This finite element analysis compared a tissue-level implant with an engaging Ti-base to abutment-free, direct-to-implant, tissue-level configurations (3.7 mm and 4.5 mm platforms; short and long retention screws) to examine how platform width and screw length influence stresses under axial and oblique loads. Five configurations were modeled with identical materials and boundary conditions. Screw preload corresponding to a tightening torque of 35 N·cm was applied in the first step, followed by either a 400 N axial load or a 300 N at 30°. Oblique loading dominated the mechanical response, increasing stresses relative to axial loading and concentrating them at the implant neck and first thread, as well as at the crown screw-access and antirotation regions. Under oblique loads, the 3.7 mm platform implant showed the highest stresses, whereas the 4.5 mm platform implant was comparable to or slightly less stressed than the Ti-base configuration, whose peaks remained confined to a small internal recess. Crown stresses remained localized around the antirotation features, while the composite layer bore negligible load. Within the limitations of this numerical model, abutment-free, direct-to-implant workflows may achieve biomechanical performance comparable to Ti-base solutions if platform and screw selection are aligned with the occlusal scheme, but ISO-style fatigue testing and experimental or clinical validation are required.

Despite high rates of long-term survival of dental implants, the success of orthopedic rehabilitation is determined by a complex interaction of biological, biomechanical and iatrogenic factors. The purpose of the systematic review is to perform a critical analysis of current data (for the period 2016-2025) on risk factors affecting long–term outcomes of implant-based treatment. The role of bone quality and volume, soft tissue biotype and general somatic status of the patient (diabetes mellitus, osteoporosis and smoking) were analyzed. Biomechanical aspects are considered in detail, including the influence of cantilever elements, passivity of the frame adaptation and the occlusion scheme on load distribution in the implant-bone-prosthesis system. Special attention is paid to the pathogenesis and risk factors of peri-implant diseases (mucositis and peri-implantitis), as well as modern approaches to bone grafting using osteoplastic materials. The review demonstrates that minimizing the risks and achieving predictable long-term results are possible only upon condition of comprehensive, prosthesis-oriented planning and interdisciplinary interaction at all stages of treatment.

Background:Temporomandibular joint (TMJ) disorders are commonly observed in edentulous patients, potentially exacerbated by improper occlusal schemes in complete dentures. Various occlusal concepts, including balanced occlusion, lingualized occlusion, and monoplane occlusion, are used in prosthodontics, each claiming advantages in preserving TMJ health.Materials and Methods:A total of 60 completely edentulous patients aged between 50 and 75 years were selected and randomly divided into three groups (n = 20) based on the occlusal scheme: Group A – Balanced Occlusion, Group B – Lingualized Occlusion, and Group C – Monoplane Occlusion. All patients received new maxillary and mandibular complete dentures fabricated using conventional techniques. TMJ health was assessed at baseline, 3 months, and 6 months post-insertion using Helkimo’s Clinical Dysfunction Index and patient-reported outcomes on pain and joint sounds.Results:At the 6-month follow-up, Group A showed minimal TMJ symptoms with a mean dysfunction index score of 0.8 ± 0.5, compared to 1.2 ± 0.6 in Group B and 2.1 ± 0.7 in Group C. Joint sounds and pain were reported in 10% of patients in Group A, 15% in Group B, and 35% in Group C. Statistical analysis revealed significant differences between the groups (P < 0.05), favoring balanced occlusion for TMJ stability.Conclusion:Balanced occlusion in complete dentures appears to better maintain TMJ health compared to lingualized and monoplane schemes. It minimizes joint dysfunction symptoms and improves patient comfort over time.

Restorative correction of a moderate to severe malocclusion puts both the dentist and patient at a higher subjective risk regarding biologic and occlusal parameters. Without the use of orthodontics or orthognathic surgery, the prosthodontic demands on misaligned abutments can be significant. However, the use of logical force management concepts can deliver a biomechanically stable result. Some of these include accurately recording a repeatable condyle position, distributing non-axial occlusal forces evenly, adding length and buccal volume in a 1:1 ratio, and testing the new occlusal scheme for a considerable time before finalization. The present case report describes an alternative treatment route to rehabilitate a patient who declined orthodontic therapy after several specialist consultations. In summary, our expedition involved orthopedic repositioning of the condyles into an airway centric relation, increase in the vertical dimension of occlusion, autorotation of the mandible, buccalization of the maxillary arch, lingualization of the mandibular arch, dentoalveolar decompensation, diastemata closure, and prosthetic soft tissue camouflage.

Background: It has been suggested that occlusal trauma during eccentric movements may be an etiological factor in developing non carious lesions(abfractions). Objective: The objective of the study was to investigate the association between premature contacts during eccentric movements, guidance type, and development of non-carious lesions (NCCLs), while also assessing the impact of demographic factors (age and gender) on lesion formation. Methodology: A total of 100 patients of both gender attending to the clinic for prosthetic treatment were included. Minimum 2 lesions per dentition were selected so 100 participants providing a total sample of 200 teeth. Abfractions per dentition with the depth of at least 1 mm were selected and their and sizes were noted. Size of abfraction was noted using Smith &amp;Knight Tooth Wear Index. 0=tooth contour unchanged, 1=minimum loss of enamel contour, 2= defect less than 2mm in depth, 3= defect between 1-2mm deep, 4=&gt;2mm deep or pulp exposure/secondary dentine. Premature contacts in eccentric guidance were recorded. Number of premature contacts from 0; no contact to 3 i.e., maximum contacts were checked. Number of abfractions from 1 to 6 per dentition were checked. Results: Out of 200 abfraction lesions maximum teeth were having no premature contacts 61.5% followed by 19.5% with 1 premature contact. Maximum number of 4 abfractions per dentition was frequently found 50.0% followed by 3 abfractions 19.0%, only 3.0% teeth had 6 abfraction lesions. The association of development of number of abfraction lesions with premature contacts and age was significant; P &lt;0.05. The type of occlusal scheme (the canine guidance and group function) and gender had insignificant association with the number of developed abfraction lesions; p&lt;0.05. Conclusion: Premature occlusal contacts and increase of age plays a significant role in the development of abfraction lesions, whereas the type of occlusal scheme and gender, do not appear to have substantial affect.

Dental implant-supported crowns have become the standard of care for replacing missing teeth due to their predictable outcomes and high success rates. As a result, they become a routine treatment in dental practice, necessitating a thorough understanding of implant restoration principles and maintenance. However, long-term implant survival is significantly influenced by the forces exerted on the implant restoration. Excessive occlusal forces beyond the physiological limits of the bone can lead to crestal bone loss, peri-implantitis, and increased pocket depth. The objectives of this study is to assess the occlusion contact, cuspal inclination, table width of posterior implant-supported single crowns, and its impact on bone loss around the implant among patients treated by King Saud University fifth year undergraduate students between 2020 and 2022 at the Dental University Hospital Clinics, King Saud University. Analysis of the examined (n=8 patients), indicates the majority of implant crowns did not adhere to the recommended standards for prosthetic single implant-supported crown design, specifically regarding table width, cuspal inclination, and occlusal contact. Notably, no clear evidence of bone loss was observed in the examined patients. A significant number of implant crown placed by dental students in this study exhibit deviation from recommended prosthetic design. This highlight a potential area for improvement in students training and clinical practice related to single-implant restoration. However, no definitive bone loss was observed around implant during the short-term period. Therefore, further studies are needed to re-evaluate these findings over the long term for confirmation.

Background: While dental implants have become a reliable solution for tooth loss, their long-term success is increasingly challenged by biological and technical complications such as impact fracture and peri-implantitis. These complications significantly impact implant longevity and patient satisfaction. Aim: This consensus conference aimed to identify and standardize clinical guidelines to prevent implant fractures and peri-implant diseases based on current evidence and expert opinions. Methods: A panel of 10 expert clinicians and researchers in prosthodontics participated in the Osstem Global Consensus Meeting. This paper focuses on the prosthetic division. A structured literature review was conducted, and evidence was synthesized to formulate consensus-based clinical recommendations. Participants answered structured questions and discussed discrepancies to achieve consensus. Results: The panel reached consensus on several key prosthetic risk factors, including (1) the role of biomechanical overload in implant fracture, (2) the impact of emergence profile design on peri-implant tissue stability, (3) the influence of implant positioning and connection geometry on marginal bone loss, and (4) the importance of occlusal scheme and restorative material selection, particularly in high-risk patients such as bruxers. Guidelines to prevent implant fracture and peri-implantitis were developed, addressing these factors with practical preventive strategies. Conclusions: Despite the limitations of narrative methodology and reliance on retrospective data and expert opinion, this consensus provides clinically relevant guidelines to aid in the prevention of mechanical failures and peri-implant diseases. The recommendations emphasize prosthetically driven planning, individualized risk assessment, and early intervention to support long-term implant success.

Prevalence of canine guidance or group function guidance in the Jordanian population.

Traditional jaw relation recording techniques like the Twin Tables Technique and the Twin-Stage Technique have to be critically examined in light of the advancement of prosthodontic workflows through digital technologies, especially CAD/CAM systems. These methods, which were initially created to guarantee exact orientation and vertical dimension control in full-mouth rehabilitations, provide consistent results in condylar guiding simulation and occlusal plane establishment. The applicability and validity of these strategies in digital processes are reviewed in this abstract. The conceptual underpinnings of both approaches can be successfully digitalized through the use of virtual articulators, intraoral scanners, and digital facebow surrogates, as evidenced by emerging literature and clinical protocols. Custom software-driven occlusal schemes partially replicate the Twin Tables Technique, which focusses on dual-plane occlusal guiding. In the meantime, occlusal design modules in digital prosthodontics can be used to modify the Twin-Stage Technique's structured sequence for anterior and posterior tooth arrangement. The basic biomechanical concepts of these procedures are still applicable, notwithstanding certain limits in direct translation brought on by their analog-centric beginnings. Efficiency, reproducibility, and standardization are improved through integration into digital operations. For these methods to be smoothly included into digital full-arch and full-mouth rehabilitation regimens, more clinical validation and innovative software are required.

Background: Mandibular movement is inherently complex, involving both lateral and vertical components. In older adults, this complexity is compounded by diminished neuromuscular coordination and reduced proprioceptive feedback, often impairing effective mastication. Objectives: This study aimed to review dental literature on the influence of masticatory parameters in the formation of wear facets on acrylic resin denture teeth. Methods: A targeted literature review was conducted, analyzing peer-reviewed studies from 1991 to 2024 through PubMed and Scopus. The review focused on masticatory parameters, age-related neuromuscular adaptations, chewing patterns, and preferred-side denture tooth wear, affecting older adults using complete removable dentures. Results: Mandibular movement characteristics—particularly velocity, duration, and cycle frequency—were found to significantly influence denture tooth wear, often resulting in reduced bite force and masticatory efficiency. Contemporary denture materials demonstrated improved wear resistance, aiding in the regulation of chewing frequency and velocity. These factors are increasingly important as age-related changes impact the stomatognathic system. Notably, wear facets were most prominent on the maxillary first molars, regardless of the occlusal scheme. Conclusions: This review provided a comprehensive overview of existing research, analyzed current evidence, and offered insights into the role of masticatory function and wear characteristics in older complete denture wearers.

Aim: To evaluate and analyse the combined prosthodontic and periodontic factors that contribute to the long-term success, stability, and functionality of dental implants, with an emphasis on interdisciplinary treatment planning, execution, and maintenance. Method: A prospective clinical study was conducted on 100 patients, each receiving dental implant therapy over a period of 12 months. A total of 150 implants were placed. Periodontic parameters including keratinized gingiva width, bone quality (Type I–IV), and history of periodontitis were recorded preoperatively. Prosthodontic parameters including implant positioning, prosthesis retention type (screw vs. cement-retained), occlusal scheme, and crown material were evaluated post-restoration. Clinical and radiographic assessments were performed at baseline and at 3, 6, and 12 months post-placement. Implant success was defined based on Albrektsson’s criteria and absence of complications such as peri-implantitis, mobility, or significant bone loss. Statistical analysis was conducted using Chi-square and independent t-tests with significance set at p &lt; 0.05 Result : Out of 150 implants placed, 142 (94.6%) were deemed successful after 1 year. A higher success rate was observed in patients with ≥2 mm keratinized mucosa (97.1%) and good bone quality (Type I/II: 96.7%). Patients with a history of periodontitis had a reduced success rate of 89.7%, compared to 97.5% in periodontally healthy patients (p &lt; 0.05). Prosthodontically, screw-retained prostheses showed a higher success rate (96%) than cement-retained (91%) (p = 0.048). Implants with ideal 3D positioning and mutually protected occlusion demonstrated significantly better outcomes. No statistically significant difference was noted between zirconia and PFM restorations (p &gt; 0.05). Complications included peri-implant mucositis (6.7%), peri-implantitis (5.3%), and prosthetic issues such as screw loosening (4%). Conclusion : The success of dental implants is significantly influenced by both periodontic and prosthodontic factors. Adequate keratinized mucosa, optimal bone quality, and absence of prior periodontal disease enhance implant survival, while prosthodontic precision—including ideal implant positioning, screw-retained prostheses, and proper occlusal design—further contributes to favourable outcomes. A multidisciplinary, prosthetically driven approach is essential for maximizing implant longevity and minimizing complications

Introduction. Gnathology, as a branch of dentistry, studies the relationships between the structural and functional elements of the dento-maxillary system, including the temporomandibular joints, muscles, teeth, and periodontium. This discipline is fundamental to achieving functional harmony and aesthetics in orthopedic treatment. The objective of this study is to analyze and summarize scientific research based on available sources that explore the role of occlusal schemes in orthopedic treatment and the necessity of integrating gnathological principles into orthopedic dentistry. This integration aims to enhance the quality of orthopedic prosthetic structures. Materials and methods. A literature search was conducted using the PubMed electronic database to identify studies related to gnathology and the role of occlusal schemes in orthopedic treatment. Bibliosemantic and analytical methods were applied. The search terms used included “gnathology” and “occlusion scheme”. Results. A critical review of the available literature indicates that gnathology is a branch of dentistry that focuses on the study of the relationships between teeth, jaws, muscles, and joints and examines how these elements work together during such important functions as chewing, swallowing, and speech. Recent research demonstrates the need to integrate gnathological principles into prosthetic dentistry. That is, to show that successful prosthetics is not limited to restoring the aesthetics of a smile, but requires a comprehensive approach that takes into account the functional aspects of the dentofacial system. Various occlusal schemes used in prosthetic dentistry have their own advantages and disadvantages. The choice of the optimal option depends on many factors, including the individual characteristics of the patient, the state of his dentofacial system, and the clinical situation. Conclusion. Integration of modern occlusal schemes into orthodontic treatment is critical to achieving functional and aesthetic outcomes.

Aim:To evaluate masticatory efficiency and nutritional status prior and subsequent to a full mouth rehabilitation therapy. Materials and Methods:The study followed the CONSORT guidelines and was a prospective clinical trial. This trial was conducted on ten patients who were undergoing full mouth rehabilitation. Masticatory efficiency was calculated before the start and 1 month post completion of rehabilitation where the subjects were given 9 grams of peanuts (3 grams - 3 times). The participant was instructed to complete 40 chewing strokes. The masticated food was subsequently collected in a disposable container. Additionally, the participant rinsed their mouth with water twice, and the resulting rinsate was combined with the chewed food in the same disposable container. Following thorough mixing of the chewed food using a glass rod, the mixture was strained through a 10 mesh sieve. This specific test serves the purpose of quantitatively assessing the chewed food. The strained liquid, referred to as the filtrate, was then carefully transferred into tubes and subjected to centrifugation at 3000 revolutions per minute for a duration of 5 minutes. This centrifugal process effectively separated the filtrate into two distinct components: a solid pellet and a liquid supernatant. The supernatant, or the liquid portion, was subsequently discarded, while the pellet, or the solid residue, was weighed using a digital scale. In this study, masticatory performance was quantified according to the methodology proposed by Yurkstas and Manly. This evaluation encompassed assessing particle size, as determined by the size of the sieve employed, by calculating the ratio of the weight of the test food that passed through the sieve to the total weight of the test food that was recovered. This ratio was then expressed as a percentage. The initial wet weight of the materials was computed as the starting point for these calculations. The specimens were then placed in a hotair oven at 40℃ for 8 hours and again the dry weights were measured. Fasting venous blood samples from each participant were collected for means of measuring hemoglobin, total serum calcium, total serum protein, and total cholesterol levels as indicators of nutritional status. The tests were carried out at similar intervals as chewing efficiency. Results:All of the patients showed a statistically significant improvement in masticatory efficiency post full mouth rehabilitation (p &lt;.001) which was calculated with Yurkstas and Manly formula. There was no significant relationship between age, gender and occlsal scheme provided to the masticatory efficiency pre and post FMR. Paired sample t test revealed that haemoglobin, total serum protein and total ionic calcium showed a significant improvement post full mouth rehabilitation at 1 month follow up (p&lt;0.05). There was no statistically significant difference in cholesterol values. Conclusion:We can conclude that full mouth rehabilitation leads to a notable increase in masticatory efficiency. A significant improvement in nutritional status was also seen post completion of therapy. There was no influence of age, gender and occlusal scheme on chewing efficiency

What occlusal scheme should be used for tooth-supported fixed partial dentures?

Automatic adjustment of dental crowns using Laplacian mesh editing.

To assess the effect of occlusion and implant number/position on stress distribution in Kennedy Class II implant-assisted removable partial denture (IARPD). IARPDs were designed in six models: with one implant (bone level with a platform of 4 mm and length of 10 mm) at the site of (I) canine, (II) between first and second premolars, (III) first molar, (IV) second molar, or two implants at the sites of (V) canine-first molar, and (VI) canine-second molar. A conventional RPD served as control. Loads were applied according to the group function (GF) (500N load was applied to the left canine/premolar/molar teeth in the ratio of 1:1:2) or canine guidance (CG) (125N load was to the canine tooth) occlusions. Maximum displacement and Von Mises Stress in different components were analyzed by finite element analysis (FEA). The control model showed the highest displacement followed by the IARPD with a canine implant in both occlusal schemes. In GF, the maximum and minimum jaw stress were recorded in IARPDs with canine implants (16.45 MPa) and canine-first molar implants (13.47 MPa), respectively. In CG, the maximum and minimum jaw stress was recorded in IARPD with first/second premolar implant (15.91 MPa) and canine-first molar implants (12.38 MPa), respectively. The highest stress in resin, framework, and implant(s) was noted in IARPD with canine implant in both schemes. The lowest stress in the implant(s) was recorded in IARPD with canine-second molar implants in GP and IARPD with canine-first molar implants in CG. Dental implants reduced the total displacement of IARPDs, increased stress in mechanical components, and did not affect stress distribution in biological components. Insertion of two implants decreased implant stress. The GP scheme caused greater stress on mechanical components.

Objectives: Biomechanical behavior analysis of the periodontal ligament (PDL) under various loading conditions is essential for understanding the impact of occlusal force distribution. A comprehensive understanding of this aspect is fundamental, and radiographic examination is a crucial modality for evaluating periodontal health. This review aims to illustrate the role of radiographic examination in influencing dental prognosis through the use of Finite Element Analysis (FEA) to assess occlusal load and stress distribution in PDLs. Review: Radiographic imaging techniques are critical for assessing the extent of occlusal trauma and its impact on the periodontal ligament and surrounding structures. Modalities such as conventional radiography, cone-beam computed tomography (CBCT), and micro-computed tomography (micro-CT) are commonly used to evaluate occlusal load. Studies have demonstrated that a balanced occlusal scheme results in a more uniform stress distribution, while an unbalanced scheme leads to localized stress concentrations, increasing the risk of periodontal damage. FEA has emerged as a powerful tool for simulated and visualizing stress patterns in the PDL and quantitatively calculating stresses and deformations in the periodontium. Technological advances in imaging, when applied in conjunction with finite element computational techniques, have shown that oblique loading results in higher stress concentrations compared to vertical loading, particularly in the PDL of mandibular first molars. These higher stresses, often observed in the cervical and apical regions, highlight the potential for more significant PDL damage, making it useful for evaluating bone loss and PDL integrity. for eligibility and completeness of journals. Conclusion: Integration of advance radiographic imaging with FEA has significantly enhanced the understanding of occlusal load and stress distribution in the periodontal ligament. This advancement has propelled the field of periodontal biomechanics, offering very valuable insights into PDL’s biomechanical behavior as it responds to varying occlusal loads, to optimize outcomes in periodontal and orthodontic care.

ObjectiveThis study aimed to evaluate the use of a stainless-steel fixed retainer for post-orthodontic retention in patients with labiolingual alveolar bone resorption in the mandibular anterior segment.MethodsThree mandibular anterior segment models (with or without labial or lingual alveolar bone resorption) with 0.5-mm-diameter retainers bonded to all teeth were constructed. Two occlusion schemes were simulated a 285.3 N force applied to four mandibular incisors (incisor biting) and a 93 N force applied to the left canine (laterotrusion). The tooth displacement and stress distribution in the periodontal ligament (PDL), retainer, and composite were evaluated.ResultsCompared to no resorption, labial bone resorption significantly increased tooth displacement and PDL stress concentration in the central incisors during incisor biting, whereas lingual resorption had a greater effect on the guiding canine during laterotrusion. The retainers were susceptible to stress concentrations in the resin-uncovered area, mesial region of the lateral incisors under incisor biting, and mesial region of the guiding canine under laterotrusion. For the composite, the composite–retainer interface was prone to stress concentrations, especially in the mesial or distal extremes of the adhesive composite of the incisors.ConclusionsA 0.5-mm-diameter stainless-steel lingual retainer bonded on all teeth is a clinically acceptable retention procedure for patients with lingual bone resorption in the lower anterior region. However, it should be used more cautiously for patients with labial bone resorption as it exposes the lower central incisors to a greater risk. Excessive stress on the retainer and composite due to the occlusion force may lead to unwanted tooth movement, necessitating closer monitoring.

ObjectiveThis study aimed to assess the occlusal contact area (OCA), occlusal contact number (OCN), bite force, and artificial tooth wear in complete dentures with lingualized and bilateral balanced occlusion.MethodsEdentulous participants who fulfilled the inclusion criteria were divided into the three groups as follows: group I, dentures with lingualized occlusion using interpenetrating polymer network artificial teeth; group II, dentures with lingualized occlusion using double cross-linked artificial teeth; and group III, dentures with bilateral balanced occlusion using anatomical micro-hybrid resin teeth. The silicone techniques were used to assess the OCA and OCN of the mandibular dentures and the Dental Prescale II was used to evaluate the bite force at the 2-week, 3-month, and 12-month follow-up visits. Occlusal contact analyzer software was used to assess the maxillary and mandibular posterior tooth wear at the 12-month follow-up visit. All data was analyzed using the SPSS software.ResultsThe OCA of group III was significantly higher than that of groups I and II at the 2-week follow-up visit, whereas group I was considerably higher than groups II and III at the 3-month and 12-month follow-up visits. The OCN of the three groups exhibited significant differences at all three follow-up visits. Groups I and II had significantly lower bite force than Group III at the three follow-up visits. At the 12-month follow-up visit, groups I and II had significantly higher wear than Group III.ConclusionsAs the duration of use increases, the occlusal contact area of complete dentures increases, regardless of the occlusal schemes. The bite force of lingualized occlusion is typically lower than that of bilateral balanced occlusion. The wear locations of artificial teeth differ between the two types of occlusal schemes. (Retrospectively registered: The Chinese Clinical Trial Registry, No. ChiCTR2300073420(11/07/2023))

The maxillary and mandibular canines are described by many clinicians as the "cornerstone" of the arch. When in their optimal position, they play a critical role in providing a well-balanced occlusal scheme that contributes toward functional as well as neuromuscular stability, harmony, esthetics, and dentofacial balance. When an aberration is noted with the normal eruptive and development process, early diagnosis with strategic intervention is critical and may often require a multidisciplinary approach. A proper diagnosis, risk assessment, and management of the soft tissues, hard tissues, and adjacent structures are vital for a successful outcome. This review highlights the diagnostic and treatment modalities that require consideration for the orthodontic as well as the periodontal management of impacted canines. The reader is guided through the etiology, diagnosis, prevention, and intervention of clinical cases that were managed with different approaches.