Search Results (41)

Background: The clinical translation of natural nanomaterials and smart delivery systems in regenerative dentistry relies heavily on practitioner acceptance; however, end-user perspectives remain under-investigated. Objective: This study evaluated dental practitioners’ self-reported knowledge, attitudes, and perceived barriers regarding these innovations. The questionnaire examined stated intention and self-reported willingness, not clinical behaviour. Methods: A cross-sectional survey using convenience sampling was conducted among 713 Romanian dentists. Statistical analysis included Chi-square tests and odds ratio estimation to identify factors associated with willingness to adopt nano-formulations. Results: Self-reported familiarity was moderate, with only 19.1% of respondents describing themselves as “very familiar” with nanodentistry; nevertheless, 77.3% believed natural nano-formulations could match synthetic efficacy. High costs (36.5%), lack of long-term evidence (35.9%), and staining concerns (46.0%) were identified as primary perceived barriers. Experience with digital technologies (CAD/CAM) was significantly associated with a positive attitude toward adoption (OR = 2.05, 95% CI: 1.41–2.98, p < 0.001). Conclusions: Respondents demonstrated a generally positive attitude toward integrating bioactive nanomaterials, though widespread adoption is currently limited by economic, educational, and evidentiary gaps. Future strategies should focus on establishing clear clinical protocols, providing robust long-term safety data, and improving the aesthetic stability of natural biomaterials. Full article

The management of dental caries has evolved from the traditional mechanical approach of “extension for prevention” to a biologically oriented philosophy centered on preserving natural tooth structures. Minimally invasive dentistry (MID) emphasizes early detection, risk assessment, prevention, and conservative intervention based on the lesion’s activity and depth. This review outlines current evidence on non-operative, micro-invasive, and minimally invasive strategies, including fluoride therapy, remineralizing agents such as casein phosphopeptide–amorphous calcium phosphate (CPP-ACP), self-assembling peptides that promote biomimetic enamel repair, sealants, and resin infiltration. Minimally invasive operative methods employ advanced technologies for selective tissue removal—chemomechanical systems (Carisolv, Papacarie, Brix3000), sono-and airabrasion, and new-generation polymeric and ceramic burs (SmartBur, Cerabur) designed to preserve sound dentin. Laser photoablation, particularly with erbium lasers (Er:YAG, Er,Cr:YSGG), enables precise cavity preparation with minimal thermal and mechanical stress. These approaches enhance patient comfort, reduce anesthesia requirements, and maintain tooth vitality. Despite limitations related to cost, equipment, and operator sensitivity, MID represents not only a set of refined clinical techniques but also a comprehensive, evidence-based treatment philosophy founded on biological principles, structural preservation, and the promotion of long-term oral health. Full article

Using multifunctional dual-cure smart bioactive resin luting agents (DRLs) offers benefits in adhesive dentistry, but their optical stability remains a concern. Their pre-cured form is a shear-thinning structure with thixotropic gel-like behavior. The effect of their hydrophilicity and different thicknesses of nanoceramic hybrid on the final shade of milled esthetic restorations needs further investigation. This study examined how the optical function deterioration of dual-cure smart bioactive resin luting agents used to bond a CAD/CAM nano-ceramic hybrid composite would influence the restoration’s final shade at three different thicknesses. A nanoceramic hybrid composite (GD) was cut into blocks and grouped by thickness (0.8, 1.0, 1.5 mm). Ten blocks from each group were assigned to subgroups based on the DRL type: Panavia SA Universal (PN), Predicta Bioactive (PR), and ACTIVA BioACTIVE (AC). Color and whiteness changes after a 24 h/day (24 days) coffee immersion were analyzed using statistical methods (ANOVA and Tukey’s HSD for ΔE₀₀; Welch’s ANOVA and Games-Howell for ΔWI_D and ΔL*). DRL type significantly affected ΔE₀₀, ΔWI_D, and ΔL* (p < 0.001). All materials showed the least color change and optical function deterioration at a restoration thickness of 1.5 mm, which was below the acceptability threshold (AT). Despite PR’s bioactive functionality, it maintained its primary optical function with the least color change at GD thicknesses of 1.0 and 1.5 mm (p < 0.001). AC exhibited the greatest ΔE₀₀ above AT, especially at a thickness of 0.8 mm (p < 0.001). ΔL*, ΔE₀₀, and ΔWI_D varied significantly based on DRL type, GD thickness, and the interaction between DRL and thickness (p < 0.05). This suggests that although dual-cure smart DRLs containing bioactive glasses are advantageous, their optical function shifts may become more noticeable in thin, translucent restorations. Increasing the restoration thickness can help mitigate this by altering the optical pathway. Full article

Conventional dental materials with organised crystal structures exhibit limitations in corrosion resistance, bioactivity, and drug delivery capability. In contrast, amorphous nanomaterials offer potential advantages in overcoming these limitations due to their unique structural properties. They are characterised by a non-crystalline, disordered atomic structure and are similar to a solidified liquid at the nanoscale. Among the amorphous nanomaterials used in dentistry, there are five major categories: calcium-, silicon-, magnesium-, zirconia-, and polymer-based systems. This study reviewed these amorphous nanomaterials by investigating their synthesis, properties, applications, limitations, and future directions in dentistry. These amorphous nanomaterials are synthesised primarily through low-temperature methods, including sol–gel processes, rapid precipitation, and electrochemical etching, which prevent atomic arrangements into crystalline structures. The resulting disordered atomic configuration confers exceptional properties, including enhanced solubility, superior drug-loading capacity, high surface reactivity, and controlled biodegradability. These characteristics enable diverse dental applications. Calcium-based amorphous nanomaterials, particularly amorphous calcium phosphate, demonstrate the ability to remineralise tooth enamel. Silicon-based amorphous nanomaterials function as carriers that can release antibacterial agents in response to stimuli. Magnesium-based amorphous nanomaterials are antibacterial and support natural bone regeneration. Zirconia-based amorphous nanomaterials strengthen the mechanical properties of restorative materials. Polymer-based amorphous nanomaterials enable controlled release of medications over extended periods. Despite the advances in these amorphous nanomaterials, there are limitations regarding material stability over time, precise control of degradation rates in the oral environment, and the development of reliable large-scale manufacturing processes. Researchers are creating smart materials that respond to specific oral conditions and developing hybrid systems that combine the strengths of different nanomaterials. In summary, amorphous nanomaterials hold great promise for advancing dental treatments through their unique properties and versatile applications. Clinically, these materials could improve the durability, bioactivity, and targeted drug delivery in dental restorations and therapies, leading to better patient outcomes. Full article

Chitosan (chit) is a specific polymer, an oligosaccharide, that demonstrates several important properties alone or in combination with other compounds or elements. These important properties include being biocompatible with the human body and simultaneously effective in destroying bacteria. Moreover, it is a smart polymer, as it can change its properties when the pH value decreases below about 7. Therefore, chitosan is widely applied in dermo-cosmetics, but it is also intensively investigated for its use in food preservation and the targeted regeneration of teeth in dentistry. Due to these advantageous characteristics, chitosan has been employed in numerous coating systems for biomedical applications. These coatings can be fabricated through a wide variety of procedures involving different deposition techniques, process parameters, and the chemical characteristics of the environment, solution, air or vacuum, as well as the substrate. Chitosan–metallic coatings have often been investigated; however, the use of elementary metals in the form of nanoparticles (NPs) was rarely reported. The main part of this paper is focused on the presentation of chitosan–metallic NPs, in particular, an application of potentially antibacterial noble and semi-noble metals such as Au, Ag, Cu, and Zn, intensively investigated by the author. The deposition methods and their limitations, the differences in properties of such coatings and those possessing Ag, Sr, Zn, and other metals in the form of cations in chemical compounds, and the perspectives of chit–MeNPs (metal nanoparticles) are thoroughly considered, and future research is proposed. Full article

Additive manufacturing (AM), commonly known as 3D printing, is revolutionizing modern dentistry, introducing high-precision, patient-specific, and digital-driven workflows across prosthodontics, orthodontics, implantology, and maxillofacial surgery. Extensive analysis explores the leading platforms in 3D printing such as stereolithography (SLA), fused deposition modeling (FDM), selective laser sintering (SLS), digital light processing (DLP), and PolyJet which all achieve superior performance across multiple areas including resolution capabilities, material compatibility options, clinical application readiness, and cost-effectiveness. Additionally, an extensive overview of common materials, including biocompatible polymers (PLA, PMMA, PEEK), metals (titanium, cobalt-chromium), and ceramics (zirconia, alumina, glass-ceramics), sheds light on the critical role of material selection for patient safety, durability, and functional performance. The review explores new advancements such as 4D printing with shape-adaptive smart biomaterials as well as artificial intelligence-enabled digital processes and prosthesis design for the transformation of regenerative dentistry and intraoral drug delivery operations into new domains and the automation of clinical planning. Equally groundbreaking are 3D printing applications in pediatric dentistry, surgical simulation, and dental education. However, full-scale adoption of AM technology is not without challenges, including material toxicity, regulatory hurdles for approval, high initial investments, and the need for extensive digital expertise training. Sustainability concerns are also being addressed, with recycled materials and circular economy models gaining traction. In conclusion, this article advocates for a future where dentistry is shaped by interdisciplinary collaboration, intelligent automation, and hyper-personalized biocompatible solutions, with 3D printing firmly established as the backbone of next-generation dental care. Full article

Gel-based delivery systems have emerged as versatile platforms in dentistry due to their biocompatibility, injectability, tunable rheology, and ability to localize therapeutic agents at the site of application. This review synthesizes current evidence on hydrogels, thermosensitive gels, mucoadhesive gels, nanoparticle-loaded gels, and stimuli-responsive systems, highlighting their structural characteristics, mechanisms of drug release, and clinical relevance. Mucoadhesive formulations demonstrate prolonged retention in periodontal pockets and oral mucosa, improving the efficacy of antimicrobials and anti-inflammatory agents. Thermosensitive gels enable minimally invasive administration and in situ gelation, supporting controlled release at body temperature. Nanoparticle-loaded gels exhibit enhanced drug stability and deeper tissue penetration, while “smart” gels respond to environmental stimuli such as pH or temperature to modulate release profiles. Clinical findings indicate reductions in probing depth, improved wound healing, decreased bacterial load, and better patient comfort when gel systems are used as adjuncts to mechanical therapy or regenerative procedures. However, despite these advances, challenges such as variability in gel stability, manufacturing reproducibility, regulatory approval pathways, and limited long-term clinical evidence still constrain widespread adoption of these systems in routine practice. Full article

Background: The accuracy and consistency of complete-arch digital impressions are fundamental for long-term success of implant-supported rehabilitations. Recently, artificial intelligence (AI)-assisted tools, such as SmartX (Medit Link v3.4.2, MEDIT Corp., Seoul, South of Korea), have been introduced to enhance scan body recognition and data alignment during intraoral scanning. Objective: This in vitro study aimed to evaluate the impact of SmartX on impression accuracy, consistency, operator confidence, and technique sensitivity in complete-arch implant workflows. Methods: Seventy-two digital impressions were recorded on edentulous mandibular models with four dummy implants, using six experimental subgroups based on scan body design (double- or single-wing), scanning technique (occlusal or combined straight/zigzag), and presence/absence of SmartX tool. Each group was scanned by both an expert and a novice operator (n = 6 scans per subgroup). Root mean square (RMS) deviation and scanning time were assessed. Data were tested for normality (Shapiro–Wilk). Parametric tests (t-test, repeated measures ANOVA with Greenhouse–Geisser correction) or non-parametric equivalents (Mann–Whitney U, Friedman) were applied as appropriate. Post hoc comparisons used Tukey HSD or Dunn–Bonferroni tests (α = 0.05). Results: SmartX significantly improved consistency and operator confidence, especially among novices, although it did not yield statistically significant differences in scan accuracy (p > 0.05). The tool mitigated early scanning errors and reduced dependence on operator technique. SmartX also enabled successful library alignment with minimal data; however, scanning time was generally longer with its use, particularly for beginners. Conclusions: While SmartX did not directly enhance trueness, it substantially improved scan reliability and user experience in complete-arch workflows. Its ability to minimize technique sensitivity and improve reproducibility makes it a valuable aid in both training and clinical settings. Further clinical validation is warranted to support its integration into routine practice. Full article

Metal additive manufacturing (AM) techniques, particularly laser powder bed fusion, are being increasingly recognized not as brand-new technologies, but as emerging technologies with their recent advancements—such as the development of optimized alloys, seamless digital workflow integration, and applications in patient-specific prostheses. With the rise in patient-specific approaches in dentistry, clinicians are seeking customized devices that precisely match individual anatomical and functional needs. AM offers various advantages, such as the fabrication of complex geometries directly from digital designs, enhanced clinical precision, reduced material waste, and simplified manufacturing workflow, and hence can uniquely address these demands. Recent advancements in AM techniques have led to the development of titanium and cobalt–chromium alloys with improved mechanical properties, corrosion resistance, and biological compatibility. These alloys show great potential for clinical applications. Additionally, AM enables precise control over the microstructures and surface topographies of these alloys during fabrication, facilitating their optimized integration with biological tissues. This mini review summarizes recent advancements in metal AM technologies relevant to personalized dentistry, highlights key material developments, discusses current clinical applications, and identifies key challenges such as high cost, materials limitations, and regulatory hurdles, and highlights future opportunities including multi-materials AM, smart implants, and AI-driven optimization for fully integrated, digitally driven personalized dental care. Full article

The growing challenge of biofilm-associated infections in dentistry necessitates advanced solutions. This review highlights the potential of smart bioactive and antibacterial materials—bioactive glass ceramics (BGCs), silver nanoparticle (AgNP)-doped polymers, and pH-responsive chitosan coatings—in transforming restorative dentistry. BGCs reduce biofilms by >90% while promoting bone integration. AgNP-polymers effectively combat S. mutans and C. albicans but require controlled dosing (<0.3 wt% in PMMA) to avoid cytotoxicity. Chitosan coatings enable pH-triggered drug release, disrupting acidic biofilms. Emerging innovations like quaternary ammonium compounds, graphene oxide hybrids, and 4D-printed hydrogels offer on-demand antimicrobial and regenerative functions. However, clinical translation depends on addressing cytotoxicity, standardizing antibiofilm testing (≥3-log CFU/mL reduction), and ensuring long-term efficacy. These smart materials pave the way for self-defending restorations, merging infection control with tissue regeneration. Future advancements may integrate AI-driven design for multifunctional, immunomodulatory dental solutions. Full article

Background: Dentistry is undergoing a digital transformation driven by emerging technologies such as Artificial Intelligence (AI), Internet of Things (IoT), Digital Twins (DTs), and Large Language Models (LLMs). These advancements offer new paradigms in clinical diagnostics, patient monitoring, treatment planning, and medical education. However, integrating these technologies also raises critical questions around security, privacy, ethics, and trust. Objective: This review aims to provide a structured synthesis of the recent literature exploring AI, IoT, DTs, and LLMs in dentistry, with a specific focus on their application domains and the associated ethical, privacy, and security concerns. Methods: A comprehensive literature search was conducted across PubMed, IEEE Xplore, and SpringerLink using a custom Boolean query string targeting publications from 2020 to 2025. Articles were screened based on defined inclusion and exclusion criteria. In total, 146 peer-reviewed articles and 18 technology platforms were selected. Each article was critically evaluated and categorized by technology domain, application type, evaluation metrics, and ethical considerations. Results: AI-based diagnostic systems and LLM-driven patient support tools were the most prominent technologies, primarily applied in image analysis, decision-making, and health communication. While numerous studies reported high performance, significant methodological gaps exist in evaluation design, sample size, and real-world validation. Ethical and privacy concerns were mentioned frequently, but were substantively addressed in only a few works. Notably, IoT and Digital Twin implementations remained largely conceptual or in pilot stages, highlighting a technology gap in dental deployment. Conclusions: The review identifies significant potential for converged intelligent dental systems but also reveals gaps in integration, security, ethical frameworks, and clinical validation. Future work must prioritize cross-disciplinary development, transparency, and regulatory alignment to realize responsible and patient-centered digital transformation in dentistry. Full article

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/Objectives: The introduction of composite attachments has greatly improved orthodontic aligner therapy, through better force delivery, more predictable movements, and enhanced retention. This in vitro study aims to present and investigate an innovative digital protocol for aligner attachment fabrication incorporating the latest 3D technology used in dentistry. Methods: A virtual attachment measuring 2.5 × 2 × 2 mm was designed using computer-aided design (CAD) software (Meshmixer, Autodesk Inc., San Francisco, CA, USA) and exported as an individual STL file. The attachments were fabricated using a digital light processing (DLP) 3D printer (model: Elegoo 4 DLP, Shenzhen, China) and a dental-grade biocompatible resin. A custom 3D-printed placement guide was used to ensure precise positioning of the attachments on the printed maxillary dental models. A flowable resin was applied to secure the attachments in place. Following attachment placement, the models were scanned using a laboratory desktop scanner (Optical 3D Smart Big, Open Technologies, Milano, Italy) and three intraoral scanners: iTero Element (Align Technology, Tempe, AZ, USA), Aoral 2, and Aoral 3 (Shining 3D, Hangzhou, China). Results: Upon comparison, the scans revealed that the iTero Element exhibited the highest precision, particularly in the attachment, with an RMSE of 0.022 mm and 95.04% of measurements falling within a ±100 µm tolerance. The Aoral 2 scanner showed greater variability, with the highest RMSE (0.041 mm) in the incisor area and wider deviation margins. Despite this, all scanners produced results within clinically acceptable limits. Conclusions: In the future, custom attachments made by 3D printing could be a valid alternative to the traditional composite attachments when it comes to improving aligner attachment production. While these preliminary findings support the potential applicability of such workflows, further in vivo research is necessary to confirm clinical usability. Full article

Background: The increasing adoption of digital workflows in implant dentistry necessitates rigorous assessment of intraoral scanning, particularly for complex full-arch rehabilitations like All-on-Four prostheses, where posterior implant angulation may impact the accuracy of optical data acquisition. Objectives: This in vitro study aimed to assess the accuracy of digital intraoral scanners in scanning All-on-Four implant models with different posterior implant angulations. Methods: Two epoxy resin All-on-Four implant models were fabricated with two posterior implant angulations (30-degree and 45-degree). Both models were digitized to obtain control datasets using a Smart Optics reference scanner (REF). Four intraoral scanners were comparatively assessed: Cerec Omnicam AC (OMN), Trios 4 (TRI), Cerec Primescan AC (PRI), and Medit i700 (MED), with nine scans per each scanner (n = 9). All STL files were exported and analyzed using Geomagic Control X with root mean square (RMS) values computed for trueness and precision assessments. Results: The comparison between IOS types in terms of trueness revealed that with 30° angulation, the MED group showed the statistically significant least deviation (p = 402). With 45° angulation, both PRI and OMN scanners showed the statistically significant highest deviation values (p = 0.047 and 0.007, respectively). MED again showed the statistically significant least deviation (p = 402). For precision evaluation in 30° angulation models, PRI and OMN scanners showed the statistically significant least deviation values (p = 402 and <0.001, respectively). While, in 45° angulation models, no statistically significant inter-scanner differences were observed. Conclusions: While MED, PRI, and OMN scanners demonstrated clinical validity for 30° angled posterior implants, only the MED system achieved sufficient accuracy for 45° tilt. These findings emphasize the critical relationship between scanner selection and extreme implant angulations in full-arch digital workflows. 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