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

Purpose: To compare digitally fabricated complete dentures to conventionally fabricated dentures using patient- and clinician-reported outcome measures.

Methods: This review was structured according to PRISMA guidelines with the protocol registered in the PROSPERO database (CRD42024526069). An electronic search of the databases with a defined search strategy was completed within PubMed/MEDLINE and Web of Science from January 2000 to March 2024. Grey literature and article references were searched. Articles were screened by title and abstract, and the remaining articles were screened by full-text review. Articles accepted for inclusion were subjected to a risk-of-bias assessment using Cochrane Collaboration tools (RoB 2 and ROBINS-I).

Results: From an initial pool of 704 articles, 15 studies met the selection criteria, of which the majority were published within the past 3 years. Within the included studies, there was inconsistency in the assessment methods of patient- and clinician-reported outcomes, making it challenging to draw definitive conclusions. Generally, digital dentures had superior cost-effectiveness and prosthesis fabrication time. Patient satisfaction and denture quality were not consistently improved with digital technology.

Conclusions: Studies showed indications of patient satisfaction with digital and conventional dentures. Digital technology may enhance clinical workflows. A trend emerged that milled dentures performed better than printed dentures. Clinicians adopting digital technology into removable prosthodontics may have a learning curve to overcome, and they should consider the patient-clinician relationship in addition to clinical outcomes to achieve patient satisfaction. Additional studies with standardized tools for assessing patient satisfaction are required to enable meaningful comparisons between digital and conventional workflows.

Purpose: Metal-ceramic screw-retained implant restorations persist as a fundamental choice in specific clinical scenarios. Little is known about the effects of fabrication steps and aging on their structural properties. This study aimed to investigate how laboratory fabrication procedures and thermomechanical loading affect the structural properties of screw-retained metal-ceramic implant restorations.

Materials and methods: Ten screw-retained metal-ceramic restorations were conventionally cast using UCLA chromium-cobalt overcast abutments. After 500 cycles of thermocycling and 500,000 cycles of mechanical loading, changes in connection dimensions and rotational freedom (RF) were measured and compared at various fabrication steps and post-thermomechanical loading. A generalized estimating equations (GEE) model was employed to analyze trends across the studied time points within the fabrication stage and after thermomechanical loading, with LSD post-hoc tests applied for pairwise comparisons. The level of significance was set at α = 0.05.

Results: Significant changes were observed across the analyzed time points: the average hexagonal side length (L) decreased (p < 0.001), and the average hexagonal angle deformation (P) increased, with notable differences observed in most comparisons between different fabrication steps (p < 0.001). Short (T1) and long (T2) diagonals of the hexagon showed downward trends (p < 0.001), while concentricity (O) and RF increased (p < 0.001), except between porcelain firing and loading steps for RF (p = 0.637). Casting had the greatest impact on variations in O (93.33%), T1 (88.88%), and T2 (45%), while porcelain firing significantly affected L (71.42%), P (71.42%), with the greatest effect on RF (75.32%).

Conclusions: The fabrication processes and simulated clinical use adversely impacted the structural integrity and RF of abutments in screw-retained chromium-cobalt overcast implant restorations.

Purpose: To evaluate the effect of material type on dimensional stability, occlusal surface wear, fracture resistance, and failure behavior of resin-based onlay restorations.

Material and methods: A mandibular right first molar typodont was prepared and digitized using an intraoral scanner to virtually design an onlay restoration with the minimum occlusal thickness of 1.5 mm. Resin-based onlay restorations (n = 15 per group) were fabricated either additively from 2 different resins indicated either for definitive or interim use or subtractively with a composite resin. After cementing onlays to corresponding dies, each of them was digitized before and after thermomechanical aging (B-STL and A-STL), and then subjected to load-to-failure test to evaluate fracture resistance. The B-STL and A-STL of each onlay were also compared to assess the dimensional stability and occlusal surface wear. One-way analysis of variance and Tukey honestly significant difference tests were used to evaluate dimensional stability, occlusal surface wear, and fracture resistance. The chi-square test was used to evaluate the Weibull modulus and characteristic strength among the groups (α = 0.05).

Results: Material type affected investigated outcomes (p < 0.001). The additively manufactured resin indicated for definitive use led to the highest external surface deviations and the additively manufactured resin indicated for interim use led to the highest mesiodistal width deviations (p ≤ 0.033). The onlays fabricated from the additively manufactured resin indicated for definitive use had the highest occlusal surface wear, while those in composite resin had the lowest (p ≤ 0.006). The composite resin onlays had the highest fracture resistance values and reliability (p ≤ 0.035).

Conclusions: Tested subtractively manufactured composite resin had the lowest occlusal surface wear with the highest fracture resistance and reliability. Additively manufactured resins had lower dimensional stability, while tested resin for additively manufactured definitive restorations had the highest occlusal surface wear.

Purpose: To evaluate the impact of glazing denture base resins (heat-polymerized and 3D-printed) on surface, mechanical, and microbiological properties.

Materials and methods: Discs (10 × 3 mm) and bars (64 × 10 × 3.3 ± 0.2 mm) were manufactured using heat-polymerized denture base resin (CT) and 3D-printed denture base resin (Yller [YL], Prizma [PZ] and PrintaX [PX]). These were divided into two groups: unglazed and glazed. Surface roughness (Ra), wettability (contact angle), brightness (GU), and topography (via scanning electron microscopy) were assessed, along with microbiological analysis of dual-species biofilms (Streptococcus mitis and Candida albicans) and Knoop microhardness on discs (n = 10). Flexural strength testing was conducted separately on bars (n = 20). Half of the specimens subjected to surface and mechanical characterizations were thermocycled (10,000 cycles). Mann-Whitney test (p < 0.05) and simple and multiple linear regression analysis (p < 0.20) were employed to evaluate the impact of glazing on denture base resins.

Results: The application of glaze reduced roughness by 0.33 µm and water contact angle by 8.47º, while increasing brightness by 21.30 units (p < 0.001) for 3D-printed resins compared to CT. After thermal cycling, roughness and wettability increased, while brightness decreased (p < 0.05). The glaze also increased hardness, with no adverse effects from thermal cycling (p < 0.001), and enhanced flexural strength for PZ compared to CT (p < 0.001). Additionally, C. albicans colonization decreased by 7.79 log CFU/mL in mixed biofilms for 3D-printed resins compared to CT (p < 0.05).

Conclusions: The application of glaze resulted in smoother, brighter, and harder surfaces for the 3D-printed resins, while also reducing biofilm colonization.

Purpose: This review aims to highlight the pivotal role of the mandibular jaw movement (MJM) signal in advancing artificial intelligence (AI)-powered technologies for diagnosing obstructive sleep apnea (OSA).

Methods: A scoping review was conducted to evaluate various aspects of the MJM signal and their contribution to improving signal proficiency for users.

Results: The comprehensive literature analysis is structured into four key sections, each addressing factors essential to signal proficiency. These factors include (1) the comprehensiveness of research, development, and application of MJM-based technology; (2) the physiological significance of the MJM signal for various clinical tasks; (3) the technical transparency; and (4) the interpretability of the MJM signal. Comparisons with the photoplethysmography (PPG) signal are made where applicable.

Conclusions: Proficiency in biosignal interpretation is essential for the success of AI-driven diagnostic tools and for maximizing the clinical benefits through enhanced physiological insight. Through rigorous research ensuring an enhanced understanding of the signal and its extensive validation, the MJM signal sets a new benchmark for the development of AI-driven diagnostic solutions in OSA diagnosis.

The "gummy smile" is a complex developmental issue that requires a three-dimensional approach to diagnosis and treatment. This article explores the multifaceted nature of the gummy smile, tracing its origins to early childhood growth patterns and breathing dysfunctions. It emphasizes the importance of understanding the interplay between skeletal development, soft tissue function, and breathing modalities in the formation of craniofacial structures. The article discusses how early mouth breathing and tongue dysfunction can lead to maladaptive skeletal growth, resulting in vertical maxillary excess and other facial imbalances. It highlights the critical role of nasal breathing and proper tongue posture in promoting healthy craniofacial development. Treatment options are presented for both growing children and adults, ranging from preventive measures to surgical interventions. For children, the focus is on early intervention to redirect growth patterns, while for adults, comprehensive treatment may include orthognathic surgery to correct established skeletal discrepancies. By providing an in-depth analysis of the three-dimensional aspects of the gummy smile, this article aims to equip interdisciplinary teams with the knowledge needed for accurate diagnosis and effective treatment planning. It underscores the importance of addressing underlying causes rather than merely treating symptoms, promoting a holistic approach to patient care in aesthetic dentistry.

Purpose: To examine the factors influencing the risk of biological and technical complications in tooth-implant-supported fixed dental prostheses (T-I-FDPs), focusing on location, configuration, and the impact of existing dental health conditions.

Materials and methods: A retrospective cohort study was conducted, accompanied by a follow-up clinical and radiological examination, involving 58 patients (37 women, 21 men; mean age: 63.4 years) who had received 68 T-I-FDPs at least 5 years earlier, at the Department of Prosthodontics, Centre of Oral Rehabilitation, Region Östergötland, Sweden. Correlations between implant placement specifics, arrangement of teeth and implants, and the presence of root-filled teeth on the incidence of complications were analyzed.

Results: The analysis highlighted significant complication risk variance, based on the location in the jaw of the implant, with reduced risk for mandibular placements (Hazard ratio [HR] 0.37). Complex arrangements (HR 2.46) and the presence of root-filled teeth (HR 1.48) were associated with higher complication rates.

Conclusion: This study demonstrates that anatomical considerations and preexisting dental health significantly influence the risk of complications in T-I-FDPs. Mandibular implant placements showed a reduced risk of complications compared to maxillary placements. The presence of root-filled teeth and complex prosthesis configurations were associated with higher complication rates. These findings highlight the need for customized treatment strategies to mitigate risks and enhance long-term outcomes for patients with T-I-FDPs.

Purpose: To investigate the mid-to-long term clinical outcomes of the implant-supported cross-arch fixed dental prostheses (IFCDPs) with monolithic zirconia-based frameworks and related risk factors of success and survival.

Materials and methods: This retrospective study encompassed individuals exhibiting terminal dentition or edentulism in the maxilla and/or mandible who underwent treatment involving IFCDPs with monolithic zirconia frameworks. Inclusion criteria required a documented follow-up period of at least five years post-definitive prosthesis delivery. Evaluation of outcomes focused on the survival rates of implant and prosthesis, along with the incidence of biological and technical complications. The mixed-effects Cox regression model was employed to analyze the risk factors associated with prosthesis failure and peri-implantitis.

Results: A cohort of 47 patients, consisting of 14 women and 33 men with a mean age of 55.2 ± 12.5 years (range: 25-83), was included in this study. The mean follow-up period was 71.6 ±13.2 months (mean ± SD, range: 60-147). A total of 51 cross-arch prostheses supported by 302 implants, distributed between the maxilla (27 prostheses) and mandible (24 prostheses), were assessed. By the end of the follow-up period, 289 (97.64%) of the 302 implants remained functional. Peri-implantitis was observed in 27 implants (24 in mandible), yielding an overall implant-related success rate of 91.06%. Nine frameworks experienced fractures (eight in mandible), resulting in an overall prosthesis-related survival rate of 82.35%. Subsequent analysis revealed the mandible to be a significant risk factor for framework fracture (HR = 11.64, p = 0.024) and peri-implantitis (HR = 10.88, p = 0.003).

Conclusions: The implant-supported cross-arch fixed dental prostheses featuring monolithic zirconia-based frameworks demonstrated favorable clinical outcomes throughout a 5-13-year observation period. Notably, in the design of monolithic zirconia-based framework prostheses, the mandible emerged as a significant risk factor for framework fractures and an independent risk factor for peri-implantitis.

Purpose: This study aimed to investigate the tensile bond strength between soft relining materials and different denture base materials.

Materials and methods: The study was conducted in accordance with ISO 23401:2023. A total of 288 rectangular specimens (10L × 10H × 20W mm) were fabricated from various denture base materials, including a heat-compression polymethylmethacrylate (PMMA), two types of milled PMAA, and three types of 3D-printed resins, with bonding using two chairside soft reline materials (Coe-Soft and Lynal). Specimens were placed in distilled water for 24 h before applying tensile force at a 5 mm/min crosshead speed. The tensile bond strength values (MPa) were calculated at maximum tensile force (N) before failure. Two-way ANOVA and post hoc multiple comparison tests were used to assess the effect of denture base and soft reline materials on the tensile bond strength (α = 0.05).

Results: A significant difference in the tensile bond strength was found among the different types of denture base materials (p < 0.001), regardless of relining material type. Lynal-relined milled IvoBase demonstrated the highest tensile bond strength (0.5 ± 0.06 MPa), followed by Lynal-relined milled Lucitone (0.44 ± 0.03 MPa), both of which are clinically acceptable as they are equal or greater 0.44 MPa. The lowest tensile bond strength was detected in Lynal-relined 3D printed FotoDent (0.09 ± 0.02 MPa). Lynal exhibited significantly higher tensile bond strength (p < 0.05) than Coe-Soft soft reline material when bonded to PMMA bases; however, there was no significant difference between Lynal and Coe-Soft when bonded to 3D-printed base materials (p > 0.05).

Conclusions: The tensile bond strength between soft relining materials and denture bases is material-dependent, influenced by both the type of denture base material and the type of soft relining material used.

Purpose: Artificial intelligence (AI) applications are growing in smile design and aesthetic procedures. The current expansion and performance of AI models in digital smile design applications have not yet been systematically documented and analyzed. The purpose of this review was to assess the performance of AI models in smile design, assess the criteria of points of reference using AI analysis, and assess different AI software performance.

Methods: An electronic review was completed in five databases: MEDLINE/PubMed, EMBASE, World of Science, Cochrane, and Scopus. Studies that developed AI models for smile design were included. The search strategy included articles published until November 1, 2024. Two investigators independently evaluated the quality of the studies by applying the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Quasi-Experimental Studies and Textual Evidence: Expert Opinion Results.

Results: The search resulted in 2653 articles. A total of 2649 were excluded according to the exclusion criteria after reading the title, abstract, and/or full-text review. Four articles published between 2023 and 2024 were included in the present investigation. Two articles compared 2D and 3D points while one article compared the outcome of satisfaction between dentists and patients, and the last article emphasized the ethical components of using AI.

Conclusion: The results of the studies reviewed in this paper suggest that AI-generated smile designs are not significantly different from manually created designs in terms of esthetic perception. 3D designs are more accurate than 2D designs and offer more advantages. More articles are needed in the field of AI and smile design.