PURPOSE:Lifestyle diseases are established risk factors for oral function decline; however, the age-dependent dynamics of these associations, specifically between "young-old" and "old-old" phases, remain unclear. This study investigated the relationship between six major lifestyle diseases and seven oral function measures across age strata to identify the critical windows for medical and dental intervention. METHODS:This cross-sectional analysis within the "Toon Health Study" recruited 395 community-dwelling individuals (mean age 68.8 ± 8.9 years), stratified into middle-aged, young-old, and old-old groups. Systemic status and oral function were evaluated using standard diagnostic criteria. Associations were analyzed using logistic regression models adjusted for age, sex, and family dentist status. The predicted probability plots visualized age-dependent associations. RESULTS:Logistic regression analysis revealed age-dependent associations between diabetes mellitus (DM) and oral hypofunction. Although DM showed a protective association in the old-old group (odds ratio [OR] = 0.28, P = 0.014), it significantly increased the risk of oral hypofunction in the young-old group (OR = 7.75, P = 0.003). Decreased masticatory function was significantly associated with DM and obesity (P < 0.05). Although these conditions increased the risk of decreased masticatory function in the young-old group, none of the participants with DM in the old-old group exhibited such an impairment. CONCLUSIONS:DM and OBE may exacerbate oral function decline in young-old individuals more strongly than aging itself, whereas continuous dental care may mitigate these effects in the old-old. This highlights the importance of integrating age-specific oral management with lifestyle disease prevention.
PURPOSE:Although computer-aided design/computer-aided manufacturing (CAD-CAM) composite resin crowns are widely used, complications such as debonding and fracture have been reported. This study aimed to evaluate the clinical survival of CAD-CAM composite resin crowns, including those applied to anterior teeth, and identify factors influencing long-term prognosis. METHODS:This retrospective cohort study included 402 CAD-CAM composite resin crowns fabricated and cemented at Kagoshima University Hospital between September 2020 and August 2024. Four resin block materials (Materials I-IV) were selected according to the tooth region based on Japan's National Health Insurance classification. Patient characteristics, abutment conditions, antagonist tooth, luting agents, and operators were extracted from medical records. Clinical outcomes were analyzed using Kaplan-Meier survival analysis and multivariate Cox proportional hazards regression. RESULTS:During a mean follow-up period of 30 months, 41 crowns (10.2%) experienced complications, primarily debonding (n = 22). The cumulative success rate was 82.9%. Crowns on vital teeth demonstrated a significantly higher hazard ratio than those on metal or resin cores (P < 0.05). In contrast, crowns fabricated from Material IV for anterior teeth were associated with a significantly lower hazard ratio (P < 0.05). CONCLUSIONS:CAD-CAM composite resin crowns demonstrated acceptable midterm clinical performance comparable to that reported in previous studies. Crowns placed on vital teeth were associated with an increased risk of failure, whereas anterior crowns fabricated from Material IV had a reduced risk of failure. These findings suggest that biomechanical factors, accurate tooth preparation, and proper execution of bonding procedures are critical for clinical success.
PURPOSE:This systematic review aimed to evaluate the treatment efficacy of resin-bonded fixed partial dentures (RBFPDs) in adults with single-tooth loss. The target interventions included the use of: (1) non-metal retainers, (2) single-retainer (SR) RBFPDs, and (3) non-metal SR-RBFPDs, compared with conventional metal and two-retainer (TR) RBFPDs. STUDY SELECTION:A comprehensive literature search of the MEDLINE, CENTRAL, Web of Science, and Ichushi databases up to November 30, 2025 was conducted; additionally, reference list screening and manual searches were performed by an external organization. Target outcomes included RBFPD survival rate, abutment tooth prognosis, oral health-related quality of life (OHRQoL), patient satisfaction, esthetics, periodontal status, and oral function. Two reviewers independently conducted study selection, data extraction, and risk of bias assessment, with disagreements resolved through discussion. RESULTS:A total of eight, six, and three articles were included for each respective comparison. There were no significant differences in survival rate, esthetics, OHRQoL, patient satisfaction, or periodontal condition between non-metal and metal retainer RBFPDs. Comparisons involving SR-RBFPDs suggested a tendency toward favorable survival and abutment tooth outcomes; however, these findings were based on a limited number of studies and should be interpreted with caution. No clear differences in OHRQoL, patient satisfaction, or esthetics were identified. CONCLUSIONS:Based on the available evidence, non-metal RBFPDs and SR-RBFPDs may be considered viable treatment options compared with metal and/or TR-RBFPDs. However, the current evidence is limited and applies primarily to anterior single-tooth loss. Further well-designed clinical studies are required to clarify the indications and long-term outcomes of SR-RBFPDs.
PURPOSE:To map and synthesize the existing evidence on the association between dental prosthesis use and glycemic control, nutritional status, and oral health-related quality of life (OHRQoL) in diabetes. STUDY SELECTION:This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and the Joanna Briggs Institute methodology. Systematic searches of PubMed and Google Scholar were conducted up to November 10, 2024. The eligible studies included observational and interventional studies of patients with diabetes who used dental prostheses (removable, fixed, or implant-supported). Evidence was synthesized across three predefined research questions, and exploratory meta-analyses were performed when feasible. RESULTS:Six studies addressed the association between dental prosthesis use and glycemic control. Five reported findings suggesting favorable associations, and exploratory quantitative synthesis showed a pooled mean difference in glycated hemoglobin (HbA1c) of -0.65% (95% confidence interval (CI): -0.89 to -0.40), suggesting a possible association with lower HbA1c levels. Only one study assessed body mass index (BMI), reporting a non-significant mean difference of 0.58 kg/m2 (95% CI: -0.29 to 1.45). Five studies investigated the relationship between dental prosthesis use and OHRQoL in diabetes. Evidence on OHRQoL was inconsistent, with some subgroups showing relatively favorable scores, whereas the pooled results remain inconclusive owing to high heterogeneity. CONCLUSIONS:This scoping review provides preliminary, hypothesis-generating evidence that dental prostheses may be associated with lower HbA1c levels in diabetes, while effects on BMI and OHRQoL remain unclear, highlighting the potential role of prosthodontic interventions in holistic diabetes care.
PATIENTS:The aim of this observational clinical case series study was to evaluate the survival rate, complication frequency, and patient satisfaction following the application of the implant-supported digital double crown rescue protocol. This approach allows for the replacement of lost or non-restorable abutment teeth while preserving the full functionality of the existing denture by inserting a dental implant, restoring it with a custom-designed meso-abutment, and reusing the original primary crown. Ten patients with a total of 15 superstructures, treated according to this concept at the Department of Prosthetic Dentistry, University Hospital, LMU Munich, were included in the study. The patients underwent clinical follow-up examinations and completed validated questionnaires to assess their quality of life and satisfaction. In addition, complications were retrospectively extracted from patient records. DISCUSSION:The survival rates for the prostheses, implants, and reinstalled primary crowns were 100%. No specific complications related to the double crown rescue protocol were identified. Implant-related complications were rare (n = 1). Prosthetic events (n = 10) and biological complications (n = 4) were more common but could mostly be managed with moderate effort. Patient satisfaction was very high in all categories assessed. CONCLUSIONS:The double crown rescue protocol proved to be clinically successful and efficient. It enables cost-effective, functional restoration of existing prostheses in cases of abutment loss using a fully digital workflow. Given the high level of patient satisfaction and the low complication rate, this approach appears promising for routine clinical application, although larger-scale studies are needed to confirm these findings.
PURPOSE:To update our understanding of the factors influencing complete denture patient satisfaction based on evidence from the past decade. STUDY SELECTION:A scoping review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify articles from five electronic databases: MEDLINE via the PubMed interface, Embase, Scopus, Web of Science, and Cochrane. RESULTS:Studies on patient satisfaction with complete dentures have gradually increased since 2018, peaking in 2022 and 2023. Randomized clinical trials (43%) were the most prevalent study design, followed by cross-sectional (32.9%) and cohort studies (11.4%). The 79 studies evaluated 16,831 individuals, with 51% female participants aged 30-93 years. Patient satisfaction was assessed using the visual analog scale and Likert scale, accounting for 67% of the assessment methods. The key aspects evaluated included comfort, retention, stability, masticatory function, esthetics, and phonetics. The main independent variables associated with satisfaction were fabrication, impression techniques, occlusal schemes, number of follow-ups, gender, age, oral condition, educational level, health history, personality and psychological factors, denture experience, socioeconomic status, dentist experience and communication skills, use of adhesives, and denture hygiene. All the included studies were judged to have a low risk of bias. CONCLUSIONS:Patient satisfaction with complete dentures is influenced by clinical techniques, patient- and dentist-related factors, and prosthesis conditions. Comfort, retention, stability, mastication, and esthetics were the most consistent determinants, whereas emerging evidence suggests that digital workflows may contribute positively.
PURPOSE:This study investigated the effects of different post-curing atmospheres and thermal aging on the surface characteristics and mechanical properties of a 3D-printed splint material fabricated using liquid crystal display technology. METHODS:The 3D-printed specimens were divided into three groups based on the post-curing atmosphere (air, nitrogen, and vacuum) and subjected to either water storage at 37 °C for 50 h or 10,000 thermal cycles (5-55 °C). The degree of conversion, surface morphology and roughness, and water sorption/solubility of the specimens were evaluated. The surface hardness was measured using the Vickers hardness test, and the flexural strength was assessed using a three-point bending test. Data were analyzed using two-way ANOVA followed by Tukey's post-hoc test (P < 0.05) after confirming the normality and homogeneity of variances using Shapiro-Wilk and Levene's tests, respectively. RESULTS:The nitrogen and vacuum groups exhibited comparable values for degree of conversion, surface roughness, and water sorption/solubility, which were all significantly higher than those of the air group. A significant difference in the surface hardness was observed among the three post-curing atmospheres (P < 0.001); however, the flexural strength was unaffected. After thermal aging, the surface hardnesses and flexural strengths of all the groups significantly decreased. CONCLUSIONS:The post-curing atmosphere significantly influenced the degree of conversion, surface roughness, and water sorption/solubility of the additively manufactured specimens, whereas thermal aging degraded their mechanical properties.
PURPOSE:Peri-implant diseases pose significant challenges to the longevity of titanium-based implants, despite their high survival rates. This study investigated how lipopolysaccharide (LPS) from Porphyromonas gingivalis (P. gingivalis) (P. gingivalis-LPS) as a virulence factor affects neutrophil recruitment and activation surrounding titanium implants to elucidate its potential role in the development of peri-implant inflammation. METHODS:Using rat and murine models of titanium implantation, we conducted transcriptomic analysis of peri-implant gingival tissues to identify pathways linked neutrophil activity, particularly in the presence of P. gingivalis-LPS. Flow cytometry was used to validate neutrophil recruitment to the peri-implant mucosa in mice. Human neutrophils were also isolated and stimulated with titanium discs and/or P. gingivalis-LPS to assess their activation and apoptosis. RESULTS:Transcriptomic data revealed significant upregulation of genes associated with neutrophil chemotaxis and activation in peri-implant tissues treated with P. gingivalis-LPS relative to those in the controls (P < 0.05). Flow cytometry data confirmed increased neutrophil infiltration of the peri-implant tissues in mice (P < 0.01). In vitro assays demonstrated that P. gingivalis-LPS significantly enhanced neutrophil CD11b expression and reactive oxygen species production in human neutrophils exposed to titanium (P < 0.01) but inhibited apoptosis (P < 0.001). CONCLUSIONS:P. gingivalis-derived LPS amplified neutrophil recruitment and prolonged neutrophil activation in the presence of titanium, suggesting a potential mechanism underlying peri-implant inflammation. This highlights the need for targeted strategies to mitigate neutrophil-induced tissue damage in peri-implant diseases.
PURPOSE:This narrative review summarizes an artificial intelligence (AI)-integrated digital workflow that enables a seamless, multidisciplinary approach to dental diagnosis and treatment planning, aiming to improve diagnostic coordination, efficiency, and interdisciplinary communication. STUDY SELECTION:All studies selected for this narrative review were extracted from the PubMed database. Forty studies were selected, of which 24 were used for general information and 16 were used for the statistical analysis of accuracy of AI software within data acquisition, treatment planning, and clinical implementation. RESULTS:The digital workflow was divided into three phases: data acquisition, treatment planning, and AI data analysis for decision support. Six articles reported the accuracy outcomes for AI-integrated data acquisition tools, such as intraoral scanners (IOS), cone-beam computed tomography (CBCT), facial scanners (FS), and jaw motion trackers (JMT); seven reported AI performance in assisting treatment planning; and three assessed the clinician acceptance rate of AI-supported decisions. IOS, CBCT, FS, and JMT achieved 88-97% overall accuracies. The integrated convolutional neural network and recurrent neural network models obtained 87-98% overall accuracy for treatment planning. Finally, the AI-generated treatment plan obtained 75-95% clinician acceptance rate. CONCLUSIONS:By integrating the IOS, CBCT, FS, and JMT, a comprehensive virtual patient can be created to facilitate seamless communication and effective treatment planning. This AI-integrated workflow may enhance interdisciplinary coordination and treatment planning. However, prospective clinical studies are required to validate their effects on patient outcomes and satisfaction.
PURPOSE:The epidemiological mechanisms linking poor oral health and oral function to declining well-being among older adults remain unclear. This study examined the association between oral frailty and well-being among community-dwelling older adults in Japan and explored potential mediating pathways across the physical, psychological, and social domains. METHODS:Data were drawn from the 2023 wave of the Itabashi Longitudinal Study on Aging, including participants aged ≥70 years. Oral frailty was assessed using the Oral Frailty 5-item Checklist. Generalized structural equation modeling (GSEM) was used to estimate the indirect effects of oral frailty on well-being, measured using the Philadelphia Geriatric Center Morale Scale (PGCMS) and the Cantril Self-Anchoring Striving Scale (CSASS), through physical frailty, undernutrition, depressive symptoms, cognitive impairment, and social isolation. RESULTS:A total of 849 older adults (503 men and 346 women; mean age = 75.8 years) were analyzed. The prevalence of oral frailty was 40.2%. The PGCMS showed significant indirect associations between oral frailty and two candidate mediators in the GSEM: undernutrition (b = -0.27, 95% confidence interval [CI]: -0.54 to -0.01) and depressive symptoms (b = -1.35, 95% CI: -1.96 to -0.74). Similar findings were observed for the CSASS, with depressive symptoms (b = -0.66, 95% CI: -0.96 to -0.36) and social isolation (b = -0.14, 95% CI: -0.25 to -0.03) emerging as significant mediators. CONCLUSIONS:Oral frailty is indirectly associated with poorer well-being in older Japanese adults, with GSEM estimates suggesting biological and social pathways involving nutritional status, mental health, and social engagement.
PURPOSE:This prospective clinical trial aimed to histologically evaluate peri-implant soft tissue response to healing abutments treated with a vacuum plasma reactor. METHODS:Thirty bone-level implants were placed with machined healing abutments designed to be retrieved using a calibrated mucotome after soft-tissue healing. Test abutments were plasma-activated immediately before placement, whereas control abutments were left untreated. After 3 months, plaque index and bleeding on probing were recorded prior to collecting peri-implant soft-tissue biopsies. The specimens were processed and evaluated clinically and histologically. RESULTS:Thirty patients with 30 implants completed the study. Histological evaluation showed lower inflammation scores in the basal zone around plasma-activated abutments (P = 0.04). Mean inflammation scores in the test group were 2.78 ± 0.7, 2.52 ± 0.5, and 1.72 ± 0.5 in the upper, intermediate, and basal zones, respectively, compared with 3.28 ± 0.8, 2.93 ± 0.6 and 2.36 ± 0.5 in controls. Connective-tissue maturation and epithelial regeneration were comparable between groups (approximately 3.1 and 3.0, respectively). Vascularization was slightly higher in the test group (1.20 ± 0.19 vs. 1.09 ± 0.05). The cornified layer contacting the abutment was significantly thicker in the test group (2.89 ± 0.8 vs. 1.91 ± 0.7, P = 0.008). No significant differences were observed for plaque index, whereas bleeding on probing was lower in the test group. CONCLUSIONS:Plasma-activated healing abutments were associated with localized histological differences at the epithelial-abutment interface, particularly in basal inflammation and cornified layer thickness, while most parameters remained comparable between groups.
PATIENTS:The patient was an 11-year-old boy with a medical history of congenital acute myeloid leukemia (AML). He received a series of treatments between 1 and 8 months of age, including chemotherapy, total body irradiation, and peripheral blood stem cell transplantation. Although the permanent incisors had erupted, both crown and root formation were incomplete. No tooth buds were observed for the remaining permanent teeth. The deciduous teeth were still present; however, their roots were shortened and showed mobility. At 18 years of age, growth of the upper and lower jaws had ceased; therefore, occlusal rehabilitation was performed using implants. All teeth except the first molars were extracted, and six implants were placed in the jaws. A screw-retained, implant-supported bridge was fitted, and regular follow-up and maintenance were scheduled. Four years and 9 months after placement of the final prosthesis, the occlusion has remained stable. DISCUSSION:This patient had congenital AML and received chemotherapy during early childhood, coinciding with the critical period of tooth development and resulting in root shortening, tooth microdontia, and absence of tooth buds for the permanent teeth. Following completion of maxillofacial growth, occlusal rehabilitation was performed using implants, and the occlusion has remained stable. The findings of the present case suggest that implant-supported prosthetic treatment represents an effective option for full occlusal reconstruction in congenital AML survivors with severe hypodontia. CONCLUSIONS:Dental implant treatment for full occlusal reconstruction in a patient with severe hypodontia who had received chemotherapy for AML is described herein.
PURPOSE:This study used chitosan (CS)-coated iron oxide nanoparticles (IONPs) to create a dual-nanocarrier consisting of chlorhexidine (CHX) and miconazole (MCZ) and assessed their impact on a denture stomatitis microcosm biofilm. METHODS:CHX and MCZ were immobilized on IONPs functionalized with CS and the nanocarriers were characterized by physicochemical tests. Biofilms originating from the saliva of patients with denture stomatitis were formed on acrylic surfaces and were treated with IONPs-CS carrying different concentrations of CHX-MCZ (7.8, 19.5, 39, or 78 µg/mL). Untreated biofilms served as the negative control (NC), whereas IONPs, CS, and CHX-MCZ served as controls. Biomass, metabolism, lactic acid generation, number of cultivable cells, cell viability, and biofilm thickness were assessed. Analysis of Variance (ANOVA) or Kruskal-Wallis tests were used to examine all results, and then the Student-Newman-Keuls post hoc test was applied (α=0.05). RESULTS:The nanocarriers were spherical with a diameter of 6.6 nm. The nanocarrier concentration of 78 µg/mL increased the biomass compared with NC. This nanocarrier compound also reduced metabolism and lactic acid generation, surpassing the effects of CHX-MCZ. For the total microorganism and Streptococcus mutans loads, IONPs-CS-CHX-MCZ behaved similarly to CHX-MCZ, and both led to significant reductions relative to NC. The nanocarrier reduced cell viability and increased biofilm thickness compared with the NC. CONCLUSIONS:The dual nanocarriers showed an antibiofilm effect equal to or greater than that of CHX-MCZ, depending on the variable analyzed. Nanotherapy has potential for use in mouthwashes, denture cleaning solutions, or anti-biofilm mucoadhesive coatings.
PURPOSE:This study aimed to compare the 5-year cumulative survival and success rates of anterior CAD-CAM composite-resin crowns and identify the risk factors for complications associated with these restorations. METHODS:Clinical data were analyzed for consecutive single anterior CAD-CAM composite-resin crowns placed over a 5-year period and post-treatment events recorded during follow-up. Survival curves for the CAD-CAM composite-resin crowns were generated using Kaplan-Meier analysis, and statistical differences between the groups were assessed using the log-rank test. Cox proportional hazards analysis was performed to identify the risk factors for complications. RESULTS:The 5-year cumulative survival and success rates of CAD-CAM composite-resin crowns were 95.6% and 91.5%, respectively. The 5-year cumulative success rate was significantly higher in the buccolingual total occlusal convergence (TOC) < 20° group than in the buccolingual TOC > 20° group (P = 0.021). In addition, the incidence of complications was significantly greater in the buccolingual TOC > 20° group than in the buccolingual TOC < 20° group (P = 0.024; hazard ratio, 22.105). CONCLUSIONS:Anterior CAD-CAM composite-resin crowns demonstrated significantly high 5-year survival and success rates. However, a buccolingual TOC > 20° might be associated with an increased risk of complications.
PURPOSE:Dental wear of anterior teeth may compromise aesthetics, function, and occlusal stability. Resin composite palatal veneers have been proposed as a minimally invasive and repairable option for restoring worn palatal surfaces. This systematized review evaluated their clinical performance by distinguishing restoration survival from clinical success. STUDY SELECTION:Electronic searches were conducted in PubMed, Scopus, and SciELO (August-October 2024). Clinical trials, observational studies, and case series evaluating direct or indirect resin composite palatal veneers, used alone or as part of a rehabilitation approach, were included. Studies assessing exclusively non-composite materials were excluded. Data on study design, sample characteristics, follow-up duration, and outcomes were qualitatively synthesized due to methodological heterogeneity. RESULTS:Seven studies with 1,532 restorations in 306 patients included one randomized clinical trial, one prospective non-controlled study, two observational studies, and three case series, with follow-up from 5 months to 8 years. Survival rates ranged from 93.8% to 100%, and failure rates ranged from 0.5% to 1.8%. Outcomes included technical issues such as wear, discoloration, marginal defects, and biological issues such as gingival inflammation. Most complications were minor and repairable; catastrophic failures were rare. CONCLUSIONS:Resin composite palatal veneers show favorable medium-term survival. However, survival should not be equated with clinical success, as technical and biological complications may occur without restoration loss. Given the limited long-term and standardized evidence, further prospective studies are required. CLINICAL RELEVANCE:Resin composite palatal veneers offer a comprehensive rehabilitation strategy via a conservative and repairable approach for restoring worn palatal surfaces.
PURPOSE:Large language models (LLMs) are increasingly used in dental esthetic assessment, yet evidence of their feasibility and reliability for objective scoring of single-tooth restorations remains limited. This preliminary study explored the potential of GPT-5.0 for esthetic evaluation using established indices and compared its performance with experienced clinicians and senior dental students. METHODS:A retrospective dataset of 46 maxillary central incisor restorations with natural adjacent teeth and standardized, high-quality photographs was analyzed. Each case was independently scored using the Pink Esthetic Score (PES) and White Esthetic Score (WES) by three expert prosthodontists, three calibrated senior dental students, and GPT-5.0 guided by a detailed prompt and expert examples. Intra- and inter-group reliability were assessed using intraclass correlation coefficients (ICCs), and group differences were evaluated with repeated-measures analysis of variance. RESULTS:GPT-5.0 showed high internal consistency and strong agreement with human raters, particularly for restorative (WES) parameters. ICCs between GPT-5.0 and expert consensus were 0.944 (total), 0.868 (PES), and 0.943 (WES). Minor but significant differences occurred in certain soft tissue (PES) subitems (P = 0.035), with slightly greater variability than that of the human raters. Reliability was lower for subjective soft tissue parameters, especially the mesial papilla and soft tissue convexity/color/texture subitems; generalizability beyond idealized conditions remains to be established. CONCLUSIONS:With detailed guidance, GPT-5.0 can approach expert-level performance for objective scoring of single-tooth restorations in a controlled setting, but reliability is lower for subjective soft tissue parameters, and broader clinical validation is needed before routine implementation.
PURPOSE:The purpose of this systematic review was to evaluate the 5-year clinical performance of posterior resin bonded fixed partial dentures (P-RBFPDs). STUDY SELECTION:Electronic literature searches were conducted on PubMed/Medline, Embase, Scopus and Web of Science for clinical studies with 5-year or more follow-up periods and screened by 2 independent reviewers. Information on P-RBFPDs with its clinical outcomes were extracted. Statistical analysis was performed based on the defined failure rates to estimate the 5-year and 10-year survival rates along with annual failure rates of P-RBFPDs. RESULTS:A total of 15 out of 283 studies were analyzed statistically based on the inclusion criteria. The overall estimated 5-year and 10-year survival rate were 82.77% (95% CI: 75.88-87.85%) and 68.51% (95% CI: 57.57-77.17%), respectively. The estimated annual failure rate was 3.78% (95% CI: 2.59-5.52), with no significant differences among P-RBFPDs based on prosthesis type (Fixed-Fixed, Fixed-Movable, Cantilever) or framework materials at the 95% confidence level. Despite this, non-cantilevered P-RBFPDs demonstrated nearly twice the estimated annual failure rate compared to two-unit cantilevered P-RBFPDs (4.19% Vs 2.20%). Two-unit cantilevered P-RBFPDs exhibited higher estimated survival rates at 5 and 10 years compared to non-cantilevered prostheses, although this difference was not statistically significant. CONCLUSIONS:The type of prosthesis and framework material did not significantly impact the clinical outcomes. Two-unit cantilevered P-RBFPDs demonstrate higher 5- and 10-year survival rates compared to non-cantilevered options. Further high-quality long-term clinical trials are still needed.
PURPOSE:This study evaluates and compares the flexural properties of computer-aided design-computer-aided manufacturing (CAD-CAM) resin composite and polyetheretherketone (PEEK) blocks used for molar crowns under three storage conditions. Furthermore, the relationship between the inorganic filler content (>70 wt. %) and the flexural properties of the resin composite blocks was clarified. METHODS:Five commercially available resin composite blocks and one PEEK block were subjected to three storage conditions: dry storage, water immersion for 7 d at 37 °C, and 10,000 thermal cycles between 5 and 55 °C. The flexural strength and flexural modulus were analyzed using two-way ANOVA, followed by Tukey's post-hoc comparisons. The inorganic filler content and water sorption were analyzed via one-way ANOVA and the Tukey-Kramer post-hoc test, with the level of significance set at 5%. RESULTS:The resin composite blocks exhibited a significantly higher flexural strength and flexural modulus than the PEEK block. A positive correlation was observed between the inorganic filler content and the flexural properties of the CAD-CAM blocks, specifically for the flexural strength (r = 0.49) and flexural modulus (r = 0.63). However, the PEEK block exhibited the lowest water sorption and minimal flexural properties changes across all conditions, as compared to the resin composite blocks. CONCLUSIONS:Both the inorganic filler content and matrix resin composition influenced the flexural properties of the CAD-CAM crown materials. PEEK demonstrated superior durability under thermal and humid conditions, indicating its potential as a long-term restorative material for posterior crowns.
PURPOSE:Osseointegration begins at the initial blood-implant contact; however, titanium-adhesive blood proteins remain incompletely defined. We used a structure-free, nano-smooth titanium substrate (Ra ≈ 0.6 nm) to identify titanium-adhesive blood proteins and determine whether coating such proteins modulates cell adhesion, osteogenic differentiation, and peri-implant bone formation. METHODS:Whole blood from Sprague-Dawley rats was seeded on nano-smooth titanium, followed by stringent washing. Adherent proteins were recovered and analyzed using LC-MS/MS and STRING-based bioinformatics screening. Vitronectin was identified as a major titanium-adhesive protein and functionally evaluated using a recombinant protein. Bone marrow stromal cell (BMSC) adhesion, osteogenic gene expression, mineralization, and peri-implant bone formation were assessed in a rat model. Phosphate-buffered saline (PBS)-treated, albumin-coated, and fibronectin-coated titanium surfaces were used as controls. RESULTS:The vitronectin coating significantly enhanced early BMSC adhesion compared to all control surfaces, whereas fibronectin and albumin demonstrated no effect. Vitronectin did not alter osteogenic gene expression or mineralization in vitro but significantly accelerated peri-implant bone formation in vivo. CONCLUSIONS:Vitronectin exhibits physicochemical affinity for nano-smooth titanium and promotes peri-implant bone formation, primarily by accelerating early cell adhesion rather than by directly stimulating osteogenic differentiation.
