Search Results (192)

Objectives: Ameloblastoma is a locally aggressive odontogenic tumor of the jaws characterized by a high recurrence rate. This work aims to present our clinical experience in managing patient oral rehabilitation following an extensive mandibular ameloblastoma, with a specific focus on mandibular reconstruction using a fibula free flap, followed by dental implant placement and prosthetic rehabilitation in a female patient. Additionally, we provide a comprehensive review of the current evidence on surgical management, reconstruction techniques, and long-term outcomes in ameloblastoma treatment. Methods: A 44-year-old female patient presented with a painless swelling in the left mandible. Orthopantomography (OPG) and computed tomography (CT) demonstrated a well-defined radiolucent lesion extending from the canine to the second premolar. An incisional biopsy was performed, and histopathological examination confirmed the diagnosis of mandibular ameloblastoma. The patient underwent segmental resection of the left mandibular body, followed by immediate reconstruction using a vascularized fibular free flap. Eighteen months postoperatively, four dental implants were placed. One implant failed during the osseointegration phase and was removed. Due to residual hard and soft tissue deficiency, prosthetic rehabilitation was achieved with a metal-reinforced resin overdenture, restoring both function and aesthetics. Results: At the three-year follow-up, clinical and radiographic examinations revealed no evidence of tumor recurrence. The patient remained asymptomatic, reporting neither pain nor functional discomfort. Prosthetic rehabilitation with the metal-reinforced resin overdenture was successfully completed, achieving satisfactory masticatory function and aesthetics. Conclusions: The use of the fibula free flap for mandibular reconstruction after ameloblastoma resection provides excellent flexibility, enabling effective bone integration of dental implants. Full article

Background/Objectives: The present study aimed to evaluate the oral health and patient satisfaction of flexible and non-metal clasp dentures (NMCD) compared to removable partial dentures (RPD) using a systematic review. Methods: The PICOS framework of this review was as follows: Do rehabilitations involving flexible dentures or NMCD have a similar success rate to those using RPD? Thus, the PICOS approach involves the following topics: (P) Population/Problem: partial edentulous adult patients; (I) Intervention: patients rehabilitated with flexible dentures or NMCD; (C) Comparison: patients rehabilitated with standard RPD; (O) Outcome: clinical parameters such as oral health, masticatory function, and patient satisfaction; and (S) Study Type: clinical trials and observational studies (cohort, case–control, and cross-sectional). No language restrictions were applied to the studies. The search strategy consisted of the following keywords in different databases: ((flexible) OR (nonmetal) OR (non-metal) OR (thermoplastic)) AND (denture). Only clinical trials and observational studies (cohort, case–control, and cross-sectional studies) from the last 15 years were included, and no language restrictions were applied. Studies that did not describe the denture material were excluded. Results: Of the 2197 potentially relevant records, 14 studies were included in the present review. Two studies reported retrospective results, while twelve reported a prospective evaluation. Considering the thermoplastic materials, five studies evaluated polyester, five polyamides, three polyacetals, and only one study evaluated polyetheretherketone (PEEK). Flexible dentures and NMCD demonstrated similar periodontal status and bone levels on abutment teeth to RPD after up to 12 months. Flexible dentures exhibited a higher degree of redness of the mucosa after 12 months. One study showed a lower maximum bite force for flexible dentures compared to RPD. No study has performed a clinical evaluation of mastication and chewing ability. Conclusions: Despite increased short-term patient satisfaction for flexible dentures and NMCD, there is weak evidence to support a similar clinical performance of flexible dentures and NMCD to RPD. Full article

Aging is a multifactorial process that affects various physiological functions, including masticatory performance, which is crucial for oral health and nutritional well-being. Impaired masticatory function, often due to factors such as tooth loss, reduced salivation, or muscle atrophy, can lead to significant nutritional challenges and compromise the overall health of elderly individuals. Recent research has illuminated the interconnectedness of masticatory function, oral microbiota, and gut health, suggesting that altered chewing ability may disrupt oral microbial communities, which in turn affect gastrointestinal health and systemic inflammation. This commentary review provides a comprehensive analysis of the role of masticatory function in aging, exploring its impact on the oral microbiota, gut health, and broader nutritional status. We discuss the potential consequences of impaired mastication, including malnutrition, dysbiosis, and gastrointestinal disorders, and explore possible strategies for improving masticatory function and maintaining a healthy gut microbiome through interventions like dietary modifications, oral care, and rehabilitation. We aim to underscore the importance of integrating masticatory function management into the broader context of aging-related healthcare, promoting holistic, multidisciplinary approaches to support nutritional needs and quality of life in older adults. Full article

Primary teeth play a crucial role in a child’s development, particularly in maintaining space for permanent teeth. The premature loss of a primary tooth can lead to orthodontic issues, making the use of space maintainers essential to ensure proper growth and development of permanent teeth. To preserve space, the fabrication of a space maintainer is necessary. Since conventional space maintainers do not restore masticatory function, this study presents an innovative solution for space preservation following the extraction of the first primary molar through the design of the functional space maintainer KOS&MET (Key Orthodontic System and Materials Enhanced Therapy). The space maintainer was designed using the 3Shape Dental Designer 2023 version software tool and manufactured via additive 3D printing, utilizing a metal alloy with high resistance to masticatory forces. The crown is supported by the primary canine, while an intraoral window is created to monitor the eruption of the successor tooth. This design does not interfere with occlusion and enables bilateral chewing. Masticatory performance was assessed using two-color chewing gum, and the results showed improvement after cementing the space maintainer. This innovative approach not only preserves space for permanent teeth but also enhances masticatory function, contributing to the proper growth and development of the jaws and teeth. Full article

Ceramic dental prosthetics with internal metal structures are made from a cobalt–chromium alloy that is coated with ceramic. This study aims to validate surface treatments for the metal that enhance the adhesion of the ceramic coating under masticatory forces. Surface conditioning is performed using mechanical methods, like sandblasting (SB), and thermal methods, such as oxidation (O). The ceramic coating is applied to the metal component following the conditioning process, which can be conducted using either a single method or a combination of methods. Each conditioned sample undergoes characterization through various techniques, including drop shape analysis (DSA), scanning electron microscopy (SEM), X-ray diffraction (EDX), and atomic force microscopy (AFM). After the ceramic coating is applied and subjected to thermal sintering, the metal–ceramic samples are mechanically tested to assess the adhesion of the ceramic layer. The research findings, illustrated by scanning electron microscopy (SEM) images of the metal structures’ surfaces, indicate that alloy powder particles ranging from 10 to 50 µm were either adhered to the surfaces or present as discrete dots. Particles that exceed the initial design specifications of the structure can be smoothed out using sandblasting or mechanical finishing techniques. The energy-dispersive spectroscopy (EDS) results show that, after sandblasting, fragments of aluminum oxide remain trapped on the surface of the metal structures. These remnants are considered impurities, which can negatively impact the adhesion of the ceramic to the metal substrate. The analysis focuses on the exfoliation of the ceramic material from the deformed metal surfaces. The results emphasize the significant role of the sandblasting method and the micro-topography it creates, as well as the importance of the oxidation temperature in the treatment process. Drawing on 25 years of experience in dental prosthetics and the findings from this study, this publication aims to serve as a guide for applying the ceramic bonding layer to metal surfaces and for conditioning methods. These practices are essential for enhancing the adhesion of ceramic materials to metal substrates. Full article

Optimizing stress distribution at the bone–implant interface is critical to enhancing the long-term biomechanical performance of dental implant systems. Vertical misalignment between splinted implants can result in elevated localized stresses, increasing the risk of material degradation and peri-implant bone resorption. This study employs three-dimensional finite element analysis (FEA) to evaluate the mechanical response of peri-implant bone under oblique loading, focusing on how variations in vertical implant platform alignment influence stress transmission. Four implant configurations with different vertical placements were modeled: (A) all crestal, (B) central subcrestal with lateral crestal, (C) lateral subcrestal with central crestal, and (D) all subcrestal. A 400 N oblique load was applied at 45° simulated masticatory forces. Von Mises stress distributions were analyzed in both cortical and trabecular bone, with a physiological threshold of 100 MPa considered for cortical bone. Among the models, configuration B exhibited the highest cortical stress, exceeding the physiological threshold. In contrast, configurations with uniform vertical positioning, particularly model D, demonstrated more favorable stress dispersion and lower peak values. Stress concentrations were consistently observed at the implant–abutment interface across all configurations, identifying this area as critical for design improvements. These findings underscore the importance of precise vertical alignment in implant-supported restorations to minimize stress concentrations and improve the mechanical reliability of dental implants. The results provide valuable insights for the development of next-generation implant systems with enhanced biomechanical integration and material performance under functional loading. Full article

Background/Objectives: This study aimed to explore the functional implications of occlusal changes during clear aligner treatment (CAT) to (a) analyze occlusal changes throughout CAT and the extent of post-treatment occlusal recovery; (b) assess the relationship between post-treatment occlusion and masticatory performance; (c) investigate whether case complexity, facial biotype, and type of malocclusion influence occlusal adaptation and functional outcomes; and (d) evaluate the presence and progression of signs or symptoms of TMDs in patients undergoing CAT. Methods: This longitudinal cohort pilot study included 42 individuals who underwent CAT. Occlusion was evaluated at three timepoints: before treatment (T0), at treatment completion (T1), and three months after with night-only aligner use (T2). Masticatory performance was assessed using a two-colored chewing gum test analyzed through colorimetric software. TMD signs/symptoms were assessed using the Diagnostic Criteria for TMD [DC/TMD]. Statistical analysis used non-parametric tests. Results: A significant decrease in occlusal contact area was observed during active CAT [p = 0.016], which partially recovered at follow-up. Individuals with normal facial proportions (normodivergent) showed more anterior contacts at T1 compared to hyperdivergent individuals [p = 0.013]. Masticatory performance remained stable between T1 and T2 [p = 0.528]. A weak negative correlation was found between posterior contact number and performance score at T1 [r = −0.378, p < 0.05], suggesting that more contacts may be linked to better chewing. No TMD signs or symptoms were detected at any timepoint. Conclusions: Although CAT temporarily reduces occlusal contact area, it does not negatively impact chewing efficiency or trigger TMD symptoms. These findings support the functional safety of CAT when treatment is properly planned and monitored. Full article

Background: Dental implants enhance masticatory efficiency in edentulous patients, yet discrepancies exist between objective assessments and patient perceptions. This study evaluated masticatory efficiency before and after implant rehabilitation using the two-color mixing test (Hue-Check Gum^®) and Viewgum^® software Version 1.4. 32-bit, correlating objective data with patient-reported outcomes. Methods: In a prospective study of 30 patients receiving implant-supported prostheses, masticatory efficiency was assessed objectively (VOH values via Viewgum^®) and subjectively (10 cm VAS). Statistical analysis included Shapiro–Wilk, paired t-tests (VAS), and Wilcoxon tests (VOH). Correlation and regression analyses examined subjective–objective relationships. Results: Significant improvements occurred post-rehabilitation. VAS scores rose from 3.46 (95% CI: 2.54–4.39) to 7.29 (6.55–8.02; p < 0.001). VOH values decreased from 0.462 (0.426–0.497) to 0.438 (0.403–0.473; p = 0.001), confirming better chewing performance. No correlation was found between VAS and VOH, pre- (p > 0.346) or post-treatment (p > 0.980). Conclusion: Implant rehabilitation improves masticatory function objectively and subjectively. However, the lack of correlation underscores the need for dual assessment in clinical practice. Future studies should explore factors influencing satisfaction and performance to optimize outcomes. Full article

Background: In this study, we aimed to investigate the association between a patient’s selection of implant treatment for a missing mandibular second molar and the magnitude of occlusal force, masticatory ability, mandibular morphology, and age before treatment intervention. Materials and Methods: We retrospectively assessed occlusal force, masticatory performance, and mandibular morphology in female patients who either selected or declined implant treatment for a missing unilateral mandibular second molar. Results: Thirty-three women (mean age of 56.1 ± 9.7 years) were divided into an implant treatment (IT) group and a no-treatment (NT) group. The IT group showed significantly higher occlusal force (p = 0.021 < 0.05), while masticatory performance and gonial angle demonstrated no significant difference. Conclusion: The IT group had significantly higher occlusal force, and age had no significant effect on it. Notably, masticatory performance in the IT group increased significantly with age (p = 0.047 < 0.05). Full article

Background/Objectives: Oral health is an important element of overall health and quality of life. However, few studies have evaluated the association between quality of life (QOL) and oral function, including tongue and lip movements. This study aimed to investigate the relationship between oral-related QOL and oral function, including tongue and lip movements, in independent elderly people. Methods: The participants were 143 community-dwelling elderly people in Taiwan (40 men, 103 women; 76.4 ± 6.4 years). We used the General Oral Health Assessment Index (GOHAI) to evaluate oral-related QOL. The items used to evaluate oral function were as follows: the speed of tongue movement from side to side, maximum tongue pressure, maximum lip pressure, the repeated saliva swallowing test, oral diadochokinesis (speed and dexterity when pronouncing /pa/, /ta/, and /ka/), and masticatory performance. In addition, we surveyed the number of remaining teeth, denture use, and awareness of problems at mealtimes. For the analysis, we compared the GOHAI score for each group, divided by cutoff values. Results: The univariate analysis revealed significant differences in the GOHAI score according to denture use, the number of remaining teeth, the state of occlusal support areas, the speed of tongue movement from side to side, oral diadochokinesis /ta/ and /ka/, and masticatory performance. The logistic regression analysis revealed that oral diadochokinesis /ka/ was a significant explanatory variable for low GOHAI scores (odds ratio = 13.145). Conclusions: Our results imply that lower oral-related QOL was associated with slow motor function at the rear area of the tongue. Full article

Objective: This in vitro study aimed to evaluate the influence of cervical margin design—tangential versus chamfer—on the fracture resistance of monolithic crowns fabricated from lithium disilicate and zirconia ceramics. Materials and Methods: Forty extracted human molars were randomly assigned to two preparation types: chamfer and tangential. Each group was restored with CAD/CAM-fabricated crowns made from either zirconia (IPS e.max^® ZirCAD Prime) or lithium disilicate (IPS e.max^® CAD), resulting in four subgroups (n = 10). Standardized adhesive cementation protocols were applied. After 24 h storage in distilled water, the specimens underwent static load-to-failure testing using a ZwickRoell ProLine Z005 universal testing machine. Results: Zirconia crowns with chamfer margins exhibited the highest mean fracture resistance (2658 N), while lithium disilicate crowns with tangential margins showed the lowest (1862 N). Chamfer preparation significantly increased the fracture resistance of lithium disilicate crowns (p < 0.01), whereas margin design had no significant effect on zirconia. All restorations exceeded physiological masticatory forces, confirming their clinical viability. Conclusions: Cervical margin design significantly affected the fracture performance of lithium disilicate crowns but not zirconia. Chamfer preparations are recommended when using lithium disilicate to optimize mechanical strength. These findings underscore the importance of preparation geometry in guiding material selection for CAD/CAM ceramic restorations. Full article

End-stage masticatory muscle fibrosis may occur following trauma, resulting in the inability to open the mouth for eating, drinking, panting and vomiting. Following MRI and EMG confirmation of end-stage muscle fibrosis, a bilateral wedge ostectomy was performed of the mandibles, leaving a permanent mouth opening of 3.5 cm. The osteotomies were stabilized with 6-hole dynamic compression plates and screws. A temporary percutaneous endoscopic gastrotomy tube was placed while the dog underwent rehabilitation and reconditioning. The dog was able to eat, drink, and pant after recovery, which allowed the dog to live a relatively normal and good quality life. Wedge osteotomies of the mandibles with bone plate stabilization may allow dogs with permanent restrictive mouth opening due to fibrosis of the masticatory muscles to live a relatively normal life. Full article

Background/Objectives: Accurate scientific methods are essential for monitoring the osseointegration of dental implants postoperatively. This study aims to evaluate peri-implant bone changes using the fractal analysis (FA) method during follow-up. Methods: Periapical radiographs were obtained from 77 patients with dental implants, and 33 permanent teeth serving as a control group, retrieved from the radiology archive. Radiographs were taken using the parallel technique at 3, 6, and 12 months post-surgery. All images were digitized and saved in TIFF. Each image was aligned using the TurboReg plugin in ImageJ software. Regions of interest (ROIs) were selected from the mesial and distal aspects of the implants, then prepared for fractal analysis. FA was performed to assess changes in bone structure over time. Results: In the study group, radiographs of 24 patients for 0, 3 and 6 month, radiographs of 34 patients for 0, 6 and 12 month, radiographs of 8 patients for 0 and 12 month, radiographs of 5 patients for 0 and 3 month, radiographs of 5 patients for 0 and 6 month, and 1 patient of 0, 3, 6 and 12 month of radiographs were used in the study. There were no statistically significant differences in FA values over time when analyzed by gender and age in both the study and control groups. However, a statistically significant difference was observed in FA value changes over time and jaws. Conclusions: The study indicates a positive correlation between bone remodeling over time and FA results, likely due to the restoration of masticatory forces in the implant area. Image analysis on two-dimensional dental radiographs can be a useful tool for detecting changes in bone density. Fractal analysis is a cost-effective and practical diagnostic method for monitoring bone changes over time. Full article

Stomatognathic dysfunctions, particularly bruxism, orofacial pain, and temporomandibular joint (TMJ) disorders, are frequently associated with anxiety and depression. However, the reverse hypothesis that these dysfunctions may act as peripheral stressors contributing to neuropsychological imbalance by activating the hypothalamic–pituitary–adrenal (HPA) axis remains underexplored. Objective: To assess the relationship between the severity of stomatognathic symptoms and both physiological and psychological stress markers to determine whether such dysfunctions may influence or exacerbate anxiety and depressive disorders. Methods: A cross-sectional observational study was conducted on 120 adult patients. Clinical assessment was included evaluation of TMJ function, bruxism, and orofacial pain. Psychological screening was performed using validated questionnaires (GAD-7 for anxiety and PHQ-9 for depression). Electromyographic (EMG) analysis of the masseter and temporalis muscles was conducted, along with the quantification of salivary cortisol using an enzyme-linked immunosorbent assay (ELISA). Multiple regression models were applied to identify statistically significant correlations (p < 0.05). Results: A positive correlation was found between the severity of stomatognathic dysfunction and scores on anxiety and depression measures, along with elevated salivary cortisol levels and increased masticatory muscle activity. Conclusions: These findings suggest a bidirectional relationship between stomatognathic dysfunctions and neuropsychological status, underscoring the potential value of integrated therapeutic approaches that combine dental care with psychological support. Full article

Objectives: To evaluate any changes in condylar and mandibular ramus height and dental malocclusion in adult patients with temporomandibular disorders (TMDs) diagnosed with DC/TMD criteria after treatment with an upper occlusal splint. Methods: This retrospective observational study included 48 adult patients with TMDs treated with an occlusal splint in the upper arch for about 12 months. For each patient, panoramic dental X-rays were analyzed using the Habets method to calculate the asymmetry index between the condyles and mandibular branches before and after treatment. The digital dental models were also studied at T0 and T1 to define the occlusal sagittal molar relationship and the posterior dental crossbite. The statistical analysis was performed using the Shapiro–Wilk normality tests, Student t-tests, or Wilcoxon tests using the R studio software (released version 4.3.3). Results: Condylar height showed a statistically significant difference (p = 0.022) and reduced condylar asymmetry between T0 and T1. The measurement of the condylar branch showed a statistical significance (p = 0.037), revealing an improvement of the mandibular symmetry in the vertical direction after treatment. Moreover, at T0, posterior dental crossbite was found in 37.5% of patients, specifically, bilateral in 12.5%, while unilateral crossbite in 22.9% on the right and 2.1% on the left side, and Class I malocclusion was found in the main part of the sample (72.9%). Conclusions: Patients with TMDs diagnosed according to DC/TMD and treated with an upper stabilization occlusal splint in the case of symptoms of masticatory muscle dysfunction showed a symmetrization in the mandibular ramus and condyle pre- and post-treatment (T0-T1). At the same time, no clinical differences were found in the occlusal characteristics. Full article