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Clinical Implant Dentistry and Related... Aug 2023The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and... (Review)
Review
BACKGROUND
The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex.
PURPOSE
To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease.
MATERIALS AND METHODS
This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry.
RESULTS AND CONCLUSIONS
Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
Topics: Humans; Dental Implants; Peri-Implantitis; Dental Prosthesis, Implant-Supported; Dental Occlusion; Causality
PubMed: 36373771
DOI: 10.1111/cid.13152 -
The Journal of Prosthetic Dentistry Mar 2024The consequences of edentulism depend on its complexity and are far-reaching, but limited evidence regarding its association with neurologic health is available. (Review)
Review
STATEMENT OF PROBLEM
The consequences of edentulism depend on its complexity and are far-reaching, but limited evidence regarding its association with neurologic health is available.
PURPOSE
The purpose of this systematic review was to establish the relationship between oral prosthetic rehabilitation and the regional increase in brain activity.
MATERIAL AND METHODS
This systematic review was registered in the International Prospective Register of Systematic Reviews (CRD42021262247), and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. Randomized clinical trials, prospective studies comparing the brain activity of patients rehabilitated with and without the use of dental prostheses, and studies that analyzed the human brain by using noninvasive techniques were used as inclusion criteria. The risk of bias in each study was assessed by using the Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I).
RESULTS
The search was carried out in the PubMed/MEDLINE, Embase, Cochrane Library, and https://clinicaltrials.gov databases up to June 2021. After a search conducted by 2 reviewers, 8 articles were included in the review. A regional increase in blood flow and regional cerebral activity during dental prosthesis use was identified in the studies.
CONCLUSIONS
A positive association was found between the different types of prosthetic rehabilitation and brain function. Prostheses may preserve and restore neurological health.
Topics: Humans; Brain; Databases, Factual; Dental Prosthesis; Prosthesis Implantation
PubMed: 35305835
DOI: 10.1016/j.prosdent.2022.02.007 -
Journal of Clinical Orthodontics : JCO Aug 2023
Topics: Humans; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported
PubMed: 37778122
DOI: No ID Found -
Journal of Prosthodontics : Official... Feb 2024To evaluate the survival rate of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs), taking into... (Review)
Review
PURPOSE
To evaluate the survival rate of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs), taking into consideration the potential influence of tooth-vitality, presence and type of post, and type of prosthetic restoration material.
MATERIALS AND METHODS
In October 2022, two authors independently conducted a search in PubMed, Web of Science, and Scopus electronic databases as well as a hand search to identify clinical human studies on full-coverage SCs and FDPs supported by vital and/or non-vital abutments and/or a combination of both, with a minimum observation period of 24 months.
RESULTS
Out of 4198 studies identified through the database search and 22 through hand searching, 26 studies fulfilled the inclusion criteria and were included in the analysis of the present systematic review. Included studies scored six points and more according to Newcastle-Ottawa Scale (NOS). The highest estimated 5-year survival rate was observed for (metal-ceramic and all-ceramic) SCs on vital teeth (98.3%; 95% CI [98.1, 98.6%]) and all ceramic SCs on non-vital teeth with fiber post (95.0%; 95% CI [94.5-95.4%]). Metal-ceramic SCs on vital teeth (97.1%; 95% CI [95.6-98.7%]) showed a statistically significant higher estimated 5-year survival rate compared to metal-ceramic SCs with cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001), fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001) and without post (85.7%; 95% CI [80.7, 90.6%], P < 0.032). All-ceramic SCs with fiber post had a statistically significant higher estimated 5-year survival rate (95.0%; 95% CI [94.5-95.4%]) compared to metal-ceramic SCs on non-vital teeth with fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001). SCs (all-ceramic and metal-ceramic) with fiber post had a statistically significantly higher estimated 5-year survival rate of (92.7%; 95% CI [92.4-92.9%]) than SCs made of metal-ceramic and retained by cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001). For FDPs, the 5-year survival rate was significantly higher for FDPs on vital abutments (84.9%; 95% CI [75.9, 93.9%]) compared to FDPs retained by non-vital abutment/s (81.3%; 95% CI [80.3, 82.2%], P = 0.049) irrespective to presence, type of post, and FDPs material. The results are limited by the limited number of studies and the presence of uncontrolled confounding clinical variables.
CONCLUSIONS
Within the limitations of the study, tooth vitality is suggested to contribute positively to the survival of SCs and FDPs.
Topics: Humans; Tooth, Nonvital; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Dental Materials; Ceramics; Crowns; Metals; Denture, Partial, Fixed
PubMed: 37455556
DOI: 10.1111/jopr.13735 -
Journal of Prosthodontic Research Apr 2024The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent... (Review)
Review
PURPOSE
The present study aimed to identify, through a critical review of the literature, the success factors associated with the splinting of fixed prostheses on adjacent implants of the posterior sectors in partially edentulous patients compared with those not splinted.
STUDY SELECTION
A MEDLINE strategy was implemented based on a research question to systematically search and extract information from databases (PubMed and Scopus) using MeSH terms/keywords identified for each domain. Systematic reviews, clinical and in vitro studies were selected and classified according to eligibility criteria based on the research question and level of evidence using the PRISMA flowchart.
RESULTS
A total of 32 studies were selected for data extraction and analysis according to study design (three systematic reviews, 14 clinical studies, and 15 in vitro studies). Overall, the studies found no significant difference in the association between the survival rate and prosthesis type. In clinical studies, there have been no differences in marginal bone loss between splinted and non-splinted prostheses, and the influence of peri-implant status and restorative materials has been poorly evaluated. The distribution of stress and loads determined in the in vitro studies showed results that could favor splinted prostheses; however, are generally associated with implant design.
CONCLUSIONS
The need for splinted or non-splinted adjacent implant-supported prostheses remains controversial. The reviewed evidence indicates that factors such as implant size and its relationship with coronal height could be important in decision-making.
Topics: Humans; Dental Implants; Dental Materials; Mouth, Edentulous; Dental Prosthesis, Implant-Supported; Dental Prosthesis Design
PubMed: 37648482
DOI: 10.2186/jpr.JPR_D_22_00220 -
Journal of Clinical Orthodontics : JCO Jul 2023
Topics: Humans; Dental Implants; Orthodontics; Esthetics, Dental; Dental Implantation, Endosseous; Dental Implants, Single-Tooth; Dental Prosthesis, Implant-Supported; Treatment Outcome; Maxilla; Crowns
PubMed: 37562799
DOI: No ID Found -
Journal of Dentistry Oct 2023To explore the perspectives and experiences of edentate individuals in regard to the immediate-loading protocol of an implant-supported overdenture.
OBJECTIVES
To explore the perspectives and experiences of edentate individuals in regard to the immediate-loading protocol of an implant-supported overdenture.
METHODS
A qualitative approach and interpretive description methodology was used. Seventeen edentate individuals (mean age: 61.9 ± 6.6 years) who received implant-supported overdentures through an immediate-loading protocol participated. Audio-recorded, semi-structured, in-depth interviews, each with a 60-90-minute duration, were conducted by two trained interviewers. The interview guide was developed based on Perneger's Detailed Model. Qualitative data were analyzed using a thematic approach including interview debriefing, transcript coding, data display, inductive thematic analysis, and interpretation.
RESULTS
Three main themes emerged from the interviews: patient awareness and engagement with treatment, experience-shaped expectations, and immediate gratification. All patients expressed satisfaction with the treatment. Providing detailed information, good communication, and accessibility of the dental care provider had a significant impact on patient satisfaction with prosthetic care. Patients highlighted that the high cost of implant therapy was the major barrier to receiving this treatment in the private sector and perceived dental insurance coverage as a facilitator of this process.
CONCLUSIONS
Study findings conclude that patient awareness about immediate-loading protocol improved their treatment engagement, and patient satisfaction with the treatment outcomes was higher than anticipated. The satisfaction was primarily related to prosthesis stability, receiving the prosthesis the same day, and low cost of treatment. Patients' positive experience and satisfaction with the immediate-loading protocol indicate that this treatment modality should be considered in treatment planning for edentate individuals.
CLINICAL SIGNIFICANCE
The perceptions and experiences of edentulous patients gathered in this study highlight their satisfaction with immediate loading for implant-supported overdentures. This therapeutic modality can be considered a viable option in treatment planning for edentulous individuals.
Topics: Humans; Middle Aged; Aged; Dental Implants; Patient Satisfaction; Denture, Overlay; Mandible; Dental Prosthesis, Implant-Supported; Treatment Outcome; Immediate Dental Implant Loading; Jaw, Edentulous; Mouth, Edentulous; Personal Satisfaction
PubMed: 37527728
DOI: 10.1016/j.jdent.2023.104644 -
The International Journal of... Feb 2024To compare the marginal and internal fit of monolithic zirconia (MZ) 3-unit fixed dental prostheses (FDPs) fabricated using two CAD/CAM workflows: full-chairside (FCH)...
PURPOSE
To compare the marginal and internal fit of monolithic zirconia (MZ) 3-unit fixed dental prostheses (FDPs) fabricated using two CAD/CAM workflows: full-chairside (FCH) and lab (LAB).
MATERIALS AND METHODS
The right maxillary first premolar and first molar were prepared for MZ 3-unit FDPs on a typodont. CEREC Primescan digitized the typodont model 15 Omes. A total of 30 FDPs was fabricated using two processes: FCH (n = 15) and LAB (n = 15). FCH and LAB FDPs were designed using CEREC SW 4.5.1 and Exocad and milled using CEREC MC X and Zirkonzhan 600/V3, respectively. A fast-sintering protocol was used in both groups. A dual-scan technique was used to assess the cement space at the occlusal surface (OC), axial wall (AX), and margin (MA). Statistical analysis of the results was performed using univariate ANOVA with Scheff. post hoc test (a = .05).
RESULTS
Measurements in the FCH and LAB groups were within the clinically acceptable marginal and internal fit. The fit of FCH FDPs at MA, AX, and OC was 77.50 ± 29.99 μm, 99.67 ± 21.58 μm, and 150.03 ± 30.78 μm, respectively. The fit of LAB FDPs at MA, AX, and OC was 100.27 ± 27.06 μm, 116.53 ± 17.90 μm, and 142.30 ± 19.00 μm, respectively. The difference between the two groups was not statistically significant.
CONCLUSIONS
MZ 3-unit FDPs fabricated using FCH have clinically acceptable marginal and internal fit. This result verifies the ability of FCH workflow to fabricate MZ mulOunit FDPs in a single visit.
Topics: Dental Prosthesis Design; Dental Marginal Adaptation; Zirconium; Dental Cements; Computer-Aided Design; Dental Prosthesis
PubMed: 38381993
DOI: 10.11607/ijp.8087 -
Clinical Oral Investigations Aug 2023This study aimed to evaluate the influence of vestibuloplasty on the clinical success and survival of dental implants in head and neck tumor patients.
Vestibuloplasty and its impact on the long-term survival and success of dental implants in irradiated and non-irradiated patients after head and neck tumor therapy: a retrospective study.
OBJECTIVES
This study aimed to evaluate the influence of vestibuloplasty on the clinical success and survival of dental implants in head and neck tumor patients.
MATERIALS AND METHODS
A retrospective single-center study was conducted. All patients received surgical therapy of a tumor in the head or neck and underwent surgical therapy and, if necessary, radiotherapy/radiochemotherapy. Patients with compromised soft tissue conditions received vestibuloplasty using a split thickness skin graft and an implant-retained splint. Implant survival and success and the influence of vestibuloplasty, gender, radiotherapy, and localizations were evaluated.
RESULTS
A total of 247 dental implants in 49 patients (18 women and 31 men; mean age of 63.6 years) were evaluated. During the observation period, 6 implants were lost. The cumulative survival rate was 99.1% after 1 year and 3 years and 93.1% after 5 years for patients without vestibuloplasty, compared to a survival and success rate of 100% after 5 years in patients with vestibuloplasty. Additionally, patients with vestibuloplasty showed significantly lower peri-implant bone resorption rates after 5 years (mesial: p = 0.003; distal: p = 0.001).
CONCLUSION
This study demonstrates a high cumulative survival and success rate of dental implants after 5 years in head and neck tumor patients, irrespective of irradiation. Patients with vestibuloplasty showed a significantly higher rate of implant survival and significantly lower peri-implant bone resorption after 5 years.
CLINICAL RELEVANCE
Vestibuloplasty should always be considered and applied if required by the anatomical situations to achieve high implant survival/success rates in head and neck tumor patients.
Topics: Male; Humans; Female; Middle Aged; Dental Implants; Retrospective Studies; Dental Implantation, Endosseous; Vestibuloplasty; Head and Neck Neoplasms; Bone Resorption; Dental Prosthesis, Implant-Supported
PubMed: 37330421
DOI: 10.1007/s00784-023-05096-x -
Compendium of Continuing Education in... 2023Current diagnostic and treatment planning tools support a complete digital workflow that takes the guesswork out of implant dentistry and facilitates asynchronous...
Current diagnostic and treatment planning tools support a complete digital workflow that takes the guesswork out of implant dentistry and facilitates asynchronous collaboration between all involved specialties, from the restorative dentist to the surgeon to the dental laboratory. Long gone are the days of freehanded implant placement as guided as well as navigated surgery and now even robots provide unprecedented precision and predictability in implant placement based on the individual medical, morphologic, and anatomic situation of each patient.
Topics: Humans; Dental Implants; Workflow; Computer-Aided Design; Dental Implantation, Endosseous; Dental Prosthesis, Implant-Supported
PubMed: 37450680
DOI: No ID Found