Objective: To evaluate the value and advantages of digital procedures and guided surgery for implant-prosthetic rehabilitation in the aesthetic area. Materials: Intraoral arch scans were matched with the CBCT DICOM file to visualize the final prosthetic result. Implant placement was virtually planned and used to design a surgical guide. The project was then sent to the laboratory for CAD/CAM production. Results: The digital workflow enabled accurate surgical planning and guided implant placement. Conclusions: Digital planning for implant-prosthetic rehabilitation using dedicated software allows optimal use of the remaining bone and pre-surgical selection of the implant. Project previsualization reduces the risk of operator error and operating time. Computer-guided surgery minimizes surgical invasiveness and may reduce post-operative sequelae.
Class II malocclusion due to mandibular retrusion is one of the most common dentoskeletal discrepancies in growing patients and a major indication for functional orthopedic therapy. This retrospective cohort study with an untreated control comparison evaluated the three-dimensional skeletal, dentoalveolar, and temporomandibular joint (TMJ) effects of Twin Block therapy and assessed whether treatment timing influenced the magnitude of change. Fifty-four subjects were analyzed: 18 treated in the pre-pubertal stage (ETG), 18 treated in the pubertal stage (LTG), and 18 untreated controls (CG) with comparable baseline Class II characteristics. Treated patients underwent cone-beam computed tomography (CBCT) before treatment (T1) and at the end of functional therapy (T2); control data were obtained from matched radiographic records. Three-dimensional skeletal, dentoalveolar, and TMJ variables were measured using dedicated software; repeatability was assessed with the intraclass correlation coefficient. Both treated groups showed significant mandibular advancement compared with controls, with larger changes in the pubertal group. SNB increased by 1.2° in ETG and 2.3° in LTG, ANB decreased by 1.1° and 2.0° respectively, and Co- Gn increased by 1.9 mm in ETG versus 3.5 mm in LTG. Overjet decreased by 3.8 mm in ETG and 4.1 mm in LTG. Condylar displacement was mainly antero-inferior, without radiologic signs of TMJ degeneration. Twin Block therapy was effective in correcting Class II mandibular retrusion, but the greatest orthopedic response was observed when treatment was performed during the pubertal growth phase.
Background Orthognathic surgery remains the reference treatment for severe dentofacial deformities when orthodontic treatment alone cannot restore skeletal harmony, facial balance, and stable occlusal function. The surgery-first approach reverses the conventional orthodontics-first sequence by performing skeletal correction before comprehensive orthodontic decompensation, aiming to reduce total treatment duration and provide immediate facial improvement. This narrative literature review synthesizes comparative evidence on treatment duration, skeletal stability, quality of life, digital workflow, practical limits, and patient selection. The evidence supports a clinically meaningful reduction in overall treatment time, generally without clear compromise of short- to medium-term stability in carefully selected cases. The strongest early advantages concern facial aesthetics, motivation, and oral health-related quality of life, whereas the main limitations involve occlusal instability, residual dentoalveolar compensation, relapse risk in complex patterns, and dependence on precise interdisciplinary planning.
Objective: This narrative review synthesizes the current literature on the essential elements of polishing procedures for zirconia prosthetic restorations, analyzing biological, mechanical, and clinical aspects to inform clinicians’ decision-making. Method: A non-systematic literature review was conducted using PubMed/MEDLINE and Scopus. The following keywords were used: “zirconia” AND “polishing”; “zirconia” AND “surface roughness”; “zirconia” AND “wear”. Filters applied: from 1 January 2000 to 31 December 2025 (last 25 years). Subject area: Dentistry. This study focused on articles, clinical studies, and in vitro studies concerning polishing methods for zirconia materials used in dental restorations, with particular reference to the biological, mechanical, and clinical consequences of these procedures. Results and discussion: The introduction of multilayer zirconia materials has broadened the applications of monolithic zirconia restorations, highlighting the critical need for proper polishing techniques. Clinical adjustments are often necessary for zirconia restorations to address issues like occlusal interferences, interproximal spacing, or aesthetic and morphological refinements. However, such modifications can significantly affect surface roughness, potentially impacting critical aspects such as bacterial adhesion, wear resistance, tribological performance, and the overall mechanical integrity of the restoration. These effects may vary depending on the crystallographic phases present in the zirconia composition. To mitigate these effects, adhering to specific polishing protocols after adjustments is highly recommended. Polishing helps minimize surface defects and microcracks while also reducing the depth of phase transformation and the amount of monoclinic phase created during grinding. This process not only restores zirconia’s surface to an acceptable roughness level (Ra) but also enhances its flexural strength, improving its durability and clinical performance. Conclusion: Chairside adjustments are commonly performed during the delivery of most restorations. Currently, the first choice for clinicians is to apply a zirconia-specific polishing protocol after adjustment. Proper polishing is essential to restore surface quality after grinding, preventing cracks, improving wear resistance, and optimizing durability. Additionally, polishing should aim to achieve Ra values of no more than 0.2 μm to prevent bacterial adhesion. The operating protocols for clinicians include instruments with mandatory sequences according to the manufacturer’s instructions. Despite the inherent variability of clinical adjustment procedures, existing polishing protocols have been streamlined and standardized to achieve predictable, less operator-dependent outcomes applicable across all zirconia types. However, advances in zirconia materials and diverse market options call for further research to optimize these procedures.
