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Alic Z, Vaskovich T, Franz A, Lettner S, Moritz A, Watts DC, Schedle A. Do strength of zirconia-abutment-interfaces depend on cement, zirconia type and titanium abutment dimensions? Dent Mater 2024:S0109-5641(24)00082-4. [PMID: 38734486 DOI: 10.1016/j.dental.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 04/17/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES Part 1 of this study investigates the influence of zirconia types, chimney heights, and gingival heights on the strength of the zirconia-abutment-interface. Part 2 extends the analysis to include adhesive brands and macro-retentions. METHODS In Part 1, the study utilized three zirconia types (700 MPa, 1000 MPa, 1200 MPa) to fabricate 234 screw-retained zirconia crowns with varying chimney heights (3.5 mm, 4.1 mm, 5 mm) and gingival heights (0.65 mm, 1.2 mm, 3 mm) of the titanium abutments. All adherend surfaces underwent sandblasting with aluminum oxide before cementation with a specific resin cement. In Part 2, the investigation of 240 screw-retained zirconia crowns focused on a single zirconia type (1000 MPa) with chimney heights of 3.5 mm and 5 mm and a gingival height of 0.65 mm of the titanium abutments, cemented with three different resin cements. All adherent surfaces underwent sandblasting with aluminum oxide before cementation, whereas 120 out of 240 abutments received additional macro retentions. Storage in water at 37 °C for 24 h preceded the tensile test. RESULTS The study revealed a substantial impact of chimney height and zirconia type on the bond strength of the zirconia-abutment-interface. Neither adhesive brands nor macro retentions significantly impacted the bond strength. Fracture incidence was significantly influenced by gingival height and zirconia type in part 1, whereas in part 2 smaller chimney heights correlated with a higher fracture incidence. SIGNIFICANCE This study contributes insights into the complex interplay of factors influencing the zirconia-abutment-interface. The results provide a foundation for refining clinical approaches, emphasizing the importance of chimney height and zirconia type in achieving successful anterior gap implant restorations.
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Affiliation(s)
- Zumreta Alic
- University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Tom Vaskovich
- University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Alexander Franz
- University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Stefan Lettner
- University Clinic of Dentistry, Medical University of Vienna, Austria
| | - Andreas Moritz
- University Clinic of Dentistry, Medical University of Vienna, Austria
| | - David C Watts
- School of Medical Sciences and Photon Science Institute, University of Manchester, Manchester, UK
| | - Andreas Schedle
- University Clinic of Dentistry, Medical University of Vienna, Austria.
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Thoma DS, Haas R, Sporniak-Tutak K, Garcia A, Taylor TD, Tutak M, Pohl V, Hämmerle CHF. Randomized controlled multi-centre study comparing shorter dental implants (6 mm) to longer dental implants (11-15 mm) in combination with sinus floor elevation procedures: 10-year data. J Clin Periodontol 2024; 51:499-509. [PMID: 38296249 DOI: 10.1111/jcpe.13954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/27/2023] [Accepted: 01/12/2024] [Indexed: 03/16/2024]
Abstract
AIM To compare implant survival and complication rates between shorter and standard-length implants with sinus augmentation and restored with single crowns, at 10 years of loading. MATERIALS AND METHODS One-hundred and one patients (137 implants) with a ridge height of 5-7 mm in the posterior maxilla were randomly assigned to two treatment modalities: shorter implants (6 mm) (group short [GS]) or standard-length implants (11-15 mm) with sinus grafting (group graft [GG]). Following the insertion of final restorations, patients were regularly recalled for up to 10 years. Assessed outcomes encompassed implant survival, marginal bone levels (MBLs), biological and technical parameters and patient-reported outcome measures (OHIP-49 = Oral Health Impact Profile). Non-parametric statistical analysis was used to analyse the data. RESULTS For the 5- to 10-year follow-up period, 77 patients with 105 implants (GS: 36 patients/48 implants; GG: 41/57) were available for re-examination (drop-out rate 21%). Implant survival rates at the patient level were 96.0% (GS; 2 failures) and 100% (GG) (inter-group p = .24). Median MBLs amounted to 0.00 mm (min 0.00; max 3.25; GS) and 0.00 mm (min 0.00; max 4.55; GG) (inter-group p = .73). Technical complications predominantly occurred within the first 5 years (inter-group p > .05). Peri-implantitis rates were 4.2% (GS) and 13.3% (GG) (intergroup p = .37). Median OHIP-49 scores were 7.00 (0.00; 39.00; GS) and 9.00 (0.00; 196; GG) (inter-group p = .61) at 10 years. CONCLUSIONS Based on similar 10-year implant survival rates, reduced patient morbidity and lower costs, the use of shorter dental implants might well serve as an alternative treatment concept to longer implants placed in conjunction with sinus grafting for patients with a limited ridge height in the posterior maxilla. Study register: https://clinicaltrials.gov/ct2/show/NCT01030523.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Reconstructive Dentistry Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Robert Haas
- Akademie für Orale Implantologie, Private Practice, Vienna, Austria
| | | | - Abel Garcia
- University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Marcin Tutak
- Aesthetic Dent, Private Practice, Szczecin, Poland
| | - Veronika Pohl
- Akademie für Orale Implantologie, Private Practice, Vienna, Austria
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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Potdukhe SS, Iyer JM, Nadgere JB. Evaluation of marginal bone level, technical and biological complications between screw-retained and cement-retained all-ceramic implant-supported crowns on zirconia abutment: A systematic review and meta-analysis. J Indian Prosthodont Soc 2024; 24:25-35. [PMID: 38263555 PMCID: PMC10896314 DOI: 10.4103/jips.jips_524_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/25/2024] Open
Abstract
PURPOSE The purpose of this study was to evaluate the difference in marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment at different follow-up periods. MATERIALS AND METHODS Independent search was conducted in Cochrane Library, EBSCO, and PubMed/PubMed Central/MEDLINE databases and the Google Scholar search engine for prospective studies and randomized controlled trials published between January 2014 and June 2023 evaluating the marginal bone level, technical and biological complications between screw-retained and cemented all-ceramic implant-supported crowns fabricated on zirconia abutment. Meta-analysis was conducted to assess the quantitative data on the marginal bone level and biological complications. RESULTS A total of eight studies were included for qualitative synthesis and six studies for quantitative synthesis. For marginal bone level, no statistically significant difference was observed (P = 0.83 and P = 0.69, respectively) during the follow-up period of 3 years and 5 years. For probing depth, the cemented group showed more amount of probing depth than the screw-retained group at a follow-up period of 3 years (P < 0.05) whereas no statistically significant difference was observed at a follow-up period of 5 years (P = 0.73). For bleeding on probing, the cemented group showed more probing depth than the screw-retained group at a follow-up period of 5 years (P = 0.10). CONCLUSION The evidence suggests that the screw-retained group showed no statistically significant difference in marginal bone level, comparatively fewer biological complications, and relatively higher technical complications than the cemented group at different follow-up periods.
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Affiliation(s)
- Shruti S. Potdukhe
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Janani M. Iyer
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Jyoti B. Nadgere
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Han JW, Han JW, Pyo SW, Kim S. Impact of profile angle of CAD-CAM abutment on the marginal bone loss of implant-supported single-tooth posterior restorations. J Prosthet Dent 2023:S0022-3913(23)00780-1. [PMID: 38129258 DOI: 10.1016/j.prosdent.2023.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
STATEMENT OF PROBLEM Although the emergence angle has been related to marginal bone loss, information regarding the relationship between the transmucosal configuration of a computer-aided design and computer-aided manufacturing (CAD-CAM) abutment at specific subgingival levels and the amount of marginal bone loss is lacking. PURPOSE The purpose of this retrospective clinical study was to evaluate the influence of CAD-CAM abutment profile angles, measured at different subgingival positions, on the marginal bone loss of posterior single-tooth implant-supported restorations. MATERIAL AND METHODS A total of 260 posterior single-tooth implant-supported restorations using CAD-CAM abutments were analyzed in 206 patients. All implants had internal conical seal connections with a platform-switched design. The following data were extracted using digital periapical radiography: emergence profile, profile angle at distance ranges of 0 to 1 mm, 1 to 2 mm, and 2 to 3 mm from the implant-abutment junction, and peri-implant marginal bone loss (MBL). The MBL was measured from the time of delivery of the restorations up to 7 years or more. A linear mixed model was applied to investigate whether there was a significant difference in MBL based on the emergence profile and time, followed by the Bonferroni correction post hoc test. A Pearson correlation analysis was used to analyze the correlation between the profile angle and MBL at each distance range. The cut-off points for each distance range were determined by using the c-index, and independent t tests were conducted based on these cut-off values to evaluate the statistical differences (α=.05 for all statistical analyses). RESULTS The convex emergence profile exhibited greater MBL than the concave and straight profiles at each follow-up visit (P<.001). A significant correlation was found between the profile angle and MBL in the 0 to 1 mm, 1 to 2 mm distance ranges. However, no significant correlation was found between the profile angle and MBL in the 2 to 3 mm distance range (P>.05). The cut-off points were 34 degrees at the mesial and 28 degrees at the distal in the 0 to 1 mm range, and 33 and 20 degrees at the mesial and distal in the 1 to 2 mm range. CONCLUSIONS The profile angle near the implant-abutment junction and the type of emergence profile of the CAD-CAM abutment were closely associated with MBL in implants with internal conical seal connection with a platform switch design.
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Affiliation(s)
- Jin-Won Han
- Former Graduate student, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jin-Woo Han
- Graduate student, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Se-Wook Pyo
- Clinical Assistant Professor, Department of Prosthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Sunjai Kim
- Professor and Chairman, Department of Prosthodontics, Gangnam Severance Dental Hospital, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Reis INRD, Fukuoka GL, Nagay BE, Pannuti CM, Spin-Neto R, da Silva EVF. Incidence of peri-implant disease associated with cement- and screw-retained implant-supported prostheses: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00563-2. [PMID: 37793953 DOI: 10.1016/j.prosdent.2023.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 10/06/2023]
Abstract
STATEMENT OF PROBLEM Implant-supported fixed dental prostheses can be cement- or screw-retained on the implant or abutment, with advantages and disadvantages for each method. Cemented prostheses have been associated with peri-implant disease because cement remnants act as a reservoir for bacteria and hinder biofilm control. However, contrasting evidence has been presented regarding this association based on studies with varying designs, and a systematic review and meta-analysis is required. PURPOSE The purpose of this systematic review and meta-analysis was to answer the focused question: In patients who received implant-supported prostheses, is the incidence of peri-implant diseases higher in cemented implant-supported prostheses than in screw-retained ones? MATERIAL AND METHODS The search was conducted using the National Library of Medicine (MEDLINE-PubMed), SCOPUS, EMBASE, and ISI Web of Science databases. Randomized clinical trials (RCTs) that assessed the incidence of peri-implant disease in cement- and screw-retained prostheses were included. Two authors independently screened the titles and abstracts, and analyzed the full texts, extracted data, and assessed the risk of bias. The findings were summarized using meta-analyses with random effects, and the level of certainty of the evidence was determined using the grading of recommendations, assessments, development, and evaluations (GRADE) approach. RESULTS The search yielded 4455 articles that met the inclusion criteria based on the title and/or abstract selection. A total of 6 RCTs were included for analysis. The meta-analysis revealed no significant difference between cement- and screw-retained prostheses for the risk of peri-implant mucositis (RR: 1.36, 95% CI: 0.42-4.38, P=.61). Similarly, no significant difference was observed between cement- and screw-retained prostheses for the incidence of peri-implantitis (RR: 1.00, 95% CI: 0.23-4.31, P=1.00). CONCLUSIONS Moderate certainty evidence suggests that cement- and screw-retained prostheses present a similar risk for peri-implant mucositis and peri-implantitis.
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Affiliation(s)
- Isabella Neme Ribeiro Dos Reis
- Postgraduate student, Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil.
| | - Gisele Lie Fukuoka
- Postgraduate student, Department of Prosthodontics, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Bruna Egumi Nagay
- Postgraduate student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Claudio Mendes Pannuti
- Associate Professor, Department of Stomatology, Division of Periodontics, School of Dentistry, University of São Paulo (USP), São Paulo, Brazil
| | - Rubens Spin-Neto
- Associate Professor, Department of Dentistry and Oral Health, Section for Oral Radiology, School of Dentistry, Aarhus University, Aarhus, Denmark
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Zadrożny Ł, Górski B, Baldoni E, Lumbau AI, Meloni SM, Pisano M, Tallarico M. Minimally Invasive Treatment of Lateral Incisors with Guided One-Piece or Two-Piece Titanium-Made Narrow Diameter Implants: A Retrospective Comparative Study with Up to Two Years Follow-Up. J Clin Med 2023; 12:jcm12113711. [PMID: 37297907 DOI: 10.3390/jcm12113711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/17/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Restoring teeth with dental implants has become the gold standard in recent years, especially in the esthetic zone. However, limited amount of available bone as well as limited interdental space in the anterior zone may create problems for implant treatment. Narrow diameter implants (NDI) may be a treatment option to resolve the above-mentioned limitations and providing minimally invasive implant therapy without additional regenerative procedures. In this retrospective study, a comparison of clinical and radiographic outcomes between one-piece and two-piece titanium-made NDIs was done with the follow-up of two years after loading. Twenty-three NDI cases were analyzed, 11 in the one-piece implant group (group one) and 12 in the two-piece implant group (group two). The outcomes were implant and prosthetic failures, any complications occurred, peri-implant bone level changes, and as well as the Pink Esthetic score. No implant or prosthetic failures, as well as, no complications were reported at the two-year follow-up examination. At the same time the marginal bone loss was 0.23 ± 0.11 in the group one and 0.18 ± 0.12 in the group two. Difference was not statistically significant (p = 0.3339). The Pink Esthetic Score, recorded two years after definitive loading, was 12.6 ± 0.97 in the group one and 12.2 ± 0.92 in the group two, with no statistically significant difference between groups (p = 0.3554). With the limitations of the present study, including the small sample size and short follow-up, it is possible to conclude that either one and two-piece NDI can be successfully used to restore lateral incisors with comparable results within the two years of follow-up.
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Affiliation(s)
- Łukasz Zadrożny
- Department of Dental Propaedeutics and Prophylaxis, Medical University of Warsaw, Nowogrodzka 59 St., 02-006 Warsaw, Poland
| | - Bartłomiej Górski
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, Binieckiego 6 St., 02-097 Warsaw, Poland
| | - Edoardo Baldoni
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
| | | | - Silvio Mario Meloni
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
| | - Milena Pisano
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07021 Sassari, Italy
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