The International journal of prosthodontics最新文献

In patients with insufficient posterior occlusal support, transfer of the interocclusal relationship to a mechanical articulator commonly requires record bases to stabilize gypsum casts. This short communication describes a digital-to-physical workflow that combines intraoral scanner-derived interocclusal registration with a patient-specific, 3D-printed gyroid-based mounting jig. Digital mounting was established intraorally and transferred to gypsum casts mounted on an articulator without an additional clinical visit. The workflow was demonstrated in a single clinical case as a proof of concept. This approach may reduce clinical steps and facilitate efficient articulator mounting in selected clinical situations.

Purpose: This study aimed to compare the diagnostic performance of different 5Ts evaluation approaches and to establish the most accurate method and cut-off point (CP) in non-clinical populations.

Materials and methods: A cross-sectional study was conducted with 278 participants (mean age 22.17 years [SD 1.82]) recruited from a large private university. Participants completed a survey including demographics, the 5Ts with no/yes responses, and 5Ts-F with frequency options. TMD diagnoses were established using the DC/TMD protocol and algorithms. Diagnostic accuracy was analyzed using the area under the receiver operating characteristic (ROC) curves, sensitivity, specificity, and predictive values for four approaches: A1 (5Ts; conventional), A2 (5Ts; CP 1.5), A3 (5Ts-F; CP 1.5), and A4 (5Ts-F; CP 2.5).

Results: Among participants, 68.7% received a DC/TMD diagnosis. A1 identified 72.3% as TMD-positive, showing AUCs of 0.94 for all TMDs, PT, and IT. A2 to A4 had AUCs below 0.9. A1's sensitivity/specificity were 100%/88.5%. When items were analyzed separately, A1's AUCs increased to 0.99 for PT and 0.95 for IT.

Conclusions: The conventional 5Ts assessment method was the most accurate, and total scores of ≥1 can identify the presence of TMDs in non-clinical samples when points are assigned for no/yes responses.

Purpose: This case report highlights the use of a hybrid digital protocol for the fabrication of bimaxillary complete removable dentures (CRDs) in an elderly, fully edentulous patient. The aim was to minimize the number of clinical appointments while achieving functional, esthetic, and durable results.

Materials and methods: An 84-year-old edentulous patient, previously discouraged by a conventional denture protocol, underwent rehabilitation using a three-appointment hybrid workflow. Digital intraoral and facial scans were captured during the initial visit using custom devices to determine the vertical dimension of occlusion (VDO) and centric relation (CR). In the second session, secondary impressions were taken with polyether materials using digitally fabricated occlusion bases. Intermaxillary relationships were refined with the Gnathometer system, and all records were digitized. Final dentures were virtually designed and milled from poly(methyl methacrylate) discs, integrating the base and teeth into a monolithic structure (Ivotion, Ivoclar, Schaan, Liechtenstein). The third session focused on prosthesis delivery and functional validation.

Results: The hybrid protocol enabled the precise capture of anatomical and functional data while significantly reducing treatment time. The final prostheses demonstrated excellent fit, retention, stability, and occlusion, with no need for adjustments. The patient expressed high satisfaction with both the comfort and efficiency of the process.

Conclusions: This case suggests that a hybrid digital protocol may offer a viable alternative for the prosthetic rehabilitation of edentulous elderly patients, particularly when reducing chair time is critical. However, these results are limited to a single clinical case and require confirmation through larger-scale studies.

Purpose: This retrospective study aimed to elucidate a fully digital workflow incorporating neuromuscular and jaw-tracking systems and to compare the clinical outcomes of partial implant-supported fixed dental prostheses (P-FDPs) and complete-arch implant-supported fixed dental prostheses (CA-FDPs) fabricated within this workflow.

Materials and methods: Participants who underwent full-mouth rehabilitation using this digital protocol were identified through a retrospective review of clinical records. Evaluated parameters included prosthesis delivery time, implant and prosthesis survival rates, success rates, prosthetic complications rate, and marginal bone loss (MBL). MBL was reported as the median (Q1, Q3), and group differences were analyzed using the Mann-Whitney U test (α = .05).

Results: Twelve participants with 22 arches (12 maxilla, 10 mandible), 96 implants, and 29 FDPs were analyzed over a mean follow-up of 6.5 ±3.6 years. The P-FDP group (14 arches, 42 implants, 21 prostheses) had a mean follow-up of 5.6 ± 3.8 years, while the CA-FDP group (8 arches, 54 implants, 8 prostheses) had 7.8 ± 2.2 years. Implant and prosthesis survival rates were 100% in both groups, whereas implant success rates were 95.2% for P-FDPs and 100% for CA-FDPs. Prosthetic complications occurred in 25% of CA-FDPs (two cases of chipping) but none in P-FDPs. Overall median MBL was 0.46 mm (0.13, 0.72), with significantly higher annual MBL in P-FDPs (0.09 mm) than CA-FDPs (0.04 mm; P< .001).

Conclusions: Within this digital workflow supported by neuromuscular and jaw-tracking systems, P-FDPs showed statistically significantly greater MBL, whereas CA-FDPs exhibited more prosthetic complications.

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.