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Mangano FG, Yang KR, Lerner H, Porrà T, Khachatryan LG, Gordienko ID, Admakin O. 3D-printed short-span hybrid composite implant-supported restorations fabricated through tilting stereolithography: A retrospective clinical study on 85 patients with 1 year of follow-up. J Dent 2024; 147:105095. [PMID: 38788917 DOI: 10.1016/j.jdent.2024.105095] [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: 04/23/2024] [Revised: 05/12/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Abstract
PURPOSE To report the clinical results obtained with fixed short-span (single crowns [SCs] and fixed partial prostheses [FPPs]) implant-supported hybrid composite restorations fabricated through tilting stereolithography (TSLA). METHODS This retrospective clinical study included 85 patients who had been restored with 95 fixed short-span implant-supported hybrid composite (Irix Max®, DWS Systems) restorations (70 SCs and 25 FPPs up to three units) fabricated with TSLA. The full-digital model-free workflow was based on intraoral implant scanning, computer-assisted design (CAD) and 3D printing using TSLA (Dfab®, DWS Systems). The primary outcomes were the marginal adaptation, the quality of the occlusal and interproximal contact points, and the chromatic integration of the restorations, assessed independently by two experienced operators (a prosthodontist and a periodontist). A score from 1 to 5 (with 5 as the highest value, 4 for satisfactory quality, 3 for acceptable quality, and 2 and 1 as the lowest values, expressing unsatisfactory quality) was assigned by each operator to each restoration at delivery. The secondary outcomes were the survival and success of the restorations at the 1-year follow-up. The restoration was defined as successful in the absence of any complications throughout the follow-up period. A statistical analysis was conducted. RESULTS For the quality of the marginal closure and occlusal and interproximal contact points, the 3D-printed hybrid composite restorations scored highly; the aesthetic integration was satisfactory. One year after placement, all restorations survived, with a low incidence (4.2 % overall, 5.7 % SCs) of complications (two abutment screw loosenings, two decementation of the restorations, and one upper portion of the hybrid abutment decemented from the titanium base), for a success rate of 95.8 %. CONCLUSIONS Within the limits of this study (retrospective design, follow-up limited to 1 year from the delivery, and only cemented restorations included) fixed short-span implant-supported hybrid composite crowns and bridges fabricated through TSLA were clinically precise, presenting a low incidence of complications at 1 year. STATEMENT OF CLINICAL RELEVANCE The use of TSLA printing technology can open new perspectives for the treatment of small edentulous gaps with definitive implant-supported prosthetic restorations.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, I. M. Sechenov First State Medical University, 8-2 Trubetskaya Street, Moscow 119991, Russian Federation.
| | | | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, Frankfurt, Germany
| | | | - Lusine G Khachatryan
- Department of Pediatric Diseases, N. F. Filatov Clinical Institute of Children's Health, I. M. Sechenov First State Medical University, Moscow, Russian Federation
| | - Igor Dmitrievich Gordienko
- Department of Pediatric, Preventive Dentistry and Orthodontics, I. M. Sechenov First State Medical University, 8-2 Trubetskaya Street, Moscow 119991, Russian Federation
| | - Oleg Admakin
- Department of Pediatric, Preventive Dentistry and Orthodontics, I. M. Sechenov First State Medical University, 8-2 Trubetskaya Street, Moscow 119991, Russian Federation
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Molinero-Mourelle P, Schimmel M, Forrer FA, Hicklin SP, Raabe C, Chappuis V, Fonseca M. Clinical and radiographic performance of late placed and early loaded dental implants with a conditioned hydrophilic surface in posterior mandible sites: A prospective case series with an 8.5- to 9.5-year follow-up. Clin Implant Dent Relat Res 2024; 26:704-713. [PMID: 38711297 DOI: 10.1111/cid.13333] [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: 01/06/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE To assess the clinical outcomes by means of implant and prosthetic survival of late placed and early loaded implants with a hydrophilic, moderately rough surface for partially edentulous patients after a follow-up of 8.5 to 9.5 years. MATERIALS AND METHODS A prospective case series study involving 15 patients with single, late placed and early loaded implants in the posterior mandible was performed. Clinical and radiographical parameters, including biological and technical complications and patient satisfaction, were assessed. RESULTS From an initial sample of 15 patients, 12 were included. A total of 16 implants were observed. After a mean follow-up of 9 years and 7 months (SD ± 3.8 months), implant success and survival rate were 100%. The prosthetic survival rate was 100%, and the prosthetic success rate was 93.8% since a major chipping was observed. No biological complications were observed, and the mean modified plaque index was 0.03 (SD ± 0.09) with a mean probing pocket depth of 2.95 mm (SD ± 0.09). A mean marginal bone level (MBL) of 0.04 mm (SD ± 0.88) and a mean VAS of 9.42 (SD ± 0.90) for patient satisfaction were recorded. CONCLUSION Late placed and early loaded implants with a moderately rough endosseal surface are a reliable option for rehabilitating partially edentulous patients. An implant survival rate of 100% and a prosthodontic success rate of 93.8% were observed. Patient satisfaction scores were high and peri-implant hard and soft tissues remained healthy. The study findings should be carefully interpreted because of the small sample.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Stefan Paul Hicklin
- Clinic of Preventive Dentistry, Periodontology and Cariology, and Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Clemens Raabe
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Manrique Fonseca
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Balel Y, Zogo A, Yıldız S, Tanyeri H. Can ChatGPT-4o provide new systematic review ideas to oral and maxillofacial surgeons? JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101979. [PMID: 39068990 DOI: 10.1016/j.jormas.2024.101979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE This study aims to evaluate the capacity of ChatGPT-4o to generate new systematic review ideas in the field of oral and maxillofacial surgery. The data obtained from this study will provide evidence-based information to oral and maxillofacial surgeons regarding the academic use of GPT-4o. MATERIALS AND METHODS ChatGPT-4o was asked to provide four previously unpublished systematic review ideas each for the topics of impacted third molars, dental implants, orthognathic surgery, and temporomandibular disorders. A literature search was conducted in the PubMed database to check if the ideas generated by GPT-4o had been previously published, and the search results were compared with the ideas generated by the AI. RESULTS The PubMed database search resulted in a total of 871 publications, with 37 publications found to be related to the topics generated by GPT-4o after the first and second screening. Out of the 16 publication ideas generated by GPT-4o, 9 (56.25 %) were determined to be previously unexplored according to the PubMed database search. There was no statistically significant relationship between the presence of ChatGPT's suggestions in PubMed and the subject areas of the studies. CONCLUSION ChatGPT-4o has a high potential to be used as a valuable tool for suggesting systematic review topics in oral and maxillofacial surgery. Additionally, this tool can assist researchers not only in proposing publication ideas but also in developing the methodology of the study.
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Affiliation(s)
- Yunus Balel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Türkiye.
| | - Atakan Zogo
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, İstanbul Kent University, İstanbul, Türkiye
| | | | - Hakkı Tanyeri
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, İstanbul Kent University, İstanbul, Türkiye
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Chen Z, Wang Y, Sun Z, Zhao J, Lin N, Zheng Y. Clinical evaluation of closed tray impression and intraoral scanning techniques in single posterior tissue-level implant-supported crowns: A self-controlled case study. J Prosthet Dent 2024:S0022-3913(24)00379-2. [PMID: 38955602 DOI: 10.1016/j.prosdent.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 07/04/2024]
Abstract
STATEMENT OF PROBLEM Different techniques have been used to record the locations of dental implants, yet research examining the clinical outcomes of posterior implant-supported prostheses generated by different techniques, particularly concerning their fit, is lacking. PURPOSE The purpose of this self-controlled study was to evaluate the clinical outcomes of closed tray impression making and intraoral scanning for single posterior implant-supported restorations. MATERIAL AND METHODS Eighty-two participants with a single missing posterior tooth were included. The restorations were delivered a minimum of 3 months after tissue-level implant placement. Each participant was provided with 2 screw-retained monolithic zirconia crowns, produced using 3-dimensional (3D) gel deposition from both closed tray impression making (control group) and intraoral scanning using an iTero scanner (experimental group). The recording operating time, the patient comfort assessed using a visual analog scale (VAS), and the fit of the crowns were recorded during clinical evaluation. The paired t test and Mann-Whitney U test were conducted to statistically analyze the differences between the 2 techniques (α=.05). RESULTS Seventy-six participants completed the study with a dropout rate of 7.3%. The mean ±standard deviation recording operating time of the control and experimental groups was 683 ±164 and 777 ±407 s, respectively (P<.05). The mean ±standard deviation VAS score of the control and experimental groups was 2.6 ±1.6 and 1.3 ±1.0, respectively (P<.05). The crowns in both groups showed excellent marginal fit (P>.05), but the occlusal contacts of crowns in the experimental group were significantly better (P<.05), while the interproximal contacts were significantly worse (P<.05) compared with those in the control group. In the control group, 1 crown was rated as Delta for occlusal contact and deemed clinically unacceptable. CONCLUSIONS In single posterior tissue-level implant-supported restorations, the clinical outcomes of most of the screw-retained monolithic zirconia crowns generated from closed tray impression making and intraoral scanning with the iTero system and fabricated by 3D gel deposition were acceptable. Compared with the closed tray impression technique, intraoral scanning resulted in better patient comfort and occlusal contacts but worse interproximal contacts. Efficiency was lower with intraoral scanning.
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Affiliation(s)
- Zhi Chen
- Graduate student, Graduate Prosthodontics, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Ningbo Dental Hospital/Ningbo Oral Health Research Institute, Ningbo, PR China
| | - Yong Wang
- Attending, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Department of Stomatology, Shangcheng District Jiubao Community Health Center of Hangzhou City, Hangzhou, PR China
| | - Zhe Sun
- Resident, Department of General Dentistry, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Jing Zhao
- Attending, Department of General Dentistry, Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Nengjie Lin
- Resident, Department of General Dentistry, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, PR China
| | - Yuanna Zheng
- Professor, School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Ningbo Dental Hospital/Ningbo Oral Health Research Institute, Ningbo, PR China.
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Mahato M, Hota S, Jain A, Dutta D, Bhushan P, Raut A. Comparison of Conventional and Digital Workflows in the Fabrication of Fixed Prostheses: A Systematic Review. Cureus 2024; 16:e61764. [PMID: 38975453 PMCID: PMC11226733 DOI: 10.7759/cureus.61764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/09/2024] Open
Abstract
When considering dental restorations, the use of fixed partial dentures is one of the most widely accepted treatment options. In the past, fabrication was done using traditional techniques and the conventional workflow was by far the popular method; however, nowadays digital workflows are being used as a means to produce the prosthesis. This systematic review aims to compare the workflows by considering their respective qualities, such as precision, efficiency, cost-effectiveness, and clinical performance. A complete search has been carried out to incorporate any relevant studies published between the years 2012 and 2023 in databases such as Scopus, Web of Science, PubMed, ScienceDirect, and Cochrane Library. Two independent reviewers screened articles for inclusion and assessed the studies' methodological quality rating via the NIH Tool. A total of 22 relevant articles were reviewed after a systematic search strategy. The main outcome of the review was digital workflows were found to reduce working time, eliminate the selection of trays, minimize material consumption, and enhance patient comfort and acceptance. The studies also showed that digital workflows resulted in greater patient satisfaction and higher success rates than conventional workflows. Workflows for digital dentistry demonstrated to be better than traditional ones due to the cost-effectiveness, accuracy, and time optimization for the fabrication of fixed prostheses.
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Affiliation(s)
- Mousumi Mahato
- Prosthodontics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Sadananda Hota
- Prosthodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Amulya Jain
- Prosthodontics and Crown and Bridge, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Debanwita Dutta
- Prosthodontics, Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Purnendu Bhushan
- Prosthodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
| | - Anjana Raut
- Prosthodontics, Kalinga Institute of Dental Sciences, Kalinga Institute of Industrial Technology (KIIT) DU, Bhubaneswar, IND
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Beck F, Zupancic Cepic L, Lettner S, Moritz A, Ulm C, Zechner W, Schedle A. Clinical and Radiographic Outcomes of Single Implant-Supported Zirconia Crowns Following a Digital and Conventional Workflow: Four-Year Follow-Up of a Randomized Controlled Clinical Trial. J Clin Med 2024; 13:432. [PMID: 38256565 PMCID: PMC10816133 DOI: 10.3390/jcm13020432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/29/2023] [Accepted: 01/01/2024] [Indexed: 01/24/2024] Open
Abstract
PURPOSE This study aimed to compare the clinical and radiographic outcomes of single posterior screw-retained monolithic implant crowns following a digital and conventional workflow and to report on the survival/complication rate after a mean 4-year follow-up. MATERIALS AND METHODS Thirty patients with a single posterior tooth missing were rehabilitated with a bone-level implant. After a healing period of ≥3 months, they were subjected to both a digital and conventional workflow to fabricate two screw-retained monolithic implant crowns. The quantitative clinical adjustments to both crowns (intrasubject comparison) and a questionnaire were recorded at try-in. Thereafter, a crown of the digital and conventional workflows was randomly inserted. At the last follow-up, the marginal bone level (MBL), peri-implant health-related parameters (bleeding on probing (BoP), plaque, pocket probing depth (PPD)), and functional implant prosthodontic score (FIPS) were assessed. Furthermore, the implant survival and success rates and technical complications were evaluated. RESULTS A total of 27 patients were followed for a mean period of 4.23 ± 1.10 years. There was no significant difference between the digital and conventional workflows regarding clinical adjustments and questionnaire outcomes. More than twice as many participants recommended digital (n = 16) compared to conventional impressions (n = 7) to friends. The implant survival and success rate were 100% and 96.3%, respectively. Furthermore, two de-cementations and one fracture of the ti-base abutment occurred. There were no significant differences in BoP, plaque, and PPD metrics between the two groups. The changes in the MBL between implant crown insertion (baseline) and the last follow-up were 0.07 ± 0.19 mm and 0.34 ± 0.62 mm in the digital and conventional groups, respectively (p = 0.195). The mean overall FIPS score was 8.11 ± 1.37 (range: 5-10). CONCLUSIONS The clinical and radiographic outcomes of single screw-retained monolithic implant crowns were similar between both workflows after a mean of 4 years of service. The patients did not clearly prefer an impression technique for their restoration, although they would recommend the digital impression more often to friends. Thus, decision regarding clinical workflows may be based on the patient's and/or clinician's preference.
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Affiliation(s)
- Florian Beck
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Lana Zupancic Cepic
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Lettner
- Austrian Cluster for Tissue Regeneration, Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, 1200 Vienna, Austria
- Core Facility Hard Tissue Research and Biomaterial Research, Karl Donath Laboratory, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Andreas Moritz
- Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
- Division for Dental Student Training and Patient Care, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Christian Ulm
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Werner Zechner
- Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
| | - Andreas Schedle
- Competence Center Dental Materials, University Clinic of Dentistry, Medical University of Vienna, 1090 Vienna, Austria
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Schierz O, Hirsch C, Krey KF, Ganss C, Kämmerer PW, Schlenz MA. DIGITAL DENTISTRY AND ITS IMPACT ON ORAL HEALTH-RELATED QUALITY OF LIFE. J Evid Based Dent Pract 2024; 24:101946. [PMID: 38401951 DOI: 10.1016/j.jebdp.2023.101946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 02/26/2024]
Abstract
Over the past 50 years, digitization has gradually taken root in dentistry, starting with computer tomography in the 1970s. The most disruptive events in digital dentistry were the introduction of digital workflow and computer-aided manufacturing, which made new procedures and materials available for dental use. While the conventional lab-based workflow requires light or chemical curing under inconsistent and suboptimal conditions, computer-aided manufacturing allows for industrial-grade material, ensuring consistently high material quality. In addition, many other innovative, less disruptive, but relevant approaches have been developed in digital dentistry. These will have or already impact prevention, diagnosis, and therapy, thus impacting patients' oral health and, consequently, their oral health-related quality of life. Both software and hardware approaches attempt to maintain, restore, or optimize a patient's perceived oral health. This article outlines innovations in dentistry and their potential impact on patients' oral health-related quality of life in prevention and therapy. Furthermore, possible future developments and their potential implications are characterized.
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Affiliation(s)
- Oliver Schierz
- Department of Prosthetic Dentistry and Material Sciences, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Christian Hirsch
- Clinic of Pediatric and Preventive Dentistry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Karl-Friedrich Krey
- Department of Orthodontics and Craniofacial Orthopedics, University Medicine Greifswald, Greifswald, Germany
| | - Carolina Ganss
- Department for Operative Dentistry, Endodontics, and Pediatric Dentistry, Section Cariology, Philipps-University Marburg, Marburg, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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Vavrickova L, Kapitan M, Schmidt J. Patient-reported outcome measures (PROMs) of digital and conventional impression methods for fixed dentures. Technol Health Care 2024; 32:885-896. [PMID: 37661898 DOI: 10.3233/thc-230277] [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] [Indexed: 09/05/2023]
Abstract
BACKGROUND Digital impression technique or computer-aided impression (CAI) has been recently concluded as a clinically acceptable alternative to conventional impression method (CIM) in the fabrication of crowns, short fixed partial dentures (FPDs), and implant-supported crowns. OBJECTIVE The purpose of this study was to investigate the patients' opinion and subjective perception of two different ways of impression - digital and conventional. METHODS A total of 45 patients were treated with CAI and CIM for the fabrication of tooth or implant-supported crowns. They fulfilled a questionnaire including 11 questions regarding the treatment time, gag reflex, discomfort related to manipulation, and other aspects of treatment. RESULTS CAI was considered the preferential method for future treatment in 53% of patients, whereas 28.9% of the respondents preferred CIM. The preference for the impression method was influenced by the total time spent with the procedure, discomfort during manipulation with the tray or scanning head, size of the tray or scanning head, maximal opening discomfort, and (the tendency towards) gag reflex. CONCLUSION CAI was considered a more comfortable and preferential method. Discomfort or difficulties during CAI negatively affected the patients' attitude to CAI, whereas the difficulties associated with CIM did not have any influence on the preferred method.
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Blasi A, Henarejos-Domingo V, Palacios-Bañuelos R, Vidal-Ponsoda C, Aparicio C, Roig M. CAD-CAM and analog occlusal splints comparison based on the amount of occlusal adjustments. 3D analysis of the volumetric changes: A pilot study. J ESTHET RESTOR DENT 2023; 35:1271-1278. [PMID: 37395327 DOI: 10.1111/jerd.13080] [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: 05/11/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To evaluate the volumetric changes on occlusal surface of computer-aided design and computer-aided manufacturing (CAD-CAM) occlusal devices fabricated following a fully digital workflow after occlusal adjustment, compared to those fabricated with an analog workflow. MATERIALS AND METHODS Eight participants were included in this clinical pilot study, receiving two different occlusal devices fabricated with two different workflows, fully analog and fully digital. Every occlusal device was scanned before and after the occlusal adjustments to compare the volumetric changes using a reverse engineering software program. Moreover, three independent evaluators assessed a semi-quantitative and qualitative comparison using visual analog scale and dichotomous evaluation. The Shapiro-Wilk test was performed to validate normal distribution assumption, and a dependent t-Student test for paired variables was used to determine statistically significant differences (p-value < 0.05). RESULTS The root mean square value was extracted from the 3-Dimensional (3D) analysis of the occlusal devices. The average values of the root mean square were higher for the analogic technique (0.23 ± 0.10 mm) than the digital technique (0.14 ± 0.07 mm) but the differences were not statistically significant (paired t-Student test; p = 0.106) between the two fabrication techniques. The semiquantitative visual analog scale values between the impression for the digital (5.08 ± 2.4 cm) and analog (3.80 ± 3.3 cm) technique were significant (p < 0.001), and statistically significant differences values were assessed for evaluator 3 compared to the other evaluators (p < 0.05). However, the three evaluators agreed on the qualitative dichotomous evaluation in 62% of the cases, and at least two evaluators agreed in 100% of the evaluations. CONCLUSIONS Occlusal devices fabricated following a fully digital workflow resulted in fewer occlusal adjustments, as they could be a valid alternative to those fabricated following an analog workflow. CLINICAL SIGNIFICANCE Fabricated occlusal devices following a fully digital workflow could have some advantages over analog workflow such reduce occlusal adjustments at delivery appointment, which can result in reduced chair time and therefore increased comfort for the patient and clinician.
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Affiliation(s)
- Alvaro Blasi
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
- Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, Georgia
| | - Víctor Henarejos-Domingo
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
| | - Ricardo Palacios-Bañuelos
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
| | - Carla Vidal-Ponsoda
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
| | - Conrado Aparicio
- Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
| | - Miguel Roig
- Faculty of Dentistry, Department of Restorative Dentistry, International University of Catalunya, Barcelona, Spain
- Faculty of Dentistry, International University of Catalunya, Barcelona, Spain
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Klein M, Tuminelli FJ, Sallustio A, Giglio GD, Lerner H, Berg RW, Waltuch A. Full-arch restoration with the NEXUS IOS® system: A retrospective clinical evaluation of 37 restorations after a one year of follow-up. J Dent 2023; 139:104741. [PMID: 37832627 DOI: 10.1016/j.jdent.2023.104741] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/08/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023] Open
Abstract
OBJECTIVES Report the results with a novel workflow of digital restoration for completely edentulous patients with implant supported full arch fixed dental prostheses (ISFDP). METHODS This multicenter retrospective clinical study was based on the evaluation from a cohort of 29 patients restored with 37 ISFDP designed and manufactured from the data captured by a direct intraoral scan, using a novel full digital system (NEXUS IOS®, Osteon Medical, a Keystone Dental Group company, Melbourne, Australia). Data was collected over a 3-year period, in six different dental centers. This study reported on the clinical parameters including: precision of marginal fit, functional and aesthetic integration of Nexus ISFDP. All patients were followed for a period of one year post delivery. Implant survival, biologic and prosthetic complications were assessed, at one year. A statistical analysis was conducted. RESULTS All 37 ISFDP were deemed clinically acceptable on insertion. Implant survival at one year was 100 %. The biologic and prosthetic complications were minimal during the follow-up period. CONCLUSIONS ISFDP, designed and manufactured using the NEXUS IOS® system, are clinically acceptable, with a low incidence of complications at one year. Long-term clinical studies are needed. STATEMENT OF CLINICAL RELEVANCE Within the limitations of this study (retrospective design, small patient sample, limited follow-up) the NEXUS IOS® system seems to represent a viable solution for the restoration of completely edentulous patients with ISFDP, in a full digital workflow.
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Affiliation(s)
| | - Frank J Tuminelli
- Diplomate & Director, American Board of Prosthodontics, Director, Graduate Prosthodontics VA NY Harbor Healthcare System, Adjunct Clinical Instructor, NYU Dental School, Clinical Assistant Professor, Hofstra Northwell School of Medicine, New York, NJ, USA
| | - Anthony Sallustio
- Chief of Maxillofacial Prosthetics, The Regional Craniofacial Center, St. Joseph's Hospital, Paterson, NJ, USA
| | | | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe-University, Frankfurt am Main, Private Practice, Baden, Germany
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Ioannidis A, Pala K, Strauss FJ, Hjerppe J, Jung RE, Joda T. Additively and subtractively manufactured implant-supported fixed dental prostheses: A systematic review. Clin Oral Implants Res 2023; 34 Suppl 26:50-63. [PMID: 37750533 DOI: 10.1111/clr.14085] [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: 02/06/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 09/27/2023]
Abstract
AIM To compare and report on the performance of implant-supported fixed dental prostheses (iFDPs) fabricated using additive (AM) or subtractive (SM) manufacturing. METHODS An electronic search was conducted (Medline, Embase, Cochrane Central, Epistemonikos, clinical trials registries) with a focused PICO question: In partially edentulous patients with missing single (or multiple) teeth undergoing dental implant therapy (P), do AM iFDPs (I) compared to SM iFDPs (C) result in improved clinical performance (O)? Included were studies comparing AM to SM iFDPs (randomized clinical trials, prospective/retrospective clinical studies, case series, in vitro studies). RESULTS Of 2'184 citations, no clinical study met the inclusion criteria, whereas six in vitro studies proved to be eligible. Due to the lack of clinical studies and considerable heterogeneity across the studies, no meta-analysis could be performed. AM iFDPs were made of zirconia and polymers. For SM iFDPs, zirconia, lithium disilicate, resin-modified ceramics and different types of polymer-based materials were used. Performance was evaluated by assessing marginal and internal discrepancies and mechanical properties (fracture loads, bending moments). Three of the included studies examined the marginal and internal discrepancies of interim or definitive iFDPs, while four examined mechanical properties. Based on marginal and internal discrepancies as well as the mechanical properties of AM and SM iFDPs, the studies revealed inconclusive results. CONCLUSION Despite the development of AM and the comprehensive search, there is very limited data available on the performance of AM iFDPs and their comparison to SM techniques. Therefore, the clinical performance of iFDPs by AM remains to be elucidated.
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Affiliation(s)
- Alexis Ioannidis
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Kevser Pala
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jenni Hjerppe
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Tim Joda
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, University of Basel, Basel, Switzerland
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Chantler JGM, Evans CDJ, Zitzmann NU, Derksen W. Clinical performance of single implant prostheses restored using titanium base abutments: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34 Suppl 26:64-85. [PMID: 37750524 DOI: 10.1111/clr.14128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 09/27/2023]
Abstract
PURPOSE The aim of this review was to evaluate the survival rates of restorations utilizing titanium base abutments (TBA) for restoring single-unit implant prostheses. MATERIALS AND METHODS This review was conducted following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The focus question was: In patients who require the restoration of a single dental implant utilizing a titanium base abutment, what are the determining factors and outcomes relating to implant prosthesis prognosis and survival? A comprehensive search of databases (PubMed, EMBASE, and Cochrane Library) was conducted on 16 April 2023 and updated on 5 May 2023. Randomized clinical trials (RCT), retrospective studies and prospective studies, reporting on the use of TBA for single implant prostheses, were reviewed. A Cochrane collaboration risk of bias assessment analysis was performed for randomized clinical studies, and the Newcastle-Ottawa Scale tool was applied for non-randomized studies. A meta-analysis was performed on clinical trials reporting on survival rates of both TBA and other abutments. Other clinical studies, reporting on TBA only, were included for descriptive statistics. RESULTS The search provided 1159 titles after duplicates were removed. Six RCTs were included to perform a meta-analysis and compare the survival of the TBA to other abutments [OR 0.74; 95% CI: 0.21-2.63, heterogeneity; I2 0%; p = .99]. Twenty-three prospective and retrospective studies fulfilled the criteria and were included in the meta-analysis after 12 months of function. A total of 857 single implant-supported prostheses fabricated with a TBA were included. TBA abutments have an estimate 98.6% survival rate after 1 year in function (95% CI: 97.9%-99.4%). The mean follow-up period was 31.2 ± 16.9 months. CONCLUSIONS Single implant prosthesis restored with titanium base abutments showed favourable short-term survival rates.
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Affiliation(s)
| | | | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University of Basel, Basel, Switzerland
| | - Wiebe Derksen
- Department of Oral Implantology and Prosthetic Dentistry, Amsterdam, Netherlands
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The Complete Digital Workflow in Fixed Prosthodontics Updated: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11050679. [PMID: 36900684 PMCID: PMC10001159 DOI: 10.3390/healthcare11050679] [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: 01/23/2023] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023] Open
Abstract
Digital applications have changed therapy in prosthodontics. In 2017, a systematic review reported on complete digital workflows for treatment with tooth-borne or implant-supported fixed dental prostheses (FDPs). Here, we aim to update this work and summarize the recent scientific literature reporting complete digital workflows and to deduce clinical recommendations. A systematic search of PubMed/Embase using PICO criteria was performed. English-language literature consistent with the original review published between 16 September 2016 and 31 October 2022 was considered. Of the 394 titles retrieved by the search, 42 abstracts were identified, and subsequently, 16 studies were included for data extraction. A total of 440 patients with 658 restorations were analyzed. Almost two-thirds of the studies focused on implant therapy. Time efficiency was the most often defined outcome (n = 12/75%), followed by precision (n = 11/69%) and patient satisfaction (n = 5/31%). Though the amount of clinical research on digital workflows has increased within recent years, the absolute number of published trials remains low, particularly for multi-unit restorations. Current clinical evidence supports the use of complete digital workflows in implant therapy with monolithic crowns in posterior sites. Digitally fabricated implant-supported crowns can be considered at least comparable to conventional and hybrid workflows in terms of time efficiency, production costs, precision, and patient satisfaction.
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Same-Day Digital Dentistry Restorative Workflow for Single Immediate Provisionalization of Narrow-Diameter Implants: An Exploratory Prospective Study. PROSTHESIS 2023. [DOI: 10.3390/prosthesis5010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
This study evaluated the two-year clinical outcomes of 3.1 mm diameter dental implants, immediately provisionalized and later restored using same-day dentistry, in 10 patients receiving 11 narrow-diameter (3.1 mm) single implants. Each implant was placed and immediately restored with a provisional crown after placement. At least 2 months after placement, the implant was restored with a prefabricated titanium abutment and an all-ceramic crown using a same-day dentistry protocol. Clinical outcomes, including apical bone loss, probing depths, gingival index, and surgical and prosthetic complications, were documented. There was no implant failure over the course of two years. No surgical complications were reported. Two cases lost provisional crowns. One crown needed to be remade due to esthetic concern. The cumulative two-year survival rate of the implants was 100%. Implant bone loss after two years of functional loading was −0.56 ± 0.54 mm and −0.32 ± 0.68 mm for mesial and distal crestal bone, respectively. Two prosthetic complications included recementation of a crown and remaking of a crown. This exploratory study suggests that immediate provisionalization and a same-day restorative dentistry digital workflow protocol for narrow-diameter implants appear to be predictable clinical procedures with no reported surgical complications and minimal prosthetic complications.
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Gintaute A, Zitzmann NU, Brägger U, Weber K, Joda T. Patient-reported outcome measures compared to professional dental assessments of monolithic ZrO 2 implant fixed dental prostheses in complete digital workflows: A double-blind crossover randomized controlled trial. J Prosthodont 2023; 32:18-25. [PMID: 35938349 PMCID: PMC10087166 DOI: 10.1111/jopr.13589] [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: 06/07/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE This double-blind randomized controlled trial analyzed patient-reported outcome measures in terms of subjective patient satisfaction compared to objective dental evaluation of prosthetic treatment with 3-unit monolithic zirconium dioxide implant fixed dental prostheses (iFDPs) in 3 digital workflows. MATERIAL AND METHODS Twenty patients were restored with 3 iFDPs each on Straumann TL-implants with 2 completely digital workflows using different intraoral optical scanning systems with model-free fabrication of the restoration (Trios 3/3Shape [Test-1]; Virtuo Vivo/Straumann [Test-2]), and mixed analog-digital workflow with conventional impressions and digitized gypsum casts (Impregum/3M Espe [Control]). The order of impression-taking and the prosthetic try-in were randomly allocated. Sixty iFDPs were compared for patient satisfaction and dental evaluation using ANOVA. RESULTS For iFDP evaluation, patients generally provided more favorable ratings than dental experts, regardless of the workflow. ANOVA revealed no significant difference for overall satisfaction when comparing Test-1, Test-2, or Control, either for patients (f-ratio: 0.13; p = 0.876) or dentist (f-ratio: 1.55: p = 0.221). Secondary, patients clearly favored the digital impression workflows over the conventional approach (f-ratio: 14.57; p < 0.001). Overall, the 3Shape workflow (Test-1) received the highest scores for all analyses. CONCLUSIONS The different digital workflows demonstrated minor influence on the subjective and objective evaluation of the monolithic zirconium dioxide iFDPs in nonesthetic regions; however, the dentist may significantly increase patient satisfaction by choosing intraoral scanning instead of conventional impressions. The dentist has to consider individual patients' needs to fulfill their expectations for a personalized solution.
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Affiliation(s)
- Aiste Gintaute
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Nicola U Zitzmann
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Karin Weber
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Tim Joda
- Department of Reconstructive Dentistry, University Center for Dental Medicine, University of Basel, Basel, Switzerland.,Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Chandran S, Sers L, Picciocchi G, Luongo F, Lerner H, Engelschalk M, Omar S. Guided implant surgery with R2Gate®: A multicenter retrospective clinical study with 1 year of follow-up. J Dent 2022; 127:104349. [PMID: 36283626 DOI: 10.1016/j.jdent.2022.104349] [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: 09/23/2022] [Revised: 10/18/2022] [Accepted: 10/20/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE To present the results obtained with a novel sleeveless and keyless guided implant surgery system. METHODS Inclusion criteria for this multicenter clinical retrospective study were fully or partially edentulous patients who had been treated with a sleeveless and keyless guided implant surgery system (R2Gate®, Megagen), and who had been rehabilitated with fixed restorations, with a minimum follow-up of 1 year. All surgeries and prosthetic procedures were conducted following the same protocol, and data were obtained from the patients' medical records. The outcomes were the fit and stability of the surgical guide, any intra-operative and immediate post-operative complications, any biologic and prosthetic complications that occurred during the 1-year follow-up period, implant survival, and prosthetic success. RESULTS Sixty patients were selected for the installation of 124 implants, through a guided procedure: 66 sleeveless, keyless surgical guides were manufactured. The incidence of immediate intra-operative (lack of space: 12.1%; lack of implant stability 2.6%) and immediate post-operative (pain and discomfort: 6.6%; mild swelling 3.3%) complications was low. In total, 112/124 implants (90.3%) were successfully placed with a guided procedure, in 52 patients; among them, 82 (73.2%) were placed with a flapless procedure. Thirty fixtures supported single crowns (SCs), 42 fixed partial dentures (FPDs) and 52 full-arch (FA) restorations. Sixty-two fixed prosthetic restorations (30 SCs, 22 FPDs and 10 FAs) were delivered; among these restorations, 15 (24.1%) were subjected to immediate functional loading. All implants (100%) survived. Two implants had peri‑implant mucositis (1.6%), two SCs had abutment screw loosenings (1.6%), two FAs and one FPD had ceramic chipping/fracture (2.4%), for an overall prosthetic success amounting to 88.7%. CONCLUSIONS Within the limits of this study, this novel guided surgery system appeared to be clinically reliable; further studies are needed to confirm these results. STATEMENT OF CLINICAL RELEVANCE The use of sleveless and keyless surgical guides can be clinically reliable and may be represent a valid option for the surgeon.
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Affiliation(s)
- Segin Chandran
- Research Fellow, Santosh University, No.1 Santosh Nagar, Pratap Vihar, Ghaziabad, Uttar Pradesh 201009, India
| | - Laurent Sers
- Private Practitioner, 54 Rue d'Antibes, Cannes 06400, France
| | - Guido Picciocchi
- Private Practitioner, via Brigata Liguria 3, Genova 16121, Italy
| | | | - Henriette Lerner
- Department of Oral, Maxillofacial and Plastic Surgery, Goethe University, Frankfurt, Germany
| | | | - Sam Omar
- Private Practitioner, OneDay Clinic, Shalz Mall, G2C4 2nd floor, El Sheikh Zayed City 7th District, Mogawra 2, Giza, Governorate 12593, Egypt; OneDay Digital Academy, Shalz Mall, G2C13 2nd Floor, El Sheikh Zayed City 7th District, Mogawra 2, Giza, Governorate 12593, Egypt.
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Bjelopavlovic M, Weyhrauch M, Scheller H, Wentaschek S, Lehmann KM. Retentive Strength of CAD/CAM-Fabricated All-Ceramic Crowns Luted on Titanium Implant Abutments Using Different Ceramic Materials and Luting Agents: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6968. [PMID: 36234309 PMCID: PMC9571208 DOI: 10.3390/ma15196968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
Objectives: This study aimed to determine the retentive strength of monolithic hybrid-all-ceramic crowns luted on titanium implant abutments. Material and Methods: In total, 450 crowns (75 each of Mark II, Empress CAD, e.max CAD, Suprinity, Enamic, Celtra Duo) were milled using a CAD/CAM system. The crowns were cemented onto sandblasted titanium implant abutments using five luting agents (Multilink Implant, Variolink II, RelyX Unicem, Fujicem, and Panavia 2.0). After thermocycling was performed (5000 cycles: 5−55 °C, 30-s dwell time), the crowns were removed using a universal testing machine. The location of luting-agent residue on the abutment and inner crown surfaces was evaluated. Analyses of variance (ANOVA) with the Bonferroni correction were performed to evaluate differences of retentive strength depending on the crown material and the kind of the luting agent. Results: The retentive strengths for the different ceramic materials were Vita Mark II: 652N-759N (SD:134N-146N), Empress CAD: 681N-822N (SD: 89N-146N), e.max CAD: 784N-1044N (SD: 109N-176N), Vita Enamic: 716N-1177N (SD: 132N-220N), Vita Suprinity: 867N-1488N (SD: 202N-278N), and Celtra Duo 772N-1335N (SD:151N-229N). After the removal trials, the visual documentation showed different adhesive residue location depending on the ceramic materials. Furthermore, the pull-off force was dependent on the choice of adhesives. No significant differences were found between different luting agents and the ceramic material Vita Mark II and Empress CAD. EmaxCAD showed significant differences with Unicem and FujiCem compared to Panavia, as did VitaSuprinity, VitaEnamic, and Celtra Duo (p < 0.001). Conclusions: The ceramic material used seems to influence the retentive strength and the use of certain luting agents results in a higher retentive strength for some ceramic materials.
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Affiliation(s)
- Monika Bjelopavlovic
- Department of Prosthetic Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
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