The International journal of prosthodontics最新文献

Objective: To evaluate how specific anatomical and planning-related parameters affect the accuracy of immediate implant placement using static guided surgery in the anterior maxilla.

Materials and methods: This investigation included 29 patients and 40 immediate implants placed in one of the six anterior maxillary teeth using a fully digital static guided protocol. Preoperative planning was performed using STL and CBCT data, and implant positions were planned for screw-retained restorations. Surgical guides were tooth-supported and 3D printed. Postoperative intraoral scans were superimposed onto the virtual plan to measure implant deviation. Angular deviation and 3D offsets at the platform and apex were calculated. Additional variables included the number of socket walls in contact with the first and last drill, drilling depth, and planned alignment relative to the socket's long axis. Non-parametric tests were used for statistical analysis.

Results: Among the 40 implants, 38 showed buccal deviation at the implant platform. Angular deviation averaged 3.03° ± 1.7°, and mean 3D offsets at the platform and apex were 0.98 ± 0.50 mm and 1.23 ± 0.64 mm, respectively. Implants planned outside the socket's axis exhibited significantly greater deviation regarding the angular deviation and the 3D deviation at the implant apex (p < 0.05). A higher number of socket walls in contact with the drill also correlated with increased angular and apex deviation. Drilling depth showed a weak but non significant correlation with angular deviation.

Conclusion: Both anatomical and planning-related factors influence the accuracy of immediate implant placement in the anterior maxilla using static guided surgery. Buccal deviation was consistently observed, and greater deviations occurred when multiple socket walls were engaged or when the implant was not aligned with the socket's natural axis. Careful planning is critical to improve surgical precision.

Purpose: This proof-of-concept study investigates the marginal and internal fit of lithium disilicate overlays produced using traditional and digital workflows. It also evaluates the influence of variables such as tooth preparation design and 3D printer type on the accuracy of the final restoration.

Materials and methods: Two extracted maxillary third molars were prepared with two different self-centering preparations (C1 and C2). Impressions were obtained with both conventional polyvinylsiloxane and digital intraoral scanners. Two different 3D printers were employed in this study. Working models were fabricated using conventional plaster and resin-based 3D printing techniques. Lithium disilicate overlays were then produced using both lost-waxing and 3D-printing workflows. All overlays were seated on their corresponding prepared tooth and scanned using micro-CT to assess the marginal and internal fit.

Results: The findings of this study revealed that restorations produced via 3D printing demonstrated comparable accuracy in marginal and internal fit to those fabricated through traditional heat-pressing techniques. The flat preparation design (C1) resulted in a superior marginal accuracy of the restorations. Although some differences in marginal accuracy were observed between the two printers tested in this study, these differences consistently remained below 100µm.

Conclusions: Within the limitations of this proof-of-concept design, both traditional and digital workflows are capable of producing lithium disilicate overlays with clinically acceptable accuracy. This study suggests that 3D printing represents a viable and efficient alternative to conventional techniques for fabricating indirect restorations in clinical practice.

Objective: This systematic review evaluates the accuracy, reliability, and clinical utility of jaw motion tracking (JMT) systems compared to traditional occlusal assessment methods, providing an overview of current evidence supporting their integration in dental practice.

Materials and methods: The review followed PRISMA guidelines (PROSPERO Registration: CRD42024567619). A comprehensive search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library (January 2005- December 2025) using predefined keywords related to JMT systems and digital occlusal analysis. Studies were included if they assessed JMT device performance in clinical, experimental, or in vitro settings, comparing them to conventional mechanical articulators or manual occlusal techniques. The QUADAS-2 tool evaluated study quality, focusing on bias, patient selection, and applicability concerns.

Results: Twenty studies met inclusion criteria, ranging from single-patient case studies to larger clinical trials. Optical tracking systems demonstrated higher precision and accuracy in recording mandibular movements compared to traditional methods. JMT systems showed potential in reducing chair time and improving prosthetic outcomes. The risk of bias was high, mainly due to small sample sizes and the lack of long-term evaluations.

Conclusions: Digital JMT technologies improve occlusal assessment and treatment planning, particularly in prosthodontics and TMJ diagnostics. However, further research is needed to standardize protocols, validate these systems across diverse populations, and ensure clinical applicability. Despite the potential benefits, methodological inconsistencies highlight the need for more rigorously designed studies.

Purpose: This study aimed to compare patient satisfaction and oral health impact between individuals receiving complete dentures made by digital methods and those utilizing conventional techniques.

Materials and methods: In this randomized crossover clinical trial, 23 patients aged 40 and older with completely edentulous arches were enrolled at three treatment centers. Each participant received two sets of complete dentures: one set created using conventional methods (selective pressure impression) and the other through digital techniques (mucostatic digital impression). The order of denture placement was randomized, with each set used for four weeks. A trained specialist administered treatments, alongside research tools, including a general information questionnaire, a denture satisfaction survey, and the OHIP-14 interview tool. Statistical analysis was conducted using the Mann-Whitney U Test.

Results: Participants with digital dentures reported significantly higher satisfaction regarding treatment duration, comfort, confidence, chewing ability, aesthetics, and overall satisfaction compared to those with conventional dentures. There were no significant differences in satisfaction concerning speech and pronunciation. Overall, the oral health impact on quality of life was similar between denture types, but participants indicated improved quality of life while using dentures compared to being edentulous.

Conclusions: Patients with digital dentures exhibited greater satisfaction across various domains compared to those with conventional dentures, despite similar satisfaction levels in speech and pronunciation. The impact on quality of life was comparable between both types, as measured by the OHIP-14.

Purpose: The aim of this study was to analyze the scientific level and publication trends on digital complete dentures through a bibliometric and altmetric analysis.

Material and methods: A search was conducted in December 2024 in the Web of Science Core Collection (WoS-CC). From the selected articles, data related to publication profiles were extracted. Collaboration networks were generated using VOSviewer. Altmetric performance was assessed through the Dimensions platform. The risk of bias in clinical studies was evaluated using the Cochrane RoB 2.0 Tool. Spearman's correlation was applied for citation data analysis.

Results: A total of 306 studies were included. The Journal of Prosthetic Dentistry was the journal with the highest number of publications (n = 93). Most studies were laboratory (n = 121), focusing on protocol descriptions (n = 128). Mucosa-supported dentures were predominant (n = 207). Printed dentures stood out (n = 105). The United States led in the number of publications (n = 69). Mentions in Mendeley were identified in Dimensions. Collaboration between authors was identified in VOSviewer.

Conclusions: This study highlighted the growth of scientific production on digital complete dentures, which are associated with reduced costs and fewer appointments. There was an increase in studies on printed dentures. Despite the presence of clinical trials, studies with higher methodological rigor are still lacking.

Objectives: To assess the association of sleep (SB), awake (AB), and combined SB/AB bruxism with temporomandibular joint and/or temporal pain, emotional dysregulation, depression, anxiety, stress, and sleep quality.

Materials and methods: The sample (n=240) were police officers (Brigada Militar) in active duty (35% women, 69% less than 45 years old). The Temporomandibular Pain Screener short-version (Diagnostic Criteria for Temporomandibular Disorders - DC/TMD); the Difficulties in Emotion Regulation Scale (DERS); the Depression, Anxiety, and Stress Scale (DASS-21); and the Pittsburgh Sleep Quality Index (PSQI) were used for data collection.

Results: The combined AB/SB showed more than twice the prevalence of AB and SB separately (45.6% versus 7.2% and 19.0%, respectively). Significantly moderate to strong positive associations (odds ratio - OR) were found in combined AB/SB for TMJ and/or temporal pain (14.33, p<0.001), depression (2.11, p<0.05), and stress (2.69, p<0.05); followed by AB for stress only (4.48, p<0.05); while SB had no significant associations. Regarding sleep variables, strong positive and significant associations (OR) were found: a) combined AB/SB for sleep quality (3.25, p<0.01) and sleep disturbance (5.14, p<0.01), and b) AB for sleep duration (3.60, p<0.05). No significant associations were found for SB against sleep variables. Combined AB/SB had more positive interactions with AB than with SB in most variables.

Conclusions: The new combined AB/SB bruxism classification has shown to have higher prevalences and stronger associations with most of the variables analyzed in this study as compared to AB or SB separately; therefore, future studies and consensus statements must include this new bruxism classification.

Purpose: To investigate patterns of social media (SM) use among dental specialists and to assess SM's perceived role in daily practice and patient care.

Materials and methods: A cross-sectional pilot paper survey was administered to specialist dentists in Greece (May-June 2024). The 23-item questionnaire covered four domains: demographics, personal SM use, professional-patient communication, and perceived impact on patient care. Descriptive statistics were reported as frequencies, medians (IQR), or means ± SD. Exploratory associations used Fisher's exact or χ² tests for categorical variables and Kruskal-Wallis or Wilcoxon tests for ordinal outcomes, with 95% confidence intervals. Statistical significance was set at p<0.05; all analyses were exploratory.

Results: Forty-five dentists participated (66.7% women; median age 30 [IQR 10]); 64.4% were prosthodontists and 35.6% orthodontists. Most respondents (97.8%) had ≥1 SM.

Purpose: This study aimed to compare the accuracy of reduction guides produced through virtual planning and three-dimensional (3D) printing with those produced conventionally.

Materials and methods: Definitive casts of partially edentulous arches were used to fabricate reduction guides [Conventional Group (CG=30); Digital Group (DG=30)]. The guides were designed for anterior and posterior teeth with adjacent contacts and isolated posterior abutments. Retention, stability, accuracy of the guiding planes, and time required for each step were recorded. Sensitivity and specificity tests were performed to assess accuracy. Fisher's Exact test was used to evaluate associations between variables, and the Mann-Whitney test was applied for time comparisons.

Results: Both techniques achieved 100% retention and stability for guides placed on anterior and posterior teeth with adjacent contacts. For isolated teeth, retention ranged from 70% to 90% and stability from 60% to 70%, with no significant differences between techniques (P>.05). Accuracy ranged from 0.80 (anterior teeth) to 1.00 (posterior teeth). There was higher precision for guides fabricated on molars (100%) and isolated abutments regardless of the surface analyzed (76%-100%). The digital technique required significantly more time for design, guide fabrication, and overall processing (P<.001), however, isolated abutments were more time-efficient (P<.001).

Conclusions: The digital technique demonstrated comparable accuracy, retention, and stability to the conventional method. Despite longer processing time, it offers standardization and reduced chairside time.

Objective: To evaluate the 5-year survival of metal-ceramic and all-ceramic tooth-supported fixed dental prostheses (FDPs) and assess biological and technical complication rates.

Methods: Randomized clinical trials and prospective studies on tooth-supported FDPs with a mean follow-up of ≥3 years were included. A systematic search of Medline (PubMed), Embase, and Cochrane CENTRAL (January 2014-December 2024) identified relevant studies. Seventeen additional studies from prior systematic reviews were included to cover earlier periods. Survival and complication rates were estimated using robust Poisson regression models to generate pooled 5-year survival estimates.

Results: Forty-one studies, including 600 metal-ceramic and 1532 all-ceramic FDPs, met inclusion criteria. The 5-year survival rates were 92.9% for veneered densely sintered zirconia, 91.3% for metal-ceramic, 88.4% for glass-infiltrated alumina, 87.9% for monolithic densely sintered zirconia, and 82.5% for lithium-disilicate reinforced glass-ceramic FDPs. Lithium-disilicate FDPs showed ignificantly lower survival than metal-ceramic restorations; other differences were not significant. 71.0% of restorations remained complication-free after five years. All-ceramic FDPs had higher rates of marginal caries and loss of retention than metal-ceramic FDPs. Framework fractures occurred more frequently in lithium-disilicate and glass-infiltrated alumina FDPs (>10% over five years). Ceramic surface chipping was common but least frequent in monolithic zirconia FDPs.

Conclusions: Veneered and monolithic densely sintered zirconia and metal-ceramic FDPs demonstrate comparable 5-year survival. High fracture rates make weaker ceramics unsuitable for multi-unit restorations. Monolithic zirconia offers improved resistance to chipping and framework fractures.

Purpose: This study aimed to comparatively evaluate the manufacturing accuracy, marginal and internal fit of implant-supported permanent crowns fabricated using different brands of permanent hybrid ceramic resins via 3D printing. Additionally, these outcomes were compared with crowns produced from Vita-Enamic using the subtractive CAD/CAM technique.

Materials and methods: Six groups were formed, including five different 3D printing resins and Vita-Enamic. Crown accuracy was evaluated following ISO Standard 12836:2015. For accuracy measurements, root mean square values were calculated and recorded using Geomagic-DesignX software, based on methodologies described in the literature. Marginal and internal fit were assessed by measuring points on sectioned specimens under an optical microscope. Data were analyzed using SPSS version 22.0.

Results: The Saremco Crowntec showed (p<0,05) the highest internal and marginal fit (55,10 ± 9,433; 89,30 ± 20,966), while the Bego VarseoSmile TriniQ demonstrated the lowest marginal fit (141,70 ± 39,668) and external accuracy (92,90 ± 11,239). No significant difference was found between additive and subtractive groups in marginal fit and accuracy; the best internal fit (63,62 ± 13,352) was observed in additive groups, whereas Vita-Enamic showed (p<0,05) external accuracy (27,70 ± 6,961). Among production technologies, digital light processing exhibited (p<0,05) the lowest external accuracy (64,73 ± 25,209), with no significant difference between subtractive manufacturing and stereolithography (p>0,05).

Conclusions: Case-specific material choice is essential. Each material has distinct advantages and limitations. Additive resins may be preferred where retention and internal fit are critical, while subtractive materials are suitable when surface accuracy is prioritized.