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Bentonite and marconite are the low resistance moisture retaining conductive backfill materials used in earthing applications. Both the products contains some drawbacks: bentonite has limited moisture retaining capacity and marconite has 15–20% impurities which will corrode the earth connections resulting in the loss of the system which are found to be very expensive. Taking into consideration of the above drawbacks, the present study aimed at developing a cost effective and highly conductive backfill material for earthing application with improved performance. For this study, commercially available bentonite and metakaolin (binary) clay was activated through physical, chemical and thermal treatments and the corrosion performance of binary clay was evaluated by using mild steel (MS) and galvanized (GI) steel Among the three activation methods, chemical activation method was found beneficial for mild steel in binary clay media. The conductivity of the chemically activated clay was 204.7 mS/cm, pH was 12.58, and the particle size distribution was found to be 40–50 µm indicates the better corrosion resistance and quite suitable for earthing applications. Chemical activation of the clay mainly involves the breaking of bonds and dissolution of the three-dimensional network structure of glass which in turn cause Na+ ions move closer to the center point of crystal structure and the solubility of SiO2 in clay markedly increases. Potential-time studies showed that galvanizing loses its coating property within ten days in all the three type of clays used. Activation process significantly reduced the corrosion rate (44 and 74 times) in the case of thermally activated (TAC) and chemically activated clay (CAC) respectively. Earth excavation studies were conducted to monitor the corrosion of MS and GI using embedded MnO2 sensor. This investigation opens up a lot of scope for utilizing activated binary clay for all earthing applications. Keywords: Bentonite, Metakaolin, Activated clay, Corrosion studies, Mild steel, Galvanized iron

Clay is a naturally occurring material, and it has been utilized for many industrial processes. In this study, two types of clay namely white clay (WC) and black clay (BC) was used for this investigation. The corrosion performance of the clay samples was carried out using mild steel and galvanized pipes under a buried condition in the field and laboratory exposure studies were carried in the clay extracts. Generally mild steel (MS) and galvanized iron (G.I) are being used as an encasing material for earthing applications. In some places, the soil was enriched with acidic clay, and it causes corrosion of the MS and G.I and it needs periodic replacement of pipes. In this context, a detailed study has been carried out to evaluate the relative corrosion performance of the MS and G.I exposed to the clay environment. Electrochemical corrosion behavior of MS and G.I in clay medium were carried out by using electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization. The corrosion product formation was characterized by X-Ray Diffraction and Carbon Hydrogen Nitrogen Spectrum analysis. The surface morphology of MS and G.I after the exposure was characterized by Scanning Electron Microscopy (SEM) studies. The results proved that G.I in clay soil was severely affected by corrosion. The reason may be attributed to the insufficient thickness of the zinc coating and the presence of microbes which enhanced the G.I corrosion. Keywords: Clay, Mild steel, Galvanized steel, Corrosion, Electrochemical studies

Objectives: This double-blind randomised crossover trial aimed to compare the aesthetic outcomes of CAD-CAM manufactured provisional restorations created using cone beam computed tomography (CBCT) and intraoral scanners (IOS) acquisition methods., Methods: Twelve participants (mean-age: 38 ± 5 years) requiring full mouth rehabilitation were included in this crossover trial. Two sets of identical CAD-CAM provisional restorations, differing only in the method of data acquisition (A: CBCT, B: IOS), were fabricated. Restorations were cemented for two weeks, with washout period between interventions. Esthetic evaluations were conducted using clinician and patient-reported outcome questionnaires. Both parametric and non-parametric tests were used to account for data variability: Mann-Whitney U test compared pink esthetic score (PES), white esthetic score (WES), and modified US Public Health Service (USPHS) score. An unpaired t-test compared Oral Health Impact Profile- Aesthetic Questionnaire (OHIP-Aes) scores and Orofacial Esthetic scores., Results: Clinician-reported outcomes showed significantly better esthetic scores for provisional restorations fabricated using CBCT compared to IOS. CBCT scored higher in Pink Esthetic Score (PES) [Mean rank: CBCT = 16.00, IOS = 9.00; P = 0.012] and White Esthetic Score (WES) [Mean rank: CBCT = 17.25, IOS = 7.75; P < 0.001]. No significant differences were observed for Modified USPHS scores across groups [Mean rank: CBCT = 11.38, IOS = 13.63; P = 0.221]. Patient-reported outcomes indicated no significant differences between groups in OHIP-Aes scores [CBCT = 1.25 ± 1.76, IOS = 1.58 ± 1.62; P = 0.635] or Orofacial Esthetic Index (OFEI) scores [CBCT = 65.75 ± 1.54, IOS = 65.50 ± 1.62; P = 0.703]., Conclusion: Both CBCT and IOS acquisition techniques provide aesthetically satisfactory CAD-CAM provisional restorations. CBCT demonstrated significantly higher clinician-reported esthetic outcomes for both pink and white esthetic scores. While patient satisfaction was similar for both methods, CBCT offers practical advantages, including the elimination of separate diagnostic appointments, making it a preferred choice for enhanced esthetic outcomes in CAD-CAM provisional restorations., Clinical Implications: CBCT acquisition methods yield significantly better clinician-reported esthetic outcomes for CAD-CAM provisional restorations compared to IOS. Additionally, CBCT eliminates the need for separate diagnostic appointments, reducing treatment time and number of visits, while both methods provide similar satisfactory patient-reported outcomes., Clinical Trial Registration Number: Approval number: CTRI/2023/03/050410., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The study aimed to assess the prevalence and nature of emotional expressions in care-dependent older adults, using an automated face coding (AFC) software. By examining the seven fundamental emotions, the study sought to understand how these emotions manifest and their potential implications for dental care in this population., Methods: Fifty care-dependent older adults' (mean-age: 78.90 ± 10.83 years; n = 50, men = 25, women = 25) emotional expressions were analyzed using an AFC software. The study measured the prevalence of the seven fundamental emotions including neutral, happy, sad, angry, surprised, scared, and disgusted. Correlations were explored between these expressions and demographic variables such as sex, age, Mini-Mental State Examination (MMSE) scores, as well as the use of sedation. Descriptive statistics, non-parametric tests and Spearman's rho correlations were applied for statistical analysis (p < 0.05)., Results: Neutral expression was the most common emotion (0.732 ± 0.23), with other emotions largely inactive. A trace of happiness was detected in women (0.110 ± 0.23), though not statistically significant (p = 0.061). Significant correlations were found between happy expressions and left eye opening (p = 0.021), and a negative correlation was observed between mouth opening and sad expressions (p = 0.049). No significant associations were found with age, MMSE scores, or sedation use., Conclusions: This study found that AFC software can detect and quantify emotions from facial expressions of dependent older adults and that they predominantly exhibited neutral expressions, with few signs of other emotions. Future research should explore these influences to inform personalized care approaches., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests., (Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: This pilot study assessed the feasibility of using facial thermography to detect intra-oral problems in older adults with cognitive decline and care-resistant behaviors, who are often unable to communicate pain or early symptoms., Methods: Twenty-three older adults (mean age 73.7 ± 13.2 years) with cognitive decline were enrolled. Thermal images of four facial views were taken using a smartphone-connected thermal camera. Intra-oral examinations were conducted, and the thermographic data were analyzed to extract temperature values in the regions of interest (ROI). Point-biserial correlations and ROC curve analyses were performed to evaluate associations between temperature data and clinical findings, with a significance level of p < 0.05., Results: Intra-oral issues requiring treatment were found in 12 participants, with six reporting clinical pain. The overall mean temperature in the ROI was 33.5 ± 3.9 °C, and significant temperature differences were found between the body and ROI temperatures. Correlations were observed between clinical problems and various temperature metrics, including the minimum and maximum ROI temperatures (r pb =-0.327, p = 0.002 and rpb=-0.309, p = 0.003). ROC analysis indicated that ROI temperature could predict the presence or absence of clinical problems, with AUC values ranging from 0.651 to 0.796 for different metrics., Conclusion: Thermographic facial imaging shows significant potential as a non-invasive tool for detecting oral health problems in vulnerable older adults. While promising, further research is essential to enhance image quality, streamline the technique, and incorporate AI for improved diagnostic accuracy and ease of use., Clinical Significance: This non-invasive, inexpensive technique is easy to perform, independent of patient compliance and, is promising to detect early oral problems in noncommunicative patients., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study compared the clinical accuracy of two different stationary face scanners, employing progressive capture and multi-view simultaneous capture scanning technologies., Methods: Forty dentate volunteers participated in the study. Soft tissue landmarks were marked with a pen on the participants' faces to measure the distances between them. Clinical measurements were manually obtained using a digital vernier caliper by two independent examiners. The participants were then scanned using one of two stationary face scanners: Obiscanner (Fifthingenium), which employs progressive capture technology requiring the subject's head to rotate during image acquisition, or RAYFace (RAY), which utilizes multiple cameras to simultaneously capture a complete 3D image. The scans were imported into mesh-processing software, and digital measurements were taken by the same examiners. Data analysis included pairwise comparison tests and the calculation of the intra-class correlation coefficient (ICC; α = 0.05)., Results: Digital measurements were significantly longer than clinical measurements across all measured distances (p < 0.001). Comparisons between the scanners revealed that vertical measurements using RAYface exhibited greater percentage differences compared to those using Obiscanner (p < 0.05), while horizontal measurements were more variable with Obiscanner than those obtained using RAYface (p < 0.05). Intra-examiner differences were significant for both methods (p < 0.001), although inter-examiner differences were only significant for clinical measurements (p < 0.001), not for digital measurements (p > 0.05). Inter-examiner reliability for digital measurements was high (ICC≥0.99)., Conclusions: Significant differences were observed in the accuracy of the two stationary face scanners using progressive capture and multi-view simultaneous capture scanning technologies, with each device demonstrating specific strengths and limitations., Clinical Significance: Although face scanners offer relatively high accuracy and consistency, particularly across different acquisition technologies, careful consideration of their performance characteristics is essential for optimizing accuracy in facial measurements., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This study aimed to explore the feasibility and reliability of measuring the vertical dimension of occlusion/rest (OVD/RVD) on 3D facial scans of edentulous patients., Methods: Nineteen edentulous participants rehabilitated with complete removable dental prostheses (CDs) participated in this study. Analog measurements (control) were obtained directly on the face for each participant with the jaws positioned at the rest position (without CDs, RVD) and at centric occlusion (with dentures, OVD), between the facial landmarks: Glabella (G) and Soft Pogonion (SP), Pronasale (PN) and SP, and Subnasale (SN) and SP. Participants' faces were scanned twice, using a face-scanner (Class 1 LASER, Obiscanner). Scans were imported into a mesh-processing software, and the OVD/RVD were measured digitally. Two investigators performed all the measurements and were blinded. Data analysis included intra-class correlation coefficient (ICC) and pairwise comparison tests (p < 0.05)., Results: Digital measurements were higher than analog measurements, and the mean paired difference ranged from -4.86±3.2 to 0.42±2.7 mm. All the differences were statistically significant, expect for SN-SP (p = 0.110). Magnitude of the differences for the RVD were large for G-SP and SN-SP (ES>0.80) and moderate for PN-SP (ES>0.50). There was a large effect for G-SP when measuring OVD (ES>0.50), and small effect for PN-SP and SN-SP (ES≤0.20)., Conclusion: Considering the limitations associated with the specific type of facial scanner used in this study, it can be concluded that registering the resting vertical dimension in edentulous patients through digital methods may not be currently recommended. This is due to the potential errors that may arise during the data acquisition process, which could compromise the accuracy and reliability of the measurements., Clinical Significance: Digital methods for registering the vertical dimension of rest (RVD) in edentulous patients can introduce errors, resulting in occlusal errors and discomfort. Clinicians must, for the moment, still use conventional analog methods to ensure accurate RVD measurement for a successful denture therapy., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests., (Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: This study aimed to investigate the resin compounds from CAD-CAM 3D-printed denture resins, focusing on the identification and classification of free monomers and other components. The primary objective was to determine the chemical profile of these 3D-prinding resin materials., Methods: Four 3D-printed denture resins, two base materials (1: DentaBASE, Asiga Ltd., Alexandria, NSW, Australia; 2: DENTURETEC, SAREMCO Dental AG), and two tooth-colored materials (1: DentaTOOTH, Asiga Ltd.; 2: CROWNTEC (SAREMCO Dental AG), were analyzed using high-performance liquid chromatography and mass spectrometry (HPLC-MS). Data analysis was processed including peak alignment and normalization to an ethanol blank, resulting in detailed identification of compounds in the resin., Results: Out of 5,208 detected compounds in the resin, 63 were retained after applying filtering criteria for further analysis, categorized into methyl methacrylate (MMA) and derivatives (31), photo initiators (8), UV stabilizers (1), and other additives (23). Sample 2B exhibited the highest number of resin compounds (62), including the most MMA derivatives and additives. MMA accounted for over 69% in abundance across samples, with unique additives such as ethyl-4-dimethylaminobenzoate and bis(acryloyloxymethyl) tricyclo [5.2.1.02,6] decane (TCD-DI-HEA) identified. Variations in the resin composition distribution and abundance highlighted differences in resin formulations., Conclusions: Within the limits of this in vitro, exploratory study, unpolymerized 3D-printed denture resins were analyzed, and various resin compounds in 3D-printed denture resins, including MMA, photo initiators, UV stabilizers, and additives, were identified along with significant variability between samples. While 3D-printing enhances efficiency and customization, further investigation is needed to better understand and assess the long-term intraoral effects and their effectiveness in complete dentures., Significance: This study provides insights into the chemical composition of 3D-printed denture resins, highlighting variability in resin compound profiles. Understanding these materials is essential for ensuring biocompatibility and performance. The findings support the need for further research and standardized testing to guide clinicians in the safe and effective use of 3D-printed dentures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025. Published by Elsevier Ltd.)

Objective: This systematic review and meta-analysis aimed to evaluate the efficacy of non-surgical laser therapies compared to other treatment modalities for managing peri-implantitis and to analyze post-treatment outcomes of different interventions., Data and Sources: A comprehensive search was conducted across Medline (PubMed), Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL), identifying 4675 studies published between January 1953 and November 2023., Study Selection: A total of 15 randomized controlled trials (RCTs) involving 540 patients and 658 implants met the inclusion criteria, with 10 studies eligible for meta-analyses. Meta-analyses revealed that Er:YAG laser therapy significantly reduced bleeding on probing (BOP) by 35.6 % (95 % CI: 17.3 % to 53.9 %; I2 = 83 %) and probing depth (PD) by 0.65 mm (95 % CI: 0.33 to 0.97; I2 = 0 %). The combination of mechanical debridement (MD) and Er,Cr:YSGG laser therapy improved PD by 1.23 mm (95 % CI: 0.76 to 1.70; I2 = 0 %) and reduced BOP by 47.3 % (95 % CI: 38.4 % to 56.1 %; I2 = 0 %). However, none of the therapies showed any significant advantage in preventing crestal bone loss (CBL). Laser therapies did not demonstrate any significant superiority over traditional therapies (p > 0.05)., Conclusions: Non-surgical laser therapies, including Er:YAG, Er,Cr:YSGG, Nd:YAG and diode lasers, demonstrated effectiveness in reducing inflammation and probing depths but did not consistently outperform MD alone or in combination with other treatments. The findings emphasize the need for further research and standardized protocols, as no modality significantly prevented CBL. These results provide evidence-based insights into optimizing non-surgical management strategies for peri-implantitis., Clinical Significance: Non-surgical laser therapies demonstrate significant reductions in inflammation and probing depths in peri-implantitis treatment. However, their comparable outcomes to mechanical debridement highlight the need for further studies to establish their role and develop standardized protocols for optimized clinical use., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: This study evaluated the quality of nutritional uptake of the care-dependent, community-dwelling older adults., Methods: Community-dwelling care-dependent elders were recruited in this study. The food items along with their nutritional content were extracted from the participants' refrigerators and categorized according to the NOVA classification (G1: unprocessed/minimally processed; G2: processed culinary ingredients; G3: processed; G4: ultra-processed). The nutritional information of the food items was entered into a dietary analysis software that analyzed the content. Data was verified for a normal distribution and non-parametric tests were applied for statistical analysis (p < 0.05)., Results: 100 subjects (mean age = 81.1±9.5 y; mean MMSE: 26.6±6.8) participated in this study. The participants had significantly more G1 than G2, G3 or G4 (p < 0.001) foods. Women had more G1 items in their refrigerators than men (r s = 0.372, p < 0.001). Higher socio-economic status indicated a presence of more G1 (r s = 0.313, p = 0.002), G2 (r s = 0.342, p < 0.001) and G4 (r s = 0.237, p = 0.024) foods. Higher cognitive scores revealed an increase in presence of G4 (r s = 0.238, p = 0.023) items. Participants with an increased need for assistance had less G2 (r s = -0.332, p = 0.001), and G4 (r s = -0.215, p = 0.041) foods; age had no influence., Conclusion: The findings of this study confirm that the majority of care-dependent, community-dwelling adults procured healthy dietary aliments for their daily living; however, whether this correlated to the actual nutritional state of these older adults needs to be further investigated. This highlights the need for further investigation and tailored interventions to ensure good nutrition, emphasizing regular assessments and comprehensive support beyond just food access., Clinical Relevance: Clinicians must recognize that access to healthy food alone may not ensure good nutrition in older adults. Regular nutritional assessments, personalized dietary interventions, and additional support services like meal preparation assistance, nutritional counseling, and tailored programs are essential to address specific dietary needs and preferences., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests., (Copyright © 2024. Published by Elsevier Ltd.)

Objective: This study evaluated the reliability of a face scanner in measuring the vertical dimension of occlusion (VDO)., Methods: Fully dentate volunteers (n = 20; mean-age = 30.0 ± 10.7 years) were recruited. Clinical facial measurements were obtained using a digital caliper and a face scanner (Obiscanner, Fifthingenium, Italy). The scans were imported into a mesh-processing software, and the distances were measured digitally. Measurements were obtained for each participant with the jaws positioned in maximal intercuspation (MI) and with increased vertical distances of 2, 4, and 6 mm. Vertical and horizontal measures were obtained using facial anatomical landmarks: Glabella (GL), Pronasale (PrN), Subnasale (SbN), inferior border of the right and left Alare, Labiale superius (Ls), right and left Cheilion (Ch), Soft Pogonion (SPg), right and left Tragus of the ear (Tr), for all selected vertical positions. Data analysis included intra-class correlation coefficient (ICC), pairwise comparison tests, Bland-Altman plots, and Passing-Bablok regression., Results: 120 VDO measurements (clinical=60, digital=60) were recorded by two independent evaluators. Mean differences between digital and clinical measurements ranged from 0.054 ± 0.14 mm to 0.203 ± 0.13 mm. All parameters were strongly correlated (r > 0.93; p < 0.001). ICC estimates revealed excellent reliability, and the measuring procedure yielded the same results on repeated trials irrespective of the raters and measurement methods. Bland-Altman plots revealed a difference, between digital and clinical measurements, of 1.7 % for the vertical measurements. Regression analysis revealed no significant proportional difference between the two methods, so both can be used interchangeably., Conclusions: The findings of this study demonstrate that VDO can be measured accurately from face scans using 3D mesh-processing software and that even small changes in the VDO could be detected using the digital methods., Clinical Significance: Findings provide evidence about the reliability of a digital method for jaw relation registrations and may be applied towards incorporating this method into clinical workflows for computer-aided-design/ computer-assisted-manufacturing (CAD-CAM) dentures., Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: This study aimed to compare the physical and mechanical properties of four denture base materials: Polyan IC (PA), milled polymethylmethacrylate (PMMA), three-dimensional (3D)-printed resin (3DP), and SR Ivocap (SR)., Methods: Ninety-six samples were prepared and divided into four groups as follows. Group A consisted of 3DP (Asiga DentaBASE, Asiga) fabricated using a manufacturer-recommended 3D printer (Asiga Pro 4k, Asiga). Group B comprised milled PMMA (MP) (Ivotion Base, Ivoclar Vivadent). Group C included PA (BredentSenden), meanwhile, group D involved SR (Ivoclar VivadentSchaan). Cuboid samples (65 mm x 10 mm x 2.5 mm) were used for biaxial flexure strength testing in a universal testing machine (UTM). Cylindrical samples of 20 mm x 40 mm were used for compressive strength testing in a UTM. Additionally, cuboid samples (65 mm x 10 mm x 2.5 mm) were used for Vickers surface hardness testing in a microhardness tester. disk samples (10 mm x 2.5 mm) were employed for color stability testing both in a coffee solution and Coca-Cola, using a digital spectrophotometer. Statistical analyses were performed using one-way analysis of variance and Tukey's post hoc analysis (α=0.05)., Results: MP demonstrated superior compressive strength (p = 0.002) and color stability compared to that exhibited by 3DP (p < 0.001) while displaying similar flexure strength (p = 0.336) and hardness (p = 0.708). MP and PA displayed similar compressive strength (p = 0.081), flexure strength (p = 0.159), and color stability in coke (p = 0.071). However, MP had reduced hardness (p < 0.001) and color stability in coffee (p < 0.001). Moreover, MP demonstrated a higher compressive strength (p < 0.001) than that displayed by SR. However, the flexure strength, hardness, and color stability were similar (p > 0.05). Furthermore, 3DP exhibited comparable compressive strength (p = 0.334) to that of PA but demonstrated significantly lower flexure strength (p = 0.005), hardness (p < 0.001), and color stability (p < 0.001) compared to PA. In comparison to SR, PA had a higher compressive strength (p < 0.001), hardness (p = 0.001), and color stability in coffee (p < 0.001), although they demonstrated similar (p > 0.05) flexure strength and color stability in coke., Conclusions: The MP and PA demonstrated superior compressive strength than that exhibited by the other materials tested. The tested materials had similar flexure strengths, except for PA which demonstrated superiority over the 3DP. Among all tested materials, PA exhibited the highest hardness, while the 3DP was the least color-stable., Clinical Significance: Considering the mechanical properties and color stability, Polyan and milled polymethylmethacrylate are preferred for complete denture fabrication. However, the limited repairability and complex handling of Polyan should be considered., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This review was undertaken to evaluate, whether a shortened dental arch (SDA) was a good alternative to a conventional prosthodontic rehabilitation (RPD) in older adults when nutritional and economic factors are compared., Data: A total of 92 studies were included for the full-text analysis, and finally 4 reports from two RCTs qualified for data extraction and analysis. The final search update was performed on 06.11.2022 and no further searches and updates were performed after this date., Sources: Electronic databases [PubMed (MEDLINE), Embase, CENTRAL] were systematically searched to identify studies comparing nutritional and economic outcomes in partially edentate adults rehabilitated with conventional RPD and SDA therapy., Study Selection: Studies were excluded if there were less than 10 participants per group, and if the subjects were not clinically followed up in recall visits. Two investigators performed the data extraction and were reciprocally blinded. Inter-investigator reliability was assessed using Cohen's unweighted kappa (κ). A meta-analysis could not be performed and the results were reported qualitatively., Results: The calculated κ ranged between 0.80 and 1.00. Three reports from two studies reported on nutritional outcomes and one report provided information on economic benefits, when comparing between the SDA therapy and conventional prosthodontic rehabilitation. No significant difference was recorded in the nutritional status of patients rehabilitated using the SDA concept compared with RPDs. Higher costs for treatment provision and maintenance for patients in the RPD group was found when compared to SDA treatment., Conclusions: This systematic review identified the shortened dental arch concept as a reasonable alternative to the conventional prosthodontic rehabilitation where cost-effectiveness and nutrition are concerned based on the limited evidence obtained from current literature., Clinical Significance: SDA therapy may be considered as a feasible treatment concept in older adults especially in those with complex medical statuses and limited finances., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interests., (Copyright © 2023. Published by Elsevier Ltd.)

Objectives: The aim of this study was to compare the shear bond strength of relined CAD-CAM complete removable dental prosthesis (CRDP) resins with conventional heat-polymerized polymethylmethacrylate (PMMA) resin., Methods: A total of 96 resin specimens in identical dimensions of 10 mm × 10 mm × 11 mm were fabricated for four study groups [#1- Conventional heat-polymerized group: n=24 (ProBase); #2- Milled#1: n=24 (Ivobase); #3- Milled#2: n=24 (Ivotion); #4- 3D-printed: n=24, (NextDent Denture 3D+)]. Twelve specimens in each group were sectioned in the middle to produce a 3 mm defect and then were relined using a conventional denture relining material. All specimens underwent thermocycling (5-55°C) for 10,000 cycles. The shear bond tests were carried out in a universal testing machine. One-way ANOVA and Tukey's test were used for statistical analysis (p<0.05). The two-parameter Weibull distribution values were calculated., Results: Relined 3D-printed specimens had a significantly lower shear bond strength when compared with conventional (p=0.0003) and milled groups (Milled#1: p=0.0004; Milled#2: p<0.0001). There were no differences in the shear bond strengths between the milled and conventional groups. Weibull distribution presented the highest shape value for the non-relined Milled#1 (22.83) group and the lowest values for the 3D-printed relined group (4.001)., Conclusion: The findings of this study conclude that the shear bond strength of the conventionally-relined 3D-printed resins used for fabricating CRDPs was inferior to the shear bond strength of conventionally-relined resins employed for manufacturing CRDPs using CAD-CAM milling and conventional heat-polymerization techniques., Clinical Significance: When considering 3D-printing for the fabrication of CRDPs, it is recommended to employ it in clinical situations where a frequent need for denture relining is not expected., Competing Interests: Declaration of Competing Interest The authors did not have any commercial interest in any of the materials used in this study., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: The study aimed to quantitatively evaluate the elution of methylmethacrylate from CAD-CAM manufactured removable complete dentures (RCDs) using high performance liquid chromatography (HPLC)., Methods: Thirty-two RCDs were manufactured following either the CNC-milling (Milled: n=8) or the 3D-printing (n=24) protocols. The 3D-printed dentures were further categorized into three groups based on their post-production rinsing cycles [Extended wash cycle (EWC), Standard wash cycle (SWC), and SWC with an additional Durécon coating (SWC2)]. HPLC was used to evaluate the methylmethacrylate concentrations (MMCs) eluted from the dentures in each group for different time periods (1, 2, 4, 8, and 24 hours). Mean and standard deviations were calculated for the MMCs; data was verified for normal distribution, ANOVA and post hoc tests were applied for statistical analyses (⍺=0.05)., Results: The HPLC revealed that all the denture groups recorded some amounts of MMCs, with significant differences [F (3, 31) = 23.646, p<0.0001]. The milled denture group had the highest MMCs at 24 hours when compared to the EWC (p<0.0001), SWC (p=0.001), and SWC2 (p<0.0001) denture groups. SWC had a higher MMC than EWC (p=0.032) and SWC2 (p=0.015). No differences were found in MMCs when comparing EWC and SWC2 (p=0.989)., Conclusion: Methylmethacrylate concentrations were significantly lower in 3D-printed RCDs than in milled RCDs when using the resins employed in this study. Furthermore, the MMCs can be further decreased in 3D-printed RCDs when coated with an additional thin protective layer (Durécon) by following the manufacturer-recommended rinsing protocol or when an extended isopropanol wash cycle is adopted., (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: This double-blind, randomized, crossover, clinical trial aimed to evaluate and compare the differences between milled and 3D-printed complete removable dental prostheses (CRDPs)., Methods: Fifteen edentulous patients (men: n = 10, women: n = 5; age: 66.7 ± 8.0 years) rehabilitated with conventional CRDPs were recruited for this trial. Participants were randomized to first receiving either the milled or 3D-printed CAD-CAM manufactured CRDPs and then after 6-weeks cross over to the other set. Both, clinicians and participants were blinded to the group allocation. Outcomes included patient's denture satisfaction (PDS), oral-health related quality of life (OHIP-EDENT), willingness-to-pay analysis, final choice (FC) of CRDPs, clinician's denture quality evaluation (CDQE), chewing efficiency (CE), maximum-voluntary-bite-force (MBF), and prosthodontic maintenance needs. The outcomes were measured at baseline (with old CRDPs), at 1 and 6 weeks after new CRDP insertion; following crossover with the second set of CRDPs, an identical protocol was followed. Generalized linear regression for repeated measures was used for statistical analysis with α=0.05., Results: All participants completed the trial. 3D-printed CRDPs required more maintenance visits, adjustment time (p = 0.0003), and adjustment costs (p = 0.021). Patients were willing-to-pay an average of 606.67 Swiss Francs more than the actual cost for the milled CRDPs. There were no differences in the PDS, OHIP, FC, CDQE, CE, and MBF between the two CRDPs groups., Conclusions: The findings of this double-blind randomized crossover clinical trial confirm that both milled and 3D-printed CRDPs are valid treatment modalities for edentulous patients, with the latter performing inferiorly with regard to the time and costs involved with the prosthodontic aftercare, as well as the patients' willingness-to-pay., Clinical Relevance: The findings of this trial provide evidence to help the clinician in choosing the appropriate CAD-CAM manufacturing process for fabricating the CRDPs., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction: Complete removable dental prostheses' (CRDPs) appearance may vary between conventional and contemporary CAD-CAM manufacturing techniques., Objectives: The aim of this randomized survey was to analyze appreciation of CRDPs, manufactured with different techniques, by dental professionals and elder CRDP wearers., Methods: Four participant groups, comprised of undergraduate students (n=10), postgraduate residents (n=10), dental technicians (n=10) and elder CRDP wearers (n=10), evaluated the appearance of maxillary CRDPs manufactured by six different techniques: three conventional methods 1. flask-pack-press (FP), 2. Injection-molded (IM), 3. intrinsically colored natural gingiva finish before injection-molded (NG) and three CAD-CAM methods 4. milled base with bonded prefabricated teeth (M), 5. fully milled including milled teeth (FM) and 6. rapid-prototyped including printed teeth (P). A randomized, blinded survey included 18 pairwise comparative assessments and 12 individual judgements of the CRDPs on general appearance as well as pink and white aspects. Statistical analyses included parametric- and nonparametric tests as well as linear regression models; the level of statistical significance was set at p<.05., Results: NG was preferred by the professional groups but not by the elder CRDP wearers (p<.05). P was scored lowest by all four participant groups (p<.05). CRDP wearers' ratings were less severe and within a narrower range. The ratings of the two CAD-CAM milled CRDPs (M and FM) were ranked closer to FP and IM); the order of preference was different depending on the participant groups., Conclusions: The findings of this study revealed marked differences in the assessment of CRDP appearances between dental professionals and older CRDP wearers., Clinical Significance: A shared and informed approach to decision making concerning the CRDP appearance might foster denture acceptance and treatment success., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: In recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients., Objective: The aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER)., Results: Outcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group - 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score., Conclusions: Findings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources., Clinical Significance: The immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Objectives: This study evaluated the biocompatibility, mechanical properties, and surface roughness of CAD-CAM milled and rapidly-prototyped/3D-printed resins used for manufacturing complete dentures., Methods: Six groups of resin specimens were prepared, milled-base (MB), milled-tooth shade (MT), printed-tooth shade (PT), printed-base with manufacturer-recommended 3D-printer (PB1), printed-base with third-party 3D-printer (PB2), printed-base in a vertical orientation (PB2V). Human epithelial (A-431) and gingival (HGF-1) cells were cultured and tested for biocompatibility using Resazurin assays. Three-point bending and nanoindentation tests measured the mechanical properties of the resin groups. Surface roughness was evaluated using a high-resolution laser profilometer. ANOVA and post-hoc tests were used for statistical analyses (α = 0.05)., Results: There were no significant differences in biocompatibility between any of the investigated groups. MB revealed a higher ultimate strength (p = 0.008), elastic modulus (p = 0.002), and toughness (p = 0.014) than PB1. MT had significantly higher elastic modulus than PT (p < 0.001). Rapidly-prototyped resin samples with a manufacturer-recommended 3D-printer (PB1) demonstrated higher ultimate strength (p = 0.008), elastic modulus (p < 0.001), hardness (p < 0.001) and a reduced surface roughness (p < 0.05) when compared with rapidly-prototyped groups using a third-party 3D-printer (PB2). Rapidly-prototyped samples manufactured with a vertical printing orientation (PB2V) revealed a significantly lower elastic modulus than samples groups manufactured using horizontal printing orientation (PB2) (p = 0.011)., Conclusions: Within the limits of this present study, CAD-CAM milled and rapidly-prototyped complete denture resins performed similarly in terms of biocompatibility and surface roughness. However, the milled denture resins were superior to the rapidly-prototyped denture resins with regard to their mechanical properties. Printing orientation and type of 3D-printer can affect the resin strength and surface roughness., (Copyright © 2021. Published by Elsevier Ltd.)

Objectives: This review compared Computer-aided designand Computer-aided manufactured (CAD-CAM) and conventionally constructed removable complete dentures (CDs)., Data: Seventy-three studies reporting on CAD-CAM (milled/3D-printed) CDs were included in this review. The most recent literature search was performed on 15/03/2021., Sources: Two investigators searched electronic databases [PubMed (MEDLINE), Embase, CENTRAL], online search engines (Google) and research portals. Hand searches were performed to identify literature not available online., Study Selection: Studies on CAD-CAM CDs were included if they reported on trueness of fit, biocompatibility, mechanical, surface, chemical, color , microbiological properties, time-cost analysis, and clinical outcomes. Inter-investigator reliability was assessed using kappa scores. Meta-analyses were performed on the extracted data ., Results: The kappa score ranged between 0.897-1.000. Meta-analyses revealed that 3D-printed CDs were more true than conventional CDs (p = 0.039). Milled CDs had a higher flexural-strength than conventional and 3D-printed CDs (p < 0.0001). Milled CDs had a higher flexural-modulus than 3D-printed CDs (p < 0.0001). Milled CDs had a higher yield-strength than injection-molded (p = 0.004), and 3D-printed CDs (p = 0.001). Milled CDs had superior toughness (p < 0.0001) and surface roughness characteristics (p < 0.0001) than other CDs . Rapidly-prototyped CDs displayed poor color-stability compared to other CDs (p = 0.029). CAD-CAM CDs d displayed better retention than conventional CDs (p = 0.015). Conventional CDs had a higher strain at yield point than milled CDs (p < 0.0001), and had superior esthetics than 3D-printed (p < 0.0001). Fabrication of CAD-CAM CDs required less chairside time (p = 0.037) and lower overall costs (p < 0.0001) than conventional CDs., Conclusions: This systematic review concludes that CAD-CAM CDs offer a number of improved mechanical/surface properties and are not inferior when compared to conventional CDs., Clinical Significance: CAD-CAM CDs should be considered for completely edentulous patients whenever possible, since this technique offers numerous advantages including better retention, mechanical and surface properties but most importantly preserves a digital record. This can be a great advantage for older adults with limited access to dental care., (Copyright © 2021. Published by Elsevier Ltd.)

Background & Aims: Oral nutritional supplements (ONS) administered to malnourished elders and other patients contain high-levels of carbohydrates that could be a potential risk factor for dental caries. This study aimed to evaluate the cariogenic potentials of ONS using intraoral plaque telemetry., Methods: Ten ONS were tested on five healthy volunteers (mean age: 76.8 ± 9.15 years). Participants were requested to refrain from performing oral hygiene 3-7 days prior to testing. The pH-value below the dental plaque on the tooth was measured while the ONS was being consumed. After neutralizing the participant's saliva, a control solution (10% sucrose) was administered and telemetry measurements were repeated. Mean relative cariogenicity (RC) was calculated for each ONS. ANOVA and post hoc tests were used for statistical analyses (p < 0.05)., Results: All ten ONS were potentially cariogenic on enamel with an overall RC of 0.519 ± 0.35 (Range: Min = 0.31 ± 0.16; Max = 1.00 ± 0.34). RC differed significantly between the ONS (p = 0.002). RC was lower in ONS that contained high-protein (p = 0.018). RC was not influenced by other factors such as readily consumable (p = 0.102), flavor (p = 0.869), consistency (p = 0.126), fiber containing (p = 0.134), style (p = 0.112), and age of plaque (p = 0.339)., Conclusions: The ONS administered to elders and malnourished patients are potentially cariogenic. It is imperative that the administration of ONS must be based on individual needs to potentiate a maximum benefit. Wherever possible, an attempt to limit the use of high-carbohydrate containing ONS must be practiced along with the adoption of suitable preventive measures to arrest the development and progression of caries., Competing Interests: Conflict of interest AS, IN, TA, MS: declare no conflicts of interest. FW: member of the board of Toothfriendly Switzerland., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: This study compared the clinical time spent and the costs incurred whilst constructing complete dentures (CDs) using a two-visit digital-denture protocol with the conventional complete denture protocol, in a university setting., Methods: Twelve undergraduate final-year dental students utilized both the digital denture protocol and the conventional complete denture protocol to construct two sets of CDs for patients requiring either an upper CD opposing a partial natural dentition restored using a partial removable prosthesis [Group#1: students: n = 6, upper CD: n = 12 (6-digital complete dentures +6-conventional complete dentures)] or both upper and lower CDs [Group#2: students: n = 6, upper and lower CDs: n = 24 (12-digital complete dentures+ 12-conventional complete dentures)]. Overall time spent and costs (clinical, materials, and laboratory) were calculated. A cost minimization analysis was performed to compare the economic costs of the two protocols. Paired t-tests were applied for the statistical analyses (p < 0.05)., Results: Conventional complete denture protocol required longer clinical time than digital complete dentures for both Group#1 (p = 0.0206) and Group#2 (p = 0.0020). The materials costs were higher for the digital complete dentures in both groups (Group#1 p < 0.0001; Group#2: p = 0.0002). The overall costs, were significantly higher for the conventional complete denture protocol than for the digital denture protocol (Group#1: p = 0.0032; Group 2: p = 0.0080)., Conclusions: In a university setting student clinic in Geneva in Switzerland, the digital denture protocol is less costly when compared with the conventional complete denture protocol. The costs for clinical chairside time, laboratory and the overall costs were significantly lower for the digital denture protocol, even though the materials costs for this protocol were higher., Clinical Significance: The digital denture protocol might prove highly beneficial to the elderly and/or the compromised edentulous patient, as it can help decrease the treatment burden on the patient by reducing the clinical procedures, number of visits, treatment time and incurred costs., (Copyright © 2018 Elsevier Ltd. All rights reserved.)