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Tekpınar L, Yiğit V. Cost-Effectiveness Analysis of Implant-Supported Single Crown and Tooth-Supported Fixed Dental Prostheses in Türkiye. Value Health Reg Issues 2024; 42:100979. [PMID: 38340673 DOI: 10.1016/j.vhri.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/19/2023] [Accepted: 01/08/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES The most cost-effective option for replacing lost teeth is not evident because there is a dearth of evidence-based information on implant-supported single crowns versus tooth-supported fixed dental prostheses. This study conducted the analysis of cost-effectiveness of implant-supported single crown and tooth-supported fixed dental prostheses from a social perspective in Türkiye. METHODS Costs were calculated in the analysis from a social perspective for 2021. Costs and quality-adjusted prosthesis year (QAPY) values were computed over a 20-year period in the study using the Markov model. The computed values were discounted by 5%. The results are presented as the incremental cost-effectiveness ratio. To assess the impact of uncertainty on cost-effectiveness analyses, a tornado diagram and Monte Carlo simulations were created. RESULTS Throughout the 20-year time horizon, tooth-supported fixed dental prostheses cost $985.58 cumulatively, whereas implant-supported single crown cost $2161.64 (US $1 = 9.22 ₺ as of 15 October 2021). The calculated incremental cost-effectiveness ratio is 1.333 per QAPY. Compared with the implant-supported single crown tooth-supported fixed dental prostheses, it offers a QAPY of 0.882 over a 20-year period, while costing an additional $1176.06. CONCLUSIONS These results suggest that the implant-supported single crown provided higher QAPY value but was costlier. When the research's findings are compared with the literature, it becomes clear that Türkiye has lower dental care expenses than most other nations.
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Affiliation(s)
- Lütfiye Tekpınar
- Department of Health Economics, Nezahat Keleşoğlu Faculty of Health Sciences, Necmettin Erbakan University, Konya, Türkiye; Department of Health Management, Nezahat Keleşoğlu Faculty of Health Sciences, Necmettin Erbakan University, Konya, Türkiye.
| | - Vahit Yiğit
- Department of Hospital Management, Faculty of Economics and Administrative Sciences, Süleyman Demirel University, Isparta, Türkiye; Department of Health Management, Faculty of Economics and Administrative Sciences, Süleyman Demirel University, Isparta, Türkiye
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Hashemi S, Baghaei K, Fathi A, Aghadavoudi N, Hashemi SS, Atash R, Khademi SS. Stress Analysis of Endodontically Treated Tooth-Implant Different Connectors Designs in Maxillary Posterior Region: A Finite Element Analysis. Eur J Dent 2024; 18:587-597. [PMID: 37848070 PMCID: PMC11132775 DOI: 10.1055/s-0043-1772780] [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: 10/19/2023] Open
Abstract
OBJECTIVES Using finite element analysis (FEA), this study aimed to determine the effect of nonrigid connectors (NRCs) and their position on the success of tooth and implant-supported fixed prostheses in the maxillary posterior region. MATERIALS AND METHODS Three three-dimensional FEA models were designed, presuming maxillary second premolar and first molar to be extracted. Implant (replacing first molar), abutment, bone (spongious and cortical), first premolar (containing dentin, root cement, gutta-percha, and casting post and core), periodontal ligament, and three three-unit cemented porcelain-fused-to-metal prostheses (a rigid one and two nonrigid) were modeled. The NRC was once on the tooth side and once on the implant side. The prostheses were loaded twice. The first molar (180 N) and premolars (120 N) teeth were subjected to progressive vertical and oblique (12-degree) loads, and maximum von Mises stress and strain in teeth and connectors were calculated for each model. RESULTS The findings of the current study showed evidence that tooth-implant design with an NRC has significantly increased the average stress in the tooth. The average stress in dentin was 769.02 for the mesial connector and 766.95 for the distal connector, and this was only 731.59 for rigid connector. Furthermore, it was observed that rigid connector has considerably minimized the stress within the tooth-implant-supported fixed partial denture. The average stress for the crown and metal frame is 346.22 and 526.41 in rigid connector, while it is 1,172.9 and 2,050.9 for the nonrigid mesial connector. CONCLUSION Although distal NRC was more efficient than mesial NRC, using NRC will only reduce the stress applied to cortical bone and is not recommended in the posterior region of the maxilla.
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Affiliation(s)
- Sara Hashemi
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kimia Baghaei
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirhossein Fathi
- Department of Dental Prosthodontics, Dental Materials Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Navid Aghadavoudi
- Dental Students Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ramin Atash
- Department of Prosthodontics, School of Dentistry, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Sayed Sobhan Khademi
- Department of Prosthodontics, School of Dentistry, Islamic Azad University (Khorasgan Branch), Isfahan, Iran
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Rohr N, Karakas-Stupar I, Karlin S, Zitzmann NU, Zaugg LK. Effect of implant type on the stability of cantilever fixed dental prostheses: An in vitro study. Clin Oral Implants Res 2024; 35:419-426. [PMID: 38329172 DOI: 10.1111/clr.14240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/30/2023] [Accepted: 01/11/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES To simulate the replacement of a premolar with an implant-supported cantilever fixed dental prosthesis (ICFDP) and how the fracture load is affected by implant type, positioning within the zirconia blank, and aging protocol. MATERIALS AND METHODS Seventy-two ICFDPs were designed either within the enamel- or dentin layer of a 4Y-PSZ blank for bone-level and tissue-level titanium-zirconium implants. Fracture load was obtained on the cantilever at baseline (no aging) or after aging in a chewing simulator with the load applied within the implant axis (axial aging) or on the cantilever (12 groups with n = 6). A three-way ANOVA was applied (α = .05). RESULTS A three-way ANOVA revealed a significant effect on fracture load values of implant type (p = .006) and aging (p < .001) but not for the position within the zirconia blank (p = .847). Fracture load values significantly increased from baseline bone level (608 ± 118 N) and tissue level (880 ± 293 N) when the implants were aged axially, with higher values for tissue level (1065 ± 182 N) than bone level (797 ± 113 N) (p < .001). However, when the force was applied to the cantilever, fracture load values decreased significantly for tissue-level (493 ± 70 N), while values for bone-level implants remained stable (690 ± 135 N). CONCLUSIONS For ICFDPs, the use of bone-level implants is reasonable as catastrophic failures are likely to be restricted to the restoration, whereas with tissue-level implants, the transmucosal portion of the implant is susceptible to deformation, making repair more difficult.
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Affiliation(s)
- Nadja Rohr
- Biomaterials and Technology, Department of Research, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Irina Karakas-Stupar
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Sabrina Karlin
- Biomaterials and Technology, Department of Research, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Lucia K Zaugg
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
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Lee SJ, Alamri O, Cao H, Wang Y, Gallucci GO, Lee JD. Occlusion as a predisposing factor for peri-implant disease: A review article. Clin Implant Dent Relat Res 2023; 25:734-742. [PMID: 36373771 DOI: 10.1111/cid.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/23/2022] [Accepted: 10/25/2022] [Indexed: 08/04/2023]
Abstract
BACKGROUND The restoration of dental implants presents a unique challenge due to the intrinsic biomechanical differences between osseointegrated implants and natural teeth, and their subsequent responses to occlusal loading. However, controversy exists regarding the role that occlusion plays in the physiology of the peri-implant complex. PURPOSE To provide an overview of the scientific literature regarding occlusion as it relates to implant dentistry and peri-implant disease. MATERIALS AND METHODS This article presents a narrative review on occlusal loading and its potential effects on the peri-implant complex, as well as some generally accepted guidelines for occlusion in implant dentistry. RESULTS AND CONCLUSIONS Although there is strong evidence linking occlusal factors to mechanical complications of dental implants, the same cannot be said regarding biological complications. There is no clear scientific evidence on the relationship between occlusal overload and peri-implant disease. However, occlusal overload may be an accelerating factor for peri-implant disease in the presence of inflammation. As the biomechanical properties of dental implants differ from that of the natural dentition, modifications to classic concepts of occlusion may be necessary when dental implants are involved. Thus, clinical recommendations are proposed which function to minimize unfavorable occlusal forces on implant restorations and reduce the associated biological and mechanical complications.
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Affiliation(s)
- Sang J Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Osamah Alamri
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Huilin Cao
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Yujun Wang
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - German O Gallucci
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jason D Lee
- Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Lone MA, Iqbal UA, Lone MM, Adnan S, Heboyan A, Ahmed N, Karobari MI, Marya A. Current Trends in Fixed Prosthodontics Education in Undergraduate Dental Colleges. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2023; 10:23821205231193282. [PMID: 37614332 PMCID: PMC10443680 DOI: 10.1177/23821205231193282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 07/21/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES The objective of this study was to explore current trends in undergraduate fixed prosthodontics teaching at undergraduate dental level education. METHODS This cross-sectional descriptive study included close-ended questions to inquire about the teaching practices of fixed prosthodontics at Bachelor of Dental Surgery level education. Electronic copies of the survey forms were sent to the heads or directors of department of prosthodontics responsible for undergraduate dental students teaching and learning in various institutes of Sindh by the help of Google forms in December 2020. The form included questions on sociodemographic details and questions inquiring the theoretical and clinical teaching practices in undergraduate fixed prosthodontics course. Data was entered and analyzed using SPSS 25. Frequency distribution and percentages of categorical variables were recorded. RESULTS Out of total 18 dental institutes of Sindh, 15 returned the completely filled form, giving a response rate of 83.3%. Seven (46.7%) schools teach various fixed prosthesis in the preclinical years to their students. All 15 colleges carry out didactic teaching and provide exposure by live clinical demonstrations for various fixed prosthesis. Faculty of 12 (80%) dental colleges where fixed prostheses are being constructed in the dental outpatient department mentioned that their students observe or assist the clinical procedures during their clinical rotation; but none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. CONCLUSION Didactic teaching and live clinical demonstrations of fixed prosthodontics is being carried out in all dental colleges of Sindh. Almost half of the dental schools teach crown preparation on phantom teeth during their preclinical course. Contrary to this, none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. As these procedures are not included in the current undergraduate curriculum, recommendations should be forwarded to governing educational body of the country to include cases of fixed prosthesis in their skill set prior to their graduation.
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Affiliation(s)
- Muneeb Ahmed Lone
- Department of Prosthodontics, Dr Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Uzma Anam Iqbal
- Department of Prosthodontics, Dr Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Maham Muneeb Lone
- Department of Operative Dentistry Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Samira Adnan
- Department of Operative Dentistry Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
- Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Mohmed Isaqali Karobari
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Anand Marya
- Department of Orthodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
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Clinical performance of different types of dental prosthesis in patients with head and neck tumors-a retrospective cohort study. Clin Oral Investig 2022; 26:7121-7133. [PMID: 35976496 DOI: 10.1007/s00784-022-04673-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 08/09/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate how different types of dental prosthesis perform in patients with head and neck tumors. MATERIALS AND METHODS In this retrospective clinical cohort study, the impact of different patient-related factors was analyzed as influencing factors on the survival probability of dental prosthesis using Kaplan-Meier estimate. For analysis, the dental prosthesis was divided into groups: group 1 (fixed dental prosthesis), group 2 (removable dental prosthesis), group 3 (implant-supported dental prosthesis), and group 4 (prostheses anchored using wrought wire clasps and obturators). The incidental aftercare measures were also evaluated. RESULTS Two hundred seventy-nine restorations were observed (mean observation: 2.7 ± 3.0 years, max.14.8 years) out of which 49 (17.6%) had to be replaced during the observation. After 5 years, 100% of group 1 restorations, 79.9% of group 2 restorations, 91.4% of group 3 restorations, and 30% of group 4 restorations were still functional. Four hundred eighty-eight dental implants were observed, of which 77 (15.8%) failed. CONCLUSIONS Groups 1, 2, and 3 restorations showed good survival times after 5 years in function, whereas group 4 presented the worst survival times. Group 2 restorations showed the highest amount of necessary aftercare measures. CLINICAL RELEVANCE The current investigation shows that groups 1, 2, and 3 restorations should be preferred in the prosthetic treatment planning of patients with head and neck tumors. A treatment with group 4 restorations should only be considered if no other prosthetic treatment is possible or as temporary treatment.
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Assessment of the Socioeconomic Status and Analysis of the Factors Motivating Patients to Apply for Prosthetic Treatment by Students of Dentistry at the Poznań University of Medical Sciences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095703. [PMID: 35565097 PMCID: PMC9104844 DOI: 10.3390/ijerph19095703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023]
Abstract
This study aimed to determine the motives for undertaking prosthetic treatment at the Prosthetics Clinic of the Poznan University of Medical Sciences (PUMS), pursued by fifth- and sixth-year medicine and dentistry students. The survey consisted of 18 questions, of which 1 to 11 concerned general patient data, while questions 12 to 18 concerned prosthetic treatment. The only open question in the questionnaire was one regarding the motives for the decision to receive treatment. The study group consisted of 153 patients (102 women—66.67% and 51 men—33.33%) of the Prosthetic Clinic. After collecting a total of 200 questionnaires, rejecting 47 (23.50%) due to the lack of answers to all questions (other than question 18), a total of 153 completed (76.50%) questionnaires were obtained. The main motivating factors for patients to undertake prosthetic treatment are functional and aesthetic considerations. In addition, it turned out, that the authority of the university unit is of greater importance than financial issues. Additionally, some patients undergo treatment by students because they can see positive aspects in it, both for them and for students. Hence, the evaluation of the treatment provided by students, as well as their communication skills and their attitude, are rated very highly, although, again, the evaluation was influenced by the education level.
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Investigating the Effect of Nonrigid Connectors on the Success of Tooth-and-Implant-Supported Fixed Partial Prostheses in Maxillary Anterior Region: A Finite Element Analysis (FEA). Int J Dent 2021; 2021:5977994. [PMID: 34804166 PMCID: PMC8604583 DOI: 10.1155/2021/5977994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/25/2021] [Indexed: 11/17/2022] Open
Abstract
Objective This study was designed to assess the effect of nonrigid connectors (NRCs) and their location in the success of tooth-and-implant-supported fixed prostheses in the maxillary anterior region by finite element analysis (FEA). Materials and Methods Three 3D FEA models were designed, presuming maxillary lateral incisor and canine to be extracted. Implant (replacing canine), abutment, bone (spongious and cortical), central incisor (containing dentin, root cement, gutta-percha, and casting post and core), periodontal ligament, and three three-unit cemented PFM prostheses (a rigid one and two nonrigid) were modeled. The NRC was once in the tooth side and once in the implant side. The prostheses were loaded twice: 250N to the incisal edges (0° to the long axis) and 200 N to the cingula (45° to the long axis). The von-Mises stress and vertical displacement were analyzed. Results Under both vertical and oblique loadings, the rigid model presented the highest stress. Under vertical loading, the NRC caused a significant decrease in the applied stress to the prosthesis, bone, implant, and tooth. Locating the NRC in the tooth side decreased the applied stress to the prosthesis and NRC. Under oblique loading, prosthesis and implant tolerated less stress in the presence of an NRC. Placing the NRC in the tooth side resulted in the least stress in all of the components except for porcelain and patrix. Vertical displacement of the tooth apex was approximately equal in all models. Conclusion Using an NRC on the tooth side is the most efficient method in reducing the applied stress to prosthesis, implant, tooth, and bone. The amount of intrusion is not dependent on using an NRC or not.
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Risk Indicators Affecting the Survival of the Mandibular First Molar Adjacent to an Implant at the Mandibular Second Molar Site: A Retrospective Study. J Clin Med 2021; 10:jcm10122543. [PMID: 34201316 PMCID: PMC8227410 DOI: 10.3390/jcm10122543] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/29/2021] [Accepted: 06/04/2021] [Indexed: 11/22/2022] Open
Abstract
This study aimed to compare the survival of mandibular first molars (MnM1s) adjacent to implants placed in mandibular second molar sites (ImM2s) with MnM1s adjacent to mandibular second molars (MnM2s) and to investigate risk indicators affecting the survival of MnM1s adjacent to ImM2s. A total of 144 patients who had MnM1s adjacent to ImM2s and MnM1s adjacent to MnM2s on the contralateral side were included in this study. Clinical variables and radiographic bone levels were evaluated. The survival of MnM1s adjacent to ImM2s or MnM2s was evaluated using a Kaplan–Meier analysis and Cox proportional hazards model. The 5-year cumulative survival rates of MnM1s adjacent to ImM2s and MnM2s were 85% and 95%, respectively. MnM1s adjacent to ImM2s of the internal implant-abutment connection type had higher multivariate hazard ratios (HR) for loss. MnM1s that had antagonists with implant-supported prostheses also had higher HR for loss. The multivariate HR for the loss of MnM1s adjacent to ImM2s with peri-implant mucositis was 3.74 times higher than MnM1s adjacent to healthy ImM2s. This study demonstrated several risk indicators affecting the survival of MnM1s adjacent to ImM2s. It is suggested that supportive periodontal and peri-implant therapy combined with meticulous occlusal adjustment can prolong the survival of MnM1s and ImM2s.
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Bitinas D, Bardijevskytė G. Short implants without bone augmentation vs. long implants with bone augmentation: systematic review and meta-analysis. Aust Dent J 2021; 66 Suppl 1:S71-S81. [PMID: 34037243 DOI: 10.1111/adj.12859] [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: 03/12/2021] [Revised: 04/19/2021] [Accepted: 05/13/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Anatomical limits such as the location of the lower alveolar nerve, the maxillary sinus in atrophied jaws might extend implant surgery treatment. The purpose of this systematic literature review is to review the literature and determine whether short implants can be an effective alternative to standard-length implants after bone augmentation. MATERIALS AND METHODS A systematic search was performed on PRISMA wizard. Searched for clinical trials 2010-2020 in the Medline database. The keywords chosen are "short versus long implants, augmented bone, clinical trial", and their various variations. RESULTS Meta-analyses of the studies of implant loss after 1, 3 and 5 years showed a statistically insignificant difference between groups. The number of complications after 1 year was statistically significantly higher in the control group. Meta-analyses with follow-up periods of 3 and 5 years showed a statistically insignificant difference; Meta-analyses of studies of marginal bone loss after 1, 3 and 5 years showed a statistically insignificant difference between the groups. CONCLUSIONS Short dental implants may be a suitable alternative to standard length dental implants after bone augmentation. The risk of their complications is possibly lower because of the lack of need for bone augmentation.
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Affiliation(s)
- Donatas Bitinas
- Medical academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
| | - Gailė Bardijevskytė
- Medical academy, Lithuanian University of Health Sciences, Eivenių 2, Kaunas, Lithuania
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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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Performance of fixed dental prostheses up to 6 years-A massive data analysis. J Prosthet Dent 2021; 128:350-354. [PMID: 33622552 DOI: 10.1016/j.prosdent.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 01/06/2021] [Accepted: 01/06/2021] [Indexed: 11/22/2022]
Abstract
STATEMENT OF PROBLEM Metal and metal-ceramic fixed dental prostheses (FDPs) have been clinically determined to provide long-term durable restorations. However, data on their performance under practice conditions are sparse. PURPOSE The purpose of this clinical study was to evaluate the longevity of FDPs under practice conditions by analyzing a large insurance claims database. MATERIAL AND METHODS Data were extracted from the data warehouse of a major German national health insurance company (BARMER). The analysis focused on the FDP types with the lowest deductibles in the insurance system. All metal-based FDPs replacing up to 3 adjacent teeth were included. Ceramic veneering was optional and only approved on the labial surfaces of maxillary teeth mesial to the first molar and mandibular teeth mesial to the second premolar. Fee codes allowed clinical courses to be traced on a day count basis. Three groups with FDPs replacing 1 tooth, 2 teeth, and 3 teeth were formed. Kaplan-Meier survival analyses were conducted for the target events removal or extraction, indicating FDP failure and extraction of an abutment tooth. RESULTS The sample comprised 124 660 FDPs that replaced 1 tooth (76.5%), 2 teeth (19.8%), or 3 teeth (3.7%). The cumulative survival rates for removal or extraction at 6 years differed significantly, with 83.0% for 1-pontic FDPs, 78.1% for 2-pontic FDPs, and 74.0% for 3-pontic FDPs. Thus, approximately 1 of 6 one-pontic FDPs, 1 of 5 two-pontic FDPs, and 1 of 4 three-pontic FDPs failed. The cumulative survival rates for extraction of an abutment tooth at 6 years showed no significant difference, with 96.0% for 1-pontic FDPs, 95.6% for 2-pontic FDPs, and 95.1% for 3-pontic FDPs. CONCLUSIONS The survival rates of FDPs according to insurance data were lower than those reported by clinical studies, indicating a gap between efficacy and effectiveness.
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Zhao F, Yang Z, Liu L, Chen D, Shao L, Chen X, Fz, Ls, Fz, Zy, Ll, Xc, Dc, Xc, Ls, Fz, Xc. Design and evaluation of a novel sub-scaffold dental implant system based on the osteoinduction of micro-nano bioactive glass. BIOMATERIALS TRANSLATIONAL 2020; 1:82-88. [PMID: 35837658 PMCID: PMC9255813 DOI: 10.3877/cma.j.issn.2096-112x.2020.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/16/2022]
Abstract
Alveolar ridge atrophy brings great challenges for endosteal implantation due to the lack of adequate vertical bone mass to hold the implants. To overcome this limitation, we developed a novel dental implant design: sub-scaffold dental implant system (SDIS), which is composed of a metal implant and a micro-nano bioactive glass scaffold. This implant system can be directly implanted under mucous membranes without adding any biomolecules or destroying the alveolar ridge. To evaluate the performance of the novel implant system in vivo, SDISs were implanted into the sub-epicranial aponeurosis space of Sprague-Dawley rats. After 6 weeks, the SDIS and surrounding tissues were collected and analysed by micro-CT, scanning electron microscopy and histology. Our results showed that SDISs implanted into the sub-epicranial aponeurosis had integrated with the skull without any mobility and could stably support a denture. Moreover, this design achieved alveolar ridge augmentation, as active osteogenesis could be observed outside the cortical bone. Considering that the microenvironment of the sub-epicranial aponeurosis space is similar to that of the alveolar ridge, SDISs have great potential for clinical applications in the treatment of atrophic alveolar ridges. The study was approved by the Animal Care Committee of Guangdong Pharmaceutical University (approval No. 2017370).
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Affiliation(s)
- Fujian Zhao
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Zhen Yang
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong Province, China,National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong Province, China
| | - Lu Liu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong Province, China,National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong Province, China
| | - Dafu Chen
- Laboratory of Bone Tissue Engineering, Beijing Laboratory of Biomedical Materials, Beijing Research Institute of Orthopaedics and Traumatology, Beijing Jishuitan Hospital, Beijing, China
| | - Longquan Shao
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong Province, China,Corresponding authors: Xiaofeng Chen, ; Longquan Shao,
| | - Xiaofeng Chen
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, Guangdong Province, China,National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, Guangdong Province, China,Corresponding authors: Xiaofeng Chen, ; Longquan Shao,
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Papi P, Penna D, Di Murro B, Pompa G. Clinical and volumetric analysis of peri-implant soft tissue augmentation using an acellular dermal matrix: A prospective cohort study. J Periodontol 2020; 92:803-813. [PMID: 33000864 DOI: 10.1002/jper.20-0219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The role of keratinized mucosa in promoting peri-implant health is controversial, however recent evidence support the use of soft tissue augmentation procedures around dental implants. Soft tissue substitutes have been proposed to replace autogenous connective tissue grafts, therefore the aims of this study are to report clinical and volumetric three-dimensional changes in mucosal thickness (MT) 1 year after treatment with an acellular dermal matrix (ADM). METHODS Soft tissue augmentation was performed at second-stage surgery in the premolar maxillary area with an ADM. MT was assessed prior to implant placement and 1, 6, and 12 months after treatment. Digital linear and volumetric measurements were recorded at baseline and after 1 and 12 months. Furthermore, clinical parameters (Probing Pocket Depths, Bleeding On Probing, Plaque Index) and marginal bone loss were also recorded. Esthetic outcomes of treatment were evaluated objectively using the Pink Esthetic Score and through patient reported outcomes. RESULTS Twelve patients were enrolled in this prospective study. Post-hoc analysis of the assessments with Tukey's honestly significant difference adjustment revealed that the MT had increased significantly from baseline to 1 month (P < 0.001), 6 months (P < 0.001) and 12 months (P < 0.001), and remained stable between 6 months and 12 months (P > 0.05). Based on the volumetric evaluation, a shrinkage of 23.31% occurred from 1 month to 12 months (P > 0.05). CONCLUSIONS A significant increase in MT was reported after 1 year, with a mean gain of 1.25 mm. Soft tissues were stable, with no statistically significant differences between 6 months and 1 year.
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Affiliation(s)
- Piero Papi
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Diego Penna
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Bianca Di Murro
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Giorgio Pompa
- Department of Oral and Maxillo-Facial Sciences, "Sapienza" University of Rome, Rome, Italy
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La Monaca G, Pranno N, Annibali S, Massimo C, Polimeni A, Patini R, Paola Cristalli M. Survival and complication rates of tooth-implant versus freestanding implant supporting fixed partial prosthesis: a systematic review and meta-analysis. J Prosthodont Res 2020; 65:1-10. [PMID: 32938874 DOI: 10.2186/jpr.jpor_2019_494] [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] [Indexed: 11/06/2022]
Abstract
PURPOSE This systematic review was performed to compare tooth, implant and prosthesis failures and biological and technical complications in toothimplant vs freestanding implant supported fixed partial prostheses, in order to evaluate the effectiveness and predictability in combining teeth and implants in the same fixed partial prosthesis. STUDY SELECTION A comprehensive and systematic literature research was conducted, according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, to identify human trials, with a minimum sample size of 10 patients, comparing tooth-implant to freestanding implant supported fixed partial prostheses. Four groups of meta-analyses were performed based on the patients treated with toothimplant vs freestanding implant-supported fixed partial prostheses: abutment failures, biological and mechanical complications, prosthesis failures, and prosthetic (technical) complications. RESULTS The search yielded 749 records, after removal of duplicates. Based on the title assessment, the abstracts reading and the full-texts evaluation, 8 articles, published between 1999 and 2013, fulfilled the inclusion criteria and were included in the meta-analysis. The studies included were: 4 controlled clinical trials, 2 prospective and 2 retrospective cohort studies. The meta-analysis revealed no significant difference between tooth-implant and implant-implant supported fixed in the number of abutment (implant or tooth) failures, biological complications, prosthesis lost, and prosthetic complications. CONCLUSIONS Within the limitations of the present systematic review, although the freestanding implant supported fixed partial prosthesis remains the first choice, joining teeth and implants to support fixed prosthesis in partially edentulous patients becomes a valid alternative with an acceptable success rate.
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Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome
| | - Cordaro Massimo
- Clinical Dentistry Institute of Head and Neck Clinical Area. School of dentistry, Catholic University of Sacred Heart, Rome
| | - Antonella Polimeni
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome
| | - Romeo Patini
- Clinical Dentistry Institute of Head and Neck Clinical Area. School of dentistry, Catholic University of Sacred Heart, Rome
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, Sapienza, University of Rome, Rome, Italy
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Jeong HJ, Gwak SJ, Seo KD, Lee S, Yun JH, Cho YS, Lee SJ. Fabrication of Three-Dimensional Composite Scaffold for Simultaneous Alveolar Bone Regeneration in Dental Implant Installation. Int J Mol Sci 2020; 21:E1863. [PMID: 32182824 PMCID: PMC7084329 DOI: 10.3390/ijms21051863] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 02/03/2023] Open
Abstract
Dental implant surgeries involve the insertion of implant fixtures into alveolar bones to replace missing teeth. When the availability of alveolar bone at the surgical site is insufficient, bone graft particles are filled in the insertion site for successful bone reconstruction. Bone graft particles induce bone regeneration over several months at the insertion site. Subsequently, implant fixtures can be inserted at the recipient site. Thus, conventional dental implant surgery is performed in several steps, which in turn increases the treatment period and cost involved. Therefore, to reduce surgical time and minimize treatment costs, a novel hybrid scaffold filled with bone graft particles that could be combined with implant fixtures is proposed. This scaffold is composed of a three-dimensionally (3D) printed polycaprolactone (PCL) frame and osteoconductive ceramic materials such as hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP). Herein, we analyzed the porosity, internal microstructure, and hydrophilicity of the hybrid scaffold. Additionally, Saos-2 cells were used to assess cell viability and proliferation. Two types of control scaffolds were used (a 3D printed PCL frame and a hybrid scaffold without HA/β-TCP particles) for comparison, and the fabricated hybrid scaffold was verified to retain osteoconductive ceramic particles without losses. Moreover, the fabricated hybrid scaffold had high porosity and excellent microstructural interconnectivity. The in vitro Saos-2 cell experiments revealed superior cell proliferation and alkaline phosphatase assay results for the hybrid scaffold than the control scaffold. Hence, the proposed hybrid scaffold is a promising candidate for minimizing cost and duration of dental implant surgery.
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Affiliation(s)
- Hun-Jin Jeong
- Department of Mechanical Engineering, Wonkwang University, Iksan 54538, Korea; (H.-J.J.); (K.D.S.)
| | - So-Jung Gwak
- Department of Chemical Engineering, Wonkwang University, Iksan 54538, Korea;
| | - Kyoung Duck Seo
- Department of Mechanical Engineering, Wonkwang University, Iksan 54538, Korea; (H.-J.J.); (K.D.S.)
| | - SaYa Lee
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju 54896, Korea; (S.L.); (J.-H.Y.)
| | - Jeong-Ho Yun
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju 54896, Korea; (S.L.); (J.-H.Y.)
| | - Young-Sam Cho
- Department of Mechanical Engineering, Wonkwang University, Iksan 54538, Korea; (H.-J.J.); (K.D.S.)
- Department of Mechanical and Design Engineering, Wonkwang University, Iksan 54538, Korea
| | - Seung-Jae Lee
- Department of Mechanical Engineering, Wonkwang University, Iksan 54538, Korea; (H.-J.J.); (K.D.S.)
- Department of Mechanical and Design Engineering, Wonkwang University, Iksan 54538, Korea
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Glücker C, Rauch A, Hahnel S. Attitude and treatment options in implant-supported prosthetics: A survey among a cohort of German dentists. J Adv Prosthodont 2020; 12:15-21. [PMID: 32128082 PMCID: PMC7040449 DOI: 10.4047/jap.2020.12.1.15] [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: 08/23/2019] [Revised: 01/26/2020] [Accepted: 02/03/2020] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The aim of the current study was to analyze treatment concepts of a cohort of German dentists for planning, fabrication, and maintenance of implant-supported fixed and removable restorations. MATERIALS AND METHODS A questionnaire including queries about experiences with implant-supported restorations as well as prosthetic and maintenance treatment concepts for supplying patients with fixed and removable implant-supported prosthetic restorations was developed and sent to 350 dental offices registered in the municipal area of Leipzig, Germany. RESULTS An overall total of 62 returned questionnaires were included in the analyses, which relates to a response rate of 17.7%. Participating dentists were more involved in the prosthetic aspects of implant dentistry rather than surgery, while prosthetic concepts such as backward planning, digital processing, and application of all-ceramic materials were not commonly performed. Simple attachments were preferred over complex retention systems in removable implant-supported restorations. Tooth/implant-supported fixed denture prostheses as well as removable denture prostheses with supporting posterior implants were not regarded as a favorable treatment option. CONCLUSION Within the limitations of the study, the data indicate that dentists favor simple and conventional treatment approaches in implant prosthetics. Prosthetic aspects in the planning of implant-supported restorations are often neglected. Prosthetic treatment guidelines and aspects should commonly be considered in the planning phase of implant-supported prosthetic restorations, and awareness should be increased in postgraduate education.
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Affiliation(s)
- Carolin Glücker
- Prosthodontics and Dental Materials Clinic, University Hospital, Leipzig University, Leipzig, Germany
| | - Angelika Rauch
- Prosthodontics and Dental Materials Clinic, University Hospital, Leipzig University, Leipzig, Germany
| | - Sebastian Hahnel
- Prosthodontics and Dental Materials Clinic, University Hospital, Leipzig University, Leipzig, Germany
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