The aim of this paper is to present a technique to individualize root canal localization in teeth with calcified root canals using a digitally planned, 3D-printed endodontic guide. Root canal calcification is characterized by the apposition of tertiary dentin along the canal wall. The endodontic treatment of teeth with calcified canals is often challenging. However, digital dentistry meets these challenges. Merging CBCT images with an intraoral scan allows a clinician to prepare an endodontic guide. This article describes the clinical and digital workflow of the guided endodontic access approach in teeth with difficulties in terms of root canal localization due to post-traumatic pulp canal obliteration (PCO) and canal calcification in elderly patients. The path of entry into the root canal system was planned using cone-beam computed tomography (CBCT). The template was printed on a 3D printer using transparent resin. During root canal treatment (RCT), the endodontic tool was inserted through the sleeve until the desired location was reached. The use of an endodontic guide allowed for minimally invasive RCT, avoiding the excessive loss of tooth structures. Navigated endodontics enables clinicians to perform RCT in a more predictable manner and allows clinicians to avoid iatrogenic complications, which improves the treatment prognosis.

Implant abutments are essential components of implant prosthetic restorations. The golden standard for abutment material is titanium; however, due to its properties, the esthetic result can be compromised. The most popular esthetic material alternatives are one- and two-piece zirconia. The study aimed to answer the questions of whether zirconia abutments can be used interchangeably with titanium in both anterior and posterior regions and how aging of the abutment affects durability. For this study, an electronic search of MEDLINE (PubMed) and Scopus (Embase) was conducted. The PRISMA guidelines were followed, and a systematic review was registered with PROSPERO. The search revealed 4031 results, of which 17 studies were selected. The strongest material for abutments is titanium, closely followed by two-piece zirconia. One-piece zirconia abutments were the weakest. The cyclic loading above 1,000,000 cycles decreased the fracture resistance of the abutments. Differences in implant diameter, angulation, and restoration affected the fracture strength of all compared materials. The main mode of failure for titanium abutments was screw bending or screw fracture. One-piece zirconia most often presented catastrophic failure with internal hexagon fracture below the implant neck. Two-piece zirconia exhibits a combination of failure modes. Two-piece zirconia abutments may be suitable for use in the posterior region, given their comparable fracture resistance to titanium abutments. Despite the fact that one-piece zirconia is capable of withstanding forces that exceed those exerted during mastication, it is recommended that it be employed primarily in the anterior dentition due to its propensity for unfavorable failure modes.

The aging global population poses new challenges to healthcare systems, including dental healthcare. This study analyzes the evolution of dental status within the aging population of Poland over the last pre-pandemic decade. The goal of the study was to examine changes in dental health among Poland's aging population, with a specific focus on edentulism, partial tooth loss and functional dentition. Furthermore, the study aimed to evaluate the influence of sociodemographic factors on oral health, assess the effectiveness of public health initiatives, and identify persistent inequities in oral health. The study utilized data from 2 representative population-based studies: the PolSenior (PS) (2008-2009); and the PolSenior2 (PS2) (2018-2019). The comparative analysis involved 4,773 (PS) and 4,627 (PS2) Polish adults aged more than 65 years. The participants were categorized based on the number of teeth present (0 - edentulism, 1-19 - partial tooth loss, ≥20 - functional dentition) and analyzed for various factors, including age, sex, education level, and place of residence. The dental status of Polish older adults has improved over the past decade, with the prevalence of edentulism decreasing from 45.8% to 36.1%, and the proportion of individuals with functional dentition increasing from 6.0% to 15.0%. The prevalence of edentulism dropped from 49.4% to 40.5% among women and from 40.3% to 29.3% among men, while functional dentition increased 2.5-fold in both sexes. The most significant improvements were observed among the youngest seniors, with a reduction in edentulism and an increase in functional dentition. The findings of this study indicate a notable improvement in dental status of Polish older adults, as evidenced by a decline in the prevalence of edentulism and an increase in functional dentition. The research underscores the persistent disparities related to basic needs in relation to sociodemographic factors in dental treatment.

Background: Malnutrition and its risk are prevalent in older adults and contribute to frailty, morbidity, and mortality. Poor oral health—particularly tooth loss and inadequate prosthetic rehabilitation—may impair chewing, limit dietary variety, and accelerate nutritional decline. We investigated associations between dentition status, denture use, and nutritional status in a nationally representative sample of Polish older adults. Methods: We analyzed data from 5214 participants aged ≥60 years from the nationwide cross-sectional PolSenior2 study. Dentition status was classified as functional dentition (≥20 teeth), partial dentition (1–19 teeth), or edentulism (0 teeth). Nutritional status was assessed using the Mini Nutritional Assessment—Short Form (MNA-SF); impaired nutritional status was defined as MNA-SF <12 (malnourished or at risk). Additional indicators included hypoalbuminemia (<35 g/L) and small calf circumference (<31 cm). Associations were tested using chi-square and multivariable logistic regression adjusted for age, sex, education, and place of residence. Results: Functional dentition was present in 15.5%, partial dentition in 48.1%, and edentulism in 36.4% of participants. The proportion of edentulous individuals increased across worsening MNA-SF categories (26.2% in well-nourished, 41.8% in at risk, 46.9% in malnourished). In adjusted models, edentulism was associated with higher odds of impaired nutritional status compared with functional dentition (OR: 1.66; 95% CI: 1.32–2.10; p < 0.001), while partial dentition showed a non-significant trend (OR: 1.22; 95% CI: 0.98–1.52; p = 0.077). Among edentulous participants, denture use was more common in well-nourished individuals than in those with impaired nutritional status (93.0% vs. 77.2%), suggesting a possible association between active prosthetic rehabilitation and better nutritional status. Conclusions: In Polish older adults, tooth loss—particularly edentulism—is associated with poorer nutritional status. Screening for malnutrition risk may benefit from incorporating basic oral health and denture-use assessment while improved access to prosthetic rehabilitation may support nutritional resilience in ageing populations.

Background: An accurate determination of the biological width and the relationship of the cemento-enamel junction with the border of the alveolar bone is crucial during a clinical crown-lengthening (CCL) procedure. The aim of this study was to present a technical note about the retraction techniques in cone beam computed tomography (CBCT) prior to CCL, highlighting the significant enhancement in procedural accuracy and predictability that these techniques offer. Methods: Clinical and radiological examinations should be performed before a CCL procedure. It is necessary to determine the length of the tooth crowns, the periodontal pockets’ depth, and the phenotype of the gingiva. The ideal CBCT examination should be performed with soft tissue retraction. This can be achieved using retractors or cotton rolls. Results: Retraction of the lips, cheeks, and tongue allows one to assess the marginal gingiva, the cemento-enamel junction, and the alveolar bone. A detailed plan of the CCL procedure, which involves retraction, ensures both the aesthetic appeal and the achievement of a newly defined gingival zenith, enhancing the overall visual harmony. Conclusions: Compared with conventional radiographic imaging, the soft tissue retraction maneuver in CBCT prior to CCL surgery offers an effective approach to the evaluation and diagnosis of soft and hard tissue. This is because of the detailed planning of the aesthetic CCL procedure. Such an approach leads to superior aesthetic outcomes in dentistry, contributing to the advancement of aesthetic dentistry through a harmonious blend of art and science.

Tooth loss significantly affects health and quality of life of older adults. Removable dentures are the most common solution for restoring oral function and aesthetics. In Poland, a significant portion of elderly population suffers from edentulism or partial tooth loss. However, not all of these individuals receive the prosthetic treatment they need. The measurement of unmet denture needs, defined as the proportion of individuals with tooth loss who lack appropriate dentures, offers critical insight into disparities in the access to oral healthcare. The aim of the study was to compare changes in unmet denture needs among Polish seniors over a decade and to assess patterns in denture use among those who received prosthetic treatment, taking into account sociodemographic factors such as sex, age, education, place of residence, and financial status. The present study analyzed data from 2 nationally representative crosssectional surveys, PolSenior (2009) and PolSenior2 (2019), comprising 4,712 and 4,075 participants aged ≥65 years, respectively. The individuals were categorized based on their dental status, denture use and sociodemographic characteristics. Unmet denture need was defined as the absence of complete or partial dentures among individuals with edentulism or partial tooth loss. The χ2 test and age standardization were implemented for the purpose of the statistical analysis. The level of significance was set at p < 0.05. The proportion of edentulous and partially dentate individuals without dentures decreased from 19.4% in 2009 to 12.3% in 2019. The most pronounced improvements were noted among women, urban residents and individuals aged 85 years and older. Despite these gains, disparities by sex, place of residence, education level, and financial status persisted. Among individuals who owned dentures, denture use remained consistently high in both survey waves, exceeding 94%, with no significant differences between the study periods. The unmet need for dentures among Polish seniors has decreased over time, indicating an improvement in the accessibility to prosthetic care. However, sociodemographic disparities remain, highlighting the necessity for targeted public health strategies aimed at mitigating barriers to dental rehabilitation. The high rates of denture use confirm the enduring functional and psychosocial value of prosthetic treatment in older populations.