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Roccuzzo A, Imber JC, Lempert J, Jensen SS. Clinical, radiographic, and aesthetic outcomes at two narrow-diameter implants to replace congenital missing maxillary lateral incisors: A 3-year prospective, clinical study. Clin Implant Dent Relat Res 2024. [PMID: 38863078 DOI: 10.1111/cid.13339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/19/2024] [Accepted: 05/03/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION To present the 3-year clinical, radiographic, and aesthetic outcomes in patients with congenitally missing lateral incisors rehabilitated with two narrow-diameter implants (NDIs). METHODS The original population consisted of 100 patients rehabilitated with a cement-retained bi-layered zirconia single-unit crown supported by either a Ø2.9 mm (Test) or a Ø3.3 mm (Control) NDI (n = 50). At the 1- and 3-year follow-up (T2, T3), implant survival rate, crestal bone level (CBL) changes, biological, and technical complications were recorded, while the assessment of the aesthetic outcomes was performed using the Copenhagen Index Score. RESULTS Seventy-four patients Ø2.9 mm (n = 39) or Ø3.3 mm (n = 35) reached T3, as 24 patients were lost to follow-up and 1 implant (Ø3.3 mm) was removed. Throughout the observation period, minimal CBL changes (i.e., <1 mm) were detected between groups. Despite the positive aesthetic scores recorded (i.e., 1-2), at T3 20% of patients rehabilitated with a Ø3.3 mm versus 2.6% of patients Ø2.9 mm displayed an alveolar process deficiency (Score 3). No additional technical and/or mechanical complications were recorded between T2 and T3. Tooth vitality was maintained in all neighboring teeth. Peri-implant probing depths and plaque scores remained low in both groups (p > 0.05). CONCLUSION The use of 2.9 or 3.3 diameter implants showed comparable favorable mid-term results in terms of survival rate, CBL, and aesthetic outcomes. Hence, clinicians should rely on the use of such NDIs when replacing maxillary lateral incisors.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jakob Lempert
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Simon Storgård Jensen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
- Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Faculty of Health and Medical Sciences, Institute of Odontology, University of Copenhagen, Copenhagen, Denmark
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2
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Hosseini M, Worsaae N, Gotfredsen K. SURVIVAL RATE OF IMPLANT-SUPPORTED, SINGLE-TOOTH RESTORATIONS BASED ON ZIRCONIA OR METAL ABUTMENT IN PATIENTS WITH TOOTH AGENESIS: A 5-YEARS PROSPECTIVE CLINICAL STUDY. J Evid Based Dent Pract 2024; 24:101970. [PMID: 38821661 DOI: 10.1016/j.jebdp.2024.101970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/22/2023] [Accepted: 01/13/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES The primary aim was to investigate survival rate of zirconia versus metal abutments, and the secondary aim was clinical outcomes of all-ceramic versus metal-ceramic crowns on single-tooth implants. METHODS Patients with tooth-agenesis participated to previously published prospective clinical study with 3-year follow-up were recalled after 5 years. Biological variables included survival and success rate of implants, marginal bone level, modified Plaque and Sulcus Bleeding Index and biological complications. Technical variables included restoration survival rate, marginal adaptation and technical complications. The aesthetic outcome of crowns and peri-implant mucosa in addition to patient-reported outcome were recorded. Descriptive analysis, linear mixed model for quantitative data, or generalized linear mixed model for ordinal categorical data were applied; significance was set to 0.05. RESULTS Fifty-three patients (mean age: 32.4 years), with 89 implants participated to the 5-years examination. The implants supported 50 zirconia abutments with 50 all-ceramic (AC) crown and 39 metal abutments with 29 metal-ceramic (MC) and 10 AC crowns. The Implant and restoration survival rate was 100% and 96%, respectively. No clinically relevant biological difference between implants supporting metal or zirconia abutments was registered. The technical complications were veneering fracture of AC-crowns (n = 3), crown loosening of MC-crowns (n = 4) and one abutment screw loosening (MC-crown on metal abutment). MC-crowns had significantly better marginal adaptation than AC-crowns (p = .01). AC-crowns had significantly better color and morphology than MC-crowns (p = .01). CONCLUSIONS Zirconia-based single-tooth restorations are reliable alternative materials to metal-based restorations with favorable biological and aesthetic outcome, and few technical complications.
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Affiliation(s)
- Mandana Hosseini
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen N-2200, Denmark.
| | - Nils Worsaae
- Department of Oral and Maxillofacial Surgery, University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen N-2200, Denmark
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Pesce P, Del Fabbro M, Menini M, De Giovanni E, Annunziata M, Khijmatgar S, Canullo L. Effects of abutment materials on peri-implant soft tissue health and stability: A network meta-analysis. J Prosthodont Res 2023; 67:506-517. [PMID: 37081626 DOI: 10.2186/jpr.jpr_d_22_00223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
PURPOSE This systematic review aimed to evaluate the effect of the abutment material on peri-implant soft tissue health and stability. STUDY SELECTION An electronic and hand search was conducted until February 2022. Only prospective randomized trials (RCTs) and controlled clinical trials (CCTs) comparing titanium abutments with abutments made of different materials, with a follow-up of at least 6 months, were selected by two independent reviewers. Data on marginal bone loss (MBL) and peri-implant tissue indexes, i.e., plaque index (PI), bleeding on probing (BOP), probing depth (PD), and recession (REC), were collected. The risk of bias for RCTs and non-RCTs was evaluated according to the tool reported in the Cochrane Handbook for Systematic Reviews of Interventions and the ROBINS-I tool, respectively. Both pairwise and network meta-analyses (NMA) were performed. RESULTS We included 18 relevant studies from 1,437 identified studies. Overall, 612 patients were treated, and 848 abutments were inserted. Five studies presented a low risk of bias. Pairwise meta-analysis showed that, as compared to titanium, zirconia abutments presented a significantly reduced MBL (0.20 mm, 95% Confidence Interval CI [0.14-0.26], P < 0.00001). No significant differences were found for the other outcomes. In the NMA, zirconia abutments demonstrated an 83.3% probability of achieving the highest rank in PI, an 87.0% in BOP, and a 65.0% in PD outcome, suggesting that zirconia abutments generally performed better than titanium and alumina abutments. CONCLUSIONS Within the limits of the present study, zirconia abutments seem a viable alternative to titanium ones.
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Affiliation(s)
- Paolo Pesce
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Menini
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Emanuele De Giovanni
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
| | - Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Shahnawaz Khijmatgar
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), Division of Prosthodontics and Implant Prosthodontics, University of Genoa, L. Rosanna Benzi, Genoa, Italy
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Hamilton A, Putra A, Nakapaksin P, Kamolroongwarakul P, Gallucci GO. Implant prosthodontic design as a predisposing or precipitating factor for peri-implant disease: A review. Clin Implant Dent Relat Res 2023. [PMID: 36691784 DOI: 10.1111/cid.13183] [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: 10/24/2022] [Revised: 12/20/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023]
Abstract
Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri-implant tissue health. The objective of this narrative review was to evaluate the evidence for the corresponding implant prosthodontic design factors on the risk to peri-implant tissue health. One of the most important factors to achieve an acceptable implant restorative design is the ideal implant position. Malpositioned implants often result in a restorative emergence profile at the implant-abutment junction that can restrict the access for patients to perform adequate oral hygiene. Inadequate cleansability and poor oral hygiene has been reported as a precipitating factors to induce the peri-implant mucositis and peri-implantitis and are influenced by restorative contours. The implant-abutment connection, restorative material selection and restoration design are also reported in the literature as having the potential to influence peri-implant sort tissue health.
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Affiliation(s)
- Adam Hamilton
- Division of Oral Restorative and Rehabilitative Sciences, University of Western Australia, Perth, Western Australia, Australia.,Division of Regenerative and Implant Sciences, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Putra
- Private Practice, Perth, Western Australia, Australia.,Department of Graduate Prosthodontic, University of Washington, Seattle, Washington, USA
| | - Pranai Nakapaksin
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Pongrapee Kamolroongwarakul
- Dental Center, Private Hospital, Bangkok, Thailand.,Department of Graduate Prosthodontic, Mahidol University, Bangkok, Thailand
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Mancini L, Barootchi S, Thoma DS, Jung RE, Gallucci GO, Wang HL, Tavelli L. The peri-implant mucosa color: A systematic appraisal of methods for its assessment and clinical significance. Clin Implant Dent Relat Res 2023; 25:224-240. [PMID: 36646440 DOI: 10.1111/cid.13180] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Peri-implant mucosa color (PMC) seems to be one of the main parameters affecting the esthetic outcome of implant therapy. However, more emphasis should be given to its assessment and reporting. PURPOSE To describe the available evidence on methods to assess and report the color of the peri-implant mucosa (PMC) and the respective clinical relevance. MATERIAL AND METHODS A comprehensive electronic and manual search was performed to identify clinical studies reporting on PMC. RESULTS A total of 121 studies were included. PMC was evaluated at the time of the follow-up visit (chairside) in 45.5% studies. PMC assessment was performed qualitatively, by comparing PMC with adjacent and/or contralateral gingiva (78.6%) or quantitatively, using spectrophotometry (20.7%) or a software on clinical photographs (0.8%). The most performed method to assess PMC was through esthetic indices (76.9%), either at the time of the follow-up visit (chairside) or at later time point using photographs. Quantitative reporting of PMC included averages of points from esthetic indices or color differences to natural gingiva expressed with the CIELAB color system. PMC assessment allowed describing color discrepancies compared to natural gingiva, evaluating color changes over time, and comparing the outcomes of different treatment modalities. PMC assessment through spectrophotometry was additionally utilized to assess the role of mucosal thickness (MT) on PMC. CONCLUSIONS Various methods for PMC assessment and reporting were described, including visual assessment, mainly through esthetic indices, and spectrophotometry. PMC evaluation has allowed to demonstrate the factors affecting the color of the peri-implant soft tissue, such as the type of abutment/restoration, MT, and soft tissue augmentation.
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Affiliation(s)
- Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.,Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Science, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA.,Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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Lemos CAA, Verri FR, de Luna Gomes JM, Santiago Junior JF, Miyashita E, Mendonça G, Pellizzer EP. Survival and prosthetic complications of monolithic ceramic implant-supported single crowns and fixed partial dentures: A systematic review with meta-analysis. J Prosthet Dent 2022:S0022-3913(22)00736-3. [PMID: 36564291 DOI: 10.1016/j.prosdent.2022.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Abstract
STATEMENT OF PROBLEM Monolithic ceramic implant-supported restorations have been used to rehabilitate partially edentulous patients. However, knowledge of the survival and prosthetic complications of single crowns (SCs) and fixed partial dentures (FPDs) is limited. PURPOSE The purpose of this systematic review with meta-analysis was to evaluate the clinical performance of monolithic ceramic implant-supported SCs and FPDs in terms of survival and prosthetic complication rates. MATERIAL AND METHODS The systematic review was registered on the prospective register of systematic reviews (PROSPERO) (CRD42017078568). Five electronic databases were independently searched by 2 authors for articles published until May 2022. In addition, a hand search was performed in the nonpeer-reviewed literature, specific journals, and reference lists of included articles. A single-arm meta-analysis was performed by using the R program. The risk of bias and quality were assessed using the Cochrane risk of bias tools and the Newcastle-Ottawa scale. RESULTS Twenty-eight studies were included in the quantitative synthesis. A total of 1298 monolithic ceramic implant-supported restorations (1116 SCs and 182 FPDs) were evaluated in 1193 participants, with a median observation time of 24 months (range: 12 to 72 months). Meta-analysis indicated the proportion of failures and prosthetic complication rates of 2% (95% confidence interval [CI]: 1% to 4%) for SCs. No difference was observed for monolithic zirconia and lithium disilicate SCs. In the FPDs, only monolithic zirconia was considered, with 1 failure reported totaling the proportion of failures of 0% (0% to 1%) and complication rates of 4% (0% to 12%). The most complications reported for both types of restorations were screw loosening, debonding, and minor chipping and were considered repairable. The included studies showed a low risk of bias and good quality. CONCLUSIONS The use of monolithic ceramic implant-supported SCs, independent of ceramic material, and monolithic zirconia implant-supported FPDs should be considered an effective and safe treatment option because of favorable short-term survival and low prosthetic complications. However, additional well-conducted studies with a longer-term follow-up and direct comparison between veneered restorations are recommended to reassess clinical performance.
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Affiliation(s)
- Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Department of Dentistry, Federal University of Juiz de Fora - Campus Governador Valadares (UFJF/GV), Governador Valadares, Minas Gerais, Brazil.
| | - Fellippo Ramos Verri
- Adjunct Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | | | - Joel Ferreira Santiago Junior
- Professor, Departament of Health Sciences, School of Dentistry, Centro Universitário Sagrado Coração-UNISAGRADO, Bauru, São Paulo, Brazil
| | - Eduardo Miyashita
- Titular Professor, Department of Dentistry, UNIP - Universidade Paulista, São Paulo, Brazil
| | - Gustavo Mendonça
- Clinical Associate Professor, Department of Biological and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Eduardo Piza Pellizzer
- Titular Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
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7
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Hosseini M, Worsaae N, Gotfredsen K. A five-year randomised controlled trial comparing zirconia-based versus metal-based implant-supported single-tooth restorations in the premolar region. Clin Oral Implants Res 2022; 33:792-803. [PMID: 35633183 PMCID: PMC9546362 DOI: 10.1111/clr.13960] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/09/2022] [Accepted: 05/10/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare 5-year biological, technical, aesthetic, and patient-reported outcomes of single-tooth implant-supported all-ceramic versus metal-ceramic restorations. MATERIALS AND METHODS Thirty patients with 63 premolar agenesis participated in the 5-year follow-up. The prosthetic treatment on single-tooth implants were randomly assigned to all-ceramic crowns on zirconia abutments (AC=31) or metal-ceramic crowns on metal abutments (MC=32). All patients were recalled to clinical examinations at baseline, 1, 3, and 5 years after prosthetic treatments. Biological, technical, and aesthetic outcomes including complications, were clinically and radiographically registered. The patient-reported outcomes were recorded using OHIP-49 questionnaire before treatment and at each follow-up examination. RESULTS At 5-year examination, the survival rate was 100% for implants and 100 % for AC and 97% for MC crowns and abutments. The marginal bone loss after 5-years was minor and not significantly different (p= 0.056) between AC (mean: 0.3, SD: 1.1) and MC restorations (mean: -0.1, SD: 0.4). The success rate of the implants based on marginal bone loss was 77.4% for AC- and 93.7% for MC-restorations. The marginal adaptation was significantly better for MC than for AC restorations (p=0.025). The aesthetic outcomes and patient-reported outcomes between AC and MC restorations were not significantly different. CONCLUSIONS The biological, aesthetic and patient-reported outcomes for implant-supported AC and MC restorations were successful and with no significant difference after 5-years. The marginal adaptation of the MC crowns cemented on titanium abutments showed significantly better fit than restorations based on zirconia crowns cemented on zirconia abutments.
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Affiliation(s)
- Mandana Hosseini
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Denmark
| | - Nils Worsaae
- Department of Oral and Maxillofacial Surgery, University Hospital, Copenhagen, Denmark
| | - Klaus Gotfredsen
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Denmark
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8
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Haugen HJ, Chen H. Is There a Better Biomaterial for Dental Implants than Titanium?—A Review and Meta-Study Analysis. J Funct Biomater 2022; 13:jfb13020046. [PMID: 35645254 PMCID: PMC9149859 DOI: 10.3390/jfb13020046] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/28/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023] Open
Abstract
This article focuses on preclinical studies and reviews the available evidence from the literature on dental implant and abutment materials in the last decade. Specifically, different peri-implantitis materials and how surface modifications may affect the peri-implant soft-tissue seal and subsequently delay or hinder peri-implantitis are examined. This review analyzed more than 30 studies that were Randomized Controlled Trials (RCTs), Controlled Clinical Trials (CCTs), or prospective case series (CS) with at least six months of follow-up. Meta-analyses were performed to make a comparison between different implant materials (titanium vs. zirconia), including impact on bone changes, probing depth, plaque levels, and peri-implant mucosal inflammation, as well as how the properties of the implant material and surface modifications would affect the peri-implant soft-tissue seal and peri-implant health conditions. However, there was no clear evidence regarding whether titanium is better than other implant materials. Clinical evidence suggests no difference between different implant materials in peri-implant bone stability. The metal analysis offered a statistically significant advantage of zirconia implants over titanium regarding developing a favorable response to the alveolar bone.
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Affiliation(s)
- Håvard J. Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0318 Oslo, Norway
- Correspondence:
| | - Hongyu Chen
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY 12180, USA;
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Duong HY, Roccuzzo A, Stähli A, Salvi GE, Lang NP, Sculean A. Oral health-related quality of life of patients rehabilitated with fixed and removable implant-supported dental prostheses. Periodontol 2000 2022; 88:201-237. [PMID: 35103325 PMCID: PMC9304161 DOI: 10.1111/prd.12419] [Citation(s) in RCA: 62] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Dental implants have become a mainstream treatment approach in daily practice, and because of their high survival rates over time, they have become the preferred treatment option for prosthetic rehabilitation in many situations. Despite the relatively high predictability of implant therapy and high costs to patients, patient perceptions of success and patient-reported outcome measures have become increasingly significant in implant dentistry. Increasing numbers of publications deal with oral health-related quality of life and/or patient-reported outcome measures. The aim of this paper was to provide an overview of the available evidence on oral health-related quality of life of fully and partially dentate patients rehabilitated with fixed and removable implant-supported dental prostheses. A comprehensive electronic search was performed on publications in English up to 2021. A selection of standardized questionnaires and scales used for the evaluation of oral health-related quality of life were analyzed and explained. The analysis encompassed three aspects: a functional evaluation of oral health-related quality of life, an esthetic assessment of oral health-related quality of life, and a cost-related evaluation of oral health-related quality of life for rehabilitation with dental implants. The data demonstrated that the preoperative expectations of patients markedly affected the outcomes perceived by the patients. As expected, reconstructions supported by implants substantially improved the stability of conventional dentures and allowed improved function and patient satisfaction. However, from a patient's perspective, oral health-related quality of life was not significantly greater for dental implants compared with conventional tooth-supported prostheses. The connection of the implants to the prostheses with locators or balls indicated high oral health-related quality of life. The data also suggest that patient expectation is not a good predictor of treatment outcome. In terms of esthetic outcomes, the data clearly indicate that patients' perceptions and clinicians' assessments differed, with those of clinicians yielding higher standards. There were no significant differences found between the esthetic oral health-related quality of life ratings for soft tissue-level implants compared with those for bone-level implants. Comparison of all-ceramic and metal-ceramic restorations showed no significant differences in patients' perceptions in terms of esthetic outcomes. Depending on the choice of outcome measure and financial marginal value, supporting a conventional removable partial denture with implants is cost-effective when the patient is willing to invest more to achieve a higher oral health-related quality of life. In conclusion, the oral health-related quality of life of patients rehabilitated with implant-supported dental prostheses did not show overall superiority over conventional prosthetics. Clinicians' and patients' evaluations, especially of esthetic outcomes, are, in the majority of cases, incongruent. Nevertheless, patient-reported outcomes are important in the evaluation of function, esthetics, and the cost-effectiveness of treatment with implant-supported dental prostheses, and should be taken into consideration in daily practice.
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Affiliation(s)
- Ho-Yan Duong
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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10
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Mattheos N, Janda M, Acharya A, Pekarski S, Larsson C. Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri-implant mucositis and peri-implantitis: A critical review. Clin Oral Implants Res 2021; 32 Suppl 21:181-202. [PMID: 34642979 DOI: 10.1111/clr.13823] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 07/11/2021] [Accepted: 07/20/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri-implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri-implant mucositis and peri-implantitis. METHODS Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri-implant mucositis and peri-implantitis were included. RESULTS Emerging evidence with bone-level implants suggests a link between EA combined with convex EP and peri-implantitis. Depth of the peri-implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri-implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti-infective treatment of peri-implant mucositis. Limited evidence points to no difference with regard to the risk for peri-implant mucositis between tissue- and bone-level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri-implantitis. Literature with regard to prosthesis retention type and risk for peri-implantitis is inconclusive. CONCLUSIONS Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri-implant mucositis/peri-implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose-designed studies are required to clarify current observations.
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Affiliation(s)
- Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Aneesha Acharya
- Department of Periodontics, Dr. D. Y. Patil Dental College and Hospital, Pune, India
| | - Stephanie Pekarski
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Pjetursson BE, Sailer I, Latyshev A, Rabel K, Kohal RJ, Karasan D. A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns. Clin Oral Implants Res 2021; 32 Suppl 21:254-288. [PMID: 34642991 PMCID: PMC9293296 DOI: 10.1111/clr.13863] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 12/28/2022]
Abstract
Objective To assess the survival, failure, and complication rates of veneered and monolithic all‐ceramic implant‐supported single crowns (SCs). Methods Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow‐up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all‐ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models. Results Forty‐nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta‐analysis of the included studies indicated an estimated 3‐year survival rate of veneered‐reinforced glass‐ceramic implant‐supported SCs of 97.6% (95% CI: 87.0%–99.6%). The estimated 3‐year survival rates were 97.0% (95% CI: 94.0%–98.5%) for monolithic‐reinforced glass‐ceramic implant SCs, 96.9% (95% CI: 93.4%–98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%–97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%–97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%–87.7%) for resin‐matrix‐ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates. Conclusions With the exception of RMC SCs, veneered and monolithic implant‐supported ceramic SCs showed favorable short‐term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
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Affiliation(s)
- Bjarni Elvar Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.,Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrey Latyshev
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Maxillofacial, Oral and Plastic Surgery, Faculty of Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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12
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Totou D, Naka O, Mehta SB, Banerji S. Esthetic, mechanical, and biological outcomes of various implant abutments for single-tooth replacement in the anterior region: a systematic review of the literature. Int J Implant Dent 2021; 7:85. [PMID: 34494174 PMCID: PMC8423965 DOI: 10.1186/s40729-021-00370-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background The choice of the appropriate implant abutment is a critical step for a successful outcome. Titanium abutments have demonstrated high survival rates, due to their excellent biocompatibility and high mechanical strength, although they often result in a grayish discoloration of the peri-implant mucosa. This esthetic concern culminated in the introduction of ceramic abutments. The aim of this review was to assess the esthetic, mechanical, and biological outcomes as well as the survival of the different types of abutments used for single-implant restorations in the anterior area. Material and methods An electronic search was conducted in Medline, Embase, and Cochrane Central databases using the appropriate Mesh terms and predetermined eligibility criteria. The quality of the studies was assessed using the ROB 2 tool. The last search was conducted on 18th of March 2020. Results From the 2074 records initially identified, 23 randomized controlled trials (32 publications) were included for qualitative analysis. Data were classified based on study information, specific characteristics of the intervention and comparator, and information related to the outcome measures. Seven studies exhibited an overall low risk of bias, while twelve studies raised some concerns. Conclusions The rate of abutment failure was low and was associated with the ceramic abutments, especially those with internal connection. Limited correlation was noted between soft tissue thickness and color difference. Titanium abutments caused significantly more discoloration to the soft tissues than ceramic abutments, while hueing (gold or pink) slightly improved their color performance. Zirconia allowed a better color match than titanium or gold abutments, still discolored slightly the soft tissues. The submucosally modified zirconia abutments exhibited encouraging results. No significant difference was reported between materials or different types of retention on recession, papillary fill, and biological outcomes.
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Affiliation(s)
- Dimitra Totou
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
| | - Olga Naka
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK. .,School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Shamir B Mehta
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
| | - Subir Banerji
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
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13
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Bittencourt TC, Souza Picorelli Assis NM, Ribeiro CG, Ferreira CF, Sotto-Maior BS. Evaluation of the peri-implant tissues in the esthetic zone with prefabricated titanium or zirconia abutments: A randomized controlled clinical trial with a minimum follow-up of 7 years. J Prosthet Dent 2021; 129:573-581. [PMID: 34334178 DOI: 10.1016/j.prosdent.2021.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Long-term clinical studies are lacking on the influence of the type of abutment, titanium or zirconia, on peri-implant tissues. PURPOSE The purpose of this randomized clinical trial was to evaluate peri-implant tissues with titanium or zirconia abutments. MATERIAL AND METHODS A total of 26 single-tooth implant-supported prostheses in 14 participants were analyzed. They received either a titanium abutment with a metal-ceramic crown (TAG) or a zirconia abutment with a ceramic crown (ZAG). Data were collected immediately, at 5 months, and at a minimum of 7 years after crown delivery. The success rate, plaque and bleeding indexes, bleeding on probing, white and pink esthetic scores, and the relationships of the gingival phenotype with the pink esthetic score were analyzed. Statistical analyses were conducted with the t test for paired and independent data (α=.05). RESULTS The mean follow-up time was 95.2 ±2.6 months, showing an implant success rate of 96.7%. No statistically significant differences were found between TAG and ZAG among the time intervals evaluated for plaque or bleeding indexes (P>.05). A statistically significant difference was found for peri-implant probing depths in the mid-buccal sites between the groups at all the time intervals evaluated (TAG, P=.008; ZAG, P=.021): TAG showed an increase between 5 months (3.65 ±0.93 mm) and over 7 years (4.47 ±1.32 mm); and ZAG showed a reduction (5 months=5.22 ±1.71 mm; over 7 years=4.25 ±1.28 mm) in values. For the pink (PES) and white esthetic score (WES), ZAG (PES: immediately=6.33 ±1.41; 5 months=7.44 ±1.81; over 7 years=8.25 ±1.03; WES: immediately=7.67 ±1.50; over 7 years=8.38 ±0.74) showed higher mean values than TAG (PES: immediately=5.94 ±2.35; 5 months=6.53 ±2.15; over 7 years=7.44 ±1.81; WES: immediately=7.00 ±1.17; over 7 years=8.35 ±1.27) (P<.05). Statistically significant differences were found for gingival phenotype and for PES in TAG (P=.031), and the participants with thick phenotype showed higher PES in the 3 time intervals studied. CONCLUSIONS Zirconia abutments exhibited better results than titanium abutments in terms of the peri-implant tissues. Moreover, in those with a thin phenotype, zirconia provided improved gingival esthetics.
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Affiliation(s)
- Thais Camargo Bittencourt
- Master in Comprehensive Dentistry, Department of Prosthodontics, Federal University of Juiz de For a (UFJF) College of Dentistry, Juiz de Fora, Minas Gerais, Brazil.
| | - Neuza Maria Souza Picorelli Assis
- Associate Professor, the Department of Comprehensive Dentistry at the Federal University of Juiz de For a (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Cleide Gisele Ribeiro
- Professor, Maternidade Therezinha de Jesus (HMTJ/JF) and Faculdade de Ciências Médicas e da Saúde Juiz de For a (SUPREMA), Minas Gerais, Brazil
| | - Cimara Fortes Ferreira
- Associate Professor, Director of Implant Dentistry, Department of Periodontics, University of Tennessee (UT) College of Dentistry, Memphis, Tenn
| | - Bruno Salles Sotto-Maior
- Professor, Federal University of Juiz de Fora (UFJF), College of Dentistry, Departament of Restorative Dentistry, Juiz de Fora, Minas Gerais, Brazil
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14
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Ayyadanveettil P, Thavakkara V, Latha N, Pavanan M, Saraswathy A, Kuruniyan MS. Randomized clinical trial of zirconia and polyetheretherketone implant abutments for single-tooth implant restorations: A 5-year evaluation. J Prosthet Dent 2021; 128:1275-1281. [PMID: 33933267 DOI: 10.1016/j.prosdent.2021.02.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 02/17/2021] [Accepted: 02/17/2021] [Indexed: 10/21/2022]
Abstract
STATEMENT OF PROBLEM Titanium-supported polyetheretherketone (PEEK) abutments provide an economic alternative to zirconia abutments in esthetically important areas. Research comparing the performance regarding esthetics, longevity, and biologic parameters of PEEK abutments is lacking. PURPOSE The purpose of this clinical study was to determine whether PEEK implant abutments provide similar esthetic and biologic parameters and survival rates as zirconia implant abutments. MATERIAL AND METHODS Forty participants (age 20 to 50 years) receiving maxillary anterior and premolar implants were enrolled in the study and randomly assigned into 1 of 2 groups: Group PEEK (20 titanium-supported PEEK abutments) and group ZIR (20 zirconia abutments). Both groups were restored with pressed lithium disilicate ceramic crowns. Technical, biologic, and esthetic evaluation was performed at baseline and at 1, 3, and 5 years. The probing pocket depth, plaque control record, and bleeding on probing were recorded at the abutments (test) and compared with those at the corresponding contralateral teeth (control) and also between the 2 test groups. Standardized digital radiographs of the implants were made, and the bone level was recorded with the implant shoulder as the reference on the mesial and distal sides. The color difference between the peri-implant mucosa and control teeth gingiva and the discoloration of the implant crowns were determined with a spectrophotometer. The Student unpaired t test and repeated-measure ANOVA were used to statistically analyze the data (α=.05). RESULTS From the 5-year evaluation, both PEEK and zirconia abutments with ceramic crowns showed 100% survival rate without any fracture or restoration loss. Differences in the biologic parameters of zirconia and PEEK abutments were statistically similar: mean probing pocket depth (group ZIR: 2.32 ±0.50 mm, group PEEK: 2.13 ±0.60 mm); mean plaque control record (group ZIR: 0.19 ±0.19, group PEEK: 0.15 ±0.17); and mean bleeding on probing (group ZIR: 0.12 ±0.11, group PEEK: 0.08 ±0.12). The mean marginal bone loss at 5 years was similar for implants supporting zirconia and PEEK abutments: mean mesial bone level (group ZIR: 1.8 ±0.5 mm; group PEEK: 1.9 ±0.6 mm), and mean distal bone level (group ZIR: 1.7 ±0.6 mm, group PEEK: 1.8 ±0.3 mm). The initial color difference (ΔE) between the peri-implant mucosa and gingiva of the analogous contralateral teeth diminished over time. No discoloration of the definitive restoration supported by PEEK or zirconia was detected over 5 years. CONCLUSIONS At the 5-year evaluation, zirconia and PEEK abutments exhibited the same survival rate with similar biologic and esthetic outcomes.
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Affiliation(s)
| | - Vinni Thavakkara
- Additional Professor, Department of Prosthodontics, Government Dental College, Kozhikode, Kerala, India
| | - Neethu Latha
- Assistant Professor, Department of Prosthodontics, Government Dental College, Kozhikode, Kerala, India
| | - Meenu Pavanan
- Senior Resident, Department of Prosthodontics, Government Dental College, Thrissur, Kerala, India
| | - Arya Saraswathy
- Assistant Professor, Department of Prosthodontics, Government Dental College, Kozhikode, Kerala, India
| | - Mohamed Saheer Kuruniyan
- Assistant Professor, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
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15
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Roccuzzo A, Imber JC, Jensen SS. Need for lateral bone augmentation at two narrow-diameter implants: A prospective, controlled, clinical study. Clin Oral Implants Res 2021; 32:511-520. [PMID: 33548077 DOI: 10.1111/clr.13721] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To detect the potential influence of implant diameter and anatomic factors on the need for bone augmentation procedures (BAPs) when replacing congenitally missing lateral incisors (MLIs). MATERIALS AND METHODS Patients with congenitally missing MLIs with a mesio-distal distance between the canine and the central incisor of 5.9-6.3 mm received a Ø2.9 mm implant while Ø3.3 mm implants were placed when the distance was 6.4-7.1 mm. The following linear measurements were recorded using a calliper: width of the alveolar process (WAP), width of the bony alveolar ridge (WAR) and thickness of the facial bone after implant osteotomy (TFB). Guided bone regeneration was performed in case of fenestration- or dehiscence-type defects or a thin TFB (<1.7 mm). RESULTS Fifty Ø2.9 mm and 50 Ø3.3 mm were included in 100 patients. WAP and WAR did not differ between the groups (p > .05). TFB was statistically significant larger in the Ø2.9 group (1.75 ± 0.59 mm) compared to the Ø3.3 group (1.5 ± 0.63 mm) (p = .041). Fenestration-type defects (p = .005) and a thin facial bone wall (p = .045) was observed more frequently in the Ø3.3 compared to the Ø2.9 group. Correspondingly, BAP was indicated more frequently in the Ø3.3 compared to the Ø2.9 group (p = .017). WAP, MD and WAR were statistically significant correlated to the need for BAP (p < .001). As independent variable, only WAR influenced the probability of BAP (p < .001). CONCLUSION The use of 2.9 diameter implants was correlated to a reduced frequency of BAP compared to 3.3 mm implants, without reaching a statistically significant difference. Measurement of the WAP provides the clinician useful information to predict BAP.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Periodontology and Operative Dentistry, University Medical Center, University of Mainz, Mainz, Germany
| | - Simon Storgård Jensen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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16
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Bergamo ETP, Yamaguchi S, Coelho PG, Lopes ACO, Lee C, Bonfante G, Benalcázar Jalkh EB, de Araujo-Júnior ENS, Bonfante EA. Survival of implant-supported resin-matrix ceramic crowns: In silico and fatigue analyses. Dent Mater 2021; 37:523-533. [PMID: 33483102 DOI: 10.1016/j.dental.2020.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/20/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the fatigue survival, failure mode, and maximum principal stress (MP Stress) and strain (MP Strain) of resin-matrix ceramic systems used for implant-supported crowns. METHODS Identical molar crowns were milled using four resin-matrix ceramics (n = 21/material): (i) Shofu Hard, (ii) Cerasmart (iii) Enamic, and (iv) Shofu HC. Crowns were cemented on the abutments, and the assembly underwent step-stress accelerated-life testing. Use level probability Weibull curves at 300 N were plotted and the reliability at 300, 500 and 800 N was calculated for a mission of 50,000 cycles. Fractographic analysis was performed using stereomicroscope and scanning electron microscope. MP Stress and MP Strain were determined by finite element analysis. RESULTS While fatigue dictated failures for Cerasmart (β > 1), material strength controlled Shofu Hard, Enamic, and Shofu HC failures (β < 1). Shofu HC presented lower reliability at 300 N (79%) and 500 N (59%) than other systems (>90%), statistically different at 500 N. Enamic (57%) exhibited a significant reduction in the probability of survival at 800 N, significantly lower than Shofu Hard and Cerasmart; however, higher than Shofu HC (12%). Shofu Hard and Cerasmart (>93%) demonstrated no significant difference for any calculated mission (300-800 N). Failure mode predominantly involved resin-matrix ceramic fracture originated from occlusal cracks, corroborating with the MP Stress and Strain location, propagating through the proximal and cervical margins. SIGNIFICANCE All resin-matrix ceramics crowns demonstrated high probability of survival in a physiological molar load, whereas Shofu Hard and Cerasmart outperformed Enamic and Shofu HC at higher loads. Material fracture comprised the main failure mode.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil.
| | - Satoshi Yamaguchi
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, 565-0871, Suita, Osaka, Japan
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, Hansjorg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, 345 24th Street, 10010, New York City, NY, USA
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Chunwoo Lee
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, 565-0871, Suita, Osaka, Japan
| | - Gerson Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Everardo N S de Araujo-Júnior
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
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17
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DuVall NB, DeReis SP, Vandewalle KS. Fracture strength of various titanium-based, CAD-CAM and PFM implant crowns. J ESTHET RESTOR DENT 2020; 33:522-530. [PMID: 33174333 DOI: 10.1111/jerd.12672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE CAD-CAM has dramatically advanced dental restorative procedures to include implant-supported crowns. The purpose of this study was to compare the fracture resistance following mechanical loading and thermocycling of various screw-retained and cement-retained ceramic and polymethylmethacrylate material combinations using the TiBase abutment compared to PFM implant-supported crowns. OVERVIEW Twelve implant restorations were fabricated for each of eight groups. Three groups were screw-retained and five groups were cement-retained implant restorations. The ceramic and polymethylmethacrylate restorations were fabricated on the TiBase abutment while the PFM restorations were fabricated on an UCLA abutment. Data were analyzed with a one way Analysis of Variance and Tukey's post-hoc test to evaluate the effect of abutment and crown type on fracture load (alpha = 0.05). A significant difference was found in the maximum fracture load between groups (P < 0.001). CONCLUSIONS The screw-retained implant restorations demonstrated higher fracture loads than their cement-retained counterparts. The TiBase abutment compared favorably to the UCLA abutment. CLINICAL SIGNIFICANCE The TiBase abutment is a titanium insert which combines the esthetics of a ceramic abutment with the mechanical properties of a titanium abutment and should be considered a viable clinical alternative to the conventional implant-supported PFM crown based on theses in vitro results and in context of in vivo studies. The lithium disilicate hybrid abutment/crown implant-supported restoration utilizing the TiBase abutment may be an ideal clinical choice due to simplicity, single appointment CAD-CAM, and esthetics.
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Affiliation(s)
- Nicholas B DuVall
- Program Director, AEGD Residency, 96th Dental Squadron, Eglin AFB, Florida, USA.,US Air Force Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Stephen P DeReis
- Certified Dental Technician, 81st Dental Squadron, Keesler AFB, Mississippi, USA
| | - Kraig S Vandewalle
- US Air Force Postgraduate Dental College, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Director of Dental Research, AEGD Residency, 59th Dental Training Squadron, Joint Base San Antonio-Lackland, Texas, USA
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18
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Alqutaibi AY, Alnazzawi AA, Algabri R, Aboalrejal AN, AbdElaziz MH. Clinical performance of single implant-supported ceramic and metal-ceramic crowns: A systematic review and meta-analysis of randomized clinical trials. J Prosthet Dent 2020; 126:369-376. [PMID: 32891403 DOI: 10.1016/j.prosdent.2020.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/01/2022]
Abstract
STATEMENT OF PROBLEM Evidence relating to the choice of materials for single implant-supported crowns is sparse. PURPOSE The purpose of this systematic review and meta-analysis was to assess articles that compared the clinical performance of ceramic and metal-ceramic (MC) implant-supported single crowns with regard to prosthesis failure, complication rate, and patient satisfaction. MATERIAL AND METHODS A comprehensive search of databases (PubMed/MEDLINE, Scopus, and Cochrane Library) was performed. The last search was conducted in December 2019. Randomized clinical trials comparing ceramic and MC implant-supported single crowns with at least a 12-month follow-up were included, all of which were published in English. The pooled effects were presented as both a risk difference (RD) and mean difference according to the type of data with 95% confidence intervals (CIs). RESULTS Seven randomized clinical trials fulfilled the eligibility criteria and were included in the meta-analysis. The pooled data did not show any statistically significant differences concerning prosthesis failure (RD: 0.000, 95% CI: -0.05 to 0.06), marginal bone loss (mean difference [MD]: -0.02, 95% CI: -0.75 to 0.35), mechanical complications (RD: -0.06, 95% CI: -0.18 to 0.07), biological complications (RD: 0.02, 95% CI: -0.07 to 0.11), or patient satisfaction (MD: 4.86, 95% CI: -2.86 to 12.58). CONCLUSIONS Ceramic and MC crowns had similar outcomes with regard to prosthesis failure, mechanical and biological complication rates, and patient satisfaction. As a result, the selection of single implant crown material depends on the preference of the dentist and patient.
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Affiliation(s)
- Ahmed Yaseen Alqutaibi
- Assistant Professor of Prosthodontics, Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia; Assistant Professor of Prosthodontics, Prosthodontics Department, College of Dentistry, Ibb University, Ibb, Yemen.
| | - Ahmad Abdulkareem Alnazzawi
- Associate Professor of Prosthodontics, Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
| | - Radwan Algabri
- Assistant Professor of Prosthodontics, Prosthodontics Department, College of Dentistry, Ibb University, Ibb, Yemen
| | - Afaf N Aboalrejal
- Lecturer of Oral Biology, Oral Biology Department, College of Dentistry, Ibb University, IBB, Yemen
| | - Mohammed Hosny AbdElaziz
- Associate Professor of Crown and Bridge Department, Faculty of Dental Medicine, AlAzhar University, Cairo, Egypt; Associate Professor of prosthodontics, substitutive dental science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
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19
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Hu ML, Lin H, Zhang YD, Han JM. Comparison of technical, biological, and esthetic parameters of ceramic and metal-ceramic implant-supported fixed dental prostheses: A systematic review and meta-analysis. J Prosthet Dent 2020; 124:26-35.e2. [DOI: 10.1016/j.prosdent.2019.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 01/11/2023]
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20
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Limones A, Molinero-Mourelle P, Azevedo L, Romeo-Rubio M, Correia A, Gómez-Polo M. Zirconia-ceramic versus metal-ceramic posterior multiunit tooth-supported fixed dental prostheses: A systematic review and meta-analysis of randomized controlled trials. J Am Dent Assoc 2020; 151:230-238.e7. [PMID: 32222175 DOI: 10.1016/j.adaj.2019.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/08/2019] [Accepted: 12/14/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND The authors aimed to compare the survival and complication rates of zirconia-ceramic (ZC) versus metal-ceramic (MC) restorative material in multiunit tooth-supported posterior fixed dental prostheses (FDP). TYPES OF STUDIES REVIEWED The authors conducted a systematic search of randomized controlled trials (RCTs), with no time or language restrictions, up to May 2019 using the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases, followed by a manual search. RESULTS The authors included 7 RCTs in the review and 5 RCTs in the meta-analysis. All studies had a low risk of bias. The authors included 330 participants (177 ZC and 173 MC tooth-supported FDP) in the meta-analysis, which revealed a medium-term survival rate of 95.4% (95% confidence interval [CI], 90.5% to 99.1%) for ZC FDP compared with 96.9% (95% CI, 94.3% to 99.4%) for MC FDP, with no significant differences (P = .364). The biological or technical complications did not show statistically significant differences, except in the global ceramic veneering chipping analysis (P = .023; risk difference [RD], 22.3%; 95% CI, 3.0% to 41.6%) and their subanalysis: minor chipping or chipping that can be solved with polishing (P = .044; RD, 19.5%; 95% CI, 0.5% to 38.4%), and major chipping or chipping that needs repair in the laboratory (P = .023; RD, 6.0%; 95% CI, 0.8% to 11.3%). CONCLUSIONS AND PRACTICAL IMPLICATIONS Posterior multiunit ZC restorations are considered a predictable treatment in the medium term, although they are slightly more susceptible to chipping of the veneering ceramic than MC restorations.
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Wittneben J, Gavric J, Sailer I, Buser D, Wismeijer D. Clinical and esthetic outcomes of two different prosthetic workflows for implant‐supported all‐ceramic single crowns—3 year results of a randomized multicenter clinical trail. Clin Oral Implants Res 2020; 31:495-505. [DOI: 10.1111/clr.13586] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/13/2019] [Accepted: 01/04/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Julia‐Gabriela Wittneben
- Department of Reconstructive Dentistry & Gerodontology School of Dental Medicine University of Bern Bern Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine Boston MA USA
| | - Jelena Gavric
- Division of Fixed Prosthodontics and Biomaterials School of Dental Medicine University of Geneva Geneva Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials School of Dental Medicine University of Geneva Geneva Switzerland
| | - Daniel Buser
- Department of Oral Surgery and Stomatology School of Dental Medicine University of Bern Bern Switzerland
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry ACTA University of Amsterdam and VU University Amsterdam The Netherlands
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Bonfante EA, Jimbo R, Witek L, Tovar N, Neiva R, Torroni A, Coelho PG. Biomaterial and biomechanical considerations to prevent risks in implant therapy. Periodontol 2000 2019; 81:139-151. [PMID: 31407440 DOI: 10.1111/prd.12288] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This paper is aimed to present a biomaterials perspective in implant therapy that fosters improved bone response and long-term biomechanical competence from surgical instrumentation to final prosthetic rehabilitation. Strategies to develop implant surface texturing will be presented and their role as an ad hoc treatment discussed in light of the interplay between surgical instrumentation and implant macrogeometric configuration. Evidence from human retrieved implants in service for several years and from in vivo studies will be used to show how the interplay between surgical instrumentation and implant macrogeometry design affect osseointegration healing pathways, and bone morphologic and long-term mechanical properties. Also, the planning of implant-supported prosthetic rehabilitations targeted at long-term performance will be appraised from a standpoint where personal preferences (eg, cementing or screwing a prosthesis) can very often fail to deliver the best patient care. Lastly, the acknowledgement that every rehabilitation will have its strength degraded over time once in function will be highlighted, since the potential occurrence of even minor failures is rarely presented to patients prior to treatment.
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Affiliation(s)
- Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo Bauru School of Dentistry, Bauru, Brazil
| | - Ryo Jimbo
- Department of Applied Prosthodontics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Lukasz Witek
- Department of Biomaterials, New York University, New York City, New York, USA
| | - Nick Tovar
- Department of Biomaterials, New York University, New York City, New York, USA
| | - Rodrigo Neiva
- Department of Periodontology, University of Florida at Gainesville, Gainesville, Florida, USA
| | - Andrea Torroni
- Attending Oral and Maxillofacial Surgery, Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center, New York City, New York, USA
| | - Paulo G Coelho
- Department of Biomaterials, Hansjörg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, New York City, New York, USA
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Savi A, Crescini A, Manfredi M, De Maria A, Bresciano M. Agenesis of a maxillary lateral incisor associated with bilateral canine inclusions: A noninvasive multidisciplinary approach. J ESTHET RESTOR DENT 2019; 31:542-552. [DOI: 10.1111/jerd.12515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 05/17/2019] [Accepted: 07/07/2019] [Indexed: 11/26/2022]
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Cao Y, Yu C, Wu Y, Li L, Li C. Long-Term Survival and Peri-Implant Health of Titanium Implants with Zirconia Abutments: A Systematic Review and Meta-Analysis. J Prosthodont 2019; 28:883-892. [PMID: 31282107 DOI: 10.1111/jopr.13097] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To evaluate the long-term implant survival rate of titanium implants with zirconia abutments, and the effects of implants with zirconia abutments on marginal bone loss (MBL) and pocket probing depth (PPD) compared with all-titanium implants. MATERIALS AND METHODS The searched electronic database included the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and the Chinese Biomedical Literature Database. Two types of studies were included: clinical studies reporting the survival rate of titanium implants with zirconia abutments with at least a mean/median 5-year follow-up, and clinical trials reporting the effects of implants with zirconia abutments on MBL and PPD compared with all-titanium implants. Two reviewers screened and selected the records, assessed quality, and extracted data of included studies independently. RESULTS This review included 16 studies from 18 publications. None of the comparative studies was assessed at a low risk of bias. The overall implant survival rate of implants with zirconia abutments was estimated to be 96% (confidence intervals [CIs] [94%, 98%], I2 = 0%). For the comparison between implants with zirconia abutments and all-titanium implants, the results significantly favored implants with zirconia abutments (for MBL, mean difference [MD] = -0.09, CIs [-0.17, 0.00], p = 0.05, I2 = 40%; for PPD, MD = -0.18, CIs [-0.32, -0.05], p = 0.008, I2 = 0%). Zirconia abutments were favored more when the prosthesis was an implant-supported overdenture rather than a single crown. CONCLUSIONS Implants with zirconia abutments may have an acceptable performance on peri-implant health compared with all-titanium implants; however, the implant survival rate of implants with zirconia abutments is slightly lower than all-titanium implants in the long-term follow-up. Additional studies are needed to explain this dichotomy.
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Affiliation(s)
- Yubin Cao
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Changhao Yu
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Yingyi Wu
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Longjiang Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
| | - Chunjie Li
- Department of Head and Neck Oncology, West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
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Evaluation of Implant Success in Patients with Dental Aplasia. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1680158. [PMID: 31321229 PMCID: PMC6607699 DOI: 10.1155/2019/1680158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/30/2019] [Accepted: 05/30/2019] [Indexed: 11/17/2022]
Abstract
Introduction Dental aplasia is an anomaly in which the number of teeth is reduced. It is the most commonly occurring dental anomaly during tooth development. Treatment management of patients with dental aplasia is challenging. Objectives The aim of this retrospective clinical study was to analyze the survival and success rates of dental implants placed in hypodontic patients, rated with different criteria. Methods Forty-three patients were diagnosed with dental aplasia and treated with dental implants between November 2000 and February 2016. The variables assessed included the plaque level, bleeding on probing, probing depth, implant mobility, implant stability, and implant loss. To analyze the peri-implant bone level, a panoramic X-ray of each patient was taken. The results were compared with X-rays taken immediately after implantation. Results Thirty-seven patients (16 males; 21 females) participated in this study. In total, 155 implants (86 maxillary; 69 mandibular) were inserted. Two of the 155 implants failed; the in situ survival rate was 98.7%. The success rate according to the criteria of Buser et al. was 96.8%, and that according to the criteria of Albrektsson et al. was 88.4%. Conclusion The survival and success rates of dental implants in patients with congenitally absent teeth were very high and did not differ significantly from results achieved in an unaffected population. Dental implants are a reliable therapy for patients with dental aplasia.
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Hu M, Chen J, Pei X, Han J, Wang J. Network meta-analysis of survival rate and complications in implant-supported single crowns with different abutment materials. J Dent 2019; 88:103115. [PMID: 30986515 DOI: 10.1016/j.jdent.2019.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/04/2019] [Accepted: 04/11/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To compare the survival rate of abutments, marginal bone loss and peri-implant soft tissue discoloration among implant-supported single crowns with different abutment materials. DATA Randomized controlled trials (RCTs), controlled clinical trials, and cohort studies of implant-supported single crowns with different dental abutment materials. SOURCES A systematic search was conducted by an electronic search in 6 databases without restrictions on September 16, 2018, complemented by a manual search. "Grey" literatures were also searched. STUDY SELECTION Of 3417 studies initially retrieved, thirteen were eligible for inclusion. After studies selected and data extraction, pair-wise and network meta-analyses were performed to analyze the survival rate of the abutment, the marginal bone loss and the soft tissue discoloration. The risk of bias was assessed based on the Cochrane guidelines, Newcastle-Ottawa scale, and funnel plots. Statistical heterogeneity, inconsistencies, and cumulative ranking were also evaluated. RESULTS Fourteen RCTs and nine non-RCTs were included. No significant differences was detected among titanium (Ti), zirconia (Zr), gold (Au), and alumina (Al) abutments in terms of survival rate (excluding Al < Ti (P < 0.05), marginal bone loss (excluding Zr < Ti (P < 0.05) and Au > Zr (P < 0.05)), or discoloration of peri-implant soft tissue. Additionally, Ti abutment had the highest cumulative ranking of survival rate (97.9%); Al abutment had the lowest marginal bone loss (81.4%) and Zr abutment had the least discoloration of peri-implant soft tissue (84.8%). CONCLUSIONS Ti abutment has a comparable survival rate with Zr, but better than Al. In addition, Zr abutment has a better effect in maintaining the marginal bone level, compared with Au and Ti. However, there was no difference in the discoloration of peri-implant soft tissue among Au, Ti, and Zr abutment. CLINICAL SIGNIFICANCE Based on the results of our network meta-analysis, Zr might be a recommended abutment material considering the clinical efficacy of implant-supported single crowns.
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Affiliation(s)
- Menglong Hu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Junyu Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Xibo Pei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China
| | - Jianmin Han
- Dental Medical Devices Testing Center, Dental Materials Laboratory, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China; Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, Section 3, South Renmin Road, Chengdu, 610041, China.
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Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res 2019; 29 Suppl 16:199-214. [PMID: 30328190 DOI: 10.1111/clr.13306] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The aim of the present systematic review was to analyze the survival and complication rates of zirconia-based and metal-ceramic implant-supported single crowns (SCs). MATERIALS AND METHODS An electronic MEDLINE search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort and retrospective case series on implant-supported SCs with a mean follow-up time of at least 3 years. Patients had to have been clinically examined at the follow-up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS The search provided 5,263 titles and 455 abstracts, full-text analysis was performed for 240 articles, resulting in 35 included studies on implant-supported crowns. Meta-analysis revealed an estimated 5-year survival rate of 98.3% (95% CI: 96.8-99.1) for metal-ceramic implant supported SCs (n = 4,363) compared to 97.6% (95% CI: 94.3-99.0) for zirconia implant supported SCs (n = 912). About 86.7% (95% CI: 80.7-91.0) of the metal-ceramic SCs (n = 1,300) experienced no biological/technical complications over the entire observation period. The corresponding rate for zirconia SCs (n = 76) was 83.8% (95% CI: 61.6-93.8). The biologic outcomes of the two types of crowns were similar; yet, zirconia SCs exhibited less aesthetic complications than metal-ceramics. The 5-year incidence of chipping of the veneering ceramic was similar between the material groups (2.9% metal-ceramic, 2.8% zirconia-ceramic). Significantly (p = 0.001), more zirconia-ceramic implant SCs failed due to material fractures (2.1% vs. 0.2% metal-ceramic implant SCs). No studies on newer types of monolithic zirconia SCs fulfilled the simple inclusion criteria of 3 years follow-up time and clinical examination of the present systematic review. CONCLUSION Zirconia-ceramic implant-supported SCs are a valid treatment alternative to metal-ceramic SCs, with similar incidence of biological complications and less aesthetic problems. The amount of ceramic chipping was similar between the material groups; yet, significantly more zirconia crowns failed due to material fractures.
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Affiliation(s)
- Bjarni E Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.,Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Nicola A Valente
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Shiming Liu
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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Wittneben JG, Wismeijer D, Brägger U, Joda T, Abou-Ayash S. Patient-reported outcome measures focusing on aesthetics of implant- and tooth-supported fixed dental prostheses: A systematic review and meta-analysis. Clin Oral Implants Res 2019; 29 Suppl 16:224-240. [PMID: 30328183 DOI: 10.1111/clr.13295] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/24/2018] [Accepted: 05/15/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to summarize the existing evidence on patient-reported aesthetic outcome measures (PROMs) of implant-supported, relative to tooth-supported fixed dental prostheses. MATERIAL AND METHODS In April 2017, two reviewers independently searched the Medline (PubMed), EMBASE, and Cochrane electronic databases, focusing on studies including patient-reported aesthetic outcomes of implant- and tooth-supported fixed dental prostheses (FDPs). Human studies with a mean follow-up period of at least 1 year, a minimum of ten patients, and English, German, or French publication were included. For the comparison of subgroups, random-effects meta-regression for aggregate-level data was used. RESULTS The systematic search for implant-supported prostheses focusing on patient-reported outcomes identified 2,675 titles, which were screened by two independent authors. Fifty full-text articles were analyzed, and finally, 16 publications (including 19 relevant study cohorts) were included. For tooth-supported prostheses, no studies could be included. A total of 816 implant-supported reconstructions were analyzed by patients. Overall aesthetic evaluation by the patients' visual analogue scale (VAS) rating was high in implant-supported FDPs (median: 90.3; min-max: 80.0-94.0) and the surrounding mucosa (median: 84.7; min-max: 73.0-92.0). Individual restorative materials, implant neck design (i.e., tissue or bone level type implants), and the use of a fixed provisional had no effect on patients' ratings of the definitive implant-supported FDPs. CONCLUSIONS Aesthetics is an important patient-reported measure, which lacks in standardized methods; however, patients' satisfaction was high for implant- supported FDPs and the surrounding mucosa.
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Affiliation(s)
- Julia-Gabriela Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, ACTA, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Samir Abou-Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Rabel K, Spies BC, Pieralli S, Vach K, Kohal RJ. The clinical performance of all-ceramic implant-supported single crowns: A systematic review and meta-analysis. Clin Oral Implants Res 2019; 29 Suppl 18:196-223. [PMID: 30306684 DOI: 10.1111/clr.13337] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/30/2018] [Accepted: 06/05/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This review aimed at evaluating the survival and technical complication rates of all-ceramic implant-supported single crowns (SC). MATERIAL AND METHODS Three electronic databases were searched for clinical studies conducted at ≥ 15 patients examining implant-supported all-ceramic SCs over ≥ 12 months. Survival rates of implants and restorations plus technical complication rates of SCs were calculated and tested for statistical correlation with confounding variables. Statistical analysis was performed using a negative binomial distribution model to calculate 5- and 10-year survival and complication estimates. RESULTS Forty-one included studies reported on implant-supported SCs made of veneered and monolithic high-strength oxide ceramics, monolithic, and veneered glass-based ceramics and of a monolithic resin-nano-ceramic (RNC). Survival estimates for SCs of 93% (95% CI: 86.6%-96.4%) after 5 years and 94.4% (95% CI: 91.1%-96.5%) after 10 years were calculated, corresponding values for implant survival were 95.3% (95% CI: 90.6%-97.7%) and 96.2% (95% CI: 95.1%-97.1%). Technical complication rates after 5/10 years were as follows: chipping 9.0% (95% CI: 5.4%-14.8%)/2.7% (95% CI: 2.1%-3.5%), framework fractures 1.9% (95% CI: 0.7%-4.9%)/1.2% (95% CI: 1%-1.5%), screw loosening 3.6% (95% CI: 1.6%-8.4%)/5.2% (95% CI: 3.6%-7.5%), and decementations with 1.1% (95% CI: 0.4%-2.8%) after 5 years. Some confounding variables influenced the above-mentioned estimates significantly. CONCLUSIONS All-ceramic implant-supported SCs showed-with the exception of a RNC material-high survival rates. However, failures and technical complications occurred which have to be considered when informing patients on the treatment with implant-supported all-ceramic SCs.
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Affiliation(s)
- Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Benedikt Christopher Spies
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefano Pieralli
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Campus Benjamin Franklin (CBF), CC 3 Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kirstin Vach
- Institute of Medical Biometry and Statistics, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
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Lemos CAA, Verri FR, Gomes JMDL, de Souza Batista VE, Cruz RS, Oliveira HFFE, Pellizzer EP. Ceramic versus metal-ceramic implant-supported prostheses: A systematic review and meta-analysis. J Prosthet Dent 2019; 121:879-886.e4. [PMID: 30661882 DOI: 10.1016/j.prosdent.2018.09.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM There is insufficient evidence to recommend the restorative material for implant-supported prostheses. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate studies that compared ceramic and metal-ceramic restorations for implant-supported prostheses (within the same study to avoid indirect comparison) in terms of the mechanical and biological complication rates, prosthesis survival rate, and marginal bone loss. MATERIAL AND METHODS Two independent reviewers performed a comprehensive search in databases (PubMed/MEDLINE, Web of Science, and Cochrane Library) for articles indexed until March 31, 2018. The search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and methods were registered in the International Prospective Register of Systematic Reviews (PROSPERO). The focused question was "Do ceramic restorations have mechanical/biological complication rates, prosthesis survival rates, and marginal bone loss similar to those of metal-ceramic restorations?" RESULTS The search identified 949 references. The interinvestigator agreement using kappa values was 0.87 for PubMed/MEDLINE, 0.93 for Scopus, and 1.0 for the Cochrane Library. After analysis, 12 studies were selected for qualitative and quantitative analysis. The mechanical complication rate did not differ between ceramic and metal-ceramic restorations (P=.89), independent of the type of prostheses (single crown: P=.63; fixed partial denture: P=.65). The biological complication rate was also not significantly different between ceramic and metal-ceramic restorations (P=.21). The prosthesis survival rate showed no significant differences between the 2 types of restorations (P=.56). Marginal bone loss was also similar for both types of restorations (P=.12). CONCLUSIONS This systematic review indicated that ceramic and metal-ceramic implant-supported prostheses have similar mechanical and biological complication rates, prosthesis survival rates, and marginal bone loss. Thus, both treatments are appropriate options for long-term rehabilitation treatment.
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Affiliation(s)
- Cleidiel Aparecido Araújo Lemos
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil.
| | - Fellippo Ramos Verri
- Adjunct Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Jéssica Marcela de Luna Gomes
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Victor Eduardo de Souza Batista
- Associate Professor, Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - Ronaldo Silva Cruz
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | | | - Eduardo Piza Pellizzer
- Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
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Naveau A, Rignon-Bret C, Wulfman C. Zirconia abutments in the anterior region: A systematic review of mechanical and esthetic outcomes. J Prosthet Dent 2019; 121:775-781.e1. [PMID: 30617036 DOI: 10.1016/j.prosdent.2018.08.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM The success of single, anterior, implant-supported restorations relies on mechanical and esthetic outcomes. Titanium has been the most commonly used material for abutments, but zirconia is increasingly chosen for its appearance despite its unclear mechanical performance. Today, manufacturers market prefabricated, computer-aided design and computer-aided manufacturing (CAD-CAM) custom and zirconia abutments with titanium connections. PURPOSE The purpose of this study was to systematically review the mechanical and esthetic outcomes of implant zirconia abutments used in the anterior region, considering the design changes of the past 5 years. MATERIAL AND METHODS An electronic search was conducted in Medline (PubMed) for studies on zirconia abutments. All clinical studies with at least a 1-year follow-up and case series (>5 abutments) published after 2013 were included. Mechanical and esthetic outcomes were collected. RESULTS Of the 231 retrieved studies, 20 remained for quantitative analysis. Twelve described mechanical outcomes, and 15 focused on esthetics, using mainly the pink esthetic score. Five articles reported abutment fractures and no chipping. No difference was found between prefabricated and custom abutments or internal and external implant connections regarding fractures or screw loosening. All authors reported "good to excellent" esthetic integration in terms of restorations and soft-tissue color and the presence and height of papillae. The most difficult esthetic parameters to achieve were root convexity, soft-tissue color, and texture and level of mucosa. CONCLUSIONS Esthetics remain the major advantage of zirconia abutment when compared with titanium, despite reservations concerning the risk of mechanical complications. Data are lacking for zirconia abutments with titanium inserts, although the prospects for this design are promising.
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Affiliation(s)
- Adrien Naveau
- Associate Professor, Prosthodontics Department, University of Bordeaux, Bordeaux, France; Saint Andre Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Christophe Rignon-Bret
- Associate Professor, Prosthodontics Department, Paris Descartes University - Sorbonne Paris Cité, Paris, France; Dental Department, Henri Mondor Hospital-University Group, AP-HP (Public Assistance-Paris hospital), Creteil, France
| | - Claudine Wulfman
- Associate Professor, Prosthodontics Department, Paris Descartes University - Sorbonne Paris Cité, Paris, France; Dental Department, Henri Mondor Hospital-University Group, AP-HP (Public Assistance-Paris Hospital), Creteil, France.
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Ali Z, Baker SR, Shahrbaf S, Martin N, Vettore MV. Oral health-related quality of life after prosthodontic treatment for patients with partial edentulism: A systematic review and meta-analysis. J Prosthet Dent 2019; 121:59-68.e3. [DOI: 10.1016/j.prosdent.2018.03.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/05/2018] [Accepted: 03/06/2018] [Indexed: 12/19/2022]
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Nouh I, Kern M, Sabet AE, Aboelfadl AK, Hamdy AM, Chaar MS. Mechanical behavior of posterior all-ceramic hybrid-abutment-crowns versus hybrid-abutments with separate crowns-A laboratory study. Clin Oral Implants Res 2018; 30:90-98. [DOI: 10.1111/clr.13395] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 02/04/2023]
Affiliation(s)
- Ingy Nouh
- Department of Prosthodontics, Propaedeutic and Dental Materials, School of Dentistry; Christian-Albrechts University; Kiel Germany
- Fixed Prosthodontics Department, Faculty of Dentistry; Ain Shams University; Cairo Egypt
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutic and Dental Materials, School of Dentistry; Christian-Albrechts University; Kiel Germany
| | - Ahmed E. Sabet
- Fixed Prosthodontics Department, Faculty of Dentistry; Ain Shams University; Cairo Egypt
| | - Ahmad K. Aboelfadl
- Fixed Prosthodontics Department, Faculty of Dentistry; Ain Shams University; Cairo Egypt
| | - Amina M. Hamdy
- Fixed Prosthodontics Department, Faculty of Dentistry; Ain Shams University; Cairo Egypt
| | - Mohamed S. Chaar
- Department of Prosthodontics, Propaedeutic and Dental Materials, School of Dentistry; Christian-Albrechts University; Kiel Germany
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Jain JK, Sethuraman R, Chauhan S, Javiya P, Srivastava S, Patel R, Bhalani B. Retention failures in cement- and screw-retained fixed restorations on dental implants in partially edentulous arches: A systematic review with meta-analysis. J Indian Prosthodont Soc 2018; 18:201-211. [PMID: 30111908 PMCID: PMC6070851 DOI: 10.4103/jips.jips_25_18] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 06/01/2018] [Indexed: 12/20/2022] Open
Abstract
PURPOSE This systematic review aimed to evaluate retention failures in cement- and screw-retained fixed restorations on dental implants in partially edentulous arches. METHODS The relevant articles were retrieved from MEDLINE (PubMed), Cochrane Library, and EBSCO electronic databases for articles published from January 1995 to January 2016 and were restricted to randomized controlled trials and retrospective and prospective studies on human subjects that were reported in English. A further hand search was conducted on individual journals and reference list of the articles found. Reviewed studies which reported retention failures in fixed implant-supported prostheses using screw and cement retention mechanism. Information on the type and nature of restoration, as well as different luting cement, were also collected. RESULTS Thirty-three articles were finalized, 20 short-term clinical studies (up to 5 years) and 13 long-term studies (≥5 years). Out of 33 studies, 16 studies were included in meta-analysis, 8 in short-term and 8 in long-term studies. The results of the meta-analysis for short-term studies showed statistically significant difference between cement-retained and screw-retained prosthesis, with the forest plot favoring cement-retained prostheses (risk ratio [RR]: 0.26; confidence interval [CI]: 0.09-0.74; P < 0.0001; I2 = 79%). In long-term studies, the forest plot revealed statistically significant difference between both retention systems favoring cement-retained prostheses (RR: 0.31; CI: 0.13-0.76; P = 0.03; I2 = 56%). CONCLUSION Analysis of the short- and long-term studies shows lesser retention failures with cement-retained prostheses when compared to screw-retained prostheses. Further, multicentric, high-quality randomized controlled studies with long-term observations and modified cementation protocols can yield higher grades of recommendation to avoid retention failures.
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Affiliation(s)
- Jatin K. Jain
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Rajesh Sethuraman
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Sameer Chauhan
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Piyush Javiya
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Shreya Srivastava
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | - Rutvik Patel
- Department of Prosthodontics and Crown and Bridge, K.M. Shah Dental College and Hospital, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
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Sanz-Sánchez I, Sanz-Martín I, Carrillo de Albornoz A, Figuero E, Sanz M. Biological effect of the abutment material on the stability of peri-implant marginal bone levels: A systematic review and meta-analysis. Clin Oral Implants Res 2018; 29 Suppl 18:124-144. [DOI: 10.1111/clr.13293] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/05/2018] [Accepted: 05/08/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Ignacio Sanz-Sánchez
- Section of Graduate Periodontology; University Complutense; Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | | | | | - Elena Figuero
- Section of Graduate Periodontology; University Complutense; Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
| | - Mariano Sanz
- Section of Graduate Periodontology; University Complutense; Madrid Spain
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group; University Complutense; Madrid Spain
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Filius MAP, Vissink A, Cune MS, Raghoebar GM, Visser A. Effect of implant therapy on oral health-related quality of life (OHIP-49), health status (SF-36), and satisfaction of patients with several agenetic teeth: Prospective cohort study. Clin Implant Dent Relat Res 2018; 20:592-597. [PMID: 29787641 PMCID: PMC6099259 DOI: 10.1111/cid.12625] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/12/2018] [Accepted: 04/17/2018] [Indexed: 11/26/2022]
Abstract
Background Effect of fixed prosthodontics on patients with several agenetic teeth is not well understood. Purpose To assess the effect of implant‐based fixed prosthodontics on oral health‐related quality of life (OHRQoL), general health status, and satisfaction regarding dental appearance, ability to chew and speech in patients with several agenetic teeth. Materials and Methods For this prospective cohort study, all patients (≥18 years) with several agenetic teeth who were scheduled for treatment with fixed dental implants between September 2013 and July 2015 at our department were approached. Participants received a set of questionnaires before and 1 year after implant placement to assess OHRQoL (OHIP‐NL49), general health status (SF‐36), and satisfaction regarding dental appearance, ability to chew and speech. Results About 25 out of 31 eligible patients (10 male, 15 female; median age: 20 [19;23] years; agenetic teeth: 7 [5;10]) were willing to participate. Pre‐ and post‐treatment OHIP‐NL49 sum‐scores were 38 [28;56] and 17 [7;29], respectively (P < .001). Scores of all OHIP‐NL49 subdomains decreased tool, representing an improved OHRQoL (P < .05) as well as that satisfaction regarding dental appearance, ability to chew and speech increased (P < .001). General health status did not change with implant treatment (P > .05). Conclusions Treatment with implant‐based fixed prosthodontics improves OHRQoL and satisfaction with dental appearance, ability to chew and speech, while not affecting general health status.
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Affiliation(s)
- Marieke A P Filius
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen and University of Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen and University of Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Marco S Cune
- Department of Fixed and Removable Prosthodontics and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands.,Department of Oral and Maxillofacial Surgery, Prosthodontics and Special Care, University Medical Center Utrecht and Utrecht University, PO Box 85090, Utrecht, 3854 EA, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen and University of Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Anita Visser
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen and University of Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
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Cheng CW, Chien CH, Chen CJ, Papaspyridakos P. Randomized Controlled Clinical Trial to Compare Posterior Implant-Supported Modified Monolithic Zirconia and Metal-Ceramic Single Crowns: One-Year Results. J Prosthodont 2018. [PMID: 29528175 DOI: 10.1111/jopr.12767] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The purpose of this randomized controlled clinical trial was to investigate the prosthetic outcomes of posterior implant-supported single crowns (SCs) with a modified monolithic zirconia or metal-ceramic design at 1 year of loading. MATERIALS AND METHODS Forty participants with 73 dental implants in need of at least 1 maxillary or mandibular posterior implant-supported SC were consecutively selected for this study. The included participants were randomly divided into modified monolithic zirconia (MMZ) and metal-ceramic (MC) groups. The implant-supported SCs were examined after 1 year for survival and technical complications. Descriptive statistics were used to illustrate the data, and the association associated risks of complications were estimated using the logistic regression model with Firth's approach for rare outcome (α = 0.05). RESULTS During the observation period, 2 participants in the MC group were lost to follow-up. A total of 38 participants with 70 posterior implant-supported SCs (36 and 34 SCs in the MMZ and MC groups respectively) completed the 1-year follow-up examination. One implant failed in the MMZ group. The 1-year survival rates for implants and crowns were both 97.2% in the MMZ group. The survival rates for implants and crowns were both 100% in the MC group. One screw loosening event was observed in one screw-retained SC in the MMZ group; however, 8 complication events occurred in 7 SCs in the MC group. Therefore, the complication-free rates were 97.1% and 79.4% in the MMZ and MC SCs respectively. The most common complication in the MC group was screw loosening (14.7%), followed by loss of retention (5.9%), and ceramic fracture (2.9%). Significantly more technical complications were observed in the MC SCs than MMZ SCs (p = 0.0432). CONCLUSION The modified monolithic zirconia design applied to the posterior implant-supported SCs had a significantly lower technical complication rate than did the metal-ceramic one.
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Affiliation(s)
- Chih-Wen Cheng
- Division of Prosthodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Chia-Hui Chien
- Division of Prosthodontics, Department of Dentistry, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chun-Jung Chen
- Division of Periodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Panos Papaspyridakos
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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ElHoussiney AG, Zhang H, Song J, Ji P, Wang L, Yang S. Influence of implant location on the clinical outcomes of implant abutments: a systematic review and meta-analysis. Clin Cosmet Investig Dent 2018. [PMID: 29520162 PMCID: PMC5834166 DOI: 10.2147/ccide.s143910] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose To compare the failure events and incidence of complications of different abutment materials in anterior and posterior regions. Failure was defined as complete loss of the abutment requiring replacement by a new abutment. Materials and methods Electronic searches using PubMed/Medline and Google Scholar complemented with manual searches were performed with specific search terms. Searches were restricted to publications in English between January 2006 and March 2016. Results A total of 863 and 1,264 implants were inserted in the anterior and posterior regions, respectively, in a total of 1,529 patients. No titanium abutments failed in anterior or posterior regions. On the other hand, 1.6% of zirconia abutments failed in the anterior region and 1.5% failed in the posterior region. Technical complications occurred mostly in the posterior region and mostly involved zirconia abutment. Meta-analysis was possible only for zirconia-abutment failure, due to considerable heterogeneity of studies and outcome variables. No significant difference in failure rate was found between anterior and posterior zirconia abutments (risk ratio 1.53, 95% CI 0.49–4.77; P=0.47). Conclusion This systematic review and meta-analysis showed similar outcomes of different abutment materials when used in anterior and posterior regions in terms of failure events and biological and aesthetic complications. The only significant finding was the increased incidence of technical complications in the posterior region, mostly involving zirconia abutments. Abutment-screw loosening was the most common technical complication.
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Affiliation(s)
| | - He Zhang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Jinlin Song
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Ping Ji
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, College of Stomatology, Chongqing Medical University, Chongqing, China
| | - Lu Wang
- Department of Prosthodontics
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Stefanini M, Felice P, Mazzotti C, Mounssif I, Marzadori M, Zucchelli G. Esthetic evaluation and patient-centered outcomes in single-tooth implant rehabilitation in the esthetic area. Periodontol 2000 2018; 77:150-164. [DOI: 10.1111/prd.12215] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Barber S, Bekker HL, Meads D, Pavitt S, Khambay B. Identification and appraisal of outcome measures used to evaluate hypodontia care: A systematic review. Am J Orthod Dentofacial Orthop 2018; 153:184-194.e18. [PMID: 29407495 DOI: 10.1016/j.ajodo.2017.10.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 10/01/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Identification and appraisal of the outcome measures that have been used to evaluate hypodontia treatment and deliver services are essential for improving care. A lack of alignment between outcomes and patient values can limit the scope for patient-centered care. Our objectives were to identify and appraise the outcomes selected to evaluate hypodontia care. METHODS Data sources included 10 electronic databases and grey literature, searched using terms for hypodontia and its treatment methods. Study eligibility included mixed study designs to ensure comprehensive identification of outcomes, excluding case reports and case series with fewer than 10 participants and nonsystematic reviews. Participants and interventions involved people with hypodontia receiving any dental treatment to manage their hypodontia. Simulated treatment, purely laboratory-based interventions, and future treatments still in development were excluded. Research outcomes were identified and synthesised into 4 categories: clinical indicators, and patient-reported, clinician-reported, and lay-reported outcomes. No synthesis of efficacy data was planned, and consequently no methodologic quality appraisal of the studies was undertaken. RESULTS The search identified 497 abstracts, from which 106 eligible articles were retrieved in full. Fifty-six studies and 8 quality-improvement reports were included. Clinical indicators were reported in 49 studies (88%) including appearance, function, dental health, treatment longevity, treatment success and service delivery. Patient-reported outcomes were given in 22 studies (39%) including oral health-related quality of life, appearance, function, symptoms of temporomandibular dysfunction, and patient experience. Clinician-reported outcomes were limited to appearance. Variability was seen in the tools used for measuring outcomes. CONCLUSIONS There is a lack of rationale and consistency in the selection of outcome measures used to evaluate hypodontia care. Outcomes are largely clinician and researcher-driven with little evidence of their relevance to patients. There was a paucity of outcomes measuring access to care, quality of care, and cost. Evidence from hypodontia research is clinician-focused and likely to have limited value to support patients during decision making. Attempts to synthesise the evidence base for translation into practice will be challenging. There is a need for a core outcomes set with a patient-centric approach to drive improvements in health services.
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Affiliation(s)
- Sophy Barber
- Department of Orthodontics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
| | - Hilary L Bekker
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - David Meads
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Sue Pavitt
- Department of School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Balvinder Khambay
- Department of Orthodontics, University of Birmingham, Birmingham, United Kingdom
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Wittneben J, Gavric J, Belser U, Bornstein M, Joda T, Chappuis V, Sailer I, Brägger U. Esthetic and Clinical Performance of Implant-Supported All-Ceramic Crowns Made with Prefabricated or CAD/CAM Zirconia Abutments: A Randomized, Multicenter Clinical Trial. J Dent Res 2016; 96:163-170. [DOI: 10.1177/0022034516681767] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Patients’ esthetic expectations are increasing, and the options of the prosthetic pathways are currently evolving. The objective of this randomized multicenter clinical trial was to assess and compare the esthetic outcome and clinical performance of anterior maxillary all-ceramic implant crowns (ICs) based either on prefabricated zirconia abutments veneered with pressed ceramics or on CAD/CAM zirconia abutments veneered with hand buildup technique. The null hypothesis was that there is no statistically significant difference between the 2 groups. Forty implants were inserted in sites 14 to 24 (FDI) in 40 patients in 2 centers, the Universities of Bern and Geneva, Switzerland. After final impression, 20 patients were randomized into group A, restored with a 1-piece screw-retained single crown made of a prefabricated zirconia abutment with pressed ceramic as the veneering material using the cut-back technique, or group B using an individualized CAD/CAM zirconia abutment (CARES abutment; Institut Straumann AG) with a hand buildup technique. At baseline, 6 mo, and 1 y clinical, esthetic and radiographic parameters were assessed. Group A exhibited 1 dropout patient and 1 failure, resulting in a survival rate of 94.7% after 1 y, in comparison to 100% for group B. No other complications occurred. Clinical parameters presented stable and healthy peri-implant soft tissues. Overall, no or only minimal crestal bone changes were observed with a mean DIB (distance from the implant shoulder to the first bone-to-implant contact) of −0.15 mm (group A) and 0.12 mm (group B) at 1 y. There were no significant differences at baseline, 6 mo, and 1 y for DIB values between the 2 groups. Pink esthetic score (PES) and white esthetic score (WES) values at all 3 examinations indicated stability over time for both groups and pleasing esthetic outcomes. Both implant-supported prosthetic pathways represent a valuable treatment option for the restoration of single ICs in the anterior maxilla ( ClinicalTrials.gov NCT02905838).
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Affiliation(s)
- J.G. Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA
| | - J. Gavric
- Division of Fixed Prosthodontics and Biomaterials, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - U.C. Belser
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - M.M. Bornstein
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - T. Joda
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Section for Digital Reconstructive Technology + Implant Dentistry [DiRecT+ID], School of Dental Medicine, University of Bern, Bern, Switzerland
| | - V. Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - I. Sailer
- Division of Fixed Prosthodontics and Biomaterials, School of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - U. Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Terheyden H, Wüsthoff F. Occlusal rehabilitation in patients with congenitally missing teeth-dental implants, conventional prosthetics, tooth autotransplants, and preservation of deciduous teeth-a systematic review. Int J Implant Dent 2016; 1:30. [PMID: 27747652 PMCID: PMC5005685 DOI: 10.1186/s40729-015-0025-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 08/27/2015] [Indexed: 01/24/2023] Open
Abstract
Background Implant patients with congenitally missing teeth share some common charateristics and deserve special attention. Methods The PICO question was “In patients with congenitally missing teeth, does an early occlusal rehabilitation with dental implants in comparison to tooth autotransplants, conventional prosthetics on teeth or preservation of deciduous teeth have better general outcomes in terms of survival, success and better patient centered outcomes in terms of quality of life, self-esteem, satisfaction, chewing function?” After electronic database search, a total of 63 relevant studies were eligible, of which 42 qualified for numerical data synthesis, 26 being retrospective studies. A data synthesis was performed by weighted means for survival/success/annual failure rates. Results The mean survival of implants was 95.3 % (prosthesis survival 97.8 %), autotransplants 94.4 %, deciduous teeth 89.6 %, and conventional prostheses 60.2 %. The implant survival in children, adolescents, and adults was 72.4, 93.0, and 97.4 %. Annual failure rates of implants 3.317 %, autotransplants 1.061 %, deciduous teeth 0.908 %, and conventional prostheses 5.144 % indicated better results for natural teeth and more maintenance needs for the both prosthetic treatments. The mean OHIP score was 27.8 at baseline and a mean improvement of 14.9 score points was reported after implant prosthetics. The mean satisfaction rates were 93.4 (implants), 76.6 (conventional prostheses), 72.0 (autotransplants), and 65.5 % (orthodontic space closure). Conclusions In synopsis of general and patient-centered outcomes, implants yielded the best results, however, not in children <13 years. Autotransplants and deciduous teeth had low annual failure rates and are appropriate treatments in children and adolescents at low costs. Conventional prosthetics had lower survival/success rates than the other options. Due to heterogeneity and low number of studies, patient-reported outcomes in this review have to be interpreted with caution.
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Affiliation(s)
- Hendrik Terheyden
- Department of Oral and Maxillofacial Surgery, Red Cross Hospital, Hansteinstr. 29, D-34121, Kassel, Germany.
| | - Falk Wüsthoff
- Department of Oral and Maxillofacial Surgery, Schleswig-Holstein University Hospital, Arnold-Heller-Straße 3, Haus 26, 2D-4105, Kiel, Germany
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Abstract
INTRODUCTION The use of zirconia in medicine and dentistry has rapidly expanded over the past decade, driven by its advantageous physical, biological, esthetic, and corrosion properties. Zirconia orthopedic hip replacements have shown superior wear-resistance over other systems; however, risk of catastrophic fracture remains a concern. In dentistry, zirconia has been widely adopted for endosseous implants, implant abutments, and all-ceramic crowns. Because of an increasing demand for esthetically pleasing dental restorations, zirconia-based ceramic restorations have become one of the dominant restorative choices. Areas covered: This review provides an updated overview of the applications of zirconia in medicine and dentistry with a focus on dental applications. The MEDLINE electronic database (via PubMed) was searched, and relevant original and review articles from 2010 to 2016 were included. Expert commentary: Recent data suggest that zirconia performs favorably in both orthopedic and dental applications, but quality long-term clinical data remain scarce. Concerns about the effects of wear, crystalline degradation, crack propagation, and catastrophic fracture are still debated. The future of zirconia in biomedical applications will depend on the generation of these data to resolve concerns.
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Affiliation(s)
- Yen-Wei Chen
- a Department of Restorative Dentistry , University of Washington School of Dentistry , Seattle , WA , USA
| | - Joelle Moussi
- a Department of Restorative Dentistry , University of Washington School of Dentistry , Seattle , WA , USA
| | - Jeanie L Drury
- a Department of Restorative Dentistry , University of Washington School of Dentistry , Seattle , WA , USA
| | - John C Wataha
- a Department of Restorative Dentistry , University of Washington School of Dentistry , Seattle , WA , USA
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Cooper LF, Stanford C, Feine J, McGuire M. Prospective assessment of CAD/CAM zirconia abutment and lithium disilicate crown restorations. J Prosthet Dent 2016; 116:33-9. [DOI: 10.1016/j.prosdent.2015.08.023] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 11/30/2022]
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Zembic A. Externally Connected Zirconia Abutments with Standard Platform are Successful Long Term in Anterior Regions. J Evid Based Dent Pract 2016; 16:130-2. [DOI: 10.1016/j.jebdp.2016.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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46
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Bonfante EA, Suzuki M, Hirata R, Bonfante G, Fardin VP, Coelho PG. Resin composite repair for implant-supported crowns. J Biomed Mater Res B Appl Biomater 2016; 105:1481-1489. [DOI: 10.1002/jbm.b.33683] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 03/29/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Estevam A. Bonfante
- Department of Prosthodontics; University of São Paulo, Bauru College of Dentistry; Bauru SP Brazil
| | - Marcelo Suzuki
- Department of Operative Dentistry and Prosthodontics; Tufts University School of Dental Medicine; Boston Massachusetts
| | - Ronaldo Hirata
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York New York 10010
| | - Gerson Bonfante
- Department of Prosthodontics; University of São Paulo, Bauru College of Dentistry; Bauru SP Brazil
| | - Vinicius P. Fardin
- Department of Prosthodontics; University of São Paulo, Bauru College of Dentistry; Bauru SP Brazil
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York New York 10010
| | - Paulo G. Coelho
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York New York 10010
- Director for Research; Department of Periodontology and Implant Dentistry; New York University College of Dentistry; New York New York
- Affiliated Faculty; Division of Engineering; New York University Abu Dhabi; Abu Dhabi United Arab Emirates
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Spies BC, Kohal RJ, Balmer M, Vach K, Jung RE. Evaluation of zirconia-based posterior single crowns supported by zirconia implants: preliminary results of a prospective multicenter study. Clin Oral Implants Res 2016; 28:613-619. [DOI: 10.1111/clr.12842] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Benedikt Christopher Spies
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Freiburg Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry; Center for Dental Medicine; Medical Center - University of Freiburg; Freiburg Germany
| | - Marc Balmer
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Kirstin Vach
- Center for Medical Biometry and Medical Informatics; Institute for Medical Biometry and Statistics; Medical Center - University of Freiburg; Freiburg Germany
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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48
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Comparison of Marginal and Internal Adaptation of CAD/CAM and Conventional Cement Retained Implant-Supported Single Crowns. IMPLANT DENT 2016; 25:103-8. [DOI: 10.1097/id.0000000000000346] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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49
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Spies BC, Patzelt SBM, Vach K, Kohal RJ. Monolithic lithium-disilicate single crowns supported by zirconia oral implants: three-year results of a prospective cohort study. Clin Oral Implants Res 2015; 27:1160-8. [DOI: 10.1111/clr.12716] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Benedikt Christopher Spies
- Center for Dental Medicine; Department of Prosthetic Dentistry; Medical Center - University of Freiburg; Freiburg Germany
| | | | - Kirstin Vach
- Center for Medical Biometry and Medical Informatics; Institute for Medical Biometry and Statistics; Medical Center - University of Freiburg; Freiburg Germany
| | - Ralf-Joachim Kohal
- Center for Dental Medicine; Department of Prosthetic Dentistry; Medical Center - University of Freiburg; Freiburg Germany
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50
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Kutkut A, Abu-Hammad O, Mitchell R. Esthetic Considerations for Reconstructing Implant Emergence Profile Using Titanium and Zirconia Custom Implant Abutments: Fifty Case Series Report. J ORAL IMPLANTOL 2015; 41:554-61. [DOI: 10.1563/aaid-joi-d-12-00274] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Titanium and zirconia custom implant abutments are now commonly used for esthetic implant dentistry. Custom implant abutments allow the clinician to improve an implant's emergence profile, to customize cervical margins in accordance with the anatomy of the natural root, and to compensate for poor implant angulation. All of these are essential for optimum esthetic outcomes. Computer-aided design/computer-aided machining (CAD/CAM) technology allows the clinician to design custom implant abutment configurations and create natural-looking superstructures that are in harmony with the adjacent dentition and soft tissue. The CAD/CAM technique provides precise fit, reduces the cost of the procedure, and eliminates dimensional inaccuracies inherent in the conventional waxing and casting technique. The aim of this report is to describe a simplified technique for reconstructing emergence profiles during implant restoration using milled titanium and zirconia custom implant abutments. The results of 50 consecutive cases are reported.
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Affiliation(s)
- Ahmad Kutkut
- Department of Oral Health Practice, Division of Restorative Dentistry, College of Dentistry, University of Kentucky, Lexington, Ky
| | - Osama Abu-Hammad
- Faculty of Dentistry, Taibah University, Almadena Almunawaara, Kingdom of Saudia Arabia
| | - Richard Mitchell
- Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Ky
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