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Clinical Implant Dentistry and Related... Aug 2023To provide an overview about the current approaches to prevent peri-implant diseases in edentulous patients with complete-arch implant-supported prostheses, and to... (Review)
Review
OBJECTIVES
To provide an overview about the current approaches to prevent peri-implant diseases in edentulous patients with complete-arch implant-supported prostheses, and to review the clinical applications of the latest digital technologies for implant prosthodontics.
METHODS
A review of the guidelines to prevent peri-implant diseases in patient's receiving complete-arch implant-supported prostheses including facially driven treatment planning procedures using either conventional or digital methods, computer-aided implant planning procedures, and prosthodontic design variables including the optimal number and distribution of dental implants, implant to abutment connection type, implant or abutment level design, screw- or cement-retained alternatives, prostheses contours, and material selection is provided. Furthermore, an outline of the current therapeutic management approaches to address peri-implant diseases is reviewed.
CONCLUSIONS
Clinicians should understand and know different planning and design-related variables that can affect biological and mechanical complication rates of complete-arch implant-supported prostheses. Maintenance protocols are fundamental for minimizing biological and mechanical complications.
Topics: Humans; Dental Implants; Peri-Implantitis; Follow-Up Studies; Mouth, Edentulous; Dental Prosthesis, Implant-Supported; Dental Restoration Failure
PubMed: 36707075
DOI: 10.1111/cid.13182 -
The Journal of Prosthetic Dentistry May 2024Little is known about the association between the number of teeth and self-rated happiness or the association between dental prosthesis use and self-rated happiness in...
STATEMENT OF PROBLEM
Little is known about the association between the number of teeth and self-rated happiness or the association between dental prosthesis use and self-rated happiness in an older population.
PURPOSE
The purpose of this cross-sectional study was to examine the association between the number remaining of teeth with and without dental prosthesis use and self-rated happiness in an older population.
MATERIAL AND METHODS
The survey data from the 2016 Japan Gerontological Evaluation Study (JAGES) on independent participants aged 65 years or older were assessed. The Poisson regression and multiple imputation methods were used for analyses. Covariates were age, sex, marital status, educational attainment, self-rated health, self-rated economic situation, and symptoms of depression.
RESULTS
The data from 178 090 participants, 81 489 men (45.8%) and 96 601 women (54.2%), were analyzed, with a mean ±standard deviation age of 73.6 ±6.1 years. Overall, 66.4% of the participants were happy, declining to 45.7% in those who had 0 to 9 teeth and no dental prosthesis (n=3102). It was 61.5% in those who had 0 to 9 teeth and used a dental prosthesis (n=41 424), 56.8% in those who had 10 to 19 teeth and no dental prosthesis (n=6719), 65% in those who had 10 to 19 teeth and used a dental prosthesis (n=31 592), 70.5% in those who had ≥20 teeth and no dental prosthesis (n=52 525), and 70.1% in those who had ≥20 teeth and used a dental prosthesis (n=42 728). The interaction analysis showed that the reduction in the probability of being happy among those with fewer teeth was smaller among those who used a dental prosthesis.
CONCLUSIONS
Having a higher number of teeth and using a dental prosthesis were independently associated with being happy. A significant interaction suggested that dental prosthesis use improves happiness among those with moderate to severe tooth loss (<20 remaining teeth).
Topics: Humans; Cross-Sectional Studies; Female; Male; Aged; Happiness; Japan; Dental Prosthesis; Aged, 80 and over; Tooth Loss; Surveys and Questionnaires
PubMed: 35459542
DOI: 10.1016/j.prosdent.2022.02.014 -
Journal of Prosthodontics : Official... Dec 2023To assess the effect of different scan patterns on the fit of implant-supported complete-arch prototype prostheses fabricated via a complete digital extraoral protocol...
PURPOSE
To assess the effect of different scan patterns on the fit of implant-supported complete-arch prototype prostheses fabricated via a complete digital extraoral protocol with a reverse scan body.
MATERIALS AND METHODS
A mandibular cast with four multi-unit abutment (MUA) implant analogs with adequate antero-posterior spread served as the reference cast, simulating a common clinical patient situation, and a polymethylmethacrylate interim screw-retained prosthesis was fabricated on it. Novel reverse scan bodies were connected to the interim prosthesis on the intaglio of the MUA abutments and extraoral scanning was performed with a white light intraoral scanner (TRIOS 4; 3 shape) and three different scan patterns: starting from the occlusal surface of the interim prosthesis (O-group), starting from the intaglio (I-group), and helix pattern (H-group). The resulting STL files from the three groups were then imported to computer-aided design (CAD) software and after the digital design, the STL files were exported to a computer-aided manufacturing (CAM) milling machine which generated a total of 15 CAD-CAM milled prototype prostheses per group. Two clinicians assessed the fit of each digitally fabricated prototype prosthesis on the reference cast, utilizing the screw-resistance test and radiographic evaluation. Fisher's exact test was used to test the difference between the three groups, and Cohen's k-score was used to assess the inter-examiner agreement.
RESULTS
Out of the three different groups, the O-group scan pattern led to 100% prosthesis fit, while the prototype prostheses generated from I- and H-groups had 80% and 53% fit, respectively. The results were statistically significant (p = 0.008).
CONCLUSIONS
Occlusal scan pattern leads to fitting milled prototype prostheses after extraoral scanning with reverse scan bodies without intraoral implant data acquisition.
Topics: Humans; Dental Prosthesis, Implant-Supported; Computer-Aided Design; Dental Care; Bone Screws; Dental Implants
PubMed: 37721306
DOI: 10.1111/jopr.13772 -
Dental and Medical Problems 2023In the context of dental prostheses, splinting multiple implants together may improve their stability. The approach may be especially favorable when performing immediate...
BACKGROUND
In the context of dental prostheses, splinting multiple implants together may improve their stability. The approach may be especially favorable when performing immediate loading procedures, increasing the implant osseointegration rate, and reducing the risk of implant and prosthetic failure. The instantaneous loading technique (ILT) involves creating a metal framework to splint the implants by intraorally welding them pair-by-pair, using purposefully created abutments.
OBJECTIVES
The aim of the study was to investigate the prosthetic success when using ILT to rehabilitate partially edentulous patients through immediately loaded prostheses.
MATERIAL AND METHODS
Clinical records of patients treated with ILT were retrospectively assessed, and the prosthetic success rate was analyzed in terms of fractures, chipping, unscrewing, screw fracture rate, and mucositis. Furthermore, the implant success rates were evaluated by measuring marginal bone loss (MBL).
RESULTS
A total of 55 patients (20 males and 35 females with a mean age of 59.8 ±9.4 years), corresponding to 66 prostheses, were included. A total of 160 implants were placed. At the last follow-up (39.6 ±28.4 months), 1 patient (1.8%; 1 prosthesis (1.5%)) showed the fracture of the prosthesis material. Peri-implantitis affected 4 implants (2.5%), and 4 more implants (2.5%) showed radiolucency, affecting 5 patients (9.1%). Two other patients (3.6%) suffered from mucositis. The implant success rate, according to the Albrektsson and Zarb criteria, was 94.4%. No implants were lost. The mean MBL values at the implant level, the prosthesis level and the patient level were 0.28 ±0.56 mm, 0.30 ±0.51 mm and 0.33 ±0.54 mm, respectively.
CONCLUSIONS
The instantaneous loading technique appears to be a viable approach to rehabilitating partially edentulous patients through immediate loading.
Topics: Male; Female; Humans; Middle Aged; Aged; Dental Implants; Retrospective Studies; Mucositis; Jaw, Edentulous; Mouth, Edentulous; Fractures, Bone; Dental Prosthesis, Implant-Supported; Dentures
PubMed: 37706658
DOI: 10.17219/dmp/154981 -
The Journal of Prosthetic Dentistry Nov 2023Standard-diameter dental implants are not always applicable because of anatomic limitations of the residual ridge. Thus, mini-implants have been increasingly used and... (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Standard-diameter dental implants are not always applicable because of anatomic limitations of the residual ridge. Thus, mini-implants have been increasingly used and offer an alternative. However, data regarding prosthetic complications, maintenance factors, and clinical outcomes are limited.
PURPOSE
The purpose of this systematic review and meta-analysis was to compare prosthetic complications and maintenance events and clinical outcomes in residual ridges rehabilitated with mandibular implant overdentures (IODs) by using standard implants or mini-implants.
MATERIAL AND METHODS
Nine electronic databases were searched. Quantitative analyses to measure the risk ratio (RR) and standardized mean difference (SMD) were applied. Those methods were used to assess prosthetic complications and maintenance events (abutment adjustments, replacement of retentive element, occlusal adjustment, and overdenture fracture) and clinical outcomes related to postoperative pain, probing depth (PD), plaque index (PI), marginal bone loss (MBL), and implant survival rate.
RESULTS
Altogether, 7 publications were selected. Mini-implants presented reduced abutment adjustments (RR 0.23 [0.07, 0.73], P=.01), replacement of retentive element (RR 0.41 [0.31, 0.54], P<.001), occlusal adjustment (RR 0.53 [0.31, 0.91], P=.02), and overdenture fracture (RR 0.46 [0.23, 0.94], P=.03) compared with standard implants. Additionally, mini-implants presented lower values for PI at 6 months (SMD -0.27 [-0.47, -0.08], P=.006) and 12 months (SMD -0.25 [-0.46, -0.05], P=.01). No additional tangible differences were noted.
CONCLUSIONS
Mini-implants might be an alternative choice based on the number of prosthetic complications and maintenance events. This was also confirmed by the comparable clinical data between standard implants and mini-implants.
Topics: Humans; Dental Implants; Denture, Overlay; Dental Prosthesis, Implant-Supported; Alveolar Bone Loss; Mandible
PubMed: 35120735
DOI: 10.1016/j.prosdent.2021.11.010 -
Journal of Stomatology, Oral and... Dec 2023With the rise of digital workflow, the production of implant guides is becoming increasingly easy and reproducible. The objective is to obtain an optimal correlation...
INTRODUCTION
With the rise of digital workflow, the production of implant guides is becoming increasingly easy and reproducible. The objective is to obtain an optimal correlation between the prosthetic and implant axis to ensuring the "X jaw - one day" concept in the short term and a sustainable technique in a long term TECHNIQUE: This approach requires a strict and rigorous preoperative evaluation. The data recording steps allow a complete visualization of the case and are used to custom the guide. The bone support is surmounted by several stages (positioning guide, drilling guide and the future temporary prosthesis).
CONCLUSION
Despite the time-consuming nature, this technique provides a reliable and reproducible protocol for immediate loading without compromising the prosthetic axis.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Surgery, Computer-Assisted; Workflow; Dental Prosthesis, Implant-Supported
PubMed: 37001585
DOI: 10.1016/j.jormas.2023.101459 -
The International Journal of... Feb 2024This position paper summarizes all relevant aspects of the use of working models derived from digital data in digital and hybrid workflows, aiming to (1) provide the... (Review)
Review
PURPOSE
This position paper summarizes all relevant aspects of the use of working models derived from digital data in digital and hybrid workflows, aiming to (1) provide the reader with a comprehensive review of the types of models that currently can be produced from a digital file created by an intraoral scanner (IOS); (2) critically analyze issues that may undermine or compromise their reliability when requested for the fabrication of both tooth-borne and implant-supported fixed dental prostheses (FDPs); and (3) indicate the procedures to be implemented in order to overcome these issues and produce satisfactory restorations.
MATERIALS AND METHODS
By way of a thorough literature review, the authors highlight the critical issues of milled and 3D-printed models, solid and alveolar, explaining the differences in terms of accuracy and reliability.
RESULTS AND CONCLUSIONS
By describing the peculiarities of models with prepared natural teeth and those incorporating metal implant analogs, the clinical indications for their use are given while proposing the strategies that can be adopted to avoid errors during fabrication or to overcome inaccuracies.
Topics: Humans; Workflow; Models, Dental; Computer-Aided Design; Printing, Three-Dimensional; Reproducibility of Results; Dental Prosthesis, Implant-Supported; Dental Prosthesis Design
PubMed: 38787588
DOI: 10.11607/ijp.8932 -
Journal of Indian Prosthodontic Society 2023To evaluate and compare the strain development and distribution of maxillary implant-supported complete fixed dental prosthesis (ISCFDP) with computer-aided...
Comparative evaluation to study the effect of implant support on complete fixed dental prosthesis fabricated with peek framework when implants placed in all-on-4 and all-on-6 situation, by strain gauge analysis and finite element analysis - An study.
AIM
To evaluate and compare the strain development and distribution of maxillary implant-supported complete fixed dental prosthesis (ISCFDP) with computer-aided design-computer-aided manufacturing milled PEEK BIO-HPP superstructure when placed using All-on-4 and All-on-6 situation using a strain gauge and finite element analysis (FEA).
SETTING AND DESIGN
This is an in vitro study to evaluate and compare the stress minimization and strain developed at implant in premolar and in two clinically simulated situation of All-on-4 and All-on -6 ISCFDP.
MATERIALS AND METHODS
The study involved converting a human skull into. stl format to create 3D-printed stereolithography models with a modulus of elasticity closer to bone. Implants were placed in two models (M1 nad M2) in incisor, premolar, and pterygoid regions. A fixed dental prosthesis framework was fabricated on both models, and strain gauge sensors were attached.
STATISTICAL ANALYSIS USED
Descriptive and analytical statistics were done. The normality of data was analyzed by the Shapiro-Wilk test.
RESULTS
The results obtained were tabulated and it showed strain around the neck of ISCFDP under 100N configuration in strain gauge analysis. Stress was found more in the molar region when compared to the premolar region. This design showed that the largest stress around the neck of ISFDP under 100 N load was found more in the premolar region when compared to the molar region due to the reduction of stresses in the pterygoid region in FEA.
CONCLUSION
In the present study, strain gauge analysis at 100 N for loading at the premolar and molar region shows the reduced strain on tilted implants in All-on-6 situation due to stress dissipation to the terminal pterygoid implant using strain gauge.
Topics: Humans; Dental Implants; Finite Element Analysis; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Stress, Mechanical
PubMed: 37861614
DOI: 10.4103/jips.jips_196_23 -
Clinical Oral Investigations Nov 2023This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic and clinical parameters, as well as biological and mechanical complications, were considered.
MATERIALS AND METHODS
A systematic search was performed up to March 2022 to identify CCTs/RCTs comparing zirconia and titanium implants with a minimum of 12 months of follow-up. Meta-analysis was performed when ≥ 2 articles with similar characteristics were retrieved.
RESULTS
Four published articles with two RCTs (2 different patient populations) with 100 zirconia and 99 titanium implants that were followed up over 12-80 months were selected out of the 6040 articles. A non-statistically significant difference between zirconia and titanium implant survival at 12 months was suggested (P = 0.0938). The success rates were 57.5-93.3% and 57.1-100% for zirconia and titanium implants, respectively. The pink aesthetic score (PES) was higher for zirconia (10.33 ± 2.06 to 11.38 ± 0.92) compared to titanium implants (8.14 ± 3.58 to 11.56 ± 1.0).
CONCLUSION
Based on the 2 RCTs retrieved in the literature, similar survival rates were reported for zirconia and titanium implants in the short term (12 months of follow-up). Future RCTs are warranted to evaluate the long-term outcomes of zirconia implants.
CLINICAL RELEVANCE
Zirconia implants may be the procedure of choice, particularly in the aesthetic zone, since they show a similar survival and success rate as titanium implants on a short-term follow-up.
TRIAL REGISTRATION
Systematic review registration number-CRD42021288704 (PROSPERO).
Topics: Humans; Dental Implants; Titanium; Dental Restoration Failure; Esthetics, Dental; Zirconium; Dental Prosthesis Design
PubMed: 37740825
DOI: 10.1007/s00784-023-05242-5 -
Acta Odontologica Scandinavica Jul 2023The objective of the study was to assess patient-reported preferences and outcomes in patients rehabilitated with both an implant-supported single crown (ISC) and a...
OBJECTIVE
The objective of the study was to assess patient-reported preferences and outcomes in patients rehabilitated with both an implant-supported single crown (ISC) and a tooth-supported fixed dental prosthesis (FDP).
MATERIALS AND METHODS
The electronic journal system at the Faculty of Dentistry, University of Oslo, was searched to find patients presenting both an ISC and an FDP replacing no more than two teeth between abutments. Identified patients that agreed answered a questionnaire followed by a clinical examination. Descriptive statistics was calculated.
RESULTS
Thirty patients were included. The mean function time was 11.8 years for FDPs and 6.6 years for ISCs. All but three patients were satisfied with both rehabilitation modalities. No patients were unsatisfied with aesthetics or function of either rehabilitation. All patients reported satisfactory function of their restorations and reported chewing without problems. The self-reported post-operative complications were few, but less than observed in the clinical examinations.
CONCLUSIONS
More patients reported food impaction with their FDP as compared to their ISC. Function and aesthetics of FDPs and ISCs were rated similarly, but more patients found the ISC treatment more uncomfortable. Despite this finding, most patients would prefer to undergo ISC treatment if they were to replace another missing tooth.
Topics: Humans; Dental Prosthesis, Implant-Supported; Patient Preference; Patient Satisfaction; Denture, Partial, Fixed; Dental Restoration Failure; Dental Implants, Single-Tooth; Treatment Outcome; Cross-Sectional Studies; Pilot Projects; Male; Female; Adult; Middle Aged; Aged; Aged, 80 and over
PubMed: 36519292
DOI: 10.1080/00016357.2022.2155239