Purpose: This systematic review evaluated the effect of different printing orientations on the physical-mechanical properties and accuracy of resin denture bases and related specimens.
Study selection: Utilizing PRISMA 2020 guidelines, a comprehensive search of PubMed, Web of Science, Cochrane, and Scopus databases was conducted until June 2024. Included studies examined the accuracy, volumetric changes, and mechanical or physical properties of 3D-printed denture bases in various orientations. Studies without relevant data were excluded. Bias risk was assessed using a modified CONSORT checklist.
Results: This review included 24 studies on 3D-printed denture base resins, mainly based on stereolithography and digital light processing. Horizontal orientation (0°) generally enhanced flexural strength, while tilted and vertical orientations (90°) reduced it. Microhardness results varied due to differences in materials, layer thicknesses, and post-curing. Surface roughness was highest at 45°. Vertical orientation uses less material but is less time-efficient. Microbial adhesion, influenced by surface roughness, varied with printing orientation without a clear consensus on the optimal direction.
Conclusions: Printing orientation significantly impacts the physical and mechanical properties and accuracy of 3D-printed resin dentures. A horizontal orientation (0°) improved flexural strength, while accuracy and adaptability were better at 45° and 90°. Surface roughness, translucency, and chemical stability are also affected by orientation, post-curing, and material choice. Although a 90° orientation reduces material use, it increases printing time. Standardized study designs are recommended for drawing definitive conclusions in future research.
This systematic review addresses the effect of printing orientation on the physical-mechanical properties and accuracy of additively manufactured resin denture bases. The findings showed that a horizontal orientation improved the flexural strength, whereas accuracy and adaptability were better at 45°and 90°. Orientation, post-curing, and material choice affect surface roughness, translucency, and chemical stability. Although a 90° orientation reduces material use, it increases the printing time. These results have significant implications for researchers and clinicians involved in three-dimensional printing in prosthodontics.
Patients: Three residents of a long-term care home volunteered to participate in a rehabilitation program involving a virtual reality blowgun game. The participants played the game 5 days a week as a new exercise routine. After 4 weeks of intervention, tongue pressure and forced expiratory volume in 1 s improved in all participants. In addition, the jaw-opening force and forced expiratory volume in 6 s improved in two participants. All three participants rated the virtual reality blowgun game as more enjoyable than their regular rehabilitation programs.
Discussion: Previous studies have shown that gamification can be useful in dysphagia rehabilitation. However, there are no previous reports describing the use of virtual reality in rehabilitation programs aimed at improving swallowing and respiratory functions in older adults while investigating participant motivation. The outcomes of the cases described herein suggest that such programs can be as effective as conventional expiratory training. Furthermore, gamification can enhance enjoyment, even in exercises designed to improve physical function.
Conclusions: These cases indicate that the virtual reality blowgun game may effectively improve swallowing and respiratory functions in older adults while being enjoyable.
This preliminary case series introduced a novel VR blowgun game for older adults that targets swallowing and respiratory functions. All participants showed functional improvement and reported greater enjoyment than with conventional exercise. By combining gamification with therapeutic goals, this study highlighted the potential of VR as an effective tool for geriatric rehabilitation. This innovative approach may enhance patient motivation and adherence in clinical and long-term care settings
Purpose: Excessive occlusal forces resulting from inadequate dental prosthesis, along with periodontal infection (PI), lead to severe periodontitis; however, the roles of senescent cells and their involvement in the mechanisms underlying this process remain unclear. Therefore, this study aimed to elucidate the roles of senescent cells and their cell types in severe periodontitis with excessive force (occlusal trauma [OT]).
Methods: To determine whether senescent cells exacerbate alveolar bone resorption, we developed a severe periodontitis rat model by inducing PI and OT and assessed the presence of senescent cells and bone resorption. Senolytics (dasatinib + quercetin [DQ]) were administered to evaluate the changes in the appearance of senescent cells and bone resorption.
Results: PI and OT + PI increased senescent cells as well as osteoclasts. Furthermore, p21 and receptor activator of nuclear factor-kappa B ligand (RANKL) co-expressing cells were observed in the OT + PI group rats, suggesting a correlation between bone resorption and senescent cells. Cell type analysis identified osteoblasts and Th17 cells as RANKL+ cells expressing p21 or p16. DQ administration reduced senescent cells and osteoclasts, thereby preventing alveolar bone resorption.
Conclusions: RANKL+ senescent osteoblasts and Th17 cells are involved in osteoclastogenesis and bone resorption. Our findings highlight a new target for the prosthetic treatment of severe periodontitis.
This study revealed that occlusal overloading can biologically accelerate periodontal destruction by inducing senescent, RANKL-expressing osteoblasts, and Th17 cells, which are key drivers of bone resorption. Senolytic drugs suppress this process, thereby highlighting a new therapeutic avenue. This underscores the importance of occlusal harmony biomechanically and at the cellular level for prosthodontists, reinforcing the role of prosthetic design in preventing inflammation-driven bone loss.
Purpose: This study evaluated biomechanical behavior of endocrown and post-core restorations produced from computer aided design/computer aided manufacturing (CAD/CAM) and traditional materials in severely damaged teeth that lack a ferrule and assessed the associated failure risk of resin cement.
Methods: A phantom maxillary central incisor and mandibular second premolar were trimmed 1 mm coronally to the cemento-enamel junction, the root canals were enlarged, and the teeth were scanned. Data were transferred to a solid modeling software. Twenty-two models were constructed, including endocrowns (hybrid ceramic, lithium disilicate, and polyetheretherketone [PEEK]) and post-cores (glass-fiber post/composite core; glass-fiber single-piece post-core; PEEK single-piece post-core; gold single-piece post-core). Hybrid ceramic and lithium disilicate crowns were modeled on the post-cores. Loads of 100 N for the central incisor and 300 N for the premolar were applied in a 45° oblique direction. von Mises stresses were analyzed on both root dentin and restorations, and the failure risks for the resin cement were calculated.
Results: The highest stresses were found at the roots of the PEEK endocrown (37.6 MPa) for the central incisor and of the lithium disilicate endocrown for the premolar (40.0 MPa) among endocrown groups. PEEK endocrowns had the lowest stress within the restoration and presented a higher risk of cement failure. The glass-fiber post/composite core groups demonstrated the highest adhesive and cohesive failure risks for post cement.
Conclusions: For the central incisor and mandibular premolar, lithium disilicate and PEEK endocrowns, respectively, generated less stress at the root. However, PEEK endocrowns had a higher risk of cement failure.
This study presented a novel three-dimensional finite element analysis of the biomechanical behavior of various CAD/CAM and conventional materials in the endocrown and post-core restorations of structurally compromised teeth lacking a ferrule. The results demonstrated that lithium disilicate and PEEK optimized stress distribution depending on the tooth’s location (anterior or posterior), whereas gold post-core systems provide superior root stress mitigation. Notably, PEEK exhibited a higher risk of cement failure despite the lower internal stress levels. These findings offer evidence-based insights to guide clinicians in material selection, highlighting the importance of aligning mechanical performance with clinical demands for long-term restorative success.
Purpose: Psoriasis is a complex, chronic inflammatory keratosis of unclear origin that is challenging to treat. In patients with psoriasis suspected of having metal allergies, the removal of oral metallic prostheses contributes to the alleviation of psoriasis symptoms. However, the relationship and mechanism of the metal removal effect and improvement in psoriasis symptoms in patients with metal allergies are unknown. This study aimed to investigate the relationship between metal allergies and psoriasis using an animal model.
Methods: In the metal allergy model, 4-week-old rats were sensitized and treated with nickel (II) chloride (NiCl2) solution (provocation model). In the psoriasis model, imiquimod (IMQ) cream was applied to the shaved dorsal skin of rats (IMQ model). To create a psoriasis/metal-allergy composite rat model, we combined the provocation and IMQ models (provocation + IMQ model). Macroscopic observation, histological analysis, and quantitative gene expression analyses were performed to evaluate outcomes.
Results: In the IMQ model, psoriasis-like symptoms were visually observed from day 2 to day 9. In the provocation + IMQ model, psoriasis-like symptoms persisted for at least 11 days. Histological analysis revealed epidermal thickening and an increase in the number of interleukin (IL)-17-positive cells in the provocation + IMQ model on days 7 and 9. The gene expression of IL-17 in the submandibular lymph nodes and spleen increased in the provocation + IMQ model.
Conclusions: The induced state of Ni allergy may contribute to the maintenance of psoriasis pathology through IL-17 activity.
In patients with suspected dental metal allergies, psoriasis symptoms improved after removal of the metal from the oral prosthesis. However, the relationship and mechanism of the metal removal effect and improvement of psoriasis symptoms in patients with metal allergies remain unknown. This study investigated the relationship between metal allergies and psoriasis using an animal model. The results suggested that nickel allergy may prolong psoriasis via IL-17 production in the submandibular lymph nodes and spleen.
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Article ID JPR_D_24_00283
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Ahmed M Aziz, Hiba Alshaibah, Adam Bin Husein
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