Prosthesis

2024

Jump to: 2023, 2022

11 pages, 2016 KiB

Open AccessArticle

An In Vitro Study on the Accuracy of a Splint for the Transfer of Dental Implants

by Rommy Chalacan Galindo, Angel Tul Tipantuña, Maria Flores Araque, Lupe Poussin and Byron Velasquez Ron

Prosthesis 2024, 6(6), 1575-1585; https://doi.org/10.3390/prosthesis6060113 - 17 Dec 2024

Viewed by 329

Abstract

The purpose of this study is to measure the positional accuracy of transfers during the splinting printing process using four biomaterials (two acrylic resins and two bis acrylic resins). Materials and Methods: A master model was constructed for the acrylic simulation of edentulous [...] Read more.

The purpose of this study is to measure the positional accuracy of transfers during the splinting printing process using four biomaterials (two acrylic resins and two bis acrylic resins). Materials and Methods: A master model was constructed for the acrylic simulation of edentulous mandibles with four multiunit analogs (Bioinnovation, Sao Paulo, Brazil) positioned between the lateral incisor and premolar areas. Eighty samples (n = 80) were created in total. Four different dental materials, Duralay (Reliance, Chicago, IL, USA); Pattern Resin LS (GC, Tokyo, Japan) with a ratio of one part liquid and two parts powder; Structur (Vocco, Colonia, Germany); and Protemp (3 M ESPE, Neus, Germany), were used as splints with five samples each. Measurements were obtained for distances between points A, B, C, and D in sequential order through an INSIZE digital calibrator (Inzise, Taiwan, Seng, China). Results: The results were as follows: Distance A: better performance was observed for Pattern Resin (mean = 38.59 mm) and Duralay (mean = 38.58 mm) compared to the base (mean = 38.59 mm); distance B: Pattern Resin (mean = 19.08 mm) and Duralay (mean = 19.07 mm) were compared to the base (mean = 19.08 mm); distance C: no significant differences in relation to the base (prom = 18.85 mm) were shown for the three materials of Pattern Resin (prom = 18.86 mm), Structur (prom = 18.85 mm), and Duralay (mean = 18.85 mm); and distance D: Pattern Resin (mean = 20.46 mm) and Duralay (mean = 20.46 mm) provided lower performance compared to the base (mean = 20.47 mm), ANOVA (Prob = 0.333 > 0.05). Conclusions: Pattern resins and Duralay acrylic resins exhibit better dimensional stability when used as splints for the transfer of multiple dental implants. Full article

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12 pages, 9673 KiB

Open AccessTechnical Note

Impression Reference Technique for the Open Flap Digital Workflow in the Immediate Loading Rehabilitation of the Upper and Lower Jaws

by Gerardo Pellegrino, Gabriele Anselmo, Carlo Barausse, Stefano Ratti, Cristiana Breccia, Edoardo Mancuso, Amerigo Giudice, Pietro Di Bene and Pietro Felice

Prosthesis 2024, 6(6), 1479-1490; https://doi.org/10.3390/prosthesis6060107 - 3 Dec 2024

Viewed by 368

Abstract

Immediate loading implant surgery has emerged as a significant advancement in the rehabilitation of edentulous patients. This approach requires meticulous planning and precise execution to ensure successful outcomes. Transferring established intermaxillary and occlusal relationships to the definitive prostheses can be challenging. However, with [...] Read more.

Immediate loading implant surgery has emerged as a significant advancement in the rehabilitation of edentulous patients. This approach requires meticulous planning and precise execution to ensure successful outcomes. Transferring established intermaxillary and occlusal relationships to the definitive prostheses can be challenging. However, with a digital approach, this procedure can be standardized in cases of fully guided surgery with a flapless technique or by using disposable guides. Conversely, when extensive open flap implant surgery is required, such as in the treatment of severely atrophic patients (e.g., with zygomatic implants or simultaneous bone augmentation), the digital workflow can be demanding. The impression reference technique was proposed to enhance the digital workflow for immediate loading in zygomatic implant rehabilitation. This study aims to describe the impression reference technique, applied to both upper and lower jaws for immediate loading open flap rehabilitations, using standard implants. Full article

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13 pages, 4316 KiB

Open AccessArticle

Comparison of Full-Arch Intraoral Scans Immediately After Implant Insertion Versus Healed Tissue: A Multicentric Clinical Study

by Francesco Bagnasco, Maria Menini, Paolo Pesce, Armando Crupi, Umberto Gibello, Francesca Delucchi, Massimo Carossa and Francesco Pera

Prosthesis 2024, 6(6), 1359-1371; https://doi.org/10.3390/prosthesis6060098 - 20 Nov 2024

Viewed by 579

Abstract

Objectives: The purpose of this clinical study is to compare implant full-arch intraoral scans taken immediately after implant placement with those obtained after tissue healing in patients rehabilitated with implant-supported fixed prostheses. Methods: Between September 2023 and March 2024, a total [...] Read more.

Objectives: The purpose of this clinical study is to compare implant full-arch intraoral scans taken immediately after implant placement with those obtained after tissue healing in patients rehabilitated with implant-supported fixed prostheses. Methods: Between September 2023 and March 2024, a total of 19 patients with compromised residual dentition (6 women; 13 men) were rehabilitated using 4-to-6 immediately loaded post-extraction implants. These implants supported fixed full-arch screw-retained prostheses either in the lower jaw (9 patients) or upper jaw (10 patients). Intraoral scans were taken immediately after implant placement (termed “immediate scan”). After a healing period of four months, the provisional prosthesis was removed, and a second intraoral scan was performed using the same scan bodies and scan pattern as the initial scan (termed “delayed scan”). The two scans were overlaid, and the discrepancies between them were measured. Results: The average discrepancy between the immediate and delayed scans was 0.1905 mm. Our statistical analysis revealed larger discrepancies for implants placed in the posterior areas, with the implant in site 1.6 (Implant 1) showing a discrepancy of 0.2326 mm, and the implant in site 2.6 (Implant 4) showing a discrepancy of 0.2124 mm (p = 0.05). No statistically significant difference was observed when comparing patients treated in the upper and lower jaws. Conclusions: Within the limitations of the study and based on this result, clinicians should be aware that an immediate post-surgical intraoral digital scan for implant-supported full-arch rehabilitations may result in a higher risk of imprecision. Furthermore, according to the results of the study, the accuracy of the digital impression on implant full-arch rehabilitations seems to be influenced by the clinician’s skills. Further studies with larger sample sizes are required to confirm our results. Full article

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13 pages, 320 KiB

Open AccessReview

Stereo-Photogrammetry for Impression of Full-Arch Fixed Dental Prosthesis—An Update of the Reviews

by Paulo Ribeiro, Carmen María Díaz-Castro, Blanca Ríos-Carrasco, José Vicente Ríos-Santos and Mariano Herrero-Climent

Prosthesis 2024, 6(4), 939-951; https://doi.org/10.3390/prosthesis6040068 - 15 Aug 2024

Viewed by 1171

Abstract

Photogrammetry (PG) appeared as an alternative for multiple implant impressions. Stereo-photogrammetry is a more sophisticated alternative to PG, which estimates the 3D coordinates of the points of an object, making the process quicker and more precise. A search in PubMed MEDLINE, PMC, and [...] Read more.

Photogrammetry (PG) appeared as an alternative for multiple implant impressions. Stereo-photogrammetry is a more sophisticated alternative to PG, which estimates the 3D coordinates of the points of an object, making the process quicker and more precise. A search in PubMed MEDLINE, PMC, and Google Scholar was conducted to find systematic reviews published in the last 10 years. The PICdental^® camera (IDITEC NORTH WEST, SL; Torrelodones, Spain) is a stereocamera that records implant positions in the mouth by means of photogrammetry with the objective of registering and obtaining a viable, reliable, and direct digital impression of the positions of the multiple implants. The use of photogrammetry via PiCdental^® camera as an alternative to digital impression for multiple implants is an easy and trustworthy technique that permits an adequate fit without prosthetic complications. Full article

16 pages, 4019 KiB

Open AccessArticle

Comparative Evaluation of Primary Stability in Truncated Cone Implants with Different Macro-Geometries in Low-Density Polyurethane Blocks Simulating Maxillary Sinus Rehabilitations

by Luca Comuzzi, Tea Romasco, Adriano Piattelli, Francesco Inchingolo, Carlos Fernando Mourão and Natalia Di Pietro

Prosthesis 2024, 6(4), 923-938; https://doi.org/10.3390/prosthesis6040067 - 13 Aug 2024

Viewed by 566

Abstract

After tooth loss, particularly in the posterior maxilla, the alveolar ridges undergo bone resorption. Therefore, ensuring the appropriate quantity and quality of alveolar bone is crucial for accurate implant positioning and achieving optimal esthetic and functional results. This study aimed to evaluate biomechanical [...] Read more.

After tooth loss, particularly in the posterior maxilla, the alveolar ridges undergo bone resorption. Therefore, ensuring the appropriate quantity and quality of alveolar bone is crucial for accurate implant positioning and achieving optimal esthetic and functional results. This study aimed to evaluate biomechanical parameters (insertion torque: IT, removal torque: RT, and implant stability quotient: ISQ) of distinct truncated cone implant designs (Sinus-plant and SLC) on polyurethane blocks simulating type D3 and D4 bone. SLC implants exhibited significantly higher IT, RT, and ISQ values compared to Sinus-plant implants, except in the 10 pounds per cubic foot (PCF) density block with a cortical layer for the IT (24.01 ± 0.91 vs. 23.89 ± 1.66 Ncm). The IT values for SLC implants ranged from 13.95 ± 0.19 Ncm in the lowest density block to 37.94 ± 0.45 Ncm in the highest density block, consistently providing significantly higher primary stability with an ISQ of approximately 70 in the highest density block. Despite lower ISQ in the lowest density block (48.60 ± 0.52 and 48.80 ± 0.42 in buccolingual and mesiodistal directions), it was deemed acceptable considering the inadequate bone densities in the maxillary region. These findings on SLC suggest potential clinical advantages, including reduced procedure duration and costs, improved stability, and the possibility of immediate implant placement following sinus augmentation, thereby streamlining the rehabilitation process. Full article

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17 pages, 2201 KiB

Open AccessArticle

Biomechanical Factors in the Prognosis of Implants: A Clinical Study

by Paola Ceresuela and Javier Montero

Prosthesis 2024, 6(4), 896-912; https://doi.org/10.3390/prosthesis6040065 - 9 Aug 2024

Viewed by 871

Abstract

This study aims to assess the impact of occlusal loadings on peri-implant bone loss by measuring the cantilever of each implant and evaluating the occlusal pattern using PRESCALE^® and to examine the relationship between occlusal overload and peri-implant bone loss, including marginal [...] Read more.

This study aims to assess the impact of occlusal loadings on peri-implant bone loss by measuring the cantilever of each implant and evaluating the occlusal pattern using PRESCALE^® and to examine the relationship between occlusal overload and peri-implant bone loss, including marginal bone loss (MBL) and biomechanical factors, in a sample of 41 patients with a total of 135 implants. In addition, this study examines the influence of occlusal overload among patient groups with no marginal bone loss, unilateral bone loss, and bilateral bone loss. The PRESCALE^® quantifies the occlusal area and load along the dental arch. The analysis of variance (ANOVA) was used for comparing quantitative variables between groups and the Pearson correlation coefficient (r) was applied to analyze linear relationships between quantitative variables. The results of occlusal distribution and pressure range were presented using the PRESCALE^®. It was found that the mesial cantilever was statistically significantly greater (p < 0.05) for the bilateral bone loss group. Additionally, MBL was significantly proportional to occlusal loading in the left anterior sector (r = 0.47; p < 0.01) and to follow-up time (r = 0.29; p < 0.01), though it was also proportional to implant diameter and length (r = 0.27 and r = 0.20). The presence of a wider cantilever and excess occlusal loading appears to be associated with increased bone loss. Full article

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16 pages, 1062 KiB

Open AccessSystematic Review

Single Dental Implant Restoration: Cemented or Screw-Retained? A Systematic Review of Multi-Factor Randomized Clinical Trials

by Luca Fiorillo, Cesare D’Amico, Vincenzo Ronsivalle, Marco Cicciù and Gabriele Cervino

Prosthesis 2024, 6(4), 871-886; https://doi.org/10.3390/prosthesis6040063 - 2 Aug 2024

Cited by 2 | Viewed by 2407

Abstract

Background: Dental implant rehabilitation has significantly advanced prosthodontics by providing a reliable, long-lasting solution for missing teeth. This systematic review compares the clinical, technical, and biological outcomes of cemented versus screw-retained single dental implant restorations based on randomized clinical trials (RCTs). Materials and [...] Read more.

Background: Dental implant rehabilitation has significantly advanced prosthodontics by providing a reliable, long-lasting solution for missing teeth. This systematic review compares the clinical, technical, and biological outcomes of cemented versus screw-retained single dental implant restorations based on randomized clinical trials (RCTs). Materials and Methods: This review included recent human and in vitro studies focusing on the keywords “cemented vs. screw-retained” and “dental implant”. Eight studies met the inclusion criteria, which investigated parameters, including implant survival rate, bleeding on probing (BOP), probing depth, plaque index, marginal bone loss (MBL), cytokine concentrations, mechanical complications, esthetic outcomes, patient satisfaction, treatment time, and technical failures. Results: The primary outcomes, BOP and MBL, did not statistically differ between cemented and screw-retained implants (p-values for MBL and BOP are 0.5813 and 0.8093, respectively). The reviewed studies, including RCTs, split-mouth studies, and clinical evaluations, demonstrated comparable clinical, technical, and biological outcomes between the two restoration methods. Conclusions: Screw-retained and cemented dental implant restorations exhibit similar clinical, technical, and biological outcomes. Screw-retained restorations offer advantages such as retrievability, ease of repair, and predictable passive fit, while cemented restorations provide superior esthetics. The risk of peri-implant complications due to residual cement in cemented restorations must be considered. Future research should explore long-term stability and the impact of different prosthetic protocols on peri-implant health. Full article

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13 pages, 2356 KiB

Open AccessArticle

Determinants of Temperature Development during Dental Implant Surgery

by Kirsten Sekura, Carolin Erbel, Matthias Karl and Tanja Grobecker-Karl

Prosthesis 2024, 6(3), 657-669; https://doi.org/10.3390/prosthesis6030046 - 12 Jun 2024

Viewed by 1278

Abstract

Mechanical and thermal trauma during implant surgery may be reasons for initial peri-implant bone loss. Temperature development during drilling and implant insertion were quantified in this series of in vitro and animal experiments. Polyurethane foam material mimicking different classes of alveolar bone was [...] Read more.

Mechanical and thermal trauma during implant surgery may be reasons for initial peri-implant bone loss. Temperature development during drilling and implant insertion were quantified in this series of in vitro and animal experiments. Polyurethane foam material mimicking different classes of alveolar bone was used as a model material for simulating implant surgery. Using thermocouples, temperature development was determined in the model material at depths of 3 mm and 10 mm during site preparation and implant insertion. Additionally, an infrared camera allowed for measuring drill temperatures both in vitro and as part of an animal trial using an intraoral minipig model. Drill diameter and repeated usage of drills did not have a major effect on temperature generation. The addition of a diamond-like carbon coating, bone density, predrilling, and irrigation heavily affected intraosseous temperatures. In vivo, applying regular drill protocols, an intraosseous temperature rise of approximately 3 °K was determined. Implant geometry as well as the amount of undersizing of an osteotomy governed heat generation during implant insertion. Drill protocols and the amount of undersizing of an implant osteotomy constitute parameters by which clinicians can limit trauma during implant surgery. Full article

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23 pages, 19273 KiB

Open AccessArticle

Soft-Tissue Management Dental Implants with Digitally Customized Healing Abutments: A Pilot Study

by Maurizio De Francesco, Elisabetta Ferrara, Francesco Inchingolo, Grazieli Dalmaschio, Alberto Pispero, Angelo Michele Inchingolo, Gianna Dipalma, Tiziano Testori, Gianluca Martino Tartaglia and Biagio Rapone

Prosthesis 2024, 6(3), 596-618; https://doi.org/10.3390/prosthesis6030042 - 10 Jun 2024

Cited by 1 | Viewed by 1792

Abstract

Background: This pilot study aimed to evaluate the effectiveness of digitally crafted customized healing abutments in stabilizing peri-implant soft tissues following tooth extraction and assess the preservation of peri-implant soft tissue architecture over 5 years. Material and Methods: Forty patients (age ≥ 25 [...] Read more.

Background: This pilot study aimed to evaluate the effectiveness of digitally crafted customized healing abutments in stabilizing peri-implant soft tissues following tooth extraction and assess the preservation of peri-implant soft tissue architecture over 5 years. Material and Methods: Forty patients (age ≥ 25 years) were divided into test (n = 20) and control (n = 20) groups. The test group received dental implants with immediate loading after tooth extraction, along with customized healing abutments fabricated using CAD/CAM technology. The control group received dental implants with immediate loading without customized healing abutments. The primary outcome was the change in distance between the peri-implant soft tissue margin and implant fixture surface from baseline to 5 years post implantation. Results: In the test group, there was a significant decrease in the distance between the peri-implant soft tissue margin and fixture surface from baseline to 5 years (p < 0.001), with pairwise comparisons showing significant differences between multiple time points (p < 0.05). The control group showed less pronounced changes over time. Conclusions: Within the limitations of this pilot study, digitally fabricated customized healing abutments appear effective in stabilizing peri-implant soft tissues and preserving soft tissue architecture around dental implants over 5 years following immediate implant placement. Randomized controlled trials are needed to confirm these findings. Full article

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14 pages, 3905 KiB

Open AccessArticle

Evaluating Angled Abutments: Three-Dimensional Finite Element Stress Analysis of Anterior Maxillary Implants

by Chethan K N, Afiya Eram, Nisha Shetty, Divya D. Shetty, Mohan Futane and Laxmikant G. Keni

Prosthesis 2024, 6(2), 315-328; https://doi.org/10.3390/prosthesis6020024 - 25 Mar 2024

Cited by 2 | Viewed by 1384

Abstract

Restorative dentistry is the repairing of damaged teeth and restoring oral health and function. Dental implants are typically placed within the cortical bone of the jaw to provide stability and support for prosthetic restorations. The successful restoration of complex anatomical features of the [...] Read more.

Restorative dentistry is the repairing of damaged teeth and restoring oral health and function. Dental implants are typically placed within the cortical bone of the jaw to provide stability and support for prosthetic restorations. The successful restoration of complex anatomical features of the maxillary anterior is difficult for prosthodontists. Using a 3D slicer, CT scan images were used to create a detailed three-dimensional model of the maxilla bone. This study utilizes ANSYS Workbench, a finite element software program, to analyze the abutment angles, ranging from 0° to 25°, and the impact stress distribution within peri-implant bone. The outcomes of our studies align with and substantiate certain evidence in the literature documenting bone resorption, specifically at the level of the implant neck and near the cortical bone. The study aims to provide a comprehensive understanding of angled abutment stress patterns in the bone surrounding dental implants, offering valuable insights for clinical applications in critical areas of the mouth. Full article

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14 pages, 5072 KiB

Open AccessArticle

Exploring Stresses in Mandibular Jawbone during Implant Insertion: A Three-Dimensional Explicit Dynamic Analysis

by Chethan K N, Afiya Eram, Nisha Shetty, Divya D. Shetty, Mohan Futane and Laxmikant G. Keni

Prosthesis 2024, 6(2), 301-314; https://doi.org/10.3390/prosthesis6020023 - 25 Mar 2024

Viewed by 1154

Abstract

In dental implant insertion, an artificial foundation is prepared for the prosthetic device, which involves the surgical positioning of the implant in the jaw bone. The success of dental implants relies on the osseointegration process. The biomechanical factors, such as stress and strain, [...] Read more.

In dental implant insertion, an artificial foundation is prepared for the prosthetic device, which involves the surgical positioning of the implant in the jaw bone. The success of dental implants relies on the osseointegration process. The biomechanical factors, such as stress and strain, developed during the insertion affect the jawbone and its surroundings. In this current study, the stresses during the implant insertion in the mandibular jawbone bone are analyzed using three-dimensional explicit dynamic analysis, and the Cowper–Symonds model is implemented with the damage model. The implant’s design has a substantial impact on stress distribution within the cancellous bone during the insertion procedure. The stress variation takes place as the implant moves into the pre-drilled hole. This is because of the contact between the bone and the fixture on the implant. The upper edge of the predrilled site shows that the stresses are more at the crestal region of the implant due to surface area. There is a gradual increase in the stress level as the implant reaches the lower edge from the top edge. This is because of the concept of mechanical interlocking. Clinicians can use this information to anticipate and address potential stress-related challenges during implant placement. Full article

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19 pages, 4169 KiB

Open AccessArticle

Extensometry Study of the Most Appropriate Position and Arrangement of Stress-Breaker Bridges with Pier Abutment

by Carolina Barletta del Campo, Javier Gracia Rodríguez, Gregorio Fidalgo Valverde and Fernando Sánchez Lasheras

Prosthesis 2024, 6(2), 216-234; https://doi.org/10.3390/prosthesis6020017 - 21 Feb 2024

Viewed by 1448

Abstract

The arrangement of a stress breaker in the pier abutment of a fixed-mobile bridge affects the deformations that may occur in its supports. This article aims to study the most appropriate position and arrangement of a stress breaker. To verify the established objectives, [...] Read more.

The arrangement of a stress breaker in the pier abutment of a fixed-mobile bridge affects the deformations that may occur in its supports. This article aims to study the most appropriate position and arrangement of a stress breaker. To verify the established objectives, an experimental “in vitro” study was carried out with five different bridge designs: one with rigid connectors and four with non-rigid connectors (interlocks), placed on the distal and mesial surface of the intermediate abutment, and combining the retention stop at cervical and occlusal positions. The strain level at the support ground of each bridge was measured with strain gauges. The statistical analysis was performed with the help of the Kruskal–Wallis test and a linear regression model. Initial results show that the model with the highest average value of maximum strain is the non-rigid bridge with the interlock on the distal surface of the pier abutment and the occlusal retention stop. In any case, the presence of an intermediate abutment, with or without interlock, influences the maximum tension supported by the abutment, especially in relation to the intermediate abutment. Full article

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16 pages, 3239 KiB

Open AccessArticle

Digital Analysis of Occlusion in Fixed Partial Implant Prostheses: How to Overcome Age-Related Changes in the Stomatognathic System

by Juan Dib Zakkour, Sara Dib Zakkour, Javier Montero, Begoña García-Cenador, Javier Flores-Fraile and Abraham Dib Zaitun

Prosthesis 2024, 6(1), 119-134; https://doi.org/10.3390/prosthesis6010010 - 26 Jan 2024

Viewed by 1131

Abstract

Due to their lack of periodontal ligaments (PLs) and the differences between dental implants and natural teeth, it is necessary to improve and generate a new occlusal scheme to prolong the life of implants and prostheses. The age and the sex of patients [...] Read more.

Due to their lack of periodontal ligaments (PLs) and the differences between dental implants and natural teeth, it is necessary to improve and generate a new occlusal scheme to prolong the life of implants and prostheses. The age and the sex of patients must be considered because of their effects on the stomatognathic system’s physiology. Operators must manage all the changes to obtain good sensations during mastication and a better occlusal scheme for implanting fixed partial prostheses. Dentists should try to protect this type of prosthesis using adjacent teeth and the PL. This is why new digital systems were created. The combination of T-Scan^® (digital software for occlusal analysis) and electromyography (EMG) could allow doctors to find areas where it is necessary to act and to find suitable solutions for the problems generated by using conventional methods of occlusal analysis (such as articulating paper). In this study, a new method for establishing occlusion on fixed partial implant prostheses has been created, combining digital systems with conventional articulating paper. This method consists of asking the patient to bite down with different forces and situations in an attempt to achieve Implant-Protected Occlusion (IPO). The use of digital systems has been shown to be more effective than using only conventional systems. This new method allows a safer mode of occlusion which protects implants and prostheses, saving all the differences between them and natural teeth, and increasing the satisfaction of patients. This method also helps to overcome the changes in the stomatognathic system as age increases, adjusting the occlusion to changes in PLs with age. Full article

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4 pages, 185 KiB

Open AccessEditorial

Oral Implantology: Current Aspects and Future Perspectives

by Andrea Scribante, Simone Gallo and Maurizio Pascadopoli

Prosthesis 2024, 6(1), 89-92; https://doi.org/10.3390/prosthesis6010007 - 24 Jan 2024

Cited by 1 | Viewed by 2308

Abstract

In recent years, dental implantology has significantly improved with the development of more advanced techniques which have greatly increased the reliability of dental implant therapy while reducing patient morbidity [...] Full article

15 pages, 4627 KiB

Open AccessArticle

Investigating the Influence of All-Ceramic Prosthetic Materials on Implants and Their Effect on the Surrounding Bone: A Finite Element Analysis

by Saniya Juneja, Glynis Miranda, Afiya Eram, Nisha Shetty, Chethan K N and Laxmikant G. Keni

Prosthesis 2024, 6(1), 74-88; https://doi.org/10.3390/prosthesis6010006 - 17 Jan 2024

Cited by 2 | Viewed by 1234

Abstract

This study aims to assess and compare the impact of Monolithic Zirconia (MZ) and In-Ceram Zirconia (ZP) superstructures on stress distribution within implants and D2/D4 bone densities under 200 N vertical and oblique occlusal loads using three-dimensional finite element analysis via ANSYS WORKBENCH [...] Read more.

This study aims to assess and compare the impact of Monolithic Zirconia (MZ) and In-Ceram Zirconia (ZP) superstructures on stress distribution within implants and D2/D4 bone densities under 200 N vertical and oblique occlusal loads using three-dimensional finite element analysis via ANSYS WORKBENCH R2. The analysis employed maximum and minimum von Mises stress values. Modeling an implant (4.2 mm diameter, 10 mm length) and abutment (0.47 mm diameter), with an 8 mm diameter and 6 mm length single crown, the research identified lower von Mises stresses in D2 cancellous bone with the MZ model under vertical loading. Conversely, under oblique loading, the ZP model exhibited maximum von Mises stresses in D4 bone around the implant. This underscores the critical need to consider physical and mechanical properties, beyond mere aesthetics, for sustained implant success. The findings highlight the effect of material composition and stress distribution, emphasizing the necessity of durable and effective implant treatments. Full article

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2023

Jump to: 2024, 2022

12 pages, 1276 KiB

Open AccessFeature PaperReview

Narrow Implants and Overdentures in the Total Rehabilitation of Atrophic Edentulous Jaws: Review of Clinical Aspects with Meta-Analysis

by Alessio Rosa, Alberto Maria Pujia, Riccardo De Angelis and Claudio Arcuri

Prosthesis 2024, 6(1), 41-52; https://doi.org/10.3390/prosthesis6010003 - 21 Dec 2023

Cited by 3 | Viewed by 1248

Abstract

Background: The present study analyzes the clinical aspects of the use of small-diameter implants for the fixation of total overdenture-type prostheses on both totally edentulous dental arches. Materials and methods: This is a review of all randomized controlled trials of at least ten [...] Read more.

Background: The present study analyzes the clinical aspects of the use of small-diameter implants for the fixation of total overdenture-type prostheses on both totally edentulous dental arches. Materials and methods: This is a review of all randomized controlled trials of at least ten patients with a control group in which at least two narrow implants were placed, published between January 2010 and July 2023. Most databases were analyzed, and clinical studies involving the insertion of at least two narrow implants (<3.5 mm in diameter) were analyzed. Results: Studies showed that the survival rate of narrow implants varied from 78% to 100%. Conclusions: The results indicated that narrow-type implants have satisfactory and predictable clinical performance for the long-term stability of overdenture-type prostheses. Full article

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14 pages, 487 KiB

Open AccessSystematic Review

Systematic Review of In Vitro Studies on Distortion Generated by Intraoral Scanning Systems for Oral Rehabilitations with More Than Three Implants

by Luminita Oancea, Ioana Luca, Sergiu Radulescu, Andrei Macris and Toma Ciocan

Prosthesis 2023, 5(4), 1139-1152; https://doi.org/10.3390/prosthesis5040080 - 8 Nov 2023

Cited by 7 | Viewed by 1851

Abstract

(1) Background: This systematic review intends to answer the following Patient–Intervention–Comparison–Outcome (PICO) question: Do digital impression systems generate significant errors during scanning in extensive implant restorative treatments? (2) Methods: Following the PRISMA protocol and according to predefined inclusion criteria, two trained investigators searched [...] Read more.

(1) Background: This systematic review intends to answer the following Patient–Intervention–Comparison–Outcome (PICO) question: Do digital impression systems generate significant errors during scanning in extensive implant restorative treatments? (2) Methods: Following the PRISMA protocol and according to predefined inclusion criteria, two trained investigators searched for relevant articles in the PubMed database and related sources using a standard keyword sequence. The investigators were responsible for selecting studies and performing quality analysis. (3) Results: From 78 titles, only 9 studies were selected. An analysis of registration distortion variations was conducted for each potential influencing factor in terms of accuracy: interimplant distance, implant angulation, scanner type, and scanning body type. The results showed repeatable differences in accuracy between types of scanning technologies and techniques, and a positive correlation between interimplant distance and the amplitude of deviations detected in comparative analysis, with the highest error levels in total edentulous arch recording. There was no consensus on the error level owing to implant angulation, and statistically significant differences were found between the types of scan bodies used. (4) Conclusions: Digital impression systems generate significant errors during scanning in extensive implant restorative treatments, influenced by scanning technology, interimplant distance, and scanning body type. Full article

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15 pages, 3726 KiB

Open AccessArticle

Single Crown Restorations Supported by One-Piece Zirconia Dental Implants: Case Series with a Mean Follow-Up of 58 Months

by Eugenio Romeo, Riccardo Scaringi, Diego Lops and Antonino Palazzolo

Prosthesis 2023, 5(4), 1060-1074; https://doi.org/10.3390/prosthesis5040074 - 19 Oct 2023

Cited by 5 | Viewed by 2259

Abstract

The main aim of this case series was to report the clinical and radiographic outcomes of 22 one-piece zirconia dental implants positioned in 19 patients to restore single edentulisms and followed up for at least 2 years. The mean observation period was 58.18 [...] Read more.

The main aim of this case series was to report the clinical and radiographic outcomes of 22 one-piece zirconia dental implants positioned in 19 patients to restore single edentulisms and followed up for at least 2 years. The mean observation period was 58.18 months. At the last follow-up visit, no issues, such as foreign body sensation, discomfort or pain, were reported by the patients. No implant showed signs of infection with suppuration or implant mobility. Marginal bone levels (MBL) were assessed through standardized dental radiographs and a dedicated software. The mean distance between the implant head and the first detectable bone to implant contact was calculated at the mesial and distal aspect of each implant. The mean MBL at baseline was 1.82 ± 0.63 mm while the mean MBL at the last follow-up visit was 2.57 ± 0.72 mm. The results obtained in the present case series over a mean follow-up period of 58.18 months (range 27–96) showed that one-piece zirconia dental implants could be an alternative option to support single crowns in patients requiring metal-free restorations. Nevertheless, further better-controlled research featuring an adequate study design and longer follow-up is needed in order to clarify advantages and limitations which are related to this treatment modality. Full article

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10 pages, 271 KiB

Open AccessArticle

Impact of Implant Diameter on Success and Survival of Dental Implants: An Observational Cohort Study

by Georgios E. Romanos, Aigerim Schesni, Georg-Hubertus Nentwig, Anna Winter, Robert Sader and Silvia Brandt

Prosthesis 2023, 5(3), 888-897; https://doi.org/10.3390/prosthesis5030062 - 6 Sep 2023

Cited by 14 | Viewed by 2437

Abstract

Narrow-diameter implants (NDIs) can be inserted instead of standard dental implants (SDIs) in sites with limited space and bone availability. The aim of this study was to evaluate the effect of implant diameter on peri-implant bone, attached mucosa, and on the associated probability [...] Read more.

Narrow-diameter implants (NDIs) can be inserted instead of standard dental implants (SDIs) in sites with limited space and bone availability. The aim of this study was to evaluate the effect of implant diameter on peri-implant bone, attached mucosa, and on the associated probability of implant success and survival. The implants with progressive thread design and platform switching (Ankylos^®, Dentsply Sirona; Mannheim, Germany) investigated were identified retrospectively and assigned to two groups based on their diameter: 3.5 mm (NDIs) and 4.5 mm (SDIs). Peri-implant bone loss was analyzed based on available radiographs. Descriptive and implant-associated factors were gathered from patient files. Data were statistically analyzed using the Kolmogorov–Smirnov–Lilliefors test and regression analyses. The level of significance was p ≤ 0.05. Results: In total, data for 415 implants in 194 patients were included in the study. Ten-year survival was 95.8% (NDIs) and 91.1% (SDIs). Implant diameter had no significant effect on peri-implant crestal bone loss (p = 0.098) or on the width of the attached gingiva (p = 0.052). Survival and success rates of NDIs were like or slightly better than those of SDIs. Because implant diameter had no effect on peri-implant tissue, NDIs can be recommended in selected cases. Full article

17 pages, 528 KiB

Open AccessSystematic Review

Three-Dimensional Accuracy of Surgical Guides for Static Computer-Aided Implant Surgery: A Systematic Review

by Lucio Lo Russo, Mariani Pierluigi, Khrystyna Zhurakivska, Chiara Digregorio, Eleonora Lo Muzio and Luigi Laino

Prosthesis 2023, 5(3), 809-825; https://doi.org/10.3390/prosthesis5030057 - 4 Sep 2023

Cited by 6 | Viewed by 1606

Abstract

Background: The purpose of this study was to evaluate the dimensional accuracy of surgical guides for static computer-aided implant placements processed using milling or 3D printing. Methods: A comprehensive literature search was performed on electronic databases inclusive of PUBMED, SCOPUS, Cochrane Database of [...] Read more.

Background: The purpose of this study was to evaluate the dimensional accuracy of surgical guides for static computer-aided implant placements processed using milling or 3D printing. Methods: A comprehensive literature search was performed on electronic databases inclusive of PUBMED, SCOPUS, Cochrane Database of Systematic Reviews, EBSCO host Research Databases, and Web of Knowledge were searched without restriction to date. Studies investigating the surgical guides fabricated by milling or 3D-printing, comparing them with their computer-aided design model, and reporting outcome measures about the accuracy of the internal/external surface, the angular deviation of the sleeves, and the vertical or horizontal deviations of the sleeves’ access were included. Results: From 1928 retrieved records, 33 studies were selected; 11 out of them fulfilled the eligibility criteria. All studies analyzed printed surgical guides, while only two studies analyzed both printed and milled templates. Studies were very heterogeneous in methodology and equipment; moreover, different parameters were used for accuracy measurements which made their results not comparable and quantitative synthesis not feasible. Conclusion: There is no clear evidence to address which manufacturing technology provides surgical guides with better accuracy, although milling might achieve better results, at least in terms of reduced variation. For additive technologies, several factors could influence accuracy. Since this issue has sensible clinical implications, future studies are encouraged. Full article

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12 pages, 990 KiB

Open AccessArticle

Clinical, Radiological, and Aesthetic Outcomes after Placement of a Bioactive-Surfaced Implant with Immediate or Delayed Loading in the Anterior Maxilla: 1-Year Retrospective Follow-Up Study

by Roberta Iacono, Yaniv Mayer, Gaetano Marenzi, Balan Vitor Ferreira, Godoy Eduardo Pires, Marco Migliorati and Francesco Bagnasco

Prosthesis 2023, 5(3), 610-621; https://doi.org/10.3390/prosthesis5030043 - 7 Jul 2023

Cited by 14 | Viewed by 1907

Abstract

Background: Dental implants have become the standard for replacing missing teeth. However, patients’ demands for shorter treatment times and the desire for aesthetics in their results can complicate the rehabilitation process, particularly when poor-quality bone is involved. In order to address these challenges, [...] Read more.

Background: Dental implants have become the standard for replacing missing teeth. However, patients’ demands for shorter treatment times and the desire for aesthetics in their results can complicate the rehabilitation process, particularly when poor-quality bone is involved. In order to address these challenges, new methods of treating implant surfaces have been introduced. These methods aim to make the implants superhydrophilic and bioactive, enhancing their functionality and interactions with the surrounding tissues. Aim: The aim of the study was to retrospectively examine the efficacy of a superhydrophilic and bioactive implant for treatment of the edentulous maxillary anterior area. The study also aimed to evaluate whether this improved implant surface, by enhancing the osseointegration processes, could serve as a factor in speeding up the loading protocols. Materials and Methods: For this retrospective study, a total of 13 implants were included: 6 delayed restored implants and 7 immediately loaded implants placed in the anterior maxillary area. Clinical, radiographic, and esthetic outcomes were assessed. Baseline measurements of the insertion torque value (ITV) and stability implant quotient (ISQ) were recorded for all implants. In the early-loaded group, these measurements were also taken 30 days (t30) and 45 days (t45) after the placement of the implant to monitor their changes over time. Marginal bone loss (MBL) was calculated according to the changes in marginal bone level on intraoral X-rays taken at two different time points: at baseline and one year after loading. To evaluate the esthetic results, the pink esthetic score (PES) and the white esthetic score (WES) were assessed. For this evaluation, intraoral photographs were taken one year after implant loading. Results: A total of 7 implants were immediately restored, with a mean ITV of 32.29 ± 9.01 Ncm and a mean ISQ of 72.71 ± 2.81. These implants were placed in a bone environment with a mean density of 410.00 ± 194.42 HU. On the other hand, 6 implants with delayed loading had a mean ITV of 28.50 ± 3.27 Ncm, an ISQ of 67.92 ± 8.43, and a mean bone density of 607.50 ± 140.83 HU. The mean PES and WES after 1 year were, respectively, 8.71 ± 1.89 and 8.57 ± 0.79 for immediate and 8.33 ± 1.36 and 9.17 ± 1.33 for delayed-loaded implants. At 12 months after loading, the immediately loaded group had a MBL of 0.29 ± 0.29 mm, while the delayed-loaded group had a MBL of 0.33 ± 0.25. No statistically significant differences between the two treatment groups were found for any of the evaluated outcomes. Conclusions: Despite the limitations of this study, the obtained results may support the use of a superhydrophilic and bioactive implant surface for implant-prosthetic rehabilitation in critical loading protocols with satisfactory esthetic results. Full article

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12 pages, 720 KiB

Open AccessReview

Influence of Implant–Abutment Connection Biomechanics on Biological Response: A Literature Review on Interfaces between Implants and Abutments of Titanium and Zirconia

by Sunyoung Choi, Young Suk Kang and In-Sung Luke Yeo

Prosthesis 2023, 5(2), 527-538; https://doi.org/10.3390/prosthesis5020036 - 1 Jun 2023

Cited by 17 | Viewed by 6965

Abstract

The interface between a dental implant and an abutment is stabilized by two mechanical characteristics: a preload of an abutment screw and the friction between the contact surfaces of the implant and the abutment. These mechanical properties are quantitatively analyzed by using physical [...] Read more.

The interface between a dental implant and an abutment is stabilized by two mechanical characteristics: a preload of an abutment screw and the friction between the contact surfaces of the implant and the abutment. These mechanical properties are quantitatively analyzed by using physical and mechanical formulas. The important thing is that such mechanical properties cause various biological phenomena when medical devices are inserted into human bodies. Some mechanical complications in dental implant prostheses are closely associated with biological complications. This literature review explores the mechanical complications of the implant–abutment connection and their biological effects in a titanium dental implant system, which is the system most widely used in dental clinics. Understanding the biomechanics of the implant–abutment connection helps to predict the merits and limits of zirconia dental implants, which have been recently introduced and clinically applied. Full article

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16 pages, 2741 KiB

Open AccessReview

Full-Digital Customized Meshes in Guided Bone Regeneration Procedures: A Scoping Review

by Andrea Scribante, Martina Ghizzoni, Matteo Pellegrini, Federica Pulicari, Mattia Manfredini, Pier Paolo Poli, Carlo Maiorana and Francesco Spadari

Prosthesis 2023, 5(2), 480-495; https://doi.org/10.3390/prosthesis5020033 - 18 May 2023

Cited by 6 | Viewed by 2892

Abstract

Meshes, especially titanium ones, are being widely applied in oral surgery. In guided bone regeneration (GBR) procedures, their use is often paired with membranes, being resorbable or non-resorbable. However, they present some limitations, such as difficulty in the treatment of severe bone defects, [...] Read more.

Meshes, especially titanium ones, are being widely applied in oral surgery. In guided bone regeneration (GBR) procedures, their use is often paired with membranes, being resorbable or non-resorbable. However, they present some limitations, such as difficulty in the treatment of severe bone defects, alongside frequent mesh exposure. Customized meshes, produced by a full-digital process, have been recently introduced in GBR procedures. Therefore, the focus of the present review is to describe the main findings in recent years of clinical trials regarding patient-specific mesh produced by CAD/CAM and 3D printing workflow, made in titanium or even PEEK, applied to GBR surgeries. The purpose is to analyze their clinical management, advantages, and complications. This scoping review considered randomized clinical trials, observational studies, cohort studies, and case series/case reports studies. Studies that did not meet inclusion criteria were excluded. The preferred reporting items for scoping reviews (PRISMA-ScR) consensus was followed. A total of 15 studies were selected for this review. Based on the studies included, the literature suggests that meshes produced by a digital process are used to restore complex and severe bone defects. Moreover, they give satisfactory aesthetic results and fit the defects, counteracting grid exposure. However, more clinical trials should be conducted to evaluate long-term results, the rate of complications, and new materials for mesh manufacturing. Full article

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16 pages, 925 KiB

Open AccessArticle

Radiological and Periodontal Evaluation of Stock and Custom CAD/CAM Implant Abutments—A One-Year Follow-Up Study

by Ivica Pelivan, Ivan Šeparović, Marko Vuletić, Nikša Dulčić and Dragana Gabrić

Prosthesis 2023, 5(2), 437-452; https://doi.org/10.3390/prosthesis5020030 - 26 Apr 2023

Cited by 10 | Viewed by 2827

Abstract

Implant abutment selection is an important step in implant treatment to restore one or more lost teeth. The aim of this study was to compare stock and individual CAD/CAM full-form abutments after one year in function. A total of 64 subjects with one [...] Read more.

Implant abutment selection is an important step in implant treatment to restore one or more lost teeth. The aim of this study was to compare stock and individual CAD/CAM full-form abutments after one year in function. A total of 64 subjects with one missing tooth were divided into two groups according to the type of abutment: 34 patients were given a stock abutment, and 30 an individual CAD/CAM abutment. Patients were scheduled for check-ups seven days after functional loading and after four, eight, and twelve months. Peri-implant soft tissue status was checked at every check-up by monitoring parameters traditionally used in similar studies: plaque index; bleeding on probing; and probing depth. To assess the stability of the bone tissue, radiological methods of measuring the amount of bone level compared to the implant shoulder were used. When needed, data were analysed by χ² test or by Fisher’s exact test. The normality of the distribution of quantitative measurements (properties) was tested by the Shapiro–Wilk test. Differences in the distribution of quantitative variables frequencies were analysed by Student’s t-test. Student’s t-test was used for repeated measurements, Mann–Whitney’s U test and ANOVA test for repeated measurements, and Friedmann’s two-way analysis of variance for repeated measurements. The predictive values of the chosen variables on the ABI index were assessed by the logistic regression model (Enter method). The results of this study showed that the impact of the abutment type (individual CAD/CAM or stock) on the average bleeding on probing was significant, especially after eight or twelve months. However, the abutment type did not show a significant correlation with the total crestal bone loss. The level of oral hygiene showed a significant correlation with the average bleeding on probing. The influence of smoking cigarettes on the total crestal bone loss evaluation was also significant. Overall, from a clinical perspective, custom CAD/CAM abutment performed slightly better than stock abutments during the one-year follow-up. Full article

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47 pages, 1000 KiB

Open AccessSystematic Review

Survival of Single Immediate Implants and Reasons for Loss: A Systematic Review

by Patricia Soegiantho, Patricia Gillian Suryawinata, Wendy Tran, Omar Kujan, Bryar Koyi, Nabil Khzam and Leticia Algarves Miranda

Prosthesis 2023, 5(2), 378-424; https://doi.org/10.3390/prosthesis5020028 - 17 Apr 2023

Cited by 25 | Viewed by 5519

Abstract

Background: Immediate implant placement (IIP) or Type I implants have become more attractive than conventional implant placements as it reduces the number of surgical procedures and allows faster delivery of the final restoration compared to conventional implant placements. However, the survival of Type [...] Read more.

Background: Immediate implant placement (IIP) or Type I implants have become more attractive than conventional implant placements as it reduces the number of surgical procedures and allows faster delivery of the final restoration compared to conventional implant placements. However, the survival of Type I implants varies depending on multiple factors. Purpose: To evaluate the survival rate of Type I implants, and to describe the factors influencing their failure. Materials and methods: A developed search strategy was applied to identify randomised controlled trials on single-unit immediate implants including at least six human participants with a minimum follow-up time of 12 months and published between 1 January 1999 and 1 January 2020 in several databases. The data were extracted independently using validated data extraction forms. Information on survival rates, number of implants placed, loading protocols, setting of the study, location of implants in the jaw, antibiotic protocol, grafting methods, and implant geometry were obtained and assessed. Results: Twenty-six randomised controlled trials with an average follow-up time of 24 months (range = 12–120 months) were included and analysed to give a survival rate ranging between 83.7 and 100%. Fifteen studies reported implant failures, of which twelve reported early losses (loss before definitive restoration). Nine early losses were due to lack of osseointegration, two did not report the reason for implant failure, and one was reported as iatrogenic. Of the eleven studies with 100% survival rates, the common trend observed was the use of titanium implants and an antibiotic regimen using amoxicillin. Conclusions: The survival rate for immediate single implant placement ranged from 83.7 to 100%. Implant failure was not consistently reported and when reported, failure due to lack of osseointegration prior to placement of the definitive restoration was the most common descriptor. Other attributed reasons included infection abscess, mobility after immediate loading, and iatrogenic complications. Full article

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12 pages, 1923 KiB

Open AccessArticle

Functional Differences between Chewing Sides of Implant-Supported Denture Wearers

by Masaoki Yokoyama, Hiroshi Shiga, Shin Ogura, Mako Sano, Marie Komino, Hitoshi Takamori, Hanako Uesugi, Keiji Haga and Yoshikazu Murakami

Prosthesis 2023, 5(2), 346-357; https://doi.org/10.3390/prosthesis5020025 - 24 Mar 2023

Cited by 29 | Viewed by 2568

Abstract

Humans are said to have habitual and non-habitual chewing sides; however, the functional differences between the chewing sides of implant-supported denture wearers have not been sufficiently clarified. This study aimed to clarify the presence or absence of functional differences between the chewing sides [...] Read more.

Humans are said to have habitual and non-habitual chewing sides; however, the functional differences between the chewing sides of implant-supported denture wearers have not been sufficiently clarified. This study aimed to clarify the presence or absence of functional differences between the chewing sides in implant-supported denture wearers. Forty-five patients with bilateral posterior implants were included in this study. The participants were asked to chew a gummy jelly on one side, and the masticatory movement was recorded using a Motion Visi-trainer (MVT V1). For 10 cycles from the fifth cycle after the start of mastication, the pattern of the movement path, the opening distance, the masticatory width, and the cycle time were calculated as parameters of masticatory movement. The amount of glucose eluted during the chewing of gummy jelly was measured and used as a parameter of masticatory performance. Each parameter representing masticatory movement and masticatory performance was compared between the right and left chewing sides and between the habitual and non-habitual chewing sides using a chi-squared test or a paired t-test. There was no difference in the frequency of masticatory path patterns between the right and left chewing sides. Most participants had a normal pattern on the habitual chewing side; however, abnormal patterns were also observed on the non-habitual chewing side. When comparing right and left chewing, no significant difference was observed between chewing sides in terms of opening distance, masticatory width, cycle time, or amount of glucose eluted (p > 0.05). When comparing the habitual and non-habitual chewing sides, masticatory movement on the habitual chewing side showed a larger opening distance (p < 0.001) and masticatory width (p = 0.008), shorter cycle time (p = 0.004), and higher masticatory performance (p < 0.001). It was suggested that there is a functional difference between the habitual and non-habitual chewing sides in the masticatory movement and masticatory performance of implant-supported denture wearers. Full article

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17 pages, 6220 KiB

Open AccessArticle

Influence of the Printing Orientation on Parallelism, Distance, and Wall Thickness of Adjacent Cylinders of 3D-Printed Surgical Guides

by Aisha Ali, Hossein Bassir and Rafael Delgado-Ruiz

Prosthesis 2023, 5(1), 310-326; https://doi.org/10.3390/prosthesis5010023 - 13 Mar 2023

Cited by 3 | Viewed by 2345

Abstract

This in-vitro study aimed to evaluate the influence of the printing orientation on parallelism, distance, and thickness between adjacent cylinders of 3D-printed surgical guides. CAD software was used to design a surgical guide with two adjacent parallel cylinders (reference); the design was saved [...] Read more.

This in-vitro study aimed to evaluate the influence of the printing orientation on parallelism, distance, and thickness between adjacent cylinders of 3D-printed surgical guides. CAD software was used to design a surgical guide with two adjacent parallel cylinders (reference); the design was saved as standard tessellation software (STL) and 63 samples were printed using three different orientations (0, 45, and 90 degrees). A metrology digital microscope was used to measure the distance, the angle and the thickness of the guides cylinders. Afterwards, the printed guides were scanned and cloud comparison software was used to compare STL files from the printed guides against the reference CAD model. One-way analysis of variance and Tukey test were used for multiple comparisons between groups and significance was p < 0.05. The printing orientation affected the distance between cylinders, the parallelism and the wall thickness. In addition, there were global deviations in all printing orientations. Printing with 90 degrees orientation produced almost-parallel cylinders but walls thicker than the reference model; all the cylinders converged toward the coronal but printing at 0 degrees produced the closest distance to the reference value. Within the limitations of this experimental in-vitro study it can be concluded that all the printing orientations influence the angle, the distance, and the thickness between adjacent cylinders of a surgical guide. Printing at 90 degrees produces the best global correspondence with the master model. Full article

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15 pages, 631 KiB

Open AccessArticle

Marginal Bone Loss and Treatment Complications with Mandibular Overdentures Retained by Two Immediate or Conventionally Loaded Implants—A Randomized Clinical Trial

by Beatriz Pardal-Peláez, Abraham Dib, Yasmina Guadilla, Javier Flores-Fraile, Norberto Quispe-López and Javier Montero

Prosthesis 2023, 5(1), 295-309; https://doi.org/10.3390/prosthesis5010022 - 13 Mar 2023

Cited by 2 | Viewed by 2535

Abstract

This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the [...] Read more.

This study aimed to assess marginal bone loss and complication rates of mandibular overdentures retained on two implants with conventional and immediate loading protocols. Twenty edentulous patients were treated with mandibular two-implant-retained overdentures and new complete maxillary dentures. In one half of the sample, the implants were loaded immediately by VulkanLoc^® abutments. In the counterpart group, these abutments were connected to the implants two months after implant placement (conventional protocol). Treatment outcomes were evaluated at 2, 6, and 12 months after implant placement. According to the pre- and post-insertion radiographs, there was a mean marginal bone loss of 0.25–0.59 mm (CI 95%) after 13.4 ± 2.1 months of follow-up. There were no significant differences between groups. The failure rate (percentage of implants failing per year) was slightly higher in the conventional loading group (14.0 ± 32.7%) than in the immediate loading group (8.3 ± 18.0%). The findings of the present study suggested that there were no differences in marginal bone loss observed at one year for immediately loaded implants (0.40–0.39 mm) versus conventionally loaded implants (0.44- 0.36 mm) placed for the retention of mandibular overdentures. There were no differences in primary and secondary stability of immediately loaded versus conventional implants; however, in the conventional loading group, stability increased significantly between implant placement compared at both 6 and 12 months post-placement. Full article

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17 pages, 4704 KiB

Open AccessEditor’s ChoiceArticle

Bioengineering Applied to Oral Implantology, a New Protocol: “Digital Guided Surgery”

by Luca Fiorillo, Agron Meto and Marco Cicciù

Prosthesis 2023, 5(1), 234-250; https://doi.org/10.3390/prosthesis5010018 - 17 Feb 2023

Cited by 10 | Viewed by 2700

Abstract

Rehabilitative dentistry has made enormous progress in recent years, not only due to the advent of new implant-prosthetic methods, but also thanks to new information technologies that support the doctor. This study aims to present a new implant protocol that involves the application [...] Read more.

Rehabilitative dentistry has made enormous progress in recent years, not only due to the advent of new implant-prosthetic methods, but also thanks to new information technologies that support the doctor. This study aims to present a new implant protocol that involves the application of bioengineering methods. With the application of the finite element analysis, it is possible to evaluate the distribution of the forces of a fixture and possible implant rehabilitation on each patient, even before performing the surgery. This protocol provides for the combination of radiographic images and three-dimensional files to obtain predictable results on possible rehabilitation, guiding its planning in the best possible way. Surely, the evolution of machines and computers will enable the surgeon to carry out and maintain these protocols in a chair-side manner, and to carry out safe and predictable rehabilitations. Full article

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13 pages, 16130 KiB

Open AccessCase Report

Computer-Guided Osteotomy with Simultaneous Implant Placement and Immediately Loaded Full-Arch Fixed Restoration: A Case Report

by Claudia Todaro, Michael Cerri, Gaetano Isola, Andrea Manazza, Stefano Storelli, Ruggero Rodriguez y Baena and Saturnino Marco Lupi

Prosthesis 2023, 5(1), 221-233; https://doi.org/10.3390/prosthesis5010017 - 9 Feb 2023

Cited by 4 | Viewed by 2222

Abstract

Aim: This case report aims to illustrate a clinical protocol that allows for the rehabilitation of patients requiring extensive osteotomy, simultaneous implant placement, and full-arch, screwed-in prosthetics in one session. This protocol allows for the improvement of the aesthetics and functionality of the [...] Read more.

Aim: This case report aims to illustrate a clinical protocol that allows for the rehabilitation of patients requiring extensive osteotomy, simultaneous implant placement, and full-arch, screwed-in prosthetics in one session. This protocol allows for the improvement of the aesthetics and functionality of the fixed implant-supported prosthesis through the preoperative planning of all surgical procedures, including osteotomy, and of the prosthesis through the application of 3D-printing technology for the creation of surgical templates and prostheses. Methods: This case report concerns a 72-year-old patient, ASA1, who, following diagnosis, the establishment of a treatment plan, and the provision of informed consent, opted for an immediate, full-arch rehabilitation of the lower arch. The digital planning stage started with the correct positioning of the fixtures. The proper bone levels were found and used to guide the creation of the provisional screwed-in prothesis. Two templates with the same supports (landmarks/pins) were then 3D-printed: a positioning template, including a slit to assist the surgeon during the osteotomy, and a surgery template to assist the surgeon during the implants’ positioning. A screwed-in prosthesis encased in resin C&B MFH (NEXTDENT^®, Soesterberg, The Netherlands) was delivered. Minimal occlusal adjustments were performed. Results: In a single clinical session, through careful planning and the pre-operative 3D printing of a prosthesis, a temporary implant-supported prosthetic rehabilitation was possible in a case that required an extended osteotomy. Clinically, the correspondence between the virtual design phase and the final realization was consistent. At a functional level, the provisional prosthesis required minimal occlusal adjustments and the DVO values obtained in the immediate post-operative period were found to be comparable to those of the virtual design. By planning the final position of the bone and the implants in advance, it was possible to deliver a full-arch prothesis with proper implant emergence, occlusal vertical dimensions, and occlusal relationship. Conclusion: This fully digital protocol allows the clinician to preview and plan the osteotomy and implant surgery as well as the delivery of the temporary, immediately loaded, complete, fixed prosthesis in patients who are candidates for post-extraction surgery with the need for severe osteotomy. Full article

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11 pages, 3991 KiB

Open AccessArticle

Same-Day Digital Dentistry Restorative Workflow for Single Immediate Provisionalization of Narrow-Diameter Implants: An Exploratory Prospective Study

by Janina Golob Deeb, Nitya G. Reddy, Liam J. Hopfensperger, April L. Harris and Sompop Bencharit

Prosthesis 2023, 5(1), 197-207; https://doi.org/10.3390/prosthesis5010015 - 6 Feb 2023

Cited by 3 | Viewed by 2621

Abstract

This study evaluated the two-year clinical outcomes of 3.1 mm diameter dental implants, immediately provisionalized and later restored using same-day dentistry, in 10 patients receiving 11 narrow-diameter (3.1 mm) single implants. Each implant was placed and immediately restored with a provisional crown after [...] Read more.

This study evaluated the two-year clinical outcomes of 3.1 mm diameter dental implants, immediately provisionalized and later restored using same-day dentistry, in 10 patients receiving 11 narrow-diameter (3.1 mm) single implants. Each implant was placed and immediately restored with a provisional crown after placement. At least 2 months after placement, the implant was restored with a prefabricated titanium abutment and an all-ceramic crown using a same-day dentistry protocol. Clinical outcomes, including apical bone loss, probing depths, gingival index, and surgical and prosthetic complications, were documented. There was no implant failure over the course of two years. No surgical complications were reported. Two cases lost provisional crowns. One crown needed to be remade due to esthetic concern. The cumulative two-year survival rate of the implants was 100%. Implant bone loss after two years of functional loading was −0.56 ± 0.54 mm and −0.32 ± 0.68 mm for mesial and distal crestal bone, respectively. Two prosthetic complications included recementation of a crown and remaking of a crown. This exploratory study suggests that immediate provisionalization and a same-day restorative dentistry digital workflow protocol for narrow-diameter implants appear to be predictable clinical procedures with no reported surgical complications and minimal prosthetic complications. Full article

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2022

Jump to: 2024, 2023

9 pages, 249 KiB

Open AccessArticle

Implant Survival Rate and Prosthetic Complications of OT Equator Retained Maxillary Overdenture: A Cohort Study

by Rodolfo Reda, Alessio Zanza, Dario Di Nardo, Valentina Bellanova, Edit Xhajanka and Luca Testarelli

Prosthesis 2022, 4(4), 730-738; https://doi.org/10.3390/prosthesis4040057 - 16 Dec 2022

Cited by 9 | Viewed by 2464

Abstract

(1) Background: The overdenture is a complete denture, an implant-supported prosthesis, that the patient can remove at home for the usual oral hygiene procedures, thanks to a simple and intuitive anchoring system. Clinically, the execution of this rehabilitation for the lower arch is [...] Read more.

(1) Background: The overdenture is a complete denture, an implant-supported prosthesis, that the patient can remove at home for the usual oral hygiene procedures, thanks to a simple and intuitive anchoring system. Clinically, the execution of this rehabilitation for the lower arch is often favored, but when it is necessary to limit the extension of the palate in the upper arch, it can represent the least invasive and economic solution. The aim of the study is to analyze post-loading implant loss for implant-supported prostheses in the edentulous upper jaw. (2) Methods: This retrospective study was carried out on patients who received a superior overdenture on four implants for rehabilitation. A total of 42 patients were included in this study and initially evaluated clinically and radiographically. The follow-up period for patients after delivery of the upper overdenture is between 48 and 72 months. A total of 168 implants were inserted and monitored in this period. Clinical and radiographic tests were carried out on all 168 implants, with constant re-evaluation. (3) Results: The overall implant survival rate is 92.9%, a value that corresponds to those present in the literature in previously published studies. There were few prosthetic complications, mainly the detachment of anterior prosthetic teeth. (4) Conclusions: Most of these complete prostheses, which as antagonist had another previously made overdenture on four or on two implants, achieved excellent success rates in this study at 72 months. Full article

11 pages, 1253 KiB

Open AccessArticle

Clinical Outcomes of Dental Implants with Two Different Internal Connection Configurations—A RCT

by Maria Menini, Paolo Pesce, Emilio Corvino, Giuliano Iannello, Domenico Baldi and Luigi Canullo

Prosthesis 2022, 4(4), 564-574; https://doi.org/10.3390/prosthesis4040046 - 12 Oct 2022

Cited by 3 | Viewed by 3678

Abstract

Background: The aim of the present study was to highlight clinical and radiographical differences among implants sharing the same macro-geometry but with two different prosthodontic connections. Methods: Patients requiring at least 2 implants in the posterior area of the jaw were randomly divided [...] Read more.

Background: The aim of the present study was to highlight clinical and radiographical differences among implants sharing the same macro-geometry but with two different prosthodontic connections. Methods: Patients requiring at least 2 implants in the posterior area of the jaw were randomly divided into two groups (Conical (CS) and Internal Hexagonal (IH) connection). At implant surgery (T0), insertion torque, implant stability quotient (ISQ values recorded by resonance frequency analysis, RFA), and soft tissue thickness (STH) were assessed. A 1-abutment/1-time protocol was applied, and the prosthesis was realized following a fully digital workflow. At the 36-month follow-up periapical x-rays were taken. In order to statistically analyse differences among the two groups and the different variables, paired T-test was used. Linear regression analysis was conducted to analyze how marginal bone loss (MBL) was affected by other independent variables. A neural network created to predict the success (good or not good) of the implant itself was implemented. Results: 30 out of 33 patients (14 males, 16 females, mean age: 68.94 ± 13.01 years) (32 CS and 32 IH) were analyzed. No implants failed. Marginal bone loss at the 3-year time-point was 0.33 ± 0.34 mm and 0.43 ± 0.37 mm respectively for CS and IH with a significant difference between the two groups (p = 0.004). The presence of keratinized gingiva (p = 0.034) significantly influenced MBL. Conclusions: Both the implant connections investigated presented optimal clinical outcomes with minimal marginal bone loss; however, CS implants and implants with the presence of a greater width of keratinized tissue presented significantly lower MBL. Full article

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14 pages, 1008 KiB

Open AccessSystematic Review

Computer-Guided Surgery for Dental Implant Placement: A Systematic Review

by Elena Araujo-Corchado and Beatriz Pardal-Peláez

Prosthesis 2022, 4(4), 540-553; https://doi.org/10.3390/prosthesis4040044 - 26 Sep 2022

Cited by 8 | Viewed by 3992

Abstract

Implant therapy is currently the treatment of choice for the replacement of missing teeth. Correct implant positioning is of vital importance. To this end, radiographic techniques providing 3D information and guided surgery techniques, both static and dynamic, have been developed. The primary objective [...] Read more.

Implant therapy is currently the treatment of choice for the replacement of missing teeth. Correct implant positioning is of vital importance. To this end, radiographic techniques providing 3D information and guided surgery techniques, both static and dynamic, have been developed. The primary objective of this work is to study whether placing dental implants in partially edentulous patients with guided surgery techniques results in less, equal or greater precision than placing them freehand. The secondary objectives are to gain an understanding of the advantages and disadvantages, indications, limitations, and complications of this type of surgery. A literature search was performed in Pubmed and BVS, and six randomized clinical trials meeting the marked inclusion criteria were included. The different guided surgery techniques were compared with each other and with the traditional method. Freehand surgery was found to be the least accurate, as the implants placed with this technique showed the largest deviations between the planned position and the final position, both when calculating the global (3D) deviation and when measuring the deviation in each of the axes (vertical, mesio-distal, bucco-lingual and lateral), and the angular deviation and voxel overlap. In contrast, the most accurate surgeries were fully guided and half-guided, with the smallest deviations between the planned and final implant position. With any guided surgery technique, more precise implant positioning is achieved than with freehand placement. Advantages include reduced trauma and surgery time; disadvantages include reduced primary implant stability and higher cost. This type of surgery is more indicated in cases of critical anatomy, but may encounter limitations in terms of cost, degree of buccal opening, visibility and adjustment of the guides and the need for prior familiarization with the procedure. Nevertheless, this surgical technique reduces the complication rate. Full article

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11 pages, 5047 KiB

Open AccessArticle

Scanning Electron Microscopy Analyses of Dental Implant Abutments Debonded from Monolithic Zirconia Restorations Using Heat Treatment: An In Vitro Study

by Marco Tallarico, Łukasz Zadrożny, Nino Squadrito, Leonardo Colella, Maurizio Gualandri, Daniele Montanari, Gianantonio Zibetti, Simone Santini, Witold Chromiński, Edoardo Baldoni, Silvio Mario Meloni, Aurea Immacolata Lumbau and Milena Pisano

Prosthesis 2022, 4(3), 500-510; https://doi.org/10.3390/prosthesis4030041 - 19 Sep 2022

Viewed by 2330

Abstract

Aim: The aim of this in vitro study is to present a debonding protocol developed to remove a screw-retained, monolithic, zirconia restoration from its titanium-base abutment, and to microscopically evaluate the abutment integrity at both the prosthetic and connection levels. Materials and Methods: [...] Read more.

Aim: The aim of this in vitro study is to present a debonding protocol developed to remove a screw-retained, monolithic, zirconia restoration from its titanium-base abutment, and to microscopically evaluate the abutment integrity at both the prosthetic and connection levels. Materials and Methods: A total of 30 samples were tested. Each sample consisted of a monolithic zirconia restoration bonded on a titanium link abutment. Five different shapes were designed and fabricated. Randomly, one-third of the Ti-link abutments were subjected to an anodizing process. Then, all the zirconia samples were bonded to the Ti-link abutments according to a pre-established protocol. Forty-eight hours later, the samples were debonded according to the experimental protocol. The outcomes were evaluated by a visual inspection with an optical microscope, scanning electron microscopy (SEM), and chemical composition analysis. Results: Thirty samples were collected and visually analyzed. Seven samples were randomly evaluated via scanning electron microscopy. In all the examinations, no relevant changes were reported. Chemical composition analysis also relieved no changes in the chemical structure of the titanium. Conclusions: The titanium-base abutments do not alter the structure and properties of the material, not creating phase changes or the birth of oxides such as to induce fragility. Further clinical studies with longer follow-up periods are needed to confirm these preliminary results. Full article

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10 pages, 10053 KiB

Open AccessArticle

Finite Element Analysis of Zirconia Dental Implant

by Luca Fiorillo, Dario Milone, Danilo D’Andrea, Dario Santonocito, Giacomo Risitano, Gabriele Cervino and Marco Cicciù

Prosthesis 2022, 4(3), 490-499; https://doi.org/10.3390/prosthesis4030040 - 8 Sep 2022

Cited by 17 | Viewed by 3303

Abstract

Titanium dental implants have had new competitors in recent years, such as fixtures made of zirconia, which promise better aesthetics. The purpose of this study is to evaluate their mechanical performance in silico (Finite Element Analysis). The investigation was performed on a single [...] Read more.

Titanium dental implants have had new competitors in recent years, such as fixtures made of zirconia, which promise better aesthetics. The purpose of this study is to evaluate their mechanical performance in silico (Finite Element Analysis). The investigation was performed on a single tooth Patent™ Dental Implant (Zircon Medical^®, Altendorf, Switzerland) in two configurations: without offset (Test I) and with offset (Test II, 1.5 mm within the cortical bone). The Patent Implant system consists of two components: the implant with integrated abutment and the fibreglass post. The components of the dental implants were tested using a compression load of 400 N along the implant axis. The results showed that the chewing load generates stress distribution on the bone, therefore, the offset configuration should be avoided. Full article

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12 pages, 15820 KiB

Open AccessEditor’s ChoiceReview

CAD/CAM Abutments versus Stock Abutments: An Update Review

by Simone Gallo, Maurizio Pascadopoli, Matteo Pellegrini, Federica Pulicari, Mattia Manfredini, Paolo Zampetti, Francesco Spadari, Carlo Maiorana and Andrea Scribante

Prosthesis 2022, 4(3), 468-479; https://doi.org/10.3390/prosthesis4030038 - 16 Aug 2022

Cited by 9 | Viewed by 3090

Abstract

With the evolution of CAD/CAM technology, custom titanium and/or zirconia abutments are increasingly being used, leading to several comparisons in the literature, both mechanical and aesthetic, to evaluate performance differences between these two types of abutments. Therefore, the aim of this comprehensive review [...] Read more.

With the evolution of CAD/CAM technology, custom titanium and/or zirconia abutments are increasingly being used, leading to several comparisons in the literature, both mechanical and aesthetic, to evaluate performance differences between these two types of abutments. Therefore, the aim of this comprehensive review is to present the most recent data on the latest comparisons between CAD/CAM and stock abutment applications. The PICO model was used to perform this review, through a literature search of the PubMed (MEDLINE) and Scopus electronic databases. CAD/CAM abutments allow individualization of abutment parameters with respect to soft tissue, allow increased fracture toughness, predict the failure mode, show no change in the fracture toughness over time, reduce the prosthetic steps, and reduce the functional implant prosthesis score and pain perceived by patients in the early stages. The advantages associated with the use of stock abutments mainly concern the risk of corrosion, time spent, cost, and fit, evaluated in vitro, in the implant–abutment connection. Equal conditions are present regarding the mechanical characteristics during dynamic cycles, screw loss, radiographic fit, and degree of micromotion. Further randomized controlled clinical trials should be conducted to evaluate the advantages reported to date, following in vitro studies about titanium and/or zirconia stock abutments. Full article

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10 pages, 1796 KiB

Open AccessArticle

Analysis of CBCT Bone Density Using the Hounsfield Scale

by Leonard Morar, Grigore Băciuț, Mihaela Băciuț, Simion Bran, Horațiu Colosi, Avram Manea, Oana Almășan and Cristian Dinu

Prosthesis 2022, 4(3), 414-423; https://doi.org/10.3390/prosthesis4030033 - 3 Aug 2022

Cited by 20 | Viewed by 9707

Abstract

Assessing bone density in prospective dental implant sites is crucial both for choosing the implant type and for planning a drilling procedure that will ensure the implant’s primary stability and osseointegration. This study aimed to investigate possible differences between the bone densities of [...] Read more.

Assessing bone density in prospective dental implant sites is crucial both for choosing the implant type and for planning a drilling procedure that will ensure the implant’s primary stability and osseointegration. This study aimed to investigate possible differences between the bone densities of various edentulous sites in the maxilla and mandible. The study was conducted on a group of forty partly edentulous patients who underwent radiological examination by scanning the areas of interest using cone beam computed tomography (CBCT). Hounsfield units (HU) were analyzed using dedicated software. Higher HU were observed at the site of mandibular central incisors compared to the site of maxillary central incisors. The HU values in the mandibular first molars region were higher than those of the maxillary first molars. Buccal vs. lingual or palatal cortical HU values did not differ significantly. Within the limitations of this study, it can be stated that an objective assessment of site-specific bone density before the installation of dental implants may provide valuable clinical information for the selection of implant size and the planning of a patient-specific drilling protocol. Full article

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16 pages, 20316 KiB

Open AccessCase Report

Digital Workflow for Prosthetically Driven Implants Placement and Digital Cross Mounting: A Retrospective Case Series

by Marco Tallarico, Davide Galiffi, Roberto Scrascia, Maurizio Gualandri, Łukasz Zadrożny, Marta Czajkowska, Santo Catapano, Francesco Grande, Edoardo Baldoni, Aurea Immacolata Lumbau, Silvio Mario Meloni and Milena Pisano

Prosthesis 2022, 4(3), 353-368; https://doi.org/10.3390/prosthesis4030029 - 18 Jul 2022

Cited by 11 | Viewed by 4183

Abstract

Fully digital workflow in implant dentistry is ever increasing. Treatment of partial edentulous cases is well-documented; nevertheless, complete edentulous cases are still a challenge. To present several innovations in the treatment of complete edentulous patients using digital solutions, both for implant placement and [...] Read more.

Fully digital workflow in implant dentistry is ever increasing. Treatment of partial edentulous cases is well-documented; nevertheless, complete edentulous cases are still a challenge. To present several innovations in the treatment of complete edentulous patients using digital solutions, both for implant placement and restoration delivery, was the objective of this study. It was designed as a retrospective case series study, aimed to tune further research with larger sample size, and a longer follow-up. Patients requiring complete, implant-supported restoration were asked to participate in this study. Enrolled patients were treated with four implants, immediate loading and a definitive complete arch restoration. Patients were treated using computer-assisted, template-based surgery. Multi-piece surgical templates were used to accurately place the implants, to manage the bone if needed and to make immediate loading procedure quicker and easier. After osseointegration period, definitive, extra-oral, digital impressions were taken using newly developed scan analogs, connected in the patient mouth using temporary cylinders and stabilized by means of the low-shrinkage, flowable, resin composite. Outcomes were implant and prosthesis survival rate, complications, accuracy, and patient satisfaction. Radiographic evaluation performed with a preliminary, radiopaque aluminum try-in, was used to test the accuracy of the digital impressions. Overall, 20 implants were placed in five patients. All the implants osseointegrated without complications. One impression was taken a second time due to inaccuracy of the aluminum tray-in. Finally, all of the patients were completely satisfied with both surgical and prosthetic procedures. Within the limitations of this case series, multi-piece surgical templates showed promising results improving the clinician’s confidence in the case of bone reduction, post-extractive implants and immediate loading. The prosthetic template increased the trueness of the digital impression for complete edentulous patients. Finally, even if an impression was performed again, the scan-analog used for extra-oral chair-side digital impressions seemed to be a promising tool. Continuous improvements and further study are needed to confirm these preliminary results. Full article

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