Search Results (119)

Background/Objectives: Anterior dental trauma in adolescents presents complex restorative challenges due to ongoing craniofacial development and high aesthetic expectations. This study evaluated the long-term clinical performance of feldspathic ceramic veneers and lithium disilicate crowns used in the anterior region following dental trauma in adolescents. Methods: A total of 209 restorations were placed in 85 adolescents (50 females, 35 males), aged 11.1–17.9 years (mean age: 15.1 years). Of these, 144 were lithium disilicate crowns, and 65 were feldspathic ceramic veneers. All restorations were fabricated using minimally invasive protocols and followed up for periods ranging from 3 to 60 months. Outcomes were assessed based on standardized clinical criteria for success and failure. Results: Lithium disilicate crowns exhibited superior long-term performance, with the majority of failures occurring in feldspathic veneers (p < 0.001), primarily due to chipping or structural fracture. Age and gender had no statistically significant influence on failure rates. Conclusions: Both feldspathic and lithium disilicate ceramic restorations represent viable treatment options for anterior dental trauma in adolescents. However, lithium disilicate demonstrates greater mechanical reliability, particularly in teeth with significant hard tissue loss. These results support the use of durable ceramic materials in adolescent restorative protocols involving dental trauma. Full article

Background: Aesthetic dentistry increasingly demands minimally invasive, predictable, and patient-centered solutions. Digital technologies and AI-driven planning tools are now integral to interdisciplinary treatments. Aim: To evaluate, by means of a 16-item questionnaire, patients’ perceptions of smile aesthetics and oral function before and after receiving clear aligner therapy followed by minimally invasive ceramic veneers, using digital planning and Smile Creator software. Materials and Methods: Five adult patients underwent digital smile design, clear aligner therapy, and feldspathic veneer placement. Pre- and post-treatment perceptions of smile aesthetics and function were assessed using a structured questionnaire. AI-based simulation tools (2D and 4 K TruSmile video previews) were incorporated. Paired t-tests were used to compare outcomes before and after treatment. Results: Mean pre-treatment scores were 4.8 for smile aesthetics and 6.6 for function. Post-treatment scores significantly improved to 9.8 (p = 0.001) and 9.4 (p = 0.002), respectively. Patients rated AI-generated smile previews more favorably than 2D designs and acknowledged the value of digital tools in understanding and accepting treatment. Conclusions: The integration of digital and AI-based tools in aesthetic dentistry enhances patient communication, improves predictability, and enables minimally invasive treatment. Patient satisfaction was high, underscoring the effectiveness of the combined orthodontic and prosthetic approach. Full article

Background: Intraoral scanners have become increasingly popular for final dental prostheses due to their precision, efficiency, and patient-friendly approach. However, their use for capturing final impressions of highly esthetic and thin restorations, such as ceramic veneers, presents unique challenges. Veneer preparations differ significantly from traditional full-coverage crowns, with their smaller and more delicate margins often located at or below the gingival level. This complexity may lead to hesitancy among clinicians regarding the routine use of intraoral scanners in such cases. Methods: A comprehensive literature review was performed to evaluate the effectiveness of intraoral scanners for final digital impressions in ceramic veneer restorations within the esthetic zone. Studies published between January 2010 and January 2025 were included in the review. Additionally, a case illustration was provided, detailing the use of an intraoral scanner to capture final impressions for a patient requiring 10 ceramic veneers in the esthetic zone. Results: The review demonstrated that intraoral scanning is a reliable technique for veneer impressions, delivering clinically acceptable outcomes. The benefits include enhanced patient comfort, improved workflow efficiency, and a reduction in chairside time. Nonetheless, clinicians must overcome a learning curve with digital technologies and ensure optimal conditions, such as maintaining a dry tooth surface during scanning. The presented case successfully illustrated the use of intraoral scanning, resulting in precise impressions and the fabrication of highly esthetic and functional veneers. Conclusions: Intraoral scanning is a predictable and effective method for capturing final impressions for veneer restorations. It offers results comparable to traditional methods while enhancing patient experience and enabling the fabrication of high-quality restorations within an efficient workflow. Full article

Purpose: The aim of this study was to evaluate the long-term clinical results of two different implant–abutment connection types (screw-retained/Morse locking taper), marginal bone loss, and complications in prosthetic restorations. Materials and Methods: In 2017–2018, 579 implants and 242 implant-supported restorations applied to 137 patients were included in the study. Patients were recalled every six months, clinical evaluations were accomplished, and complications were recorded. When examining the distribution of prosthetic restorations by type, it was determined that 38 (15.70%) were single crowns, 136 (56.19%) were fixed partial cement-retained bridge restorations, 53 (21.90%) were fixed partial screw-retained bridge restorations, and 15 (6.19%) were overdenture prostheses. Findings: Overall, complications included eighteen (21.68%) retention losses, nineteen (22.89%) instances of screw loosening, twenty-one (25.30%) veneer ceramic fractures, three (3.61%) acrylic base fractures, fourteen (16.87%) cases of peri-implantitis, and eight (9.64%) implant losses. Conclusions: Differences in complication rates were observed between implants with different implant–abutment connection designs. While no significant differences were found regarding annual mesial and distal marginal bone loss for implants with conical locking connections, a significant difference was detected in those with screw-retained connections. In both implant groups, mesial and distal marginal bone loss progressed gradually over the follow-up period. Full article

Background: Composite resin veneers have gained popularity due to their affordability and minimally invasive application as biomimetic restorations. However, long-term clinical challenges, such as discoloration, wear, and reduced fracture resistance, necessitate their replacement over time. Ceramic veneers, particularly feldspathic and lithium disilicate, offer superior esthetics and durability, as demonstrated by studies showing their high survival rates and enamel-preserving preparation designs. However, while ceramic veneers survive longer than composite resin veneers, ceramic veneers may need to be removed and replaced. Reports vary for using Er:YAG (erbium-doped yttrium aluminum garnet) lasers for the removal of existing veneers. Methods: A review was conducted to evaluate the effectiveness of removing restorative materials with an Er:YAG laser. A clinical study was included, highlighting the conservative removal of aged composite resin veneers using the Er:YAG laser. This method minimizes enamel damage and facilitates efficient debonding. Following laser application, minimally invasive tooth preparation was performed, and feldspathic porcelain veneers were bonded. Results: The review showed positive outcomes whenever the Er:YAG laser was used. In the case study, after a 3-year follow-up, the restorations exhibited optimal function and esthetics. Conclusions: Laser-assisted debonding provides a safe and predictable method for replacing failing composite veneers with ceramic alternatives, aligning with contemporary biomimetic principles. Full article

Acid-etched zirconia has emerged as a high-strength alternative to traditional glass ceramics for laminate veneers in aesthetic dentistry. This randomized, double-blind controlled clinical trial aimed to evaluate the one-year clinical performance of zirconia veneers etched with a hydrofluoric-nitric acid mixture and bonded using a 10-methacryloyloxydecyl dihydrogen phosphate (MDP) containing polymeric adhesive system, compared to lithium disilicate veneers. Fifty-two patients were treated with either translucent zirconia or lithium disilicate veneers, and restorations were bonded using light-cured resin-based adhesives. Clinical parameters, including veneer survival, esthetics, marginal adaptation, postoperative sensitivity, and periodontal health, were assessed using modified United States Public Health Service (USPHS) criteria and periodontal indexes at 2 weeks, 6 months, and 12 months. Both materials showed high survival rates with no statistically significant differences in clinical outcomes. One zirconia veneer debonded early but was successfully rebonded without fracture, while one lithium disilicate veneer fractured upon debonding. The findings support the viability of acid-etched zirconia veneers bonded with polymer-based adhesives as a durable and esthetic restorative option. The study highlights the clinical relevance of polymeric bonding systems in enhancing zirconia veneer performance and reinforces their role in modern adhesive dentistry. Full article

Purpose: This study aimed to evaluate the load-bearing capacity of three different millable lithium silicate derivatives compared with lithium disilicate ceramic when used as ultra-thin occlusal veneers on eroded molars. The null hypothesis stated that there would be no significant differences in load-bearing capacity (F_max). Material and Methods: Four groups were tested: three groups with lithium silicate derivatives—“Celt” (Celtra, Dentsply Sirona, Bensheim, Germany), “Vita” (Vita Suprinity PC, Vita Zahnfabrik, Bad Säckingen, Germany), and “Nice” (n!ce, Straumann, Basel, Switzerland)—and a control group with lithium disilicate ceramic, “Emax” (IPS e.max CAD, Ivoclar Vivadent) (n = 20 per group). Extracted molars (n = 80) were prepared to simulate erosion and restored with occlusal veneers designed and milled by using CAD/CAM technology. After thermo-mechanical aging, the specimens were subjected to static load testing until fracture. Failure types were recorded and analyzed. Statistical evaluation included the Wilcoxon rank-sum test for group comparisons and Weibull distribution modeling to assess fracture probabilities. Results: Thermo-mechanical aging caused restoration debonding in three specimens from the “Nice” and “Celt” groups, resulting in fatigue resistance of 100% for “Emax” and “Vita”, 90% for “Celt”, and 95% for “Nice”. The mean F_max values ranged from 892 N to 2087 N, with the “Vita” group demonstrating the highest values. Significant differences in stress values were observed among groups (p < 0.05). Cohesive failure was the most frequent failure mode. Conclusions: All tested lithium silicate derivatives demonstrated high load-bearing capacity and are suitable for ultra-thin occlusal veneers on eroded molars. Cohesive failures dominated, indicating reliable material performance and stable bonding under load. Full article

Background: The bonding protocol for lithium disilicate veneers in the esthetic zone plays a crucial role in modern dental restoration techniques, focusing on the replication of natural tooth properties and esthetics. This process involves several meticulous steps on both ceramic and tooth surfaces to optimize material performance and bond strength. Methods: The objective of this article is to provide an updated review of the literature on the clinical steps for bonding lithium disilicate veneers in the anterior dentition and to document a clinical case where these advanced restorative techniques were applied to treat a female patient seeking to improve her smile. A preliminary review was conducted on the existing literature regarding the clinical protocols for bonding lithium disilicate veneers in the esthetic zone. The main advantage of careful bonding procedures is that they maximize the full potential of the materials’ properties. Results: A review of the literature reveals some minor differences in cleaning the veneers prior to cementation and in the number of steps involved when combining certain materials in a single application process. However, well-executed bonding procedures, following the manufacturer’s recommendations, can maximize the adhesion between the ceramic and the tooth, allowing the restorations to meet the patient’s esthetic demands. Conclusions: Effective bonding of lithium disilicate veneers in the esthetic zone requires multiple treatments on both the ceramic and tooth surfaces. When procedures are followed carefully, long-term esthetic and functional outcomes can be achieved. It is essential that clinicians are familiar with these steps. Proper patient selection, thoughtful treatment planning, and methodical execution of the case can lead to highly esthetic results that satisfy the patient’s demands and ensure long-term success. Full article

Background: Lithium disilicate ceramic veneers are considered the gold standard in aesthetic dentistry due to their translucency, strength, and adhesive bonding properties. This clinical case report details the aesthetic rehabilitation of a patient through the use of pressed lithium disilicate veneers, highlighting the treatment workflow, material selection rationale, and the long-term functional and aesthetic outcomes achieved. Methods: A review was conducted to evaluate the long-term success of lithium disilicate. A case study is presented that involves a 32-year-old female patient with anterior tooth discoloration, minor morphological discrepancies, and a desire for smile enhancement. A conservative approach using pressed lithium disilicate was chosen to restore harmony and enhance natural aesthetics. The treatment involved minimally invasive tooth preparation, digital smile design, and adhesive cementation using a total-etch technique with light-cured resin cement. High-resolution intra-oral and extra-oral photographs documented the case, capturing the preoperative, preparation, and final restoration stages. These images highlight shade matching, margin adaptation, and smile transformation after veneering. Results: Postoperative evaluation showed excellent aesthetic outcomes, color integration, and marginal adaptation, with the patient expressing high satisfaction. The veneers exhibited optimal translucency and strength, ensuring long-term durability. A one-year follow-up revealed no debonding, marginal discoloration, or surface degradation, confirming the clinical reliability of lithium disilicate veneers. Conclusions: Lithium disilicate provides predictability, durability, and high aesthetic results, making it an ideal choice for minimally invasive smile enhancement. The use of photographic documentation emphasizes the importance of case planning, precise preparation, and adhesive bonding for successful outcomes. Future research should focus on long-term survival rates and complication prevention to further refine material selection and bonding protocols. Full article

This study assessed the shear bond strength (SBS) and failure modes of lithium disilicate ceramic veneering material to different high-performance polymers. Thirty-six square specimens measuring 7 × 7 × 2 ± 0.05 mm were prepared from pure polyetheretherketone (PEEK), Bio-high performance PEEK (BioHPP) and Trilor discs. Polymer specimens were air-borne abraded utilizing aluminum oxide particles, cleaned, and a bonding agent was applied (visio. link). The veneering LDC material (3 × 2 mm) was milled, hydrofluoric acid etched (9.5%) and primed (Clearfil ceramic). The LDC was bonded to the polymer specimens using dual-cured resin cement (Panavia V5) and light polymerized. The bonded specimens were subjected to 5000 cycles of physiological aging by thermocycling, and the SBS test was performed in a universal testing machine at 0.5 mm/min cross-head speed. The debonded specimens were analyzed to determine the primary bond failure sites (adhesive, mixed or cohesive). Data analysis was performed using one-way ANOVA and a post hoc Tukey test (α ≤ 0.05). The BioHPP material demonstrated the highest SBS values (23.94 ± 1.43 MPa), and the Trilor group recorded the lowest SBS values (17.09 ± 1.07 MPa). The PEEK group showed a mean SBS of 21.21 ± 1.51 MPa. The SBS comparison showed significant variations across all material groups (p < 0.001). Regarding failure modes, adhesive failure was observed in 40% of BioHPP and PEEK specimens and 90% of Trilor specimens. The cohesive failure occurred in 50% of PEEK and 30% of BioHPP specimens, while the Trilor specimens showed no cohesive failure. Mixed failures were reported in 30% of BioHPP and 10% of PEEK and Trilor specimens. The BioHPP material demonstrated high SBS followed by PEEK and Trilor. The SBS between the tested materials was statistically significant. However, the SBS of the tested implant framework materials was above the limit stipulated by the ISO 10477 standard (5 MPa) and the clinically acceptable range of 10–12 MPa. Full article

Fluorapatite glass-ceramics (FGC) have been widely used in dental ceramics due to their excellent aesthetic properties and biocompatibility. In recent years, new synthesis methods, forming technologies, and the continuous optimization of performance attributes have driven the application of FGC in dental veneers, coatings, composites, and other restorations. This review summarizes the current research and applications of this material in the dental field and looks forward to its future optimization directions. The article focuses on five aspects: the development of preparation techniques for FGC; advances in their application in dental restoration shaping technologies; the performance advantages and limitations of these materials as dental materials; the current application status in veneers, coatings, composites, and other restorations; as well as the challenges in the current applications and prospects. In addition, additive manufacturing technology shows extremely broad application potential in FGC molding and applications. This review is hoped to provide strong guidance for the further application of FGC in the dental field, promoting the integration of related research and industry upgrades better to meet the needs of clinical practice and patients. Full article

Background: This case report outlines the clinical workflows for immediate implant placement for both maxillary central incisors and ceramic laminate veneers for the remaining teeth in the smile zone. Methods: The patient’s chief complaint was to improve her smile and address periapical infections with purulent exudate at the apex of her central incisors. Clinical and CBCT evaluations determined that the maxillary central incisors were non-restorable, while the lateral incisors and canines showed signs of incisal wear. Atraumatic extractions were performed for the central incisors, and immediate implants were placed with a 3D-printed surgical guide in conjunction with an autogenous soft tissue grafting procedure. Once the soft tissue between the central incisors was contoured with provisional implant restorations, minimally invasive veneer preparations were performed for porcelain laminate veneers. Final restorations were bonded under dental dam isolation. Results: Single immediate implants for maxillary central incisors can be successfully paired with ceramic laminate veneers on adjacent teeth in the smile zone to replace non-restorable teeth in the esthetic zone. Conclusions: Atraumatic tooth extraction, 3D implant planning with grafting procedures, and minimally invasive ceramic veneers can help in meeting patients’ esthetic and functional expectations. Total isolation using a dental dam maximizes the bonding performance of ceramic restorations. Full article

Zirconia restorations are widely used in dentistry due to their high esthetic expectations and physical durability. However, zirconia’s opaque white color can compromise esthetics. Therefore, zirconia is often veneered with porcelain, but fractures may occur in the veneer layer. Monolithic zirconia restorations, which do not require porcelain veneering and offer higher translucency, have been developed to address this issue. Zirconia exists in three main crystal phases: monoclinic, tetragonal, and cubic. Metal oxides such as yttrium are added to stabilize the tetragonal phase at room temperature. 3Y-TZP contains 3 mol% yttrium and provides high mechanical strength but has poor optical properties. Recently, 4Y-PSZ and 5Y-PSZ ceramics, which offer better optical properties but lower mechanical strength, have been introduced. This review examines the factors affecting the color change in monolithic zirconia ceramics. These factors are categorized into six main groups: cement type and color, restoration thickness, substrate color, sintering, aging, and zirconia type. Cement type and color are crucial in determining the final shade, especially in thin restorations. Increased restoration thickness reduces the influence of the substrate color while the sintering temperature and process improve optical properties. These findings emphasize the importance of material selection and application processes in ensuring esthetic harmony in zirconia restorations. This review aims to bridge gaps in the literature by providing valuable insights that guide clinicians in selecting and applying zirconia materials to meet both esthetic and functional requirements in restorative dentistry. Full article

This study evaluated the colour and translucency changes in resin cements and lithium disilicate veneer restorations, as well as the sorption and solubility of cements after staining. Four resin cements (G-CEM ONE, RelyX Universal, Panavia V5, Variolink Esthetic) were tested. Cylindrical specimens and LiSi veneer restorations cemented to a G-aenial Universal Injectable dentine base (N = 10/group) were stained in black tea for 72 h. Changes in colour (∆E₀₀) and the translucency parameter (∆TP₀₀) were analyzed using a spectrophotometer, while sorption and solubility were calculated via mass/volume formulae. G-Cem and RelyX exhibited significantly lower ∆E₀₀ than Variolink and Panavia (p < 0.001), while RelyX uniquely showed increased ∆TP₀₀ (p < 0.001). The ∆E₀₀ of cemented veneers ranged from 2.7 ± 0.5 (G-Cem) to 3.9 ± 0.7 (Panavia), with decreased translucency after staining across groups (p > 0.05). The initial TP positively correlated with the ∆E₀₀ of both cements and veneer restorations, while the ∆E₀₀ of cements correlated with that of veneer restorations. RelyX had the highest sorption, and Variolink showed the highest solubility, though neither correlated with colour changes. Resin cements influenced colour changes in veneer restorations post-staining, with colour differences associated with initial cement translucency but independent of sorption and solubility. Full article

Background/Objectives: The injection moulding technique (IMT) is a minimally invasive restorative treatment. This technique enables the application of thin, flowable composite layers into a stable, transparent silicone index that serves as a mould. Due to the fluid properties of the composite, it efficiently fills the silicone tray and seamlessly integrates with the tooth structure, often obviating tooth preparation and preserving overall tooth integrity. The procedure employs the etch-and-rinse protocol and is highly reproducible. Minimally invasive restorative techniques are particularly relevant following orthodontic treatment, where minor tooth adjustments are often required to achieve optimal aesthetics and function. Integrating orthodontic and restorative treatments is pivotal for long-term success, especially in complex interdisciplinary cases. Methods: This retrospective study describes the application of conservative restoration using the IMT in two pediatric patients (12.6 years old and 12.3 years old) to restore maxillary lateral incisors before and after orthodontic treatment. The technique provides a viable option for temporary composite restorations until the patients are suitable candidates for permanent all-ceramic veneers. Results: The injectable technique is ideal for minimal diastemas, small interdental spaces, or retruded teeth. The cases presented, involving irregular tooth sizes and morphologies, demonstrate the suitability of the IMT in scenarios requiring an additive approach. This technique effectively addresses such irregularities without necessitating invasive preparation. Conclusions: The IMT is a valuable tool for pediatric patients undergoing orthodontic treatment, both at its initiation and completion. The technique assists orthodontists in finalising treatment by addressing Bolton index discrepancies and correcting tooth shape anomalies. Additionally, a digital workflow reduces clinical sessions, as thermo-printed retainers can be delivered during the same appointment as the IMT, providing economic and organisational benefits. This approach underscores the utility of the IMT in enhancing treatment efficiency and outcomes in orthodontic–restorative care. Full article