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

Purpose: Debonding of zirconia restorations remains a significant clinical challenge due to its glass-free microstructure, which limits micromechanical and chemical adhesion. Zircos-E, a nitric-hydrofluoric acid mixture, has been proposed as a simplified room-temperature alternative to airborne-particle abrasion (APA). This meta-analysis aimed to compare the shear bond strength (SBS) of zirconia surfaces treated with Zircos-E etching versus APA.

Methods: A systematic search of PubMed, Web of Science, and Scopus databases identified in vitro studies published from 2015 to January 2025 comparing Zircos-E etching with APA and reporting SBS values with standard deviations and sample sizes. Eight studies (308 specimens) met the inclusion criteria. Quality assessment was performed using the QUIN tool. A random-effects model was applied to calculate standardized mean differences (SMDs) with 95% confidence intervals (CIs). Subgroup analyses were conducted according to aluminum oxide particle size, and heterogeneity was assessed using the I² statistic.

Results: Overall, Zircos-E etching significantly increased SBS compared with APA (SMD = 1.54; 95% CI: 0.08-3.00; p = 0.04), with substantial heterogeneity (I² = 95%). Subgroup analysis showed no significant difference between 50 and 110 µm Al₂O₃ particle sizes (p = 0.86). Sensitivity analysis excluding the study with the largest effect size reduced the pooled effect (SMD = 1.16; 95% CI: -0.06 to 2.38) and statistical significance (p = 0.06), although the direction of effect remained consistent. In the subgroup analysis by aging protocol, Zircos-E demonstrated a statistically significant improvement in the non-thermocycled subgroup (SMD = 1.72, 95% CI: 0.23-3.21, p = 0.03), while no significant difference was found in the thermocycled subgroup (SMD = 1.38, 95% CI: -1.80 to 4.55, p = 0.30).

This clinical report presents a comprehensive digital workflow for rehabilitating a patient with maxillary terminal dentition using a full-arch, implant-supported fixed dental prosthesis (FP-1). It highlights the integration of a 3D-printed polychromatic flangeless trial denture and a customized anatomic bone reduction template, enabling prosthetically driven implant planning and optimal bone architecture modification. The workflow incorporated fully guided implant surgery using sequential templates and immediate loading with a closed-mouth pickup system. Intraoral scanning protocols were employed for definitive prosthesis fabrication. This approach addressed high esthetic risks while achieving surgical precision, efficient treatment execution, and favorable clinical outcomes.

Purpose: Stress is a significant concern in healthcare professions, impacting both physiological and psychological well-being. In the field of dentistry, stress among practitioners is well-documented; however, there is a notable gap in understanding stress levels specifically within postgraduate prosthodontic training programs. The study hypothesis aimed to assess perceived stress levels among prosthodontic residents and, secondarily, identify associated risk factors, while exploring stress management strategies.

Materials and methods: A cross-sectional, mixed-methods design was employed, utilizing a modified version of the Graduate Dental Environment Stress (GDES) survey along with qualitative open-ended questions. REDCap (Research Electronic Data Capture), a secure, web-based software platform designed to support data capture for research studies, was used for instrument design, data management, and storage. A REDCap Survey link was distributed to prosthodontic program directors across North America, with the intention of distributing it to their residents. Responses were recorded via a Likert scale for the quantitative assessment and through narrative responses for the qualitative assessment. A score of 76 was determined to be the threshold value at or above which the participants were considered stressed. Descriptive summaries were used to characterize the participants. The main study outcome was presented as a percentage of the corresponding 95% confidence interval (CI). The assessment of risk factors of stress among the study population was done by using a logistic regression model, and coping mechanisms were tagged via open coding and presented as themes. SAS statistical software package was used.

Results: A response rate of 13.2% indicated that over a third of postgraduate prosthodontic residents experienced high levels of stress, as defined by a GDES score ≥76. A risk factor for stress was identified as the year of study. Qualitative analysis revealed common themes in stress management strategies, with exercise, socializing, and spending time with family members being the most prevalent.

Conclusion: The findings of high perceived stress among prosthodontic residents included "Lack of time for leisure activities" followed by "Lack of adequate staff in the clinics" and "Neglect of personal life" being the highest reported stressors. Stress management strategies such as "Self-care," "Time management," and "Connecting with others" highlight the importance of proactive strategies to manage stress. By understanding the factors contributing to stress and effective coping mechanisms, stakeholders can better support their residents.

This article presents three cases outlining the benefits of utilizing a combination of digital and conventional workflows for the fabrication of immediate complete dentures. This combined digital and conventional approach addresses the recording of denture border extensions, digital articulation, and fabrication of complete dentures.

Purpose: This in vitro study aims to compare the effects of electrolytic polishing (EP), plasma electrolytic polishing (PP), dry electropolishing (DP), and their combination on the surface characteristics, corrosion resistance, and material reduction of selective laser melting (SLM) printed dental cobalt-chromium (Co-Cr) alloy.

Materials and methods: Standard samples and removable partial denture (RPD) frameworks were SLM-printed and then polished using the following methods: mechanical polishing (MP), EP, PP, DP, PDP (PP + DP), DPP (DP + PP), and PDPP (PP + DP + PP). Surface characteristics were analyzed using optical profilometry, scanning electron microscopy (SEM), and x-ray photoelectron spectroscopy (XPS). Corrosion resistance was assessed through electrochemical testing and ion release experiments. The metal reduction was evaluated by measuring weight loss, major connector and clasp thickness loss, and framework adaptation. The post-processing time for the technician's fine polishing of these frameworks was recorded to further evaluate the polishing quality of the frameworks. All measurements were presented as mean ±standard deviation. Statistical data were analyzed using analysis of variance (ANOVA) and nonparametric one-way analysis.

Results: The MP group exhibited the lowest roughness (0.04 ± 0.01 µm), followed by the PDPP group (0.49 ± 0.12 µm). All groups had a passivation film composition predominantly composed of Cr₂O₃, with a small amount of CrO₃ observed in the PDP group. PDPP exhibited minimal ion release (0.12 µg/cm²) and stable Nyquist plots. PDPP can significantly reduce the technician's post-processing time (45.75 s, p < 0.05) without compromising the adaptation of the frameworks.

Conclusions: PDPP forms a stable passivation film with extremely low ion release and a highly smooth, uniform surface. This significantly reduces the time required for manual post-processing while maintaining the accuracy of RPD frameworks, making it highly suitable for large-scale clinical framework polishing.

Purpose: This study aimed to evaluate and compare the marginal and internal fit of permanent crowns fabricated using three different DLP 3D printers and their corresponding permanent resin materials. The fit was quantitatively assessed using micro-computed tomography (micro-CT) and digital 3D analysis.

Materials and methods: A premolar tooth was prepared according to conventional ceramic tooth preparation protocols and scanned with an intraoral scanner (TRIOS 5). The resulting standard tessellation language (STL) file was imported into the software for design. A total of 24 crowns were fabricated using three different printer and resin combinations (n = 8): an Asiga printer with Saremco Crowntec permanent resin (Group S), a Denta Fab printer with Power Resin C&B permanent resin (Group C), and a SprintRay printer with Crown permanent resin (Group SP). These crowns were then re-scanned with an intraoral scanner to obtain STL files. Marginal, axial, and occlusal alignment were calculated and compared using 3D analysis software and micro-CT software. As the data were normally distributed, comparisons were made using one-way ANOVA. The significance level was set at p < 0.05.

Results: In the marginal area, Group SP demonstrated significantly superior fit compared to Group S (p = 0.002) and Group C (p = 0.0005). No statistically significant difference was observed between Group S and Group C (p = 0.245). The findings obtained from both micro-CT and 3D superimposition analyses were consistent, confirming the reliability and agreement of the two evaluation methods.

Conclusion: This study demonstrates that crown restorations fabricated using 3D printers exhibit significant variations in fit depending on the type of resin employed. In particular, the resin used in Group SP tended to show improved marginal adaptation compared to Groups S and C, which exhibited comparable results. These findings may offer guidance for clinical decision-making regarding the selection of 3D printing systems and resins for crown fabrication in prosthodontic applications.

Advances in dental implantology, such as immediate loading protocols, digital planning, and improved biomaterials, have revolutionized the treatment of edentulous patients by offering faster and more predictable outcomes. This case report describes a complete digital workflow for maxillary and mandibular implant-supported full-arch prostheses in an edentulous patient with nonuniform bone shape, limited interarch space, and excessive gingival display. A full-arch immediate loading protocol, including a fixation base, a scalloped bone-reduction guide for preserving the interdental bone, an osteotomy guide, and provisional prostheses, was digitally designed and fabricated. The reverse scan technique using laboratory analog was used for fabricating definitive zirconia prostheses. The reverse scan technique integrates digital technology with clinical practice to improve the accuracy of full-arch implant restorations.

Purpose: This study aims to evaluate the readability and accuracy of content produced by ChatGPT, Copilot, Gemini, and the American College of Prosthodontists (ACP) for patient education in prosthodontics.

Materials and methods: A series of 26 questions were selected from the ACP's list of questions (GoToAPro.org FAQs) and their published answers. Answers to the same questions were generated from ChatGPT-3.5, Copilot, and Gemini. The word counts of responses from chatbots and the ACP were recorded. The readability was calculated using the Flesch Reading Ease Scale and Flesch-Kincaid Grade Level. The responses were also evaluated for accuracy, completeness, and overall quality. Descriptive statistics were used to calculate mean and standard deviations (SD). One-way analysis of variance was performed, followed by the Tukey multiple comparisons to test differences across chatbots, ACP, and various selected topics. The Pearson correlation coefficient was used to examine the relationship between each variable. Significance was set at α < 0.05.

Results: ChatGPT had a higher word count, while ACP had a lower word count (p < 0.001). The cumulative scores of the prosthodontist topic had the lowest Flesch Reading Ease Scale score, while brushing and flossing topics displayed the highest score (p < 0.001). Brushing and flossing topics also had the lowest Flesch-Kincaid Grade Level score, whereas the prosthodontist topic had the highest score (p < 0.001). Accuracy for denture topics was the lowest across the chatbots and ACP, and it was the highest for brushing and flossing topics (p = 0.006).

Conclusions: This study highlights the potential for large language models to enhance patient's prosthodontic education. However, the variability in readability and accuracy across platforms underscores the need for dental professionals to critically evaluate the content generated by these tools before recommending them to patients.