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Ramadan RE, Bahgat MM, Abdelhamid AM, Khamis MM. Registration of maxillomandibular relationship through a fully digital workflow for complete-mouth rehabilitation with screw-retained fixed implant-supported prostheses: A clinical report. J Prosthet Dent 2024; 132:6-13. [PMID: 36609083 DOI: 10.1016/j.prosdent.2022.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 01/06/2023]
Abstract
Digital recording of the maxillomandibular relationship by using intraoral scanning in completely edentulous patients for computer-aided design and computer-aided manufacture implant-supported prostheses can be challenging. This clinical report describes the fabrication of complete arch, screw-retained implant-supported prostheses in a completely edentulous patient with a fully digital workflow.
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Affiliation(s)
- Rania E Ramadan
- Assistant Lecturer, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Mariam M Bahgat
- Assistant Lecturer, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ahmed M Abdelhamid
- Professor, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Moataz Khamis
- Professor and Chairman, Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Juntavee N, Juntavee A, Jaralpong C. Color Characteristics of High Yttrium Oxide-Doped Monochrome and Multilayer Partially Stabilized Zirconia upon Different Sintering Parameters. Eur J Dent 2024. [PMID: 38942053 DOI: 10.1055/s-0044-1787700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVES Sintering influences the optical properties of zirconia. This study examined the effect of altering sintering temperature and time of monochrome (Mo) and multilayer (Mu) 5 mol% yttria-partially stabilized zirconia (5Y-PSZ) on color characteristics. MATERIALS AND METHODS Three hundred specimens (width × length × thickness = 10 × 20 × 2 mm) were prepared from Mo and Mu (with cervical [C], middle [M], and incisal [I] region) 5Y-PSZ and randomly sintered at decreasing (Td: 1,450°C), regular (Tr: 1,500°C), and increasing (TI: 1,550°C) sintering temperature, with extremely short (He: 10 minutes), ultrashort (Hu: 15 minutes), short (Hs: 30 minutes), and regular (Hr: 135 minutes) sintering time (n = 15/group). Color appearance (EW ), translucency parameter (TP), contrast ratio (CR), opalescence parameter (OP), and color appearance difference (∆E diff) were evaluated in the CIE L*a*b* system. Microstructures were evaluated by scanning electron microscope (SEM) and X-ray diffractometer (XRD). STATISTICAL ANALYSIS Analysis of variance (ANOVA) and Bonferroni comparisons were determined for significant differences (p < 0.05). RESULTS Significant differences in color parameters upon zirconia type, sintering temperature, and sintering time, and their interactions were indicated (p < 0.05). Increasing sintering temperature and extended sintered time resulted in larger grain, reduced tetragonal-to-monoclinic phase transformation, and significantly increased the TP and OP, but decreased the CR and ∆E diff (p < 0.05). Decreasing sintering temperature and time led to clinically unacceptable color appearance. CONCLUSION Mo was found to be more translucent than Mu. To achieve the most favorable optical properties, increasing sintering temperature and extending sintering time are recommended. Decreasing sintering temperature is not suggested. However, shortened sintering time is feasible, but it needs sintering with increasing sintering temperature to achieve a promising color appearance.
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Affiliation(s)
- Niwut Juntavee
- Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Apa Juntavee
- Department of Preventive Dentistry, Division of Pediatric Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Chutikarn Jaralpong
- Division of Biomaterials and Prosthodontics Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Juntavee N, Juntavee A, Jaralpong C. Flexural Strength of Two Multilayered and Monochromatic High Yttria Containing Zirconia Materials Following Different Sintering Parameters. Eur J Dent 2024; 18:551-562. [PMID: 37729931 PMCID: PMC11132776 DOI: 10.1055/s-0043-1772569] [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] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVES Sintering parameters influence the properties of zirconia. This study examined the effect of altering sintering temperature and time of monochrome and multilayer 5 mol% yttria-partially stabilized zirconia (5Y-PSZ) on flexural strength. MATERIALS AND METHODS Three hundred specimens (width × length × thickness = 10 × 20 × 2 mm) were prepared from monolayer (ZX) and multilayer (ZM) 5Y-PSZ and randomly sintered at decreasing (TD: 1,450°C), regular (TR: 1,500°C), and increasing (TI: 1,550°C) sintering temperature, with extremely short (HE: 10 minutes), ultrashort (HU: 15 minutes), short (HS: 30 minutes), and regular (HR: 135 minutes) sintering time (n = 15/group). The precrack was induced on the tension side before testing for flexural strength (σ). STATISTICAL ANALYSIS Analysis of variance and Tukey's test were used for significant differences of σ at p < 0.05. The microstructure and crystalline (monoclinic; m, tetragonal; t, cubic; c) phase were evaluated by scanning electron microscope (SEM) and X-ray diffractometer (XRD). RESULTS ZXTIHS indicated the highest σ for ZX (315.81 ± 18.91 MPa), whereas ZMTIHS indicated the highest σ for ZM (335.21 ± 36.18 MPa). There was no significant difference for σ between ZX and ZM (p > 0.05). Sintering zirconia at TI or HR indicated significantly higher σ than sintering at TD or TR or with HS, HE, or HU for both ZX and ZM (p < 0.05). There was no significant difference for σ between TRHR and TIHS, TIHU, and TIHE (p > 0.05). SEM indicated intergranular and transgranular fractures. XRD revealed predominately c- and t-phases and minor amounts of m-phase. CONCLUSION Increasing sintered temperature with decreasing time offers acceptable strength to regular sintering. Raising sintering temperature with decreasing time is suggested to facilitate chairside restorative reconstruction.
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Affiliation(s)
- Niwut Juntavee
- Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Apa Juntavee
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Chutikarn Jaralpong
- Division of Biomaterials and Prosthodontics Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Menini M, Delucchi F, Bagnasco F, Baldi D, Canullo L, Setti P, Migliorati M, Simetti E, Pesce P. Shock Absorption Capacity of High-Performance Polymers for Dental Implant-Supported Restorations: In Vitro Study. Dent J (Basel) 2024; 12:111. [PMID: 38668023 PMCID: PMC11048904 DOI: 10.3390/dj12040111] [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: 01/23/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Restorative materials might significantly affect load transmission in peri-implant bone. The aim of the present study is to evaluate the shock absorption capacity of two different polymeric materials to be used for implant-supported prostheses. METHODS A masticatory robot was used to compare the shock absorption capacity of veneered and non-veneered polyetherketoneketone (PEKK), Pekkton®ivory (Cendres+Mètaux), and the glass fiber-reinforced composite (GFRC), TRINIATM (Bicon). Five identical sample crowns for each of the three groups were tested. Forces transmitted at the simulated peri-implant bone were recorded and statistically analyzed. RESULTS The statistical analysis of forces transmitted at the simulated dental implant revealed significant differences between the materials tested and between these materials and zirconia, glass ceramic, composite resin, and acrylic resin. Only differences between PEKK and veneered PEKK and between PEKK and one of the previously tested composite resins were not statistically significant. PEKK samples demonstrated significantly greater shock absorption capacity compared to GFRC. CONCLUSIONS PEKK revealed optimal shock absorption capacity. Further studies are needed to evaluate its efficacy in the case of long-span prostheses with reduced prosthetic volume.
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Affiliation(s)
- Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | - Francesca Delucchi
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | - Francesco Bagnasco
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | - Domenico Baldi
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | - Luigi Canullo
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
| | | | - Marco Migliorati
- Orthodontic Division, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy;
| | - Enrico Simetti
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genova, 16132 Genova, Italy
| | - Paolo Pesce
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genova, 16132 Genova, Italy; (F.D.); (F.B.); (D.B.); (L.C.); (P.P.)
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De Giorgis L, Pesce P, Barberis F, Lagazzo A, Pera F, Baldi D, Canullo L, Menini M. Fiber-Reinforced Composites for Full-Arch Implant-Supported Rehabilitations: An In Vitro Study. J Clin Med 2024; 13:2060. [PMID: 38610826 PMCID: PMC11012982 DOI: 10.3390/jcm13072060] [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: 02/08/2024] [Revised: 03/07/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Fiber-reinforced composites (FRCs) have been proposed as an alternative to traditional metal alloys for the realization of frameworks in full-arch implant-supported prostheses. The aim of the present in vitro study was to evaluate the deflection under load of seven prostheses endowed with frameworks made of different materials, including different types of fiber-reinforced composites (FRCs). Methods: A master cast with four implant analogues in correspondence with the two lateral incisors and the two first molars was used to create full-arch fixed prostheses with the same shape and different materials. Prostheses were made of the following different materials (framework+veneering material): gold alloy+resin (Au+R), titanium+resin (Ti+R), FRC with multidirectional carbon fibers+resin (ICFRC+AR), FRC with unidirectional carbon fibers+composite (UCFRC+C), FRC with glass fibers+resin (GFRC+AR), FRC with glass fibers+composite (GFRC+C), and resin (R, fully acrylic prosthesis). Flexural tests were conducted using a Zwick/Roell Z 0.5 machine, and the deflection of the lower surface of the prosthesis was measured in order to obtain load/deflection graphs. Results: Greater rigidity and less deflection were recorded for UCFRC+C and GFRC+C, followed by Ti+R and Au+R. The greatest deformations were observed for resin alone, ICFRC+R, and GFRC+R. The results were slightly different in the incisal region, probably due to the greater amount of veneering material in this area. Conclusions: When used to realize full-arch frameworks, Au and Ti allow for predictable mechanical behavior with gradual deformations with increasing load. UCFRC also demonstrated good outcomes and less deflection than ICFRCs when loaded. The GFRC full-arch framework may be a valid alternative, although it showed greater deflections. Further studies are needed in order to evaluate how different prosthesis designs and material thicknesses might affect the outcomes.
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Affiliation(s)
- Luisa De Giorgis
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (L.D.G.); (P.P.); (D.B.); (M.M.)
| | - Paolo Pesce
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (L.D.G.); (P.P.); (D.B.); (M.M.)
| | - Fabrizio Barberis
- Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia 15, 16145 Genova, Italy (A.L.)
| | - Alberto Lagazzo
- Department of Civil, Chemical and Environmental Engineering, University of Genoa, Via Opera Pia 15, 16145 Genova, Italy (A.L.)
| | - Francesco Pera
- CIR Dental School, Department of Surgical Sciences, University of Turin, 10126 Torino, Italy;
| | - Domenico Baldi
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (L.D.G.); (P.P.); (D.B.); (M.M.)
| | - Luigi Canullo
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (L.D.G.); (P.P.); (D.B.); (M.M.)
| | - Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences, University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; (L.D.G.); (P.P.); (D.B.); (M.M.)
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Mishra SK, Bhasmey SR, Chowdhary R. Complete-arch implant-supported fixed dental prostheses fabricated with PEEK and PEKK framework: a systematic review. Evid Based Dent 2023; 24:193. [PMID: 37674039 DOI: 10.1038/s41432-023-00928-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/08/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE To evaluate the performance of complete-arch implant-supported fixed dental prostheses (FDPs) fabricated with polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) framework in clinical cases. MATERIALS AND METHODS This systematic review followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was registered in the International Prospective Register of Systematic Reviews with the number CRD42023399494. The electronic database PubMed, Cochrane Library and EBSCOhost were assessed for clinical research and reports on complete-arch implant-supported FDPs fabricated with PEEK and PEKK framework. Human studies with a minimum follow-up of 1 year and published in an English language were the only ones included. RESULTS The initial database and hand search provided 564 articles. Finally, 12 articles published between 2018 and 2022 were included in this systematic review. The mean follow-up ranged from 1 year to 6 years. The included studies reported 119 (114 PEEK, 5 PEKK) complete-arch implant-supported FDPs during 1 year follow-up. The cumulative survival rate of prostheses with PEEK as a framework was 97.3%. Prostheses fractures and complications were found with both PEEK and PEKK frameworks. No implant failure reported with both PEEK and PEKK prostheses. CONCLUSION In short-term follow-up, the complete-arch implant-supported FDPs with PEEK as a framework showed a good survival rate and acceptable health of the supporting tissues. The PEEK framework had shown adhesion issues as the most common prosthetic complication. Limited data were available on PEKK as framework material, so further long-term clinical trials are required.
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Affiliation(s)
- Sunil Kumar Mishra
- Department of Prosthodontics, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India.
| | - Srinivas Rao Bhasmey
- Department of Prosthodontics, Gitam Dental College, Visakhapatnam, Andhra Pradesh, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Sri Siddhartha Dental College and Hospital, Tumkur, Karnataka, India
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Martakoush-Saleh S, Salgado-Peralvo AO, Peña-Cardelles JF, Kewalramani N, Gallucci GO. Evaluating the clinical behavior of veneered zirconia in comparison with monolithic zirconia complete arch implant-supported prostheses: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00497-3. [PMID: 37696747 DOI: 10.1016/j.prosdent.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 09/13/2023]
Abstract
STATEMENT OF PROBLEM Because the use of zirconia in dentistry is relatively new, the number of published studies on the subject is scarce, even though material selection is an important factor in clinical performance. Therefore, a systematic assessment of the impact of the prosthetic material, framework design, veneering material, and manufacturing process is required. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the survival and success rates of feldspathic porcelain veneered zirconia (VZir) in comparison with monolithic zirconia (MZir) complete arch implant-supported prostheses (CAISPs). A secondary objective was to assess the influence of the type of loading, the presence or absence of a cantilever, the type of zirconia used, the location, and the opposing arch on complications rates and patient satisfaction. MATERIAL AND METHODS An electronic search of the MEDLINE database (via PubMed), Scopus, Science Direct, Cochrane Library, and OpenGrey was carried out. The criteria described in the preferred reporting items for systematic reviews and meta-analyses statement were used. The search was restricted from January 2000 to January 2022. RESULTS The systematic search resulted in 20 articles that met the established criteria. In total, 751 patients (VZir=302; MZir=449) with 3038 CAISPs (VZir=368; MZir=2670) were analyzed. Higher prosthetic survival and success rates were found in MZir compared with VZir CAISPs (100% and 95.45%, respectively). The meta-analysis found significantly fewer complications related to MZir (9.4% [4.8%-14.1%]) compared with VZir (33.7% [17.5%-49.9%]). CONCLUSIONS Based on the findings of this systematic review, MZir CAISPs had higher survival and success rates than VZir CAISPs, with significantly fewer prosthetic complications. The influence of factors such as the type of functional loading, the presence of a cantilever, the material used in the prosthodontic workflow, the location of the CAISP, and the type of antagonist arch on the performance of Zir CAISPs remains unclear.
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Affiliation(s)
- Sara Martakoush-Saleh
- Postgraduate student, Department of Dental Clinical Specialties, Complutense University of Madrid, Spain
| | - Angel-Orión Salgado-Peralvo
- Professor, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University of Madrid, Spain.
| | - Juan-Francisco Peña-Cardelles
- Professor, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Naresh Kewalramani
- Professor, Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, Madrid, Spain
| | - German O Gallucci
- Professor and Department Chair, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
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Sun J, Pu T, Ding Q, Xu H, Kang Y, Zhang L. Digital replication and transfer of interim to definitive complete arch implant-supported fixed prostheses by using a laboratory scanner. J Prosthet Dent 2023:S0022-3913(23)00361-X. [PMID: 37453885 DOI: 10.1016/j.prosdent.2023.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 07/18/2023]
Abstract
The present technique describes an effective digital approach for the replication and transfer of occlusion, maxillomandibular relationship, and esthetic parameters from interim to definitive complete arch implant-supported fixed prostheses by laboratory scanning with transfer plates. Monolithic zirconia complete arch implant prostheses have been fabricated with satisfactory functional and esthetic outcomes.
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Affiliation(s)
- Jiao Sun
- Graduate student, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Tingting Pu
- Dental Technician, Denture Processing Center, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Qian Ding
- Resident, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China.
| | - Hong Xu
- Dental Technician, Denture Processing Center, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - Yanfeng Kang
- MDS Graduate, Department of Prosthodontics and Center for Oral Functional Diagnosis, Treatment and Research, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Lei Zhang
- Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
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Silvestri F, Maille G, Mansuy C, Graillon N, Mense C. Prosthetic rehabilitation of a completely edentulous maxilla with a sectioned implant-supported screw-retained prosthesis in a multiamputee patient with microstomia: A clinical report. J Prosthet Dent 2023:S0022-3913(23)00411-0. [PMID: 37442751 DOI: 10.1016/j.prosdent.2023.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 05/26/2023] [Accepted: 05/26/2023] [Indexed: 07/15/2023]
Abstract
Providing fixed implant-supported prostheses for edentulous patients with microstomia or limited mouth opening is challenging. The clinical treatment of a patient who was a multiple amputee with microstomia and a complete loss of lips elasticity is described. A custom half-sectioned prosthesis was fabricated to resolve numerous difficulties. A screw-retained complete implant-supported prosthesis was developed from a monolithic zirconia framework supported by 4 implants and with digital scanning and computer-aided design and computer-aided manufacturing of the prosthesis. The protocol achieved a complete screw-retained implant-supported prosthesis and offered a solution for a patient with microstomia and limited mouth opening, leading to improved quality of life.
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Affiliation(s)
- Frédéric Silvestri
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France.
| | - Gérald Maille
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
| | - Charlotte Mansuy
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
| | - Nicolas Graillon
- Assistant Professor, School of Medicine, Aix-Marseille University, Marseille, France; and Assistant Professor, Department of Maxillofacial and Oral Surgery, Conception Hospital, Marseille, France
| | - Chloë Mense
- Assistant Professor, Department of Prosthesis and Implantology, School of Dental Medicine, ADES, CNRS, Aix-Marseille University, Marseille, France
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10
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Thompson J, Schoenbaum TR, Pannu D, Knoernschild K. Survival analysis of zirconia implant-supported, fixed complete dentures: A 5-year retrospective cohort study. J Prosthet Dent 2023:S0022-3913(23)00288-3. [PMID: 37286415 DOI: 10.1016/j.prosdent.2023.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/25/2023] [Accepted: 04/26/2023] [Indexed: 06/09/2023]
Abstract
STATEMENT OF PROBLEM Existing data on the mid-term to long-term survival rates of zirconia implant-supported, fixed complete dentures (Zir-IFCDs) are lacking. PURPOSE The purpose of this retrospective clinical study was to assess the prosthetic survival rate in patients treated with Zir-IFCDs. MATERIAL AND METHODS The patient record system at the Dental College of Georgia (DCG), Augusta University was searched to identify all patients treated with Zir-IFCDs from 2015 through 2022 by the DCG graduate prosthodontic, general practice residency, and Advanced Education in General Dentistry (AEGD) programs. Reasons for replacement were grouped as failure of veneering porcelain, framework fracture, implant loss, patient-driven concerns, excessive occlusal wear, and other. RESULTS A total of 67 arches were found that met the inclusion criteria, 46 maxillary and 21 mandibular. The median follow-up time was 8.5 months (interquartile range, 2.7 to 30.9 months). A total of 9 of the 67 arches were identified as having failed (4 maxillary, 5 mandibular), requiring replacement. Reasons for failure were as follows: 3 framework fractures, 2 implant losses, 2 patient-related concerns, 1 fracture of veneering porcelain, and 1 unknown. The combined survival rate (Kaplan-Meier, log-normal modeling) for Zir-IFCDs was 88.8% at 1 year and 72.5% at 5 years CONCLUSIONS: Based on the findings, the Zir-IFCDs investigated had a survival rate lower than that reported in similar studies, though higher than published results for metal-acrylic resin-IFCDs. The most common source of failure was fracture of the zirconia framework. Thickness of the zirconia framework, interocclusal space, cantilever length, occlusal force, and status of the opposing dentition may have been associated with framework failures and should be investigated further.
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Affiliation(s)
- James Thompson
- Resident, Department of Restorative Sciences, Advanced Education in Prosthodontics, The Dental College of Georgia at Augusta University, Augusta, GA
| | - Todd R Schoenbaum
- Professor, Department of Restorative Sciences, The Dental College of Georgia at Augusta University, Augusta, GA.
| | - Darshanjit Pannu
- Program Director, Department of Prosthodontics, The Dental College of Georgia at Augusta University, Augusta, GA
| | - Kent Knoernschild
- Department Chair, Department of Restorative Sciences, The Dental College of Georgia at Augusta University, Augusta, GA
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11
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Oyar P, Durkan R. The effects of heating rate and sintering time on the biaxial flexural strength of monolithic zirconia ceramics. BIOMED ENG-BIOMED TE 2023:bmt-2022-0338. [PMID: 36930871 DOI: 10.1515/bmt-2022-0338] [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: 08/26/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
Abstract
The strength of zirconia ceramic materials used in restorations is dependent upon sintering. Varying sintering protocols may affect the biaxial flexural strength of zirconia materials. This in vitro study was conducted to investigate the effects of sintering parameters on the biaxial flexural strength of monolithic zirconia. Two different monoblock zirconia ceramics were used. Following coloration, samples of both types of ceramics were divided into groups according to whether or not biaxial flexural strength testing was performed directly after sintering or following thermocycling. Biaxial flexural strength data was analysed with a Shapiro Wilk normality test, followed by 1-way ANOVA, Tukey post hoc tests for inter-group comparisons, and paired samples t-tests for intra-group comparisons. A significant difference was found between the biaxial flexural strengths of Zircon X and Upcera ceramics before thermocycling (p<0.05). In both Zircon X and Upcera ceramic groups, the thermocycling process created a significant difference in the biaxial flexural strength values of the ceramic samples in Group 6 (p<0.05) which had the slowest heating rate and longest holding time. The zirconia ceramics have higher BFS at higher heating rates either before or after thermocycling. The holding time has significant effects on thermocycling and flexural strength. The zirconia achieved its optimum strength when it sintered at longer time regardless of heating rates.
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Affiliation(s)
- Perihan Oyar
- Professor, Dental Prosthetics Technology, Vocational School of Health Services, Hacettepe University, Ankara, Türkiye
| | - Rukiye Durkan
- Department of Prosthodontics, Faculty of Dentistry, Istanbul Okan University, Istanbul, Türkiye
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Revilla-León M, Yilmaz B, Kois JC, Att W. Prevention of peri-implant disease in edentulous patients with fixed implant rehabilitations. Clin Implant Dent Relat Res 2023. [PMID: 36707075 DOI: 10.1111/cid.13182] [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: 11/14/2022] [Accepted: 01/07/2023] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To provide an overview about the current approaches to prevent peri-implant diseases in edentulous patients with complete-arch implant-supported prostheses, and to review the clinical applications of the latest digital technologies for implant prosthodontics. METHODS A review of the guidelines to prevent peri-implant diseases in patient's receiving complete-arch implant-supported prostheses including facially driven treatment planning procedures using either conventional or digital methods, computer-aided implant planning procedures, and prosthodontic design variables including the optimal number and distribution of dental implants, implant to abutment connection type, implant or abutment level design, screw- or cement-retained alternatives, prostheses contours, and material selection is provided. Furthermore, an outline of the current therapeutic management approaches to address peri-implant diseases is reviewed. CONCLUSIONS Clinicians should understand and know different planning and design-related variables that can affect biological and mechanical complication rates of complete-arch implant-supported prostheses. Maintenance protocols are fundamental for minimizing biological and mechanical complications.
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Affiliation(s)
- Marta Revilla-León
- Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA.,Kois Center, Seattle, Washington, USA.,Department of Prosthodontics, Tufts University, Boston, Massachusetts, USA
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.,Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio, USA
| | - John C Kois
- Kois Center, Seattle, Washington, USA.,Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA.,Private Practice, Seattle, Washington, USA
| | - Wael Att
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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13
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Pozzi A, Arcuri L, Fabbri G, Singer G, Londono J. Long-term survival and success of zirconia screw-retained implant-supported prostheses for up to 12 years: A retrospective multicenter study. J Prosthet Dent 2023; 129:96-108. [PMID: 34187699 DOI: 10.1016/j.prosdent.2021.04.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 01/18/2023]
Abstract
STATEMENT OF PROBLEM Despite the broad clinical application of zirconia for fixed implant-supported prostheses, evidence of long-term performance is sparse. PURPOSE The purpose of this retrospective study was to evaluate the long-term clinical and radiographic outcomes of zirconia-based partial and complete screw-retained implant-supported zirconia fixed dental prostheses (ISZFDPs). MATERIAL AND METHODS Records of patients treated with dental implants and ISZFDPs between December 2004 and June 2017 were screened. Eligible study participants, according to inclusion criteria, were contacted and invited to undergo clinical and radiographic examinations. Outcomes were evaluated as implant and prosthetic survival rates, prosthetic success rate, complications, marginal bone level (MBL) change, and soft tissue condition. Along with the effects of zirconia prosthesis type and level, the effects of implant type and connection, type of loading, and follow-up on MBL were tested with a generalized linear effects model (GLEM) (α=.05). RESULTS A total of 118 patients were identified, of whom 20 (16.9%) were not available for clinical examination for various reasons. Ninety-eight participants (mean age 60.7 ±11.7 years) with 337 implants were included, of which 176 (52.2%) had been immediately loaded. A total of 111 ISZFDPs (96 zirconia connection and 15 titanium base) were investigated: 24 complete ISZFDPs with a zirconia connection (12.9 ±0.97 dental units, minimum 12, maximum 14), 72 partial with a zirconia connection (3.11 ±1.12, minimum 2, maximum 7), 15 partial with a titanium base (3.62 ±1.02, minimum 2, maximum 5). Forty ISZFDPs had been in function for ≥10 years (36%), 38 for 5 to 9 years (34.2%), and 33 for 2 to 4 years (22.8%). The mean follow-up time was 7.2 ±3.4 years. No zirconia fractures were identified. Two implants and 2 ISZFDPs failed, with chipping being the most common complication (13.5%). The implant survival rate was 99.4%, and the prosthetic survival rate was 98.2%. The cumulative prosthetic success rate was 91.9%. MBL change was -0.18 ±0.59 mm. Thirteen implants were treated for peri-implantitis (3.8%), and 9 for mucositis (2.7%), but presented healthy peri-implant soft tissues at the follow-up examination. A significant difference was found between the implant-level and abutment-level prostheses (P=.013), with less marginal bone loss observed in ISZFDPs delivered at the implant level. CONCLUSIONS Zirconia-based screw-retained implant-supported prosthesis can be considered a reliable long-term treatment option for partial and complete edentulism. No zirconia fractures were experienced. Stable bone levels and low peri-implantitis rates were reported regardless of the ISZFDP type and level, implant type and connection, and type of loading.
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Affiliation(s)
- Alessandro Pozzi
- Adjunct Associate Professor, Goldstein Center for Esthetic and Implant Dentistry, Department of Restorative Sciences, The Dental College of Georgia at Augusta University, Augusta, Ga; Private practice, Rome, Italy.
| | - Lorenzo Arcuri
- Assistant Professor, Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy
| | | | | | - Jimmy Londono
- Associate Professor, Director of Goldstein Center for Esthetic and Implant Dentistry, Department of Restorative Sciences, The Dental College of Georgia at Augusta University, Augusta, Ga
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Lemos CAA, Verri FR, de Luna Gomes JM, Santiago Junior JF, Miyashita E, Mendonça G, Pellizzer EP. Survival and prosthetic complications of monolithic ceramic implant-supported single crowns and fixed partial dentures: A systematic review with meta-analysis. J Prosthet Dent 2022:S0022-3913(22)00736-3. [PMID: 36564291 DOI: 10.1016/j.prosdent.2022.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 12/24/2022]
Abstract
STATEMENT OF PROBLEM Monolithic ceramic implant-supported restorations have been used to rehabilitate partially edentulous patients. However, knowledge of the survival and prosthetic complications of single crowns (SCs) and fixed partial dentures (FPDs) is limited. PURPOSE The purpose of this systematic review with meta-analysis was to evaluate the clinical performance of monolithic ceramic implant-supported SCs and FPDs in terms of survival and prosthetic complication rates. MATERIAL AND METHODS The systematic review was registered on the prospective register of systematic reviews (PROSPERO) (CRD42017078568). Five electronic databases were independently searched by 2 authors for articles published until May 2022. In addition, a hand search was performed in the nonpeer-reviewed literature, specific journals, and reference lists of included articles. A single-arm meta-analysis was performed by using the R program. The risk of bias and quality were assessed using the Cochrane risk of bias tools and the Newcastle-Ottawa scale. RESULTS Twenty-eight studies were included in the quantitative synthesis. A total of 1298 monolithic ceramic implant-supported restorations (1116 SCs and 182 FPDs) were evaluated in 1193 participants, with a median observation time of 24 months (range: 12 to 72 months). Meta-analysis indicated the proportion of failures and prosthetic complication rates of 2% (95% confidence interval [CI]: 1% to 4%) for SCs. No difference was observed for monolithic zirconia and lithium disilicate SCs. In the FPDs, only monolithic zirconia was considered, with 1 failure reported totaling the proportion of failures of 0% (0% to 1%) and complication rates of 4% (0% to 12%). The most complications reported for both types of restorations were screw loosening, debonding, and minor chipping and were considered repairable. The included studies showed a low risk of bias and good quality. CONCLUSIONS The use of monolithic ceramic implant-supported SCs, independent of ceramic material, and monolithic zirconia implant-supported FPDs should be considered an effective and safe treatment option because of favorable short-term survival and low prosthetic complications. However, additional well-conducted studies with a longer-term follow-up and direct comparison between veneered restorations are recommended to reassess clinical performance.
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Affiliation(s)
- Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Department of Dentistry, Federal University of Juiz de Fora - Campus Governador Valadares (UFJF/GV), Governador Valadares, Minas Gerais, Brazil.
| | - Fellippo Ramos Verri
- Adjunct Professor, Departament of Dental Materials and Prosthodontics, São Paulo State Univeristy (UNESP), Araçatuba Dental School, Araçatuba, São Paulo, Brazil
| | | | - Joel Ferreira Santiago Junior
- Professor, Departament of Health Sciences, School of Dentistry, Centro Universitário Sagrado Coração-UNISAGRADO, Bauru, São Paulo, Brazil
| | - Eduardo Miyashita
- Titular Professor, Department of Dentistry, UNIP - Universidade Paulista, São Paulo, Brazil
| | - Gustavo Mendonça
- Clinical Associate Professor, Department of Biological and Material Sciences, School of Dentistry, University of Michigan, Ann Arbor, Mich
| | - Eduardo Piza Pellizzer
- Titular Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
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Abualsaud R, Alalawi H. Fit, Precision, and Trueness of 3D-Printed Zirconia Crowns Compared to Milled Counterparts. Dent J (Basel) 2022; 10:dj10110215. [PMID: 36421402 PMCID: PMC9689223 DOI: 10.3390/dj10110215] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/08/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022] Open
Abstract
Precise fit of a crown and accurate reproduction of the digital design are paramount for successful treatment outcomes and preservation of clinician and technician time. The study aimed to compare the internal fit, marginal adaptation, precision, and trueness of 3D-printed zirconia crowns compared to their milled counterpart. A total of 20 monolithic 3 mol% yttria stabilized-zirconia crowns (n = 10) were made using computer-assisted design (CAD) followed by additive (3D-printed) and subtractive (milled) manufacturing. Digital scanning of the master die with and without a fit checker followed by image superimposition, and analysis was performed to evaluate internal and marginal adaptation in four areas (occlusal, axial, marginal, and overall). ISO 12836:2015 standard was followed for precision and trueness evaluation. Statistical analysis was achieved using a t-test at α = 0.05. Internal fit and marginal adaptation revealed no significant difference between the two test groups (p > 0.05). The significant difference in trueness (p < 0.05) was found between the two groups in three areas (occlusal, axial, and internal). The best and worst trueness values were seen with 3D-printed crowns at occlusal (8.77 ± 0.89 µm) and Intaglio (23.90 ± 1.60 µm), respectively. The overall precision was statistically better (p < 0.05) in the 3D-printed crowns (9.59 ± 0.75 µm) than the milled (17.31 ± 3.39 µm). 3D-printed and milled zirconia crowns were comparable to each other in terms of internal fit and marginal adaptation. The trueness of the occlusal and axial surfaces of 3D-printed crowns was better, whereas the trueness of fitting surface of milled crowns was better. 3D-printed crowns provided a higher level of precision than milled crowns. Although the internal and marginal fit of both production techniques were comparable, 3D printing of zirconia produced more precise crowns.
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Novais M, Silva AS, Mendes J, Barreiros P, Aroso C, Mendes JM. Fracture Resistance of CAD/CAM Implant-Supported 3Y-TZP-Zirconia Cantilevers: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6638. [PMID: 36233980 PMCID: PMC9571496 DOI: 10.3390/ma15196638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
(1) Introduction: Implant-supported fixed complete dentures are mostly composed of cantilevers. The purpose of this work was to evaluate the fracture resistance of zirconia (Prettau®, second generation, or Ice Zirkon Translucent, first generation) with cantilever lengths of 6 and 10 mm, and zirconia’s fracture resistance in relation to an average bite force of 250 N. (2) Materials and methods: Forty structures were created in CAD/CAM and divided into four groups: group A (6 mm cantilever in IZT), group B (10 mm cantilever in IZT), group C (6 mm cantilever in Pz), and group D (10 mm cantilever in pz). The study consisted of a traditional “load-to-failure” test. (3) Results: A statistically significant result was found for the effect of cantilever length, t(38) = 16.23 (p < 0.001), with this having a large effect size, d = 4.68. The 6 mm cantilever length (M = 442.30, sd = 47.49) was associated with a higher mean force at break than the 10 mm length (M = 215.18, sd = 40.74). No significant effect was found for the type of zirconia: t(38) = 0.31 (p = 0.757), and d = 0.10. (4) Conclusions: All the components with cantilever lengths of 6 mm broke under forces higher than 250 N. Cantilevers larger than 10 mm should be avoided.
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Three-dimensional macroscopical quantification of plaque accumulation on implant-supported fixed complete dental prostheses surfaces: A methodological pilot study. J Prosthet Dent 2022; 128:467.e1-467.e8. [DOI: 10.1016/j.prosdent.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/20/2022]
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Fischer P, Barbu HM, Fischer CAI, Pantea M, Baciu F, Vranceanu DM, Cotrut CM, Spinu TC. Bending Fracture of Different Zirconia-Based Bioceramics for Dental Applications: A Comparative Study. MATERIALS 2021; 14:ma14226887. [PMID: 34832293 PMCID: PMC8621405 DOI: 10.3390/ma14226887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 01/09/2023]
Abstract
The fabrication of fixed dental prostheses using aesthetic materials has become routine in today’s dentistry. In the present study, three-unit full zirconia fixed prosthetic restorations obtained by computer-aided design/computer-aided manufacturing (CAD/CAM) technology were tested by bending trials. The prostheses were intended to replace the first mandibular left molar and were manufactured from four different types of zirconia bioceramics (KatanaTM Zirconia HTML and KatanaTM Zirconia STML/Kuraray Noritake Dental Inc.; NOVAZir® Fusion float® ml/NOVADENT/Dentaltechnik; and 3D PRO Zirconia/Bloomden Bioceramics). In total, sixteen samples were manufactured—four samples per zirconia material. Additionally, the morphology, grain size area distribution, and elemental composition were analyzed in parallelepiped samples made from the selected types of zirconia in three different areas, noted as the upper, middle, and lower areas. The scanning electron microscope (SEM) analysis highlighted that the grain size area varies with respect to the researched area and the type of material. Defects such as microcracks and pores were also noted to a smaller extent. In terms of grain size area, it was observed that most of the particles in all samples were under 0.5 μm2, while the chemical composition of the investigated materials did not vary significantly. The results obtained after performing the bending tests showed that a zirconia material with fewer structural defects and an increased percentage of grain size area under 0.5 µm2, ranging from ~44% in the upper area to ~74% in the lower area, exhibited enhanced mechanical behavior. Overall, the resulting values of all investigated parameters confirm that the tested materials are suitable for clinical use.
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Affiliation(s)
- Peter Fischer
- Oral Implantology Department, Titu Maiorescu University, 67A Gh. Petrascu Street, 040441 Bucharest, Romania; (P.F.); (H.M.B.)
| | - Horia Mihail Barbu
- Oral Implantology Department, Titu Maiorescu University, 67A Gh. Petrascu Street, 040441 Bucharest, Romania; (P.F.); (H.M.B.)
| | - Caroline Adela Ingrid Fischer
- Doctoral School, Faculty of Dental Medicine, Titu Maiorescu University, 67A Gh. Petrascu Street, 040441 Bucharest, Romania;
| | - Mihaela Pantea
- Department of Fixed Prosthodontics and Occlusology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 17-23 Plevnei Street, 010221 Bucharest, Romania; (M.P.); (T.C.S.)
| | - Florin Baciu
- Department of Strength of Materials, Faculty of Industrial Engineering and Robotics, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania;
| | - Diana Maria Vranceanu
- Department of Metallic Materials Science, Physical Metallurgy, Faculty of Materials Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
- Correspondence: (D.M.V.); (C.M.C.); Tel.: +40-(0)21-316-9563 (D.M.V. & C.M.C.)
| | - Cosmin Mihai Cotrut
- Department of Metallic Materials Science, Physical Metallurgy, Faculty of Materials Science and Engineering, University Politehnica of Bucharest, 313 Splaiul Independentei, 060042 Bucharest, Romania
- Correspondence: (D.M.V.); (C.M.C.); Tel.: +40-(0)21-316-9563 (D.M.V. & C.M.C.)
| | - Tudor Claudiu Spinu
- Department of Fixed Prosthodontics and Occlusology, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 17-23 Plevnei Street, 010221 Bucharest, Romania; (M.P.); (T.C.S.)
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Lerner H, Nagy K, Pranno N, Zarone F, Admakin O, Mangano F. Trueness and precision of 3D-printed versus milled monolithic zirconia crowns: An in vitro study. J Dent 2021; 113:103792. [PMID: 34481929 DOI: 10.1016/j.jdent.2021.103792] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To compare the trueness and precision of 3D-printed versus milled monolithic zirconia crowns (MZCs). METHODS A model of a maxilla with a prepared premolar was scanned with an industrial scanner (ATOSQ®, Gom) and an MZC was designed in computer-assisted-design (CAD) software (DentalCad®, Exocad). From that standard tessellation language (STL) file, 10 MZCs (test) were 3D-printed with a Lithography-based Ceramic Manufacturing (LCM) printer (CerafabS65®, Lithoz) and 10 MZCs (control) were milled using a 5-axis machine (DWX-52D®, DGShape). All MZCs were sintered and scanned with the aforementioned scanner. The surface data of each sample (overall crown, marginal area, occlusal surface) were superimposed to the original CAD file (ControlX®, Geomagic) to evaluate trueness: (90-10)/2, absolute average (ABS AVG) and root mean square (RMS) values were obtained for test and control groups (MathLab®, Mathworks) and used for analysis. Finally, the clinical precision (marginal adaptation, interproximal contacts) of test and control MZCs was investigated on a split-cast model printed (Solflex350®, Voco) from the CAD project, and compared. RESULTS The milled MZCs had a significantly higher trueness than the 3D-printed ones, overall [(90-10)/2 printed 37.8 µm vs milled 21.2 µm; ABS AVG printed 27.2 µm vs milled 15.1 µm; RMS printed 33.2 µm vs milled 20.5 µm; p = 0.000005], at the margins [(90-10)/2 printed 25.6 µm vs milled 12.4 µm; ABS AVG printed 17.8 µm vs milled 9.4 µm; RMS printed 22.8 µm vs milled 15.6 µm; p= 0.000011] and at the occlusal level [(90-10)/2 printed 50.4 µm vs milled 21.9 µm; ABS AVG printed 29.6 µm vs milled 14.7 µm; RMS printed 38.9 µm vs milled 22.5 µm; p = 0.000005]. However, with regard to precision, both test and control groups scored highly, with no significant difference either in the quality of interproximal contact points (p = 0.355) or marginal closure (p = 0.355). CONCLUSIONS Milled MZCs had a statistically higher trueness than 3D-printed ones; all crowns, however, showed high precision, compatible with the clinical use. CLINICAL SIGNIFICANCE Although milled MZCs remain more accurate than 3D-printed ones, the LCM technique seems able to guarantee the production of clinically precise zirconia crowns.
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Affiliation(s)
- Henriette Lerner
- Department of Oral Surgery, University of Szeged, Szeged, Hungary.
| | - Katalin Nagy
- Department of Oral Surgery, University of Szeged, Szeged, Hungary.
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy.
| | - Fernando Zarone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy.
| | - Oleg Admakin
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
| | - Francesco Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russia.
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Technical and Biological Complications of Screw-Retained (CAD/CAM) Monolithic and Partial Veneer Zirconia for Fixed Dental Prostheses on Posterior Implants Using a Digital Workflow: A 3-Year Cross-Sectional Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5581435. [PMID: 34307657 PMCID: PMC8279852 DOI: 10.1155/2021/5581435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/10/2021] [Accepted: 06/28/2021] [Indexed: 01/31/2023]
Abstract
Objective The introduction of CAD/CAM and the development of zirconia-based restorations have allowed clinicians to use less expensive materials and faster manufacturing procedures. The purpose of the study was to analyze the differences, in terms of mechanical and biological complication, in multiunit zirconia fixed dental prosthesis (FPDs) on posterior implants produced using a digital workflow. Method and Materials. This study was a retrospective investigation, and patients treated with screw-retained monolithic or partial veneer FPDs on dental implants were selected. Periapical radiographs were taken at baseline and at the 3-year follow-up. Complications were recorded and classified as technical and biological ones. Results The study population included 25 patients. The occlusal and interproximal corrections were not clinically significant. In the study sample, the survival rate and success rate of the FPDs after 3 years were 100% and 96%, respectively. One implant failed immediately after placement. Conclusion Monolithic zirconia FPDs and partial veneer FPDs showed a 100% survival rate, presenting an interesting alternative to metal ceramic restorations. The partial veneer FPDs had a higher technical complication rate than the monolithic FPDs; however, no statistically significant difference was found.
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Framework Materials for Full-Arch Implant-Supported Rehabilitations: A Systematic Review of Clinical Studies. MATERIALS 2021; 14:ma14123251. [PMID: 34204681 PMCID: PMC8231547 DOI: 10.3390/ma14123251] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/24/2022]
Abstract
The purpose of this systematic review was to investigate the clinical outcomes of frameworks made of different materials in patients with implant-supported full-arch prostheses. A literature search was conducted on MEDLINE, Scopus and Cochrane Library, until the 1st of March 2021, with the following search terms: framework or substructure combined with "dental implants". The outcomes evaluated were: implant and prosthesis survival, bone resorption, biological and technical complications. The Cochrane Handbook for Systematic Reviews of Interventions was employed to assess the risk of bias in randomized clinical trials. The Newcastle-Ottawa quality assessment scale was used for non-randomized studies. In total, 924 records were evaluated for title and abstract, and 11 studies were included in the review: 4 clinical randomized trials and 7 cohort studies. The framework materials investigated were: gold alloy, titanium, silver-palladium alloy, zirconia and polymers including acrylic resin and carbon-fiber-reinforced composites. High implant and prosthetic cumulative survival rates were recorded by all included studies. Various materials and different fabrication techniques are now available as alternatives to traditional cast metal frameworks, for full-arch implant-supported rehabilitations. Further long-term studies are needed to validate the use of these materials and clarify their specific clinical indications and manufacturing protocols to optimize their clinical outcomes.
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Laumbacher H, Strasser T, Knüttel H, Rosentritt M. Long-term clinical performance and complications of zirconia-based tooth- and implant-supported fixed prosthodontic restorations: A summary of systematic reviews. J Dent 2021; 111:103723. [PMID: 34119611 DOI: 10.1016/j.jdent.2021.103723] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/21/2021] [Accepted: 06/02/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To present an overview on systematic reviews on prosthodontic zirconia restorations and to discuss long-term complications as well as information on anatomical and functional changes to the masticatory system. DATA/SOURCES MEDLINE, EMBASE, Trip medical, and Cochrane Library databases were searched for systematic reviews up to February 2021. Bias was assessed and clinical survival and complications were analyzed. STUDY SELECTION 38 eligible articles published between 2006 and 2021 were included. The reviews were based on 128 in vivo studies on approximately 10,000 zirconia restorations. 5-year cumulative survival rates varied between 91.2% and 95.9% for tooth-supported (TS) single crowns (SC), 89.4% and 100% for TS multi-unit fixed dental prostheses (FDP), 97.1% and 97.6% for implant-supported (IS) SCs and 93.0% and 100% for IS FDPs. Chipping was the most often technical complication, followed by framework fracture, loss of retention, marginal discrepancies/discoloration, occlusal roughness and abutment/screw loosening. Color mismatch was the only esthetic complication. Biological complications were caries, endodontic complications, tooth fracture, periodontal disease, abrasion/attrition, persisting pain, high sensitivity, peri‑implantitis and soft tissue issues. Patients with bruxism were only examined sporadically. CONCLUSIONS 5-year results for zirconia restorations were satisfactory. The predominant technical problem of veneering fractures could be overcome with adapted design or fabrication and application of monolithic restorations, but reviews of clinical studies on this subject are rare. The impact of zirconia restorations on the masticatory system remains unclear. CLINICAL SIGNIFICANCE Zirconia restorations are experiencing a rapidly increasing use in dental practice. Being highly wear-resistant, hard and durable, it can be assumed that they do not follow natural abrasion and changes in the masticatory system. Possible long-term effects on the stomatognathic system as a whole should therefore be considered.
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Affiliation(s)
- Harald Laumbacher
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Thomas Strasser
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, 93042 Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany.
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Tirone F, Salzano S, Rolando E, Pozzatti L, Rodi D. Framework Fracture of Zirconia Supported Full Arch Implant Rehabilitation: A Retrospective Evaluation of Cantilever Length and Distal Cross-Sectional Connection Area in 140 Patients Over an Up-To-7 Year Follow-Up Period. J Prosthodont 2021; 31:121-129. [PMID: 33963652 DOI: 10.1111/jopr.13388] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To evaluate the relationship between different dimensional parameters in implant-supported monolithic zirconia fixed complete dental prostheses (IFCDPs) and the incidence of framework fracture in a large sample of cases in vivo. MATERIALS AND METHODS This retrospective observational study evaluated all patients rehabilitated with screw-retained zirconia IFCDPs between January 2013 and April 2019 at a private practice. The minimum follow-up period was 1 year after occlusal loading. Fractures were classified as: type I-fractures that happened between but not involving the two most posterior screw-access openings (SAOs) and type II-fractures of the distal cantilever. Cantilever length, distal connector cross-sectional area, and screw access opening length were measured using data obtained from digital scans. Logistic regression was performed to evaluate the relationship between types I and II fractures and the independent variables (dimensional parameters). Using the receiver operating characteristic curves, two parameters were identified to be useful for establishing a cut-off and predicting type II fractures. RESULTS A total of 180 prostheses delivered to 140 patients were analyzed. Five implants failed in three patients: three before delivery of the definitive prostheses and two after. Ten prostheses failed (5.6% prosthetic failure rate): 2 because of implant failures, and 8 because of framework fractures. Five fractures were classified as type I and three as type II. Significant associations were found between cantilever length and type I fractures (Wald = 5.772, df = 1, p = 0.016), distal connector cross-sectional area and type II fractures (Wald = 3.806, df = 1, p = 0.051), and cantilever length and the total number of fractures (Wald = 6.117, df = 1, p = 0.013). CONCLUSION Zirconia IFCDPs may be reliable medium-term solutions if some dimensional parameters are followed. The ratios between the cantilever length and cross-sectional connector area should be <0.51, while the ratio between the cantilever length and screw access opening length should be <1.48.
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Affiliation(s)
| | | | - Erik Rolando
- Laboratorio Odontoprotesico Rolando Cerato, Cuneo, Italy
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Mazza LC, Lemos CAA, Pesqueira AA, Pellizzer EP. Survival and complications of monolithic ceramic for tooth-supported fixed dental prostheses: A systematic review and meta-analysis. J Prosthet Dent 2021; 128:566-574. [PMID: 33745685 DOI: 10.1016/j.prosdent.2021.01.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 01/11/2023]
Abstract
STATEMENT OF PROBLEM Although recent studies have reported the success of implant-supported monolithic restorations, consensus on the use of monolithic ceramic restorations is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the survival and biological and technical complication rates of monolithic single crowns and fixed partial dentures (FPDs). MATERIAL AND METHODS An electronic search was conducted by 2 independent authors on the PubMed/MEDLINE, Scopus, and Cochrane Library databases. The Newcastle-Ottawa scale and Cochrane risk of bias tool were used to assess the quality and risk of bias of the included studies. Meta-analysis was performed by using the R software program. RESULTS The search identified 763 articles, 18 of which met the eligibility criteria. A total of 15 studies evaluated monolithic ceramic single crowns, and 4 studies evaluated FPDs. The studies included 1061 monolithic single crowns (524 lithium disilicate, 461 zirconia, and 76 polymer-infiltrated ceramic network [PICN]) and 104 FPDs (36 lithium disilicate and 68 zirconia). Meta-analysis of single-arm studies indicated the proportion of survival, biological, and technical complication rates of 1% (95% confidence interval [CI]: 0% to 3%), 1% (CI: 0% to 4%), and 2% (CI: 1% to 4%), respectively, for single crowns, independent of ceramic material, and 3% (CI: 0% to 34%), 5% (CI: 1% to 21%), and 5% (CI: 1% to 21%) for FPDs, respectively. Only 5 studies performed a direct comparison between monolithic and veneered ceramic restorations, and no significant difference was observed in terms of survival (risk ratio [RR]: 0.68; CI: 0.25-1.91; P=.96), biological (RR: 0.69; CI: 0.31-1.53; P=.35), and technical complication rates (RR: 0.87; CI: 0.40-1.88; P=.29). CONCLUSIONS The use of monolithic ceramic can be considered a favorable treatment for tooth-supported single crowns and FPDs, with high survival and low complication rates. However, further randomized controlled trials are needed to reassess these clinical performances, mainly by comparing them with the performance of veneered restorations.
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Affiliation(s)
- Letícia Cerri Mazza
- MSc student, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Adjunct Professor, Division of Prosthodontics, Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Aldiéris Alves Pesqueira
- Assistant Professor, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil.
| | - Eduardo Piza Pellizzer
- Titular Professor, São Paulo State University (UNESP), School of Dentistry, Department of Dental Materials and Prosthodontics, Araçatuba, Sao Paulo, Brazil
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25
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Hafezeqoran A, Koodaryan R, Hemmati Y, Akbarzadeh A. Effect of connector size and design on the fracture resistance of monolithic zirconia fixed dental prosthesis. J Dent Res Dent Clin Dent Prospects 2021; 14:218-222. [PMID: 33575010 PMCID: PMC7867680 DOI: 10.34172/joddd.2020.039] [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: 09/28/2018] [Accepted: 06/12/2020] [Indexed: 11/09/2022] Open
Abstract
Background. Designing a high strength all-ceramic fixed partial denture with favorable esthetics can be challenging for clinicians; this study aimed to evaluate the effect of connector size and design on the fracture resistance of monolithic zirconia fixed dental prostheses.
Methods. Two groups of twenty 3-unit monolithic zirconia (Sirona inCoris TZI, Sirona Dental Systems GmbH) bridges, extending from the mandibular first premolar to the first molar with different connector sizes (9 mm2 and 12 mm2), were divided into two subgroups with different connector designs (round and sharp). The specimens were subjected to the three-point bending test to obtain the fracture-bearing load. The results were reported using descriptive statistics (mean ± standard deviation). Mann-Whitney U test was used to compare the fracture load in two types of designs for each connector size and two connector size types for each connector design. The significance level was considered at P<0.05.
Results. The minimum failure load was related to the group with a 9-mm2 connector size and a sharp embrasure design (1054.4±133.89 N), and the highest mean value belonged to the group with 12-mm2 connector size and rounded embrasure design (1599.8±167.09 N). Mann-Whitney U test indicated a significant difference between the mean failure load of the rounded and sharp embrasure designs in the 9-mm2 connector size (P =0.007). However, the difference was insignificant in the 12-mm2 connector size (P =0.075).
Conclusion. Sharp embrasure design is not recommended for high-stress areas with restricted occlusogingival height. A 9-mm2 connector size for 3-unit monolithic zirconia fixed dental prosthesis (FDP), which is recommended by the manufacturer, should be used more cautiously
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Affiliation(s)
- Ali Hafezeqoran
- Department of Prosthodontics, Dental faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roodabeh Koodaryan
- Department of Prosthodontics, Dental faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yasser Hemmati
- Department of Prosthodontics, Dental faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ayshin Akbarzadeh
- Department of Prosthodontics, Dental faculty, Tabriz University of Medical Sciences, Tabriz, Iran
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26
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Al-Qarni FD, Goodacre CJ. Reducing the need to maintain fixed complete dentures by providing gold occlusal surfaces: A clinical report. J Prosthet Dent 2021; 127:538-541. [PMID: 33573831 DOI: 10.1016/j.prosdent.2020.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/08/2020] [Accepted: 12/08/2020] [Indexed: 11/25/2022]
Abstract
The excessive occlusal wear of complete-arch implant-supported prostheses made with metal and acrylic resin is a clinical complication that can require repeated maintenance in certain patients. A patient who presented with moderate occlusal wear of the prosthetic teeth and substantial fracture of the maxillary anterior acrylic resin base only 2 years after a previous replacement of the acrylic resin base and denture teeth is described. Because of the patient's history and existing wear, both the maxillary and mandibular prostheses were repaired by replacing the acrylic resin bases and resin denture teeth but with the addition of cast gold occlusal surfaces on the posterior prosthetic teeth. The provided treatment helped this patient, who was likely to need more frequent maintenance visits in the future because of his history of accelerated occlusal wear and increased occlusal force.
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Affiliation(s)
- Faisal D Al-Qarni
- Assistant Professor, Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Charles J Goodacre
- Distinguished Professor, Loma Linda University School of Dentistry, Loma Linda, Calif
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27
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Xiao W, Chen Y, Chu C, Dard MM, Man Y. Influence of implant location on titanium-zirconium alloy narrow-diameter implants: A 1-year prospective study in smoking and nonsmoking populations. J Prosthet Dent 2021; 128:159-166. [PMID: 33551139 DOI: 10.1016/j.prosdent.2020.09.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/21/2020] [Accepted: 09/21/2020] [Indexed: 02/05/2023]
Abstract
STATEMENT OF PROBLEM Titanium-zirconium (Ti-Zr) alloy (Roxolid) narrow-diameter implants (NDIs) have been widely used for implant-supported prostheses in anterior and posterior regions in the jaws. However, the relationship between implant location and clinical outcome remains unclear. PURPOSE The purpose of this clinical study was to evaluate and compare the clinical and radiographic outcomes of NDIs placed in different regions of the jaws in both smokers and nonsmokers. MATERIAL AND METHODS Eighty-four participants scheduled to receive NDIs for tooth rehabilitation were included, and the inserted NDIs were divided into 3 groups depending on their locations: implants used to restore anterior teeth, implants used to restore premolars, and implants used to restore molars. Crestal bone loss (CBL), implant survival and success rates, bleeding on probing (BOP), and pocket probing depth (PPD) were evaluated 6 and 12 months after implant loading (α=.017 for implant survival and success rates after Bonferroni correction, α=.05 for other parameters). RESULTS Statistical analysis of 6- and 12-month CBL of all participants presented no statistically significant difference among the 3 groups. For smokers, the molar group presented significantly more CBL than the premolar group (0.90 ±0.94 versus 0.16 ±0.27 mm, P=.027) at the 6-month examination. The implant survival rates were 95.65%, 100%, and 100% for anterior, premolar, and molar regions, respectively (P=.283). No statistically significant difference was observed regarding periodontal parameters (P>.05). CONCLUSIONS Implant location has no influence on the clinical and radiographic parameters of Ti-Zr NDIs placed in a nonsmoking population. However, the combination of posterior location and smoking may induce higher risk of crestal bone loss. Caution should be taken when restoring molars for smokers with NDIs.
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Affiliation(s)
- Wenlan Xiao
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases &Department of Oral Implantology, West China School of Stomatology, Sichuan University, Chengdu, PR China
| | - Yaqian Chen
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Chenyu Chu
- Graduate student, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Michel M Dard
- Global Medical Director, Medical Affairs, Straumann Group, Basel, Switzerland; Associate Professor of Dental Medicine, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University, College of Dental Medicine, New York, NY
| | - Yi Man
- Professor, State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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28
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Modification of denture teeth for improved occlusal stability of a maxillary removable complete denture opposed by a mandibular implant-supported fixed complete denture: A clinical report. J Prosthet Dent 2020; 125:22.e1-22.e6. [PMID: 33129499 DOI: 10.1016/j.prosdent.2020.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 11/22/2022]
Abstract
Wear of artificial teeth is the most common complication associated with an implant-supported fixed complete denture (ISFCD). This wear alters the occlusal scheme, with loss of eccentric occlusal balance and vertical dimension of occlusion (VDO). This clinical report describes the fabrication of a new maxillary removable complete denture opposing an existing ISFCD with occlusal modifications. Both prostheses received splinted zirconia crowns cemented with composite resin cement.
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Full-Mouth Screw-Retained Implant-Supported Rehabilitation with Multiunit Abutments Using Virtual Guided Surgery and Digital Prosthetics Protocol. Case Rep Dent 2020; 2020:3585169. [PMID: 32963837 PMCID: PMC7501563 DOI: 10.1155/2020/3585169] [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: 07/23/2019] [Revised: 01/04/2020] [Accepted: 02/01/2020] [Indexed: 11/17/2022] Open
Abstract
Total rehabilitation is one of the most sophisticated kinds of dental implant-supported prosthetics. The usage of multiunit abutment system allows the clinician an accurate and passive fitting of screw-retained full-arch construction. In addition, it retains a condition of soft and bone tissues around prosthetic construction. The aim of this case is to demonstrate a modern approach in planning and realisation of full-mouth screw-retained dental implant prosthetics. A 59-year-old patient had an extraction of all failed teeth on upper and lower jaws with immediate 16 implant placement (8 implants on maxilla and 8 implants on mandible) using surgical template. Multiunit abutments were installed intraoperatively. Temporary constructions were fixed immediately after surgery. After 3 months of dental impressions, plaster models and their scan were prepared to make final screw-retained zirconium dioxide constructions. Reevaluation of functional and aesthetic result of the treatment was made after 12 months.
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30
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Alqutaibi AY, Alnazzawi AA, Algabri R, Aboalrejal AN, AbdElaziz MH. Clinical performance of single implant-supported ceramic and metal-ceramic crowns: A systematic review and meta-analysis of randomized clinical trials. J Prosthet Dent 2020; 126:369-376. [PMID: 32891403 DOI: 10.1016/j.prosdent.2020.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/01/2022]
Abstract
STATEMENT OF PROBLEM Evidence relating to the choice of materials for single implant-supported crowns is sparse. PURPOSE The purpose of this systematic review and meta-analysis was to assess articles that compared the clinical performance of ceramic and metal-ceramic (MC) implant-supported single crowns with regard to prosthesis failure, complication rate, and patient satisfaction. MATERIAL AND METHODS A comprehensive search of databases (PubMed/MEDLINE, Scopus, and Cochrane Library) was performed. The last search was conducted in December 2019. Randomized clinical trials comparing ceramic and MC implant-supported single crowns with at least a 12-month follow-up were included, all of which were published in English. The pooled effects were presented as both a risk difference (RD) and mean difference according to the type of data with 95% confidence intervals (CIs). RESULTS Seven randomized clinical trials fulfilled the eligibility criteria and were included in the meta-analysis. The pooled data did not show any statistically significant differences concerning prosthesis failure (RD: 0.000, 95% CI: -0.05 to 0.06), marginal bone loss (mean difference [MD]: -0.02, 95% CI: -0.75 to 0.35), mechanical complications (RD: -0.06, 95% CI: -0.18 to 0.07), biological complications (RD: 0.02, 95% CI: -0.07 to 0.11), or patient satisfaction (MD: 4.86, 95% CI: -2.86 to 12.58). CONCLUSIONS Ceramic and MC crowns had similar outcomes with regard to prosthesis failure, mechanical and biological complication rates, and patient satisfaction. As a result, the selection of single implant crown material depends on the preference of the dentist and patient.
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Affiliation(s)
- Ahmed Yaseen Alqutaibi
- Assistant Professor of Prosthodontics, Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia; Assistant Professor of Prosthodontics, Prosthodontics Department, College of Dentistry, Ibb University, Ibb, Yemen.
| | - Ahmad Abdulkareem Alnazzawi
- Associate Professor of Prosthodontics, Substitutive Dental Science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
| | - Radwan Algabri
- Assistant Professor of Prosthodontics, Prosthodontics Department, College of Dentistry, Ibb University, Ibb, Yemen
| | - Afaf N Aboalrejal
- Lecturer of Oral Biology, Oral Biology Department, College of Dentistry, Ibb University, IBB, Yemen
| | - Mohammed Hosny AbdElaziz
- Associate Professor of Crown and Bridge Department, Faculty of Dental Medicine, AlAzhar University, Cairo, Egypt; Associate Professor of prosthodontics, substitutive dental science Department, College of Dentistry, Taibah University, Al-Madinah, Saudi Arabia
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AL‐Rabab'ah MA, AlTarawneh S, Jarad FD, Devlin H. Methodological Quality of Systematic Reviews Relating to Performance of All‐Ceramic Implant Abutments, Frameworks, and Restorations. J Prosthodont 2020; 30:36-46. [DOI: 10.1111/jopr.13206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 01/07/2023] Open
Affiliation(s)
- Mohammad A. AL‐Rabab'ah
- Department of Conservative Dentistry, School of Dentistry The University of Jordan Amman Jordan
- School of Dentistry University of Liverpool UK
- Division of Dentistry The University of Manchester UK
| | - Sandra AlTarawneh
- Department of Removable Prosthodontics, School of Dentistry The University of Jordan Amman Jordan
- Department of Restorative Dentistry UIC College of Dentistry Chicago IL
| | | | - Hugh Devlin
- Division of Dentistry The University of Manchester UK
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Tribst JPM, Dal Piva AMDO, Lo Giudice R, Borges ALS, Bottino MA, Epifania E, Ausiello P. The Influence of Custom-Milled Framework Design for an Implant-Supported Full-Arch Fixed Dental Prosthesis: 3D-FEA Sudy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114040. [PMID: 32517097 PMCID: PMC7313457 DOI: 10.3390/ijerph17114040] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/01/2020] [Accepted: 06/03/2020] [Indexed: 11/16/2022]
Abstract
The current study aimed to evaluate the mechanical behavior of two different maxillary prosthetic rehabilitations according to the framework design using the Finite Element Analysis. An implant-supported full-arch fixed dental prosthesis was developed using a modeling software. Two conditions were modeled: a conventional casted framework and an experimental prosthesis with customized milled framework. The geometries of bone, prostheses, implants and abutments were modeled. The mechanical properties and friction coefficient for each isotropic and homogeneous material were simulated. A load of 100 N load was applied on the external surface of the prosthesis at 30° and the results were analyzed in terms of von Mises stress, microstrains and displacements. In the experimental design, a decrease of prosthesis displacement, bone strain and stresses in the metallic structures was observed, except for the abutment screw that showed a stress increase of 19.01%. The conventional design exhibited the highest stress values located on the prosthesis framework (29.65 MPa) between the anterior implants, in comparison with the experimental design (13.27 MPa in the same region). An alternative design of a stronger framework with lower stress concentration was reported. The current study represents an important step in the design and analysis of implant-supported full-arch fixed dental prosthesis with limited occlusal vertical dimension.
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Affiliation(s)
- João Paulo Mendes Tribst
- Department of Dental Materials and Prosthodontics at São Paulo State University (Unesp), Institute of Science and Technology, São Paulo 01049-010, Brazil; (J.P.M.T.); (A.M.d.O.D.P.); (A.L.S.B.); (M.A.B.)
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials and Prosthodontics at São Paulo State University (Unesp), Institute of Science and Technology, São Paulo 01049-010, Brazil; (J.P.M.T.); (A.M.d.O.D.P.); (A.L.S.B.); (M.A.B.)
| | - Roberto Lo Giudice
- Deptartment of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
- Correspondence: ; Tel.: +39-393-439-9197
| | - Alexandre Luiz Souto Borges
- Department of Dental Materials and Prosthodontics at São Paulo State University (Unesp), Institute of Science and Technology, São Paulo 01049-010, Brazil; (J.P.M.T.); (A.M.d.O.D.P.); (A.L.S.B.); (M.A.B.)
| | - Marco Antonio Bottino
- Department of Dental Materials and Prosthodontics at São Paulo State University (Unesp), Institute of Science and Technology, São Paulo 01049-010, Brazil; (J.P.M.T.); (A.M.d.O.D.P.); (A.L.S.B.); (M.A.B.)
| | - Ettore Epifania
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Dentistry, University of Naples Federico II, S, via Sergio Pansini n. 5, 80131 Napoli, Italy; (E.E.); (P.A.)
| | - Pietro Ausiello
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Dentistry, University of Naples Federico II, S, via Sergio Pansini n. 5, 80131 Napoli, Italy; (E.E.); (P.A.)
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Shah K, Lee DJ. Fabricating a screw-retained, complete arch, fixed implant prosthesis using selective metal laser sintering: A clinical report. J Prosthet Dent 2020; 123:373-378. [PMID: 31307806 DOI: 10.1016/j.prosdent.2019.01.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 01/04/2019] [Accepted: 01/04/2019] [Indexed: 12/17/2022]
Abstract
In contemporary prosthodontic practice, implant-supported therapy has consistently resulted in high success rates, with satisfactory and predictable outcomes for completely edentulous patients. Of the several options, complete-arch, fixed screw-retained solutions are generally considered to be the preferred treatment solution. Screw retention offers advantages such as predictable retrievability and potentially easy prosthodontic maintenance, as well as excess cement not being a concern. However, implant mispositioning and malalignment may often necessitate the use of cement-retained prostheses. This clinical report describes a method of fabricating a complete-arch, implant screw-retained, double framework metal-ceramic prosthesis, despite the unfavorable implant positioning, by using selective direct metal laser sintering technology.
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Affiliation(s)
- Karnik Shah
- Private practice, Austin, Texas; Former Resident, Advanced Prosthodontics Program, Division of Restorative Sciences and Prosthodontics, The Ohio State University College of Dentistry, Columbus, Ohio.
| | - Damian J Lee
- Director and Assistant Professor, Advanced Prosthodontics Program, Division of Restorative Sciences and Prosthodontics, The Ohio State University College of Dentistry, Columbus, Ohio
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34
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Has zirconia made a material difference in implant prosthodontics? A review. Dent Mater 2020; 36:1-8. [DOI: 10.1016/j.dental.2019.08.100] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/19/2019] [Indexed: 12/17/2022]
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Aesthetic Rehabilitation of a Patient with Bruxism Using Ceramic Veneers and Overlays Combined with Four-Point Monolithic Zirconia Crowns for Occlusal Stabilization: A 4-Year Follow-Up. Case Rep Dent 2019; 2019:1640563. [PMID: 31531247 PMCID: PMC6720662 DOI: 10.1155/2019/1640563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/20/2019] [Accepted: 07/31/2019] [Indexed: 11/26/2022] Open
Abstract
Management of severe worn dentition in patients with bruxism is challenging as a result of the loss of tooth structure and occlusal vertical dimension, temporomandibular implications, tooth hypersensitivity, and masticatory or aesthetic impairment. This case describes the 4-year follow-up clinical evaluation of a full mouth tooth-supported rehabilitation made on a 66-year-old man with bruxism and tooth wear, with aesthetic complaints and compromised masticatory function. The prosthetic treatment was planned with a digital smile design and a mock-up technique for an aesthetic and minimally invasive approach using lithium disilicate pressed and layered veneers on anterior teeth, posterior CAD/CAM lithium disilicate overlays with facial coverage, and CAD/CAM monolithic zirconia crowns with facial feldspathic ceramic on maxillary and mandibular canines and first molars in order to ensure the occlusal stability at the increased occlusal vertical dimension. After 4 years of function, no complications were registered. The choice of an appropriate material for the rehabilitation of these patients is essential to improve treatment prognosis and should be guided by mechanical and aesthetical properties. The use of four-point occlusal stabilization with CAD/CAM high strength monolithic zirconia crowns combined with ceramic veneers and overlays appears to be a reliable treatment option that enhances aesthetics and minimizes the occurrence of ceramic fractures, ensuring the treatment prognosis and predictability.
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Ali K, Kay EJ. What are the long-term survival and complication rates of complete-arch fixed implant rehabilitation in edentulous patients? Evid Based Dent 2019; 20:97-98. [PMID: 31562417 DOI: 10.1038/s41432-019-0052-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cohort selection The study cohort was selected through screening of electronic records of all patients rehabilitated with interforaminal implants and implant-supported fixed complete dental prostheses (IFCDPs) over an 11-year period at the Tufts University School of Dental Medicine. Evaluation was based on medical and dental history; clinical oral examination of hard and soft tissues; and radiographic examination during a single visit.Data analysis Survival and failure rates of implants and prostheses were recorded based on predefined criteria. Along with descriptive statistics, the observed annual incidence, and the estimated five- and ten-year biologic and technical complications were computed with 95% confidence intervals.Results The study cohort included 41 patients with an average age of 65.8 years (range = 39 to 88 years) and comprised 19 females and 22 males. A total of 359 moderately rough surface dental implants (Nobel Biocare, Straumann, Biomet 3i) were used to rehabilitate 36 cement-retained and 19 screw-retained metal-ceramic IFCDPs in maxilla (N = 32) mandible (N = 23). The mean observation times for implants and prostheses were 5 and 7.5 years, respectively. Two implant failures in a single patient were recorded 11 years post-insertion, yielding an implant survival rate of 99.4%. The cumulative prostheses survival rate was 98.2% (100% at five years and 92.9% at ten years). Biologic and/or technical complications were associated with all 55 prostheses. Among major complications, the most frequent biologic complication was peri-implantitis while porcelain fractures were the most common technical complication. The cumulative rates of 'prostheses free of biologic complications' were 50.4% (95% CI: 36.4% to 63.0%) at five years and 10.1% (95% CI: 3.5% to 20.8%) at ten years. The cumulative rates for 'prosthesis free of technical complications' were 56.4% (95% CI: 41.7% to 68.8%) at five years and 9.8% (95% CI: 3.2% to 21.0%) at ten years.Conclusions Metal-ceramic implant-supported fixed full arch dental prostheses show high survival rates at five-year follow-up, including an implant survival rate of 99.4% and prosthesis survival rate of 98.2%. However biological and technical complications were observed in 47.1% and 42%, respectively.
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Affiliation(s)
- Kamran Ali
- Peninsula Dental School, University of Plymouth, Plymouth, Devon, UK
| | - Elizabeth J Kay
- Peninsula Dental School, University of Plymouth, Plymouth, Devon, UK
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AlTarawneh S, Abu-Awwad M, Riyal S, Samara R, Hattar S. A multi-center retrospective assessment of monolithic zirconia restorations on posterior teeth and implants. JOURNAL OF ORAL RESEARCH 2019. [DOI: 10.17126/joralres.2019.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: the purpose of this multicenter retrospective study was to report on survival, success, and complication rates in monolithic zirconia restorations on teeth and implants. Materials and Methods: data on 671 monolithic zirconia restorations was collected by five prosthodontists from three different specialty practice centers, including a dental school and two private practice centers. Restorations included single crowns and multiple-unit fixed dental prostheses on teeth and implants in the posterior area (premolar and molars). Follow-up time was up to 62 months. Results: mean follow-up time was 28.1±12.9 months. A total of 671 units, 534 single crowns, and 137 multi-unit restorations. Cumulative survival and success rates at 5 years were 97.4%, and 93.8% respectively. Complications presented in 11 restorations out of 671 and included: decementation, abutment screw loosening, restoration crack, restoration fracture, and tooth fracture. No significant differences were observed between tooth-supported and implant-supported restoration (p=0.42), single crowns and multiple-unit restorations (p=0.07), bruxers and non-bruxers (p=0.57). Patients with group function occlusal scheme had significantly less survival rates (p=0.001). Conclusion: the use of monolithic zirconia for restorations on the posterior teeth and implants seems to be promising as it provides a durable solution with a low rate of complications.
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Robati Anaraki M, Torab A, Mounesi Rad T. Comparison of stress in implant-supported monolithic zirconia fixed partial dentures between canine guidance and group function occlusal patterns: A finite element analysis. J Dent Res Dent Clin Dent Prospects 2019; 13:90-97. [PMID: 31592107 PMCID: PMC6773921 DOI: 10.15171/joddd.2019.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 07/30/2019] [Indexed: 12/18/2022] Open
Abstract
Background. Monolithic zirconia is an emerging material for crowns and bridges. The possibility of full digital design has made it an attractive alternative material for implant-supported prostheses. A proper design is vital in the success of such a prosthesis like any other. This study, in the shortage of scientific evidence, has tried to assess the stress distribution of occlusal forces inside the implant-prosthesis system of a 3-unit bridge made of monolithic zirconia. Methods. A 3-unit monolithic zirconia bridge supported by two implant fixtures placed on the teeth #13 and #15 was digitalized. It was converted to a mesh of 59000 nodes and 34000 elements. Five types of occlusal forces (one as vertical centric, two at 15º and 30º simulating canine pattern of lateral movement, and two at 15º and 30º simulating group function pattern) were applied. The stress distribution among all the components of the implant-bridge system was assessed using Ansys Workbench 14 software and finite element analysis. Results. The maximum stress was between 286 and 546 MPa, which were found in either the fixture‒abutment screw area or in the upper part of the pontic connector between the canine and first premolar. The maximum pressure increased with an increase in the angle of occlusal force. Significantly higher stress was recorded in the group function occlusal pattern. Conclusion. Monolithic zirconia can be promising in designing bridges in the canine‒premolar area. However, proper design is necessary with more attention to the connectors and types of occlusal forces.
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Affiliation(s)
- Mahmood Robati Anaraki
- Dental and Periodontal Research Center, Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Ali Torab
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
| | - Taymaz Mounesi Rad
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Science, Tabriz, Iran
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Ahmed WM, Troczynski T, McCullagh AP, Wyatt CCL, Carvalho RM. The influence of altering sintering protocols on the optical and mechanical properties of zirconia: A review. J ESTHET RESTOR DENT 2019; 31:423-430. [PMID: 31140674 DOI: 10.1111/jerd.12492] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/17/2019] [Accepted: 05/20/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE As a result of advancements in chairside technology and speed sintering techniques and increased esthetic demands of patients, efforts have been made to produce monolithic zirconia restorations that are highly translucent, strong, and dense. While methods for processing zirconia are well known, there is a tendency to modify the process parameters with the aim of decreasing the overall processing time and, in particular, the sintering time. This review provides clinicians with scientific evidence of the effects of altering sintering parameters used for dental zirconia on its microstructure, phase transformation, and mechanical and optical properties. MATERIALS AND METHODS A systematic search of Embase and Medline using Boolean operators was performed to locate relevant articles. RESULTS Eleven articles were selected for this review. The following characteristics of monolithic zirconia have been confirmed to be affected by alterations in sintering: the microstructure, mechanical properties, optical properties, wear behavior, and low thermal degradation. CONCLUSIONS The alteration of sintering parameters has been found to alter the grain size, wear behavior, and translucency of zirconia. There is a lack of clinical studies that investigate the influence of altering sintering parameters or methods on the clinical performance of monolithic zirconia restorations. CLINICAL SIGNIFICANCE Alteration of sintering parameters alters the microstructural, mechanical, and optical properties of zirconia. This will consequently impact the clinical performance of zirconia prostheses. Future clinical investigations are encouraged to support these in vitro findings.
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Affiliation(s)
- Walaa M Ahmed
- Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada.,Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Tom Troczynski
- Faculty of Applied Science, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Anthony P McCullagh
- Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Chris C L Wyatt
- Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ricardo M Carvalho
- Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
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Abstract
Dental implants continue to grow in popularity because they are a predictable treatment to replace missing teeth. They have a high success rate; however, they are still associated with some clinical complications. This article discusses a diverse range of complications related to the restorative and mechanical aspects of dental implants and the management of such complications, as well as potential factors contributing to them.
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Affiliation(s)
- Ingeborg J De Kok
- Department of Restorative Sciences, University of North Carolina, CB # 7450, Chapel Hill, NC 27599-7450, USA.
| | - Ibrahim S Duqum
- Division of Prosthodontics, Department of Restorative Sciences, University of North Carolina, CB # 7450, Chapel Hill, NC 27599-7450, USA
| | - Lauren H Katz
- Department of Restorative Sciences, University of North Carolina, CB # 7450, Chapel Hill, NC 27599-7450, USA
| | - Lyndon F Cooper
- Department of Oral Biology, University of Illinois at Chicago, College of Dentistry, Room 402E, 801 S Paulina Street, Chicago, IL 60612, USA
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Degirmenci K, Kocak-Buyukdere A, Ekici B. Evaluation of reliability of zirconia materials to be used in implant-retained restoration on the atrophic bone of the posterior maxilla: A finite element study. J Adv Prosthodont 2019; 11:112-119. [PMID: 31080572 PMCID: PMC6491356 DOI: 10.4047/jap.2019.11.2.112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Zirconia materials have been used for implant-retained restorations, but the stress distribution of zirconia is not entirely clear. The aim of this study is to evaluate the stress distribution and risky areas caused by the different design of zirconia restorations on the atrophic bone of the posterior maxilla. MATERIALS AND METHODS An edentulous D4-type bone model was prepared from radiography of an atrophic posterior maxilla. Monolithic zirconia and zirconia-fused porcelain implant-retained restorations were designed as splinted or non-splinted. 300-N occlusal forces were applied obliquely. Stress analyses were performed using a 3D FEA program. RESULTS According to stress analysis, the bone between the 1) molar implant and the 2) premolar in the non-splinted monolithic zirconia restoration model was stated as the riskiest area. Similarly, the maximum von Mises stress value was detected on the bone of the non-splinted monolithic zirconia models. CONCLUSION Splinting of implant-retained restorations can be more critical for monolithic zirconia than zirconia fused to porcelain for the longevity of the bone.
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Affiliation(s)
- Kubra Degirmenci
- Department of Prosthodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Ayse Kocak-Buyukdere
- Department of Prosthodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey
| | - Bulent Ekici
- Department of Mechanical Engineering, Faculty of Engineering, Marmara University, Istanbul, Turkey
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Cooper LF, De Kok IJ, Thalji G, Bryington MS. Prosthodontic Management of Implant Therapy: Esthetic Complications. Dent Clin North Am 2019; 63:199-216. [PMID: 30825986 DOI: 10.1016/j.cden.2018.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The essential promise of implant dentistry is the ability to imperceptibly replace missing teeth. To achieve this, careful planning, execution, and maintenance is required by the dentist and patient to maintain a long-term esthetic and functional result. Unfortunately, as a result of biological, prosthetic, and iatrogenic factors, unesthetic results can occur. This article explores the potential causes for the unesthetic dental implant and the possible solutions that may improve the clinical situation. Whereas relatively simple errors may be corrected through prosthetic means, greater complications may require surgical intervention to achieve the desired result.
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Affiliation(s)
- Lyndon F Cooper
- Department of Oral Biology, University of Illinois at Chicago, 801 South Paulina Street, 402E, Chicago, IL 60612, USA.
| | - Ingeborg J De Kok
- Department of Restorative Sciences, University of North Carolina, CB #7450, Chapel Hill, NC 27599-7450, USA
| | - Ghadeer Thalji
- Department of Restorative Sciences, University of Illinois at Chicago, 801 South Paulina Street, Room 365B, Chicago, IL 60612, USA
| | - Matthew S Bryington
- Department of Restorative Dentistry, West Virginia University, School of Dentistry, PO Box 9495, One Medical Center Drive, Morgantown, WV 26506-9495, USA
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Lemos CAA, Verri FR, Gomes JMDL, de Souza Batista VE, Cruz RS, Oliveira HFFE, Pellizzer EP. Ceramic versus metal-ceramic implant-supported prostheses: A systematic review and meta-analysis. J Prosthet Dent 2019; 121:879-886.e4. [PMID: 30661882 DOI: 10.1016/j.prosdent.2018.09.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM There is insufficient evidence to recommend the restorative material for implant-supported prostheses. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate studies that compared ceramic and metal-ceramic restorations for implant-supported prostheses (within the same study to avoid indirect comparison) in terms of the mechanical and biological complication rates, prosthesis survival rate, and marginal bone loss. MATERIAL AND METHODS Two independent reviewers performed a comprehensive search in databases (PubMed/MEDLINE, Web of Science, and Cochrane Library) for articles indexed until March 31, 2018. The search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and methods were registered in the International Prospective Register of Systematic Reviews (PROSPERO). The focused question was "Do ceramic restorations have mechanical/biological complication rates, prosthesis survival rates, and marginal bone loss similar to those of metal-ceramic restorations?" RESULTS The search identified 949 references. The interinvestigator agreement using kappa values was 0.87 for PubMed/MEDLINE, 0.93 for Scopus, and 1.0 for the Cochrane Library. After analysis, 12 studies were selected for qualitative and quantitative analysis. The mechanical complication rate did not differ between ceramic and metal-ceramic restorations (P=.89), independent of the type of prostheses (single crown: P=.63; fixed partial denture: P=.65). The biological complication rate was also not significantly different between ceramic and metal-ceramic restorations (P=.21). The prosthesis survival rate showed no significant differences between the 2 types of restorations (P=.56). Marginal bone loss was also similar for both types of restorations (P=.12). CONCLUSIONS This systematic review indicated that ceramic and metal-ceramic implant-supported prostheses have similar mechanical and biological complication rates, prosthesis survival rates, and marginal bone loss. Thus, both treatments are appropriate options for long-term rehabilitation treatment.
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Affiliation(s)
- Cleidiel Aparecido Araújo Lemos
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil.
| | - Fellippo Ramos Verri
- Adjunct Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Jéssica Marcela de Luna Gomes
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | - Victor Eduardo de Souza Batista
- Associate Professor, Department of Prosthodontics, Presidente Prudente Dental School, University of Western São Paulo (UNOESTE), Presidente Prudente, Brazil
| | - Ronaldo Silva Cruz
- Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
| | | | - Eduardo Piza Pellizzer
- Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil
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Prosthetic Rehabilitation of Edentulous Patients With Implants Based on Facial Profile Assessment: A Case Report. IMPLANT DENT 2019; 28:91-98. [PMID: 30640310 DOI: 10.1097/id.0000000000000856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To introduce a user-friendly protocol for implant-retained prosthetic rehabilitation of fully edentulous patients based on facial profile and the cephalometric intermaxillary relationship. MATERIALS AND METHODS The prosthetic rehabilitation of edentulous patients with implants based on facial profile assessment protocol commences with a clinical and cephalometric analysis, followed by a preliminary projection to obtain a harmonious interarch relationship, eventually stabilized by the preplanned prosthesis. The protocol is divided into the following 5 phases: esthetic evaluation; cephalometric-occlusal assessment; surgery; provisionalization; and definitive prosthesis. Evaluation of patient's satisfaction from the treatment provided was performed through a preoperative and postoperative visual analogue scale scores. RESULTS The patient was granted immediate function and superior esthetics at day 1 of the treatment. These results were re-evaluated on an interval of 18 months and continued to be stable. The overall treatment time was significantly reduced. CONCLUSION Our recommended protocol gives the clinician a chance to grasp results beyond the offered by traditional protocols by using a wider perspective of rehabilitation, involving the patient's facial profile, thus fulfilling the integration of both occlusal and cephalometric parameters in a unified surgical-prosthetic approach.
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Caramês J, Marques D, Malta Barbosa J, Moreira A, Crispim P, Chen A. Full-arch implant-supported rehabilitations: A prospective study comparing porcelain-veneered zirconia frameworks to monolithic zirconia. Clin Oral Implants Res 2018; 30:68-78. [DOI: 10.1111/clr.13393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 11/14/2018] [Accepted: 11/24/2018] [Indexed: 12/01/2022]
Affiliation(s)
- João Caramês
- Department of Oral Surgery and Implant Dentistry; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- LIBPhys-FCT UID/FIS/04559/201; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- Department of Oral Surgery and Implant Dentistry; Implantology Institute; Lisbon Portugal
| | - Duarte Marques
- LIBPhys-FCT UID/FIS/04559/201; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- Department of Morfo-Functional Sciences; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- Department of Oral Rehabilitation; Implantology Institute; Lisbon Portugal
| | - João Malta Barbosa
- Department of Oral Rehabilitation; Implantology Institute; Lisbon Portugal
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York New York
| | - André Moreira
- Department of Oral Rehabilitation; Implantology Institute; Lisbon Portugal
| | - Pedro Crispim
- Department of Oral Rehabilitation; Implantology Institute; Lisbon Portugal
- Department of Occlusion and Oral Rehabilitation; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
| | - André Chen
- Department of Oral Surgery and Implant Dentistry; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- Department of Oral Surgery and Implant Dentistry; Implantology Institute; Lisbon Portugal
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46
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The smiling scan technique: Facially driven guided surgery and prosthetics. J Prosthodont Res 2018; 62:514-517. [DOI: 10.1016/j.jpor.2018.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 02/24/2018] [Accepted: 03/01/2018] [Indexed: 11/23/2022]
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47
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Wong CKK, Narvekar U, Petridis H. Prosthodontic Complications of Metal-Ceramic and All-Ceramic, Complete-Arch Fixed Implant Prostheses with Minimum 5 Years Mean Follow-Up Period. A Systematic Review and Meta-Analysis. J Prosthodont 2018; 28:e722-e735. [DOI: 10.1111/jopr.12797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 10/17/2022] Open
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Bakitian F, Seweryniak P, Papia E, Larsson C, Vult von Steyern P. Effect of different semimonolithic designs on fracture resistance and fracture mode of translucent and high-translucent zirconia crowns. Clin Cosmet Investig Dent 2018; 10:51-60. [PMID: 29628778 PMCID: PMC5878660 DOI: 10.2147/ccide.s157118] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to describe different designs of semimonolithic crowns made of translucent and high-translucent zirconia materials and to evaluate the effect on fracture resistance and fracture mode. Methods One hundred crowns with different designs were produced and divided into five groups (n=20): monolithic (M), partially veneered monolithic (semimonolithic) with 0.3 mm buccal veneer (SM0.3), semimonolithic with 0.5 mm buccal veneer (SM0.5), semimonolithic with 0.5 mm buccal veneer supported by wave design (SMW), and semimonolithic with 0.5 mm buccal veneer supported by occlusal cap design (SMC). Each group was divided into two subgroups (n=10) according to the materials used, translucent and high-translucent zirconia. All crowns underwent artificial aging before loading until fracture. Fracture mode analysis was performed. Fracture loads and fracture modes were analyzed using two-way ANOVA and Fisher's exact probability tests (P≤0.05). Results SM0.3 design showed highest fracture loads with no significant difference compared to M and SMW designs (P>0.05). SM0.5 design showed lower fracture loads compared to SMW and SWC designs. Crowns made of translucent zirconia showed higher fracture loads compared to those made of high-translucent zirconia. M, SM0.3, and all but one of the SMC crowns showed complete fractures with significant differences in fracture mode compared to SMW and SM0.5 crowns with cohesive veneer fractures (P≤0.05). Conclusion Translucent and high-translucent zirconia crowns might be used in combination with 0.3 mm microcoating porcelain layer with semimonolithic design to enhance the esthetic properties of restorations without significantly decreasing fracture resistance of the crowns. If 0.5 mm porcelain layer is needed for a semimonolithic crown, wave design or cap design might be used to increase fracture resistance. In both cases, fracture resistance gained is likely to be clinically sufficient as the registered fracture loads were high in relation to expected loads under clinical use.
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Affiliation(s)
- Fahad Bakitian
- Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Evaggelia Papia
- Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Per Vult von Steyern
- Department of Materials Science and Technology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Belur D, Nagy WW. An alternative digital workflow for fabricating a mandibular implant-supported complete fixed dental prosthesis with limited restorative space: A clinical report. J Prosthet Dent 2018; 120:1-4. [PMID: 29580562 DOI: 10.1016/j.prosdent.2017.11.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/18/2017] [Accepted: 11/20/2017] [Indexed: 11/28/2022]
Abstract
This clinical report describes the prosthetic rehabilitation of a patient with a mandibular implant-supported complete fixed dental prosthesis with limited interocclusal restorative space. The problem was manifested by repeated fractures of the acrylic resin teeth and distortion of the supporting framework. The definitive restoration included a custom computer-aided design and computer-aided manufacturing (CAD-CAM) titanium framework with the lingual cusps and most of the occlusal table of the mandibular posterior teeth milled in titanium as part of the framework. An esthetic CAD-CAM milled denture base along with teeth was bonded over this framework.
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Affiliation(s)
- Druthil Belur
- Resident, Graduate Prosthodontics, Department of Restorative Dentistry, Texas A&M University College of Dentistry, Dallas, Texas.
| | - William W Nagy
- Professor, Department of Restorative Dentistry, Texas A&M University College of Dentistry, Dallas, Texas
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50
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Tischler M, Patch C, Bidra AS. Rehabilitation of edentulous jaws with zirconia complete-arch fixed implant-supported prostheses: An up to 4-year retrospective clinical study. J Prosthet Dent 2018; 120:204-209. [PMID: 29559219 DOI: 10.1016/j.prosdent.2017.12.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/05/2017] [Accepted: 12/05/2017] [Indexed: 12/21/2022]
Abstract
STATEMENT OF PROBLEM Limited data are available on the clinical outcomes of patients with edentulism treated with zirconia complete-arch fixed implant-supported prostheses (CAFIPs). PURPOSE The primary purpose of this retrospective clinical study was to study the failure rate of dental implants as well as the fracture rate of zirconia CAFIPs. The secondary purpose was to study the survival outcomes of patients with edentulism treated with zirconia CAFIPs as well as the rate of technical complications. MATERIAL AND METHODS This retrospective clinical study from private practice included 128 patients rehabilitated between January 1, 2013, and December 31, 2016, with 1072 implants supporting 191 zirconia CAFIPs for single-jaw as well as double-jaw rehabilitations. All zirconia prostheses were of 1-piece design and were veneered with feldspathic porcelain only at the gingival region and therefore considered as predominantly monolithic. Additionally, all prostheses were bonded to implant manufacturer's titanium cylinders that provided an intimate contact with the implants. The primary outcome measures were implant failure rate and prosthesis fracture rate. The secondary outcome measures were prosthodontic treatment survival rate and the incidence of technical complications with respect to monolithic zirconia CAFIPs. Cumulative survival rate (CSR) for implants and prostheses was calculated after a life-table survival analysis. RESULTS Of the analyzed samples over a 4-year period, at least 288 implants and 49 prostheses had a minimum of 4 years of follow-up. A total of 18 implant failures were noted (13 in maxilla, 5 in mandible), yielding a CSR of 97.6% for implants. One fracture of the zirconia prosthesis was recorded, yielding a CSR of 99.4% for the prostheses over the 4-year period. Another 3 prostheses required remaking because the supporting implants failed, and 1 prosthesis was remade because the lack of passive fit resulted in a CSR of 96.8% for the prosthodontic treatment itself. During the 4-year period, 1 zirconia prosthesis had a technical complication related to the debonding of titanium cylinders, and 2 prostheses had fractured screws, which were resolved successfully. No zirconia prostheses had chipping of the veneered gingival porcelain. CONCLUSIONS Findings from this retrospective clinical study from private practice showed that prosthodontic treatment of edentulous patients with a 1-piece, complete-arch fixed implant-supported zirconia prosthesis with veneered porcelain restricted to the gingival region had high survival rates for implants and prostheses. Minimal technical complications related to this type of treatment for edentulous jaws and no chipping of the veneered gingival porcelain were encountered.
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