Editorial

4 pages, 812 KiB

Open AccessEditorial

Advancements in Dental Care: The Evolving Landscape of Prosthetic Dentistry

by João Paulo Mendes Tribst, Gabriel Kalil Rocha Pereira and Cornelis Johannes Kleverlaan

J. Clin. Med. 2024, 13(5), 1225; https://doi.org/10.3390/jcm13051225 - 21 Feb 2024

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In the dental field, the specialty of prosthodontics stands out as the frontline of innovation, continually pushing the boundaries to enhance both function and aesthetics for optimal oral rehabilitation [...] Full article

(This article belongs to the Special Issue Clinical Advancements in Prosthodontics: Bridging the Gap between Function and Aesthetics)

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Research

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15 pages, 3000 KiB

Open AccessArticle

Fiber-Reinforced Composites for Full-Arch Implant-Supported Rehabilitations: An In Vitro Study

by Luisa De Giorgis, Paolo Pesce, Fabrizio Barberis, Alberto Lagazzo, Francesco Pera, Domenico Baldi, Luigi Canullo and Maria Menini

J. Clin. Med. 2024, 13(7), 2060; https://doi.org/10.3390/jcm13072060 - 02 Apr 2024

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Abstract

Background: Fiber-reinforced composites (FRCs) have been proposed as an alternative to traditional metal alloys for the realization of frameworks in full-arch implant-supported prostheses. The aim of the present in vitro study was to evaluate the deflection under load of seven prostheses endowed with [...] Read more.

Background: Fiber-reinforced composites (FRCs) have been proposed as an alternative to traditional metal alloys for the realization of frameworks in full-arch implant-supported prostheses. The aim of the present in vitro study was to evaluate the deflection under load of seven prostheses endowed with frameworks made of different materials, including different types of fiber-reinforced composites (FRCs). Methods: A master cast with four implant analogues in correspondence with the two lateral incisors and the two first molars was used to create full-arch fixed prostheses with the same shape and different materials. Prostheses were made of the following different materials (framework+veneering material): gold alloy+resin (Au+R), titanium+resin (Ti+R), FRC with multidirectional carbon fibers+resin (ICFRC+AR), FRC with unidirectional carbon fibers+composite (UCFRC+C), FRC with glass fibers+resin (GFRC+AR), FRC with glass fibers+composite (GFRC+C), and resin (R, fully acrylic prosthesis). Flexural tests were conducted using a Zwick/Roell Z 0.5 machine, and the deflection of the lower surface of the prosthesis was measured in order to obtain load/deflection graphs. Results: Greater rigidity and less deflection were recorded for UCFRC+C and GFRC+C, followed by Ti+R and Au+R. The greatest deformations were observed for resin alone, ICFRC+R, and GFRC+R. The results were slightly different in the incisal region, probably due to the greater amount of veneering material in this area. Conclusions: When used to realize full-arch frameworks, Au and Ti allow for predictable mechanical behavior with gradual deformations with increasing load. UCFRC also demonstrated good outcomes and less deflection than ICFRCs when loaded. The GFRC full-arch framework may be a valid alternative, although it showed greater deflections. Further studies are needed in order to evaluate how different prosthesis designs and material thicknesses might affect the outcomes. Full article

(This article belongs to the Special Issue Clinical Advancements in Prosthodontics: Bridging the Gap between Function and Aesthetics)

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12 pages, 275 KiB

Open AccessArticle

Quantification and Influence of IL-1β on Pain and Inflammatory Response after Placement of a Cement–Screw-Retained Restoration

by Lady Arbelaez-Bonozo, Serafín Maza-Solano, María Baus-Domínguez, Raquel Gómez-Díaz, Gonzalo Ruiz-de-Leon-Pacheco, Daniel Torres-Lagares and María-Angeles Serrera-Figallo

J. Clin. Med. 2024, 13(6), 1669; https://doi.org/10.3390/jcm13061669 - 14 Mar 2024

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Abstract

Background: The objective of this study was to evaluate the pain and inflammatory response in soft tissues using healing and prosthetic abutments of different diameters and lengths. Methods: The study population was rehabilitated with Astra Tech EV single implants (Dentsply Sirona, Atlantis, Dentsply [...] Read more.

Background: The objective of this study was to evaluate the pain and inflammatory response in soft tissues using healing and prosthetic abutments of different diameters and lengths. Methods: The study population was rehabilitated with Astra Tech EV single implants (Dentsply Sirona, Atlantis, Dentsply Sirona S.A., Barcelona, Spain) of 4.2 and 4.8 millimetres in diameter in the upper and lower maxilla and loaded with custom abutments digitally designed using Dentsply Sirona’s Virtual Atlantis Design software (Atlantis WebOrder, Dentsply Sirona S.A., Barcelona, Spain), version 4.6.5. The custom abutments had a larger diameter than the healing abutments to evaluate for biomarkers through ELISA. Results: Rehabilitations in the mandible and with healing abutments with diameters less than 4.29 mm and rehabilitators with diameters less than 2.18 mm elicited a higher pain and inflammatory response and, in turn, higher interleukin-1β values. Conclusions: Greater inflammation was evident in cases in which healing abutments with reduced diameter were used compared to the same subsequent rehabilitation with prosthetic abutments with larger diameters. Full article

(This article belongs to the Special Issue Clinical Advancements in Prosthodontics: Bridging the Gap between Function and Aesthetics)

12 pages, 2033 KiB

Open AccessArticle

Influence of Narrow Titanium Dental Implant Diameter on Fatigue Behavior: A Comparison between Unitary and Splinted Implants

by Rodrigo González Terrats, María Bonnín Liñares, Miquel Punset, Meritxell Molmeneu, José Nart Molina, Vanessa Ruíz Magaz, Matteo Albertini, José María Manero and Javier Gil Mur

J. Clin. Med. 2024, 13(6), 1632; https://doi.org/10.3390/jcm13061632 - 13 Mar 2024

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Abstract

Background: Scientific literature lacks strong support for using narrow diameter implants (NDI) in high masticatory force areas, especially in molars. Implant splinting in cases of multiple missing teeth reduces lateral forces, improves force distribution, and minimizes stress on implants. However, no studies have [...] Read more.

Background: Scientific literature lacks strong support for using narrow diameter implants (NDI) in high masticatory force areas, especially in molars. Implant splinting in cases of multiple missing teeth reduces lateral forces, improves force distribution, and minimizes stress on implants. However, no studies have evaluated the fatigue load resistance of unitary or splinted implants. Methods: This in vitro study compares five groups of new metal alloy implants, including unitary and splinted implants with varying diameters. Mechanical characterization was assessed using a BIONIX 370 testing machine (MTS, Minneapolis, MN, USA) according to ISO 14801. For each of the five study sample groups, (n = 5) specimens underwent monotonic uniaxial compression at break testing and (n = 15) cyclic loading to determine the maximum force (Fmax) and the fatigue life (LF) values. Scanning electron microscopy (SEM) was employed for the fractographic analysis of the fractured samples. Results: The Fmax values for unitary samples ranged from 196 N to 246 N, whereas the two-splinted samples displayed significantly higher values, ranging from 2439 N to 3796 N. Similarly, the LF values for unitary samples ranged from 118 N to 230 N, while the two-splinted samples exhibited notably higher values, ranging from 488 N to 759 N. Conclusions: The observed resistance difference between sample groups in terms of Fmax and LF may be due to variations in effective cross-sectional area, determined by implant diameter and number. Additionally, this disparity may indicate a potential stiffening effect resulting from the splinting process. These findings have significant implications for dental clinical practice, suggesting the potential use of splinted sets of small-sized NDI as replacements for posterior dentition (premolars and molars) in cases of alveolar bone ridge deficiencies. Full article

(This article belongs to the Special Issue Clinical Advancements in Prosthodontics: Bridging the Gap between Function and Aesthetics)

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11 pages, 2906 KiB

Open AccessArticle

Digital Protocol to Record Occlusal Analysis in Prosthodontics: A Pilot Study

by Emanuele Risciotti, Nino Squadrito, Daniele Montanari, Gaetano Iannello, Ugo Macca, Marco Tallarico, Gabriele Cervino and Luca Fiorillo

J. Clin. Med. 2024, 13(5), 1370; https://doi.org/10.3390/jcm13051370 - 28 Feb 2024

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Abstract

Background: Digital technologies enable the accurate replication of occlusion, which is pivotal for stability in maximum intercuspation and dynamic occlusion. CAD softwares generates standardized occlusal morphologies requiring significant adjustments. The consideration of individual mandibular movements during restoration leads to better functional integration. This [...] Read more.

Background: Digital technologies enable the accurate replication of occlusion, which is pivotal for stability in maximum intercuspation and dynamic occlusion. CAD softwares generates standardized occlusal morphologies requiring significant adjustments. The consideration of individual mandibular movements during restoration leads to better functional integration. This pilot study evaluates the efficacy of a novel, fully digital protocol for occlusal analysis recording in prosthodontics. Methods: Patients needing single or multiple metal-free restorations were included. Teeth underwent horizontal finish line preparation, while restorations on implants were either directly screwed or used multi-unit abutments. A digital impression (Trios 3 Intraoral Scanner) captured the mouth’s elements. Dynamic occlusion was recorded via Patient Specific Motion (PSM). After the placement and functionalization of temporary restorations, subsequent scans included various elements, and CAD software (Dental system) was used for the restoration design. Restorations were milled in monolithic zirconia, pressed from CAD/CAM-milled wax, and sintered. Results: An evaluation of 52 restorations in 37 patients indicated high accuracy in restorations manufactured via the fully digital workflow. Monolithic zirconia was predominantly used. Subtractive (17.3%) and additive (7.7%) occlusal adjustments were mainly chairside. Conclusion: This study underscores the efficacy of meticulous verification measures and a centric contact system in reducing the need for clinical occlusal refinements in prosthetic restorations. Full article

(This article belongs to the Special Issue Clinical Advancements in Prosthodontics: Bridging the Gap between Function and Aesthetics)

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12 pages, 882 KiB

Open AccessArticle

Conometric Connection for Implant-Supported Crowns: A Prospective Clinical Cohort Study

by Saturnino Marco Lupi, Dario De Martis, Claudia Todaro, Gaetano Isola, Mario Beretta and Ruggero Rodriguez y Baena

J. Clin. Med. 2023, 12(24), 7647; https://doi.org/10.3390/jcm12247647 - 13 Dec 2023

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Abstract

Background: Traditional screw or cemented connections in dental implants present limitations, prompting the exploration of alternative methods. This study assesses the clinical outcomes of single crowns and fixed partial prostheses supported by conometric connections after one year of follow-up. Methods: Twenty-two patients received [...] Read more.

Background: Traditional screw or cemented connections in dental implants present limitations, prompting the exploration of alternative methods. This study assesses the clinical outcomes of single crowns and fixed partial prostheses supported by conometric connections after one year of follow-up. Methods: Twenty-two patients received 70 implants, supporting 33 rehabilitations. Biological responses and prosthodontic complications were evaluated at baseline, 6 months, and 12 months. Results: All implants exhibited successful osseointegration, with no losses or peri-implant inflammation. Marginal bone levels showed minimal changes, well below pathological thresholds. The difference in marginal bone loss (MBL) was −0.27 ± 0.79 mm between T0 and T1, and −0.51 ± 0.93 mm between T0 and T2. No abutment screw loosening or crown chipping occurred. However, coupling stability loss was observed in nine cases. Conclusions: The conometric connection demonstrated successful integration and minimal complications after one year. This alternative shows promise, particularly in simplifying handling and improving marginal adaptation. Further research with larger sample sizes and longer follow-up is warranted for comprehensive validation. Full article

(This article belongs to the Special Issue Clinical Advancements in Prosthodontics: Bridging the Gap between Function and Aesthetics)

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12 pages, 26349 KiB

Open AccessArticle

Immediate Loading of Zygomatic Implants Using a Dual Scan Technique

by Mustafa Gseibat, Valerio Sorrentino, Pablo Sevilla, Jesús Peláez and Maria J. Suarez

J. Clin. Med. 2023, 12(23), 7464; https://doi.org/10.3390/jcm12237464 - 01 Dec 2023

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Abstract

The immediate loading protocol has become increasingly popular due to the progressive growth in demand for a reduction in treatment times. The possibility of applying this protocol would depend on certain important factors. The application of the digital workflow mentioned in the protocol [...] Read more.

The immediate loading protocol has become increasingly popular due to the progressive growth in demand for a reduction in treatment times. The possibility of applying this protocol would depend on certain important factors. The application of the digital workflow mentioned in the protocol guarantees rapidity, precision, and esthetics. This report aims to describe a fully digital workflow using a dual scan impression technique to fabricate immediate fixed complete dentures (FCDs) for zygomatic and standard implants. A 58-year-old female patient requested treatment for her severely atrophic maxilla, and four unrehabilitated implants in the mandible. After proper diagnosis and planification, four zygomatic implants and two standard implants were placed. During the surgery, transmucosal abutments were placed on all implants. After suturing, the positions of the implants were recorded using a stereophotogrammetric technique, creating a standard tessellation (STL) file. In the lower arch, the second phase of the surgery was carried out: the transmucosal abutments were placed, and then the implant positions were recorded in the same way. The soft tissues were rescanned after suturing with an intraoral scanner (IOS), and all STL files were aligned to obtain the virtual final models. The pre-design after virtual modifications was aligned with the definitive models. The provisional prostheses were milled and placed after six hours after the surgery, and the definitive prostheses were placed six months after the surgery. The dual scan technique used obtained a precise fit for both the provisional and definitive FCDs. This technique might be an effective and reliable alternative for the fabrication of immediate and definitive screw-retained FCDs in a completely digital workflow. The time taken for scanning and fabrication was reduced, and the clinician’s and patient’s satisfaction were improved. Full article

(This article belongs to the Special Issue Clinical Advancements in Prosthodontics: Bridging the Gap between Function and Aesthetics)

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Review

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15 pages, 901 KiB

Open AccessReview

The Potential of Nano-Based Photodynamic Treatment as a Therapy against Oral Leukoplakia: A Narrative Review

by Angela Angjelova, Elena Jovanova, Alessandro Polizzi, Simona Santonocito, Antonino Lo Giudice and Gaetano Isola

J. Clin. Med. 2023, 12(21), 6819; https://doi.org/10.3390/jcm12216819 - 28 Oct 2023

Cited by 1 | Viewed by 1217

Abstract

Oral leukoplakia is a predominantly white lesion of the oral mucosa that cannot be classified as any other definable lesion with the risk of progressing into malignancy. Despite the advancements in conventional therapy, the rates of malignant transformation remain notably high, affecting 4.11% [...] Read more.

Oral leukoplakia is a predominantly white lesion of the oral mucosa that cannot be classified as any other definable lesion with the risk of progressing into malignancy. Despite the advancements in conventional therapy, the rates of malignant transformation remain notably high, affecting 4.11% of adults, due to the difficulty of accurate diagnosis and indistinct treatment. Photodynamic therapy (PDT), being a minimally invasive surgical intervention, employs a variety of factors, including light, nano-photosensitizers (PSs) and oxygen in the management of precancerous lesions. PDT faces limitations in administering photosensitizers (PSs) because of their low water solubility. However, these challenges could be effectively resolved through the incorporation of PSs in nanostructured drug delivery systems, such as gold nanoparticles, micelles, liposomes, metal nanoparticles, dendrimers and quantum dots. This review will give an overview of the different innovative PS approaches in the management of premalignant lesions, highlighting the most recent advancements. From a clinical perspective, it is expected that nanotechnology will overcome barriers faced by traditional therapeutics and will address critical gaps in clinical cancer care. Full article

(This article belongs to the Special Issue Clinical Advancements in Prosthodontics: Bridging the Gap between Function and Aesthetics)

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