Restoration Design Research Articles

Effect of different restorative design on stress concentration of lithium disilicate and monolithic zirconia endocrown on a mandibular molar - a finite element analysis

BackgroundThe purpose of this simulation study was to evaluate effect of different restorative design on stress concentration of endocrown. Different restorative materials were used on a mandibular molar using a finite element analysis.MethodsA 3D FEA model of mandibular molar was constructed using the average values and was used in this analysis. 2 materials were used which were lithium disilicate and zirconia and 2 different margin design of knife edge and shoulder margins were used in various combinations of material and margin design. A constant 12° of internal wall angulation was considered for all the 4 models and a uniform cement thicknes of 100 μm was considered. A uniform 2 mm of bulk fill composite was used as a base beneath the endocrowns. 300 N load was applied on the cusps for each model and linear static analysis was carried out.ResultsEndocrowns of lithium disilicate was found to exert a greater stress concentration in comparison to zirconia endocrowns in both the margin designs of knife edge and shoulder. Knife edge margins were seen to yield greater stress concentration on the remaining tooth structure in comparison to shoulder margins in endocrowns of both the materials used.ConclusionThere is a positive influence of margin design selection within the same material used for the fabrication of endocrown.

Clinical behavior and survival of CAD-CAM resin nanoceramic and polymer interpenetrating ceramic network material restorations on endodontically treated teeth: A systematic review and meta-analysis.

Attempting to combine the mechanical and optical properties of ceramics and composite resins to mimic natural teeth has led to the emergence of resin nanoceramics and polymer interpenetrating ceramic network materials. Systematic reviews on the survival of these materials in endodontically treated teeth are lacking. This systematic review and meta-analysis assesses the survival of computer-aided design and computer-aided manufacturing (CAD-CAM) resin nanoceramics and polymer interpenetrating ceramic network material restorations on endodontically treated teeth and to describe the incidence of complications. The study was registered in the international prospective register of systematic reviews (PROSPERO) database and adhered to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A comprehensive search across 6 online databases was performed. Clinical studies which involved CAD-CAM manufactured resin nanoceramics and polymer interpenetrating ceramic network material restorations on endodontically treated teeth were included. Several investigators independently conducted the study selection, data extraction, and quality assessment processes. Risk of bias was assessed by using the Cochrane Risk of Bias 2 tool and Newcastle-Ottawa Scale. Failure rates were analyzed using Poisson regression models to obtain summary estimates of 3- and 5-year survival proportions, which were pooled using a random-effects model. Subgroup analysis was performed for material type and restoration design (α=.05). The search resulted in 250 studies after duplicate removal, and 11 articles were included in the final analysis. The meta-analysis of 289 restorations revealed an overall estimated failure rate of 3.44 (95% confidence interval [95% CI]: 2.67-4.21) per 100 restoration years, equivalent to a survival rate of 90.2% (95% CI: 88.1-92.3%) after 3 years and 84.2% (95% CI: 81.0-87.5%) after 5 years. A significantly lower (P<.001) failure rate was reported for polymer interpenetrating ceramic network material restorations (1.61, CI: 0.87-2.36) compared with resin nanoceramic restorations (5.97, CI: 3.52-8.41). Partial-coverage restorations (3.45, 95% CI: 1.98-4.92) had a significantly lower (P<.001) failure rate compared with 1-piece endodontic crowns (5.19, 95% CI: 2.75-7.64). Restoration debonding was the main reason for failure. Endodontically treated teeth restored with CAD-CAM manufactured resin nanoceramic and polymer interpenetrating ceramic network material restorations have an acceptable survival rate and can be recommended as an alternative to conventional indirect restorative materials. Polymer interpenetrating ceramic network material restorations have a higher survival rate than resin nanoceramic restorations.

Implant-supported full-arch fixed dental prostheses manufactured through a direct digital workflow using a calibrated splinting framework: A retrospective clinical study.

To evaluate the clinical precision, one-year survival, and complications of implant-supported full-arch fixed dental prostheses (ISFAFDPs) manufactured through a full-digital protocol, which involved intraoral scanning of the edentulous arch with a calibrated splinting framework (CSF; RingFix®; IOSFix Dental, Madrid, Spain) and computer-aided design and manufacturing of monolithic zirconia restorations. This retrospective clinical study involved 37 patients (21 males and 16 females) aged 48-87 years (mean age: 68.8 ± 9.7 years) who had been restored with 45 ISFAFDPs manufactured using a full-digital protocol. The primary outcomes were the clinical precision of the ISFAFDPs and their survival and the incidence of complications at the one-year follow-up. The correction of errors in the position of the implants generated by the intraoral scan was computed using the CSF. The data were statistically analyzed. At delivery, all ISFAFDPs were clinically precise, showing ideal passive fit on the implants, confirmed clinically and radiographically. No implants had been lost at the one-year follow-up. The incidence of prosthetic complications (4.4%) was relatively low; one prosthesis broke, giving a restoration survival rate of 97.8%. Within the limits of this study, monolithic zirconia ISFAFDPs manufactured through intraoral scanning of the edentulous arches with a CSF were clinically precise, presenting a low incidence of complications at one year. Using the CSF can improve the accuracy of digital full-arch implant scans, allowing the manufacture of clinically precise ISFAFDPs.

Micro CT evaluation of marginal discrepancies of endocrown restored molars with different intrapulpal depths and materials of fabrication. (in-vitro study)

ObjectiveThe purpose of this study was to evaluate the effect of different preparation depths (0, 2 and 4 mm) of different restoration designs (classic endocrown design versus overlay design) on marginal adaptation of restorations fabricated of two different restorative materials (lithium disilicate and PEEK).Materials and methodsSixty mandibular natural molars were collected as abutments for the restorations of this study, and grouped in three main groups of different cavity depths (0, 2 and 4). Each group was divided into two subgroups according to material of fabrication to (L) for lithium disilicate (IPS emax CAD, Ivoclar vivadent, Switzarland) and (P) for PEEK (Bio-hpp, Bredent, Germany). CAD/CAM milling technology was used for fabrication of restorations. After cementation of restorations over abutments, hydrothermal aging was performed, and then marginal adaptation was evaluated via micro CT technology.ResultsRegarding cavity depths, there was a significant difference between different groups (p < 0.001). The highest value was found in samples with 4 mm extension (84.35 ± 18.16), followed by samples with 2 mm extension (66.52 ± 21.86), while the lowest value was found in samples without pulpal extension (59.41 ± 22.16). Post hoc pairwise comparisons showed samples with 4 mm extension to have a significantly higher value than samples without extension (p < 0.001). Regarding materials of fabrication, PEEK (85.32 ± 12.37) had a significantly higher value than Emax (54.86 ± 20.86) (p < 0.001).ConclusionsIncreasing intrapulpal cavity depths increases vertical marginal gap of lithium disilicate or PEEK restorations. Endocrowns fabricated of lithium disilicate show less marginal discrepancies than that of endocrowns fabricated of PEEK.

Analysis of influencing factors on the height of gingival papilla around implants

The anatomical structure of the gingival papilla around the implant is special, and it is difficult to recover after injury. The reduction of its height will have a negative impact on function and esthetics, and it is one of the many problems in implant treatment at present. This paper analyzes the influencing factors of implant gingival papilla height from three aspects: anatomical factors, implant surgical design and implant restorative design, including the classical influencing factors such as the shape of natural teeth, interproximal distance between the implant and the adjacent tooth, soft tissue grafting, and contour of implant restorations, as well as the hot and controversial influencing factors in recent years such as the thickness of soft tissues around the implant, the implant surgical timing, the flap design, and the surgical incision, in order to provide reference for clinicians in the process of implant treatment for gingival papilla preservation and reconstruction.

Using the appropriate modulus of elasticity of periodontal ligament matters in stress analysis of human first premolar tooth and periodontium structures

Although the modulus of elasticity of the human periodontal ligament (EPDL) values used in dentistry widely ranged from 0.01 to 175 MPa, the exact EPDL value has not been determined. This study aimed to verify whether and how EPDL values affect the stress distribution over the tooth and periodontium structures, and to determine the appropriate EPDL range. A 3D multi-component human first premolar model was created based on a cone-beam computed tomography dataset. Finite element analysis was performed to analyze stress distribution and deformation of the structures under an average Asian occlusal force with different EPDL values (0.0689–68.9 MPa). The low EPDL caused excessive PDL deformation, contributing to a non-uniform stress distribution and localized stress concentration, especially in the cementum, enamel, and dentin. With the low EPDL value, the stress magnitude was overestimated by 1,195%, potentially leading to erroneous conclusions regarding material failure and tooth movement. The EPDL value significantly affects the stress magnitude and distribution over the tooth and periodontium. The appropriate EPDL range of 0.964 ± 0.276 MPa is suggested for human first premolars to ensure accurate and reliable FEA simulations and help avoid misinterpretation of the stress results, which could compromise orthodontic planning and restoration design.

Overlooked discrepancies in protocols undermine coastal restoration practices in China

To improve the success of expanding ecosystem restoration efforts, technical guiding-standards are being developed in many nations. Whether these protocols have been well adopted to guide restoration practices remains unknown, especially in developing countries where policies evolve rapidly to balance socioeconomic development with ecosystem restoration. By conducting text semantic mining analyses, we reveal widespread discrepancies between China’s coastal restoration practices and protocols over the past four decades. Over 60% of executed restoration projects had no detailed technical standards to guide implementation, especially for severely degraded ecosystems. Development of these standards lagged significantly behind project implementation, was poorly enforced, and focused more on monitoring than guiding good restoration designs and adaptive management, likely undermining restoration performance. Nevertheless, current policies toward prioritizing ecosystem restoration offer opportunities to remedy this issue. Enforcing policies to ensure that practices are guided by protocols is necessary to promote coastal restoration success in China and globally as nations strive to achieve ambitious restoration targets.

Fracture resistance and marginal fit of three different overlay designs using advanced zirconia-reinforced lithium disilicate CAD/CAM material

BackgroundConservative dentistry introduced modern restoration designs, contributing to the greater use of partial-coverage ceramic restorations. New strong bondable ceramic materials made fabricating partial coverage ceramic restorations easier to restore the badly destructed teeth.Aim of the studyThis study investigated the impact of three distinct overlay preparation designs on the marginal fit (both before and after thermal aging) and the fracture resistance of overlay restorations fabricated using advanced zirconia-reinforced lithium disilicate (ALD) CAD/CAM glass-ceramic blocks.Materials and methodsUsing a standardized preparation protocol, three typodont molars were prepared to receive three different indirect overlay ceramic restoration designs. The typodont teeth were duplicated to get 27 resin dies that were randomly allocated into three groups (n = 9) based on the preparation design; group (O): a traditional overlay preparation with anatomical occlusal reduction, group (OS): anatomical occlusal reduction with circumferential shoulder finish line, and group (OG): anatomical occlusal reduction with a central groove preparation at the mid-occlusal surface. After standardized restorations fabricated following the manufacturer’s guidelines, the restorations were cemented to their corresponding dies and exposed to thermal aging corresponding to 6-month clinical service. Marginal gap was measured before and after thermal aging procedure using an optical microscope. To measure fracture resistance, specimens were loaded till failure using the universal testing machine. The Kruskal Wallis test was utilized to assess data among the groups, followed by Dunn’s post hoc test with Bonferroni correction. Differences in the marginal fit before and after thermal aging were evaluated using Wilcoxon Sign Rank test.ResultsA statistically significant difference in marginal fit was observed between the studied groups, with a p-value of 0.032 where group OS has the lowest micro gap compared to group OG and group O. The fracture resistance group (O) recorded the highest fracture resistance with a statistically significant difference between the studied groups at p value = 0.043.ConclusionsAdjusting the tooth preparation significantly influenced both the fracture resistance load and the marginal fit observed for advanced zirconia-reinforced lithium disilicate glass-ceramic (ALD) overlays.

Evaluation of mechanical and thermal stress in an endodontically treated cracked premolar with three restorative designs: 3D-finite element analysis

We aimed to analyze the influence of different designs (inlay, onlay, and crown) on stress distribution and crack propagation in an endodontically treated cracked premolar. Three-dimensional (3D) finite element analysis (FEA) was employed to model an endodontically treated cracked premolar with three different restorations (inlay, onlay, and crown). Six types of loadings (vertical loading of 600 N; hot thermal-600 N vertical coupling loading; cold thermal-600 N vertical coupling loading; oblique loading of 200 N; hot thermal-200 N oblique coupling loading; cold thermal-200 N oblique coupling loading) were applied to simulate the hot and cold food/beverages intake. The Von-Mises Stress (VMS) on the lower margin of the crack surface was measured at 20 points in each model, and the position of the stress concentration on the crack surface was analyzed. All three restoration types effectively improved stress distribution. The influence of different restorative modalities on the stress distribution at the crack tip exhibited different trends under different loading conditions. Lateral loading and/or hot thermal cycling increased the intensity of VMS, and crown restoration exhibited the highest stress concentration at the crack tip under lateral loading and hot thermal cycling. From a mechanical perspective, the outcome of this study suggested that a full crown restoration is not the optimal choice for preventing further crack propagation. Additionally, it is recommended to reduce the consumption of excessively hot foods and beverages daily.

Minimally invasive glass-ceramic restorations: Clinical and patient-reported outcomes in full-mouth rehabilitations.

To evaluate clinical outcomes (restoration survival, technical and biological complications), and patient-reported outcome measures (PROMs) of full mouth rehabilitation with minimally invasive glass-ceramic restorations after up to 12 years of clinical service. Twenty individuals (12 females, 8 males) received full-mouth rehabilitation with minimally invasive tooth-supported glass-ceramic restorations during the years 2009 - 2017 and agreed to participate in a follow-up visit. Full dental and periodontal examinations were completed, and the restorations were evaluated according to United States Public Health Service (USPHS) criteria. Kaplan-Meier was used for analysis of the survival time. The patients received 439 minimally invasive restorations made from lithium disilicate reinforced glass-ceramic (79.7%), feldspathic porcelain (17.5%) and leucite reinforced glass-ceramic (2.7%). Restoration design included occlusal and buccal surface partial coverage restorations (35.3%), full-contour restorations (31.2%), veneers (27.8%), onlays (4.6%) and inlays (1.1%). The mean follow-up time from restoration insertion was 4.5 years (1.5-12.4 years). Five patients lost altogether 13 restorations during the follow-up time. The estimated cumulative Kaplan-Meier 5-year survival rates were 96.6% on the restoration level and 86.4% on the patient level. Major technical complications amounted to 3% (n = 13) of the restorations, including larger chippings (n = 5) and loss of retention (n = 7). Biological complications were observed at a rate of 4.3%. Patients were very satisfied with esthetics (VAS 9.5) and function (VAS 9.3) of the restorations. Minimally invasive full-mouth rehabilitation with glass-ceramic restorations resulted in high survival rates, few complications and a high level of patient satisfaction over a mid-term time-period. There is an increasing trend toward minimally invasive restorations, as previous studies indicate that these designs preserve healthy tooth structure, leading to fewer biological complications. The present study demonstrates that minimally invasive restorations can be reliably used in full-mouth rehabilitations.

Immediate loading and Hind's technique

Immediate loading aims to rapidly restore the patient’s aesthetics, function, and phonation by placing a temporary prosthesis on dental implants immediately after or shortly following the surgical procedure. The goal of immediate loading with a temporary prosthesis during the same session as tooth extraction is to preserve or enhance both hard and soft tissues. Temporary restorations are a key step in guiding the design of permanent prosthetic restorations. Clinical studies support the successful outcome of immediate implant placement into fresh extraction sockets. This case presentation discusses immediate loading and Hind’s technique in the anterior region. Due to mobility issues, it was deemed appropriate to extract teeth numbered 11, 21, and 22. Immediate implant placement was decided for the 11 and 22 regions. On the same day, prosthetic rehabilitation was provided with a temporary prosthesis on the implants. After three months, the temporary prosthesis was removed, an impression was taken using Hind’s technique to match the shaped emergence profile, and the permanent prosthesis was fabricated. The immediate loading of the implants prevented the patient from experiencing a period of edentulism, facilitated soft tissue healing, and established the emergence profile for the permanent restorations. It was observed that the tissues shaped with Hind’s technique were transferred to the laboratory more accurately, resulting in more precisely fabricated permanent restorations. Immediate implant loading provides more aesthetics, fonetic and predictable treatment. The immediate implant placement protocol not only shortens the overall treatment time and minimizes the number of surgical interventions but also maximizes the utilization of the existing bone to achieve optimal primary stability for the implant.

Fixed Full-Arch Implant-Supported Restorations: Techniques Review and Proposal for Improvement.

Full-arch zirconia restorations on implants have gained popularity due to zirconia's strength and aesthetics, yet they are still associated with challenges like structural fractures, peri-implant complications, and design misfits. Advances in CAD/CAM and digital workflows offer potential improvements, but a technique that consistently addresses these issues in fixed, full-arch, implant-supported prostheses is needed. This novel technique integrates a facially and prosthetically driven treatment approach, which is divided into three phases: data acquisition, restoration design, and manufacturing/delivery. Digital tools, including intraoral scanning and photogrammetry, facilitate accurate implant positioning, while 3D design software enables functional and aesthetic validation before final milling. A dual software approach is used to reverse engineer a titanium bar from the final restoration design, ensuring a superior outcome to other protocols. The restoration incorporates a zirconia-titanium hybrid structure, optimizing strength, flexibility, and weight. The proposed workflow enhances restoration precision and predictability through a prosthetically driven treatment plan, by ensuring passivity and aligning with biological and mechanical principles to promote long-term stability. By starting with the proposed restoration design and reverse engineering the bar, while also allowing for flexibility in material and component choices, this technique accommodates both patient needs and financial considerations. This approach demonstrates potential for improving patient outcomes in full-arch implant restorations by minimizing complications associated with traditional methods. Further research is recommended to validate the technique's efficacy and broaden its clinical applications.

Traumatic Palatal Defect Closure With Prosthesis Post Surgical Reconstruction: A Team Approach

Background: Palatal defect may be a result of congenital malformations, trauma or tumors. In most maxillopalatal trauma, surgical reconstruction is required to restore the function and appearance. Any palatal defect caused by maxillopalatal loss that cannot be achieved with surgical reconstruction needs special and comprehensive treatment. This can be done by prosthodontist prosthesis rehabilitation.Patients and Methods: A 20-year-old man underwent open reduction and internal fixation for severe maxillopalatal fracture and palatal loss. Intraoperative, the palatal defect could not be approximated due to palatal loss. In 3-month-follow up, there was a palatal defect and slight malocclusion due to anterior dental loss. Instead of performing complicated surgical procedures, we collaborate with the prosthodontist to assemble prosthesis with dental prosthesis that accommodate the closure of defect and improve appearance aesthetically. Result: The use of prosthesis improves functional and psychological wellbeing. It does not only close the palatal defect, but it also fills the anterior dental loss thus overcoming the malocclusion. Satisfying functional and aesthetic outcome was achieved. Summary: Rehabilitation of maxillopalatal defect has been well defined for prosthodontists and surgeons. A successful prosthetic design for functional restoration of the palatal defect utilizes the remaining palate and dentition to maximize the support, stability and appearance. In this case,prosthodontist and dentition prosthesis was used as modalities that offer simple solution to close the palatal defect compared to a more complicated surgical intervention.

Primary Methods and Algorithms in Artificial-Intelligence-Based Dental Image Analysis: A Systematic Review

Artificial intelligence (AI) has garnered significant attention in recent years for its potential to revolutionize healthcare, including dentistry. However, despite the growing body of literature on AI-based dental image analysis, challenges such as the integration of AI into clinical workflows, variability in dataset quality, and the lack of standardized evaluation metrics remain largely underexplored. This systematic review aims to address these gaps by assessing the extent to which AI technologies have been integrated into dental specialties, with a specific focus on their applications in dental imaging. A comprehensive review of the literature was conducted, selecting relevant studies through electronic searches from Scopus, Google Scholar, and PubMed databases, covering publications from 2018 to 2023. A total of 52 articles were systematically analyzed to evaluate the diverse approaches of machine learning (ML) and deep learning (DL) in dental imaging. This review reveals that AI has become increasingly prevalent, with researchers predominantly employing convolutional neural networks (CNNs) for detection and diagnosis tasks. Pretrained networks demonstrate strong performance in many scenarios, while ML techniques have shown growing utility in estimation and classification. Key challenges identified include the need for larger, annotated datasets and the translation of research outcomes into clinical practice. The findings underscore AI’s potential to significantly advance diagnostic support, particularly for non-specialist dentists, improving patient care and clinical efficiency. AI-driven software can enhance diagnostic accuracy, facilitate data sharing, and support collaboration among dental professionals. Future developments are anticipated to enable patient-specific optimization of restoration designs and implant placements, leveraging personalized data such as dental history, tissue type, and bone thickness to achieve better outcomes.

A preliminary investigation of the key parameters of average value articulator based on mandibular movement trajectories in 100 adults with individual normal occlusion

Objective: To explore the method of obtaining the key parameters of the average value articulator in healthy people based on mandibular movement trajectory data, with a view to providing a reference for the clinical application of the average value articulator. Methods: One hundred healthy volunteers (42 males and 58 females) with individual normal occlusion, aged 18-55 years old, who met the inclusion criteria were recruited from Beijing, and their mandibular movement trajectory data were collected. The left and right sagittal condylar inclination(SCI) and transversal condylar inclination(TCI) were obtained from the values of the articulator parameters which were generated in the mandibular movement analysis system.The SCI and TCI were grouped by gender and calculated separately for the two groups and the overall sample; the gender differences in the two parameters and the differences between the mean values of the two parameters and the average value articulator empirical values (35° for SCI and 15° for TCI) for the overall sample were compared. Results: The differences between SCI (35.8°±7.4°) and TCI [11.2° (11.3°)] in males and the corresponding parameters [35.6°±8.3° and 10.8° (9.5°), respectively] in females were not statistically significant (t=0.10, P=0.922; Z=-0.60, P=0.552); the overall sample SCI (35.7°±7.9°) did not differ statistically from the average value articulator empirical value (t=1.23,P=0.221), and the overall sample TCI [10.9° (10.3°)] was significantly smaller than the average value articulator empirical value (W=5 825.00, P<0.001). Conclusions: The mandibular movement trajectory data of 100 adults with individual normal occlusion in this study shows that the gender factor does not affect the setting of the key parameters of the average value articulator, the SCI of the average value articulator empirical values is appropriate, and the TCI has the possibility of being on the large side. In the clinical use of the articulator to assist in the design of restorations, the parameter values should be rationally adjusted according to the actual situation of the patient's dentition and mandibular movement.

Contrasting Patterns of Plants, Bees, Hoverflies and Spiders in Different Habitats in a Central European Agricultural Landscape.

Semi-natural grasslands and their biodiversity decline rapidly, although they are key elements of agricultural landscapes. Therefore, there is a need for the re-establishment of semi-natural grasslands in intensively managed farmlands (e.g., via sowing wildflower seeds). Our knowledge, however, is limited on how different arthropod groups may respond to such newly established wildflower fields. This knowledge gap is especially relevant for the Pannonian biogeographical region, and more generally for Central Europe, where there is little to no evidence so far. We aimed to compare three different habitats (i.e., sown wildflower fields (WFF), semi-natural road verges and adjacent crop fields) in terms of their species and individual numbers and assemblage compositions to reveal differences between primary producers (plants), pollinators (bees and hoverflies) and predators (spiders). We selected eight landscapes in Central Hungary within conventionally managed crop areas. We analysed species and individual numbers by generalised linear mixed models (GLMM) and the assemblage composition with non-metric multidimensional scaling for each taxon in the three habitats. Crop, road verge and WFF habitats had distinct assemblages for each studied group, indicating clear separation among habitats. There are, however, contrasting patterns in the diversity measures of the studied groups. Crop fields are the poorest in both species and individual numbers, road verges harboured the highest abundance of spiders, while WFF had the most bees and plants. No clear pattern for hoverflies emerged. Our results suggest that the studied habitats do not harbour all groups in equal share. We propose that the design of future restorations in Central European farmlands should target a diversity of habitat types needed to support a wide range of functional groups.

Co-creating the design of equitable ecosystem restoration using the voluntary carbon market - six principles

Co-creating the design of equitable ecosystem restoration using the voluntary carbon market - six principles

How Public Urban Space Enhance Restoration Benefits Through Combined Multisensory Effects: A Systematic Review

Rapid urbanization has heightened attention fatigue and physiological stress among urban residents. However, high-density urban construction, mainly covered by streets, squares/plazas, and buildings, in particular, poses a challenge to traditional restoration dominated by green infrasturcture. This research aims to conduct a systematic review of the available body of knowledge regarding the relationship between public urban spaces and restorativeness based on combined multisensory effects. First, a conceptual framework was proposed to connect spatial properties of public realms, sensorial mechanisms, and restoration benefits. As a result, detailed spatial elements and organization affecting multiple sensory modalities combined via additive, antagonistic, and synergistic effects were extracted, which essentially act on urban restoration, including attention, stress, and emotional recovery. Last, but not least, compared with previous research, restoration design strategies of public urban spaces accelerating multisensory integration were drawn to contribute new insights for future high-density urban development.

A Combination of Internal and External Connection Screw-Retained Implant Restorations in Esthetic Zone Rehabilitation: A Case Report

This case report describes the rehabilitation of the Esthetic-Zone of the maxillary jaw of a 70-year-old female patient by using 4 implants (BEGO Semados® RS/RSX) with the challenging position of her implants due to her age and channel access of the Fixtures and also the Difficulty in supplying desired prosthetic parts due to existing problems. In the beginning, the treatment plan was to reconstruct the mouth using conventional restoration with UCLA abutments, but due to the unavailability of non-hex abutments As well as the failure to achieve the desired Esthetic demands of the patient by using this treatment plan, especially in the anterior implant area of the jaw, it Innovatively was decided to use a combination of cylindrical abutments (BEGO MultiPlus system) and UCLA abutments to Design and fabrication of the Final restoration.

Seasonally stable wetted width elucidates freshwater mussel species richness and endangered species presence: implications for T&amp;E management programs and stream restoration design

Centuries of beaver extirpation, deforestation, and other anthropogenic impacts have disconnected North American rivers from their floodplains and concentrated more hydraulic energy within their channels, degrading aquatic habitat and making the streambed more prone to erosion. Rivers naturally adjust via systematic downcutting, bank erosion, channel widening, bar building, and the gradual recovery of geomorphic equilibrium with well‐connected benches that dissipate hydraulic energy and restore a more natural streambed disturbance regime. The life histories of two endangered freshwater mussels, the fanshell (Cyprogenia stegaria) and snuffbox (Epioblasma triquetra), suggest they have evolved to and depend on the natural disturbance regime. Young juveniles excyst from their host fish in early summer, burrow into the top few millimeters of the streambed, and then need ca. 3 months of streambed stability prior to growing large enough to be less vulnerable to streambed mobilization. We propose a conceptual model that suggests a potential prerequisite to supporting fanshell and snuffbox populations is a geomorphically recovering (i.e. at least one stable bank and a wide enough channel corridor for at least partially vegetated bars/benches) or recovered (i.e. stable banks and vegetated benches) channel and floodplain corridor that sufficiently dissipates its hydraulic energy to maintain seasonal streambed stability during typical (non‐hurricane) summer/autumns. To explore this conceptual model, we conducted mussel and geomorphic surveys in a reach of the Rolling Fork River that spanned a range of channel conditions from chronically failing streambanks to a geomorphically recovered channel with wide, vegetated benches. Our analyses documented increasing mussel species richness, including the presence of the endangered fanshell or snuffbox, with increasing width of seasonally stable streambed habitat.