Purpose: The peri-implant region, where restoration interfaces with mucosal tissue, plays an essential role in overall implant success and is just as important as osseointegration. The implant abutment materials are in intimate contact with human gingival fibroblasts (HGFs). This study compares the proliferation of HGFs between zirconia and titanium abutments used in dental implants.
Methods: An electronic search was performed using PubMed, EMBASE, and Web of Science databases. English articles based on in vitro studies testing HGFs proliferation on zirconia and titanium implant abutment materials were included. A quality assessment of the selected study was performed using the web-based Science in Risk Assessment and Policy (SciRAP) tool. The HGFs proliferation and cellular morphology tests on zirconia and titanium materials from the included studies were summarized, exploring the role of material surface characteristics.
Results: The electronic search yielded 401 studies, of which 17 were selected for inclusion. Zirconia exhibited comparable or superior efficacy in promoting the proliferation of HGFs compared to titanium. Observations on cellular morphology showed similar outcomes for both materials. Establishing a definitive relationship between contact angle, surface roughness, and their influence on cellular response remains challenging due to the varied methodological approaches in the reviewed studies.
Conclusion: Based on the findings of this systematic review, zirconia shows comparable reliability to titanium as an abutment material for HGFs proliferation, with comparable or superior HGFs proliferative outcomes.
Dental implants, recognized for their enhanced functionality and aesthetic outcomes, are susceptible to peri-implant mucositis and subsequent peri-implantitis when oral hygiene is inadequate. Effective biofilm management is critical to prevent and manage these prevalent conditions and promote implant longevity. Materials with a two-dimensional (2D) structure have demonstrated robust antimicrobial properties. Among these, 2D magnesium phosphates have garnered significant attention due to their additional biocompatibility and osteoconductive properties. This case series explores the application of a thixotropic inorganic hydrogel, composed of 2D magnesium phosphate, in the surgical treatment of dental implant infections. The hydrogel was used for surgical dental implant decontamination in patients diagnosed with peri-implantitis characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. The study encompassed eight cases with a history of peri-implantitis. Clinical measurements were recorded before and after treatment, including bleeding on probing, suppuration, and probing depth. Radiographic evaluations were conducted to assess the exposure of implant threads. The findings revealed a statistically significant decrease in probing depth, bleeding on probing, and the number of exposed implant threads following treatment with the magnesium phosphate hydrogel, though the exact role of the hydrogel in these improvements warrants further exploration.
Purpose: A newly introduced sintering protocol promises to offer higher translucency while not significantly compromising the flexural strength of the material. However, the effect of the novel sintering protocol has not been thoroughly validated. The purpose of this study was to measure and compare the effect of two sintering protocols on the translucency and flexural strength of two multilayered zirconia materials.
Materials and methods: Two types of multilayered zirconia materials (ZirCAD Prime and Prime esthetic) were selected. Presintered disk specimens were obtained from Translucent, Gradient, and Dentin layers (n = 20). The disks were allocated to 2 groups: standard sintering protocol (peak temperature 1500°C) and high translucency sintering protocol (peak temperature 1600°C). After the sintering process, 10 specimens from each group were randomly selected. The optical values (L*, a*, b*) were measured and used to assess translucency using the relative translucency parameter (RTP00) and translucency differences (ΔRTP00). Then, all 20 specimens were tested for biaxial flexural strength. The outcomes were analyzed. The analysis of variance is used to analyze any significant effects on translucency and flexural strength. Then, any significant difference in the translucency and flexural strength between all pairs of materials was analyzed using Bonferroni-corrected Student's t-test (α = 0.05).
Results: The high translucency sintering protocol significantly decreased biaxial strength in the Prime translucent and dentine layer, Prime esthetic translucent, and gradient layer. RTP00 was significantly reduced in the Prime gradient and Prime esthetic gradient layer when sintered with a high translucency protocol. The lowest ΔRTP00 was observed in the Prime dentine layer, while the highest ΔRTP00 was observed in the Prime esthetic dentin layer.
Conclusions: High translucency protocol significantly lowers the biaxial flexural strength of both multilayered materials, but the alteration in translucency is within clinically acceptable thresholds (TAT00 = 2.62).
Purpose: To evaluate the impact of various preparation designs and the material type on fracture resistance of minimally invasive posterior indirect adhesive restorations after aging using a digital standardization method.
Materials and methods: One-hundred sixty human maxillary premolars free from caries were assigned into 16 groups (n = 10): bevel design on enamel substrate with mesial box only (VEM), butt joint design on enamel substrate with mesial box only (BEM), bevel design on enamel substrate with mesial and distal box (VED), butt joint design on enamel substrate with mesial and distal box (BED), bevel design on dentin substrate with mesial box only (VDM), butt joint design on dentin substrate with mesial box only (BDM), bevel design on dentin substrate with mesial and distal box (VDD), and butt joint design on dentin substrate with mesial and distal box (BDD). Each group was restored with pressable lithium disilicate (LS2) or disperse-filled polymer composite (DPC) materials. Adhesive resin cement was used to bond the restorations. The specimens were aged for 10,000 thermal cycles (5°C and 55°C), then 240,000 chewing cycles. Each specimen was subjected to compressive axial load until failure. A two-way analysis of variance (ANOVA) test followed by a post hoc Tukey test was used to analyze the data (α = 0.05).
Results: The two-way ANOVA test revealed a significant difference among designs (p < 0.001) and materials (p < 0.001) with no interaction effect (p = 0.07) between the variables. The Post hoc Tukey test revealed that the VEM group exhibited the highest mean fracture resistance value, while the BDM group had the lowest. The LS2 groups showed the highest mean fracture resistance values. The DPC groups showed a restorable fracture pattern compared to the LS2 groups.
Conclusions: Bevel and butt joint designs with mesial or distal boxes are recommended for conservative posterior indirect adhesive restorations in premolar areas. Enamel substrate improved load distribution and fracture resistance. DPCs have restorable failure patterns, while pressed LS2 may harm underlying structures.
Purpose: This systematic review and meta-analysis aimed to evaluate the dental and skeletal effects of the long-term oral appliance (OA) treatment in patients with obstructive sleep apnea (OSA) and provide insights for clinicians in treatment planning and decision-making for OSA patients undergoing OA treatment.
Materials and methods: A comprehensive literature search was conducted in major databases up to April 2024. Studies were included if they assessed long-term OA treatment (≥6 months) in adults with OSA using any type of mandibular advancement device (MADs) or tongue retaining device (TRD). Dental and skeletal changes, measured by dental cast and cephalometric analysis, were the primary outcomes.
Results: A total of 42 studies were included in the systematic review, with 23 included in the meta-analysis. Long-term OA treatment was associated with a significant decrease in overbite (0.87 mm, 95% CI: 0.69-1.05) and overjet (0.86 mm, 95% CI: 0.69-1.03). Subgroup analyses showed the decrease of overbite and overjet progressively changed over the years intervals. There was a significant retroclination of the upper incisors (U1-SN, 2.58°, 95% CI: 1.07-4.08) and proclination of the lower incisors (L1-MP, -2.67° (95% CI: -3.78-1.56). Skeletal changes were not significant.
Conclusion: Overbite and overjet gradually decreased in the long-term OA treatment, which might predominantly result from the retroclination of the upper incisors and the proclination of the lower incisors. The skeletal patterns in the anteroposterior and vertical direction might remain relatively stable over time. There was a tendency for the clockwise rotation of the mandible.
To assess the repeatability of various color-measuring mobile phone applications (MPAs) on dental materials in clinically relevant shades in 1-mm thickness.
A benchtop spectrophotometer was used as a reference instrument. Seven MPAs were used: Color Analysis, Color Analyzer—Iro Shirabe, Color Grab, and Colorimeter from Android, and Color Analyzer—Iro Shirabe, ColorMeter RGB, and Optishade from iOS. Color measurements were performed on 1-mm thickness slices of CAD-CAM materials, Vita Enamic shades 1M2, 2M2, 3M2, 4M2, and Vitablocs Mark II shades A1C, A2C, A3C, A4C (n = 10, for a total 80 specimens). The specimens were measured at three time periods, Day 0, Day 1, and Day 7, and three measurements were made on each day, to mimic short-, medium-, and long-term repeatability. The color differences were analyzed using the CIEDE2000 formula, with the corresponding color difference (ΔE00), and mean color difference from the mean (MCDM00). One-way ANOVA, Repeated measures ANOVA, and Paired sample t-tests were used for statistical analysis.
Optishade from iOS showed the lowest mean color difference among the MPAs (ΔE00 = 0.2 (SD 0.1), 0.3 (SD 0.2), and 0.2 (SD 0.1) at Day 0, 1, and 7, respectively, and ΔE00 = 0.5 (SD 0.3) for all three periods Days 0–1, 0–7, and 1–7). Material-dependent variations in the repeatability of color measurements were observed.
There was a statistically significant difference among color measurements using MPAs and a spectrophotometer, among the MPAs, and materials. The spectrophotometer exhibited the highest repeatability across the tested time periods. The iOS Optishade showed the highest repeatability among the MPAs.
Purpose: To assess the biomechanical advantages of combining zygoma and partial subperiosteal implants for maxillary reconstruction in severely atrophic maxillae, offering potential solutions to the challenges posed by traditional reconstruction methods.
Material and methods: A finite element analysis used a craniofacial model simulating a totally resected maxilla. Four treatment scenarios (SCs) were evaluated: SC-1, the quad zygoma approach; SC-2, two zygoma implants (ZIs) and a one-piece subperiosteal implant (SI); SC-3, two ZI and a two-piece SI; and SC-4, four ZI and a one-piece SI. Stress distributions on bone, implants, abutments, and metal frameworks were compared under occlusal forces.
Results: For the simulated bone regions under vertical and oblique forces, SC-4 values were higher than SC-1, while SC-2 and SC-3 values were comparable for pmax and pmin. In addition, SC-2 and SC-3 values were lower than those of SC-1 and SC-4. The most balanced von Mises stress values on the ZIsand were observed in SC-3 under vertical and oblique forces. Furthermore, lower von Mises stress values on the abutments were seen in SC-3 under oblique and vertical forces. Although the lower von Mises stress values on the metal frameworks at the lateral incisor and first premolar side were seen in SC-3, lower von Mises values were observed in SC-4 in the first molar region.
Conclusions: Overall, this study suggests that combining zygoma and partial subperiosteal implants may be a promising approach for reconstructing severely atrophic maxillae. These implants may offer improved biomechanical properties compared to ZIs alone.
Purpose: The purpose of this study was to assess the precision and trueness of three jaw motion tracking systems, the KaVo ARCUSdigma system, SDiMatriX system, and Modjaw system, in recording mandibular movements based on optical and ultrasonic principles.
Materials and methods: Twenty-five healthy subjects were selected for the present study to measure protrosive movement and left and right lateral movements using the three jaw motion tracking systems. Each subject's mandibular movement was recorded twice with a 1-week interval. Five parameters-sagittal condylar inclination (SCI) angle, incisal guide angle, Bennett angle, lateral condylar inclination angle, and Fischer's angle-were acquired for further analysis. The precision of the jaw motion tracking systems was evaluated by comparing the results of two measurements of the same parameter. Simultaneously, cone beam computed tomography (CBCT) was utilized during the initial data acquisition and was aligned with intercuspal position (ICP) and edge-to-edge occlusion intraoral scan data. Bone landmarks were used to calculate bilateral SCI as a reference for comparison with the SCI values from each jaw motion tracking system. An independent-sample t-test was conducted to compare parameter differences, with statistical significance set at a p-value below 0.05.
Results: There were no significant differences among the three jaw motion tracking systems regarding the corrected values of SCI, incisal guide angle, Bennett angle, lateral condylar inclination angle, and Fischer's angle during the 1-week interval (p > 0.05). The values of bilateral SCI obtained by CBCT were 48.57 ± 6.74 (L) and 48.35 ± 5.28 (R), respectively. No significant differences were found between the reference SCI and those parameters measured by the KaVo ARCUSdigma system and the Modjaw system (p > 0.05), while the results obtained from the SDiMatriX system indicated a significant difference compared to the reference SCI (p < 0.05).
Conclusions: The three jaw motion tracking systems exhibited favorable results in terms of precision. Regarding trueness, both the KaVo ARCUSdigma system and the Modjaw system demonstrated a satisfactory levels suitable for applications in digital prosthodontics within clinical settings. However, further refinement is needed to enhance the trueness of the SDiMatriX system.
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