Journal of Prosthodontics-Implant Esthetic and Reconstructive Dentistry最新文献

Purpose: This study validated the alignment accuracy of a novel implant-retained fiducial marker system for aligning digital scans in edentulous mandibles MATERIALS AND METHODS: A mandibular master cast with four implant analogs was fabricated. A reference scan of scan bodies (attached to analogs via spherical fiducial markers) was captured using a calibrated desktop scanner with a fixed-position jig. Without moving the cast, scan bodies were replaced with a milled interim prosthesis (using the same fiducial markers) and rescanned to ensure perfect spatial correspondence. The scan body assembly was rescanned 10 times using the desktop scanner (negative control dataset), then 10 times with an intraoral scanner (IOS). All IOS scans were aligned to the reference prosthesis scan in dental computer-aided design (CAD) software using fiducial marker-based reference alignment. Both negative control and aligned IOS scans were compared to the reference scan using metrology software to compute 3D deviation metrics. Statistical analysis used Mann-Whitney U test and Hodges-Lehmann estimator (α = 0.05).

Results: Mann-Whitney U test revealed a statistically significant difference between groups (p < 0.001). Median RMS error for fiducial alignment was 85.8 µm, compared to 8.4 µm for the negative control. Hodges-Lehmann estimator median difference of -77.7 µm (95% CI: -82.4, -75.1 µm).

Conclusions: Despite statistical differences, the novel fiducial marker system achieved a mean alignment accuracy of approximately 85 µm, which is clinically acceptable. This in vitro study demonstrates technical feasibility. Clinical validation is warranted.

Purpose: To evaluate the impact of palatal alveolar bone thickness at the implant platform level on bone resorption and failure rates in the maxillary aesthetic zone.

Materials and methods: From 2018 to 2023, 81 patients with 118 implants were included. This retrospective study used cone-beam computed tomography to measure labial/palatal bone thickness at three stages (T0: postoperative; T1: 3 months; T2: 6 months). The data are presented as the means ± SDs, with significance set at p < 0.05. Relationships between palatal alveolar bone thickness and implant outcomes were evaluated using Pearson correlations, Chi-square tests, and ANOVA with eta-squared statistics. ROC curve analysis was used to determine the cutoff value for failure-related bone thickness.

Results: The palatal alveolar bone at the level of the implant platform was unrelated to the bone resorption or failure rate. ROC analysis (AUC = 0.651) identified < 5.76 mm palatal bone thickness at T0 (root tip level) as a significant failure risk predictor (p < 0.05). Horizontal palatal and labial bone thickness decreased by 21.79% ± 41.18% (p < 0.05) from T0 to T2, with greater labial bone loss.

Conclusions: Palatal alveolar bone thickness at the implant platform level does not influence bone resorption outcomes or survival rates in the maxillary aesthetic zone. However, excessive reduction of palatal bone at the root tip (< 5.76 mm) increases failure risk. Preoperative planning should preserve adequate palatal bone mass while avoiding unnecessary bone removal for long-term stability.

Purpose: To synthesize evidence from systematic reviews on artificial intelligence (AI) applications in prosthodontics and implant dentistry, focusing on clinical applications, AI model performance, and quality of evidence.

Methods: A comprehensive search was conducted in PubMed (MEDLINE), Scopus, Web of Science, Embase, and The Cochrane Library databases, identifying systematic reviews published from 2018 to 2025. Inclusion criteria comprised systematic reviews evaluating AI in prosthodontics or implant dentistry, published in English. Narrative reviews and reviews from other dental specialties were excluded. Two reviewers independently performed study selection and data extraction, and the methodological quality of the included systematic reviews was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) tool. This umbrella review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD420251067048).

Results: Eleven systematic reviews were included. AI demonstrated substantial capability in prosthodontics for caries and fracture detection (with an accuracy of ∼82%-89%), automated tooth shade matching, and prosthesis design. In implant dentistry, AI algorithms accurately identified implant types on radiographs (∼95.6% pooled accuracy), optimized implant placement planning, and predicted treatment outcomes with moderate accuracy (62.4%-80.5%). Performance was strongest for radiographic identification and anatomic segmentation tasks in implant dentistry. It was more modest for preparation margin detection and objective shade matching in prosthodontics, as well as for multivariable prognosis and for detecting maxillary edentulous sites in implant dentistry. Convolutional neural networks (CNNs) consistently outperformed traditional algorithms in image-based tasks. However, AI prediction of long-term outcomes showed moderate performance due to data limitations and biological variability. Overall, although four reviews were rated as high quality, the majority exhibited low or critically low methodological quality, primarily due to a lack of a priori protocol registration and incomplete bias assessment.

Conclusion: AI applications in prosthodontics and implant dentistry may enhance diagnostic and planning workflows, especially for recognition and segmentation tasks. Nevertheless, most evidence comes from early-stage, retrospective, or highly controlled studies, highlighting the need for prospective clinical validation and higher-quality systematic reviews before routine clinical adoption can be recommended.

Purpose: Evidence-based dentistry relies on valid statistics, yet misuse remains common. Despite increased emphasis on statistical rigor, recent prosthodontic publications remain underexplored. We hypothesized that statistical misapplications and reporting deficiencies persist in prosthodontic research. This study evaluated the appropriateness, application, and reporting of statistical tests in high-impact prosthodontic journals.

Methods: Original clinical studies published between January 2019 and December 2024 in the Journal of Prosthodontics (JOP), International Journal of Prosthodontics (IJOP), and Journal of Prosthetic Dentistry (JPD) were screened. Eligible articles used quantitative methods with inferential statistics. A 20% stratified random sample ensured representation by journal and year. Articles were assessed using a specialty-adapted checklist covering five domains: test selection, sample size justification, assumption testing, examiner calibration, and result interpretation. A weighted scoring system categorized studies as having no major, minor, or major error. Descriptive statistics and Pearson's Chi-square test, with Monte Carlo simulation as needed, assessed associations. Twenty percent of articles (n = 24) were double-scored; consensus yielded inter-rater reliability κ = 0.94.

Results: A total of 119 clinical studies were reviewed (JPD 57, IJOP 37, JOP 25). Appropriate statistical tests were used in 88% of studies; notably, all 19 studies that involved a statistician demonstrated correct test selection. However, only 32% reported sample-size calculations. Assumption testing was completed in 47% of studies, and examiner calibration was described in 40%. Confidence intervals were absent in 83% of reports, with only 8% both reporting and interpreting them. Overall, 45% of studies had no major statistical error, 35% contained major errors, and 21% showed minor deficiencies. Having no major error was strongly associated with proper test selection and assumption verification (p < 0.001).

Conclusions: Statistical reporting deficiencies persist in prosthodontic research, particularly in sample-size justification, assumption testing, and confidence interval reporting, highlighting the need for specialty-specific checklists, enhanced training, and stronger editorial/reviewer standards.

Purpose: To evaluate the effect of different self-etching primer (Monobond Etch & Prime-MEP) application protocols and aging on micro shear bond strength (µSBS) and surface etching patterns of zirconia-reinforced lithium silicate (ZLS) and lithium disilicate (LD) ceramics.

Materials and methods: Twenty-eight blocks of Vita Suprinity (VS), Celtra Duo (CD), and IPS e.max CAD (EM) were cut into two sections each (n = 56 specimens per ceramic) and divided into groups: 5% hydrofluoric acid with silane (HF + S, control), and MEP scrubbing for 20, 40, and 60 s, with a 40-s reaction time (n = 14 per condition; n = 10 for µSBS and n = 4 for scanning electron microscopy [SEM]). For µSBS, resin cement was applied and light-cured; half of the resin cylinders were stored for 24 h, while the other half underwent thermocycling (TC) (10,000 cycles; dwell time of 30 s between 5°C and 55°C) before testing. Data were analyzed using three-way repeated measures analysis of variance (ANOVA) and Bonferroni post hoc tests (α = 0.05).

Results: The HF + S group showed higher µSBS for EM than VS and CD (p < 0.001). MEP100 achieved comparable µSBS with HF + S for CD (p < 0.001) and improved µSBS for VS and EM (p = 0.128). TC decreased the µSBS values in most groups. The only exception was observed when the VS and CD surfaces were treated with MEP100, and when the CD surface was treated with MEP80. Adhesive fractures were predominantly seen. SEM revealed MEP100 produced etching patterns like HF, with lithium metasilicate and orthophosphate crystals present.

Conclusions: Prolonged MEP application (MEP100) produced etching patterns and µSBS values comparable to HF + S, making it a viable surface treatment alternative for ZLS and LD ceramics.

Purpose: This study examined the survival rate of implants and maxillary implant-supported overdentures (MIS-ODs) and identified the frequency of maintenance needs as well as technical and biological complications associated with MIS-ODs.

Materials and methods: This retrospective cohort study included 86 patients who received 86 MIS-ODs between 1982 and 2023 in a university setting. Data analyses were performed to determine the survival rate of implants and MIS-ODs, as well as the frequency of maintenance events and complications (technical and biological). The survival proportion of MIS-ODs was estimated, and prognostic factors were analyzed using Cox regression analyses (p < 0.05).

Results: The median follow-up time for MIS-ODs in this study was 39.0 months (interquartile range [IQR]: 15.0-84.3). Among 86 MIS-ODs, 45.3% had non-splinted attachments and 54.7% had splinted attachments; 9.3% of prostheses were supported by 2 to 3 implants, 59.3% by 4 implants, and 31.4% by more than 4 implants. The most common maintenance intervention was adjustment of the prosthesis intaglio surface. Technical complications occurred in nearly 60% of cases, with inadequate prosthesis retention being the most frequently reported issue. The most prevalent biological complication was peri-implant mucositis. Lastly, 27.9% of prostheses (24 cases) required a new prosthesis after a median survival time of 58.5 months (IQR: 16.0-79.0) due to acrylic tooth wear, implant loss, fabrication errors, and suboptimal retention.

Conclusions: Within the limitations of this study, MIS-OD survival is independent of the prosthesis design characteristics. However, certain technical and biological complications can affect the survival of MIS-ODs.

Purpose: To compare the stainability, translucency, opalescence, whiteness, gloss, and hardness of 4 computer-aided design and computer-aided manufacturing (CAD-CAM) restorative materials after simulated coffee drinking and color correction.

Materials and methods: Four CAD-CAM blocks were investigated (n = 40): resin nanoceramic (Cerasmart, CS), polymer-infiltrated ceramic network (Vita Enamic, VE), lithium disilicate glass ceramic (IPS e.max CAD, EC), and zirconia-reinforced lithium silicate glass ceramic (Vita Suprinity, VS). The color stability (ΔE₀₀), relative translucency (RTP), opalescence (OP), and whiteness stability (ΔWI_D) were measured with a spectrophotometer. Gloss (GU) was recorded with a gloss meter, and hardness (HM) was detected with a Martens hardness testing device. The specimens were observed at baseline (T0), after coffee thermocycling (CTC) (T1), and after color correction (T2). ΔE₀₀ was analyzed by two-way ANOVA, ΔWI_D was analyzed with one-way ANOVA, and RTP, OP, WI_D, GU, and HM were assessed with repeated ANOVA to evaluate the effects of material type, treatment, and their interactions on the tested properties. Post hoc pairwise comparisons were assessed by Tukey HSD and Student t-tests (α = 0.05).

Results: ΔE₀₀, WI_D, OP, GU, and HM outcomes were significantly impacted by material type (p < 0.001) and treatment (p ≤ 0.028), whereas ΔWI_D and RTP were affected by material type (p ≤ 0.03). CS exceeded the ΔE₀₀ perceptibility threshold at T1. VS exhibited the highest stain resistance, RTP, and HM, and the least was in VE and CS. Color correction serums reversed CTC-induced staining among VS and VE (p < 0.001).

Conclusions: Zirconia-reinforced lithium silicate glass-ceramics demonstrated superior color stability and hardness when subjected to coffee thermocycling and color correction serum.

Purpose: Integration of three-dimensional (3D) facial scanning into digital workflows has become increasingly important for enhancing treatment planning and esthetic evaluation. However, limited data exists on the accuracy of various methods of merging facial scans with cone beam computed tomography (CBCT) scans. The purpose of this study is to compare the accuracy of integrating 3D facial scans with CBCT scans using the iterative closest point (ICP) algorithm versus a radiopaque (RO) marker technique.

Materials and methods: This prospective clinical study included 15 patients who received CBCT scans and 3D facial scans in repose and smile positions. The Digital Imaging and Communications in Medicine (DICOM) datasets from the CBCT scans containing RO markers were integrated with the standard tessellation language (STL) files from the facial scans in Exocad software using two methods: RO alignment and the ICP algorithm. The datasets from both groups were statistically compared using a paired t-test (α = 0.05).

Results: The means for the six subsets merged by the ICP algorithm ranged from 1.47 to 2.0 mm, and the means for the RO markers were 0.13 to 0.15 mm. The novel RO markers method was statistically significant and more accurate than the ICP algorithm (p < 0.001).

Conclusions: Merging 3D facial scans to CBCT using radiopaque markers demonstrated higher trueness compared to the ICP algorithm under the conditions tested. This technique may serve as a reliable alternative for improving integration accuracy in digital dental workflows, particularly where precise facial landmark preservation is essential.