Abstract

Introduction:
Minimally invasive posterior restorations (MIPRs) aim to preserve tooth structure while ensuring optimal function and esthetics. Adhesively bonded restorations such as onlays, overlays, and endocrowns provide conservative alternatives to full crowns. The clinical performance of these restorations depends largely on appropriate material selection, preparation design, and bonding procedures.

Methods:
This work presents four clinical situations illustrating different applications of MIPRs: a lithium disilicate endocrown, a zirconia endocrown, a disilicate onlay, and a zirconia overlay. Each case was analyzed regarding indication, preparation strategy, CAD/CAM fabrication, and adhesive luting protocol. Special attention was given to margin management, Immediate Dentin Sealing (IDS), and occlusal integration.

Results:
Clinical observations revealed satisfactory marginal adaptation, occlusal harmony, and esthetic integration in all four cases. Lithium disilicate restorations provided excellent translucency and enamel bonding potential, while zirconia offered enhanced fracture resistance in high-stress situations. IDS improved bonding reliability and reduced postoperative sensitivity. No complications were observed during follow-up.

Conclusions:
The clinical outcomes from these four cases support the reliability of MIPRs as conservative and durable treatment options for posterior teeth. The choice between disilicate and zirconia should be guided by the amount of residual tooth structure, esthetic expectations, and functional demands. Mastery of adhesive techniques remains essential for long-term success.

Background: Acrylic bone cement is widely used in orthopedics and dentistry for primary bone fixation. However, its limited mechanical strength and poor biological interface pose clinical challenges. To enhance their properties, carbon nanotubes (CNTs) and silver nanoparticles (Ag) have been explored. CNTs are known to reinforce polymers, while Ag nanoparticles provide antimicrobial benefits. Combining both may yield a synergistic effect, improving mechanical strength and antibacterial performance. Objective: This study evaluates the effect of incorporating 0.05 wt% silver-doped carbon nanotubes (Ag-doped CNTs) into acrylic bone cement. Key properties assessed include compressive strength, flexural strength, surface microhardness, wettability, and antibacterial activity against Staphylococcus aureus. Methods: A control group was prepared using traditional acrylic powder mixed with monomer liquid. In the modified group, 0.05 wt% Ag-doped CNTs were added to the acrylic powder before mixing. Compressive strength, flexural strength, surface microhardness, and wettability were tested. Antibacterial activity was evaluated using an agar diffusion test against S. aureus to test the inhibition zone. Independent sample t-tests (p < 0.05) were used to compare results between groups. Results: The modified acrylic cement exhibited significantly higher compressive strength (91 MPa), flexural strength (73 MPa), surface microhardness (39.1 VHN), and improved wettability (contact angle: 92.2°) compared to the control group, which recorded values of 72.3 MPa, 54.3 MPa, 21.1 VHN, and 107.9°, respectively. Additionally, the modified cement demonstrated a larger inhibition zone diameter against S. aureus (12.6 mm) than the control (9.1 mm) (P < 0.05). Conclusion: Incorporating 0.05 wt% Ag-doped CNTs into acrylic bone cement significantly improves its mechanical and antibacterial properties. This modification holds strong potential for clinical applications in both orthopedics and dentistry, offering enhanced strength, better surface characteristics, and effective bacterial inhibition compared to traditional formulations.

Printed digital and conventional complete dentures require appropriate hygiene materials and methods to prevent the formation of biofilm, tartar, stains, inflammation, and odor. However, some hygiene materials can affect resin properties, such as surface roughness, which, when increased, can favor biofilm adhesion and development. In the literature, it has been reported that roughness values ≤ 0.2 µm are considered clinically acceptable; however, studies evaluating the effects of hygiene protocols on the roughness of printed resins are scarce. So, this study compared the roughness of 3D printed resins for denture bases (3DB) and teeth (3DT) to conventional resins for base (CB) and teeth (CT), after hygiene protocol use. Ten specimens of each material were subjected to brushing and immersion in water (EA, control), 0.25% sodium hypochlorite (EHS), or 0.15% triclosan (ET). Roughness was measured after obtaining the specimens (T0) and after simulating daily 6-minute brushing and daily 20-minute immersion for 1 (T1) and 3 years (T3), using a confocal laser microscope (µm). Data were analyzed using Generalized Estimating Equations (GEEs) and Wald test with Bonferroni adjustment (α=0.05). Roughness was influenced by the following interaction: resin × hygiene protocol × time (p=0.012). In T1, the average roughness (Sa - µm) of the 3DB (EA: 0.239; EHS: 0.258; and ET: 0.265) and 3DT (EA: 0.211; EHS: 0.202; ET: 0.248) resins was considered unacceptable. In T3, the roughness of the 3DB (EA: 0.183; EHS: 0.161; ET: 0.199) and 3DI (EA: 0.181; EHS: 0.173; ET: 0.188) resins decreased, possibly due to the removal of superficial layers of resin through brushing, exposing inner layers with less roughness. Conventional resin roughness remains within acceptable limits regardless of hygiene protocol. Compared to conventional resins, printing resins should be indicated for short-term situations, when associated with the proposed hygiene protocols. Hygiene protocols can be recommended for both conventional resins during the periods studied.

Introduction: The accuracy and efficiency of dental model fabrication has experienced significant progress in recent years. However, environmental concerns, such as the use of petrochemical by-products, overproduction of plastic and waste management, have redesigned new materials that can lessen these environmental challenges and contribute to a better ecological transition. Objective: To analyze cutting-edge technology in 3D printing techniques applied to the fabrication of dental models, with a particular focus on sustainable practices. Methods: This systematic review was conducted according to PRISMA guidelines. A comprehensive literature search was conducted using the electronic academic databases PubMed, Web of Science, and Scopus. The search strategy incorporated specific keywords and MeSH terms relevant to sustainable dental 3D printing. Scientific articles reviewed and published between 2020 and 2025 were considered. Studies written in English, German and Spanish were included in the selection process. Results: A total of five in vitro studies met the inclusion criteria and contain sufficient information for this review. All studies are in vitro and are peer reviewed articles from the years 2023-2024. The materials investigated in these studies were polylactic acid (PLA), recycled PLA, recycled resins and soy-based resins. The studies employed either fused filament fabrication (FFF) or vat polymerization technology (VAT) as the main 3D printing techniques. Each study addressed sustainability as a central theme. Conclusion: The results of this systematic review show the potential of 3D dental models in the adoption of more sustainable materials such as biodegradable and/or recyclable polymers but this approach is relatively novel in the dental sector. The performance of these innovative materials has improved in terms of dimensional accuracy, efficiency and clinical application. Materials such as polylactic acid (PLA) and fused filament fabrication (FFF) are set to play a key role in the advancement of environmentally friendly dental manufacturing.

Introduction: Three-dimensional printed dentures have poor thermal and thermomechanical properties, which hinder their clinical applications. Previous denture nanocomposite studies focused on mechanical and physical properties. In this study, the impacts of TiO₂ NT addition to 3D-printed denture based on some thermal properties were studied for the first time.

Methodology: Digitally formed specimens (DLP Asiga 3D printer) for 1) Hot-Disc (thermal conductivity (W/km), diffusivity (mm²/s), volumetric heat capacity (MJ/m³K) tests). 2)Thermomechanical-analyzer (TMA) (coefficient of thermal expansion (10^‒6/K), thermal strain (%) and elastic modulus (N/mm²)). 3) Glass transition temperature (Tg) (⁰C) (by DSC, DTA and TMA). 4) Thermal stability (weight%). 5) Degree of conversion (DC%) by ATR-FTIR. Following ISO (22007, 11359, 11357, 11358 and 10640), respectively. TiO₂ NTs (Diameter=30-70nm and length=2-4µm) were added at 1.0 wt.% and 2.0 wt.%. Ultrasonication (3 minutes) for nanotube dispersion, magnetic stirrer (8 hours) for TiO₂ NTs/ 3D liquid resin mixing. Printing settings: slice thickness=50µm, heater temperature=30°C, wavelength=385nm, 90-degree printing orientation and (65 watts/30 minutes) post-polymerization curing. The effective sample size was 30 specimens for each test (10 specimens for each group), which was calculated using G power (power=85%, alpha error=.05, effect size=0.25, groups=3, measurements=5 (30°C, 40°C,50°C,60°C,70°C)). Data analysis via SPSS and Prism 8.4. Shapiro–Wilk (normality), Levene (homogeneity), ANOVA and post-hoc tests were utilized. Significance level at α=.05.

Results: Increasing TiO₂ NT concentration improved all the tested thermal and thermomechanical properties. However, Tg increased for the 1.0 wt.% group and decreased for the 2.0 wt.% group. The Tg decreased due to the aggregation of the nanofiller and functioned as a plasticizer or impurity, thus increasing the mobility of the chains. The DC% increased in both 1.0 wt.% and 2.0 wt.% groups, although this increase was statistically non-significant with a P value of 0.9801).

Potential clinical impact: improvement in thermal perception. A marginal deterioration reduction between different denture parts interface, and improved ability to withstand wide range of intra-oral temperatures during eating.

Introduction. Disc displacement with reduction (DDwR) and myalgia are among the most common temporomandibular disorders, frequently affecting young adults. While conservative therapy is considered the first-line approach, the evidence on long-term outcomes is still limited. Case Presentation. A 22-year-old female had a 7-month history of left-sided TMJ clicking, deviation to the left during opening, and 2 months of bilateral masticatory pain, which was worsened by mastication. During clinical examination, reproducible left TMJ clicking and tenderness of the masseter and temporal muscles were observed. Based on DC/TMD Axis 1, DDwR with myalgia diagnosis was made. Intervention and Results: A full maxillary stabilization splint was constructed and delivered together with patient education, dietary adjustments, and guided mandibular exercises. At baseline, pain intensity was VAS 6/10 with a maximum unassisted mouth opening of 41 mm and reproducible joint clicking. After 2 weeks, the patient reported a decrease in pain, VAS 2/10, mouth opening was 44 mm, and joint sounds were absent. After 1 year, the patient was asymptomatic (VAS 0/10) with stable function, preserved mouth opening, and completion of daily activities without limitations. Clinical Relevance and Conclusion: This case shows that multi-directional non-invasive therapy can result in complete and long-term remission of DDwR with myalgia. It emphasizes the need for careful diagnosis, through standardized instruments such as DC/TMD, and the need for personalized treatment to ensure durable clinical success.

Differentiation of PDLSCs and the development of periodontal disease are closely connected with the stimulation of inflammatory factors. The cardiovascular system, immune system, and skeletal system can all be affected by Rosuvastatin, which is a selective inhibitor of 3-hydroxy-3-methylglutarate monoacyl coenzyme reductase. The NF-κB signaling pathway can regulate stem cells' differentiation ability and inhibit the secretion of inflammatory factors by stem cells, as confirmed by existing studies. Our research found that in the inflammatory microenvironment of periodontitis, rosuvastatin sustained release by the RS-PC scaffold can effectively up-regulate the expression of miR-210, target and bind to p65, inhibit the inflammatory response regulated by the NF-κB signaling pathway, and promote osteogenic differentiation. The purpose of this project is to clarify the impact of miR-210 on the function of the PDLSCs in periodontitis conditions and its possible pathway in the PDLSCs. It became apparent that rosuvastatin targets the NF-κB signaling pathway, which controls miR-210, suppresses the release of inflammatory factors, and promotes osteogenic differentiation. The rosuvastatin in the RS-PC scaffold has been tested in animal experiments to investigate its sustained-release, anti-inflammatory, and alveolar bone repair abilities. The research findings offer a theoretical basis for investigating the mechanism behind periodontitis' occurrence and treatment methods.

Introduction:

Introduction: Polyetheretherketone (PEEK) is considered as an alternative to titanium for dental implants due to its favourable properties. However, its bio-inert and hydrophobic surface limits osseointegration. This study investigated the effects of sandblasting and gold sputter coating on cell viability of fibroblasts in contact with PEEK.

Methods: Eighty PEEK discs (8mm diameter × 2mm height; PEEK Bio Solution) were divided into four groups: untreated (C), sandblasted (SB), gold sputter coated for 30s (G30), and sputter coated following sandblasting (SBG30). The specimens were sandblasted with 50µm alumina particles at 0.25MPa pressure for 10s (Duostar, BEGO). A gold sputter coater (Agar Scientific Ltd., Stansted) was used at 30mA for 30s against the G30 and SBG30 groups. Surface roughness (Sa and Ra) was assessed by optical profilometry (Profilm3D®, Filmetric) and analysed using MANOVA. Cell viability was evaluated using L929 fibroblasts via MTT assay at 2 and 7 days, analysed by two-way ANOVA. A pilot qualitative assessment was utilised to further examine cell proliferation.

Results: Sandblasting significantly influenced roughness (p<0.001) with SBG30 showing the highest values (Sa = 1.398 ± 0.920µm; Ra = 0.663 ± 0.185µm), while C showed the lowest (Sa = 0.386 ± 0.476µm; Ra = 0.180 ± 0.050µm). Cell viability significantly increased over time for all surface treatments (p<0.001, η² = 0.896), with SB showing the lowest values at 2 days (26.55 ± 9.53%), but the highest values at 7 days (136.04 ± 26.74%). These results with a pilot microscopy assessment revealed enhanced proliferation, suggesting a correlation between roughness and cell attachment. There was no interaction effect between the surface modification and the time (p<0.076, η² = 0.129).

Conclusions: Sandblasting, with or without gold coating, enhanced PEEK’s roughness into the optimal Sa and Ra, which was found to be associated with favourable fibroblast proliferation. These findings highlight sandblasting as an effective surface modification to improve the biological performance of PEEK in dental implant applications. In contrast, gold sputter coating on its own did not show any significant effects on cell viability.

Introduction:

Post-extraction bone remodeling, often accompanied by buccal bone loss, presents a challenge in implant dentistry, potentially complicating implant placement and compromising esthetic outcomes. The socket-shield technique (SST) preserves the buccal root fragment to mitigate these changes; however, conventional SST is technique-sensitive, time-consuming, and carries risks such as root injury or shield displacement. A guided trephine-based technique was developed to enhance accuracy and predictability in shield preparation.

Methods:

This case series reports on three patients with nonrestorable maxillary anterior teeth treated in a private practice. Surgical guides were digitally designed and fabricated to direct trephine burs, as described in a patented approach (WO 2024/038478 A1; USPTO No. 509030716). The guided trephine was used to prepare and preserve a precise buccal root segment to maintain periodontal and alveolar integrity. Immediate implants were placed in the palatal socket, and restorations were completed following a standard delayed protocol. Clinical and radiographic follow-up after loading demonstrated stable outcomes at 12 months (Case 1), 6 months (Case 2), and 3 months (Case 3). Long-term data are not yet available.

Results:

All cases showed successful preservation of buccal root fragments, with reduced operative time and improved surgical control based on the author’s clinical experience. Radiographs and clinical assessments demonstrated stable peri-implant bone levels, maintained ridge contours, and indicated satisfactory esthetic outcomes. No complications, such as shield mobility or adjacent root damage, were reported.

Conclusions:

The guided trephine-based socket-shield technique may offer advantages over conventional SST in terms of precision, reproducibility, and reduced chair time. However, the present report is limited by the inclusion of only three cases with very short follow-up periods. Although early results appear to be stable both functionally and esthetically, the technique requires validation through larger, well-controlled studies to confirm its reliability and efficiency, thereby supporting wider adoption by clinicians.

Background:
Posterior maxillary rehabilitation is often complicated by sinus pneumatization and reduced residual ridge height. Traditionally, multiple adjacent implant placements in such situations require an open lateral sinus elevation. Minimally invasive internal sinus lift techniques, particularly when combined with biologically active grafts, offer a promising alternative. This case highlights the novelty of performing closed sinus elevation at multiple adjacent sites in a subantral Class 3 case, supported by the use of platelet-rich fibrin (PRF)-based sticky bone to enhance osteogenesis.

Case Description:
A 43-year-old female patient (ASA I) presented with multiple missing posterior teeth in the right maxillary arch, impairing mastication. CBCT revealed sinus pneumatization with reduced alveolar bone height, classifying the case as subantral Class 3. Internal sinus elevation was performed using osseodensification burs. Sticky bone was prepared by combining autologous PRF with a xenograft (Bio-Oss, Geistlich Pharma, Switzerland) using a centrifugation protocol (2700 rpm for 12 minutes). Three implants (4.0 × 10 mm) were simultaneously placed at the first premolar, second premolar, and first molar sites.

Results:
Sinus membrane elevations of 3.58 mm, 4.45 mm, and 6.69 mm were achieved. Implants demonstrated primary stability of 30–40 Ncm and ISQ values of 62–74. Post-operative CBCT confirmed complete bony housing along the full implant length, indicating substantial bone gain and increased peri-implant bone density. After 3 months, osseointegration was achieved, and a cement-retained zirconia fixed partial denture was delivered.

Conclusion:
Closed sinus elevation across multiple adjacent implant sites in a subantral Class 3 case, combined with PRF-enriched sticky bone, enabled predictable vertical bone gain and complete implant housing without the need for open sinus augmentation. The incorporation of growth factor-rich PRF enhanced the osteogenic potential of the sinus membrane, supporting rapid healing and successful implant integration. This approach demonstrates a minimally invasive and biologically favorable strategy for managing posterior maxillary edentulism with reduced ridge height.