Search Results (67)

The integration of artificial intelligence (AI) and advanced digital workflows is revolutionising full-arch implant dentistry, particularly for geriatric patients with edentulous and atrophic arches, for whom achieving both prosthetic passivity and optimal aesthetic outcomes is critical. This narrative review evaluates current challenges in intraoral scanning accuracy—such as scan distortion, angular deviation, and cross-arch misalignment—and presents how innovations like the Medit SmartX AI-guided workflow and the Scan Ladder system can significantly enhance precision in implant position registration. These technologies mitigate stitching errors by using real-time scan body recognition and auxiliary geometric references, yielding mean RMS trueness values as low as 11–13 µm, comparable to dedicated photogrammetry systems. AI-driven prosthetic design further aligns implant-supported restorations with facial symmetry and smile aesthetics, prioritising predictable midline and occlusal plane control. Early clinical data indicate that such tools can reduce prosthetic misfits to under 20 µm and lower complication rates related to passive fit, while shortening scan times by up to 30% compared to conventional workflows. This is especially valuable for elderly individuals who may not tolerate multiple lengthy adjustments. Additionally, emerging AI applications in design automation, scan validation, and patient-specific workflow adaptation continue to evolve, supporting more efficient and personalised digital prosthodontics. In summary, AI-enhanced scanning and prosthetic workflows do not merely meet functional demands but also elevate aesthetic standards in complex full-arch rehabilitations. The synergy of AI and digital dentistry presents a transformative opportunity to consistently deliver superior precision, passivity, and facial harmony for edentulous implant patients. Full article

Background and Clinical Significance: Juvenile ossifying fibroma (JOF) is a rare, benign, but locally aggressive fibro-osseous neoplasm that primarily affects the craniofacial skeleton of children and adolescents. Early surgical intervention is often required due to the lesion’s rapid growth and potential for significant facial deformity. Long-term functional and esthetic rehabilitation following maxillary resection in early childhood remains a clinical challenge. Case Presentation: This case reports a unique long-term follow-up of a 22-year-old female patient who underwent partial maxillary resection at the age of five due to JOF. Initial reconstructive efforts failed, necessitating a removable prosthesis to restore function and appearance. The patient experienced persistent self-consciousness and social withdrawal during adolescence, attributed to altered facial esthetics and repeated surgical disappointment. Nevertheless, prosthetic rehabilitation significantly improved mastication, phonetics, facial symmetry, and psychological well-being. Conclusions: The enduring psychosocial and functional impact of early maxillary resection for JOF and the pivotal role of prosthodontic management in long term rehabilitation are highlighted. A multidisciplinary approach that includes psychological support is suggested. This case report is among the few reports documenting long-term prosthetic outcomes for pediatric JOF patients extending into adulthood. Full article

Background. Digital dentistry continues to evolve, offering improved accuracy, efficiency, and patient experience across various prosthodontic procedures. Many previous reviews have focused on digital applications in prosthodontics. But the use of a fully digital workflow for full-arch implant-supported prostheses in edentulous patients remains an emerging and underexplored area in the literature. Objective. This article presents a comprehensive methodological review of the digital workflow in full-arch implant-supported rehabilitation. It follows a structured literature exploration and synthesizes relevant technological processes from patient assessment to prosthetic delivery. Methods. The relevant literature was retrieved from the PubMed database on 20 June 2024, to identify the most recent and relevant studies. A total of 22 articles met the eligibility criteria and were included in the review. The majority included case and technical reports. Results. The review illustrates the integration and application of digital tools in implant dentistry, including cone-beam computed tomography (CBCT) exposure, intraoral scanning, digital smile design, virtual patients, guided surgery, and digital scanning. The key findings demonstrate multiple advantages of a fully digital workflow, such as reduced treatment time and cost, increased patient satisfaction, and improved interdisciplinary communication. Conclusions. Despite these benefits, limitations persist due to the low level of evidence, technological challenges, and the lack of standardized protocols. Further randomized controlled trials and long-term clinical evaluations are essential to validate the effectiveness and feasibility of a fully digital workflow for full-arch implant-supported rehabilitation. Full article

Background/Objectives: The aim of this systematic review was to identify the role of orthodontics in patients undergoing tumor-ablative surgery, in collaboration with maxillofacial prosthodontic rehabilitation in a multidisciplinary fashion. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024582050). The focused question was constructed using the PICO (participant, intervention, comparison, and outcome) approach. A three-stage search was performed in PubMed, Scopus, and Web of Science using Medical Subject Heading (MeSH) terms. To assess the risk of bias, the National Institute of Health (NIH) “Quality Assessment Tool for case series/reports” was used. All data was synthesized qualitatively, according to the Synthesis Without Meta-analysis (SWiM) reporting guideline. Results: The initial search yielded 624 articles, of which 22 met the inclusion criteria after screening and eligibility assessment, with most being single-patient case reports and one case series involving 12 patients. The included studies primarily involved tumors in the mandible (64.5%) and maxilla (32.3%). Orthodontic treatment was initiated at various time points, ranging from one month pre-surgery to 19 years post-surgery, primarily utilizing fixed appliances (77.8%). In some studies, orthodontic appliances were used to enhance the stability of maxillofacial prostheses. The results of this study indicate that orthodontic treatment may facilitate prosthetic rehabilitation by improving conditions prior to prosthetic intervention and increasing the retention of the obturator prosthesis. Conclusions: Orthodontic treatment can enhance maxillofacial prosthetic rehabilitation after tumor-ablative surgery by optimizing jaw growth, improving occlusion, and facilitating prosthetic retention or space creation. Further research is needed to establish treatment guidelines. Orthodontic miniscrews may improve temporary prosthesis retention before final implant placement, when indicated. Full article

(1) Background: The present study was carried out to provide a state-of-the-art review of the prosthodontic factors related to customized subperiosteal implants (CSIs), and to offer clinical guidelines in this regard. (2) Methods: An expert consensus meeting was held in July 2024 in Santpedor (Manresa, Spain) to establish the most relevant clinical guidelines. (3) Results and (4) Conclusions: An interdisciplinary approach including surgeons, prosthodontists, bio-medical engineers and dental technicians, integrating both biological and mechanical considerations when designing CSI rehabilitations, is very important. While the reported survival rate of CSIs appears promising, their long-term performance beyond 5 years remains insufficiently documented. Thus, CSIs are a viable treatment option for patients with insufficient bone to place conventional implants, but there is a clear need to identify and analyze delayed-onset complications associated with these devices. The findings and their broader implications should be thoroughly examined, and potential future research directions should be highlighted. Full article

Background/Objectives: Hypohidrotic ectodermal dysplasia (HED) is a rare hereditary disorder affecting ectoderm-derived tissues including teeth, hair, and sweat glands. The dental abnormalities associated with HED, such as oligodontia and conical teeth, often result in significant functional, esthetic, and psychosocial challenges, particularly during childhood. Methods: A 10-year-old child presented with psychosocial concerns related to missing and malformed teeth. Clinical examination revealed oligodontia, conical anterior teeth, and a resorbed mandibular ridge. Based on clinical findings and a positive family history, a diagnosis of HED with significant dental involvement was confirmed. Results: A conservative prosthodontic approach was selected. A maxillary overdenture was fabricated over the retained primary teeth to enhance retention and preserve the alveolar bone, and a resin-bonded bridge was placed in the mandible due to poor ridge anatomy. The treatment restored oral function and esthetics and improved the child’s self-esteem. A recall visit after three months confirmed good prosthesis adaptation and a positive response from the patient and parents. Conclusions: This case highlights the importance of early, conservative, and developmentally appropriate prosthetic rehabilitation in pediatric patients with HED. Interim prostheses can significantly improve oral function, appearance, and psychosocial well-being while preserving future treatment options as the child matures. Full article

Background and Objectives: Complete dentures remain a primary solution for oral rehabilitation in aging and medically compromised populations. The integration of digital workflows, regenerative materials, and smart technologies is propelling prosthodontics towards a new era, transcending the limitations of traditional static prostheses. Materials and Methods: This narrative review synthesizes historical developments, current practices, and future innovations in complete denture therapy. A comprehensive review of literature from PubMed, Scopus, and Web of Science (2000–2025) was conducted, with a focus on materials science, digital design, patient-centered care, artificial intelligence (AI), and sustainable fabrication. Results: Innovations in the field include high-performance polymers, CAD–CAM systems, digital impressions, smart sensors, and bioactive liners. Recent trends in the field include the development of self-monitoring prostheses, artificial intelligence (AI)-driven design platforms, and bioprinted regenerative bases. These advances have been shown to enhance customization, durability, hygiene, and patient satisfaction. However, challenges persist in terms of accessibility, clinician training, regulatory validation, and ethical integration of digital data. Conclusions: The field of complete denture therapy is undergoing a transition toward a new paradigm of prosthetics that are personalized, intelligent, and sustainable. To ensure the integration of these technologies into standard care, ongoing interdisciplinary research, clinical validation, and equitable implementation are imperative. Full article

Background/Objectives: Edentulism is a significant public health concern, particularly among aging populations, affecting oral functionality, aesthetics, and overall health. This study assessed the edentulism status of patients at the Prosthodontic Clinic of Cluj-Napoca, Romania, and explored the possible correlations with socioeconomic factors such as age, general health, smoking, and alcohol consumption. This study aimed to inform public health strategies to reduce edentulism incidence and improve overall oral health outcomes in Romania. Methods: The current study included 208 patients (127 females and 81 males). Each participant completed a standardized data collection form designed to gather comprehensive information on socio-demographic characteristics (including age, gender, and environmental origin), self-reported general health, and lifestyle habits related to smoking and alcohol consumption. The clinical examination was performed by the same operator, recording the odontal and periodontal status, as well as prosthodontic evaluation (including Kennedy class). Results: Findings indicated that female patients had more frequent class 3 and complete edentulism in the maxilla, while males predominantly presented class 3 in the maxilla and class 1 in the mandible. The age distribution revealed that patients aged 20–40 exhibited the highest prevalence of Kennedy class 3, while those over 60 showed a notable increase in complete edentulism (p < 0.05). Although most patients were from urban areas, no significant difference was found between origin and edentulism class. A significant link between alcoholism and mandibular edentulism was also identified (p < 0.05). Conclusions: Edentulism tends to progress with advancing age, often leading to more extensive tooth loss and the need for comprehensive dental rehabilitation. The condition is closely linked to general health status, highlighting its relevance as a potential indicator of systemic health risks. Lifestyle factors, particularly smoking and alcoholism, appear to contribute significantly to the deterioration of oral health, underscoring the importance of preventive strategies and early intervention. Full article

Background: The purpose of this study was to investigate the effect of occlusal splints on temporomandibular disorders (TMDs) and well-being in patients with fibromyalgia and bruxism. This experimental study assessed the impact of Michigan-type occlusal splints on TMDs and well-being in fibromyalgia and bruxism patients and healthy individuals. Methods: This quasi-experimental study assesses the impact of an intervention on TMD symptoms and overall well-being in patients with fibromyalgia and bruxism. A total of 266 participants were divided into three groups: bruxism with fibromyalgia (ABFG, n = 37), sleep bruxism with fibromyalgia (SBFG, n = 53), awake bruxism without fibromyalgia (ABG, n = 45), sleep bruxism without fibromyalgia (SBG, n = 85), and a healthy control group (HG, n = 46). All participants received a rigid acrylic occlusal splint and counseling on behavioral changes. Pre- and post-treatment questionnaires measured various variables, including jaw function (JFLS-8), anxiety (GAD-7), oral health impact (OHIP-14), well-being (WHO-5), sleep quality (PSQI), and symptoms such as bruxism, TMJ pain, headaches, and jaw locking. Results: The study demonstrated that occlusal splints significantly improved various outcomes in patients with bruxism and fibromyalgia. For the ABFB, significant reductions were observed in JFLS-8, GAD-7, OHIP-14, and PSQI and increases in WHO-5 scores (p < 0.001). Similar improvements were noted in the SBFB. The ABG group showed significant changes in JFLS-8, OHIP-14, and WHO-5, but not in GAD-7 or PSQI. Furthermore, SBG exhibited significant improvements across all measures except WHO-5. Patients in the HG showed only slight changes in PSQI. Additionally, significant reductions in the prevalence of TMJ pain, headaches attributed to TMJ, and jaw locking were noted across the bruxism groups. Conclusion: This study finds that occlusal splints significantly enhance symptoms of TMD and enhance overall well-being, especially in patients with fibromyalgia. Significant improvements were observed in JFLS-8, GAD-7, OHIP-14, PSQI, and WHO-5 scores, alongside a marked reduction in the prevalence of TMJ pain, TMJ-related headaches, and jaw locking. This highlights occlusal splints as an effective therapeutic option for managing both physical and psychological symptoms in fibromyalgia patients. However, the benefits for healthy individuals were minimal, suggesting a need for further research on long-term effects and treatment optimization. Full article

The classical approach for the preparation of an endodontically treated molar with a post and core involves widening the anatomically complex system of canals, which may be narrow or curved with variable angulation. The aforementioned along with the fact that restorative dentistry stands against the wastage of tooth tissue make endocrowns an appealing alternative. Bindl and Mörmann first described an all-ceramic crown anchored to the internal portion of the pulp chamber and on the cavity margins, thus obtaining macromechanical retention provided by the axial opposing pulpal walls and microretention attained with the use of adhesive cementation. The purpose of this report is to describe the protocol for the treatment plan selection, preparation, impression, and adhesive cementation of an endocrown with a follow-up of 5 years. A 56-year-old male patient presented to the Postgraduate Clinic of Prosthodontics seeking rehabilitation for tooth No. #36. A clinical examination revealed multiple immediate composite resin restorations with unacceptable morphology and adaptation to the remaining tooth as well as a lack of a contact point but, rather, a large, concave contact area facilitating food entrapment. Since the tooth was endodontically treated, the proposed treatment plan included the fabrication of an all-ceramic endocrown. The steps of preparation, attribution of the correct shape, impression, and adhesive luting under rubber dam isolation are thoroughly described. The final functional and aesthetic result, patient’s satisfaction, and the 5-year follow-up render restorations such as endocrowns, which draw their retention from adhesive luting, a viable alternative to conventional approaches. Full article

Odontogenic myxoma (OM) is a rare, benign intraosseous tumor that arises from the dental follicle, dental papilla, or periodontal ligament. It typically affects the mandible, maxilla, and sinuses, more frequently in women than men. The histopathology of OM is characterized by a myxoid stroma with varying degrees of collagenization and spindle cells. Treatment is surgical, but there are no standardized guidelines. Available options include enucleation and curettage, with conservative approaches offering better aesthetics and functionality but a higher recurrence risk. This case report aims to discuss a rare presentation of OM in the anterior part of the mandible of a 22-year-old female patient with Hashimoto’s thyroiditis and idiopathic thrombocytopenic purpura. The patient presented with painless swelling and tooth mobility in the symphysis region. Radiographic evaluation revealed a unilocular lesion extending from the left second incisor to the right first incisor, with no root resorption. Histopathological analysis confirmed the OM diagnosis. Due to the patient’s young age and the size of the lesion, a conservative treatment approach was chosen, with the potential for future implant-prosthodontics rehabilitation. The case underscores the importance of thorough clinical, radiological, and histopathological assessment to ensure accurate diagnosis and management of OM. Long-term follow-up is essential due to the increased risk of recurrence in younger patients. Full article

The present study describes the case of a severe surgical complication in a 42-year-old female patient undergoing bimaxillary orthognathic surgery for the correction of skeletal class III, where a detachment of the surgical plates and fibrous healing of the palatal suture occurred. The aim of this study was to enlighten two important concepts: (I) how occlusal and mandible position changes can be well tolerated by the temporomandibular joint even in the case of a failed orthognathic surgery; (II) how a prosthodontic approach based on the search for occlusal stabilization made it possible to manage a complicated clinical case. Clinical Presentation: Clinically, the patient presented an occlusal instability and a split and mobile maxillary bone with respect to the cranial base. The case was resolved using full-mouth prosthodontic rehabilitation to fix the occlusal instability and guide maxillofacial surgeons, establishing the new occlusal position during an orthognathic reintervention. Clinical Relevance: The function was reestablished independently on any treatment planning centered on the temporomandibular joint repositioning concepts. However, although neuromuscular plasticity and the patient’s adaptation skills can explain the clinical success in such complex rehabilitations, these findings must be interpreted with caution due to the limited generalizability inherent to the study’s design. Full article

As the discipline of prosthodontics evolves, it encounters a dynamic landscape characterized by innovation and improvement. This comprehensive analysis underscores future developments and transformative solutions across its various subspecialties: fixed, removable, implant, and maxillofacial prosthodontics. The narrative review examines the latest advancements in prosthetic technology, focusing on several critical areas. The integration of artificial intelligence and machine learning into prosthetic design and fitting processes is revolutionizing the field, serving as a common thread that links these innovative technologies across all subspecialties. This includes advancements in automated diagnostics, predictive analysis, and treatment planning. Furthermore, the review offers a forward-looking perspective on how these innovations are influencing each prosthetic dentistry domain, patient outcomes, and current clinical practices. By thoroughly analyzing contemporary research and emerging technologies, the study illustrates how these advancements represent a growing focal point of interest in developing countries, such as Romania, with the potential to redefine the trajectory of prosthetic rehabilitation and enhance patient care not only within this country but also beyond. Full article

Background: Dental implant rehabilitation has significantly advanced prosthodontics by providing a reliable, long-lasting solution for missing teeth. This systematic review compares the clinical, technical, and biological outcomes of cemented versus screw-retained single dental implant restorations based on randomized clinical trials (RCTs). Materials and Methods: This review included recent human and in vitro studies focusing on the keywords “cemented vs. screw-retained” and “dental implant”. Eight studies met the inclusion criteria, which investigated parameters, including implant survival rate, bleeding on probing (BOP), probing depth, plaque index, marginal bone loss (MBL), cytokine concentrations, mechanical complications, esthetic outcomes, patient satisfaction, treatment time, and technical failures. Results: The primary outcomes, BOP and MBL, did not statistically differ between cemented and screw-retained implants (p-values for MBL and BOP are 0.5813 and 0.8093, respectively). The reviewed studies, including RCTs, split-mouth studies, and clinical evaluations, demonstrated comparable clinical, technical, and biological outcomes between the two restoration methods. Conclusions: Screw-retained and cemented dental implant restorations exhibit similar clinical, technical, and biological outcomes. Screw-retained restorations offer advantages such as retrievability, ease of repair, and predictable passive fit, while cemented restorations provide superior esthetics. The risk of peri-implant complications due to residual cement in cemented restorations must be considered. Future research should explore long-term stability and the impact of different prosthetic protocols on peri-implant health. Full article

The main objectives of the present prospective clinical study were to evaluate the survival and success rates of implant-supported zirconia single crowns fabricated with a full digital workflow for the rehabilitation of mono- and bilateral agenesis of maxillary lateral incisors after 2 years of clinical function; biological and technical parameters affecting the prosthetic restorations were recorded, as well as the patient-satisfaction score. Twenty-two patients showing mono- or bilateral agenesis of the maxillary lateral incisors were included in this study, and a total of 30 narrow-diameter implants were inserted. Thirty screw-retained monolithic cubic zirconia single crowns with internal connections were fabricated. Objective outcome evaluations were performed by means of the Functional Implant Prosthodontic Score, whereas the patient-satisfaction score was evaluated using Visual Analog Scales. Descriptive statistics were performed and the Kaplan–Meier analysis was run to analyze time-to-event data. After 2 years of clinical function, the overall FIPS found in the present study was 9.2, whereas the average patient-satisfaction score was 8.7. The Kaplan–Meier analysis at the 2-year follow-up reported a cumulative survival rate of 100% and a cumulative success rate of 93.3%. The implant-prosthetic rehabilitation with a full digital workflow proved to be an effective and reliable procedure for the functional and aesthetic treatment of the agenesis of maxillary lateral incisors in the short-term. Clinical investigations with wider sample populations and longer observational follow-ups could be useful to validate, in the long-term, the clinical outcomes of the present prospective clinical study. Full article