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Abstract The optimal configuration of a customized implant abutment is crucial for bone remodeling and is influenced by various design parameters. This study introduces an optimization process for designing two-piece zirconia dental implant abutments. The aim is to enhance bone remodeling, increase bone density in the peri-implant region, and reduce the risk of late implant failure. A 12-month bone remodeling algorithm subroutine in finite element analysis to optimize three parameters: implant placement depth, abutment taper degree, and gingival height of the titanium base abutment. The response surface analysis shows that implant placement depth and gingival height significantly impact bone density and uniformity. The taper degree has a smaller effect on bone remodeling. The optimization identified optimal values of 1.5 mm for depth, 35° for taper, and 0.5 mm for gingival height. The optimum model significantly increased cortical bone density from 1.2 to 1.937 g/cm3 in 2 months, while the original model reached 1.91 g/cm3 in 11 months. The standard deviation of density showed more uniform bone apposition, with the optimum model showing values 2 to 6 times lower than the original over 12 months. The cancellous bone showed a similar trend. In conclusion, the depth and taper have a significant effect on bone remodeling. This optimized model significantly improves bone density uniformity.

Abstract This systematic review explores the accuracy of computerized guided implant placement including computer-aided static, dynamic, and robot-assisted surgery. An electronic search up to February 28, 2023, was conducted using the PubMed, Embase, and Scopus databases using the search terms “surgery”, “computer-assisted”, “dynamic computer-assisted”, “robotic surgical procedures”, and “dental implants”. The outcome variables were discrepancies including the implant’s 3D-coronal, -apical and -angular deviations. Articles were selectively retrieved according to the inclusion and exclusion criteria, and the data were quantitatively meta-analysed to verify the study outcomes. Sixty-seven articles were finally identified and included for analysis. The accuracy comparison revealed an overall mean deviation at the entry point of 1.11 mm (95% CI: 1.02–1.19), and 1.40 mm (95% CI: 1.31–1.49) at the apex, and the angulation was 3.51˚ (95% CI: 3.27–3.75). Amongst computerized guided implant placements, the robotic system tended to show the lowest deviation (0.81 mm in coronal deviation, 0.77 mm in apical deviation, and 1.71˚ in angular deviation). No significant differences were found between the arch type and flap operation in cases of dynamic navigation. The fully-guided protocol demonstrated a significantly higher level of accuracy compared to the pilot-guided protocol, but did not show any significant difference when compared to the partially guided protocol. The use of computerized technology clinically affirms that operators can accurately place implants in three directions. Several studies agree that a fully guided protocol is the gold standard in clinical practice.

Titanium (Ti) is considered the gold standard material for provisional implant restorations. Polyetheretherketone (PEEK), a polymeric thermoplastic material, has been progressively used in prosthetic, restorative, and implant dentistry. Recently, PEEK has been used in implant dentistry as a provisional implant restoration. Plaque accumulation and biofilm formation become the major concerns when infection and inflammation occur in the peri-implant tissue. Few reports were studied regarding the biofilm formation on the PEEK surface. This study aimed to compare plaque accumulation between the PEEK and Ti healing abutments. In an in vitro setting, the Ti healing abutment and PEEK healing abutment were subjected to biofilm formation; the result was collected after 24 h, 48 h, 72 h, and 7 days. Biofilms were studied following staining with crystal violet. The data were analyzed by Two-Way ANOVA. It was found that between Ti healing abutment and PEEK healing abutment materials, the biofilm formation on the PEEK surface is slightly higher than Ti, but no statistical difference (p > 0.05) was found. The results suggested that plaque accumulation between the Ti healing abutment and the PEEK healing abutment was not different. We concluded that the plaque accumulation on the surface PEEK healing abutment was similar to the conventional Ti healing abutment materials. Hence, both the PEEK and Ti healing abutments can be used as a healing abutment biomaterial according to the requirements of the prostheses in implant dentistry.

Gold nanoparticles (AuNPs) have gained significant attention in the biomedical field owing to their versatile properties. AuNPs can be customized by modifying their size, shape and surface characteristics. In recent years, extensive research has explored the integration of AuNPs into various dental materials, including titanium, polymethylmethacrylate (PMMA) and resin composites. This review aims to summarize the advancements in the application of modified AuNPs in dental materials and to assess their effects on related cellular processes in the dental field. Relevant articles published in English on AuNPs in association with dental materials were identified through a systematic search of the PubMed/MEDLINE, Embase, Scopus and ScienceDirect databases from January 2014 to April 2024. Future prospects for the utilization of AuNPs in the field of dentistry are surveyed.

Surface modifications for titanium, a material of choice for dental implants, can greatly alter the surface micro/nanotopography and composition of implants, leading to notable enhancements in their hydrophilicity, mechanical properties, osseointegration performance, and antibacterial performance, as well as their impacts on osteoblast activity and bone formation processes. This article aims to update titanium surface modification techniques for dental implants from the past to the present, along with their effects on osteoblasts and bone formation, by thoroughly summarizing findings from published studies. Peer-reviewed articles published in English consisting of in vitro, in vivo, and clinical studies on titanium dental implant surface treatments were searched in Google Scholar, PubMed/MEDLINE, ScienceDirect, and the Scopus databases from January 1983 to December 2023 and included in this review. The previous studies show that implant surface roughness, condition, and hydrophilicity are crucial for osteoblast adhesion and growth. While various techniques enhance osseointegration comparably, one of the most common approaches to accomplishing these properties is sandblasting large-grit acid etching surface treatment and coating with hydroxyapatite or chitosan. In conclusion, this review points out the efficacy of different subtraction and addition techniques in enhancing the surface properties of titanium dental implants, promoting favorable outcomes in terms of osteoblast activity and bone formation in various degrees. However, most existing studies predominantly compare treated and non-treated titanium, revealing a need for more comprehensive studies comparing the effects of various modification techniques. Moreover, further investigation of factors playing a role in the dynamic osseointegration process in addition to osteoblasts and their functions, as well as improved surface modification techniques for the treatment of compromised patients, is greatly required.

Objective. The wear behavior of the novel zirconia generation is less well understood and may be affected by compositional modifications compared to the conventional zirconia. Materials and Methods. Combinations of keywords such as “zirconia,” “high translucent,” and “wear” were searched in PubMed and Google Scholar databases up to May 2021. The total of 23 relevant articles was selected according to inclusion criteria. Results. Reports show comparable wear resistance of translucent zirconia to the conventional zirconia despite an increased cubic phase content and lower mean flexural strength. A meticulously polished surface creates the lowest surface roughness, producing favorable zirconia wear resistance and antagonist wear compared to a glazed surface. In comparison to other ceramic materials, zirconia produces the least wear on an enamel antagonist and almost undetectable wear when opposed by zirconia. Wear when paired against resin materials yields a favorable outcome, whereas wear behavior against a metal antagonist varies with the surface hardness of the metal. Conclusions. All zirconia generations are considered wear-friendly to all types of antagonists. Nonetheless, comparative studies on antagonist wear opposing zirconia of different compositions are still limited and further investigation is required.

Introduction. The removable partial denture (RPD) components, especially the retentive arm, play a major role in the loading characteristic on supporting structures. Objective. To evaluate and compare the effect of different clasp designs on the stress distribution pattern, maximum von Mises stress, and average hydrostatic pressure on abutment teeth, as well as edentulous ridges, mini dental implants (MDIs), and peri-implant bone between the conventional removable partial denture (CRPD) and mini dental implant-assisted distal extension removable partial denture (IARPD) using a three-dimensional finite element analysis (3D FEA). Materials and Methods. 3D FEA models of mandibular arches, with and without bilateral MDI at the second molar areas, and Kennedy class I RPD frameworks, with RPA, RPI, Akers, and no clasp component, were generated. A total of 200 N vertical load was bilaterally applied on both sides of distal extension areas, and the stress was analyzed by 3D FEA. Results. The stress concentration of IARPD with RPI clasp design was located more lingually on abutment teeth, MDI, and peri-implant bone, while the other designs were observed distally on the supporting structures. The maximum von Mises stress on the abutment root surface was decreased when the RPDs were assisted with MDIs. The CRPD and IARPD with the Akers clasp design showed the highest von Mises stress followed by the designs with RPA and RPI clasp, respectively. The average hydrostatic pressure in each group was in approximation. Conclusion. The placement of MDIs on distal extension ridges helps to reduce the stress concentration on denture supporting structures. The maximum von Mises stress is affected by the different designs of clasp components. The CRPD and the IARPD with RPI clasp provide the least stress on supporting structures.

Purpose. To investigate effects of number and location on patterns of von Mises stress distribution and volume average stress on abutment tooth, edentulous ridge, mini dental implant, and surrounding bone of mini dental implant-assisted mandibular Kennedy class I removable partial denture. Materials and Methods. Eight three-dimensional finite element models of mandibular Kennedy class I with different numbers and locations of mini dental implants were constructed. Mini dental implants were generated in the area of second premolar, first molar, and second molar, respectively. A static load of 400 N was applied on all models. The von Mises stress and volumetric average stress were calculated by three-dimensional finite element analysis. Result. The minimum volumetric average stress of abutment tooth was found in the model, where there was one mini dental implant at the second molar position and 2 mini dental implants at first molar and second molar positions. The model with three mini dental implants had reduced volumetric average stress of abutment tooth, which was not different from the model with two mini dental implants. However, the minimum volumetric average stress of mini dental implant and surrounding bone were found when three mini dental implants were applied, followed by two and one mini dental implants, respectively. Conclusion. Placing at least one mini dental implant at a second molar position can help reduce stress transferred to the abutment tooth. Stresses around each implant and surrounding bone reduced with increased numbers of mini dental implants.

Customized healing abutments have been introduced in clinical practice along with implant surgery to preserve or create natural-appearing hard and soft tissue around the implant. This provides the benefits of reducing the overall treatment time by eliminating the second stage and reducing the elapsed time of the fabrication of the final prostheses. This article aims to review the types and properties of materials used for the fabrication of customized healing abutments and their clinical applications. Articles published in English on customized healing abutments were searched in Google Scholar, PubMed/MEDLINE, ScienceDirect, and the Scopus databases up to August 2022. The relevant articles were selected and included in this literature review. Customized healing abutments can be fabricated from materials available for dental implants, including PEEK, PMMA, zirconia, resin composite, and titanium. All the materials can be used following both immediate and delayed implant placement. Each material provides different mechanical and biological properties that influence the peri-implant tissues. In conclusion, the studies have demonstrated promising outcomes for all the materials. However, further investigation comparing the effects of each material on peri-implant soft and hard tissues is required.

Purpose. To investigate the effect of minidental implant location on strain distributions transmitted to tooth abutments and dental minidental implants under mandibular distal extension removable partial denture. Materials and Methods. A mandibular Kennedy Class I distal extension model missing teeth 35–37 and 45–47 was constructed. Six dental mini-implants were placed at positions A, B, and C, where position A was 6.5 mm distal to the abutment teeth with 5 mm between each position. Fourteen uniaxial strain gauges were bonded on the model at the region of dental mini-implant and abutment (first premolar). Four groups were designated according to the location of the mini-implants. A load of 150 N and 200 N was applied using an Instron testing machine. Loadings consisted of bilateral and unilateral loading. Comparisons of the mean microstrains among all strain gauges in all situations were analyzed. Results. Variation in mini-implant locations induced local strains in different areas. Strains at the tooth abutment were significantly decreased in the group in which implants were placed mesially. Strains around the mini-implants showed different patterns when loaded with different loading conditions. The group in which implants were placed distally showed the lowest strains compared to other groups. Conclusion. Mesially placed mini-implants showed the lowest strain around abutment teeth, while a distally-placed mini-implants presented the lowest strain around mini-implants themselves. Under favorable biting force, mini-implant is an option to assist mandibular distal extension removable partial denture. Mesially placed mini-implants are recommended when the abutment has periodontally compromised conditions and a distally placed mini-implant when periodontal conditions are stable.

There is limited documentation of using fluorescence images in oral potentially malignant disorders (OPMDs) and oral cancer screening through the field of teledentistry. This study aims to develop and evaluate the validity and reliability of the intraoral camera with the combination method of autofluorescence and LED white light used for OPMDs and oral cancer screening in teledentistry. The intraoral camera with fluorescent aids, which uses a combined method of both autofluorescence and LED white light, was developed before the device was evaluated for validity and reliability as a OPMDs screening tool for teledentistry. All lesions of thirty-four OPMD patients underwent biopsy for definitive diagnosis and were examined by an oral medicine specialist. Both images under autofluorescent and LED white light mode captured from the device were sent online and interpreted for the initial diagnosis and dysplastic features in addition to being compared to the direct clinical examination and histopathological findings. The combination method was also compared with autofluorescence method alone. The device provided good image quality, which was enough for initial diagnosis. Using the combination method, sensitivity, specificity, PPV, and NPV of the device via teledentistry were 87.5%, 84.6%, 63.6%, and 95.7%, respectively, which were higher than autofluorescence method alone in every parameter. The concordance of dysplastic lesion was 85.29% and 79.41% for category of lesion. The validity and reliability results of the combination method for the screening of dysplasia in OPMDs were higher than autofluorescent method alone. The intraoral camera with fluorescent aids for the OPMDs screening can be utilized for screening via teledentistry.

Polyetheretherketone (PEEK) has become a useful polymeric biomaterial due to its superior properties and has been increasingly used in dentistry, especially in prosthetic dentistry and dental implantology. Promising applications of PEEK in dentistry are dental implants, temporary abutment, implant-supported provisional crowns, fixed prosthesis, removable denture framework, and finger prosthesis. PEEK as a long-term provisional implant restoration has not been studied much. Hence, this review article aims to review PEEK as a long-term provisional implant restoration for applications focusing on implant dentistry. Articles published in English on PEEK biomaterial for long-term provisional implant restoration were searched in Google Scholar, ScienceDirect, PubMed/MEDLINE, and Scopus. Then, relevant articles were selected and included in this literature review. PEEK presents suitable properties for various implant components in implant dentistry, including temporary and long-term provisional restorations. The modifications of PEEK result in wider applications in clinical dentistry. The PEEK reinforced by 30–50% carbon fibers can be a suitable material for the various implant components in dentistry.

The purpose of this study was to investigate the effect of various types of coupling agent solutions as a surface treatment of polyoxymethylene (POM) on surface roughness and wettability. Seventy-five POM specimens were fabricated from polyoxymethylene CAD-CAM blocks and divided into non-treated (control) and 4 coupling agent solutions treated groups (n=15/group): MPS, APS, AAPMS, and Clearfil Ceramic Primer (CCP). Fifteen specimens of each treated group were assessed with a goniometer via sessile drop method and profilometer to determine surface roughness and contact angle; morphological changes in untreated and treated specimens were examined by using scanning electron microscopy and element depositions were analyzed by using energy dispersive spectrometer (EDS). One-way ANOVA was used at p< 0.05 for statistical comparison. POM specimens treated with MPS and CCP resulted in significantly lower contact angle than control, APS and AAPMS groups (p<0.05). No differences in contact angle were measured between MPS (62.2±9.9°) and CCP (52.1 ±13.0°); and also, between control (90.8±4.1°), APS (91.1 ±5.0°) and AAPMS (85.6±7.3°). Surface roughness was not significantly different after treatment between groups (p<0.05). EDS analysis showed silica on MPS, APS, AAPS and CCP. Contrary to phosphorus, that was discovered on CCP only. The surface roughness of all test groups was similar. POM treated with MPS and CCP exhibited the lowest contact angle. [ABSTRACT FROM AUTHOR]

The study aimed to develop a biomechanics model to identify the effects of post material and bonding condition on the vertical cracking of a glass-resin bilayer structure under applied axial load. The specimens consisted of cylindrical glass tubes, in which metal or fiber posts were centered and which were filled with a resin core material. Fifty specimens were divided into five groups, a control group without posts, and four experimental groups, depending on the type of post and whether bonding was used. A static load was applied using a universal testing machine and continued at 0.01 mm/min until fracture. The failure load was compared using statistical analysis (p <.05). Failure rate, fracture patterns, and failure probability were analyzed. The control group had the highest failure rate compared to groups in which posts were used. Bonded posts had no significant difference in failure rates, whereas unbonded metal posts had a higher failure rate than unbonded fiber posts. Unbonded metal posts had a significantly higher failure rate than bonded metal posts, whereas both unbonded and bonded fiber posts had no significant difference in failure rates. Post material and bonding condition affect the fracture resistance of the model. Metal and fiber posts may have similar fracture rates in cases with good bonding condition; however, fiber posts present a lower fracture rate than metal posts in cases with no bonding. Bonding condition can change peak stress concentration from the cervical area to the middle third of the glass tube. [ABSTRACT FROM AUTHOR]