95% CI −0.67° to +10.67°). Mean SCI in Class I ranged from 50.04° ± 9.56° to 54.05° ± 10.15°, and in Class II from 49.74° ± 13.80° to 53.04° ± 15.26°. No significant right–left asymmetry was found in either group (all p > 0.09). Conclusions: No statistically significant differences in SCI or BA were detected between the observed Angle Class I and Class II participants; however, the small and highly imbalanced Class II sample limits the precision of these estimates and does not allow conclusions regarding equivalence; no a priori sample-size calculation was performed, and only large differences (approximately 9–11° for SCI and 7–10° for BA) could have been detected. Modjaw recordings showed high inter-session relative reliability. Given the considerable inter-individual variability, patient-specific recording of condylar guidance appears preferable to estimation based on Angle class for articulator programming. Full article

Dental resin composites (DRCs) are widely used restorative materials because of their aesthetics, ease of handling, and compatibility with minimally invasive approaches. Research continues to improve their formulations and properties. This scoping review aimed to summarize and analyze evidence on novel DRCs and their potential development, and to discuss current trends, technologies, and research areas that may shape their evolution. A systematic search of PubMed and Scopus was conducted for studies published or available online from 2010 to 2024. Fifty-nine studies were included in the qualitative synthesis. The included studies described innovations designed to address clinical needs through bioactive materials, antibacterial agents, sustainable fillers, modified monomer systems, and other functional strategies. Future research should optimize additive concentrations, evaluate long-term clinical performance, and address cost-effectiveness, aesthetic limitations, standardization, and translational feasibility. Full article

Zirconia-based ceramics are widely used in fixed prosthodontic restorations owing to their favourable mechanical properties and evolving aesthetic characteristics. However, predicting long-term performance remains challenging because artificial ageing methodologies are highly heterogeneous and existing standards do not fully reflect the diversity of modern zirconia systems, including high-translucency and multilayer materials; variations in experimental conditions, specimen designs, measurement approaches, and reporting practices limit inter-study comparison and quantitative evidence synthesis. This review examines current artificial ageing methodologies for zirconia-based restorations and identifies a fundamental limitation beyond the absence of a universal ageing protocol: the lack of a standardised framework for preserving and exchanging experimental information. To address this, the Minimum Information About a Zirconia Experiment (MIAZE) reporting framework is proposed as a model-neutral, machine-readable structure for documenting experimental observations and associated metadata. MIAZE is proposed as a minimal reporting framework for prospective use that does not require identical experimental protocols, instrumentation, or analytical approaches, but defines the essential information needed to preserve scientific interpretability and enable future dataset reuse. By separating data documentation from subsequent interpretation, MIAZE is designed to provide a foundation for reproducibility, independent verification, quantitative meta-analysis, and the application of diverse analytical approaches, shifting the focus from a single universal ageing protocol toward interoperable experimental datasets capable of supporting evolving zirconia materials, methodologies, and computational tools. Literature was identified through PubMed searches (2000 to 2026) combining zirconia, dental, and ageing terms, supplemented by reference screening; the review is narrative and not exhaustive. MIAZE is presented as a draft proposal for prospective reporting; its benefits have not yet been demonstrated on multi-laboratory datasets, and an illustrative assessment of published studies shows that legacy data can be encoded only incompletely, which motivates prospective use. Full article

Background: Dental laboratories place a considerable burden on the environment through hazardous materials such as methyl methacrylate and gypsum, intensive energy and water use, waste generation, and transport between clinics and laboratories. Although Knowledge, Attitude and Practice (KAP) models are widely used to analyse professional behaviours, no standardised, psychometrically validated instrument exists for dental laboratory technicians. This study evaluated the preliminary psychometric properties of the newly developed “Green Dental Laboratory KAP Scale”. Methods: A methodological, cross-sectional scale development study was conducted with a convenience sample of 194 dental technology students and graduates. The 49-item instrument covered three domains: knowledge (11 items, formative), attitude (19 items, reflective), and practice (19 items, formative). The attitude construct was examined with Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), and the formative constructs and structural relationships were examined with Partial Least Squares Structural Equation Modeling (PLS-SEM). Results: Most participants had never heard of the “Green Laboratory” concept (84.0%) and had not received formal environmental training (89.7%). The attitude scale showed a unidimensional structure (eigenvalue = 12.326; 82.17% of total variance) with high internal consistency (Cronbach’s α = 0.984, AVE = 0.807). CFA fit indices were mixed: CFI (0.917), TLI (0.903), and SRMR (0.030) met the recommended cut-offs. However, the robust RMSEA (0.130) exceeded the accepted cut-off. All formative indicators showed acceptable collinearity (VIF < 5). Knowledge was positively associated with both attitude (β = 0.308, p = 0.002) and practice (β = 0.553, p < 0.001), and attitude with practice (β = 0.362, p < 0.001), a pattern consistent with partial mediation. The structural model explained 56.0% of the variance in practice (R² = 0.560). Conclusions: The Green Dental Laboratory KAP Scale is a preliminary psychometric evidence tool for assessing sustainability competencies in dental technology education and professional practice. The findings suggest that, alongside knowledge acquisition, cultivating pro-environmental attitudes is central to the adoption of green laboratory practices. Full article

Background/Objectives: The biomechanical response of posterior single crowns is influenced by restorative stiffness, device geometry, loading direction, and bone architecture. This study evaluated the effect of crown material on stress distribution in posterior single crowns supported by the Bioxide-S Symbionic Tooth (ST) under two idealized bone architectures. Methods: Twelve three-dimensional static finite element models were generated by combining two ST configurations (premolar: 4.1 × 11 mm; molar: 5.0 × 11 mm), three crown materials (zirconia, IPS e.max lithium disilicate, and GC Cerasmart resin-matrix ceramic), and either a cortical–cancellous or an all-cortical bone model simulating Misch D1 conditions. A 200 N oblique load at 20° was applied to the premolar models, whereas a 400 N axial load was applied to the molar models. Results: Zirconia consistently produced the highest global equivalent von Mises stress, IPS e.max produced intermediate values, and GC Cerasmart produced the lowest. Bone architecture had a limited effect in molar models but a greater, material-dependent influence in premolar configurations. Stress concentrations were mainly observed at the cervical ST region, crown–post–device transition, first threads, and crestal cortical bone. Conclusions: These findings indicate that crown material substantially influences stress redistribution within the modeled system, whereas the effect of bone architecture is more configuration-dependent. The results should be interpreted as comparative biomechanical trends rather than predictors of material failure or clinical performance. Full article

Objectives: Disinfection of 3D-printed acrylic resin is essential to reduce fungal colonization and improve the clinical performance of dentures. This in vitro study assessed the antifungal activity of aluminum potassium sulfate (alum) solutions against Candida albicans in 3D-printed acrylic resin at different concentrations, while also illustrating their effects on the material’s surface roughness and wettability. Materials and methods: The study included 120 specimens prepared from 3D-printed acrylic resin and then randomly assigned to four groups: distilled water as the negative control, a CHX 2% as the positive control, and two concentrations (10% and 15%) of alum solution. A total of 40 specimens were used for each of the three tests, with 10 specimens per group. An additional 16 specimens were fabricated for microstructural characterization, with 3 specimens per group for SEM and 1 specimen per group for AFM, bringing the total number of specimens to 136. The antifungal activity against Candida albicans was evaluated using a colony-forming unit (CFU) method. Surface roughness was evaluated utilizing a profilometer, while wettability was assessed by a contact angle goniometer. Before surface roughness, wettability, SEM, and AFM testing, the specimens in the alum (10% and 15%) and 2% chlorhexidine (CHX) groups were immersed for 5 min per cycle, completing 90 immersion cycles over 10 days to simulate approximately 3 months of clinical denture use. In contrast, the specimens used for the colony-forming unit (CFU) test against Candida albicans were immersed only once for 5 min. The negative control specimens were not subjected to any disinfection. Statistical assessments were conducted out by employing one-way ANOVA with Games–Howell post hoc for CFU, as well as one-way ANOVA with Bonferroni post hoc were chosen for wettability and roughness data. In all statistical assessments, the significance was determined at p < 0.05. Results: Number of CFU of Candida albicans was significantly reduced (p < 0.0001) in all tested groups relative to the negative control group, along with a significant rise in surface roughness. Chlorhexidine revealed higher wettability (decreased contact angle), though no significant change was found between either the 10% or 15% alum groups and the negative control (p > 0.05). Conclusions: Alum solutions at concentrations of 10% and 15% for 5 min revealed antifungal activity against Candida albicans in 3D-printed acrylic denture base resin. There was no statistical change in wettability for any concentration compared to the negative control, while surface roughness increased after treatment. Full article

A 60-year-old male patient presented seeking replacement of missing posterior teeth and improvement of his smile. Clinical findings included partial edentulism, bilateral posterior crossbite, secondary caries, defective restorations, anterior and posterior tooth wear, posterior gingival inflammation, supraeruption of the mandibular posterior teeth, and unfavorable inclination of the mandibular posterior teeth. An interdisciplinary treatment plan combining orthodontic, implant, and restorative therapy was selected to improve tooth position, occlusion, restorative space, and esthetics before definitive rehabilitation. Following orthodontic treatment, a digital workflow incorporating intraoral scanning, digital wax-up, restorative space evaluation, and computer-aided design was used to plan a full-mouth rehabilitation. Implant-supported restorations replaced the missing posterior teeth, while the remaining dentition was restored with tooth-supported restorations. Partial-coverage restorations and occlusal veneers were used posteriorly to preserve sound tooth structure, and minimally invasive labial veneers were used anteriorly to improve esthetics. Zirconia was selected because of its favorable mechanical properties and clinical versatility. Cementation was performed under complete dental dam isolation to minimize contamination. This case illustrates how a staged interdisciplinary approach supported by digital planning can facilitate conservative full-mouth rehabilitation and maintain satisfactory functional and esthetic outcomes over a 3-year follow-up. Full article

Background/Objectives: Local mesh density characterizes the polygonal representation of digital surface models; however, reference values and clinically relevant thresholds for posterior occlusal meshes generated through intraoral scanning and subsequent software processing have not been established. This study aimed to characterize the occlusal mesh density of maxillary first molars using V/A as the primary descriptor and F/A as a topology-derived secondary descriptor, and to evaluate mean bilateral differences between teeth 16 and 26. Methods: Twenty participants with intact bilateral maxillary first molars were included in this prospective within-subject observational study. Full-arch scans were acquired with a Medit i900 intraoral scanner and exported as STL files. Occlusal regions of interest were isolated in Medit Design, exported as PLY files, and analyzed for surface area, vertex count, face count, vertices per unit area (V/A), and faces per unit area (F/A). Bilateral differences were evaluated using paired-sample t-tests. Results: Mean participant-level occlusal mesh density was 37.62 ± 2.13 vertices/mm² and 73.13 ± 4.22 faces/mm². No significant bilateral differences were found for surface area, vertex or face counts, V/A, or F/A (all p > 0.05). For V/A, the mean right–left difference was 0.48 vertices/mm², with Bland–Altman 95% limits of agreement from −3.87 to 4.82 vertices/mm². In a descriptive cross-study comparison involving independent participant samples, the occlusal mesh-density values observed in the present study were higher than the buccal-surface values reported previously. Conclusions: Under the specified Medit i900 acquisition and Medit Design ROI-processing workflow, no statistically significant mean right–left differences in local mesh density were detected. The reported V/A and F/A values provide workflow-specific baseline descriptors of the final exported PLY mesh structure and should not be interpreted as measures of scanning accuracy. Their relationship to downstream CAD, AI-based design, or clinical outcomes requires direct investigation. Full article

Background/Objectives: Artificial intelligence (AI) is rapidly entering dental education and clinical practice, yet data on how dental professionals in the Middle East perceive it are scarce. This study assessed the awareness, attitudes, and perceived barriers toward AI among dental professionals in Kuwait, and compared responses across specialty, work sector, place of training, and experience, in order to inform regional education and adoption strategies. Methods: A cross-sectional online survey of 27 items across five domains (demographics, knowledge and awareness, clinical practice, attitudes, and barriers and concerns) was distributed to dental care providers practicing in Kuwait’s government, private, and academic sectors between January 2024 and January 2025. An investigator-defined composite “belief” score (range 0–9), calculated as the sum of affirmative responses to nine attitude and expectation items (Kuder–Richardson 20 = 0.79), was categorized a priori as low (0–4), moderate (5–7), or high (8–9). This score was constructed for the present study to summarize overall positive orientation toward AI and is not a previously validated instrument. Categorical data were compared using the chi-square or Fisher exact test, and ordinal logistic regression was used to identify predictors of a higher belief-score category. Results: A total of 321 dental professionals accessed the survey, and 300 with complete belief-score data formed the analytic sample. Just over half were aware of AI tools designed for dentistry (56.3%), yet exposure was limited: only 38.7% had attended an AI-related lecture, workshop, or webinar, 29.0% had read AI research, and 15.7% had used AI-assisted tools, while 94.0% were interested in AI training and 92.0% were open to adopting AI if beneficial. Among the 292 respondents who answered the multiple-response barrier item, the most frequently reported barriers were a lack of training and expertise (71.2%), technical challenges (63.4%), and cost (56.5%); these did not differ significantly across work sector or specialty. High composite beliefs were more common among male than female respondents (44.1% vs. 25.3%, p = 0.003), and in ordinal regression male gender (estimate = 0.736, p = 0.004), general dentistry (estimate = 0.924, p = 0.003), and prosthodontics (estimate = 1.120, p = 0.003) independently predicted higher beliefs (model χ² = 25.56, df = 9, p = 0.002). Conclusions: Dental professionals in Kuwait show high enthusiasm for AI but limited training and hands-on exposure, and a lack of training and expertise was the leading perceived barrier (71.2% of the 292 respondents answering this item) across all sectors and specialties. Targeted, hands-on AI training and the integration of AI content into dental curricula are needed to support effective and responsible adoption in Kuwait. Full article

Background: Amelogenesis imperfecta affecting enamel formation is frequently associated with a variety of malocclusions and eruption disturbances. Orthodontic treatment is crucial in comprehensive patient management. Previous studies have shown that orthodontic treatment becomes more challenging in patients with AI as the defective enamel affects the bracket bonding, retention of appliances and treatment mechanics and often needs modified bonding protocols, pre-treatment restorative build-ups, skeletal anchorage and general multidisciplinary management. There is no evidence of the ideal orthodontic treatment yet; available evidence only consists of case reports and small observational studies that address specific aspects with no established consensus. Therefore, this narrative review aimed to critically examine the contemporaneous evidence on orthodontic assessment and treatment planning in AI patients, drawing on studies identified through a structured literature search. Materials and Methods: An electronic search of the literature was conducted in the PubMed, Scopus, and ScienceDirect databases. Out of 640 records that were initially identified, 11 studies met the inclusion criteria for qualitative synthesis. Results: Bonding issues resulting from enamel defects tend to be identified as a significant clinical challenge necessitating modified orthodontic techniques. The included studies demonstrated that by using individualized treatment planning, modified bonding procedures, fixed appliances, expansion procedures, skeletal anchorage and combined orthognathic surgery in some cases within the multidisciplinary treatment approach, there can be successful orthodontic management for these patients. Conclusions: Vital steps such as early diagnosis, careful treatment planning, and coordination with restorative and prosthodontic treatment were associated with better functional and esthetic outcomes. Consequently, even though there is limited evidence, the available literature supports a customized interdisciplinary approach as the most predictable and effective strategy for managing orthodontic problems in patients with AI, while emphasizing that case reports and small observational studies are the main sources of current findings. Full article

Background: Thymol has been considered a possible bioactive phytocompound in dentistry due to its antimicrobial, antibiofilm, antifungal and anti-inflammatory properties. The current narrative review aims to critically review the present evidence on biological properties, mechanism of action, formulations and applications of thymol in preventive dentistry, periodontics, endodontics, prosthodontics and emerging dental materials and delivery systems, highlighting the current limitations and future perspectives. Methods: A literature search was carried out on PubMed, Scopus, ScienceDirect and Google Scholar databases. The search included publications related to thymol and its applications in oral health and dentistry. Results: The most recent evidence supports the adjunctive use of thymol in preventive and periodontal oral-care products, particularly in essential oil-based formulations. Moreover, recent advances in nanoformulations and dental materials suggest that its therapeutic potential can be further improved by optimized delivery systems. Conclusions: Thymol is a naturally occurring active compound that offers numerous benefits in various dental applications due to its multifaceted properties and safety profile. Preliminary and clinical evidence is encouraging, but more standardized clinical studies are needed to better define its long-term efficacy, optimal formulations, therapeutic concentrations, and clinical applicability in dentistry. Full article

Background/Objectives: Dental procedure-related emphysema is an infrequently reported complication of dental care that may extend from superficial facial tissues into deep cervical, mediastinal, orbital, thoracic, intracranial, or vascular compartments. This revised scoping review aimed to map contemporary published cases using an expanded multi-database search and to characterize procedures, anatomical distribution, clinical presentation, diagnostic assessment, management, complications, and outcomes. Methods: PubMed/MEDLINE, Scopus, and Web of Science Core Collection were searched for English-language reports published from 1 January 2016 through 26 August 2026. Records were deduplicated and screened using predefined eligibility criteria; data were charted descriptively in accordance with PRISMA-ScR. Results: The expanded searches yielded 642 database records. After application of the publication window and deduplication, 246 unique records were screened. The synthesis included 109 studies describing 129 patients. The case literature remained dominated by extraction-related events, while restorative/prosthodontic treatment, dental cleaning/air-polishing, and endodontic procedures were also represented. Facial and cervical emphysema remained the most frequently reported distributions, and mediastinal and deep fascial-space extension were prominent among published cases. CT and antibiotics were frequently reported, but the case-report evidence does not establish their comparative effectiveness. Conclusions: Dental procedure-related emphysema is represented by a heterogeneous case literature with strong potential for publication bias. Sudden swelling with crepitus after dental treatment should prompt immediate assessment, with imaging and escalation guided by suspected anatomical extent and clinical severity. Reported frequencies should not be interpreted as incidence, procedure-specific risk, or evidence of treatment effectiveness. Full article

Objectives: We aim to assess the 5-year clinical outcomes of a cylindrical-conical implant system with a progressive thread design and a sandblasted, acid-etched surface and its fixed prostheses under routine clinical conditions. Methods: This retrospective single-center cross-sectional follow-up study included patients treated with implants with a progressive thread design and an internal butt-joint connection between January 2019 and August 2020 at a specialist referral practice in Germany. Of 112 patients treated, 44 (94 implants with fixed restorations) attended the five-year recall. Outcomes were the Functional Implant Prosthodontic Score (FIPS), peri-implant tissue health parameters (bleeding on probing, suppuration, dehiscence, width of keratinized mucosa, and other signs of inflammation), marginal bone level on periapical radiographs, and implant survival. Results: All 94 implants available for examination remained in situ at five years, corresponding to 100% survival among recalled implants. Mean FIPS was 7.6 out of 10 (interproximal 1.3, occlusion 1.8, design 1.6, mucosa 1.4, bone 1.5). Bleeding on probing was absent in 37.2% of implants and present at ≥3 of 6 sites in 30.9%; suppuration was absent in all cases. Bleeding was descriptively more frequent where keratinized mucosa was narrow: implants with <2 mm bled at nearly three times as many sites as those with ≥2 mm. No implant showed a marginal bone level ≥2.0 mm apical to the shoulder. Conclusions: Within the limitations of this retrospective cross-sectional follow-up study, the implant system with a progressive thread design demonstrated favorable 5-year prosthodontic, biological and radiological findings under referral-practice conditions. Full article

Background: Tooth loss remains a major clinical challenge, affecting mastication, speech, facial aesthetics, and oral health-related quality of life. Prosthetic rehabilitation must therefore balance functional demands, biological limitations, patient preferences, maintenance capacity, and cost. Implant-assisted removable partial dentures (IARPDs) have emerged as a practical alternative to conventional removable partial dentures (RPDs) and full-arch fixed implant prostheses, particularly in distal-extension cases where conventional RPDs often demonstrate greater displacement and unfavorable stress distribution. Objectives: This narrative review summarizes current concepts in IARPDs treatment, with an emphasis on attachment-retained designs and implant-surveyed crown removable partial dentures (ISCRPDs). Methods: A narrative literature review was conducted using PubMed and Scopus. English-language articles related to IARPDs, surveyed crowns, attachment systems, material considerations, biomechanics, clinical outcomes, and complications were identified and narratively synthesized. Results: Available evidence suggests that IARPDs provide superior patient-reported outcomes compared with conventional RPDs, largely through improved retention, stability, comfort, and reduced prosthesis movement. Attachment systems offer versatile retention and aesthetic advantages but may require regular maintenance because of component wear and progressive loss of retention. In contrast, surveyed crowns provide a space-efficient and potentially more cost-effective design, with favorable implant survival and prosthetic outcomes reported in retrospective studies. However, complications such as clasp loosening, sore spots, crown dislodgement, and crown or framework fracture remain clinically relevant. Material selection for frameworks and implant crowns further influences aesthetics, durability, hygiene, and long-term maintenance. Conclusions: IARPDs treatment should be individualized according to the available prosthetic space, residual ridge anatomy, implant position, oral hygiene ability, aesthetic expectations, financial limitations, and access to follow-up care. Prospective comparative studies are needed. Full article

The free fibula flap (FFF) is a reference reconstructive option, particularly for extensive mandibular defects. This narrative review examines the evolution of implant–prosthetic rehabilitation from conventional free-hand reconstruction to prosthetically driven digital workflows. A structured, non-systematic search of PubMed/MEDLINE, Scopus, and Web of Science included English-language publications from 1989 to May 2026. Early approaches were limited by anatomical discrepancies, unfavorable implant positioning, excessive prosthetic space, and difficult peri-implant maintenance. Surgical refinements, including double-barrel reconstruction and soft-tissue procedures, improved rehabilitative conditions in selected cases. Virtual surgical planning, CAD/CAM guides, patient-specific fixation, and guided implant placement subsequently enabled closer coordination of reconstruction, implant positioning, and prosthetic design, supporting immediate protocols such as Jaw-in-a-Day. However, the available evidence remains heterogeneous and predominantly retrospective. Although digital workflows may improve accuracy and operative efficiency, their superiority in terms of long-term biological, prosthetic, functional, and patient-reported outcomes has not been conclusively demonstrated. Emerging technologies, including augmented reality, robotics, artificial intelligence, and digital twins, remain largely preliminary. Full article