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Background The advent of digital technologies has introduced novel methods for RPD fabrication, potentially enhancing the fit compared to the conventional approaches. This systematic review aimed to evaluate the methods to assess the accuracy of fit and precision of the RPD framework fabricated using conventional and digital (3D printed and milled) methods. Methods A comprehensive literature search (Registration Number CRD42023459566) was conducted across different electronic databases like PubMed/MEDLINE, Embase, Scopus, Web of Science, and Google Scholar. Studies investigating RPD fit and precision assessment using various techniques (Visual inspection and pressing test using silicone impression material, 3D digital analyses using a software, light microscopy, digital microscope at 50x, superimposition method /surface matching software program, µCT on silicone specimens and direct measurements) in in-vitro studies were included. Data extraction and quality assessment were performed to evaluate the methodological rigour of the selected studies. A narrative synthesis of the findings was carried out to evaluate the methods to assess the accuracy of fit and precision of the RPD framework fabricated through conventional and digital methods due to heterogeneity in study variables. Results Out of 413 records, a total of 8 in-vitro studies were included in this review. The key findings of the review suggest that RPD fit accuracy varies across fabrication processes including conventional techniques, resin milling, selective laser melting (SLM), and digital superimposition. Resin milling with polyether ether ketone (PEEK) offers the best accuracy. Among the different methods used in assessing the fit accuracy of the RPD framework silicone-based fit evaluation and superimposition techniques/ surface matching are commonly used methods. Conclusion Both traditional (non-computerized) and computerized methods for the assessment of fit and precision of conventional and digital RPD frameworks are used commonly. But still, formulation of a standard method for fit assessment of RPDs is warranted. In future with further refinements, digital methods would completely outperform the traditional methods.

Newly introduced provisional crowns and fixed dental prostheses (FDP) materials should exhibit good physical and mechanical properties necessary to serve the purpose of their fabrication. The aim of this systematic literature review and meta-analysis is to evaluate the articles comparing the physical and mechanical properties of 3D-printed provisional crown and FDP resin materials with CAD/CAM (Computer-Aided Designing/Computer-Aided Manufacturing) milled and conventional provisional resins. Indexed English literature up to April 2022 was systematically searched for articles using the following electronic databases: MEDLINE-PubMed, Web of Science (core collection), Scopus, and the Cochrane library. This systematic review was structured based on the guidelines given by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The focused PICO/PECO (Participant, Intervention/exposure, Comparison, Outcome) question was: ‘Do 3D-printed (P) provisional crowns and FDPs (I) have similar physical and mechanical properties (O) when compared to CAD/CAM milled and other conventionally fabricated ones (C)’. Out of eight hundred and ninety-six titles, which were recognized after a primary search, twenty-five articles were included in the qualitative analysis, and their quality analysis was performed using the modified CONSORT scale. Due to the heterogeneity of the studies, only twelve articles were included for quantitative analysis. Within the limitations of this study, it can be concluded that 3D-printed provisional crown and FDP resin materials have superior mechanical properties but inferior physical properties compared to CAD/CAM milled and other conventionally fabricated ones. Three-dimensionally printed provisional crowns and FDP materials can be used as an alternative to conventional and CAD/CAM milled long-term provisional materials.

The aim was to assess the clinical and radiographic peri-implant status among type-2 diabetic and non-diabetic individuals with major depressive disorders (MDD). Participants were divided into four groups; Group-1: patients with type-2 diabetes; Group-2: patients with MDD; Group-3: patients with type-2 diabetes and MDD; Group-4: healthy controls. Demographic data was collected, and medical history including most recent hemoglobin A1c (HbA1c) levels were retrieved from healthcare records. Peri-implant modified plaque and gingival indices (MPI and mGI) and peri-implant probing depth (PPD) were recorded; and crestal bone loss (CBL) was measured. Sample-size was estimated using data from a pilot investigation. Statistical analysis was performed using one way-analysis of variance and Bonferroni Post-hoc adjustment tests. P-vales below 0.05 were considered statistically significant. Thirty, 30, 30 and 30 individuals were included in groups 1, 2, 3 and 4. Mean HbA1c levels were higher in groups 1, 2 and 3 compared with Group-4 ( P  < 0.05). Thirty-seven, 40, 43 and 36 implants were present in groups 1, 2, 3 and 4, respectively. In groups 1, 2, 3 and 4, the implants were in function for a mean duration of 4.7 ± 2.4, 4.9 ± 1.8, 5.05 ± 1.7 and 10.6 ± 2.2 years, respectively. The mPI, mGI, PPD and CBL were significantly higher in groups 1, 2 and 3 than individuals in Group-4 ( P  < 0.05). There was significant correlation between peri-implant PD and HbA1c levels among individuals in Group-1 ( P  < 0.05). Peri-implant soft tissue and osseous statuses are compromised among patients with type-2 DM, and MDD regardless of whether these conditions occur individually or in combination. Clinical relevance: Peri-implant soft tissue and osseous statuses are compromised among patients with type-2 DM, and MDD regardless of whether these conditions occur individually or in combination.

Background: Polyetheretherketone (PEEK) has provided the option to fabricate RPDs with aesthetics unlike metal RPDs, but little attention has been paid to its suitability, especially towards the retentive forces and deformation of the clasp. This study aimed to examine the retentive forces and the fitting surface (inner surface) deformation of clasps made from PEEK and compare it with cobalt–chromium (Co-Cr) clasp. Methods: Forty-two circumferential clasps (14 Co-Cr and 28 PEEK) were fabricated and divided into two groups with clasp undercuts (0.25 mm and 0.5 mm) with thicknesses of 1 mm and 1.5 mm. Each was examined for retentive forces after cycle test on its abutment for 360 cycles. Initial and final retentive forces were recorded. The fitting surface deformation was determined using 3-Matic research analysis software. Results: The results revealed that highest mean initial retentive force was of Co-Cr clasps with 0.50 mm undercut 22.26 N (±10.15 N), and the lowest was the 1 mm PEEK clasps with 0.25 mm undercut 3.35 N (±0.72 N) and highest mean final retentive force was the Co-Cr clasps with 0.50 mm undercut 21.40 N (±9.66 N), and the lowest was the 1 mm PEEK clasps with 0.25 mm undercut 2.71 N (±0.47 N). PEEK clasps had a lower retentive force than Co-Cr clasps with 0.50 undercut. PEEK clasps (1.5 mm) at 0.25 mm undercut had the least deformation (35.3 µm). PEEK showed significantly less deformation (p ≤ 0.014) than Co-Cr. Conclusion: The deformation of PEEK clasps fitting surface was lower than Co-Cr clasps and retentive forces were close to the Co-Cr clasps, suggesting the use of PEEK as an aesthetic clasp option for RPD framework.

Background Developing efficient bonding techniques for orthodontic brackets and all-ceramic materials continues to pose a clinical difficulty. This study aimed to evaluate the shear bond strengths (SBS) of metal and ceramic brackets to various all-ceramic CAD-CAM materials, such as lithium disilicate CAD (LDS-CAD), polymer-infiltrated ceramic (PIC), zirconia-reinforced lithium silicate glass ceramic (ZLS), and 5YTZP zirconia after different surface treatments and thermal cycling. Materials and methods The samples were divided into two groups to be bonded with ceramic and metal lower incisor brackets. Each group was subdivided into a control group devoid of any surface treatment, 10% HF acid (HFA) etching, ceramic etch & prime (MEP), Al2O3 air abrasion, and medium grit diamond bur roughening. After surface treatment, brackets were bonded with composite resin cement, thermal cycled, and tested for shear bond strength. The failed surfaces were evaluated with a digital microscope to analyse the type of failure. The data were statistically analysed using a one-way ANOVA and Tukey HSD tests at p < 0.05. Results The highest mean bond strengths were found with HFA etching in LDS-CAD (13.17 ± 0.26 MPa) and ZLS (12.85 0.52 MPa). Diamond bur recorded the lowest mean bond strength roughening across all the ceramic groups. There were significant differences in mean shear bond values per surface treatment (p < 0.001) and ceramic materials. Conclusion Among the surface treatment protocols evaluated, HFA etching and MEP surface treatment resulted in enhanced bond strength of both ceramic and metal brackets to CAD-CAM all ceramic materials.

Background This study aimed to evaluate the knowledge, awareness, and practice of intraoral scanners (IOS) and the factors affecting their accuracy amongst dental interns and practitioners. Methods This was an observational cross-sectional study in which data was collected from a representative population in Saudi Arabia, with the help of online questionnaires. The forms were distributed to 500 dental interns and practitioners and the questionnaire’s validity and reliability were evaluated for vetting and remarks. The questionnaire consisted of three parts: the participants’ demographic details, questions on the awareness and knowledge of participants regarding IOS, and the factors affecting the accuracy in clinical use of IOS. Questions were to be answered with ‘yes’, ‘no’ and ‘I don’t know’. Descriptive statistical analysis was performed using the control chart technique and the chi-squared test, with statistical significance set at p  < 0.05. Results Most of the participants (58%) knew about the IOS and its applications (47.5%), but the majority of the participants did not use IOS in their clinics (43.5%). The majority of males (57.39%) and females (50.86%) strongly agreed that cost was a barrier to purchasing an IOS. To better get more knowledge on IOS, the specialists 66 (16.5%) and interns 54 (13.5%) chose continuing dental education programs and workshops. There was a significant association ( p  < 0.05) of knowledge and awareness, perception, and factors affecting parameters with different categories and years of experience. Conclusion Within the limitations of this study, most participants had a positive stance towards IOS but due to inadequate knowledge and understanding, its use and applications were minimal. IOS was well-received regardless of operator training and experience. There is a significant need to increase awareness of this concept, as it may increase treatment efficiency and effectiveness.

Background Nowadays dental implants are commonly used and to fulfil esthetic demands, zirconia has been suggested as an implant material as an alternative to titanium. Many researchers and systematic reviews are documented on it, but the results have been often inconsistent. This overview of systematic reviews aimed to report on the factors that influence the clinical effectiveness of zirconia (Zi) versus titanium (Ti) dental implants in anterior region. Methods This overview of systematic reviews (Registration Number CRD42023396206) is in accordance with the Transparent Reporting of Systematic Reviews and Meta-analyses. PubMed, Cochrane, Scopus, Embase and Google Scholar databases were sourced for systematic review and meta-analyses. Joanna Briggs Institute (JBI) criteria and Measurement Tool to Assess systematic Reviews” (AMSTAR-2), evaluated the quality. The PICO-focused question of this overview of systematic reviews was “What are the various factors influencing the clinical performance of Zi versus Ti implants in the anterior area?”, Evaluations were assessed by two assessors. In case there was any uncertainty or dispute among the reviewers, the work was included for further screening. Using Cohen's kappa, the inter-reviewer reliability was evaluated. Results Six reviews were chosen from 57 suitable reviews for this data analysis. Although the survival and effectiveness rates backed titanium implants, there was no conclusive proof of marginal bone loss. Zirconium implants performed better in terms of aesthetics. Conclusion Clinical performance of zirconia could be considered at par with titanium implants in the anterior area. Titanium has exhibited greater mechanical performance but no significant difference between two recorded. In future, studies with improved design are needed to identify biological and technical factors that affect implant’s efficacy. Novelty and relevance This is the first overview of systematic reviews focusing specifically on the anterior region, evaluates both aesthetic and biomechanical performance of Zi and Ti Implants, offers detailed insight into material-specific advantages and limitations. In the present clinical scenario it addresses a critical gap by comparing the performance of Zi and Ti implants and evaluates patient-centred priorities, particularly in the highly visible anterior region.

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Background: At present, the evidence regarding digital impressions’ accuracy recorded by using digital scanners is lacking. This systematic review aimed to evaluate whether the type of scanning (intraoral/extraoral) affects the Accuracy of Digital Impressions. Method: Two independent reviewers performed a systematic search in the database both electronically and manually (PubMed, Ebsco HOST, the Cochrane Library, and Google Scholar) for articles published from 1 January 2010 to 1 December 2022. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42020188765) and followed the PRISMA statement. The question in focus was as follows: Does the type of scanning (intraoral or extraoral) affect the accuracy of digital impression? Results: A total of 449 papers were obtained by searching electronically and manually. In total, 15 complete-text papers qualified for assessment based on eligibility criteria. After reading the full-text articles, five studies were excluded. Ten studies were selected for the qualitative analysis. The qualitative data reported that the accuracy of both types of scanners (intraoral and extraoral) lies within the range of clinical acceptability. Nevertheless, the intraoral scanners seem to be more accurate when compared to the extraoral scanners for a partial arch situation. Conclusions: Scanning type affects the accuracy of the digital impression. Various factors influence the scanning ability. Intraoral scanners seem to be more accurate compared to extraoral scanners for a partial arch situation. More studies comparing the accuracy of the intraoral scanner and extraoral scanner for a complete arch scan and in an in vivo study setting are needed.

Short clinical crowns/abutments (SCC) pose a challenge in achieving adequate retention. Auxiliary retentive features (ARF), such as grooves, are commonly employed to enhance retention. The marginal gap (MG) and internal fit (IF) of restorations are critical factors influencing clinical success. This study aimed to evaluate the MG, IF, and cement volume of digitally fabricated (computer-aided design (CAD) and computer-aided manufacturing (CAM)) all-ceramic crowns with and without grooves on SCC using micro-computed tomography (micro-CT). A mandibular second molar typodont tooth was prepared to simulate SCC. Four groups of crowns (  = 30 per group) were fabricated: Group 1: CAD/CAM zirconia without grooves, Group 2: CAD/CAM zirconia with grooves, Group 3: CAD/CAM lithium disilicate with grooves, Group 4: Conventional lithium disilicate with grooves. Crowns were cemented using resin cement. MG, IF, and cement volume were evaluated using micro-CT. Gap measurements were taken in two planes across seven zones (Z1 to Z7). Statistical analysis was performed using one-way ANOVA and Tukey tests. Significant differences in MG and IF were observed among the groups (  < 0.001). Group 1 exhibited the lowest MG and IF, followed by Group 3, Group 2, and Group 4. Group 4 showed the highest average marginal discrepancy (AMD) and average wall discrepancy (AWD) ((AMD: Z1 = 197.36 ± 10.56 µm; Z7 = 226.5 ± 8.24 µm), (AWD: Z2 = 150.05 ± 10.89 µm; Z6 = 169.38 ± 10.57 µm)), followed by Group 2 > Group 3 > Group 1. The greatest discrepancy at the cuspal area was observed in Group 2, followed by Group 3 > Group 1 > Group 4. In the central fossa, the maximum discrepancy was also noted in Group 2 (CFD = 194.48 ± 13.71 µm). No significant differences were found in total cement space volume among the groups. CAD/CAM crowns with grooves demonstrated clinically acceptable MG and IF values, with lithium disilicate crowns showing superior performance. These findings support the use of CAD/CAM technology for SCC restorations and underscore the importance of material selection and crown design for optimal clinical outcomes.