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Journal of Prosthodontic Research Jul 2022This clinical report describes treatment with a double-crown-retained removable dental prosthesis fabricated using an intraoral scanner (IOS) and computer-aided...
PATIENT
This clinical report describes treatment with a double-crown-retained removable dental prosthesis fabricated using an intraoral scanner (IOS) and computer-aided design/manufacturing technology (CAD/CAM). A 68-year-old female patient presented with complaints of missing maxillary right first and left second premolars. CAD/CAM technology was applied to plan treatment with a double-crown-retained removable dental prosthesis. The patient consented to this treatment option but did not want orthodontic treatment for the anterior crossbite of the right side. After the definitive preparation of the abutment teeth, the shape of the provisional restoration was adjusted to match the definitive prosthesis. An IOS was used to obtain digital scans of the provisional restoration, occlusion, antagonist arch, and prepared surface of the abutment teeth. First, the primary crowns were milled from cobalt-chromium alloy. Next, using an intraoral scanner, a pick-up impression of the primary crowns was performed, and the secondary crowns were designed, milled, and veneered. After delivery, the patient expressed satisfaction with the functionality, esthetics, and fit of the double-crown-retained removable dental prosthesis.
DISCUSSION
The surface of the primary crowns was coated with scan spray when the pick-up impression was made using the IOS. Practice is needed to achieve a thin and homogeneous coating with scan spray to improve reproducibility.
CONCLUSION
Double-crown-retained removable dental prostheses can be successfully fabricated using an IOS and CAD/CAM technology, resulting in patient satisfaction.
Topics: Aged; Computer-Aided Design; Crowns; Dental Prosthesis Design; Female; Humans; Reproducibility of Results; Technology
PubMed: 34853251
DOI: 10.2186/jpr.JPR_D_21_00127 -
Journal of Prosthodontic Research Apr 2024To evaluate the marginal adaptation and fracture resistance of three computer-aided design/computer-assisted manufacturing hybrid dental materials with different...
PURPOSE
To evaluate the marginal adaptation and fracture resistance of three computer-aided design/computer-assisted manufacturing hybrid dental materials with different occlusal thicknesses.
METHODS
Ninety single-molar crowns were digitally fabricated using a milled hybrid nanoceramic (Cerasmart, CE), polymer-infiltrated ceramic network (PICN, Vita Enamic, VE), and 3D-printed materials (Varseosmile, VS) with occlusal thicknesses of 0.8, 1, and 1.5 mm (10 specimens/group). Anatomical 3D-printed resin dies (Rigid 10K) were used as supporting materials. A CEREC MCX milling unit and a DLP-based 3D printer, Freeform Pro 2, were utilized to produce the crown samples. Before cementation, the marginal adaptation, absolute marginal discrepancy (AMD), and marginal gap (MG) were assessed using micro-CT scanning. After cementation with self-adhesive resin cement, fracture resistance was evaluated using a universal testing machine. The number of fractured crowns and the maximum fracture values (N) were recorded. Data were statistically analyzed using both one- and two-way ANOVA, followed by Tukey's honestly significant difference (HSD) test.
RESULTS
For all occlusal thicknesses, the VS crowns demonstrated the lowest AMD and MG distances, significantly different from those of the other two milling groups (P < 0.05), whereas CE and VE did not differ significantly (P > 0.05). All VS crowns were fractured using the lowest loading forces (1480.3±226.1 to 1747.2±108.7 N). No CE and 1 and 1.5 mm VE crowns fractured under a 2000 N maximum load.
CONCLUSIONS
All hybrid-material crowns demonstrated favorable marginal adaptation within a clinically acceptable range, with 3D printing yielding superior results to milling. All materials could withstand normal occlusal force even with a 0.8 mm occlusal thickness.
Topics: Dental Porcelain; Crowns; Materials Testing; Ceramics; Computer-Aided Design; Printing, Three-Dimensional; Dental Prosthesis Design; Dental Marginal Adaptation
PubMed: 37438119
DOI: 10.2186/jpr.JPR_D_23_00089 -
BMC Oral Health Mar 2024Over the years, implant therapy has been a commonly used treatment option for individuals who are partially or totally edentulous, with a long-term success rate of over...
INTRODUCTION
Over the years, implant therapy has been a commonly used treatment option for individuals who are partially or totally edentulous, with a long-term success rate of over 90%. With significant advancements in biomaterials and technology, implant dentistry can now conduct prosthetic rehabilitations in the majority of patients catering to all types of needs. However, in order to meet the demands of a patient base that is always growing, new trends in implantology are emerging in recent years that are focused on minimally invasive surgery and financial sustainability. In certain clinical scenarios, connecting teeth and implants to support fixed partial prosthesis (FPPs) may be a predictable and workable course of treatment.
MATERIALS AND METHODS
22 patients were selected for this study who had tooth and implant supported prosthesis placed as a final restoration. Out of these 22 patients; 12 were male and 10 were female patients. Implants were placed following proper protocol and if grafting procedures were required they were carried out. A second stage surgical procedure was carried out and delayed loading protocols were followed. The statistical analysis was done using the IBM SPSS 24.0, Chicago, USA. The survival of the implants and teeth were measured by the Kaplan Meier survival scale. Bone loss was assessed at baseline(upon loading), 12 months and 24 months.
RESULTS
The implant survival rate was measured at 6 months, 12 months, 18 months and 24 months. At 24 months, one implant showed failure, so the survival rate of the implants were 95.4%. Bone loss of 1 mm was seen around one implant at 12 months. Bone loss of 1 and 2 mm was present around two implants and one implant respectively at 24 months.
CONCLUSION
From the results of this study, we can conclude that tooth implant supported prosthesis show very good survival when used in rehabilitation cases.
Topics: Humans; Male; Female; Dental Implants; Follow-Up Studies; Dental Implantation, Endosseous; Dental Implantation; Immediate Dental Implant Loading; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Treatment Outcome; Dental Prosthesis Design; Alveolar Bone Loss
PubMed: 38519932
DOI: 10.1186/s12903-024-04117-9 -
Clinical and Experimental Dental... Apr 2022In general, similar restorative constructions are made on natural teeth and on dental implants. The assumption is made that implants and their restoration perform the...
OBJECTIVES
In general, similar restorative constructions are made on natural teeth and on dental implants. The assumption is made that implants and their restoration perform the same as natural roots and their prosthetic restoration. Evaluating cohorts of three-unit bridges on teeth and on implants, this retrospective clinical study aimed to compare implants and teeth as supporting units, including the reconstructions, in terms of survival, success, clinical, radiographic, and patient-reported outcomes.
MATERIAL AND METHODS
From an 8-year period, all patients treated with a posterior three-unit fixed reconstruction on either implants or teeth, with a follow-up of at least 2 years, were identified. For each implant-supported reconstruction, a comparable tooth-supported reconstruction was selected, based on the length of follow-up, the material of the reconstruction, and the location in either the maxilla or mandible.
RESULTS
For the Implant-group, 24 patients could be matched with 24 best matching patients with tooth-supported fixed dental prostheses (FPDs). Supporting implants and implant-supported reconstructions were all in function with a mean follow-up of 52 ± 23 months. Two tooth-supported reconstructions had been replaced (91.7% survival) (mean follow-up: 52 ± 19 months). Radiographic bone levels and soft tissue conditions were favorable in both groups with minor differences. There was no significant difference in overall patient satisfaction. The modified USPHS-score revealed an 87.5% overall success in the Implant-group and 91.7% in the Tooth-group.
CONCLUSIONS
Implant-supported three-unit FDPs are a reliable treatment option with survival and success rates not significantly different from the results of tooth-supported three-unit FDPs.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Denture, Partial, Fixed; Humans; Retrospective Studies
PubMed: 35384361
DOI: 10.1002/cre2.562 -
Clinical Advances in Periodontics Dec 2021What are the key considerations of the incidence and timing for single-tooth implant complications, including early failure, biological complications, and prosthetic...
FOCUSED CLINICAL QUESTION
What are the key considerations of the incidence and timing for single-tooth implant complications, including early failure, biological complications, and prosthetic complications?
SUMMARY
Single-tooth dental implants have been shown to have a high overall survival rate, but implant complications affect patient satisfaction and may lead to costly and/or time-consuming repair and revision. Assessing the incidence and types of biologic and prosthetic complications and the timing of such complications is helpful so that the underlying causes can be addressed during the treatment planning process. Furthermore, identification of patient demographics, patient-, implant-, and site-specific factors associated with such complications may allow for more comprehensive risk assessment during treatment planning.
CONCLUSIONS
Overall, dental implants have a high survival rate. Identification of the incidence of both biologic and prosthetic complications and minimizing their impact in patients with dental implants is critical to overall implant success. Utilization of careful treatment planning and dental implant fixtures, surgical protocols, and prosthetic designs that reduce complication rates can improve patient acceptance and outcomes. Further research is necessary to fully assess complication rates and risk factors.
Topics: Biological Products; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Humans; Retrospective Studies
PubMed: 33829671
DOI: 10.1002/cap.10155 -
Journal of Prosthodontic Research Feb 2021To introduce a digitally assisted technique to achieve the ideal soft and bone tissue interface for anatomic-driven pink free implant supported fixed prosthesis, and...
PURPOSE
To introduce a digitally assisted technique to achieve the ideal soft and bone tissue interface for anatomic-driven pink free implant supported fixed prosthesis, and prefabricate an interim prosthesis to be used the day of the surgery as a prosthetic scaffold to condition the healing.
METHODS
The digital assisted soft tissue sculpturing (DASS) technique allows the previsualization of the ideal soft and bone tissue interface and fabricate a computer aided design computer aided manufacturing (CAD-CAM) anatomic-driven pink free complete arch interim prosthesis for the immediate loading. Bone and soft tissue interface as well as the interim prosthesis design are performed in a segmented multiple standard tessellation language (STL) file embedding the bone anatomy, the intraoral surface anatomy (dental and soft tissue), the digital wax-up and the implant positioning. The interim prosthesis is used as a prosthetic scaffold to guide the soft and bone tissue surgical sculpturing and regeneration.
CONCLUSIONS
The DASS technique is a predictable integrated digital workflow that simplifies the achievement of a scalloped tissue interface for pink free fixed implant prosthesis, reestablishing the mucosal dimension required for the protection of underlying bone while maintaining tissue health. The surgical sculpturing and maturation of the soft and bone tissue is driven and enhanced by the xenogeneic collagen matrix grafting and prosthetic scaffold effect of the digitally prefabricated interim prosthesis delivered the day of the surgery.
Topics: Computer-Aided Design; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Immediate Dental Implant Loading
PubMed: 32938863
DOI: 10.2186/jpr.JPOR_2019_386 -
BMC Oral Health Feb 2021In this research the biomechanical properties of a bone model was examined. Porcine ribs are used as experimental model. The objective of this research was to...
BACKGROUND
In this research the biomechanical properties of a bone model was examined. Porcine ribs are used as experimental model. The objective of this research was to investigate and compare the biomechanical properties of the bone model before and after implant placement.
METHODS
The bone samples were divided in three groups, Group 1 where ALL-ON-FOUR protocol was used during pre-drilling and placing the implants, Group 2 where ALL-ON-FOUR protocol was used during pre-drilling, and implants were not placed, and Group 3 consisting of intact bones served as a control group. Static and dynamic loading was applied for examining the model samples. Kruskal-Wallis statistical test and as a post-hoc test Mann-Whitney U test was performed to analyze experimental results.
RESULTS
According to the results of the static loading, there was no significant difference between the implanted and original ribs, however, the toughness values of the bones decreased largely on account of predrilling the bones. The analysis of dynamic fatigue measurements by Kruskal-Wallis test showed significant differences between the intact and predrilled bones.
CONCLUSION
The pre-drilled bone was much weaker in both static and dynamic tests than the natural or implanted specimens. According to the results of the dynamic tests and after a certain loading cycle the implanted samples behaved the same way as the control samples, which suggests that implantation have stabilized the skeletal bone structure.
Topics: Animals; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis, Implant-Supported; Swine
PubMed: 33632191
DOI: 10.1186/s12903-021-01442-1 -
Clinical Oral Implants Research Jan 2021The aim of this multicenter, randomized controlled trial was to compare the clinical and radiographic outcomes of 6-mm or 11-mm implants, placed in the posterior maxilla... (Randomized Controlled Trial)
Randomized Controlled Trial
Comparison of 6-mm and 11-mm dental implants in the posterior region supporting fixed dental prostheses: 5-year results of an open multicenter randomized controlled trial.
OBJECTIVE
The aim of this multicenter, randomized controlled trial was to compare the clinical and radiographic outcomes of 6-mm or 11-mm implants, placed in the posterior maxilla and mandible, during a 5-year follow-up period.
MATERIALS AND METHODS
Ninety-five patients with adequate bone height for 11-mm implants, were randomly allocated to a 6-mm group (test group with short implants) or an 11-mm group (control group with standard-length implants). Two or three implants of the same length were placed in each patient and after 6 weeks loaded with a splinted provisional restoration. This was followed by definitive splinted restoration 6 months after implant placement. Clinical and radiographic parameters, including the occurrence of complications were recorded.
RESULTS
A total of 49 patients were enrolled to receive 6-mm implants (n = 108) and 46 patients to receive 11-mm implants (n = 101). Three implants (two of 6 mm and one of 11 mm in length) were lost before loading and one 6-mm implant after 15 months of function, and one 11-mm implant was lost during the first year of function. The 5-year survival rates were 96.0% and 98.9% in the 6-mm and 11-mm group, respectively. The mean marginal bone level changes 5 years post-loading were 0.01 ± 0.45 mm (bone gain) in the 6-mm group and -0.12 ± 0.93 mm (bone loss) in the 11-mm group (p = .7670). Clinical parameters, including plaque, bleeding on probing and pocket probing depth were not significantly different between the groups, and also technical complications were low.
CONCLUSION
The clinical and radiographic outcomes of 6-mm short and 11-mm standard-length implants were not different during a 5-year evaluation period.
Topics: Alveolar Bone Loss; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Follow-Up Studies; Humans; Immediate Dental Implant Loading; Treatment Outcome
PubMed: 33025645
DOI: 10.1111/clr.13674 -
Dental Materials Journal May 2023The aim of this study was to evaluate the accuracy and adaptation of all-ceramic zirconia crowns fabricated by stereolithography (SLA) compared with computer-aided...
The aim of this study was to evaluate the accuracy and adaptation of all-ceramic zirconia crowns fabricated by stereolithography (SLA) compared with computer-aided design/computer-aided manufacturing (CAD/CAM) milling technology. Ten all-ceramic zirconia crowns each were fabricated with SLA (experimental group) and CAD/CAM numerical control milling technology (control group). The accuracy (including trueness and precision), and the internal and marginal adaptation of the crowns were measured with the optical impression and silicone rubber film method and the three-dimensional deviation analysis software Geomagic studio, and the results were statistically analyzed. The results indicated no statistical difference in trueness and the occlusal, axial and marginal adaptation between groups (p>0.05), and the precision in the SLA group was better than that in the milling group (p<0.05). Thus, crowns fabricated with SLA meet clinical application requirements.
Topics: Stereolithography; Dental Marginal Adaptation; Dental Prosthesis Design; Crowns; Computer-Aided Design
PubMed: 37032106
DOI: 10.4012/dmj.2022-146 -
The Journal of Prosthetic Dentistry Apr 2021A 3D printed registration device is described for implant-supported complete dentures that simultaneously register implant position, soft-tissue contour, anterior tooth...
A 3D printed registration device is described for implant-supported complete dentures that simultaneously register implant position, soft-tissue contour, anterior tooth position, occlusal vertical dimension, and centric relation. This information is captured clinically in 10 to 20 minutes and can then be transferred to the dental laboratory technician to continue the prosthetic workflow. The standard tessellation language (STL) file for the registration device is available for free download and use.
Topics: Centric Relation; Dental Implantation; Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Complete
PubMed: 32354422
DOI: 10.1016/j.prosdent.2020.01.040