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Bergamo ETP, Yamaguchi S, Lopes ACO, Coelho PG, de Araújo-Júnior ENS, Benalcázar Jalkh EB, Zahoui A, Bonfante EA. Performance of crowns cemented on a fiber-reinforced composite framework 5-unit implant-supported prostheses: in silico and fatigue analyses. Dent Mater 2021; 37:1783-1793. [PMID: 34588130 DOI: 10.1016/j.dental.2021.09.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To characterize the biomechanical performance of fiber-reinforced composite 5-unit implant-supported fixed dental prostheses (FDPs) receiving individually milled crowns by insilico and fatigue analyses. METHODS Eighteen implant-supported five-unit fiber-reinforced composite frameworks with an individually prepared abutment design were fabricated, and ninety resin-matrix ceramic crowns were milled to fit each abutment. FDPs were subjected to step-stress accelerated-life testing with load delivered at the center of the pontic and at 2nd molar and 1st premolar until failure. The reliability of the prostheses combining all loaded data and of each loaded tooth was estimated for a mission of 50,000 cycles at 300, 600 and 900 N. Weibull parameters were calculated and plotted. Fractographic and finite element analysis were performed. RESULTS Fatigue analysis demonstrated high probability of survival at 300 N, with no significant differences when the set load was increased to 600 and 900 N. 1st and 2nd molar dataset showed high reliability at 300 N, which remained high for the higher load missions; whereas 1st premolar dataset showed a significant decrease when the reliability at 300 N was compared to higher load missions. The characteristic-strength of the combined dataset was 1252 N, with 1st molar dataset presenting higher values relative to 2nd molar and 1st premolar, both significantly different. Failure modes comprised chiefly cohesive fracture within the crown material originated from cracks at the occlusal area, matching the maximum principal strain location. SIGNIFICANCE Five-unit implant-supported FDP with crowns individually cemented in a fiber-reinforced composite framework presented a high survival probability. Crown fracture comprised the main failure mode.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Satoshi Yamaguchi
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, 565-0871, Suita, Osaka, Japan
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Paulo G Coelho
- Department of Biomaterials, New York University College of Dentistry, New York, NY, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Medical Center, New York, NY, USA; Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA
| | - Everardo N S de Araújo-Júnior
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil; Department of Biomaterials, New York University College of Dentistry, New York, NY, USA.
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo - Bauru School of Dentistry, Bauru, SP, Brazil
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102
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Waldecker M, Behnisch R, Rammelsberg P, Bömicke W. Five-year clinical performance of monolithic and partially veneered zirconia single crowns-a prospective observational study. J Prosthodont Res 2021; 66:339-345. [PMID: 34556602 DOI: 10.2186/jpr.jpr_d_21_00024] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The purpose of this study was to prospectively evaluate the medium-term clinical performance and esthetics of monolithic and partially (i.e., facially) veneered zirconia single crowns (MZ-SC and PZ-SC, respectively). METHODS Between September 2011 and June 2013, 68 participants received 90 MZ-SC and 72 PZ-SC. Clinical study documentation was performed at crown cementation (baseline), at 6-month follow-up, and then yearly thereafter using standardized report forms. Three participants with four MZ-SC dropped out during clinical follow-up. Thus, 65 participants (n = 31, 47.7% men) fitted with 158 restorations (86 MZ-SC, 72 PZ-SC) were evaluated. The mean observation period of the restorations was 5.8 ±2.5 years; 6.3 ±2.2 for MZ-SC and 5.2 ±2.6 for PZ-SC. RESULTS The 5-year rate of complication-free survival (success) was 87.0% for MZ-SC and 95.8% for PZ-SC (log-rank test, p = 0.026). The 5-year failure-free survival rate was 93.1% for MZ-SC and 96.2% for PZ-SC (log-rank test, p = 0.111), and the 5-year ceramic fracture-free survival rate was 100% for MZ-SC and 98.6% for PZ-SC (log-rank test, p = 0.274). Crowns of both designs were awarded excellent scores for esthetics by participants and dentists. CONCLUSIONS Monolithic and partially veneered zirconia crowns can be used clinically with high medium-term survival and success and uncompromised esthetic results.
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Affiliation(s)
- Moritz Waldecker
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Rouven Behnisch
- Institute of Medical Biometry and Informatics, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Peter Rammelsberg
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, Heidelberg University Hospital, University of Heidelberg, Heidelberg
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Jung RE, Brügger LV, Bienz SP, Hüsler J, Hämmerle CHF, Zitzmann NU. Clinical and radiographical performance of implants placed with simultaneous guided bone regeneration using resorbable and nonresorbable membranes after 22-24 years, a prospective, controlled clinical trial. Clin Oral Implants Res 2021; 32:1455-1465. [PMID: 34543460 PMCID: PMC9293322 DOI: 10.1111/clr.13845] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 02/03/2023]
Abstract
Aim The aim was to evaluate the performance of implants placed with simultaneous guided bone regeneration (GBR) using resorbable or nonresorbable membranes compared to implants placed in pristine bone without bone regeneration after an observation period of 22–24 years. Material and Methods The patient cohort of this clinical trial was treated from 1994 to 1996. Dehiscence defects were treated with GBR by either using resorbable collagen membranes (BG) or nonresorbable ePTFE membranes (GT). Implants placed in pristine bone served as a control (CT). Clinical parameters, marginal bone levels, and technical outcomes were evaluated following restoration placement and at the present follow‐up. A 3D radiographic analysis was conducted in order to assess buccal and oral bone dimensions. Implant survival was assessed with Kaplan–Meier analysis and a frailty model (level of significance 5%). Results Out of the originally 72 patients (mean age 75.4 ± 15.70 years) with 265 implants, 39 patients with 147 implants were included in the study after a median period of 23.5 years. Implant survival was 89.3% in group BG (n = 100), 90.2% in group GT (n = 37), and 93.8% in group CT (n = 105), without significant differences (Frailty proportional hazard model p = .79). Smoking had a negative effect on survival (p = .0122). Mean vertical marginal bone levels were −2.3 ± 1.4 mm (BG, n = 59), −3.0 ± 1.5 mm (GT, n = 21), and −2.3 ± 1.6 mm (CT, n = 52). The vertical buccal bone levels were −3.0 ± 1.9 mm (BG, n = 57), −3.5 ± 2.2 mm (GT, n = 21), and −2.6 ± 1.8 mm (CT, n = 49), without significant differences. Conclusion Implant placement with GBR procedures provides treatment outcomes with favorable implant survival rates (89.3%–93.8%) after 23.5 years. Smoking, however, affected implant survival negatively.
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Affiliation(s)
- Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Lily V Brügger
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Stefan P Bienz
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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Matsushima K, Kubochi K, Komine F, Kimura F, Kobayashi T, Matsumura H. Bond strength between a veneering composite resin and zirconia frameworks with attached mechanical retentive devices. Dent Mater J 2021; 41:117-125. [PMID: 34483203 DOI: 10.4012/dmj.2021-141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The effects of mechanical retentive devices and various surface treatments on the shear bond strength between a veneering composite resin and zirconia was investigated. Zirconia disks were classified into three surface-treatment groups: airborne-particle abrasion, overglazing, and overglazing with white alumina particles of three different grain sizes (50, 70, and 105 μm) attached onto zirconia disks (ZR-50, ZR-70, and ZR-105, respectively). They were further divided into four groups (n=44): unprimed, Clearfil Porcelain Bond Activator (CA), Clearfil Photo Bond (CB), and CA+CB. An indirect composite resin was bonded to zirconia specimens. Shear bond strengths were measured. For the ZR-70 and ZR-105 groups, the CB and CA+CB specimens exhibited higher bond strengths than the other two specimens after thermocycling. The ZR-70 and ZR-105 groups achieved micromechanical interlocking, and priming with a phosphate monomer (MDP) yielded stable bond strengths between the composite resin and zirconia with alumina particles attached as retentive devices.
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Affiliation(s)
- Keisuke Matsushima
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Kei Kubochi
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Futoshi Komine
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Fumiaki Kimura
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Tatsuro Kobayashi
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Hideo Matsumura
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
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Mendes JM, Bentata ALG, de Sá J, Silva AS. Survival Rates of Anterior-Region Resin-Bonded Fixed Dental Prostheses: An Integrative Review. Eur J Dent 2021; 15:788-797. [PMID: 34428850 PMCID: PMC8630935 DOI: 10.1055/s-0041-1731587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This study aimed to review clinical publications involving anterior-region resin-bonded fixed partial dentures to evaluate their survival rates vis-à-vis their materials and design. An electronic search was conducted using PubMed/MEDLINE to identify articles that reported on the longevity of anterior resin-bonded fixed dental prostheses published between 2000 and 2020. Only primary clinical studies that involved a follow-up after at least 3 years were included in this review. A statistical analysis was performed to evaluate resin-bonded fixed dental prostheses’ survival rates in relation to their materials and design. This review ultimately included 23 clinical publications, comprising prospective studies, retrospective studies, and randomized controlled trials. Its statistical analysis estimated the studied prostheses’ 5-year survival rate at 86.2% for metal-framed prostheses, 87.9% for zirconia prostheses, 93.3% for alumina prostheses, 100% for glass or ceramic prostheses, and 81.7% for fiber-reinforced composite restorations. Failure rates did not significantly differ between the different material groups or between the single- and double-retainer groups. Resin-bonded fixed dental prostheses present excellent 5-year clinical longevity in the anterior sector and a favorable benefit/risk/cost ratio. Currently, no consensus has been established on an ideal material for these restorations. Cantilever design tends to limit constraints on the prostheses’ retainers and, thus, increases their survival time. All-ceramic cantilever fixed partial dentures can be considered as a definitive therapy, given their high success and survival rates. They are an optimal solution for adolescents or young adults facing potentially continuous growth.
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Affiliation(s)
- José Manuel Mendes
- Dental Science Department, Institute for Research and Training Advanced in Health Sciences and Technologies, Gandra, Portugal
| | - Anne Le Guen Bentata
- Department of Oral Rehabilitation, University Institute of Health Sciences Rua Central da Gandra, Gandra, Portugal
| | - Juliana de Sá
- Department of Oral Rehabilitation, University Institute of Health Sciences Rua Central da Gandra, Gandra, Portugal
| | - António Sérgio Silva
- Dental Science Department, Institute for Research and Training Advanced in Health Sciences and Technologies, Gandra, Portugal
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Luo F, Hong G, Wan Q. Artificial Intelligence in Biomedical Applications of Zirconia. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.689288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Artificial intelligence (AI) is rapidly developed based on computer technology, which can perform tasks that customarily require human intelligence by building intelligent software or machines. As a subfield of AI, machine learning (ML) can learn from the intrinsic statistical patterns and structures in data through algorithms to predict invisible data. With the increasing interest in aesthetics in dentistry, zirconia has drawn lots of attention due to its superior biocompatibility, aesthetically pleasing, high corrosion resistance, good mechanical properties, and absence of reported allergic reactions. The evolution of AI and ML led to the development of novel approaches for the biomedical applications of zirconia in dental devices. AI techniques in zirconia-related research and clinical applications have attracted much attention due to their ability to analyze data and reveal correlations between complex phenomena. The AI applications in the field of zirconia science change according to the application direction of zirconia. Therefore, in this article, we focused on AI in biomedical applications of zirconia in dental devices and AI in zirconia-related applications in dentistry.
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107
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In Vitro Evaluation of the Effect of Different Luting Cements and Tooth Preparation Angle on the Microleakage of Zirconia Crowns. Int J Dent 2021; 2021:8461579. [PMID: 34400912 PMCID: PMC8364426 DOI: 10.1155/2021/8461579] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/10/2021] [Accepted: 07/29/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Discrepancy between the crown border and prepared tooth margin leads to a microleakage that eases the penetration of microorganisms and causes the dissolution of luting cement consequently. Several factors should be considered to achieve optimal fitness, including tooth preparation taper and type of cementing agent. The study aimed to determine the relation of tooth preparation taper and cement type on the microleakage of zirconia crowns. Materials and Methods Fifty-six freshly extracted premolars without caries and restorations were selected as the study sample and divided into two groups of different tapering degrees (6 and 12 degrees). Zirconia copings were designed and fabricated by the CAD/CAM system. The samples were divided into four subgroups for cementation, and each subgroup was cemented with a different luting cement (n = 7). After 5000 thermocycles at 5°C–55°C and dye penetration, the specimens were sectioned in the mid-buccolingual direction, and a digital photograph of each section was taken under a stereomicroscope. Data were analyzed by the Kruskal–Wallis and Mann–Whitney tests (α = 0.05). Results The results showed significant differences among the four types of luting cement in marginal permeability (PV < 0.001). Regardless of the type of cement, the 12-degree tapering resulted in a lower microleakage (46.4% without microleakage) with statistically significant differences from the 6-degree tapering (PV = 0.042). Conclusion Within the limitations of this study, increasing the tapering degree of the prepared tooth for CAD/CAM zirconia copings improved the marginal fit and decreased the microleakage score. In addition, total-etch resin cement indicated the least microleakage.
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Nagay BE, Dini C, Borges GA, Mesquita MF, Cavalcanti YW, Magno MB, Maia LC, Barão VAR. Clinical efficacy of anodized dental implants for implant-supported prostheses after different loading protocols: A systematic review and meta-analysis. Clin Oral Implants Res 2021; 32:1021-1040. [PMID: 34352130 DOI: 10.1111/clr.13813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/10/2021] [Accepted: 07/06/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To summarize the clinical performance of anodized implants connected to different prostheses design after immediate/early (IL) or conventional loading (CL) protocols. MATERIALS AND METHODS Seven databases were surveyed for randomized (RCTs) and non-randomized controlled clinical trials (CCTs). Studies comparing IL vs. CL protocol of anodized implants supporting single crown, fixed partial denture (FPD), full-arch fixed dental prosthesis (FDP), or overdenture were included. Risk-of-bias was evaluated using Cochrane Collaboration tools. Meta-analyses for different follow-up were analyzed, followed by heterogeneity source assessment and GRADE approach. The outcomes included implant survival rate, marginal bone loss (MBL), implant stability quotient (ISQ), probing depth (PD), plaque index (PI), and peri-implantitis prevalence. RESULTS From 24 eligible studies, 22 were included for quantitative evaluation. Most RCTs (58%, n = 11) and all the 5 CCTs had high and serious risk-of-bias, respectively. Overall, pooling all prosthesis design, no difference between IL vs. CL protocols was observed for all outcomes (p > .05). However, according to prosthesis type subgroups, CL reduced MBL for full-arch FDP (p < .05). In a point-in-time assessment, with overdenture, although IL presented higher PI (12 months), it showed lower MBL (≥24 months), higher ISQ (3 months), and lower PD (6 and 12 months) (p < .05). Conversely, PD was higher for IL in single crown (3 and 6 months) (p < .05). Regarding MBL, IL demonstrated higher mean difference for full-arch FDP (36 months) and FPD (12 and 36 months) (p < .05). CONCLUSION Within the limitations of this study, overall, there is no significant difference in the outcomes between IL and CL loading protocols.
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Affiliation(s)
- Bruna Egumi Nagay
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Caroline Dini
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Guilherme Almeida Borges
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Marcelo Ferraz Mesquita
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Yuri Wanderley Cavalcanti
- Department of Clinic and Social Dentistry, Federal University of Paraiba (UFPB), João Pessoa, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Brazil
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Donmez MB, Diken Turksayar AA, Olcay EO, Sahmali SM. Fracture Resistance of Single-Unit Implant-Supported Crowns: Effects of Prosthetic Design and Restorative Material. J Prosthodont 2021; 31:348-355. [PMID: 34383979 DOI: 10.1111/jopr.13415] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the fracture resistance and fracture patterns of single implant-supported crowns with different prosthetic designs and materials. MATERIALS AND METHODS One hundred and forty-four identical crowns were fabricated from zirconia-reinforced lithium silicate (ZLS), leucite-based (LGC), and lithium disilicate (LDS) glass-ceramics, reinforced composite (RC), translucent zirconia (ZR), and ceramic-reinforced polyetheretherketone (P). These crowns were divided into 3 subgroups according to restoration design: cementable crowns on a prefabricated titanium abutment, cement-retained crown on a zirconia-titanium base abutment, and screw-cement crown (n = 8). After adhesive cementation, restorations were subjected to thermal-cycling and loaded until fracture. The fracture patterns were evaluated under a stereomicroscope. Statistical analysis was performed by using 2-way ANOVA/Bonferroni multiple comparison post hoc test (α = 0.05). RESULTS For each prosthetic design, ZR presented the highest fracture resistance (p ≤ 0.005). Other than the differences with ZLS and RC for screw-cement crowns (p > 0.05) and RC for crowns on zirconia-titanium base abutments (p > 0.05), LGC showed the lowest fracture resistance. P endured higher loads than LDS (p < 0.001), except for the crowns on zirconia-titanium base abutments (p > 0.05). Cementable crowns presented the highest fracture resistance (p < 0.001), other than LGC and LDS. The differences between LGC crowns (p > 0.05) or LDS crowns on prefabricated titanium and zirconia-titanium abutments were nonsignificant (p = 0.133). Fragmented crown fracture was predominant in most of the restorations. Screw and abutment fractures were observed in ZR screw-cement crowns, and all P crowns were separated from the abutments. CONCLUSIONS Restorative material and restoration design affect the fracture resistance and fracture pattern of implant-supported single-unit restorations. Clinicians may restore single-unit implants in premolar sites with the materials and prosthetic designs tested in the present study.
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Affiliation(s)
- Mustafa Borga Donmez
- Biruni University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | | | - Emin Orkun Olcay
- Biruni University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
| | - Sevil Meral Sahmali
- Biruni University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
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Di Fiore A, Granata S, Monaco C, Stellini E, Yilmaz B. Clinical performance of posterior monolithic zirconia implant-supported fixed dental prostheses with angulated screw channels: A 3-year prospective cohort study. J Prosthet Dent 2021; 129:566-572. [PMID: 34344529 DOI: 10.1016/j.prosdent.2021.06.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM The choice of retention type of an implant-supported fixed dental prosthesis (FDP) becomes critical when the dental implant is not placed in a prosthetically ideal location. In recent years, computer-aided design and computer-aided manufacturing (CAD-CAM) technology has enabled the correction of the location of screw access hole depending on the clinical needs of the patient. However, how FPDs with angulated screw channels (ASCs) perform clinically is unclear. PURPOSE The purpose of this prospective clinical study was to evaluate the mechanical complications and crestal bone loss (CBL) when posterior monolithic zirconia implant-supported FDPs with an ASC are used. MATERIAL AND METHODS Participants (N=37) with a missing single posterior tooth or multiple teeth, sufficient bone height, and an implant site without infection were included. Each participant received parallel-walled implants (Nobel Parallel CC) of 7-, 8.5-, or 10-mm length by using a 1-stage approach. After 4 months of healing, a conventional impression was made, and a digital workflow was followed. Monolithic zirconia restorations (Katana ML) were milled, stained, and mechanically attached to a titanium base (NobelProcera ASC abutment). CBL was measured from radiographs at 6, 12, 24, and 36 months after the placement of the prosthesis. Implant and prosthetic characteristics including implant diameter, implant length, screw channel angle (angle≤15 degrees versus angle>16 degrees), prosthetic type (single crown versus multiple-unit FDP), and antagonist dentition (natural versus prosthesis) were also recorded. A generalized linear mixed model with a log link was estimated to assess the independent predictors of CBL among the angles of ASC-retained definitive restorations and the clinically relevant variables (α=.05). RESULTS Thirty-seven participants received 51 implants, and the median follow-up period was 30 months (interquartile range: 22-36). Two single-crown implants failed within the first 12 months of delivery. The implant and restoration survival rate was 96% at 36 months. Screw loosening was recorded in 2 study participants. After a follow-up of 36 months, the mean ±standard deviation CBL value was 0.15 ±0.14 mm with an increase over time (P<.001). The effect of the angle of ASC, implant diameter, implant length, prosthetic type, and antagonist on the CBL was not statistically significant (P>.05). CONCLUSIONS CBL was not associated with the angle of ASC, implant diameter, implant length, prosthetic type, or antagonist when posterior monolithic zirconia implant-supported FDPs with ASCs were used. Screw loosening in 2 situations was the only mechanical complication during the first 3 years of service.
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Affiliation(s)
- Adolfo Di Fiore
- Adjunct Professor, Department of Neurosciences, School of Dentistry, Section of Prosthodontics and Digital Dentistry, University of Padova, Padova, Italy.
| | - Stefano Granata
- Adjunct Professor, Department of Neurosciences, School of Dentistry, Section of Prosthodontics and Digital Dentistry, University of Padova, Padova, Italy
| | - Carlo Monaco
- Researcher, Assistant Professor, Division of Prosthodontics and Maxillofacial Rehabilitation, Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum- University of Bologna, Bologna, Italy
| | - Edoardo Stellini
- Full Professor and Head of Dental Clinic and School of Dentistry, Department of Neurosciences, University of Padova, Padova, Italy
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
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Nielsen HB, Schou S, Bruun NH, Starch-Jensen T. Single-crown restorations supported by short implants (6 mm) compared with standard-length implants (13 mm) in conjunction with maxillary sinus floor augmentation: a randomized, controlled clinical trial. Int J Implant Dent 2021; 7:66. [PMID: 34268630 PMCID: PMC8282885 DOI: 10.1186/s40729-021-00348-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of the present study was to test the H0-hypothesis of no difference in the clinical and radiographical treatment outcome of single-crown restorations supported by short implants compared with standard length implants in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. Forty patients with partial edentulism in the posterior part of the maxilla were randomly allocated to treatment involving single-crown restorations supported by short implants or standard length implants in conjunction with MSFA. Clinical and radiographical evaluation were used to assess survival of suprastructures and implants, peri-implant marginal bone loss (PIMBL), biological, and mechanical complications. RESULTS Both treatment modalities were characterized by 100% survival of suprastructures and implants after 1 year. Mean PIMBL was 0.60 mm with short implants compared with 0.51 mm with standard length implants after 1 year of functional loading. There were no statistically significant differences in survival of suprastructure and implants, PIMBL, and mechanical complications between the two treatment modalities. However, a higher incidence of biological complications was associated with standard length implants in conjunction with MSFA. CONCLUSION Within the limitations of the present study, it can be concluded that single-crown restorations supported by short implants seems to be comparable with standard length implants in conjunction with MSFA. However, long-term studies are needed before final conclusions can be provided about the two treatment modalities. TRIAL REGISTRATION Clinicaltrials.Gov ID: NCT04518020 . Date of registration: August 14, 2020, retrospectively registered.
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Affiliation(s)
- Helle Baungaard Nielsen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
| | - Søren Schou
- Department of Periodontology, School of Dentistry, University of Copenhagen, Copenhagen, Denmark
| | - Niels Henrik Bruun
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark
| | - Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark
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Technical and Biological Complications of Screw-Retained (CAD/CAM) Monolithic and Partial Veneer Zirconia for Fixed Dental Prostheses on Posterior Implants Using a Digital Workflow: A 3-Year Cross-Sectional Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5581435. [PMID: 34307657 PMCID: PMC8279852 DOI: 10.1155/2021/5581435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/10/2021] [Accepted: 06/28/2021] [Indexed: 01/31/2023]
Abstract
Objective The introduction of CAD/CAM and the development of zirconia-based restorations have allowed clinicians to use less expensive materials and faster manufacturing procedures. The purpose of the study was to analyze the differences, in terms of mechanical and biological complication, in multiunit zirconia fixed dental prosthesis (FPDs) on posterior implants produced using a digital workflow. Method and Materials. This study was a retrospective investigation, and patients treated with screw-retained monolithic or partial veneer FPDs on dental implants were selected. Periapical radiographs were taken at baseline and at the 3-year follow-up. Complications were recorded and classified as technical and biological ones. Results The study population included 25 patients. The occlusal and interproximal corrections were not clinically significant. In the study sample, the survival rate and success rate of the FPDs after 3 years were 100% and 96%, respectively. One implant failed immediately after placement. Conclusion Monolithic zirconia FPDs and partial veneer FPDs showed a 100% survival rate, presenting an interesting alternative to metal ceramic restorations. The partial veneer FPDs had a higher technical complication rate than the monolithic FPDs; however, no statistically significant difference was found.
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113
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Sehovic E, Ioannidis A, Hämmerle CH, Özcan M, Mühlemann S. Effect of tooth brush abrasion on the color, gloss and surface roughness of internally and externally stained monolithic ceramic materials. J Prosthodont Res 2021; 66:303-311. [PMID: 34193746 DOI: 10.2186/jpr.jpr_d_20_00276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To measure the durability of the color, change in surface roughness and gloss of stained monolithic ceramic materials subjected to artificial tooth brush abrasion. MATERIALS AND METHODS Standardized specimens were manufactured from pressable lithium-disilicate glass ceramic (PC; IPS e.max Press), machinable lithium-disilicate glass ceramic (MC; IPS e.max CAD), and zirconia (ZR; Zenostar). Ceramic staining was applied before (internal; in) and after crystallization/sintering (external; ex). Of each ceramic material, specimens without staining were prepared (no staining; no). Porcelain-fused-to-metal specimens served as control (PFM). Each group consisted of 15 specimens. Tooth brushing was simulated with tooth brushing strokes of 21.6 k, 43.2 k, and 64.8 k. Color, gloss and roughness were measured at baseline and after cycle intervals. Kruskal-Wallis and paired Post-hoc Conover tests were applied to detect statistical differences between treatment groups. Differences before and after aging were calculated by Wilcoxon signed rank test (α=0.05). RESULTS In all groups, color difference (∆E) was statistically significant after aging: no-PC (P<.001, 95% CI[0.14,0.84]), no-MC (P=.003, 95% CI[0.23,1.12]), no-ZR (P=.003, 95% CI [0.33,0.62]), in-MC (P=.003, 95% CI[0.35,0.73]), in-ZR (P=.003, 95% CI[0.09,0.32]), ex-PC (P=.003, 95% CI[0.54,0.98]), ex-MC (P<.001, 95% CI[0.23,1.26]), ex-ZR (P=.003, 95% CI[0.27,0.55]), and PFM (P=.002, 95% CI[0.22,0.34]). Aging increased surface roughness and decreased the gloss within all subgroups showing statistical significance. CONCLUSIONS Color, gloss and roughness of stained monolithic ceramic materials changed significantly by means of tooth brush abrasion in vitro. Color changes were below the threshold value for the detection by the human eye (∆E 1.8).
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Affiliation(s)
- Edis Sehovic
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich
| | - Alexis Ioannidis
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich
| | | | - Mutlu Özcan
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich
| | - Sven Mühlemann
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich
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Graf T, Güth JF, Edelhoff D, Krennmair G, Stimmelmayr M. Influence of butt joint connections with long guiding areas on the stability of single crowns and 3-unit bridges - an in-vitro-study. J Prosthodont Res 2021; 65:455-460. [PMID: 34176848 DOI: 10.2186/jpr.jpr_d_20_00036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE The aim of this study was to evaluate the stability of single crowns and 3-unit bridges in relation to the implant-abutment complex with and without tube in tube connection. METHODS 60 specimens with a total of 90 implants (diameter 3.8 mm) were fabricated and distributed into 4 groups: CST (Crown with short tube), CLT (crown with long tube), BNT (Bridge without tube) and BLT (bridge with long tube). All superstructures consisted of one-piece hybrid abutment restorations out of monolithic zirconia, bonded on prefabricated titanium bases and were directly screwed into the implants. Specimen underwent artificial aging (2.000.000 cycles, 120 N, 30° off axis) and were subsequently loaded in an universal testing machine at an angle of 30° until failure. The specimens were examined for damage during and after artificial aging. RESULTS During artificial aging, one test specimen of group CLT and two test specimens of group BNT failed. The average failure load was 498.8 (± 34.4) N for CLT, 418.8 (± 41.5) N for CST, 933.1 (± 26.2) N for BLT and 634.4 (± 29.0) N for BNT, with a statistical differences (p ˂ 0.001) between the crown and bridge groups. All tested samples exhibited macroscopic deformations at the implant shoulder, which were more pronounced in the specimens without a tube in tube connection. CONCLUSIONS Single crowns and 3-unit bridges with a long tube in tube connection showed significantly higher fatigue fracture strength compared to restorations with short or without tube in tube connection.
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Affiliation(s)
- Tobias Graf
- Department of Prosthodontics, University of Munich, Munich
| | | | | | | | - Michael Stimmelmayr
- Department of Prosthodontics, University of Munich, Munich.,Private Practice for Oral Surgery, Cham
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Laumbacher H, Strasser T, Knüttel H, Rosentritt M. Long-term clinical performance and complications of zirconia-based tooth- and implant-supported fixed prosthodontic restorations: A summary of systematic reviews. J Dent 2021; 111:103723. [PMID: 34119611 DOI: 10.1016/j.jdent.2021.103723] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To present an overview on systematic reviews on prosthodontic zirconia restorations and to discuss long-term complications as well as information on anatomical and functional changes to the masticatory system. DATA/SOURCES MEDLINE, EMBASE, Trip medical, and Cochrane Library databases were searched for systematic reviews up to February 2021. Bias was assessed and clinical survival and complications were analyzed. STUDY SELECTION 38 eligible articles published between 2006 and 2021 were included. The reviews were based on 128 in vivo studies on approximately 10,000 zirconia restorations. 5-year cumulative survival rates varied between 91.2% and 95.9% for tooth-supported (TS) single crowns (SC), 89.4% and 100% for TS multi-unit fixed dental prostheses (FDP), 97.1% and 97.6% for implant-supported (IS) SCs and 93.0% and 100% for IS FDPs. Chipping was the most often technical complication, followed by framework fracture, loss of retention, marginal discrepancies/discoloration, occlusal roughness and abutment/screw loosening. Color mismatch was the only esthetic complication. Biological complications were caries, endodontic complications, tooth fracture, periodontal disease, abrasion/attrition, persisting pain, high sensitivity, peri‑implantitis and soft tissue issues. Patients with bruxism were only examined sporadically. CONCLUSIONS 5-year results for zirconia restorations were satisfactory. The predominant technical problem of veneering fractures could be overcome with adapted design or fabrication and application of monolithic restorations, but reviews of clinical studies on this subject are rare. The impact of zirconia restorations on the masticatory system remains unclear. CLINICAL SIGNIFICANCE Zirconia restorations are experiencing a rapidly increasing use in dental practice. Being highly wear-resistant, hard and durable, it can be assumed that they do not follow natural abrasion and changes in the masticatory system. Possible long-term effects on the stomatognathic system as a whole should therefore be considered.
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Affiliation(s)
- Harald Laumbacher
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Thomas Strasser
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, 93042 Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany.
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Carey C, Din ND, Lamb J, Wright H, Robb ND, Abuzar M. Survival of Single-Unit Porcelain-Fused-to-Metal (PFM) and Metal Crowns Placed by Students at an Australian University Dental Clinic over a Five-Year Period. Dent J (Basel) 2021; 9:dj9060060. [PMID: 34071165 PMCID: PMC8227166 DOI: 10.3390/dj9060060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 12/05/2022] Open
Abstract
The aim of this retrospective study was to determine the survival rate of single-unit porcelain-fused-to-metal (PFM) and metal crowns placed by dental students at an Australian university undergraduate dental clinic over a five-year period. Complications and the incidences of crown failures were recorded. Clinical records pertaining to single-unit PFM and metal crowns inserted over a five-year period were reviewed, including patient-related, tooth-related, and procedural factors for each crown. Crowns were evaluated as surviving, surviving with complications, or failed. Kaplan–Meier statistical analysis was used to estimate survival rate., This study is based on a sample of 232 (78.4%) PFM crowns and 64 (21.6%) metal crowns inserted between 2014 and 2018. Cumulatively, 224 (75.7%) were surviving, 48 (16.2%) were surviving but previously had complications, and 24 (8.1%) failed. The 5-year cumulative survival rate of all PFM and metal crowns was 83.9% (0.839 ± 0.038, Kaplan–Meier). The average survival time for all crowns was 4.432 ± 0.089 years. Comparatively, PFM crowns had a higher survival rate at 1 year (0.972 ± 0.010) and 2 years (0.919 ± 0.017), compared to metal crowns at 1 year (0.964 ± 0.011) and 2 years (0.894± 0.018). The survival rate of metal crowns remained constant from 2 years to 4 years and thereafter, whereas there was a continued decline in the survival rate of PFM crowns to 83.2% (0.832 ± 0.038) at 4 years and thereafter. Crowns placed on premolars had the highest cumulative survival rate whereas those placed on molars exhibited the lowest survival rate for the duration of the study period. Despite single-unit PFM crowns having a higher 1- and 2-year survival rate compared to metal crowns, metal crowns had a higher survival rate at 4 years and thereafter. Survival rates are comparable to previous studies.
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Affiliation(s)
- Chris Carey
- School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia; (C.C.); (N.D.D.); (J.L.); (H.W.); (N.D.R.)
| | - Nick Del Din
- School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia; (C.C.); (N.D.D.); (J.L.); (H.W.); (N.D.R.)
| | - Jessica Lamb
- School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia; (C.C.); (N.D.D.); (J.L.); (H.W.); (N.D.R.)
| | - Hazel Wright
- School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia; (C.C.); (N.D.D.); (J.L.); (H.W.); (N.D.R.)
| | - Nigel D. Robb
- School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia; (C.C.); (N.D.D.); (J.L.); (H.W.); (N.D.R.)
| | - Menaka Abuzar
- School of Medicine and Dentistry, Griffith University, Gold Coast 4215, Australia; (C.C.); (N.D.D.); (J.L.); (H.W.); (N.D.R.)
- Melbourne Dental School, University of Melbourne, Melbourne 3010, Australia
- Correspondence:
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117
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Effect of ceramic layering on the fit of cobalt-chromium alloy 3-unit fixed dental prostheses fabricated by additive, soft milling, and casting technologies. J Prosthet Dent 2021; 126:130.e1-130.e7. [PMID: 34034899 DOI: 10.1016/j.prosdent.2021.03.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM The change in fit after ceramic layering of additively manufactured cobalt-chromium alloy frameworks has not been evaluated extensively. PURPOSE The purpose of this in vitro study was to compare the fit of cobalt-chromium alloy fixed dental prostheses fabricated by different techniques before and after ceramic layering. MATERIAL AND METHODS A cobalt-chromium alloy master model was prepared to receive a 3-unit fixed dental prosthesis. Sixty cobalt-chromium alloy frameworks (N=60) were manufactured by using 3 manufacturing techniques (n=20): selective laser melting (Mediloy S-Co), soft milling (Ceramill Sintron), and conventional casting as the control group (Girobond NB). The replica technique was used to measure the marginal and internal discrepancies. The frameworks were then layered with ceramic, and the same fit measuring procedure was repeated. The results were compared before and after ceramic layering within each group. The data were analyzed using the Levene, ANOVA, and paired-samples t tests (α=.05). RESULTS A significant difference was found within groups before and after ceramic layering for selective laser melting (P=.006) and soft milling (P=.009) but not for conventional casting (P>.05). No statistical difference was reported in the marginal region for conventional casting group (P=.155) in contrast with the soft milling and selective laser melting groups (P=.003). Soft milling showed increased gap values in the marginal (P=.006) and occlusal regions (P=.004). CONCLUSIONS Ceramic layering increased the discrepancy of the laser-sintered and milled frameworks, increasing the marginal discrepancy.
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Saravi B, Vollmer A, Hartmann M, Lang G, Kohal RJ, Boeker M, Patzelt SBM. Clinical Performance of CAD/CAM All-Ceramic Tooth-Supported Fixed Dental Prostheses: A Systematic Review and Meta-Analysis. MATERIALS 2021; 14:ma14102672. [PMID: 34065202 PMCID: PMC8161295 DOI: 10.3390/ma14102672] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/16/2021] [Accepted: 05/18/2021] [Indexed: 12/29/2022]
Abstract
Although CAD/CAM ceramics present a promising alternative to metal-ceramic fixed dental prostheses, little is known about their mid- and long-term clinical performance. This systematic review aims to estimate the survival and success rates and describes the underlying complication characteristics for CAD/CAM tooth-supported zirconia- and lithium disilicate-based fixed dental prostheses (FDPs). We systematically searched MEDLINE and Web of Science to find relevant prospective studies with a follow-up of at least one year. We estimated pooled 1-, 5-, and 10-year survival and success rates by combining the collected data in a Poisson regression model. Descriptive statistics were conducted to evaluate the distribution of failures and complications in the included studies. Risk of bias for the included studies was assessed with an adapted checklist for single-arm trials. Pooled estimated 1-, 5-, and 10-year survival rates ranged from 93.80% to 94.66%, 89.67% to 91.1%, and 79.33% to 82.20%, respectively. The corresponding success rates excluding failures, but including any other types of intervention were 94.53% to 96.77%, 90.89% to 94.62%, and 81.78% to 89.25%. Secondary caries was the most frequent cause of failure, followed by chipping of the veneering. The most common cause of complication excluding failures but requiring intervention was chipping of the veneering. Risk of bias was generally acceptable for the included studies, with seven studies associated with low risk of bias, eight studies with a moderate risk of bias, and three studies with serious risk of bias. The current meta-analysis on CAD/CAM-supported FDPs revealed satisfying survival and success rates for up to 10 years of exposure. More prospective studies focusing on long-term performance are needed to strengthen the evidence currently available in the literature.
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Affiliation(s)
- Babak Saravi
- Medical Center—University of Freiburg, Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
- Correspondence:
| | - Andreas Vollmer
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany;
| | - Maja Hartmann
- Private Practice, Kantstraße 10, 60316 Frankfurt am Main, Germany;
| | - Gernot Lang
- Medical Center—University of Freiburg, Department of Orthopedics and Trauma Surgery, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
| | - Ralf-Joachim Kohal
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany; (R.-J.K.); (S.B.M.P.)
| | - Martin Boeker
- Medical Center—University of Freiburg, Institute of Medical Biometry and Medical Statistics, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany;
| | - Sebastian B. M. Patzelt
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany; (R.-J.K.); (S.B.M.P.)
- Private Practice, Am Dorfplatz 3, 78658 Zimmern o.R., Germany
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Influence of Non-Thermal Atmospheric Pressure Plasma Treatment on Retentive Strength between Zirconia Crown and Titanium Implant Abutment. MATERIALS 2021; 14:ma14092352. [PMID: 34062734 PMCID: PMC8125100 DOI: 10.3390/ma14092352] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/02/2022]
Abstract
The aim of this study is to investigate the effect of non-thermal atmospheric pressure plasma (NTP) on retentive strength (RS) between the zirconia crown and the titanium implant abutment using self-adhesive resin cement. Surface free energy (SFE) was calculated on 24 cube-shaped zirconia blocks, and RS was measured on 120 zirconia crown-titanium abutment assemblies bonded with G-CEM LinkAce. The groups were categorized according to the zirconia surface treatment as follows: Control (no surface treatment), NTP, Si (Silane), NTP + Si, Pr (Z-Prime Plus), and NTP + Pr. Half of the RS test assemblies were aged by thermocycling for 5000 cycles at 5–55 °C. The SFE was calculated using the Owens-Wendt method, and the RS was measured using a universal testing machine at the maximum load until failure. One-way analysis of variance (ANOVA) with post-hoc Tukey honestly significant difference (HSD) was performed to evaluate the effect of surface treatments on the SFE and RS. Independent sample t-test was used to compare the RS according to thermocycling (p < 0.05). For the SFE analysis, the NTP group had a significantly higher SFE value than the Control group (p < 0.05). For the RS test, in non-thermocycling, the NTP group showed a significantly higher RS value than the Control group (p < 0.05). However, in thermocycling, there was no significant difference between the Control and NTP groups (p > 0.05). In non-thermocycling, comparing with the NTP + Si or NTP + Pr group, there was no significant difference from the Si or Pr group, respectively (p > 0.05). Conversely, in thermocycling, the NTP + Si and NTP + Pr group had significantly lower RS than the Si and Pr group, respectively (p < 0.05). These results suggest that NTP single treatment for the zirconia crown increases the initial RS but has little effect on the long-term RS. Applied with Silane or Z-Prime Plus, NTP pre-treatment has no positive effect on the RS.
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Molinero-Mourelle P, Cascos-Sanchez R, Yilmaz B, Lam WYH, Pow EHN, Del Río Highsmith J, Gómez-Polo M. Effect of Fabrication Technique on the Microgap of CAD/CAM Cobalt-Chrome and Zirconia Abutments on a Conical Connection Implant: An In Vitro Study. MATERIALS 2021; 14:ma14092348. [PMID: 33946477 PMCID: PMC8125438 DOI: 10.3390/ma14092348] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 01/03/2023]
Abstract
The aim of this in vitro study was to investigate the microgaps at the implant-abutment interface when zirconia (Zr) and CAD/CAM or cast Co-Cr abutments were used. METHODS Sixty-four conical connection implants and their abutments were divided into four groups (Co-Cr (milled, laser-sintered and castable) and Zirconia (milled)). After chewing simulation (300,000 cycles, under 200 N loads at 2 Hz at a 30° angle) and thermocycling (10,000 cycles, 5 to 50 °C, dwelling time 55 s), the implant-abutment microgap was measured 14 times at each of the four anatomical aspects on each specimen by using a scanning electron microscope (SEM). Kruskal-Wallis and pair-wise comparison were used to analyze the data (α = 0.05). RESULTS The SEM analysis revealed smaller microgaps with Co-Cr milled abutments (0.69-8.39 μm) followed by Zr abutments (0.12-6.57 μm), Co-Cr sintered (7.31-25.7 μm) and cast Co-Cr (1.68-85.97 μm). Statistically significant differences were found between milled and cast Co-Cr, milled and laser-sintered Co-Cr, and between Zr and cast and laser-sintered Co-Cr (p < 0.05). CONCLUSIONS The material and the abutment fabrication technique affected the implant-abutment microgap magnitude. The Zr and the milled Co-Cr presented smaller microgaps. Although the CAD/CAM abutments presented the most favorable values, all tested groups had microgaps within a range of 10 to 150 μm.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Correspondence: ; Tel.: +34-913941922
| | - Rocio Cascos-Sanchez
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland;
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, 3007 Bern, Switzerland
| | - Walter Yu Hang Lam
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Edmond Ho Nang Pow
- Prosthodontics, Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, China; (W.Y.H.L.); (E.H.N.P.)
| | - Jaime Del Río Highsmith
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Miguel Gómez-Polo
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
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Elsayed A, Yazigi C, Kern M, Chaar MS. Mechanical behavior of nano-hybrid composite in comparison to lithium disilicate as posterior cement-retained implant-supported crowns restoring different abutments. Dent Mater 2021; 37:e435-e442. [PMID: 33875247 DOI: 10.1016/j.dental.2021.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 02/26/2021] [Accepted: 03/29/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Resin-based materials are gaining popularity in implant dentistry due to their shock absorption capacity. Therefore, the aim of this study was to evaluate the fracture strength and failure mode of resilient materials for both crowns and abutments and compare them to the most widely used materials in different combinations after subjection to long-term fatigue loading. METHODS Forty-eight cement-retained implant-restorations were assembled on titanium implants. Identical custom-made CAD/CAM abutments were milled out of 3 different materials (n = 16); T: titanium, Z: zirconia and P: ceramic-reinforced PEEK. Each group was subdivided, according to the restorative crown material, into two subgroups (n = 8); C: nano-hybrid composite and L: Lithium disilicate. Specimens were subjected to dynamic load of 98 N for 1,200,000 cycles with integrated thermal cycling. The surviving specimens were subjected to quasi-static loading until failure. Shapiro-Wilk test was used to test for normality. One-way ANOVA followed by Tukey's post-hoc test was used to detect statistically significant differences between groups. RESULTS All specimens withstood 1,200,000 load cycles. The fracture strength values varied from a minimum of 1639 ± 205 N for group PL to a maximum of 2949 ± 478 N for group ZL. SIGNIFICANCE The abutment material influenced the fracture strength and failure mode of the restoration. A combination of zirconia abutments and nano-hybrid composite showed the most favorable mode of failure within the test groups. Therefore, this combination might be recommended as an alternative for restoring single implants in the posterior area.
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Affiliation(s)
- Adham Elsayed
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany.
| | - Christine Yazigi
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany
| | - Mohamed Sad Chaar
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Germany.
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Spitznagel FA, Bonfante EA, Vollmer F, Gierthmuehlen PC. Failure Load of Monolithic Lithium Disilicate Implant-Supported Single Crowns Bonded to Ti-base Abutments versus to Customized Ceramic Abutments after Fatigue. J Prosthodont 2021; 31:136-146. [PMID: 33870577 DOI: 10.1111/jopr.13369] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This laboratory study analyzed the influence of retention mode (screw- vs cement retained) and fatigue application on the failure load of monolithic lithium-disilicate (LDS) implant-supported single crowns (ISSC). MATERIAL AND METHODS A total of 72 samples of monolithic LDS (*Ivoclar Vivadent) ISSC were divided into three groups (n = 24) according to their type of retention mode: Group Ti-CAD: Titanium base (SICvantage CAD/CAM Abutment red (SIC invent AG), screw-retained milled monolithic LDS (IPS e.max CAD*); Group Ti-P: Titanium base (SICvantage CAD/CAM Abutment red), screw-retained pressed monolithic LDS (IPS e.max Press*) and Group Ti-Cust: Titanium base with cemented press LDS (IPS e.max Press*) crown on a LDS (IPS e.max Press*) custom abutment. A mandibular first molar implant-supported single crown model was investigated (Titanium implant: SICvantage-max, SIC invent AG, diameter: 4.2 mm, length: 11.5 mm). Half of each group (n = 12) were exposed to fatigue with cyclic mechanical loading (F = 198 N, 1.2 million cycles) and simultaneous thermocycling (5-55°C). Single load to failure testing was performed, before (Subgroups Ti-CAD, Ti-P, and Ti-Cust) and after (Subgroups Ti-CAD-F, Ti-P-F, and Ti-Cust-F) fatigue. Weibull distribution was used to determine the characteristic strength and Weibull modulus differences between groups. Probability of survival at 900N load was calculated. RESULTS No samples failed during fatigue. Characteristic strength values were as follow: Ti-CAD: 3259.5N, Ti-CAD-F: 2926N, Ti-P: 2763N, Ti-P-F: 2841N, Ti-Cust: 2789N, Ti-Cust-F: 2194N. Whereas no difference was observed between pressed or milled monolithic crowns cemented to Ti-base, regardless of loading condition, fatigue decreased the characteristic strength of crowns cemented to custom abutments. Probability of survival at 900 N was not significantly different between groups. CONCLUSIONS Screw-retained pressed or milled monolithic LDS ISSC, cemented directly to Ti-base abutments or LDS crowns cemented to custom ceramic abutments resist physiological chewing forces after simulated 5-year aging in the artificial mouth and presented equally high probability of survival. However, a significant decrease in load to failure was observed in LDS crowns cemented to custom ceramic abutments after fatigue. Prospective clinical trials are needed to confirm the results of this laboratory investigation.
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Affiliation(s)
- F A Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - E A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - F Vollmer
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.,Private Practice, Tettnang, Germany
| | - P C Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
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Spitznagel FA, Röhrig S, Langner R, Gierthmuehlen PC. Failure Load and Fatigue Behavior of Monolithic Translucent Zirconia, PICN and Rapid-Layer Posterior Single Crowns on Zirconia Implants. MATERIALS 2021; 14:ma14081990. [PMID: 33921126 PMCID: PMC8071484 DOI: 10.3390/ma14081990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 11/16/2022]
Abstract
This laboratory study aimed to evaluate the thermo-mechanical fatigue behavior and failure modes of monolithic and rapid-layer posterior single-crowns (SCs) supported by zirconia implants. Methods: 120 all-ceramic crowns supported by one-piece zirconia implants (ceramic.implant; vitaclinical) were divided into five groups (n = 24 each): Group Z-HT: 3Y-TZP monolithic-zirconia (Vita-YZ-HT); Group Z-ST: 4Y-TZP monolithic-zirconia (Vita-YZ-ST); Z-XT: 5Y-TZP monolithic-zirconia (Vita-YZ-XT); Group E: monolithic-polymer-infiltrated ceramic network (PICN,Vita-Enamic); Group RL (rapid layer): PICN-“table-top” (Vita-Enamic), 3Y-TZP-framework (Vita-YZ-HT). Half of the specimens of each group (n = 12) were exposed to fatigue with cyclic mechanical loading (F = 198N, 1.2-million cycles) and simultaneous thermocycling (5–55 °C). Single-load-to-failure testing (Z010, Zwick) was performed for all specimens without/with fatigue application. Data analysis was performed using ANOVA, Tukey’s post-hoc test, two-sample t-test and Bonferroni correction (p < 0.05). Results: All specimens survived fatigue exposure. Significant differences in failure loads were detected among groups (p ≤ 0.004). Materials Z-HT and Z-ST showed the highest failure loads followed by Z-XT, RL and E. The influence of fatigue was only significant for material RL. Conclusions: All types of tested materials exceeded clinically acceptable failure load values higher than 900N and can be recommended for clinical use. Z-HT and Z-ST appear to be highly reliable towards fatigue. Rapid-layer design of PICN and YZ-HT might be an interesting treatment concept for posterior implant SCs.
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Affiliation(s)
- Frank A. Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany; (S.R.); (P.C.G.)
- Correspondence: ; Tel.: +49-211-81-04440
| | - Sara Röhrig
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany; (S.R.); (P.C.G.)
| | - Robert Langner
- Institute of Systems Neuroscience, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany;
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Centre Jülich, 52425 Jülich, Germany
| | - Petra C. Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany; (S.R.); (P.C.G.)
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Bergamo ETP, Bastos TMC, Lopes ACO, de Araujo Júnior ENS, Coelho PG, Benalcazar Jalkh EB, Zahoui A, Bonfante EA. Physicochemical and mechanical characterization of a fiber-reinforced composite used as frameworks of implant-supported prostheses. Dent Mater 2021; 37:e443-e453. [PMID: 33865619 DOI: 10.1016/j.dental.2021.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/31/2020] [Accepted: 03/29/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To characterize the physicochemical and mechanical properties of a milled fiber-reinforced composite (FRC) for implant-supported fixed dental prostheses (FDPs). METHODS For FRC characterization, scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS), X-ray diffraction, Fourier-transformed infrared spectrometry, simultaneous thermogravimetric analysis and differential scanning calorimetry were performed. For fatigue testing, 3-unit FRC frameworks were fabricated with conventional (9 mm2 connector area) and modified designs (12 mm2 connector area and 2.5 mm-height lingual extension). A hybrid resin composite was veneered onto the frameworks. FDPs were subjected to step-stress accelerated-life fatigue testing until fracture or suspension. Use level probability Weibull curves at 300 N were plotted and the reliability for 100,000 cycles at 300, 600 and 800 N was calculated. Fractographic analysis was performed by stereomicroscope and SEM. RESULTS The FRC consisted of an epoxy resin (∼25%) matrix reinforced with inorganic particles and glass fibers (∼75%). Multi-layer continuous regular-geometry fibers were densely arranged in a parallel and bidirectional fashion in the resin matrix. Fatigue analysis demonstrated high probability of survival (99%) for FDPs at 300 N, irrespective of framework design. Conventional FDPs showed a progressive decrease in the reliability at 600 (84%) and 800 N (19%), whereas modified FDPs reliability significantly reduced only at 800 N (75%). The chief failure modes for FRC FDPs were cohesive fracture of the veneering composite on lower loads and adhesive fracture of the veneering composite at higher loads. SIGNIFICANCE Milled epoxy resin matrix reinforced with glass fibers composite resulted in high probability of survival in the implant-supported prosthesis scenario.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil.
| | - Tiago M C Bastos
- Department of Physics, Technological Institute of Aeronautics, 50 Marechal Eduardo Gomes, 12228-900, São José dos Campos, SP, Brazil
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Everardo N S de Araujo Júnior
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, Hansjorg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, 345 24th Street, 10010, New York City, NY, USA
| | - Ernesto B Benalcazar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil; Department of Biomaterials and Biomimetics, Hansjorg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, 345 24th Street, 10010, New York City, NY, USA
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
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Shen XT, Li JY, Luo X, Feng Y, Gai LT, He FM. Peri-implant marginal bone changes with implant-supported metal-ceramic or monolithic zirconia single crowns: A retrospective clinical study of 1 to 5 years. J Prosthet Dent 2021; 128:368-374. [PMID: 33618860 DOI: 10.1016/j.prosdent.2020.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM Monolithic zirconia has excellent mechanical and biologic properties. However, evidence of the clinical properties of implant-supported monolithic zirconia prostheses is limited. PURPOSE The purpose of this retrospective clinical study was to compare the peri-implant marginal bone changes of metal-ceramic and monolithic zirconia single crowns in the posterior region after prosthetic loading. MATERIAL AND METHODS A total of 224 participants treated with 327 implants restored with either metal-ceramic or monolithic zirconia single crowns in the posterior region between 2012 and 2016 were included in this study. Clinical outcomes, including the plaque index, peri-implant probing depth, and bleeding on probing, were recorded, and the marginal bone level was recorded by using the panoramic radiographs obtained at implant placement, second-stage surgery, and the most recent follow-up visit. The included parameters were analyzed with the nonparametric Mann-Whitney tests (α=.05). RESULTS The mean follow-up time was 30.4 months, and the cumulative survival rate of implants was 100% and that of the prostheses was 99.1%. The plaque index was 0.46 in the metal-ceramic group, which was significantly higher (P<.05) than 0.37 in the monolithic zirconia group. However, no significant differences (P>.05) were observed in peri-implant probing depth and bleeding on probing between the 2 groups. The marginal bone level at implant placement, second-stage surgery, and the most recent follow-up visit was above the implant platform in both the metal-ceramic and monolithic zirconia groups. The marginal bone changes of the metal-ceramic group was 0.31 mm in the healing period and 0.38 mm in the prosthetic loading period, while in the monolithic zirconia group, it was 0.25 mm in the healing period and 0.43 mm in the prosthetic loading period; no significant differences (P>.05) were observed between the 2 groups. CONCLUSIONS The peri-implant marginal bone level change was comparable after prosthetic loading for metal-ceramic and monolithic zirconia single crowns, although monolithic zirconia was associated with reduced plaque.
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Affiliation(s)
- Xiao-Ting Shen
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, PR China
| | - Jia-Ying Li
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Xin Luo
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Yi Feng
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Li-Ting Gai
- Attending Physician, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, PR China
| | - Fu-Ming He
- Chief physician, Department of Oral Implantology and Prosthodontics, The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, PR China.
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Mecholsky JJ, Hsu SM, Jadaan O, Griggs J, Neal D, Clark AE, Xia X, Esquivel-Upshaw JF. Forensic and reliability analyses of fixed dental prostheses. J Biomed Mater Res B Appl Biomater 2021; 109:1360-1368. [PMID: 33527747 DOI: 10.1002/jbm.b.34796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/18/2020] [Accepted: 12/15/2020] [Indexed: 11/12/2022]
Abstract
This article describes the protocol for determining the cause of failure for retrieved failed implant supported fixed dental prostheses (FDPs) in a clinical study of three-unit bridges. The results of loading of flexure bars of different veneer compositions at different stress rates were presented for two veneer materials (leucite reinforced and fluorapatite glass-ceramic veneers) and a Y-TZP core zirconia ceramic used in the clinical study. From these results, the strengths of the fast loading conditions were used to determine the fracture toughness of these materials. Fractal dimension measurements of the flexure bars and selected FDPs of the same materials demonstrated that the values were the same for both the bars and the FDPs. This allowed the use of fracture toughness values from the flexure bars to determine the strengths of the FDPs. The failure analysis of clinically obtained FDP replicates to determine the size of the fracture initiating cracks was then performed. Using the information from the flexure bars and the size of the fracture initiating cracks for the failed FDPs, the strengths of the FDPs were determined. The clinical failures were determined to be most likely the result of repeated crack growth due to initial overload and continuous use after initial cracking.
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Affiliation(s)
- John J Mecholsky
- Department of Materials Science Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, Florida, USA
| | - Shu-Min Hsu
- Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Osama Jadaan
- Department of Engineering, University of North Florida, Jacksonville, Florida, USA
| | - Jason Griggs
- Department of Biomaterials, University of Mississippi, Jackson, Mississippi, USA
| | - Daniel Neal
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Arthur E Clark
- Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Xinyi Xia
- Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Josephine F Esquivel-Upshaw
- Department of Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Florida, USA
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Alaidrous M, Finkelman M, Kudara Y, Campos HC, Kim Y, De Souza AB. Influence of zirconia crown artifacts on cone beam computed tomography scans and image superimposition of tomographic image and tooth surface scan: An in vitro study. J Prosthet Dent 2021; 125:684.e1-684.e8. [PMID: 33549342 DOI: 10.1016/j.prosdent.2020.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 10/22/2022]
Abstract
STATEMENT OF PROBLEM Zirconia restorations create significant artifacts on 3D cone beam computed tomography (CBCT) imaging. Static computer-assisted implant surgery (s-CAIS) relies on the accuracy of superimposition between an intraoral surface scan and CBCT imaging. However, how the artifacts from zirconia on the tomographic image might affect the predictability of s-CAIS is unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of zirconia crown restorations on the superimposition process for s-CAIS. MATERIAL AND METHODS Four stone casts generated 4 groups: a control group (CG) with no crowns and 3 experimental groups with 4 (TG4), 7 (TG7), and 13 (TG13) zirconia crowns. A total of 40 CBCT scans were made for the 4 groups (n=10). All CBCTs were imported into a computer planning software program, and the casts from all 4 groups were scanned by using a high-resolution laboratory scanner. The standard tessellation language (STL) files were imported, segmented, and the 3 files superimposed for all groups. The accuracy of the superimposition was assessed, in millimeters, in 3 planes corresponding to anterior-posterior, horizontal, and vertical, as well as the overall measurement, and the results were analyzed statistically (α=.05). RESULTS The overall analysis demonstrated statistically significant differences between all groups (P<.001), except between CG and TG4. The anterior-posterior dimension demonstrated significant differences between CG and TG7 (P<.001), CG and TG13 (P<.001), TG4 and TG7 (P=.004), and TG4 and TG13 (P=.001). For the vertical dimension analysis, significant differences were found between CG and TG7 (P=.001), CG and TG13 (P<.001), and TG4 and TG13 (P<.001). For the horizontal variable, statistically significant differences were found between CG and TG7 (P=.049), CG and TG13 (P<.001), TG4 and TG13 (P<.001), and TG7 and TG13 (P=.003). CONCLUSIONS The accuracy of the superimposition of the images was influenced by the number of zirconia crowns, with an increased number reducing the superimposition accuracy.
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Affiliation(s)
- May Alaidrous
- Graduate Prosthodontics, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Matthew Finkelman
- Associate Professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Yukio Kudara
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Hugo C Campos
- Assistant Professor, Interim Division Director Oral and Maxillofacial Radiology Department of Diagnostic Sciences, Tufts University School of Dental Medicine, Boston, Mass
| | - Yongjeong Kim
- Associate Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Andre Barbisan De Souza
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass.
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Bergamo ETP, Yamaguchi S, Coelho PG, Lopes ACO, Lee C, Bonfante G, Benalcázar Jalkh EB, de Araujo-Júnior ENS, Bonfante EA. Survival of implant-supported resin-matrix ceramic crowns: In silico and fatigue analyses. Dent Mater 2021; 37:523-533. [PMID: 33483102 DOI: 10.1016/j.dental.2020.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/20/2020] [Accepted: 12/30/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the fatigue survival, failure mode, and maximum principal stress (MP Stress) and strain (MP Strain) of resin-matrix ceramic systems used for implant-supported crowns. METHODS Identical molar crowns were milled using four resin-matrix ceramics (n = 21/material): (i) Shofu Hard, (ii) Cerasmart (iii) Enamic, and (iv) Shofu HC. Crowns were cemented on the abutments, and the assembly underwent step-stress accelerated-life testing. Use level probability Weibull curves at 300 N were plotted and the reliability at 300, 500 and 800 N was calculated for a mission of 50,000 cycles. Fractographic analysis was performed using stereomicroscope and scanning electron microscope. MP Stress and MP Strain were determined by finite element analysis. RESULTS While fatigue dictated failures for Cerasmart (β > 1), material strength controlled Shofu Hard, Enamic, and Shofu HC failures (β < 1). Shofu HC presented lower reliability at 300 N (79%) and 500 N (59%) than other systems (>90%), statistically different at 500 N. Enamic (57%) exhibited a significant reduction in the probability of survival at 800 N, significantly lower than Shofu Hard and Cerasmart; however, higher than Shofu HC (12%). Shofu Hard and Cerasmart (>93%) demonstrated no significant difference for any calculated mission (300-800 N). Failure mode predominantly involved resin-matrix ceramic fracture originated from occlusal cracks, corroborating with the MP Stress and Strain location, propagating through the proximal and cervical margins. SIGNIFICANCE All resin-matrix ceramics crowns demonstrated high probability of survival in a physiological molar load, whereas Shofu Hard and Cerasmart outperformed Enamic and Shofu HC at higher loads. Material fracture comprised the main failure mode.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil.
| | - Satoshi Yamaguchi
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, 565-0871, Suita, Osaka, Japan
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, Hansjorg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, 345 24th Street, 10010, New York City, NY, USA
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Chunwoo Lee
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, 565-0871, Suita, Osaka, Japan
| | - Gerson Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Everardo N S de Araujo-Júnior
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry. 9-75, Otávio Pinheiro Brisola, 17012-901, Bauru, SP, Brazil
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Komine F, Kimura F, Kubochi K, Takano R, Nakase D, Matsumura H. Influence of roughening procedures and priming agents on shear bond strength of CAD/CAM materials to zirconia frameworks. Dent Mater J 2021; 40:664-673. [PMID: 33456028 DOI: 10.4012/dmj.2020-175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study investigated the influence of roughening procedures and application of primers on shear bond strengths of CAD/CAM composite resin material or ceramic material to zirconia frameworks. A CAD/CAM composite resin block (Katana Avencia Block; AVE) and lithium disilicate glass-ceramic block (IPS e.max CAD; IEC) were used as veneer materials. The veneers were divided into three surface treatment groups; HF, hydrofluoric acid etching; AB, airborne-particle abrasion; and CON, no surface treatment. Each veneer was primed with four agents: Clearfil Porcelain Bond Activator (ACT), Clearfil Photo Bond (CPB), Clearfil Photo Bond with Porcelain Bond Activator (CPB+ACT), and no priming (UP). The zirconia frameworks and AVE or IEC veneers were resin-bonded. In the AVE specimen, AB treatment showed significantly higher shear bond strength than the other treatments at 0 and 20,000 thermocycles, except for UP and CPB+ACT groups at 20,000 thermocycles. Airborne-particle abrasion is necessary for resin bonding to Avencia blocks.
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Affiliation(s)
- Futoshi Komine
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Fumiaki Kimura
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Kei Kubochi
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Ryoki Takano
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Daishi Nakase
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Hideo Matsumura
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
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Pitta J, Hjerppe J, Burkhardt F, Fehmer V, Mojon P, Sailer I. Mechanical stability and technical outcomes of monolithic CAD/CAM fabricated abutment-crowns supported by titanium bases: An in vitro study. Clin Oral Implants Res 2020; 32:222-232. [PMID: 33258267 DOI: 10.1111/clr.13693] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 11/08/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate mechanical stability (survival and complication rates) and bending moments of different all-ceramic monolithic restorations bonded to titanium bases (hybrid abutment-crowns) or to customized titanium abutments compared to porcelain-fused-to-metal crowns (PFM) after thermo-mechanical aging. MATERIAL AND METHODS Sixty conical connection implants (4.3 mm-diameter) were divided in five groups (n = 12): PFM using gold abutment (GAbut-PFM), lithium disilicate crown bonded to customized titanium abutment (TAbut+LDS), lithium disilicate abutment-crown bonded to titanium base (TiBase+LDS), zirconia abutment-crown bonded to titanium base (TiBase+ZR), polymer-infiltrated ceramic-network (PICN) abutment-crown bonded to titanium base (TiBase+PICN). Simultaneous thermocycling (5°-55°C) and chewing simulation (1,200,000-cycles, 49 N, 1.67 Hz) were applied. Catastrophic and non-catastrophic events were evaluated under light microscope, and survival and complication rates were calculated. Specimens that survived aging were loaded until failure and bending moments were calculated. RESULTS Survival rates after aging were 100% (TAbut+LDS, TiBase+LDS), 91.7% (GA-PFM), 66.7% (TiBase+ZR) and 58.3% (TiBase+PICN) and differed among the groups (p = .006). Non-catastrophic events as screw loosening (GA-PFM) and loss of retention or micro-/macro-movement (TiBase groups) were observed. Complication rates varied among the groups (p < .001). TiBase+PICN had lower bending moment than all the other groups (p < .001). CONCLUSIONS Hybrid abutment-crowns made of lithium disilicate can be an alternative to PFM-based restorations, although concerns regarding the bonded interface between the titanium base and abutment-crown can be raised. PICN and zirconia may not be recommended due to its inferior mechanical and bonding outcomes, respectively. Titanium customized abutment with bonded lithium disilicate crown appears to be the most stable combination.
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Affiliation(s)
- João Pitta
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Jenni Hjerppe
- Departments of Oral and Maxillofacial Diseases, Helsinki University Hospital (HUH), Helsinki, Finland.,Department of Prosthodontics and Stomatognathic physiology, University of Turku, Turku, Finland
| | - Felix Burkhardt
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Vincent Fehmer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Philippe Mojon
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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131
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Bergamo ETP, Cardoso KB, Lino LFO, Campos TMB, Monteiro KN, Cesar PF, Genova LA, Thim GP, Coelho PG, Bonfante EA. Alumina-toughened zirconia for dental applications: Physicochemical, mechanical, optical, and residual stress characterization after artificial aging. J Biomed Mater Res B Appl Biomater 2020; 109:1135-1144. [PMID: 33314536 DOI: 10.1002/jbm.b.34776] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/23/2020] [Accepted: 11/28/2020] [Indexed: 01/01/2023]
Abstract
To characterize the physicomechanical properties of an alumina-toughened zirconia (ATZ). ATZ synthesis consisted of the addition of alumina particles in an yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP) matrix. Specimens were obtained by uniaxial and isostatic pressing ATZ and 3Y-TZP powders and sintering at 1600°C/1 h and 1550°C/1 h, respectively. Crystalline content and residual stress were evaluated using X-ray diffraction (XRD). Microstructure was characterized by scanning electron microscopy (SEM). Optical properties were determined by reflectance test. Mechanical properties were assessed by biaxial flexural strength test. All analyses were performed before and after aging (134°C, 20 h, 2 bar). XRD and SEM revealed a typical ATZ and 3Y-TZP crystalline content, chiefly tetragonal phase, with a dense polycrystalline matrix, though a smaller grain size for ATZ. Aging triggered a similar monoclinic transformation for both systems; however, ATZ exhibited higher residual compressive stresses than 3Y-TZP. While as-processed 3Y-TZP demonstrated significantly higher characteristic strength relative to ATZ, no significant difference was observed after aging (~215 MPa increase in the ATZ strength). ATZ presented significantly higher opacity relative to 3Y-TZP, although aging significantly increased the translucency of both systems (increase difference significantly higher in the 3Y-TZP compared to ATZ). ATZ physicomechanical properties support its applicability in the dental field, with a lower detrimental effect of aging relative to 3Y-TZP.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Karina B Cardoso
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Lucas F O Lino
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
| | - Tiago M B Campos
- Department of Physics, Aeronautics Technological Institute, São José dos Campos, SP, Brazil
| | - Kelli N Monteiro
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Paulo F Cesar
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Luis A Genova
- Center of Materials Science and Technology, Institute of Research in Nuclear Energy, São Paulo, SP, Brazil
| | - Gilmar P Thim
- Department of Physics, Aeronautics Technological Institute, São José dos Campos, SP, Brazil
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, Hansjörg Wyss Department of Plastic Surgery, Mechanical and Aerospace Engineering, New York University, New York City, NY, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry - University of São Paulo, Bauru, SP, Brazil
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Cost-Effectiveness Analysis of Rehabilitation Interventions for Teeth With Extensive Coronary Destruction. Value Health Reg Issues 2020; 23:122-130. [PMID: 33217715 DOI: 10.1016/j.vhri.2020.07.581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/05/2020] [Accepted: 07/07/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To perform a cost-effectiveness analysis of rehabilitation interventions for management of posterior teeth (molar) with extensive coronary destruction. METHODOLOGY An economic model by Markov simulated a hypothetical 10-year cohort with 1,000 patients requiring treatment for a molar tooth with pulp necrosis and extensive coronary destruction. This study adopted the perspective of a local manager from Specialized Center in Dentistry, based on the transfer from the Ministry of Health. Treatments were proposed: Tooth Extraction + Removable Partial Denture (TE+RPD); Root Canal Treatment + Intra-Radicular Restoration + Single Crown (RCT+RIR+SC); and Tooth Extraction + Dental Implant + Single Crown (TE+DI+SC). The costs were obtained from the SUS Integrated System of Procedures, Medicines and orthoses; prostheses and special materials table management (SIGTAP). Failure and survival rates were obtained from systematic reviews. The variable "years of survival" was an outcome of effectiveness. The probabilistic simulation considered the confidence interval of 95%, variation of parameters by 5% and annual discount rate of 5%. RESULTS TE+RPD intervention presented lower cost and effectiveness. The incremental cost-effectiveness ratio (ICER) of RCT+IRR+SC and TE+DI+SC interventions compared to TE+RPD were $13.06 and $9.92 per year of survival. Compared to RCT+IRR+SC, the TE+DI+SC intervention had an ICER=$26.90 per year of survival. The acceptability curve indicates that the choice of intervention depends on the willingness to pay. CONCLUSION The RCT+IRR+SC intervention presented a balance of cost-effectiveness. Rehabilitation with implants can be considered in view of the higher expectation of longevity and, especially, greater willingness to pay.
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Optimizing the esthetic outcome by using screw-retained implant abutment crowns: A 3-year clinical follow-up. J Prosthet Dent 2020; 126:608-615. [PMID: 33160619 DOI: 10.1016/j.prosdent.2020.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/14/2020] [Accepted: 09/14/2020] [Indexed: 11/21/2022]
Abstract
This clinical report describes a ceramic complete-mouth rehabilitation with screw-retained implant abutment crowns, optimizing esthetics by combining the properties of ceramic materials. The abutments connected a titanium insert to a computer-aided design and computer-aided manufacturing (CAD-CAM) monolithic zirconia framework, offering improved esthetics and biologic response without negatively affecting the implant abutment interface. Lithium disilicate crowns were cemented extraorally on the abutments, resulting in a screw-retained restoration.
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134
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Monolithic and Minimally Veneered Zirconia Complications as Implant-Supported Restorative Material: A Retrospective Clinical Study up to 5 Years. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8821068. [PMID: 33134389 PMCID: PMC7593719 DOI: 10.1155/2020/8821068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/01/2020] [Accepted: 10/07/2020] [Indexed: 11/30/2022]
Abstract
Objective Long-term clinical data on the success and complication rates of monolithic or minimally veneered zirconia implant-supported restorations are lacking. Hence, the purpose of this retrospective clinical study was to analyze the complications of monolithic or partially veneered zirconia implant-supported restorations up to 5 years follow-up. Material and Methods. Single crowns, bridges, and full-arch rehabilitations were included. The selection process was achieved by reviewing data from the prosthetic laboratory and excluding cases in which zirconium and full-ceramic coating restorations were used. A total of 154 restorations were included (82 monolithic and 72 with buccal ceramic stratification). All the complications encountered, and the solutions applied, were explained. Results A total of 93 restorative units had a follow-up of between 24 and 60 months, and 61 restoration units had a follow-up of between 12 and 24 months. A total of 7 complications were encountered (14.58% of cases; 95.45% per prosthetic unit). The technical complication rate was 2.08% (one case of minor chipping in one prosthetic unit); regarding the mechanical complications, four decementations (8.33% of the cases) and two screw loosening (4.17% of the cases) were encountered. Conclusions Considering the limitations of this study, it can be concluded that monolithic or partially veneered zirconia implant-supported restorations have a good clinical behavior during a follow-up period of up to 5 years.
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Hjerppe J, Perea-Lowery L, Lassila LVJ, Vallittu PK. Effect of potassium hydrogen difluoride in zirconia-to-resin bonding. Dent Mater J 2020; 40:245-252. [PMID: 33087632 DOI: 10.4012/dmj.2019-389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective of this study was to compare potassium hydrogen difluoride (KHF2) etching for zirconia with commonly used surface roughening and chemical bonding methods (silane, MDP-monomer primer) for resin-based luting cement bonding to zirconia. Zirconia specimens were divided into six groups (n=10) according to surface treatment and bonding procedures, with and without thermocycling (6,000 cycles, 5-55ºC): 1) air-borne particle abrasion with alumina+MDP-monomer (ABP), 2) air-borne particle abrasion with silica-coated trialuminium trioxide+silane (ABPR-S) and 3) KHF2 etching+silane (ETC). Surface roughness and bond strength (SBS-test) for dry and thermocycled specimens were measured. SBS did not vary statistically between the dry groups, but thermocycling decreased the bond strengths of all the tested methods (p<0.05). After thermocycling, ABP had statistically significantly lower bond strength values compared to ABPR-S and ETC (p<0.05). Etching method with KHF2 did not provide better bonding capacity to previously introduced and commonly adopted bonding methods.
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Affiliation(s)
- Jenni Hjerppe
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry University of Turku.,Departments of Oral and Maxillofacial Diseases, Helsinki University Hospital (HUH)
| | - Leila Perea-Lowery
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre -TCBC, Institute of Dentistry, University of Turku
| | - Lippo V J Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre -TCBC, Institute of Dentistry, University of Turku
| | - Pekka K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre -TCBC, Institute of Dentistry, University of Turku.,City of Turku, Welfare Division
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Solá-Ruiz MF, Baixauli-López M, Roig-Vanaclocha A, Amengual-Lorenzo J, Agustín-Panadero R. Prospective study of monolithic zirconia crowns: clinical behavior and survival rate at a 5-year follow-up. J Prosthodont Res 2020; 65:284-290. [PMID: 33041280 DOI: 10.2186/jpr.jpr_d_20_00034] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Purpose To evaluate the clinical behavior and survival of full coverage monolithic zirconia crowns on posterior teeth over a 5-year follow-up.Methods Fifty patients were recruited and underwent restoration with a Lava Plus monolithic zirconia crown (Lava™ Frame Zirconia, 3M Espe, Germany) on premolars or molars. Patients were monitored over a 5-year follow-up (2014-19), recording any biological and/or mechanical complications; these data were used to estimate the crowns' success rate. Periodontal clinical parameters were recorded (pocket probing depth (PPD), plaque index (PLI), bleeding on probing (BOP), and gingival recession (GR)). Wear to the zirconia crowns and antagonist teeth were also evaluated with Geomagic software (3D Systems, U.S.A.). Patients' satisfaction with treatment was evaluated in a questionnaire.Results For the 50 monolithic zirconia crowns analyzed, the survival rate was 98% after 5 years. Only 6% of the crowns presented some type of complication (two debonding and one root fracture). No fracture or fissures were detected. GR and BOP were the only clinical parameters found to be significantly greater around teeth restored with crowns. The monolithic zirconia crowns suffered less wear than the enamel of antagonist teeth. Patient's general satisfaction with treatment was high.Conclusions Monolithic zirconia crowns on posterior teeth are a highly predictable treatment option, with a high survival rate. The single treatment failure was due to a biological complication arising from root fracture. This treatment may be recommended as a treatment that conserves dental structure, and requires minimal dental preparation.
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Affiliation(s)
- Mª Fernanda Solá-Ruiz
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Mar Baixauli-López
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Ana Roig-Vanaclocha
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Jose Amengual-Lorenzo
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Rubén Agustín-Panadero
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Failure Modes and Survival of Anterior Crowns Supported by Narrow Implant Systems. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1057846. [PMID: 32964016 PMCID: PMC7495162 DOI: 10.1155/2020/1057846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 08/12/2020] [Indexed: 11/18/2022]
Abstract
The reduced hardware design of narrow implants increases the risk of fracture not only of the implant itself but also of the prosthetic constituents. Hence, the current study is aimed at estimating the probability of survival of anterior crowns supported by different narrow implant systems. Three different narrow implant systems of internal conical connections were evaluated (Ø3.5 × 10 mm): (i) Active (Nobel Biocare), (ii) Epikut (S.I.N. Implant System), and (iii) BLX (Straumann). Abutments were torqued to the implants, and standardized maxillary incisor crowns were cemented. The assemblies were subjected to step-stress accelerated life testing (SSALT) in water through load application of 30 degrees off-axis lingually at the incisal edge of the crowns using a flat tungsten carbide indenter until fracture or suspension. The use level probability Weibull curves and reliability for completion of a mission of 100,000 cycles at 80 N and 120 N were calculated and plotted. Weibull modulus and characteristic strength were also calculated and plotted. Fractured samples were analyzed in a stereomicroscope. The beta (β) values were 1.6 (0.9-3.1) and 1.4 (0.9-2.2) for BLX and Active implants, respectively, and 0.5 (0.3-0.8) for the Epikut implant, indicating that failures were mainly associated with fatigue damage accumulation in the formers, but more likely associated with material strength in the latter. All narrow implant systems showed high probability of survival (≥95%, CI: 85-100%) at 80 and 120 N, without significant difference between them. Weibull modulus ranged from 6 to 14. The characteristic strength of Active, Epikut, and BLX was 271 (260-282) N, 216 (205-228) N, and 275 (264-285) N, respectively. The failure mode predominantly involved abutment and/or abutment screw fracture, whereas no narrow implant was fractured. Therefore, all narrow implant systems exhibited a high probability of survival for anterior physiologic masticatory forces, and failures were restricted to abutment and abutment screw.
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T P Bergamo E, Zahoui A, Luri Amorin Ikejiri L, Marun M, Peixoto da Silva K, G Coelho P, Soares S, A Bonfante E. Retention of zirconia crowns to Ti-base abutments: effect of luting protocol, abutment treatment and autoclave sterilization. J Prosthodont Res 2020; 65:171-175. [PMID: 32938879 DOI: 10.2186/jpr.jpor_2019_537] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the influence of resin cement type, surface pretreatment and autoclave sterilization on the retention of Y-TZP crowns to Ti-base abutments. METHODS Y-TZP crowns were designed and milled to fit Ti-base abutments. Crowns were cemented using either a conventional resin cement (conventional) with a universal adhesive or a self-adhesive resin cement (self-adhesive), both following no surface pretreatment (No) or Ti-base abutment sandblasting (SB) (n=20/group). Half of the cemented samples were subjected to in-office autoclave sterilization. Pullout testing was performed in a universal testing machine at a speed of 1 mm/min until crown displacement. Data were statistically evaluated through a linear mixed model following post hoc comparisons by LSD test. RESULTS Pullout data as a function of cement type demonstrated higher retention for conventional relative to self-adhesive cement (p < 0.001). Ti-base sandblasting (SB) favored crown retentiveness over No pretreatment (p < 0.001). Sterilized crowns exhibited higher pullout values than non-sterile (p=0.036). All the two- and three-factor interaction analyses corroborated with the superior adhesive strength of conventional compared to self-adhesive cement (all, p < 0.011), as well as, SB relative to No pretreatment (all, p < 0.024). While autoclave sterilization maximized bond strength when self-adhesive cement (data collapsed over surface pretreatment, p < 0.050) and No pretreatment were evaluated (data collapsed over surface pretreatment, p < 0.013), no significant difference was observed for conventional resin cement (p=0.280) and SB (p=0.878) groups. CONCLUSIONS Conventional resin cement and/or Ti-base sandblasting increased Y-TZP crown retentiveness, with no significant influence of autoclave sterilization. Autoclaving increased retentiveness when self-adhesive cement and/or no Ti-base pretreatment were used.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP
| | - Larissa Luri Amorin Ikejiri
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP
| | - Manoela Marun
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP
| | - Kimberly Peixoto da Silva
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, Department of Biomedical Engineering, New York University Tandon School of Engineering Brooklyn Hansjörg Wyss Department of Plastic Surgery
| | - Simone Soares
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP
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de Araújo-Júnior ENS, Bergamo ETP, Campos TMB, Benalcázar Jalkh EB, Lopes ACO, Monteiro KN, Cesar PF, Tognolo FC, Tanaka R, Bonfante EA. Hydrothermal degradation methods affect the properties and phase transformation depth of translucent zirconia. J Mech Behav Biomed Mater 2020; 112:104021. [PMID: 32882676 DOI: 10.1016/j.jmbbm.2020.104021] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/28/2020] [Accepted: 07/31/2020] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To characterize the optical and mechanical properties of a commercial and in-house translucent Y-TZP before and after aging in autoclave or hydrothermal reactor. METHODS In-house experimental discs were obtained through uniaxial and isostatic pressing a translucent Y-TZP powder and sintering at 1,550 °C/1 h. Commercial discs were milled from pre-sintered blocks fabricated with the same powder through uniaxial and isostatic pressing and sintering. Discs were allocated into three groups according to aging condition: immediate, aged via autoclave, or reactor (134 °C, 20 h, 2.2 bar). Crystalline content and microstructure were evaluated using X-ray diffraction (XRD) and scanning electron microscopy (SEM). Residual compressive stress (CS) was determined by Raman spectroscopy. Optical properties were determined by the contrast ratio (CR) and translucency parameter (TP) using reflectance data. Mechanical properties were assessed by Vickers hardness, fracture toughness and biaxial flexural strength tests. RESULTS XRD and SEM revealed a typical Y-TZP crystalline content, chiefly tetragonal phase, and a dense crystalline matrix for both processing protocols. Reactor aging triggered a more pronounced t-m transformation relative to autoclave. In-house and commercial Y-TZPs demonstrated similar CR and TP, with reactor aging significantly increasing their translucency. Similarly, reactor aging influenced Vickers hardness and fracture toughness. In-house processed Y-TZP clearly demonstrated the presence of CS, whereas commercial Y-TZP showed no presence of CS. Non-aged in-house Y-TZP resulted in significantly lower characteristic strength relative to commercial Y-TZP. While aging protocols significantly increased the characteristic strength of in-house Y-TZP, reactor significantly decreased commercial Y-TZP characteristic strength. Both Y-TZP processing protocols demonstrated high reliability at high-stress missions, with no detrimental effect of aging. CONCLUSIONS Laboratory aging methodology significantly influenced optical and mechanical properties of a commercial and in-house translucent Y-TZP.
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Affiliation(s)
- Everardo N S de Araújo-Júnior
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil.
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Tiago M B Campos
- Department of Physics, Technological Institute of Aeronautics, São José Dos Campos, SP, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Kelli N Monteiro
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Paulo F Cesar
- Department of Biomaterials and Oral Biology, University of São Paulo, School of Dentistry, São Paulo, SP, Brazil
| | - Fernanda C Tognolo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Ricardo Tanaka
- TNK Lab, Rua João de Santa Maria, 129 - Jardim da Saúde - São Paulo, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
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Karlsson K, Derks J, Wennström JL, Petzold M, Berglundh T. Occurrence and clustering of complications in implant dentistry. Clin Oral Implants Res 2020; 31:1002-1009. [PMID: 32794289 DOI: 10.1111/clr.13647] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/20/2020] [Accepted: 07/26/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The aim was to evaluate the overall occurrence and potential clustering of biological and technical complications in implant dentistry. MATERIAL AND METHODS 596 patients provided with implant-supported reconstructions were evaluated for the occurrence of (a) technical complications, (b) peri-implantitis and (c) implant loss during a period of 9 years. Time and type of event were scored, and potential risk factors were explored through parametric modelling of survival and hazards. Clustering of complications was assessed at the patient level, and patient satisfaction was evaluated by questionnaire completed at the 9-year examination. RESULTS 42% of patients were affected by technical and/or biological complications during the 9-year observation period. Extent of therapy (Hazard Ratio 2.5: patients with partial jaw restorations; HR 3.9: patients with full jaw restorations) and a history of periodontitis (HR 1.6) were identified as risk factors. While technical complications occurred mostly as isolated events, 41% of subjects identified with peri-implantitis and 52% of subjects with implant loss also presented with other complications. The hazard for technical complications and implant loss peaked at 0.7 years and 0.2 years, respectively, while the hazard for peri-implantitis was consistent throughout the observation period. The overall proportion of satisfied patients at 9 years was high (95%), and only minor differences between individuals with and without complications were noted. CONCLUSIONS Complications following implant-supported restorative therapy were common findings. Extent of therapy and periodontitis were identified as risk factors. While technical complications occurred in an isolated pattern, peri-implantitis and implant loss demonstrated clustering with other types of complications.
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Affiliation(s)
- Karolina Karlsson
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jan L Wennström
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Max Petzold
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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141
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Jum'ah AA, Brunton PA, Li KC, Waddell JN. Simulated clinical adjustment and intra-oral polishing of two translucent, monolithic zirconia dental ceramics: An in vitro investigation of surface roughness. J Dent 2020; 101:103447. [PMID: 32763368 DOI: 10.1016/j.jdent.2020.103447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/30/2020] [Accepted: 08/01/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To assess the surface roughness and residual flaws in two translucent zirconia substrates following simulated clinical adjustment and intra-oral finishing/polishing. MATERIALS AND METHODS Specimens were prepared from two translucent (5Y-ZP/8Y-ZP) and one conventional (3Y-TZP) zirconia substrates (n = 84 p/g). Arithmetic mean roughness parameter (Ra) was determined for all experimental groups at four stages (n = 21 p/g): (1) as-sintered, (2) surface grinding using a zirconia cutting diamond bur, (3) polishing using 1-step, 2-step or 4-step intra-oral polishing kits, and (4) laboratory polishing/glazing. Scanning electron microscopy (SEM) was used to evaluate residual surface flaws. Data were statistically analysed using a two-way ANOVA test, multiple and pairwise comparisons were performed using a Bonferroni post hoc test. RESULTS Ra was significantly higher for as-sintered and ground 5Y-ZP/8Y-ZP compared to 3Y-TZP (p ≤ 0.001). Material type and polishing protocol had statistically significant effect on Ra (p < 0.001). The 4-step polishing resulted in the lowest Ra in 3Y-TZP/5Y-ZP (p ≤ 0.001). No significant differences were observed between different polishing protocols in 8Y-ZP (p≥0.655). Glazing significantly reduced Ra in all materials compared to other polishing protocols (p ≤ 0.001) except for the 4-step protocol in 3Y-TZP (p = 0.195). SEM revealed pronounced surface flaws in ground 5Y-ZP/8Y-ZP. Grinding of 3Y-TZP induced ductile material removal and thereby, minimal cohesive material loss. The 4-step polishing protocol resulted in the fewest and shallowest surface flaws in all groups. Glazing of 3Y-TZP resulted in the most homogenous surface contrary to 5Y-ZP/8Y-ZP. CONCLUSIONS The finest surface finish was achieved using the 4-step polishing protocol in all studied materials. This protocol might be inadequate however for polishing of ground 5Y-ZP/8Y-ZP as a result of the pronounced surface damage induced by the grinding process. The glazing of 5Y-ZP/8Y-ZP might not be as predictable as for 3Y-TZP. CLINICAL SIGNIFICANCE The higher susceptibility to surface damage, as a result of increasing dopant concentration, may render polishing of ground, translucent zirconia more complicated compared to the conventional 3Y-TZP counterparts.
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Affiliation(s)
- Ahmad A Jum'ah
- Jordan University of Science and Technology, Faculty of Dentistry, Department of Conservative Dentistry, Irbid 22110, Jordan.
| | - Paul A Brunton
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
| | - Kai Chun Li
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
| | - J Neil Waddell
- University of Otago, Faculty of Dentistry, 310 Great King Street, Dunedin 9016, New Zealand
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142
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Prevalence of Peri-Implantitis: A Multi-Centered Cross-Sectional Study on 248 Patients. Dent J (Basel) 2020; 8:dj8030080. [PMID: 32756300 PMCID: PMC7557736 DOI: 10.3390/dj8030080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022] Open
Abstract
The aim of this multicenter cross-sectional study was to determine the prevalence of peri-implantitis and to assess its association with several patient- and implant-related factors. Patients with at least one implant, who came for a recall visit to one of the four centers over a period of five months, were enrolled. Presence of peri-implantitis (defined as bleeding on probing, exudate/suppuration, bone loss > 0.2 mm/year and increased pocket depth) and several other variables (e.g., smoking habits, history of periodontitis, diabetes) were recorded. Out of 248 enrolled patients (1162 implants), 10 patients had at least one implant with peri-implantitis (4.03%); a total of 14 implants were affected (1.20%). A statistically significant association between peri-implantitis and diabetes was found (OR 8.65; CI: 1.94–38.57). Smoking more than 10 cigarettes per day (OR: 0.53; CI 0.03–9.45) and history of periodontitis (OR: 2.42; CI: 0.49–11.89) were not found to be statistically associated with peri-implantitis. Even if implant therapy is a consolidated treatment, biological complications do happen. Strict supportive therapy recalls could lead to lower rates of peri-implantitis and earlier diagnosis.
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143
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Granato R, Bergamo ETP, Witek L, Bonfante EA, Marin C, Greenberg M, Kurgansky G, Coelho PG. Clinical, histological, and nanomechanical parameters of implants placed in healthy and metabolically compromised patients. J Dent 2020; 100:103436. [PMID: 32738285 DOI: 10.1016/j.jdent.2020.103436] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/04/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the clinical outcomes, histological parameters, and bone nanomechanical properties around implants retrieved from healthy and metabolic syndrome (MS) patients. METHODS Twenty-four patients with edentulous mandibles (12/condition), received four implants between the mental foramina. An additional implant prototype was placed for retrieval histology. The following clinical outcomes were evaluated: insertion torque (IT), implant stability quotient (ISQ) values at baseline and after 60 days of healing, and implant survival. The prototype was retrieved after the healing and histologically processed for bone morphometric evaluation of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO), and bone nanoindentation to determine the elastic modulus (Em) and hardness (H). Descriptive statistical procedures and survival tests were used to analyze the data. RESULTS The final study population was comprised of 10 women and 11 men (∼64 years). A total of 105 implants were placed, 21 retrieved for histology. Implant survival rates were similar between groups (>99 %). Similarly, IT and ISQ analyses showed no significant association with systemic condition (p > 0.216). Histological micrographs depicted similar bone morphology, woven bone, for both conditions. While MS (33 ± 5.3 %) and healthy (39 ± 6.5 %) individuals showed no significant difference for %BIC (p = 0.116), significantly higher %BAFO was observed for healthy (45 ± 4.6 %) relative to MS (30 ± 3.8 %) (p < 0.001). No significant differences on bone nanomechanical properties was observed (p > 0.804). CONCLUSIONS Although no significant influence on clinical parameters and bone nanomechanical properties was observed, MS significantly reduced bone formation in the peri-implant area in the short-term. CLINICAL SIGNIFICANCE A lower amount of bone formation in the peri-implant area was observed in comparison to healthy patients, although the other short-term clinical outcomes were not significantly different. Considering the escalating prevalence of MS patients in need for implant treatment, it becomes crucial to understand bone-to-implant response to determine the ideal loading time in this population.
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Affiliation(s)
- Rodrigo Granato
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, RJ, Brazil
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil.
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Biomedical Engineering - NYU Tandon School of Engineering, New York University, Brooklyn, NY, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Charles Marin
- Department of Oral Surgery, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Michael Greenberg
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - Gregory Kurgansky
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - Paulo G Coelho
- Department of Mechanical and Aerospace Engineering - NYU Tandon School of Engineering, Brooklyn, NY, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health School of Medicine, New York, NY, USA
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144
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Gehrke P, Abazari C, Schlichter K, Fischer C, Duddeck D, Romanos GE, Weigl P. Qualitative and Semi-Quantitative Assessment of Processing-Related Surface Contamination of One- and Two-Piece CAD/CAM Abutments before and after Ultrasonic Cleaning. MATERIALS 2020; 13:ma13143225. [PMID: 32698443 PMCID: PMC7412481 DOI: 10.3390/ma13143225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/21/2022]
Abstract
Manufacturing processes of custom implant abutments may contaminate their surfaces with micro wear deposits and generic pollutants. Such particulate debris, if not removed, might be detrimental and provoke inflammatory reactions in peri-implant tissues. Although regulatory guidelines for adequate cleaning, disinfection, or sterilization exist, there does not appear to be a consistent application and data on the amount and extent of such contaminants is lacking. The aim of the present in vitro study was to evaluate the quality and quantity of processing-related surface contamination of computer-aided design/computer-aided manufacturing (CAD/CAM) abutments in the state of delivery and after ultrasonic cleaning. A total of 28 CAD/CAM monotype and hybrid abutments were cleaned and disinfected applying a three-stage ultrasonic protocol (Finevo protocol). Before and after cleaning, the chemical composition and the contamination of the abutments were assessed using scanning electron microscopy (SEM), dispersive X-ray spectroscopy (EDX), and computer-aided planimetric measurement (CAPM). In the delivery condition, monotype abutments showed a significantly higher amount of debris compared to hybrid abutments (4.86 ± 6.10% vs. 0.03 ± 0.03%, p < 0.001). The polishing process applied in the laboratory after bonding the hybrid abutment components reduces the surface roughness and thus contributes substantially to their purity. The extent of contamination caused by computer-aided manufacturing of custom abutments can be substantially minimized using a three-stage ultrasonic protocol.
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Affiliation(s)
- Peter Gehrke
- Department of Postgraduate Education, Master of Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
- Private Practice, Bismarckstrasse 27, 67059 Ludwigshafen, Germany
| | - Cyrus Abazari
- Private Practice, Karl-Berner-Straße 23, 79400 Kandern, Germany
| | - Kai Schlichter
- Private Practice, Konrad-Lerch-Ring 9, 76877 Offenbach, Germany
| | | | - Dirk Duddeck
- Medical Materials Research Institute, Max-Planck-Strasse 3, 12489 Berlin, Germany
| | - Georgios E Romanos
- Department of Oral Surgery and Implant Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
- Department of Periodontology, School of Dental Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Paul Weigl
- Department of Prosthodontics and Head of Department of Postgraduate Education, Master of Oral Implantology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt, Germany
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145
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Sinjari B, Santilli M, D’Addazio G, Rexhepi I, Gigante A, Caputi S, Traini T. Influence of Dentine Pre-Treatment by Sandblasting with Aluminum Oxide in Adhesive Restorations. An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2020; 13:E3026. [PMID: 32645819 PMCID: PMC7372407 DOI: 10.3390/ma13133026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/20/2020] [Accepted: 07/03/2020] [Indexed: 01/22/2023]
Abstract
Dentine pretreatment through sandblasting procedures has been widely studied but no curve test results are currently available. Thus, the aim herein was to in vitro compare the adhesive strength in sandblasted or not samples using a universal testing machine. Thirty -two bovine teeth were divided into two groups, namely test (n = 16 bars), sandblasting with aluminum oxide particles (50 µm) was performed before the adhesion procedures), and control (n = 16 bars), where no sandblasting procedure was performed. A bi-material curve test was used to evaluate the characteristics of the dentine pretreatment in terms of tensile stress and fracture strength. A scanning electron microscope (SEM) was used to analyze the fracture topography in the composite, bonding, dentin, and at the relative interfaces. The results demonstrated a statistically significant difference between the two groups in terms of tensile stress at maximum load showing values of 84.300 ± 51.342 MPa and 35.071 ± 16.609 MPa, respectively for test and control groups (p = 0.033). Moreover, a fracture strength test showed values of 18.543 ± 8.145 MPa for test and 8.186 ± 2.833 MPa for control group (p = 0.008). In conclusion, the sandblasting treatment of the dentine significantly influenced the mechanical resistance of the adhesion in this in vitro study.
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Affiliation(s)
- Bruna Sinjari
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (G.D.); (I.R.); (A.G.); (S.C.); (T.T.)
- Electron Microscopy Laboratory, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Manlio Santilli
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (G.D.); (I.R.); (A.G.); (S.C.); (T.T.)
- Electron Microscopy Laboratory, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Gianmaria D’Addazio
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (G.D.); (I.R.); (A.G.); (S.C.); (T.T.)
- Electron Microscopy Laboratory, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Imena Rexhepi
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (G.D.); (I.R.); (A.G.); (S.C.); (T.T.)
- Electron Microscopy Laboratory, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Alessia Gigante
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (G.D.); (I.R.); (A.G.); (S.C.); (T.T.)
| | - Sergio Caputi
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (G.D.); (I.R.); (A.G.); (S.C.); (T.T.)
- Electron Microscopy Laboratory, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy
| | - Tonino Traini
- Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” of Chieti-Pescara, 66100 Chieti, Italy; (M.S.); (G.D.); (I.R.); (A.G.); (S.C.); (T.T.)
- Electron Microscopy Laboratory, University G. d’Annunzio Chieti-Pescara, 66100 Chieti, Italy
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146
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Mühlemann S, Lakha T, Jung RE, Hämmerle CHF, Benic GI. Prosthetic outcomes and clinical performance of CAD‐CAM monolithic zirconia versus porcelain‐fused‐to‐metal implant crowns in the molar region: 1‐year results of a RCT. Clin Oral Implants Res 2020; 31:856-864. [DOI: 10.1111/clr.13631] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 06/03/2020] [Accepted: 06/03/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Sven Mühlemann
- Clinic of Reconstructive DentistryCenter of Dental MedicineUniversity of Zurich Zurich Switzerland
| | - Tabrez Lakha
- Clinic of Reconstructive DentistryCenter of Dental MedicineUniversity of Zurich Zurich Switzerland
- Department of Prosthetic DentistryM.A. Rangoonwala College of Dental Sciences & Research Centre Pune India
| | - Ronald E. Jung
- Clinic of Reconstructive DentistryCenter of Dental MedicineUniversity of Zurich Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Reconstructive DentistryCenter of Dental MedicineUniversity of Zurich Zurich Switzerland
| | - Goran I. Benic
- Clinic of Reconstructive DentistryCenter of Dental MedicineUniversity of Zurich Zurich Switzerland
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147
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Hu ML, Lin H, Zhang YD, Han JM. Comparison of technical, biological, and esthetic parameters of ceramic and metal-ceramic implant-supported fixed dental prostheses: A systematic review and meta-analysis. J Prosthet Dent 2020; 124:26-35.e2. [DOI: 10.1016/j.prosdent.2019.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/21/2019] [Accepted: 07/22/2019] [Indexed: 01/11/2023]
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148
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AL‐Rabab'ah MA, AlTarawneh S, Jarad FD, Devlin H. Methodological Quality of Systematic Reviews Relating to Performance of All‐Ceramic Implant Abutments, Frameworks, and Restorations. J Prosthodont 2020; 30:36-46. [DOI: 10.1111/jopr.13206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Mohammad A. AL‐Rabab'ah
- Department of Conservative Dentistry, School of Dentistry The University of Jordan Amman Jordan
- School of Dentistry University of Liverpool UK
- Division of Dentistry The University of Manchester UK
| | - Sandra AlTarawneh
- Department of Removable Prosthodontics, School of Dentistry The University of Jordan Amman Jordan
- Department of Restorative Dentistry UIC College of Dentistry Chicago IL
| | | | - Hugh Devlin
- Division of Dentistry The University of Manchester UK
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149
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Xiong X, Xu T, Wang X, Qin W, Yu T, Luo G. Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis. BMC Oral Health 2020; 20:150. [PMID: 32434508 PMCID: PMC7240920 DOI: 10.1186/s12903-020-01134-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/06/2020] [Indexed: 12/31/2022] Open
Abstract
Background To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods Five electronic databases including Medline, Embase, Web of Science, the Cochrane Library and Scopus were searched. The included studies are observational human studies written in English. The population of interest included those with/without OLP who received dental implant treatment. The follow-up time after implantation was from 1 month to 20 years. The quality of the included articles regarding risk of bias and methodology were assessed with the Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I2 test. Dichotomous data are expressed as the risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results Of the 66 articles, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM and 17.0% (19/112) vs. 10.9% (12/110) for PI. The meta-analysis revealed no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77–2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53–1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75–1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70–1.15, P = 0.40) between OLP and non-OLP groups. Conclusions Available articles regarding the effects of OLP on PIDs remains very limited. Existing evidence does not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to validate the findings.
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Affiliation(s)
- Xiaoqin Xiong
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Tiantian Xu
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Xinhong Wang
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Wenguang Qin
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China
| | - Ting Yu
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China.
| | - Gang Luo
- Department of Periodontology and Oral Medicine, Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, NO.195 Dongfeng West Road, Guangzhou, 510140, China.
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150
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Ceramic Materials and Technologies Applied to Digital Works in Implant-Supported Restorative Dentistry. MATERIALS 2020; 13:ma13081964. [PMID: 32331379 PMCID: PMC7216107 DOI: 10.3390/ma13081964] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/14/2020] [Accepted: 04/20/2020] [Indexed: 12/17/2022]
Abstract
Computer-aided design and manufacturing technology has been closely associated with implant-supported restoration. The digital system employed for prosthodontic restorations comprises data acquisition, processing, and manufacturing using subtractive or additive methods. As digital implantology has developed, optical scanning, computer-based digital algorithms, fabricating techniques, and numerical control skills have all rapidly improved in terms of their accuracy, which has resulted in the development of new ceramic materials with advanced esthetics and durability for clinical application. This study reviews the application of digital technology in implant-supported dental restoration and explores two globally utilized ceramic restorative materials: Yttria-stabilized tetragonal zirconia polycrystalline and lithium disilicate glass ceramics.
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