-
Zirconia dental implants; the relationship between design and clinical outcome: A systematic review.Journal of Dentistry Apr 2024To evaluate the clinical outcome of different designs of zirconia dental implants. (Review)
Review
OBJECTIVE
To evaluate the clinical outcome of different designs of zirconia dental implants.
DATA
This systematic review adhered to the PRISMA checklist and followed the PICO framework. The protocol is registered in PROSPERO (CRD42022337228).
SOURCES
The search was conducted in March 2023 through four databases (PubMed, Web of Science, Cochrane Library, and Google Scholar) along with a search of references in the related reviews. Three authors reviewed on title, and abstract level and analysed the risk of bias, and all authors reviewed on a full-text level.
STUDY SELECTION
Clinical studies excluding case reports for patients treated with different designs of zirconia dental implants were included. From a total of 2728 titles, 71 full-text studies were screened, and 27 studies were included to assess the risk of bias (ROBINS-I tool) and data extraction. After quality assessment, four studies were included, and the remaining 23 excluded studies were narratively described.
RESULT
The included prospective studies with moderate risk of bias reported success and survival rates of one-piece implants that ranged between 95 and 98.4 % with no difference between different lengths and diameters. The acid-etched roughened surface showed higher clinical outcomes compared to other surface roughness designs.
CONCLUSION
Promising 5-year clinical outcomes were found for one-piece zirconia implants with no difference between different diameters and lengths. Concerning surface roughness, better outcomes were found when using the acid-etched implant surface. However, due to the limited available studies, further high-quality clinical studies comparing zirconia one-piece and two-piece implants with different diameters, lengths, and surface roughness are needed.
CLINICAL SIGNIFICANCE
Based on this systematic review, under suitable clinical situations, the one-piece zirconia implants with diameters of 4.0 mm, 4.5 mm, or 5.5 mm and lengths of 8 mm, 10 mm, 12 mm, or 14 mm have similar promising clinical outcomes. Additionally, the acid-etched roughened implant surface may be preferable.
Topics: Humans; Dental Implants; Dental Materials; Prospective Studies; Dental Restoration Failure; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Zirconium
PubMed: 38437977
DOI: 10.1016/j.jdent.2024.104903 -
Comparison of Blue and Infrared Light Transmission Through Dental Tissues and Restorative Materials.Operative Dentistry May 2024The depth of cure using blue-light photocuring units (BL) is limited by tooth structure and qualities of the restorative material through which the activating wavelength... (Comparative Study)
Comparative Study
OBJECTIVES
The depth of cure using blue-light photocuring units (BL) is limited by tooth structure and qualities of the restorative material through which the activating wavelength must pass. Recent developments incorporate an infrared (IR) activated upconversion (UC) fluorescence of a lining agent filled with nanocrystals of NaYF4 and doped with YB+3 and Tm+3 that emit both blue and violet light locally at the interface of the liner and restorative resin. The purpose of this study was to evaluate the BL and 975 nm infrared (IR) light power transmission through dental tissues and restorative materials.
METHODS AND MATERIALS
Power transmissions of the IR laser (975 nm) and a monowave blue-only light-curing unit (Bluephase 16i) through dental tissues (enamel, dentin, and enamel/dentin junction, or DEJ), eight (8) various dental resin composites, and eight (8) dental ceramics, each at four thicknesses (1, 2, 3 and 4 mm) were evaluated (n=5) using a thermopile sensor (PM10, Coherent Inc) connected to a laser power meter (Fieldmate, Coherent Inc). Power transmission values of each light source and restorative material were subjected to analysis of variance and Tukey test at a pre-set alpha of 0.05.
RESULTS
A linear correlation (r=0.9884) between the supplied current and emitted IR power of the laser diode was found, showing no statistical power reduction with increased distances (collimated beam). For tooth tissues, the highest power transmissions for both light sources were observed using 1.0 mm enamel while the lowest values were found for 2.0 mm dentin and an association of 2.0 mm DEJ and 1.0 mm dentin. The only group where IR demonstrated significantly higher transmission when compared to BL was 1.0 mm enamel. For all resin composites and dental ceramics, increased thickness resulted in a reduction of IR power transmission (except for EverX Posterior fiber-reinforced composite and e.max HT ceramic). IR resulted in higher transmission through all resin composites, except for Tetric EvoCeram White. The highest BL transmission was observed for SDR Flow, at all thicknesses. Higher IR/BL ratios were observed for EverX Posterior, Herculite Ultra, and Lava Ultimate, while the lowest ratio was observed for Tetric EvoCeram White. Reduced translucency shades within the same material resulted in lower power ratio values, especially for BL transmission. Higher IR/BL ratios were observed for e.Max LT, VitaVM7 Base Dentin, and e.max CAD HT, while the lowest values were found for VitaVM7 Enamel and Paradigm C.
CONCLUSION
IR power transmission through enamel was higher when compared to blue light, while no difference was observed for dentin. The power transmission of IR was higher than BL for resin composites, except for a high value and low chroma shade. Fiber-reinforced resin composite demonstrated the highest IR/BL power transmission ratio. A greater IR/BL ratio was observed for lower translucency ceramics when compared to high translucency.
Topics: Composite Resins; Humans; Infrared Rays; Dental Materials; Curing Lights, Dental; Dental Restoration, Permanent; Ceramics; Materials Testing; Dentin; Dental Enamel
PubMed: 38632862
DOI: 10.2341/23-056-L -
The International Journal of... Dec 2023To evaluate and compare the effect of accelerated aging and coffee immersion on the microhardness and gloss of a new computer-aided design and computer-aided...
PURPOSE
To evaluate and compare the effect of accelerated aging and coffee immersion on the microhardness and gloss of a new computer-aided design and computer-aided manufacturing (CAD/CAM) hybrid material (Crystal Ultra) to those of contemporary restorative materials.
MATERIALS AND METHODS
A total of 160 specimens (12 × 14 × 1 mm ± 0.05 mm) were obtained from IPS e.max (IPS), VITA Enamic (VE), Crystal Ultra (CU), Lava Ultimate (LU), and CeraSmart (CS) high-translucency CAD/CAM blocks. The Vickers microhardness and gloss of the specimens were determined after thermocycling and coffee immersion. Data analysis was performed using SPSS (α = .05).
RESULTS
IPS and CS specimens exhibited the highest (572.66 ± 11.30) and lowest (61.92 ± 3.91) microhardness, respectively. The highest gloss was observed with IPS specimens (3.31 ± 0.32), and LU specimens showed the lowest gloss (2.33 ± 0.06). A significant difference in gloss was observed between the materials at all measurement intervals (P < .01), except at T0 (P = .43). IPS specimens showed no significant changes in either group at any measurement interval.
CONCLUSIONS
The microhardness and gloss of the new CU material were comparable to those of the tested contemporary hybrid restorative materials. Glass-ceramic showed superior hardness and gloss compared to hybrid restorative materials. Accelerated aging with thermocycling and staining significantly affected the microhardness and gloss of all tested CAD/CAM materials.
Topics: Dental Porcelain; Coffee; Immersion; Materials Testing; Ceramics; Dental Materials; Computer-Aided Design; Surface Properties
PubMed: 38112735
DOI: 10.11607/ijp.7726 -
Clinical Oral Implants Research Sep 2023In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
In patients with dental implants, what is the effect of transmucosal components made of materials other than titanium (alloys) compared to titanium (alloys) on the surrounding peri-implant tissues after at least 1 year?
MATERIALS AND METHODS
This systematic review included eligible randomized controlled trials identified through an electronic search (Medline, Embase and Web of Science) comparing alternative abutment materials versus titanium (alloy) abutments with a minimum follow-up of 1 year and including at least 10 patients/group. Primary outcomes were peri-implant marginal bone level (MBL) and probing depth (PD), these were evaluated based on meta-analyses. Abutment survival, biological and technical complications and aesthetic outcomes were the secondary outcomes. The risk of bias was assessed with the RoB2-tool. This review is registered in PROSPERO with the number (CRD42022376487).
RESULTS
From 5129 titles, 580 abstracts were selected, and 111 full-text articles were screened. Finally, 12 articles could be included. Concerning the primary outcomes (MBL and PD), no differences could be seen between titanium abutment and zirconia or alumina abutments, not after 1 year (MBL: zirconia: MD = -0.24, 95% CI: -0.65 to 0.16, alumina: MD = -0.06, 95% CI: -0.29 to 0.17) (PD: zirconia: MD = -0.06, 95% CI: -0.41 to 0.30, alumina: MD = -0.29, 95% CI: -0.96 to 0.38), nor after 5 years. Additionally, no differences were found concerning the biological complications and aesthetic outcomes. The most important technical finding was abutment fracture in the ceramic group and chipping of the veneering material.
CONCLUSIONS
Biologically, titanium and zirconia abutments seem to function equally up to 5 years after placement.
Topics: Humans; Titanium; Dental Implants; Alloys; Aluminum Oxide
PubMed: 37750527
DOI: 10.1111/clr.14159 -
Oral and Maxillofacial Surgery Mar 2024This systematic review aimed to determine whether differences in the macro-geometry of titanium implants promote changes in osseointegration. (Review)
Review
PURPOSE
This systematic review aimed to determine whether differences in the macro-geometry of titanium implants promote changes in osseointegration.
MATERIAL AND METHOD
SCOPUS, PubMed/Medline, Web of Science, and EMBASE databases were searched in June 2021. In addition, it was performed a manual search of the reference lists of the included articles. Eligibility criteria were in vivo studies that addressed the effect of titanium implant macro-geometry on osseointegration, studies that evaluated periodontally healthy models, and papers indexed in Journal Citation Reports.
RESULTS
The database search resulted in 1037 articles. Of the 19 articles selected for full reading, 16 remained in this systematic review. These had a high heterogeneity making it hard to perform statistical analysis of the data, so a descriptive analysis was performed.
CONCLUSIONS
Based on the studies included in this systematic review, implant macro-geometry provides influences on osseointegration. In this sense, the various isolated characteristics (thread type, thread pitch, thread depth, face angle) should be studied so that the implant geometry can balance the compressive stress and tensile stress and produce a minimum shear force.
Topics: Humans; Osseointegration; Dental Implants; Titanium
PubMed: 36171302
DOI: 10.1007/s10006-022-01116-4 -
Clinical Implant Dentistry and Related... Aug 2023Over the past decade, emerging evidence indicates a strong relationship between prosthetic design and peri-implant tissue health. The objective of this narrative review... (Review)
Review
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.
Topics: Humans; Peri-Implantitis; Dental Implants; Precipitating Factors; Prosthodontics; Dental Materials
PubMed: 36691784
DOI: 10.1111/cid.13183 -
Acta Biomaterialia Sep 2023The preservation of oral health over a person's lifespan is a key factor for a high quality of life. Sustaining oral health requires high-end dental materials with a...
The preservation of oral health over a person's lifespan is a key factor for a high quality of life. Sustaining oral health requires high-end dental materials with a plethora of attributes such as durability, non-toxicity and ease of application. The combination of different requirements leads to increasing miniaturization and complexity of the material components such as the composite and adhesives, which makes the precise characterization of the material blend challenging. Here, we demonstrate how modern IR spectroscopy and imaging from the micro- to the nanoscale can provide insights on the chemical composition of the different material sections of a dental filling. We show how the recorded IR-images can be used for a fast and non-destructive porosity determination of the studied adhesive. Furthermore, the nanoscale study allows precise assessment of glass cluster structures and distribution within their characteristic organically modified ceramic (ORMOCER) matrix and an assessment of the interface between the composite and adhesive material. For the study we used a Fourier-Transform-IR (FTIR) microscope and a quantum cascade laser-based IR-microscope (QCL-IR) for the microscale analysis and a scattering-type scanning near-field optical microscopy (s-SNOM) for the nanoscale analysis. The paper ends with an in-depth discussion of the strengths and weaknesses of the different imaging methods to give the reader a clear picture for which scientific question the microscopes are best suited for. STATEMENT OF SIGNIFICANCE: Modern resin-based composites for dental restoration are complex multi-compound materials. In order to improve these high-end materials, it is important to investigate the molecular composition and morphology of the different parts. An emergent method to characterize these materials is infrared spectroscopic imaging, which combines the strength of infrared spectroscopy and an imaging approach known from optical microscopy. In this work, three state of the art methods are compared for investigating a dental filling including FTIR- and quantum cascade laser IR-imaging microscopy for the microscale and scattering-type scanning near-field optical microscopy for the nanoscale.
Topics: Humans; Spectroscopy, Fourier Transform Infrared; Quality of Life; Microscopy; Spectrophotometry, Infrared; Dental Materials; Materials Testing; Composite Resins
PubMed: 37479158
DOI: 10.1016/j.actbio.2023.07.017 -
Journal of Dentistry Nov 2023This umbrella review comprehensively appraised the evidence on the use of compomers in comparison to other dental filling materials for restorative treatment of decayed... (Review)
Review
OBJECTIVES
This umbrella review comprehensively appraised the evidence on the use of compomers in comparison to other dental filling materials for restorative treatment of decayed primary teeth.
DATA
The literature search was conducted based on the question: "Is the use of compomers as a dental filling material more successful in the restorative treatment of decayed primary teeth than other dental filling materials?" No language restriction was applied and systematic reviews published up to May 2023 were included. The ROBIS tool was used to assess the methodological quality of the included systematic reviews. Data were extracted for narrative synthesis, considering the restoration failure/success outcomes.
SEARCH
Online search was conducted in three databases (PubMed/Medline, Embase and Cochrane library).
STUDY SELECTION
The electronic search yielded a total of 779 publications. Finally, 18 systematic reviews were included in this umbrella review. Four systematic reviews presented a low risk of bias, 11 presented an unclear risk of bias and three presented a high risk of bias. Most systematic reviews presenting low risk of bias reported no difference in the success rates of compomers compared to other dental filling materials used for restoration of decayed primary teeth. Studies that found a significant difference or that made clear recommendations towards the use of compomers were commonly rated with a high risk of bias.
CONCLUSION
Compomers are similar to other dental filling materials for the placement of direct restorations in primary teeth.
CLINICAL SIGNIFICANCE
The results of this umbrella review indicate a similar clinical performance of compomers compared to other materials containing a resin component for direct restoration in primary teeth. Therefore, the choice of restorative material will depend on multiple factors, such as clinician's skills/preferences, patients' wishes, costs, and cavity type/location.
Topics: Humans; Compomers; Dental Caries; Dental Materials; Dental Restoration, Permanent; Glass Ionomer Cements; Tooth, Deciduous; Systematic Reviews as Topic
PubMed: 37714452
DOI: 10.1016/j.jdent.2023.104696 -
The Journal of Prosthetic Dentistry Aug 2023The new strength-gradient zirconia composed of 3-mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) and 5-mol% yttria-stabilized tetragonal zirconia...
STATEMENT OF PROBLEM
The new strength-gradient zirconia composed of 3-mol% yttria-stabilized tetragonal zirconia polycrystal (3Y-TZP) and 5-mol% yttria-stabilized tetragonal zirconia polycrystal (5Y-TZP) has been claimed to have superior mechanical properties. However, data on the fracture resistance of 3-unit gradient 5Y-TZP and 3Y-TZP fixed partial denture frameworks are lacking.
PURPOSE
The purpose of this in vitro study was to evaluate the effect of dynamic loading on the fracture resistance of gradient zirconia fixed partial denture frameworks.
MATERIAL AND METHODS
Two standardized stainless-steel master dies were designed to simulate a mandibular left second premolar and second molar prepared to receive zirconia frameworks. The frameworks were designed with a 0.6-mm uniform wall thickness. The mesiodistal width of the connectors was 3 ±0.02 mm, and the occlusogingival height was 3 ±0.02 mm. Forty zirconia frameworks were fabricated and divided into 2 groups according to the tested materials (n=20): 3Y-TZP and gradient 5Y-TZP and 3Y-TZP. The frameworks were cemented onto their corresponding dies with a conventional glass ionomer cement. Half of the cemented frameworks in each group underwent 600 000 cycles of dynamic loading in a mastication simulator (n=10). The other half was fractured without dynamic loading (n=10). Fracture resistance measurements (N) for each framework were recorded by using a universal testing machine at a crosshead speed of 1 mm/min. A fractured framework from each group was examined by using a scanning electron microscope (SEM) at ×100 magnification. The data obtained were statistically analyzed by using 2-way ANOVA, the pairwise Tukey honestly significant difference (HSD), and simple main effect tests to detect the difference between group mean values (α=.05).
RESULTS
The mean ±standard deviation of fracture load value before dynamic loading was 1919 ±193 N for the 3Y-TZP group and 908 ±99 N for the gradient 5Y-TZP and 3Y-TZP group. In addition, the mean fracture load value after dynamic loading was 1418 ±163 N for the 3Y-TZP group and 716 ±85 N for the gradient 5Y-TZP and 3Y-TZP group. The interaction between the effects of the zirconia material and dynamic loading on the fracture resistance was statistically significant (P=.002). The 3Y-TZP group had a statistically significant, higher fracture load mean value the gradient 5Y-TZP and 3Y-TZP group before and after dynamic loading (P<.001).
CONCLUSIONS
The fracture resistance of 3Y-TZP frameworks was significantly higher than that of gradient 5Y-TZP and 3Y-TZP frameworks before and after dynamic loading. Dynamic loading significantly reduced the fracture resistance of 3Y-TZP and gradient 5Y-TZP and 3Y-TZP frameworks.
Topics: Dental Materials; Materials Testing; Yttrium; Zirconium; Denture, Partial, Fixed; Dental Stress Analysis; Surface Properties
PubMed: 34740458
DOI: 10.1016/j.prosdent.2021.09.027 -
BMC Oral Health Dec 2023This study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla. (Randomized Controlled Trial)
Randomized Controlled Trial
Comparison between platelet rich fibrin as space filling material versus xenograft and alloplastic bone grafting materials in immediate implant placement: a randomized clinical trial.
BACKGROUND
This study aimed to compare the efficacy of different gap filling materials in immediate implant in anterior and premolar regions of maxilla.
MATERIALS AND METHODS
Thirty-six implants were inserted in patients seeking for replacement of non-restorable maxillary anterior and premolar teeth (esthetic zone) by immediate implant. Patients were randomly distributed into three equal groups, twelve implants in each group. Group 1 received Platelet Rich Fibrin (PRF) into the jumping distance, Group 2 received Xenograft into the jumping distance and Group 3 received Alloplastic bone grafting material into the jumping distance. Implant stability by measuring the changes in Resonance Frequency Analysis (RFA), peri-implant pocket depth, marginal bone loss and changes in buccal bone thickness were evaluated during follow up periods. All the clinical and radiographic data were subjected to statistical analysis by One Way ANOVA test and the Post Hoc Tukey test.
RESULTS
This study involved 19 female patients and 17 male patients who received 36 dental implants. There was no significant difference between the study groups regarding implant stability, peri-implant pocket depth and palatal bone loss, while there was a significant difference between PRF Group (Group 1) and the other Groups regarding buccal bone loss and changes in buccal bone thickness.
CONCLUSION
PRF can be used as a gap filling material in conjunction with immediate implant placement, but other bone grafting materials give superior result regarding buccal bone loss and changes in buccal bone thickness.
TRIAL REGISTRATION
The study was listed on www.
CLINICALTRIALS
gov with registration number (NCT05878392) on 26/05/2023. The Institutional Review Board (IRB) of the Faculty of Dentistry, Mansoura University, Mansoura, Egypt, approved the current study in compliance with the seventh revision of the Helsinki Declaration in 2013 (A0103023OS).
Topics: Humans; Male; Female; Dental Implants; Heterografts; Bone Transplantation; Platelet-Rich Fibrin; Dental Implantation, Endosseous; Dental Materials; Maxilla; Treatment Outcome
PubMed: 38066454
DOI: 10.1186/s12903-023-03678-5