Oral Implantology: Current Aspects and Future Perspectives

A topical collection in Prosthesis (ISSN 2673-1592). This collection belongs to the section "Prosthodontics".

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Editors


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Guest Editor
Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, University of Pavia, 27100 Pavia, Italy
Interests: orthodontics; dental hygiene, adhesive dentistry; dental materials; CAD/CAM; intraoral scanner; computerized cast; shear; bond strength; bracket; fiber-reinforced composite; miniscrews; remineralization; probiotics; biomimetic materials
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
Interests: oral microbiota; probiotics; periodontal treatment; conservative dentistry; dental materials; orthodontics; pediatric dentistry; bond strength; dental caries; remineralization

E-Mail Website
Guest Editor
Department of Clinical, Surgical, Diagnostic and Paediatric Sciences, Section of Dentistry, University of Pavia, Pavia, Italy
Interests: polymeric dental materials; dentistry; polymeric adhesion; orthodontics
Special Issues, Collections and Topics in MDPI journals

Topical Collection Information

Dear Colleagues,

Dental implantology has witnessed the development of multiple, increasingly more advanced techniques with the aim of improving the reliability of dental implants while reducing patient morbidity.

In particular, the biology of osseointegration has been extensively studied, and several chemical and physical implant surface treatments have been proposed, along with new surgical techniques encompassing even regenerative procedures. Moreover, the introduction of digitalization for both surgical and prosthetic planning has significantly changed the approach to clinical practice. Despite this evolution, several drawbacks are still present in the field of oral implantology, such as systemic conditions limiting the possibility of recurring implant surgery and the risk of developing peri-implant disease.

This Topic aims to highlight the continuous evolutions in oral implantology and to focus on new perspectives in this field.

We are pleased to invite you to submit a manuscript for this Special Issue. Original research articles and reviews are welcome. Research areas may include (but are not limited to) the following:

  • Implantology
  • Prosthodontics
  • Oral and maxillofacial surgery
  • Oral radiology
  • Biomaterials
  • Implant surface treatments
  • Digital workflow
  • Peri-implant mucositis
  • Peri-implant disease
  • Tissue regeneration

We look forward to receiving your contributions.

Prof. Dr. Andrea Scribante
Dr. Maurizio Pascadopoli
Dr. Simone Gallo
Guest Editors

Manuscript Submission Information

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Keywords

  • dentistry
  • oral health
  • oral surgery
  • maxillofacial surgery
  • dental implants
  • implant-supported fixed prosthodontics
  • peri-implant disease
  • systemic conditions

Published Papers (32 papers)

2024

Jump to: 2023, 2022

13 pages, 2356 KiB  
Article
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 339
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  
Article
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
Viewed by 329
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  
Article
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
Viewed by 702
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  
Article
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 742
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  
Article
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 755
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  
Article
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 684
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  
Editorial
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
Viewed by 896
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  
Article
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 727
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  
Review
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 1 | Viewed by 786
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  
Systematic 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 1 | Viewed by 1348
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  
Article
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 1 | Viewed by 1637
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  
Article
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 7 | Viewed by 1563
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  
Systematic 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 3 | Viewed by 1068
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  
Article
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 9 | Viewed by 1452
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  
Review
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 9 | Viewed by 4727
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  
Review
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 4 | Viewed by 2132
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  
Article
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 4 | Viewed by 2217
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  
Systematic 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 23 | Viewed by 4139
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  
Article
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 27 | Viewed by 1997
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  
Article
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 1913
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  
Article
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 1 | Viewed by 2014
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  
Article
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 8 | Viewed by 2170
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  
Case 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 3 | Viewed by 1720
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  
Article
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 2 | Viewed by 2126
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  
Article
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 5 | Viewed by 2008
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  
Article
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 2 | Viewed by 2899
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  
Systematic 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 7 | Viewed by 2963
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  
Article
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 1927
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  
Article
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 15 | Viewed by 2565
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  
Review
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 8 | Viewed by 2381
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  
Article
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 14 | Viewed by 6971
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  
Case 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 7 | Viewed by 3297
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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