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Roccuzzo A, Imber JC, Lempert J, Jensen SS. Clinical, radiographic, and aesthetic outcomes at two narrow-diameter implants to replace congenital missing maxillary lateral incisors: A 3-year prospective, clinical study. Clin Implant Dent Relat Res 2024; 26:777-786. [PMID: 38863078 DOI: 10.1111/cid.13339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/19/2024] [Accepted: 05/03/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION To present the 3-year clinical, radiographic, and aesthetic outcomes in patients with congenitally missing lateral incisors rehabilitated with two narrow-diameter implants (NDIs). METHODS The original population consisted of 100 patients rehabilitated with a cement-retained bi-layered zirconia single-unit crown supported by either a Ø2.9 mm (Test) or a Ø3.3 mm (Control) NDI (n = 50). At the 1- and 3-year follow-up (T2, T3), implant survival rate, crestal bone level (CBL) changes, biological, and technical complications were recorded, while the assessment of the aesthetic outcomes was performed using the Copenhagen Index Score. RESULTS Seventy-four patients Ø2.9 mm (n = 39) or Ø3.3 mm (n = 35) reached T3, as 24 patients were lost to follow-up and 1 implant (Ø3.3 mm) was removed. Throughout the observation period, minimal CBL changes (i.e., <1 mm) were detected between groups. Despite the positive aesthetic scores recorded (i.e., 1-2), at T3 20% of patients rehabilitated with a Ø3.3 mm versus 2.6% of patients Ø2.9 mm displayed an alveolar process deficiency (Score 3). No additional technical and/or mechanical complications were recorded between T2 and T3. Tooth vitality was maintained in all neighboring teeth. Peri-implant probing depths and plaque scores remained low in both groups (p > 0.05). CONCLUSION The use of 2.9 or 3.3 diameter implants showed comparable favorable mid-term results in terms of survival rate, CBL, and aesthetic outcomes. Hence, clinicians should rely on the use of such NDIs when replacing maxillary lateral incisors.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jakob Lempert
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Simon Storgård Jensen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
- Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Faculty of Health and Medical Sciences, Institute of Odontology, University of Copenhagen, Copenhagen, Denmark
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Sanatnama E, Frantz L, Ahlin E, Naoumova J. Implant-supported crowns on maxillary laterals and canines-a long-term follow-up of aesthetics and function. Clin Oral Investig 2023; 27:7545-7555. [PMID: 37940682 PMCID: PMC10713674 DOI: 10.1007/s00784-023-05344-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/14/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To assess the long-term aesthetic and functional aspects of implant-supported crowns in lateral (ISC-L) and canine positions (ISC-C). MATERIALS AND METHODS Thirty-two patients (14 males, 18 females, mean age: 23.1, SD:2.0) with an ISC-L or ISC-C participated in this prospective cohort study at baseline (T0) and in the long-term follow-up (T1, mean years: 11.1, SD: 1.0). Twenty-four patients (11 males, 13 females) participated in T1. Patient-reported outcomes (PROM) were rated using surveys with questions related to aesthetics and function. The colour of the implant crown and the buccal gingiva, the appearance of the papilla, periodontal health and temporomandibular disorder (TMD) outcomes were assessed in a clinical examination. The Mann-Whitney, Chi-square and Signed Rank tests were performed. RESULTS Patients with an ISC-L and ISC-C were equally satisfied with the crown shape and colour at T0 and T1. No differences in TMD outcomes were reported by the patients and no clinical signs of TMD were observed. At T1, ISC-C had more bleeding on probing and a three mm greater pocket depth than ISC-L (p = 0.03, p = 0.01, respectively). At T0, operators graded the crown colour of ISC-L as being too dark (35%) and ISC-C as being too light (40%). At T1, no difference was seen between the two groups regarding crown colour, gingiva colour and the papilla (p = 0.2749, p = 0.2099, p = 0.8053, respectively). CONCLUSIONS The PROM and clinical examination show that ISC-L and ISC-C are equivalent with regard to aesthetics and function in the long term. CLINICAL RELEVANCE Although ISC-L and ISC-C are aesthetically and functionally comparable in the long term, ISC-Cs are more likely to impact periodontal health.
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Affiliation(s)
- Elnaz Sanatnama
- Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Lena Frantz
- Specialist Clinic for Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Erik Ahlin
- Specialist Clinic for Orthodontics, Borås, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden
| | - Julia Naoumova
- Specialist Clinic for Orthodontics, Gothenburg, Public Dental Service, Region Västra Götaland, Gothenburg, Sweden.
- Department of Orthodontics, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Wittneben J, Yilmaz B, Wismeijer D, Shahdad S, Brägger U, Abou‐Ayash S. Patient‐reported outcome measures focusing on the esthetics of implant‐compared to tooth‐supported single crowns—A systematic review and meta‐analysis. J ESTHET RESTOR DENT 2022; 35:632-645. [DOI: 10.1111/jerd.12983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Julia‐Gabriela Wittneben
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
- Department of Restorative Dentistry and Biomaterials Sciences Harvard School of Dental Medicine 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
| | - Daniel Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, ACTA University of Amsterdam and VU University Amsterdam The Netherlands
| | - Shakeel Shahdad
- Institute of Dentistry Queen Mary University of London London UK
- Restorative Dentistry The Royal London Dental Hospital London UK
| | - Urs Brägger
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
| | - Samir Abou‐Ayash
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine University of Bern Bern Switzerland
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Roccuzzo A, Imber JC, Lempert J, Hosseini M, Jensen SS. Narrow diameter implants to replace congenital missing maxillary lateral incisors: a 1-year prospective, controlled, clinical study. Clin Oral Implants Res 2022; 33:844-857. [PMID: 35763401 PMCID: PMC9544295 DOI: 10.1111/clr.13966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/29/2022] [Accepted: 06/03/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To report the clinical, radiographic, aesthetic and patient-reported outcomes after placement of a newly developed Narrow-Diameter Implant (NDI) in patients with congenitally Missing Lateral Incisors (MLIs). MATERIALS AND METHODS Patients with MLIs with a mesio-distal distance between the canine and the central incisor of 5.9-6.3mm received a dental implant with a diameter of 2.9mm (Test), while a diameter of 3.3mm (Control) was used when the distance was 6.4-7.1mm. After healing, a cement-retained bi-layered zirconia crown was fabricated. At the 1-year follow-up (T2), implant survival rate, marginal Crestal Bone Level (CBL) changes, biological and technical complications were registered. The aesthetic outcome was assessed by using the Copenhagen Index Score, and the patient-reported outcomes were recorded using the OHIP-49 questionnaire. RESULTS One-hundred patients rehabilitated with 100 dental implants Ø2.9mm (n = 50) or Ø3.3mm (n = 50) were included. One Ø3.3mm implant was lost and 7 patients dropped out of the study, yielding an implant survival rate of 99% (p = 1.000). At T2 a CBL of -0.19 ± 0.25 mm (Test) and -0.25 ± 0.31 mm (Control) was detected, with no statistically significant difference between the groups (p = 0.342). Good to excellent aesthetic scores (i.e. 1-2) were recorded in most of cases. Technical complications (i.e. loss of retention, abutment fracture, chipping of veneering ceramic) occurred once in three patients with no statistically significant difference between the groups (p > 0.05). OHIP scores did not differ significantly at follow-ups between groups (p = 0.110). CONCLUSION The use of Ø2.9mm diameter implants represents as reliable a treatment option as Ø3.3mm implants, in terms of CBL changes, biological and technical complications. Favorable aesthetics and patient-reported outcomes were recorded for both groups.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jakob Lempert
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mandana Hosseini
- Research Area Oral Rehabilitation, Section for Oral Health, Society and Technology, Institute of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Simon Storgård Jensen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.,Research Area Oral Surgery, Section for Oral Biology and Immunopathology, Institute of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Pjetursson BE, Sailer I, Latyshev A, Rabel K, Kohal RJ, Karasan D. A systematic review and meta-analysis evaluating the survival, the failure, and the complication rates of veneered and monolithic all-ceramic implant-supported single crowns. Clin Oral Implants Res 2021; 32 Suppl 21:254-288. [PMID: 34642991 PMCID: PMC9293296 DOI: 10.1111/clr.13863] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 12/28/2022]
Abstract
Objective To assess the survival, failure, and complication rates of veneered and monolithic all‐ceramic implant‐supported single crowns (SCs). Methods Literature search was conducted in Medline (PubMed), Embase, and Cochrane Central Register of Controlled Trials until September 2020 for randomized, prospective, and retrospective clinical trials with follow‐up time of at least 1 year, evaluating the outcome of veneered and/or monolithic all‐ceramic SCs supported by titanium dental implants. Survival and complication rates were analyzed using robust Poisson's regression models. Results Forty‐nine RCTs and prospective studies reporting on 57 material cohorts were included. Meta‐analysis of the included studies indicated an estimated 3‐year survival rate of veneered‐reinforced glass‐ceramic implant‐supported SCs of 97.6% (95% CI: 87.0%–99.6%). The estimated 3‐year survival rates were 97.0% (95% CI: 94.0%–98.5%) for monolithic‐reinforced glass‐ceramic implant SCs, 96.9% (95% CI: 93.4%–98.6%) for veneered densely sintered alumina SCs, 96.3% (95% CI: 93.9%–97.7%) for veneered zirconia SCs, 96.1% (95% CI: 93.4%–97.8%) for monolithic zirconia SCs and only 36.3% (95% CI: 0.04%–87.7%) for resin‐matrix‐ceramic (RMC) SCs. With the exception of RMC SCs (p < 0.0001), the differences in survival rates between the materials did not reach statistical significance. Veneered SCs showed significantly (p = 0.017) higher annual ceramic chipping rates (1.65%) compared with monolithic SCs (0.39%). The location of the SCs, anterior vs. posterior, did not influence survival and chipping rates. Conclusions With the exception of RMC SCs, veneered and monolithic implant‐supported ceramic SCs showed favorable short‐term survival and complication rates. Significantly higher rates for ceramic chipping, however, were reported for veneered compared with monolithic ceramic SCs.
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Affiliation(s)
- Bjarni Elvar Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.,Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Andrey Latyshev
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Maxillofacial, Oral and Plastic Surgery, Faculty of Dentistry, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Kerstin Rabel
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Ralf-Joachim Kohal
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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Priest G. The treatment dilemma of missing maxillary lateral incisors-Part II: Implant restoration. J ESTHET RESTOR DENT 2019; 31:319-326. [PMID: 31033174 DOI: 10.1111/jerd.12483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/09/2019] [Accepted: 04/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This second of a two-part series reviews the single dental implant as the most current treatment alternative for replacement of a missing or lost maxillary lateral incisor. Assessments of dental maturity for implant placement, implant space requirements, surgical and restorative influence on soft tissue profiles, and implant success are reviewed. OVERVIEW Recent data indicates that implant success rates are high, and esthetics and soft tissue profiles appear to be stable for maxillary lateral incisor implants. Implant placement should be assessed by dental maturity of the specific patient as opposed to chronological age, and implant spacing should be developed and assessed by all team members. CONCLUSIONS Implant replacement of a missing lateral incisor is a predictable treatment mode if implant placement is deferred until dental maturity and then accurately placed in a well-developed site. Treatment involves more complicated planning and execution from team members than other alternatives, but innovations in techniques and materials render it a favorable alternative for lateral incisor replacement. CLINICAL SIGNIFICANCE Implant restoration of a missing or lost maxillary lateral incisor is surgically and restoratively more complex than space closure or a resin-bonded fixed dental prosthesis but demonstrates high success rates and high esthetic potential when team members follow strict treatment protocols.
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Pjetursson BE, Valente NA, Strasding M, Zwahlen M, Liu S, Sailer I. A systematic review of the survival and complication rates of zirconia-ceramic and metal-ceramic single crowns. Clin Oral Implants Res 2019; 29 Suppl 16:199-214. [PMID: 30328190 DOI: 10.1111/clr.13306] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The aim of the present systematic review was to analyze the survival and complication rates of zirconia-based and metal-ceramic implant-supported single crowns (SCs). MATERIALS AND METHODS An electronic MEDLINE search complemented by manual searching was conducted to identify randomized controlled clinical trials, prospective cohort and retrospective case series on implant-supported SCs with a mean follow-up time of at least 3 years. Patients had to have been clinically examined at the follow-up visit. Assessment of the identified studies and data extraction was performed independently by two reviewers. Failure and complication rates were analyzed using robust Poisson's regression models to obtain summary estimates of 5-year proportions. RESULTS The search provided 5,263 titles and 455 abstracts, full-text analysis was performed for 240 articles, resulting in 35 included studies on implant-supported crowns. Meta-analysis revealed an estimated 5-year survival rate of 98.3% (95% CI: 96.8-99.1) for metal-ceramic implant supported SCs (n = 4,363) compared to 97.6% (95% CI: 94.3-99.0) for zirconia implant supported SCs (n = 912). About 86.7% (95% CI: 80.7-91.0) of the metal-ceramic SCs (n = 1,300) experienced no biological/technical complications over the entire observation period. The corresponding rate for zirconia SCs (n = 76) was 83.8% (95% CI: 61.6-93.8). The biologic outcomes of the two types of crowns were similar; yet, zirconia SCs exhibited less aesthetic complications than metal-ceramics. The 5-year incidence of chipping of the veneering ceramic was similar between the material groups (2.9% metal-ceramic, 2.8% zirconia-ceramic). Significantly (p = 0.001), more zirconia-ceramic implant SCs failed due to material fractures (2.1% vs. 0.2% metal-ceramic implant SCs). No studies on newer types of monolithic zirconia SCs fulfilled the simple inclusion criteria of 3 years follow-up time and clinical examination of the present systematic review. CONCLUSION Zirconia-ceramic implant-supported SCs are a valid treatment alternative to metal-ceramic SCs, with similar incidence of biological complications and less aesthetic problems. The amount of ceramic chipping was similar between the material groups; yet, significantly more zirconia crowns failed due to material fractures.
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Affiliation(s)
- Bjarni E Pjetursson
- Department of Reconstructive Dentistry, Faculty of Odontology, University of Iceland, Reykjavik, Iceland.,Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Nicola A Valente
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Marcel Zwahlen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Shiming Liu
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland.,Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
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Naveau A, Rignon-Bret C, Wulfman C. Zirconia abutments in the anterior region: A systematic review of mechanical and esthetic outcomes. J Prosthet Dent 2019; 121:775-781.e1. [PMID: 30617036 DOI: 10.1016/j.prosdent.2018.08.005] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM The success of single, anterior, implant-supported restorations relies on mechanical and esthetic outcomes. Titanium has been the most commonly used material for abutments, but zirconia is increasingly chosen for its appearance despite its unclear mechanical performance. Today, manufacturers market prefabricated, computer-aided design and computer-aided manufacturing (CAD-CAM) custom and zirconia abutments with titanium connections. PURPOSE The purpose of this study was to systematically review the mechanical and esthetic outcomes of implant zirconia abutments used in the anterior region, considering the design changes of the past 5 years. MATERIAL AND METHODS An electronic search was conducted in Medline (PubMed) for studies on zirconia abutments. All clinical studies with at least a 1-year follow-up and case series (>5 abutments) published after 2013 were included. Mechanical and esthetic outcomes were collected. RESULTS Of the 231 retrieved studies, 20 remained for quantitative analysis. Twelve described mechanical outcomes, and 15 focused on esthetics, using mainly the pink esthetic score. Five articles reported abutment fractures and no chipping. No difference was found between prefabricated and custom abutments or internal and external implant connections regarding fractures or screw loosening. All authors reported "good to excellent" esthetic integration in terms of restorations and soft-tissue color and the presence and height of papillae. The most difficult esthetic parameters to achieve were root convexity, soft-tissue color, and texture and level of mucosa. CONCLUSIONS Esthetics remain the major advantage of zirconia abutment when compared with titanium, despite reservations concerning the risk of mechanical complications. Data are lacking for zirconia abutments with titanium inserts, although the prospects for this design are promising.
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Affiliation(s)
- Adrien Naveau
- Associate Professor, Prosthodontics Department, University of Bordeaux, Bordeaux, France; Saint Andre Hospital, Bordeaux University Hospital, Bordeaux, France
| | - Christophe Rignon-Bret
- Associate Professor, Prosthodontics Department, Paris Descartes University - Sorbonne Paris Cité, Paris, France; Dental Department, Henri Mondor Hospital-University Group, AP-HP (Public Assistance-Paris hospital), Creteil, France
| | - Claudine Wulfman
- Associate Professor, Prosthodontics Department, Paris Descartes University - Sorbonne Paris Cité, Paris, France; Dental Department, Henri Mondor Hospital-University Group, AP-HP (Public Assistance-Paris Hospital), Creteil, France.
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Stefanini M, Felice P, Mazzotti C, Mounssif I, Marzadori M, Zucchelli G. Esthetic evaluation and patient-centered outcomes in single-tooth implant rehabilitation in the esthetic area. Periodontol 2000 2018; 77:150-164. [DOI: 10.1111/prd.12215] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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