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Zamora GP, Molina-González JM, Martínez-Marco JF, Ruiz AJO, Mardas N, Garcia-Sanchez R. Aesthetic outcomes of different materials for delayed, single-tooth restorations for immediately placed implants. A randomized controlled clinical trial. J Dent 2024; 146:105067. [PMID: 38763385 DOI: 10.1016/j.jdent.2024.105067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/21/2024] Open
Abstract
OBJECTIVES The aim of this study is to compare the aesthetic outcomes of metal porcelain (C), lithium disilicate (T1) and porcelain-layered zirconium (T2) immediate implant-supported single crowns in the anterior maxilla. MATERIALS AND METHODS Forty-five immediate dental implants were provided for 45 patients that required the extraction of a single tooth in the anterior maxilla. A temporary prosthesis was provided at 8 weeks after placement followed by the final prosthesis at 24 weeks post-implantation. The patients were randomly allocated into 3 groups: 15 patients in the control group (C) received a metal-porcelain restoration, 15 patients (T1) received a lithium disilicate (LD) restoration and 15 patients (T2) received a porcelain-layered, zirconium (Z) restoration. Pink (PES) and White (WES) esthetic scores, radiographic bone levels, periodontal parameters and patient's esthetic satisfaction using a visual analogue scale (VAS) were evaluated at the time of final restoration placement (t0) and at 12-months post-loading (t12). RESULTS No implants were lost during the duration of this study. Statistically significant higher WES and VAS scores (p < 0.05) were recorded in T1 vs C and T1 vs T2 groups respectively. Similar radiographic bone levels and periodontal parameters were recorded in all groups. CONCLUSION Within the limitations of this study, it was concluded that T1 restorations provided better WES outcomes when compared to C restorations and better VAS scores when compared to T2 restorations at 12 months post-loading. Besides, different material interphases did not have an impact in PES, bone levels or periodontal parameters. CLINICAL RELEVANCE There is limited data comparing aesthetic outcomes of implant supported single crowns made of different ceramic materials based on accepted and comparable indexes and the evaluation of the patient's perspective regarding these aesthetic outcomes.
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Affiliation(s)
| | | | | | | | - Nikos Mardas
- QMUL, Barts & The London School of Dentistry, London, United Kingdom
| | - Ruben Garcia-Sanchez
- Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; King's College London, London, United Kingdom.
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Diken Türksayar AA, Demirel M, Donmez MB, Olcay EO, Eyüboğlu TF, Özcan M. Comparison of wear and fracture resistance of additively and subtractively manufactured screw-retained, implant-supported crowns. J Prosthet Dent 2024; 132:154-164. [PMID: 37479623 DOI: 10.1016/j.prosdent.2023.06.017] [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: 05/05/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/23/2023]
Abstract
STATEMENT OF PROBLEM Additively manufactured resins indicated for fixed definitive prostheses have been recently marketed. However, knowledge on their wear and fracture resistance when fabricated as screw-retained, implant-supported crowns and subjected to artificial aging is limited. PURPOSE The purpose of this in vitro study was to evaluate the volume loss, maximum wear depth, and fracture resistance of screw-retained implant-supported crowns after thermomechanical aging when fabricated using additively and subtractively manufactured materials. MATERIAL AND METHODS Two additively manufactured composite resins (Crowntec [CT] and VarseoSmile Crown Plus [VS]) and 2 subtractively manufactured materials (1 reinforced composite resin, Brilliant Crios [BC] and 1 polymer-infiltrated ceramic network, Vita Enamic [EN]) were used to fabricate standardized screw-retained, implant-supported crowns. After fabrication, the crowns were cemented on titanium base abutments and then tightened to implants embedded in acrylic resin. A laser scanner with a triangular displacement sensor (LAS-20) was used to digitize the pre-aging state of the crowns. Then, all crowns were subjected to thermomechanical aging (1.2 million cycles under 50 N) and rescanned. A metrology-grade analysis software program (Geomagic Control X 2020.1) was used to superimpose post-aging scans over pre-aging scans to calculate the volume loss (mm3) and maximum wear depth (mm). Finally, all crowns were subjected to a fracture resistance test. Fracture resistance and volume loss were evaluated by using 1-way analysis of variance and Tukey Honestly significant difference (HSD) tests, whereas the Kruskal-Wallis and Dunn tests were used to analyze maximum wear depth. Chi-squared tests were used to evaluate the Weibull modulus and characteristic strength data (α=.05). RESULTS Material type affected the tested parameters (P<.001). CT and VS had higher volume loss and maximum wear depth than BC and EN (P<.001). EN had the highest fracture resistance among tested materials (P<.001), whereas BC had higher fracture resistance than CT (P=.011). The differences among tested materials were not significant when the Weibull modulus was considered (P=.199); however, VE had the highest characteristic strength (P<.001). CONCLUSIONS Additively manufactured screw-retained, implant-supported crowns had higher volume loss and maximum wear depth. All materials had fracture resistance values higher than the previously reported masticatory forces of the premolar region; however, the higher characteristic strength of the subtractively manufactured polymer-infiltrated ceramic network may indicate its resistance to mechanical complications.
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Affiliation(s)
- Almira Ada Diken Türksayar
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey; and Guest Researcher, ADMiRE Research Center-Additive Manufacturing, Intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Villach, Austria
| | - Münir Demirel
- Assistant Professor, Oral and Dental Health, Vocational School, Biruni University, Istanbul, Turkey
| | - Mustafa Borga Donmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey; and Visiting Researcher, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Emin Orkun Olcay
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey
| | - Tan Fırat Eyüboğlu
- Associate Professor, Department of Endodontics, Istanbul Medipol University, Faculty of Dentistry, Istanbul, Turkey
| | - Mutlu Özcan
- Professor and Head, Clinic of Masticatory Disorders and Dental Biomaterials, Center for Dental Medicine, University of Zurich, Zurich, Switzerland
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Khijmatgar S, Tumedei M, Tartaglia G, Crescentini M, Isola G, Sidoti E, Sforza C, Del Fabbro M, Tartaglia GM. Fifteen-year recall period on zirconia-based single crowns and fixed dental prostheses. A prospective observational study. BDJ Open 2024; 10:54. [PMID: 38902278 PMCID: PMC11190277 DOI: 10.1038/s41405-024-00214-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/13/2024] [Accepted: 03/13/2024] [Indexed: 06/22/2024] Open
Abstract
AIM The aim of this study was to evaluate the long-term clinical outcomes of zirconia-based prostheses used for tooth-supported or implant-supported single crowns and fixed dental prostheses (FPD). METHODS The authors conducted a prospective analysis of 562 zirconia core restorations supported by endodontically treated teeth or titanium implant in 276 patients in a general dental private practice, with a follow-up period of 15 years. The study was stopped after patients achieved 15 yrs of follow-up. The study analyzed the failure and complication rates of single and multiple crowns, based on Kaplan Meier analysis. RESULTS During follow-up period, there were 26 complications and 156 failures. The crown level analysis revealed a cumulative failure rate of 28.33% and complication rate of 8.47% for zirconia crowns after 15 years. The complication rate was found to be higher for titanium implant-supported than for natural teeth-supported crowns. The different types of crown-based failure include: veener fracture 5.01% (N = 29), metal zirconia led to 14.85% (N = 86) loss of retention, and 1.73% (N = 10) loss of crown due to extraction. CONCLUSION Based on these findings, zirconia core restorations appear to be a reliable long-term solution for crowns and fixed dental prostheses. CLINICAL RELEVANCE The study suggests that zirconia restorations can be successfully used for long-term prostheses on natural teeth or implants supported. The study results provide clinicians valuable information when selecting prosthetic restorations material.
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Affiliation(s)
| | - Margherita Tumedei
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- School of Medicine, University of Madrid, Madrid, Spain
| | | | | | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via S. Sofia 78, 95124, Catania, Italy
| | | | - Chiarella Sforza
- Department of Biomedical Sciences for Health, University of Milan, Via Mangiagalli 31, 20133, Milan, Italy
| | - Massimo Del Fabbro
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- School of Medicine, University of Madrid, Madrid, Spain
| | - Gianluca Martino Tartaglia
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- School of Medicine, University of Madrid, Madrid, Spain.
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Kobayashi T, Honda J, Kubochi K, Iwasaki T, Watanabe Y, Komine F. Influence of attaching mechanical retentive devices onto frameworks on fracture resistance of implant-supported zirconia crowns. Dent Mater J 2024; 43:359-366. [PMID: 38583996 DOI: 10.4012/dmj.2023-188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
This study investigated the fracture load of implant-supported zirconia crowns (IZCs), in which indirect composite resin or feldspathic porcelain was layered onto zirconia frameworks with mechanical retentive devices. Three different zirconia frameworks were assessed: attaching mechanical retentive devices on glaze and opaque porcelain materials (GL and OP groups, respectively), and no attaching mechanical retentive devices (ND group). The frameworks were layered using feldspathic porcelain (FP veneer) and indirect composite resin (IC veneer). Fracture load of the specimens was measured. In FP veneer, the GL group recorded the highest fracture load. In the IC veneer, the GL and OP groups had significantly higher fracture load than the ND group. The fracture resistance of IZCs can be enhanced by applying glaze material before attaching mechanical retentive devices for porcelain layering. The mechanical retentive devices effectively yielded mechanical interlocking between the zirconia frameworks and the IC veneer in GL and OP groups.
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Affiliation(s)
- Tatsuro Kobayashi
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Junichi Honda
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Kei Kubochi
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Taro Iwasaki
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Yusuke Watanabe
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Futoshi Komine
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
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Guljé FL, Raghoebar GM, Gareb B, Vissink A, Meijer HJA. Single crown restorations supported by 6-mm implants in the resorbed posterior mandible: A 10-year prospective case series. Clin Implant Dent Relat Res 2024; 26:642-650. [PMID: 38534097 DOI: 10.1111/cid.13326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 03/14/2024] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE To assess marginal bone level changes, implant and restoration survival, condition of the peri-implant mucosa, and the patient's satisfaction with the single restoration supported by a 6-mm long implant in the posterior mandible after 10 years in function. MATERIALS AND METHODS Twenty-one consecutive patients missing premolars or molars in the posterior mandible, with a bone volume consisting of a width of at least 6 mm and an estimated height of 8 mm between the top of the ridge and alveolar nerve, were included. Each patient received one or more 6-mm implants. After 3 months, the implants were restored with custom-made titanium abutments and cemented zirconia-based porcelain crowns. The clinical examination and radiograph data were assessed at restoration placement and after 12, 60, and 120 months. The patients answered a questionnaire to score their satisfaction before treatment and after 12, 60, and 120 months with the restoration in function. RESULTS A total of 31 implants were placed. Implant survival was 100%. The 10-year mean marginal bone loss was 0.18 mm (SE: 0.08). The plaque, calculus, gingiva, and bleeding indices scores were low as was the mean pocket probing depth. The patients' satisfaction was high. CONCLUSION The 10-year follow-up data of this limited case series study reveal that 6-mm dental implants inserted in the resorbed posterior mandible provide a solid basis for single tooth restorations.
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Affiliation(s)
- Felix L Guljé
- Referral practice for implant dentistry, Center for Dental Implants De Mondhoek, Apeldoorn, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Donker VJJ, Raghoebar GM, Slagter KW, Hentenaar DFM, Vissink A, Meijer HJA. Immediate implant placement with immediate or delayed provisionalization in the maxillary aesthetic zone: A 10-year randomized trial. J Clin Periodontol 2024; 51:722-732. [PMID: 38454548 DOI: 10.1111/jcpe.13971] [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: 09/14/2023] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
AIM To compare the marginal bone level of immediately placed implants, with either immediate or delayed provisionalization (IP or DP), in the maxillary aesthetic zone after 10 years of function. MATERIALS AND METHODS Participants with a failing tooth in the maxillary aesthetic zone were randomly assigned to immediate implant placement with either IP (n = 20) or DP (n = 20) after primary wound closure with a free gingival graft. The final restoration was placed 3 months after provisionalization. The primary outcome was change in marginal bone level. In addition, implant survival, restoration survival and success, peri-implant tissue health, mucosa levels, aesthetic indices, buccal bone thickness and patient satisfaction were evaluated. RESULTS After 10 years, the mean mesial and distal changes in marginal bone level were -0.47 ± 0.45 mm and -0.49 ± 0.52 mm in the IP group and -0.58 ± 0.76 mm and -0.41 ± 0.72 mm in the DP group (p = .61; p = .71). The survival rate was 100% for the implants; for the restorations, it was 88.9% in the IP group and 87.5% in the DP group. Restoration success, according to modified USPHS criteria, was 77.8% in the IP group and 75.0% in the DP group. The prevalence of peri-implant mucositis was 38.9% and 35.7% and of peri-implantitis 0.0% and 6.3%, respectively, in the IP group and DP group (p = 1.0; p = .40). The Pink Esthetic Score and White Esthetic Score was 15.28 ± 2.32 in the IP group and 14.64 ± 2.74 in the DP group, both clinically acceptable (p = .48). The buccal bone thickness was lower in the DP group. Patient satisfaction was similar in both groups (p = .75). CONCLUSIONS The mean marginal bone level changes after immediate implant placement with IP were similar to those after immediate placement with DP. CLINICAL TRIAL REGISTRATION Registered in the National Trial Register (NL9340).
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Affiliation(s)
- Vincent J J Donker
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Kirsten W Slagter
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Restorative Dentistry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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7
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Molinero-Mourelle P, Schimmel M, Forrer FA, Hicklin SP, Raabe C, Chappuis V, Fonseca M. Clinical and radiographic performance of late placed and early loaded dental implants with a conditioned hydrophilic surface in posterior mandible sites: A prospective case series with an 8.5- to 9.5-year follow-up. Clin Implant Dent Relat Res 2024. [PMID: 38711297 DOI: 10.1111/cid.13333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 04/05/2024] [Accepted: 04/11/2024] [Indexed: 05/08/2024]
Abstract
OBJECTIVE To assess the clinical outcomes by means of implant and prosthetic survival of late placed and early loaded implants with a hydrophilic, moderately rough surface for partially edentulous patients after a follow-up of 8.5 to 9.5 years. MATERIALS AND METHODS A prospective case series study involving 15 patients with single, late placed and early loaded implants in the posterior mandible was performed. Clinical and radiographical parameters, including biological and technical complications and patient satisfaction, were assessed. RESULTS From an initial sample of 15 patients, 12 were included. A total of 16 implants were observed. After a mean follow-up of 9 years and 7 months (SD ± 3.8 months), implant success and survival rate were 100%. The prosthetic survival rate was 100%, and the prosthetic success rate was 93.8% since a major chipping was observed. No biological complications were observed, and the mean modified plaque index was 0.03 (SD ± 0.09) with a mean probing pocket depth of 2.95 mm (SD ± 0.09). A mean marginal bone level (MBL) of 0.04 mm (SD ± 0.88) and a mean VAS of 9.42 (SD ± 0.90) for patient satisfaction were recorded. CONCLUSION Late placed and early loaded implants with a moderately rough endosseal surface are a reliable option for rehabilitating partially edentulous patients. An implant survival rate of 100% and a prosthodontic success rate of 93.8% were observed. Patient satisfaction scores were high and peri-implant hard and soft tissues remained healthy. The study findings should be carefully interpreted because of the small sample.
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Affiliation(s)
- Pedro Molinero-Mourelle
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | | | - Stefan Paul Hicklin
- Clinic of Preventive Dentistry, Periodontology and Cariology, and Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Clemens Raabe
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Manrique Fonseca
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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8
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Graf T, Lyko A, Dahmer I, Stimmelmayr M, Dieterich H, Aggstaller H, Güth JF. Clinical performance and risk factors of all-ceramic screw-retained implant crowns in the posterior region based on a retrospective investigation. Clin Oral Implants Res 2024. [PMID: 38594815 DOI: 10.1111/clr.14264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES Clinical data on all-ceramic screw-retained implant crowns (SICs) luted on titanium base abutments (TBAs) over more than 3 years are sparse. This study aimed to evaluate the clinical performance and potential risk factors for these restorations. MATERIALS AND METHODS Analysis took place based on the medical patient-records of three dental offices. Implant survival and prosthetic complications over time were evaluated. The study included SICs in premolar and molar regions made from monolithic lithium disilicate ceramic (M_LiDi) or veneered zirconia (V_ZiO) luted on a TBA documented over an observation time of at least 3 years. Survival and complication rates were calculated and compared by a log-rank test. Cox-Regressions were used to check potential predictors for the survival (p < .05). RESULTS Six hundred and one crowns out of 371 patients met the inclusion criteria and follow-up period was between 3.0 and 12.9 (mean: 6.4 (SD: 2.1)) years. Over time, six implants had to be removed and 16 restorations had to be refabricated. The estimated survival rates over 10 years were 93.5% for M_LiDi and 95.9% for V_ZiO and did not differ significantly among each other (p = .80). However, V_ZiO showed significantly higher complication rates (p = .003). Material selection, sex, age, and implant diameter did not affect the survival of investigated SICs but crown height influences significantly the survival rate (hazard ratio, HR = 1.26 (95%CI: 1.08, 1.49); p = .043). CONCLUSIONS Screw-retained SICs luted on TBAs that were fabricated from monolithic lithium disilicate ceramic or veneered zirconia showed reliable and similar survival rates. Increasing crown heights reduced survival over the years.
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Affiliation(s)
- Tobias Graf
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Frankfurt am Main, Germany
| | | | - Iulia Dahmer
- Institute of Biostatistics and Mathematical Modelling, Faculty of Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
| | | | | | - Jan-Frederik Güth
- Department of Prosthetic Dentistry, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Frankfurt am Main, Germany
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Jin HW, Noumbissi S, Wiedemann TG. Comparison of Zirconia Implant Surface Modifications for Optimal Osseointegration. J Funct Biomater 2024; 15:91. [PMID: 38667548 PMCID: PMC11051113 DOI: 10.3390/jfb15040091] [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: 03/02/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Zirconia ceramic implants are commercially available from a rapidly growing number of manufacturers. Macroscopic and microscopic surface design and characteristics are considered to be key determining factors in the success of the osseointegration process. It is, therefore, crucial to assess which surface modification promotes the most favorable biological response. The purpose of this study was to conduct a comparison of modern surface modifications that are featured in the most common commercially available zirconia ceramic implant systems. A review of the currently available literature on zirconia implant surface topography and the associated bio-physical factors was conducted, with a focus on the osseointegration of zirconia surfaces. After a review of the selected articles for this study, commercially available zirconia implant surfaces were all modified using subtractive protocols. Commercially available ceramic implant surfaces were modified or enhanced using sandblasting, acid etching, laser etching, or combinations of the aforementioned. From our literature review, laser-modified surfaces emerged as the ones with the highest surface roughness and bone-implant contact (BIC). It was also found that surface roughness could be controlled to achieve optimal roughness by modifying the laser output power during manufacturing. Furthermore, laser surface modification induced a very low amount of preload microcracks in the zirconia. Osteopontin (OPN), an early-late osteogenic differentiation marker, was significantly upregulated in laser-treated surfaces. Moreover, surface wettability was highest in laser-treated surfaces, indicating favorable hydrophilicity and thus promoting early bone forming, cell adhesion, and subsequent maturation. Sandblasting followed by laser modification and sandblasting followed by acid etching and post-milling heat treatment (SE-H) surfaces featured comparable results, with favorable biological responses around zirconia implants.
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Affiliation(s)
- Hyun Woo Jin
- BA/DDS Joint Program, College of Dentistry, New York University, New York, NY 10010, USA
| | - Sammy Noumbissi
- Department of Oral and Maxillofacial Implantology, University of Milan, 20122 Milano, Italy
- Post-Graduate Program Oral Surgery, University of Chieti-Pescara, 65127 Pescara, Italy
- Department of Biomaterials INSA Lyon, 69100 Villeurbanne, France
- Private Practice, Silver Spring, MD 20910, USA
| | - Thomas G. Wiedemann
- Department of Oral and Maxillofacial Surgery, College of Dentistry, New York University, New York, NY 10010, USA
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10
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Thoma DS, Haas R, Sporniak-Tutak K, Garcia A, Taylor TD, Tutak M, Pohl V, Hämmerle CHF. Randomized controlled multi-centre study comparing shorter dental implants (6 mm) to longer dental implants (11-15 mm) in combination with sinus floor elevation procedures: 10-year data. J Clin Periodontol 2024; 51:499-509. [PMID: 38296249 DOI: 10.1111/jcpe.13954] [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] [Revised: 10/27/2023] [Accepted: 01/12/2024] [Indexed: 03/16/2024]
Abstract
AIM To compare implant survival and complication rates between shorter and standard-length implants with sinus augmentation and restored with single crowns, at 10 years of loading. MATERIALS AND METHODS One-hundred and one patients (137 implants) with a ridge height of 5-7 mm in the posterior maxilla were randomly assigned to two treatment modalities: shorter implants (6 mm) (group short [GS]) or standard-length implants (11-15 mm) with sinus grafting (group graft [GG]). Following the insertion of final restorations, patients were regularly recalled for up to 10 years. Assessed outcomes encompassed implant survival, marginal bone levels (MBLs), biological and technical parameters and patient-reported outcome measures (OHIP-49 = Oral Health Impact Profile). Non-parametric statistical analysis was used to analyse the data. RESULTS For the 5- to 10-year follow-up period, 77 patients with 105 implants (GS: 36 patients/48 implants; GG: 41/57) were available for re-examination (drop-out rate 21%). Implant survival rates at the patient level were 96.0% (GS; 2 failures) and 100% (GG) (inter-group p = .24). Median MBLs amounted to 0.00 mm (min 0.00; max 3.25; GS) and 0.00 mm (min 0.00; max 4.55; GG) (inter-group p = .73). Technical complications predominantly occurred within the first 5 years (inter-group p > .05). Peri-implantitis rates were 4.2% (GS) and 13.3% (GG) (intergroup p = .37). Median OHIP-49 scores were 7.00 (0.00; 39.00; GS) and 9.00 (0.00; 196; GG) (inter-group p = .61) at 10 years. CONCLUSIONS Based on similar 10-year implant survival rates, reduced patient morbidity and lower costs, the use of shorter dental implants might well serve as an alternative treatment concept to longer implants placed in conjunction with sinus grafting for patients with a limited ridge height in the posterior maxilla. Study register: https://clinicaltrials.gov/ct2/show/NCT01030523.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Reconstructive Dentistry Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Robert Haas
- Akademie für Orale Implantologie, Private Practice, Vienna, Austria
| | | | - Abel Garcia
- University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Marcin Tutak
- Aesthetic Dent, Private Practice, Szczecin, Poland
| | - Veronika Pohl
- Akademie für Orale Implantologie, Private Practice, Vienna, Austria
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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11
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Gseibat M, Sevilla P, Lopez-Suarez C, Rodriguez V, Pelaez J, Suarez MJ. Performance of posterior third-generation monolithic zirconia crowns in a complete digital workflow: A three-year prospective clinical study. J Dent Sci 2024; 19:871-877. [PMID: 38618120 PMCID: PMC11010711 DOI: 10.1016/j.jds.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/20/2023] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Translucent monolithic zirconia restorations have recently introduced. The purpose of this study was to evaluate the clinical behavior and the survival rate of the posterior third-generation monolithic zirconia crowns (MZCs) during three years of clinical service. Materials and methods Twenty-four patients who needed thirty crowns were enrolled in this study. Digital impressions were made, and the crowns were milled and cemented with a resin cement. The crowns outcomes were assessed using the California Dental Association's (CDA) criteria. Gingival index (GI), plaque index (PI), and periodontal probing depth (PPD) for MZCs and contralateral natural teeth (control) were assessed. Margin index (MI) for MZCs was also assessed. Data analysis was conducted using the Wilcoxon signed-rank and the Friedman tests. Results The 3-year survival rate was 100%. All MZCs were rated as satisfactory throughout the follow-up period, and no biological or mechanical complications were observed. No differences were recorded when GI, PI and PPD at 3-year of follow-up were compared to baseline. No differences were recorded between crowned and control teeth. The MI remained stable throughout the study period. Conclusion The third-generation monolithic zirconia appears to be a good treatment option for the rehabilitation of posterior single teeth.
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Affiliation(s)
- Mustafa Gseibat
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Pablo Sevilla
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Carlos Lopez-Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Veronica Rodriguez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Jesus Pelaez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
| | - Maria J. Suarez
- Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain
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12
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Gama LT, Bezerra AP, Schimmel M, Rodrigues Garcia RCM, de Luca Canto G, Gonçalves TMSV. Clinical performance of polymer frameworks in dental prostheses: A systematic review. J Prosthet Dent 2024; 131:579-590. [PMID: 35422333 DOI: 10.1016/j.prosdent.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/07/2022] [Accepted: 03/07/2022] [Indexed: 12/11/2022]
Abstract
STATEMENT OF PROBLEM High-performance polymers including polyetheretherketone (PEEK) and polyetherketoneketone (PEKK) have been used as substitutes for metal frameworks in dental prostheses. However, the clinical performance of polymer-based frameworks is still uncertain. PURPOSE The purpose of this systematic review was to compare the clinical performance of PEEK and PEKK with that of metal frameworks for different dental prostheses. MATERIAL AND METHODS This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Six databases and non-peer-reviewed literature (without language or follow-up restrictions) were searched for studies conducted before February 2022. Only clinical studies, either randomized clinical trials (RCTs) or nonrandomized clinical trials (N-RCTs), comparing the clinical performance of polymer and metal frameworks were included. The risk of bias and certainty of the evidence were assessed with the RoB 2.0, ROBINS-I, and GRADE. Biologic (plaque and gingival indices, probing depth, bleeding scores, implant stability quotient, marginal bone loss) and mechanical outcomes (ridge base relation, prosthetic marginal gap, and fracture) were assessed. RESULTS Only 9 studies (7 RCTs and 2 N-RCTs) were included, all with moderate to serious risk of bias and low to very low certainty of evidence. No meta-analysis was possible, but qualitative analysis revealed lower plaque and gingival indices, probing depth, and marginal bone loss, with higher survival rates for implant-supported fixed prostheses and overdentures fabricated with PEEK than for metal frameworks. No significant differences were found between groups for removable partial dentures. The marginal fit of PEEK frameworks was also better for single crowns. Three fractures were reported in the 3 PEKK fixed dental prostheses with cantilevers. CONCLUSIONS PEEK and PEKK seem to be promising materials for dental prostheses, with acceptable response from the periodontal tissue. However, further well-designed studies are necessary to better understand their clinical and long-term limitations.
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Affiliation(s)
- Lorena Tavares Gama
- PhD student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Adriana Pinto Bezerra
- PhD student, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
| | - Martin Schimmel
- Full Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern (UNIBE), Bern, Switzerland; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva (UNIGE), Geneva, Switzerland
| | - Renata Cunha Matheus Rodrigues Garcia
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Graziela de Luca Canto
- Full Professor, Department of Dentistry, Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil
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13
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Elsayed A, Chaar MS, Kern M, Libecki W, Yazigi C. Wear resistance of CAD/CAM one-piece screw-retained hybrid-abutment-crowns made from different restorative materials. Clin Implant Dent Relat Res 2024; 26:281-288. [PMID: 37408517 DOI: 10.1111/cid.13245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 05/09/2023] [Accepted: 06/22/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION The aim of this study was to measure the wear progress of three high performance polymers (HPP) materials as well as that of zirconia after artificial aging (simulated 2.5- and 5-year of clinical service with thermo-mechanical loading) and compare it with the well-documented wear of lithium disilicate. METHODS Forty implants were used to restore a maxillary first premolar, where the abutment and the crown were manufactured as hybrid-abutment-crown and connected to the implant using a titanium insert. The implants were randomly divided, according to the restorative materials used, into five groups: 3Y-TZP zirconia (Z), lithium disilicate (L), ceramic-reinforced polyetheretherketon (P), nano-hybrid composite resin (C) and polymer-infiltrated ceramic-network (E). All hybrid-abutment-crowns were produced using CAD/CAM technology. A design of a maxillary first premolar was created with an angle of 120° between the buccal and palatal cusps, which were designed as planes. The restorations were adhesively luted onto the titanium inserts, according to the manufacturers' recommendations for each material individually, by means of dual-curing luting resin with the exception of group P, where the blocks were pre-fitted (heat-pressed) with an integrated titanium insert. The suprastructures were assembled onto the implants through titanium screws. The screw channels were sealed with Teflon tape and composite resin filling material that was polished to high-gloss. All specimens underwent 1 200 000 thermo-dynamic loading cycles with 49 N in a dual-axis chewing simulator. Elastomeric impressions were made for all specimens after 600 000 and after 1 200 000 cycles. The corresponding impressions were imaged using a laser scanning microscope and then 3D-analyzed using the software (Geomagic Wrap) to measure the volume loss of the wear area for all specimens. Statistical analysis was performed using Wilcoxon-Test regarding the two different time measurements for each material. For the analysis of the material variable, Kruskal-Wallis test was conducted followed by Mann-Whitney test. RESULTS Group Z showed statistically the lowest volume loss compared to the other test materials, both after 600 000 and 1 200 000 cycles of artificial aging, with a median value of 0.002 mm3 volume loss after 1 200 000 cycles. In contrast, group E showed the highest volume loss with median values of 0.18 and 0.3 mm3 after 600 000 and 1 200 000 cycles, respectively. Artificial aging had significantly negative effect on the volume loss for all test materials. In addition, the choice of material had statistical influence on the outcome. CONCLUSION Monolithic zirconia ceramic demonstrated lower wear than that reported for enamel after simulated 5-year of clinical service, whereas all other test materials showed higher volume loss after artificial aging.
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Affiliation(s)
- Adham Elsayed
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Mohamed Sad Chaar
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Wojtek Libecki
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany
| | - Christine Yazigi
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University at Kiel, Kiel, Germany
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14
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Ghoveizi R, Baghaei M, Tavakolizadeh S, Tabatabaian F. Color match of ultra-translucency multilayer zirconia restorations with different designs and backgrounds. J Prosthodont 2024; 33:382-388. [PMID: 37155925 DOI: 10.1111/jopr.13700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 05/03/2023] [Indexed: 05/10/2023] Open
Abstract
PURPOSE The purpose of this in vitro study was to assess the color match of ultra-translucency multilayer zirconia restorations with different designs and backgrounds. MATERIALS AND METHODS Thirty ultra-translucency multilayer zirconia crown specimens were made in VITA classical shade B2 for a prepared maxillary central incisor. The specimens were divided into three groups based on the restoration design: veneered zirconia with a trestle design (VZT), veneered zirconia with a dentin core design (VZD), and full-contour zirconia (FCZ). In the groups VZT and VZD, the zirconia specimens were layered with a feldspathic veneering ceramic. The specimens were seated on five different backgrounds: shade B2 composite resin, shade B2 zirconia, copper-colored metal alloy, silver-colored metal alloy, and the prepared central incisor. CIELab values of the labial middle sections of the crown specimens were measured with a spectrophotometer. Color differences between the specimens and a shade B2 VITA classical tab (as a control) were calculated from the ΔE* ab formula and compared with an acceptability threshold (ΔE* ab = 3.7) to be clinically explicated. RESULTS Mean ΔE* ab values ranged between 1.17 and 8.48. The restoration design, the background type, and their interaction affected the ΔE* ab (p < 0.001). The mean ΔE* ab values for VZT with all backgrounds and for VZD with the silver-colored metal background were greater than the threshold (p < 0.001), whereas the mean ΔE* ab values for VZD with the other backgrounds and FCZ with all backgrounds were less than the threshold (p = 1). CONCLUSIONS Restoration design and background type affected the color match of ultra-translucency multilayer zirconia restorations. VZT restorations on all backgrounds and VZD restorations on a silver-colored metal background showed color mismatches. However, VZD restorations on the other backgrounds and FCZ restorations on all backgrounds demonstrated color matches.
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Affiliation(s)
- Rahab Ghoveizi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Baghaei
- School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Tavakolizadeh
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Tabatabaian
- Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
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15
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Angermair J, Iglhaut G, Meyenberg K, Wiest W, Rack A, Zabler S, Fretwurst T, Nelson K, Kernen F. In vitro assessment of internal implant-abutment connections with different cone angles under static loading using synchrotron-based radiation. BMC Oral Health 2024; 24:396. [PMID: 38549137 PMCID: PMC10976688 DOI: 10.1186/s12903-024-04156-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND The stability of implant-abutment connection is crucial to minimize mechanical and biological complications. Therefore, an assessment of the microgap behavior and abutment displacement in different implant-abutment designs was performed. METHODS Four implant systems were tested, three with a conical implant-abutment connection based on friction fit and a cone angle < 12 ° (Medentika, Medentis, NobelActive) and a system with an angulated connection (< 40°) (Semados). In different static loading conditions (30 N - 90º, 100 N - 90º, 200 N - 30º) the microgap and abutment displacement was evaluated using synchrotron-based microtomography and phase-contrast radioscopy with numerical forward simulation of the optical Fresnel propagation yielding an accuracy down to 0.1 μm. RESULTS Microgaps were present in all implant systems prior to loading (0.15-9 μm). Values increased with mounting force and angle up to 40.5 μm at an off axis loading of 100 N in a 90° angle. CONCLUSIONS In contrast to the implant-abutment connection with a large cone angle (45°), the conical connections based on a friction fit (small cone angles with < 12°) demonstrated an abutment displacement which resulted in a deformation of the outer implant wall. The design of the implant-abutment connection seems to be crucial for the force distribution on the implant wall which might influence peri-implant bone stability.
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Affiliation(s)
| | - Gerhard Iglhaut
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany
| | | | - Wolfram Wiest
- Chair of X-ray Microscopy LRM, University Würzburg, 97074, Würzburg, Germany
| | - Alexander Rack
- Experiments Division, ESRF - The European Synchrotron, Grenoble, France
| | - Simon Zabler
- Deggendorf Institute of Technology DIT, Dieter-Görlitz-Platz 2, 94469, Deggendorf, Germany
| | - Tobias Fretwurst
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany
| | - Katja Nelson
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany
| | - Florian Kernen
- Department of Oral and Maxillofacial Surgery, Translational Implantology, Medical Center, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
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16
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Goldstein G, Goodacre C, Brown MS, Tarnow DP. Proposal regarding potential causes related to certain complications with dental implants and adjacent natural teeth: Physics applied to prosthodontics. J Prosthodont 2024. [PMID: 38512996 DOI: 10.1111/jopr.13843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE Complications can and do occur with implants and their restorations with causes having been proposed for some single implant complications but not for others. METHODS A review of pertinent literature was conducted. A PubMed search of vibration, movement, and dentistry had 175 citations, while stress waves, movement, and dentistry had zero citations as did stress waves, movement. This paper discusses the physics of vibration, elastic and inelastic collision, and stress waves as potentially causative factors related to clinical complications. RESULTS Multiple potential causes for interproximal contact loss have been presented, but it has not been fully understood. Likewise, theories have been suggested regarding the intrusion of natural teeth when they are connected to an implant as part of a fixed partial denture as well as intrusion when a tooth is located between adjacent implants, but the process of intrusion, and resultant extrusion, is not fully understood. A third complication with single implants and their crowns is abutment screw loosening with several of the clinical characteristics having been discussed but without determining the underlying process(es). CONCLUSIONS Interproximal contact loss, natural tooth intrusion, and abutment screw loosening are common complications that occur with implant retained restorations. Occlusion is a significant confounding variable. The hypothesis is that vibration, or possibly stress waves, generated from occlusal impact forces on implant crowns and transmitted to adjacent teeth, are the causative factors in these events. Since occlusion appears to play a role in these complications, it is recommended that occlusal contacts provide centralized stability on implant crowns and not be located on any inclined surfaces that transmit lateral forces that could be transmitted to an adjacent tooth and cause interproximal contact loss or intrusion. The intensity, form, and location of proximal contacts between a natural tooth located between adjacent single implant crowns seem to play a role in the intrusion of the natural tooth. Currently, there is a lack of information about the underlying mechanisms related to these occurrences and research is needed to define any confounding variables.
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Affiliation(s)
- Gary Goldstein
- Department of Prosthodontics, New York University College of Dentistry, New York, New York, USA
| | - Charles Goodacre
- Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, California, USA
| | | | - Dennis P Tarnow
- Columbia University College of Dental Medicine, New York, New York, USA
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Tajti P, Solyom E, Váncsa S, Mátrai P, Hegyi P, Varga G, Hermann P, Borbély J, Sculean A, Mikulás K. Less marginal bone loss around bone-level implants restored with long abutments: A systematic review and meta-analysis. Periodontol 2000 2024; 94:627-638. [PMID: 37766634 DOI: 10.1111/prd.12534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023]
Abstract
The aim of this study was to investigate the biological outcomes of bone-level implants restored with long vs. short abutments, with regard to the 'one abutment at one time' protocol. The systematic search was performed in five databases: MEDLINE (PubMed), EMBASE, Web of Science, Scopus, and CENTRAL for randomized controlled trials up to January 14, 2023. Data were collected for marginal bone loss, bleeding on probing, and probing pocket depth by two reviewers. As effect size measure, mean difference (MD), and risk ratio (RR) were used for continuous and categorical outcomes, R-statistics software was used for conducting statistical analyses. For quality and certainty assessment, Risk of Bias Tool 2, ROBINS-I, and GRADE approach were used. The search resulted in 4055 records without any duplicates. After title, abstract, and full-text analysis, eight articles were found eligible for inclusion. Bone-level and platform-switched implants presented less marginal bone loss after 6 months and 1 year as well, when long abutments were used (MD 0.63, 95% CI: [-0.16; 1.42]) and (MD 0.26, 95% CI: [-0.02; 0.53]). However, subgroup analysis revealed no difference in marginal bone loss when applying 'one abutment at one time' protocol (p = 0.973). Bleeding on probing and probing pocket depth presented similarly good results in both groups without almost any differences (RR 0.97, 95% CI: [0.76; 1.23]) and (MD -0.05, 95% CI: [-1.11; 1.01]). Longer abutments on bone-level implants seem to be a favorable choice for decreasing early marginal bone loss, irrespective of connection timing.
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Affiliation(s)
- Péter Tajti
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eleonora Solyom
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Mátrai
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Krisztina Mikulás
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Gresnigt MMM, Jonker JA, van der Made SAM. The cantilever contact-point resin bonded bridge; adhesion 2.0. J ESTHET RESTOR DENT 2024; 36:37-46. [PMID: 38084818 DOI: 10.1111/jerd.13179] [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: 10/01/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
AIM When young patients are congenitally missing anterior teeth, different treatment modalities can be used to complement the dental arch. This article proposes a new treatment modality for the replacement of anterior teeth, the cantilever contact-point resin bonded bridge (CCP-RBB). MATERIALS AND METHODS In this proof of principle study, CCP-RBB's delivered by one operator were clinically assessed. Patients who were missing maxillary incisors and had suitable intra-oral conditions for a contact-point cantilever RBB were included. Three cases are presented to describe all adhesive steps. This proof of principle clinical study is presented with up to 60 months follow-up of the cantilever contact resin bonded bridges. RESULTS A total of 19 CCP-RBB's were evaluated after a mean period of 29.8 months. None of the restorations exhibited failure, carious lesions or fractures during the follow-up periods, demonstrating an absence of restoration debonding or the need for repair. CONCLUSION The new cantilever contact-point resin bonded bridge exhibited an excellent treatment modality without failure or debonding up to 5 years. More and extended duration in vivo studies are needed to evaluate this new treatment modality. CLINICAL SIGNIFICANCE In this proof of principle the new cantilever contact-point resin bonded bridge obtained excellent results up to 5 years of clinical follow-up.
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Affiliation(s)
- Marco M M Gresnigt
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Special Dental Care, Martini Hospital, Groningen, the Netherlands
| | - Joyce A Jonker
- Department of Restorative Dentistry and Biomaterials, Center for Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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19
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Guljé FL, Raghoebar GM, Gareb B, Vissink A, Meijer HJA. Single crowns in the posterior maxilla supported by either 11-mm long implants with sinus floor augmentation or by 6-mm long implants: A 10-year randomized controlled trial. Clin Oral Implants Res 2024; 35:89-100. [PMID: 37941089 DOI: 10.1111/clr.14200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 10/22/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To compare the clinical performance of single crowns in the posterior maxilla supported by either 11-mm long implants combined with maxillary sinus floor augmentation (MSFA) surgery or by 6-mm long implants during a 10-year follow-up period. MATERIALS AND METHODS Subjects were randomly allocated to receive one 11-mm long implant in combination MFSA or to receive one 6-mm long implant without any grafting. Twenty-one implants in 20 patients were placed in the 6-mm group and 20 implants in 18 patients were placed in the 11-mm group. Both groups were followed by clinical and radiographic examinations up to 10 years. Patients' satisfaction was also scored before treatment. RESULTS Two patients died and eight patients moved during the follow-up. Two patients lost an implant in the 6-mm group and one implant was lost in the 11-mm group (implant survival 89.5% and 90.9%, respectively). From loading to 10 years' follow-up, mean ± SE marginal bone loss in the 6-mm group and 11-mm group was 0.18 ± 0.10 mm and 0.26 ± 0.12 mm, respectively, without a significant difference between the groups at 10 years (p = .650). In both groups, indices scores for plaque, calculus, gingiva and bleeding were low as well as mean pocket probing depth. Patients' satisfaction at 10 years was high in both groups; mean overall satisfaction in the 6-mm group and 11-mm group was 9.6 ± 0.6 and 9.2 ± 0.8, respectively (p = .168). CONCLUSIONS Placement of 6-mm implants or 11-mm implants combined MFSA are equally successful during a 10-year follow-up period when applied for supporting a single restoration.
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Affiliation(s)
- Felix L Guljé
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Center for Dental Implants De Mondhoek, Apeldoorn, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barzi Gareb
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Restorative Dentistry, Dental School, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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20
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Nokar K, Atri F, Nokar S. Comparative Evaluation of the Effect of Implant Crown Materials on Implant Components and Bone Stress Distribution: A 3D Finite Element Analysis. Int J Dent 2023; 2023:1896475. [PMID: 38130700 PMCID: PMC10735729 DOI: 10.1155/2023/1896475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 11/06/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
Background Choosing implant crown materials for restoration remains challenging in clinical practice. This study assesses the impact of all-ceramic restoration instead of porcelain-fused-to-metal (PFM) restoration on the stress distribution within implant components and the surrounding bone. Methods Four 3D models of a mandibular second premolar were meticulously prepared. The study groups comprised zirconia, lithium disilicate, and zirconia lithium silicate monolithic ceramic crowns cemented onto a zirconia hybrid abutment. A PFM crown cemented onto a cementable abutment was chosen as the control group. A total vertical load of 583 N was applied to the occlusal contact areas. Stress distribution within the crown and implant components was analyzed using von Mises stress analysis. Principal stress analyses were employed to assess stress distribution in the peripheral bone. Results The PFM model exhibited the highest von Mises stress values for both the implant (428.7 MPa) and crown (79.7 MPa) compared to the other models. The all-ceramic models displayed the highest maximum von Mises stress within the abutment, approximately 335 MPa, compared to the PFM model. von Mises stresses of the abutment and implant in the all-ceramic models were 69% higher and 20% lower, respectively, than those in the PFM model. Screw stresses were relatively consistent across all groups. Principal stresses in spongy bone and minimum principal stress in cortical bone were consistent across all models. Conclusions All-ceramic restoration with a hybrid abutment, as opposed to traditional PFM restoration with a cementable abutment, does not adversely affect the implant and abutment screw and reduces crown stresses. Stresses within hybrid abutments were notably higher than those within cementable abutments. Spongy bone stresses remained unaffected by the type of crown or abutment.
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Affiliation(s)
- Kimia Nokar
- School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Atri
- Department of Prosthodontics, School of Dentistry, Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saied Nokar
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Alkhallagi T, Alzahrani M, Alkathiri MA, Basunbul GI, Marghalani A. Vertical Marginal Discrepancy of a Monolithic Zirconia Crown with Different Cement Spaces. Int J Dent 2023; 2023:6698453. [PMID: 38098873 PMCID: PMC10721348 DOI: 10.1155/2023/6698453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/31/2023] [Accepted: 11/03/2023] [Indexed: 12/17/2023] Open
Abstract
The long-term clinical success of indirect restorations highly depends on their marginal integrity. The cement space is an element that might affect the marginal integrity, but it can be altered during the configuring of the computer-assisted designing/computer-aided manufacturing (CAD-CAM) restoration. However, there is controversy in the literature regarding the effect of the cement space on the precision of zirconia crown marginal adaptation. The aim of this study was to measure the vertical marginal discrepancies between different cement thickness settings for CAD-CAM monolithic zirconia restorations. Material and Methods. An artificial mandibular right molar tooth mounted on a typodont was prepared for a zirconia crown using the standard method. The study sample consisted of 30 zirconia crowns (Zenostar Zr Translucent Zirconia, Weiland Dental, Germany) milled using an (iMes-iCore) milling machine. Each group of 10 crowns was designed with 30-50 and 70 μm spacer thicknesses. The vertical marginal adaptation at the center of the four different planes (mesial, distal, buccal, and palatal) was measured under a microscope at 40x magnification. A one-way analysis of variance test was used for statistical analysis. Results. The mean of Group 30 was 27.45; of Group 50 was 22.22; and of Group 70 was 22.90. There was no statistically significant difference between the groups (p ≥ 0.5). Conclusions. The increase in the cement space up to 70 μm did not influence the vertical marginal adaptation of the monolithic zirconia crowns.
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Affiliation(s)
- Turki Alkhallagi
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Meshari Alzahrani
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Majed Ali Alkathiri
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghadeer I. Basunbul
- Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amin Marghalani
- Department of Oral and Maxillofacial Surgery, College of Dental Medicine, Umm Al-Qura University, P.O. Box 715, Makkah, Saudi Arabia
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Chen S, Hong X, Ye Z, Wu M, Chen L, Wu L, Wang Y, Chen Y, Wu J, Wang J, Zhang Q, Wu Y, Sun X, Ding X, Huang S, Zhao S. The effect of root canal treatment and post-crown restorations on stress distribution in teeth with periapical periodontitis: a finite element analysis. BMC Oral Health 2023; 23:973. [PMID: 38057755 PMCID: PMC10701996 DOI: 10.1186/s12903-023-03612-9] [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: 06/26/2023] [Accepted: 11/02/2023] [Indexed: 12/08/2023] Open
Abstract
AIM To evaluate the effects of root canal treatment (RCT) and post-crown restoration on stress distribution in teeth with periapical bone defects using finite element analysis. METHODOLOGY Finite element models of mandibular second premolars and those with periapical bone defects (spherical defects with diameters of 5, 10, 15, and 20 mm) were created using digital model design software. The corresponding RCT and post-crown restoration models were constructed based on the different sizes of periapical bone defect models. The von Mises stress and tooth displacement distributions were comprehensively analyzed in each model. RESULTS Overall analysis of the models: RCT significantly increased the maximum von Mises stresses in teeth with periapical bone defects, while post-crown restoration greatly reduced the maximum von Mises stresses. RCT and post-crown restoration slightly reduced tooth displacement in the affected tooth. Internal analysis of tooth: RCT dramatically increased the maximum von Mises stress in all regions of the tooth, with the most pronounced increase in the coronal surface region. The post-crown restoration balances the internal stresses of the tooth and is most effective in periapical bone defect - 20-mm model. RCT and post-crown restoration slightly reduced the tooth displacement in all regions of the affected tooth. CONCLUSIONS Root canal treatment seemed not to improve the biomechanical state of teeth with periapical bone defects. In contrast, post-crown restoration might effectively balance the stress concentrations caused by periapical bone defects, particularly extensive ones.
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Affiliation(s)
- ShuoMin Chen
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - XinHua Hong
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
| | - ZhangYan Ye
- Department of Stomatology, Pingyang Hospital Affiliated of Wenzhou Medical University, Wenzhou, China
| | - MengHan Wu
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Liang Chen
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
| | - LinMei Wu
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
| | - Yilin Wang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
| | - YuGe Chen
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Dentistry, University of Alberta, Edmonton, Canada
| | - JiaYu Wu
- School of Medicine, Jiujiang University, Jiujiang, China
| | - Jun Wang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - QinHui Zhang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - YuTian Wu
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - XiaoYu Sun
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Periodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xi Ding
- Department of Stomatology, the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, PR China.
| | - ShengBin Huang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China.
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.
| | - ShuFan Zhao
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China.
- Department of Oral Maxillofacial Surgery, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China.
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Gadzo N, Ioannidis A, Naenni N, Hüsler J, Jung RE, Thoma DS. Survival and complication rates of two dental implant systems supporting fixed restorations: 10-year data of a randomized controlled clinical study. Clin Oral Investig 2023; 27:7327-7336. [PMID: 37906305 PMCID: PMC10713755 DOI: 10.1007/s00784-023-05323-5] [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: 05/16/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES To compare clinical, radiographic, biological and technical long-term outcomes of two types of dental implants over a period of 10 years. MATERIALS AND METHODS Ninety-eight implants were placed in 64 patients, randomly allocated to one of two manufacturers (AST and STM). All implants were loaded with fixed restorations. Outcome measures were assessed at implant insertion (Ti), at baseline examination (TL), at 1, 3, 5, 8 and 10 (T10) years. Data analysis included survival, bone level changes, complications and clinical measures. RESULTS Re-examination was performed in 43 patients (23 AST and 20 STM) at 10 years. The implant level analysis was based on 37 (AST) and 32 (STM) implants. Survival rates of 100% were obtained for both groups. The median changes of the marginal bone levels between baseline and T10 (the primary endpoint) amounted to a loss of 0.07 mm for group AST and a gain of 0.37 mm for group STM (intergroup p = 0.008). Technical complications occurred in 27.0% of the implants in group AST and in 15.6% in group STM. The prevalence of peri-implant mucositis was 29.7% (AST) and 50.1% (STM). The prevalence of peri-implantitis amounted to 0% (AST) and 6.3% (STM). CONCLUSIONS Irrespective of the implant system used, the survival rates after 10 years were high. Minimal bone level changes were observed, statistically significant but clinically negligible in favor of STM. Technical complications were more frequently encountered in group AST, while group STM had a higher prevalence of peri-implant mucositis.
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Affiliation(s)
- Naida Gadzo
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Alexis Ioannidis
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland.
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea.
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24
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Kui A, Manziuc M, Petruțiu A, Buduru S, Labuneț A, Negucioiu M, Chisnoiu A. Translucent Zirconia in Fixed Prosthodontics-An Integrative Overview. Biomedicines 2023; 11:3116. [PMID: 38137337 PMCID: PMC10740999 DOI: 10.3390/biomedicines11123116] [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: 10/29/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
Over the past two decades, dental ceramics have experienced rapid advances in science and technology, becoming the fastest-growing field of dental materials. This review emphasizes the significant impact of translucent zirconia in fixed prosthodontics, merging aesthetics with strength, and highlights its versatility from single crowns to complex bridgework facilitated by digital manufacturing advancements. The unique light-conducting properties of translucent zirconia offer a natural dental appearance, though with considerations regarding strength trade-offs compared to its traditional, opaque counterpart. The analysis extends to the mechanical attributes of the material, noting its commendable fracture resistance and durability, even under simulated physiological conditions. Various zirconia types (3Y-TZP, 4Y-TZP, 5Y-TZP) display a range of strengths influenced by factors like yttria content and manufacturing processes. The study also explores adhesive strategies, underlining the importance of surface treatments and modern adhesives in achieving long-lasting bonds. In the realm of implant-supported restorations, translucent zirconia stands out for its precision, reliability, and aesthetic adaptability, proving suitable for comprehensive dental restorations. Despite its established benefits, the review calls for ongoing research to further refine the material's properties and adhesive protocols and to solidify its applicability through long-term clinical evaluations, ensuring its sustainable future in dental restorative applications.
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Affiliation(s)
- Andreea Kui
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Manuela Manziuc
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Adrian Petruțiu
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, 13 Victor Babes Street, 400008 Cluj-Napoca, Romania
| | - Smaranda Buduru
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Anca Labuneț
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Marius Negucioiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Andrea Chisnoiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
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Piza MMT, Bergamo ETP, Campos TMB, Carvalho LF, Goulart CA, Gutierres E, Lopes ACO, Benalcazar Jalkh EB, Bonfante EA. Alumina-toughened zirconia nanocomposite: Aging effect on microstructural, optical, and mechanical properties. Dent Mater 2023; 39:1022-1031. [PMID: 37775460 DOI: 10.1016/j.dental.2023.09.005] [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: 03/13/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES To process an alumina-toughened zirconia (ATZ) nanocomposite and to characterize its crystalline phases, microstructure, residual stress, mechanical and optical properties before and after two different artificial aging methodologies. METHODS Disc-shaped specimens were obtained through uniaxial pressing of a commercial ATZ powder comprised of 80%ZrO2 / 20%Al2O3, with a particle size of 50 nm and 150 nm, respectively. Sintering was performed at 1500ºC for 2 h. Groups were established according to the aging protocol as immediate (ATZ-I) and aged either in autoclave (ATZ-A) or hydrothermal reactor (ATZ-R) at 134 ºC for 20 h at 2.2 bar. Crystalline phases and microstructure were assessed by X-ray diffraction (XRD) and scanning electron microscopy (SEM), respectively. Residual stress was evaluated by Raman spectroscopy. Contrast Ratio (CR) and Translucency Parameter (TP) were calculated to characterize optical properties. Mechanical properties were analyzed through Vickers microhardness, fracture toughness, and biaxial flexural strength test. RESULTS XRD spectra of both aging protocols revealed the presence of monoclinic zirconia (20-31%), where higher phase transformation was observed after aging in hydrothermal reactor. Optical properties evaluation demonstrated high opacity (CR: 0.99) and masking ability (TP: 0.26), with no significant differences after aging. Raman spectroscopy evidenced the presence of residual compressive stresses in the aged groups, being significantly higher for ATZ-R (-215.2 MPa). As-sintered specimens revealed hardness of ∼12.3 GPa and fracture toughness of ∼1.9 MPa.m1/2. Characteristic strength was 740 MPa for ATZ-I, 804 MPa for ATZ-A, and 879 MPa for ATZ-R, with significant differences between groups. Weibull modulus ranged from 16.5 to 18.8. All groups demonstrated high reliability up to 500 MPa stress missions (99-100%), with no significant differences after aging. SIGNIFICANCE The experimental ATZ nanocomposite presented high opacity and a high Weibull modulus. While aging created internal compressive stress responsible for an increase in characteristic strength, the nanocomposite was susceptible to hydrothermal degradation. Further studies are required to evaluate its degradation kinetics at low temperatures.
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Affiliation(s)
- Mariana M T Piza
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil.
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Tiago M B Campos
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil; Department of Physics, Technological Institute of Aeronautics, São José dos Campos, SP, Brazil
| | - Laura F Carvalho
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Celso A Goulart
- São Paulo State University, School of Sciences and Engineering, Tupã, SP, Brazil
| | - Eliezer Gutierres
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Ernesto B Benalcazar Jalkh
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
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26
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Di Fiore A, Monaco C, Stellini E. Retrospective clinical study of 1472-unit monolithic zirconia restorations with feather-edge margins realized with digital workflow. Clin Oral Investig 2023; 27:6567-6575. [PMID: 37749286 DOI: 10.1007/s00784-023-05262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/11/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES To evaluate the clinical performance of monolithic zirconia restorations with feather-edge margins fabricated by digital impressions. MATERIALS AND METHODS All participants that present monolithic zirconia restorations with feather-edge margins realized with digital workflow were evaluated during scheduled periodontal maintenance between February and September 2022 according to predetermined inclusion criteria. Clinical performance was assessed using the modified USPHS and periodontal parameters. Overall survival was calculated for monolithic zirconia restorations. Technical and biologic complications were reported. Descriptive statistical analysis and life-table analyses were performed for all data. RESULTS A total of 1472 monolithic zirconia FDPs (1279 on abutments and 193 on pontics) placed in 1189 patients (982 males and 490 females) from February 2017 to September 2020 were analyzed. The mean follow-up was 44 months (range 36-61 months), and the overall survival rate was 98.5%. There were 931 single crowns, 96 were 3-unit FDPs, 33 were 4-unit FDPs, 11 were 5-unit FDPs, and 6-unit FDPs. Three single crowns had irreparable cracks, and 6 single crowns and one 4-unit FDP were fractured. One 3-unit FDP failed due to tooth fracture and 5 single crowns failed due to endodontic failure. The loss of retention was noted in 25 monolithic zirconia FDPs and hypersensitivity in 44 single crowns. Biologic complications were uncommon. CONCLUSIONS Based on the results and its limitations, the monolithic zirconia FPDs and digital impressions represent a favorable prosthetic treatment similar to that reported with other margin designs CLINICAL RELEVANCE: Monolithic zirconia restorations on vertical-margin abutments fabricated using a digital workflow demonstrate excellent clinical performance. The digital clinical workflow without the use of a cast means a reduction in costs, steps, and operating time.
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Affiliation(s)
- Adolfo Di Fiore
- Department of Neuroscience, School of Dentistry, Division of Prosthodontics and Digital Dentistry, University of Padova, Padova, Italy.
| | - Carlo Monaco
- Department of Surgery, Medicine, and Dentistry, University of Modena and Reggio Emilia, Modena, Italy
| | - Edoardo Stellini
- Department of Neuroscience, School of Dentistry, Division of Prosthodontics and Digital Dentistry, University of Padova, Padova, Italy
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Wang X, Cui H, Chen Z, Wang L, Chen J, Yi M, Xiao G, Zhang J, Chen H, Xu C. MC design and FIB preparation of a YSZ biochemical material microstructure. J Mech Behav Biomed Mater 2023; 147:106152. [PMID: 37776762 DOI: 10.1016/j.jmbbm.2023.106152] [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: 08/02/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023]
Abstract
Aiming at the difficulty of traditional machining of Y2O3-ZrO2 (YSZ) inert ceramic materials, a different method using focused ion beam to selectively create nanoscale microscale structures on the surface of materials was proposed. The sputtering yield, surface damage, and the energy loss of YSZ materials was investigated using the SRIM software using the Monte Carlo method. It is shown that the sputtering yield increases with ion energy in the range 0-30 keV, reaching a maximum of 9.4 atoms/ion at 30 keV. At an ion beam voltage of 30 keV, the most severe damage to the material is 8 mm on the surface. At the same time, the main forms of energy loss in the treatment are phonon energy loss and ionization energy loss, of which phonon energy loss due to the recoil atoms is the largest. In addition, we continue to perform focused ion beam processing experiments on YSZ materials, combining previous MC modeling to optimize different operating conditions such as ion beam, voltage and processing mode. The optimized processing parameters are 30 keV and 2.5 nA. It is shown that the quality of the deep grooves gradually improves with decreasing ion beam current at the same ion beam voltage. However, an excessively small ion beam current leads to an excessively large depth of the deep grooves and lengthy processing times.
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Affiliation(s)
- Xintian Wang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Hao Cui
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Zhaoqiang Chen
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Shandong Machinery Design and Research Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250031, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China.
| | - Li Wang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Jun Chen
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Mingdong Yi
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Guangchun Xiao
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Shandong Machinery Design and Research Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250031, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Jingjie Zhang
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Hui Chen
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
| | - Chonghai Xu
- School of Mechanical Engineering, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China; Shandong Machinery Design and Research Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250031, China; Key Laboratory of Advanced Manufacturing and Measurement and Control, Technology for Light Industry in Universities of Shandong, Qilu University of Technology (Shandong Academy of Sciences), Jinan, 250353, China
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Zhang Y, Wei D, Tian J, Zhao Y, Lin Y, Di P. Clinical evaluation and quantitative occlusal change analysis of posterior implant-supported all-ceramic crowns: A 3-year randomized controlled clinical trial. Clin Oral Implants Res 2023; 34:1188-1197. [PMID: 37526213 DOI: 10.1111/clr.14151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES To compare the survival and complication rates of posterior screw-retained monolithic lithium disilicate (LS2 )/veneered zirconia (ZrO2 ) single implant crowns (SICs), as well as analyze the occlusal changes observed during a 3-year follow-up period. MATERIALS AND METHODS Thirty-three patients were included and randomly divided into two groups. The test group consisted of 17 patients who received monolithic-LS2 -SIC, while the control group consisted of 16 patients who received veneered-ZrO2 -SIC. Implant/prosthesis survival rates, technical complications, peri-implant soft tissue conditions, and quantitative occlusal changes of SIC (obtained by the intra-oral scanner and analyzed in reverse software Geomagic Control 2015) were assessed at 1- and 3-year follow-ups. Bone loss and Functional Implant Prosthodontic Score (FIPS) were evaluated at a 3-year follow-up. RESULTS After a 3-year follow-up period, one patient dropped out of the follow-up. No implant loss was observed. One crown was fractured, resulting in prosthesis survival rates of 93.75% for the monolithic group and 100% for the veneered group. A technical complication rate of 25% (4/16) was observed in the veneered group (p = .333). No significant differences in the marginal bone loss were observed at the 3-year follow-up (0.00 (-0.22, 0.17) mm versus 0.00 (-0.12, 0.12) mm, p = .956). The total FIPS scores for the test group were 9.0 (9.0, 9.0), while the control group received scores of 9.0 (8.0, 10.0) (p = .953). The changes in mean occlusal clearance were 0.022 ± 0.083 mm for the test and 0.034 ± 0.077 mm for the control group (at 3 years, p = .497). The changes in occlusal contact area were 1.075 ± 2.575 mm2 for the test and 1.676 ± 2.551 mm2 for the control group (at 3 years, p = .873). CONCLUSION After a 3-year follow-up, screw-retained monolithic LS2 and veneered ZrO2 SIC demonstrated similar survival rates. The occlusal performance of implant prostheses needs to be closely examined during follow-up, and appropriate occlusal adjustments need to be considered.
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Affiliation(s)
- Yifan Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Donghao Wei
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Jiehua Tian
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yijiao Zhao
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Suzumura T, Matsuura T, Komatsu K, Sugita Y, Maeda H, Ogawa T. Vacuum Ultraviolet (VUV) Light Photofunctionalization to Induce Human Oral Fibroblast Transmigration on Zirconia. Cells 2023; 12:2542. [PMID: 37947620 PMCID: PMC10647316 DOI: 10.3390/cells12212542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
Soft tissue adhesion and sealing around dental and maxillofacial implants, related prosthetic components, and crowns are a clinical imperative to prevent adverse outcomes of periodontitis and periimplantitis. Zirconia is often used to fabricate implant components and crowns. Here, we hypothesized that UV treatment of zirconia would induce unique behaviors in fibroblasts that favor the establishment of a soft tissue seal. Human oral fibroblasts were cultured on zirconia specimens to confluency before placing a second zirconia specimen (either untreated or treated with one minute of 172 nm vacuum UV (VUV) light) next to the first specimen separated by a gap of 150 µm. After seven days of culture, fibroblasts only transmigrated onto VUV-treated zirconia, forming a 2.36 mm volume zone and 5.30 mm leading edge. Cells migrating on VUV-treated zirconia were enlarged, with robust formation of multidirectional cytoplastic projections, even on day seven. Fibroblasts were also cultured on horizontally placed and 45° and 60° tilted zirconia specimens, with the latter configurations compromising initial attachment and proliferation. However, VUV treatment of zirconia mitigated the negative impact of tilting, with higher tilt angles increasing the difference in cellular behavior between control and VUV-treated specimens. Fibroblast size, perimeter, and diameter on day seven were greater than on day one exclusively on VUV-treated zirconia. VUV treatment reduced surface elemental carbon and induced superhydrophilicity, confirming the removal of the hydrocarbon pellicle. Similar effects of VUV treatment were observed on glazed zirconia specimens with silica surfaces. One-minute VUV photofunctionalization of zirconia and silica therefore promotes human oral fibroblast attachment and proliferation, especially under challenging culture conditions, and induces specimen-to-specimen transmigration and sustainable photofunctionalization for at least seven days.
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Affiliation(s)
- Toshikatsu Suzumura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Yoshihiko Sugita
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Hatsuhiko Maeda
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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Nguyen O, Lee SJ, Lee JD. Influence of varying titanium base abutment heights on retention of zirconia restorations: An in vitro study. J Prosthet Dent 2023; 130:604.e1-604.e5. [PMID: 37633730 DOI: 10.1016/j.prosdent.2023.07.034] [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: 05/22/2023] [Revised: 07/27/2023] [Accepted: 07/31/2023] [Indexed: 08/28/2023]
Abstract
STATEMENT OF PROBLEM Implant manufacturers have introduced titanium base (Ti-Base) abutments with increased abutment heights, ostensibly, to increase the retention of the bonded restoration and to improve overall strength. However, evidence regarding the effects of increasing Ti-Base height on improving retention is lacking. PURPOSE The purpose of this in vitro study was to evaluate the effect of different Ti-Base abutment heights on the retention of zirconia implant-supported crowns. MATERIAL AND METHODS Thirty Ti-Base abutments of the same diameter and heights of 3.5 mm (n=10), 4.5 mm (n=10), and 5.5 mm (n=10), were used for testing. Zirconia restorations were cemented onto the Ti-Base abutments with a resin cement after treatment with a 10-methacryloyloxydecyl dihydrogen phosphate primer by a single operator using a positioning device. The zirconia-Ti-Base restorations were tightened to an implant analog embedded in an autopolymerizing resin block. The specimens were placed and tested in a universal testing machine for pull-out testing. Retention was measured by recording the force at load drop. Statistical analysis was performed using 1-way analysis of variance with the Tukey method for pairwise comparisons. RESULTS The abutment height had a significant effect on retention (P=.010). Ti-Base abutments of 4.5 and 5.5 mm had significantly greater retention than Ti-Base abutments of 3.5 mm (P=.020, P=.040, respectively). However, Ti-Base abutments of 4.5 and 5.5 mm in height were statistically similar (P=.890). CONCLUSIONS An increase in the height of Ti-Base abutments above the standard 3.5 mm height significantly improved the retention of the overlying restoration.
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Affiliation(s)
- Olivia Nguyen
- Graduate student, Advanced Graduate Education in Prosthodontics, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Sang J Lee
- Associate Professor, Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Jason D Lee
- Instructor, Department of Restorative Dentistry and Biomaterial Sciences, Harvard School of Dental Medicine, Boston, Mass.
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Roccuzzo A, Morandini M, Stähli A, Imber JC, Sculean A, Salvi GE. Clinical and radiographic outcomes of implant-supported zirconia fixed dental prostheses with cantilever extension: A proof-of-principle study with a follow-up of at least 1 year. Clin Oral Implants Res 2023; 34:1073-1082. [PMID: 37485971 DOI: 10.1111/clr.14138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/27/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES To test the reliability of full zirconia implant-supported fixed dental prostheses with cantilever extension (FDPCs) after at least 1 year of function. MATERIALS AND METHODS Thirty-five patients in need of implant-supported single unit crowns (SUC) and FDPCs in posterior areas were enrolled. After implant placement, patients were rehabilitated with screw-retained full-zirconia FDPCs. Implant survival rate, pocket probing depth (PPD), presence/absence of bleeding on probing (BoP), and presence/absence of mechanical/technical complications were recorded. Mesial and distal radiographic marginal bone levels (mBLs) from baseline (i.e., recall appointment 3-6 months after implant loading [T0]) to the follow-up examination (i.e., latest recall appointment after at least 12 months after T0 [T1]), were calculated. RESULTS Thirty patients with 34 FDPCs (31 SUCs and 3 FDPs) supported by 37 implants were available for analysis after a mean loading time of 2.6 ± 1.5 years (range: 13-87 months). No implants were lost. MBLs and mean PPD values did not change statistically significantly from T0 to T1 from 0.92 mm ± 0.42 to 0.96 mm ± 0.38 (95% CI: -0.07/0.17; p = .418) and from 2.99 mm ± 0.70 to 3.27 mm ± 0.71 (95% CI: -0.11/0.68; p = .25) respectively. Peri-implant mucositis was diagnosed in 22 cases. Screw-loosening and zirconia chipping occurred 1× in 4 patients. CONCLUSION Within the limitations of the present proof-of-principle study, the use of full-zirconia FDPCs in posterior areas seems a valid and safe short-term treatment option.
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Affiliation(s)
- Andrea Roccuzzo
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Michele Morandini
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Jean-Claude Imber
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Rauch A, Heinzmann W, Rosentritt M, Hahnel S, Schmidt MB, Fuchs F, Koenig A. Aging and Fracture Resistance of Implant-Supported Molar Crowns with a CAD/CAM Resin Composite Veneer Structure. J Clin Med 2023; 12:5997. [PMID: 37762937 PMCID: PMC10532374 DOI: 10.3390/jcm12185997] [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: 08/21/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Chipping of implant-supported molar crowns (iSCs) is a frequently reported complication. This study aimed to investigate the in-vitro aging and fracture resistance of iSCs with a CAD/CAM resin composite veneer structure fabricated with the Rapid Layer Technology (RLT) approach. Eight iSCs per group were fabricated by using two different CAD/CAM resin composites (Shofu Block HC: SH; Grandio blocs: GB) for veneer structures, and zirconia (ZrO2), polyetheretherketone (PEEK), and cobalt-chromium (CoCr; control) as framework materials. The surfaces to be bonded were sandblasted, cleaned in an ultrasonic bath, and a coupling agent was applied. A self-adhesive resin luting composite was used to adhesively lute the veneer structures to the frameworks. The crowns were semi-permanently cemented to the abutments. After storage in deionized water, iSCs were loaded in a chewing simulator (TCML, 10,000 thermal cycles 5 °C to 55 °C for 20 s, 1.2 million, loading force 50 N). Four ZrO2 and one CoCr crown did not survive the TCML. The fracture force was determined after 24 h storage in deionized water and yielded values of ≥974 N. Lowest fracture forces were yielded in the PEEK-SH group in comparison to CoCr or ZrO2 groups (p ≤ 0.031). For identical framework materials, no significant influence of the veneering material was observed. All PEEK-GB frameworks fractured, and chipping occurred for ZrO2-SH and all CoCr frameworks. PEEK-SH and ZrO2-GB presented both chipping and framework fractures. Within the limitations of this in-vitro study, the RLT with a CAD/CAM resin composite veneer structure might be a promising approach to veneer iSCs. Yet, the choice of the CAD/CAM resin composite and of the framework material determine the fracture resistance.
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Affiliation(s)
- Angelika Rauch
- Department of Dental Prosthetics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (M.R.); (S.H.); (M.B.S.)
| | - Wendy Heinzmann
- Zahnärzte im Leipziger Westen, Karl-Heine-Straße 26, 04229 Leipzig, Germany;
| | - Martin Rosentritt
- Department of Dental Prosthetics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (M.R.); (S.H.); (M.B.S.)
| | - Sebastian Hahnel
- Department of Dental Prosthetics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (M.R.); (S.H.); (M.B.S.)
| | - Michael Benno Schmidt
- Department of Dental Prosthetics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (M.R.); (S.H.); (M.B.S.)
| | - Florian Fuchs
- Department of Prosthetic Dentistry and Dental Materials Science, Leipzig University, Liebigstr. 10-12, Haus 1, 04103 Leipzig, Germany; (F.F.); (A.K.)
| | - Andreas Koenig
- Department of Prosthetic Dentistry and Dental Materials Science, Leipzig University, Liebigstr. 10-12, Haus 1, 04103 Leipzig, Germany; (F.F.); (A.K.)
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Pjetursson BE, Sailer I, Merino-Higuera E, Spies BC, Burkhardt F, Karasan D. Systematic review evaluating the influence of the prosthetic material and prosthetic design on the clinical outcomes of implant-supported multi-unit fixed dental prosthesis in the posterior area. Clin Oral Implants Res 2023; 34 Suppl 26:86-103. [PMID: 37750526 DOI: 10.1111/clr.14103] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/24/2023] [Accepted: 04/30/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE The objectives of the study were to assess the survival, failure, and technical complication rates of implant-supported fixed dental prosthesis (iFDPs) with pontic or splinted crown (iSp C) designs in the posterior area and compare the influence of prosthetic materials and prosthetic design on the outcomes. METHODS Electronic and manual searches were performed to identify randomized-, prospective-, and retrospective clinical trials with follow-up time of ≥12 months, evaluating the clinical outcomes of posterior iFDPs with pontic or iSp Cs. Survival and complication rates were analyzed using robust Poisson's regression models. RESULTS Thirty-two studies reporting on 42 study arms were included in the present systematic review. The meta-analysis of the included studies indicated estimated 3-year survival rates of 98.3% (95%CI: 95.6-99.3%) for porcelain-fused-to-metal (PFM) iFDPs, 97.5% (95%CI: 95.5-98.7%) for veneered zirconia (Zr) iFDPs with pontic, 98.9% (95%CI: 96.8-99.6%) for monolithic or micro-veneered zirconia iFDPs with pontic, and 97.0% (95%CI: 84.8-99.9%) for lithium disilicate iFDPs with pontics. The survival rates for different material combination showed no statistically significant differences. Veneered restorations, overall, showed significantly (p < .01) higher ceramic fracture and chipping rates compared with monolithic restorations. Furthermore, there was no significant difference in survival rates (98.3% [95%CI: 95.6-99.3%] vs. 99.1% [95%CI: 97.6-99.7%]) and overall complication rates between PFM iFDPs with pontic and PFM iSp Cs. CONCLUSIONS Based on the data identified by this systematic review, PFM, veneered Zr, and monolithic Zr iFDPs with pontic and iSp Cs showed similarly high short-term survival rates in the posterior area. Veneered restorations exhibit ceramic chipping more often than monolithic restorations, with the highest fracture rate reported for veneered Zr iFDPs.
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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
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Elizabeth Merino-Higuera
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
- Department of Prosthodontics, University Center of Health Sciences, University of Guadalajara, Guadalajara, Mexico
| | - Benedikt Christopher Spies
- Department of Prosthetic Dentistry, Faculty of Medicine, Center for Dental Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Felix Burkhardt
- 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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Juntavee N, Juntavee A, Rengpattanakij N. Bond strength of ceramic veneered CAD-milled alloy upon prolonged sintering. Clin Oral Investig 2023; 27:5377-5389. [PMID: 37462729 DOI: 10.1007/s00784-023-05157-1] [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: 05/06/2023] [Accepted: 07/11/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVES Ceramic-sintering affects bond strength and longevity of metal-ceramic. This study investigated the effect of sintering temperatures and times on metal-ceramic bond strength vis-a-vis interfacial fracture toughness. MATERIALS AND METHODS One hundred eighty rectangular-shaped (25 × 8 × 1 mm) casting (Auriloy® (CA)) and CAD-milling (Ceramill Sintron® (MA)) alloys were prepared and randomly veneered with ceramic at normal (930 °C; (TN)), increased (940 °C; (TI)), and extremely increased (950 °C; (TE)) sintering temperatures and normal (1 min; (HN)), increased (2 min; (HI)), and extremely increased (3 min; (HE)) sintering time (n = 10/group). Pre-cracked was subjected to four loading-unloading cycles at 0.05 mm/min speed to determine interfacial fracture toughness from strain energy release rate (G). Microstructures were examined with a scanning electron microscope (SEM), energy-dispersive X-ray (EDX), and atomic force microscopy (AFM). ANOVA and Tukey comparisons were determined for significant differences (α = 0.05). RESULTS Significant differences in G due to the effect of alloy, sintering temperature, and time (p < 0.05) were indicated. MA revealed higher G than CA. Raising temperatures enabled increasing G for CA, not for MA. Extended sintering permitted increasing G for both alloys. Rougher surface of MA than CA was observed. Interfacial ion exchange was differently indicated between CA and MA. CONCLUSIONS Bond strength was influenced by alloy, sintering temperature, and time. Ceramic has better adhesion to MA than CA. Enhancing bond for CA was succeeded through increasing sintering temperature and time, whereas through extended sintering for MA. CLINICAL RELEVANCE MA offers stronger bond than CA. Enhancing bond is suggested by extended sintering. Raising temperature can enhance bond for CA, not for MA.
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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
| | - Nuttida Rengpattanakij
- Division of Biomaterials and Prosthodontics Research, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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Humm VL, Sailer I, Thoma DS, Hämmerle CHF, Jung RE, Zembic A. 13-year follow-up of a randomized controlled study on zirconia and titanium abutments. Clin Oral Implants Res 2023; 34:911-919. [PMID: 37340530 DOI: 10.1111/clr.14117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 05/22/2023] [Accepted: 06/04/2023] [Indexed: 06/22/2023]
Abstract
OBJECTIVES To assess survival rates and compare technical, biological, and esthetic outcomes of customized zirconia and titanium abutments at 13 years post loading. MATERIALS AND METHODS Initially, 22 patients with 40 implants in posterior regions were included. The sites were randomly assigned to 20 customized zirconia abutments with cemented all ceramic crowns (ACC) and 20 customized titanium abutments with cemented metal ceramic crowns (MCC). At a mean follow-up of 13.4 years, patients were examined and implants/restorations assessed for survival and technical complications, as well as biological and esthetic outcomes (pocket probing depth [PPD], bleeding on probing [BOP], plaque control record [PCR], bone level [BL], papilla index [PAP], mucosal thickness, and recession (distance of the margo mucosae [MM]/margo gingivae MG)). Descriptive analyses were performed for all outcome measures. RESULTS Fifteen patients with 21 abutments (13 zirconia, 8 titanium) were examined at 13 years. The drop-out rate was 25% (patient level). The technical survival rate of the abutments was 100%. The survival rate on the restorative level (crowns) was 100%. The assessed biological outcomes (PPD, PCR, BOP, BL) and esthetic outcomes (MG, PAP) were similar. CONCLUSIONS Zirconia and titanium abutments supporting single implant-borne restorations rendered a high survival rate and minimal differences in terms of technical, biological, and esthetic outcomes at 13 years of follow-up.
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Affiliation(s)
- Viviane Laura Humm
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
- Private practice, Winterthur, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Occlusion, University clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel Stefan Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | | | - Ronald Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
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Benalcázar-Jalkh EB, de Carvalho LF, Alves LMM, Campos TMB, Sousa EDO, Bergamo ETP, Coelho PG, Gierthmuehlen PC, Spitznagel FA, Zahoui A, Bonfante EA. Reliability and Failure Mode of Ti-Base Abutments Supported by Narrow/Wide Implant Systems. Dent J (Basel) 2023; 11:207. [PMID: 37754327 PMCID: PMC10529977 DOI: 10.3390/dj11090207] [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: 06/12/2023] [Revised: 08/10/2023] [Accepted: 08/16/2023] [Indexed: 09/28/2023] Open
Abstract
To assess the reliability and failure modes of Ti-base abutments supported by narrow and wide-diameter implant systems. Narrow (Ø3.5 × 10 mm) and wide (Ø5 × 10 mm) implant systems of two different manufacturers with internal conical connections (16°) and their respective Ti-base abutments (3.5 and 4.5 mm) were evaluated. Ti-base abutments were torqued to the implants, standardized metallic maxillary incisor crowns were cemented, and step stress accelerated life testing of eighteen assemblies per group was performed in three loading profiles: mild, moderate, and aggressive until fracture or suspension. Reliability for missions of 100,000 cycles at 100 and 150 N was calculated, and fractographic analysis was performed. For missions at 100 N for 100,000 cycles, both narrow and wide implant systems exhibited a high probability of survival (≥99%, CI: 94-100%) without significant differences. At 150 N, wide-diameter implants presented higher reliability (≥99%, CI: 99-100%) compared to narrow implants (86%, CI: 61-95%), with no significant differences among manufacturers. Failure mode predominantly involved Ti-base abutment fractures at the abutment platform. Ti-base abutments supported by narrow and wide implant systems presented high reliability for physiologic masticatory forces, whereas for high load-bearing applications, wide-diameter implants presented increased reliability. Failures were confined to abutment fractures.
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Affiliation(s)
- Ernesto B. Benalcázar-Jalkh
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-980, Brazil
| | - Laura F. de Carvalho
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-980, Brazil
| | - Larissa M. M. Alves
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-980, Brazil
| | - Tiago M. B. Campos
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-980, Brazil
| | - Edisa de Oliveira Sousa
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-980, Brazil
| | - Edmara T. P. Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-980, Brazil
| | - Paulo G. Coelho
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Petra C. Gierthmuehlen
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Frank A. Spitznagel
- Department of Prosthodontics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-980, Brazil
| | - Estevam A. Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru 17012-980, Brazil
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Ni J, Xu L, Lin Y, Lai D, Huang X. Effects on different full-coverage designs and materials of crack propagation in first mandibular molar: an extended finite element method study. Front Bioeng Biotechnol 2023; 11:1222060. [PMID: 37650043 PMCID: PMC10464904 DOI: 10.3389/fbioe.2023.1222060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/07/2023] [Indexed: 09/01/2023] Open
Abstract
Objectives: This study aims to investigate the biomechanical properties of fracture resistance in cracked teeth using five different full-coverage restorations made of three different materials. Materials and Methods: A 3D model of a mandibular first molar was created to design five different full-coverage repair models: crown, crown with composite resin filling inside, occlusal veneer, occlusal veneer with composite resin filling inside and onlay. These repair models were fabricated using three different materials, namely, zirconia, lithium disilicate (LDS), and a hybrid polymer-infiltrated ceramic network material (PIC). In total, 15 repair models were tested using the extended finite element method (XFEM), with an occlusal load of 5000 N applied slowly to the occlusal surface of the restoration. The analysis of stress distribution in the restoration and dentin crack line was conducted to measure and record the crack initial load on the restoration and dentin. Results: The results showed that restorations on the occlusal surface significantly improved crack resistance, with zirconia exhibiting superior fracture resistance among the materials tested. Restorations of crown with composite resin filling inside demonstrated the highest resistance to fracture, while occlusal veneers showed the lowest. MPS concentration was observed at the interface between the restoration and dentin and at the root bifurcation, with the highest values at the top of crack development. Dentin covered by oxidized restorations had the highest displacement, while PIC restorations exhibited the lowest. Pulp analysis revealed selective MPS concentration and strain patterns in models with zirconia restorations and onlay, with pronounced pulp displacement in zirconia restorations and onlay. Enamel analysis indicated larger MPS values and displacements in zirconia restoration models and onlay, with higher strain in onlay. Restoration played a crucial role in protecting the tooth, with crack propagation initial loads in dentin surpassing restorations in experimental groups. Conclusion: This study confirms that full-coverage restorations significantly increased the fracture resistance of cracked teeth, with zirconia restorations significantly protecting the underlying cracked tooth. Elimination of fracture lines in the restoration design can improve fracture resistance in cracked teeth. The findings have implications for dental prosthetic design and clinical practice.
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Affiliation(s)
| | | | | | | | - Xiaohong Huang
- Department of Stomatology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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Strasding M, Jeong Y, Marchand L, Hicklin SP, Sailer I, Sun M, Lee H. Three-Dimensional Peri-Implant Tissue Changes in Immediately vs. Early Placed Tapered Implants Restored with Two Different Ceramic Materials-1 Year Results. MATERIALS (BASEL, SWITZERLAND) 2023; 16:5636. [PMID: 37629928 PMCID: PMC10456968 DOI: 10.3390/ma16165636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/19/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND A prospective multi-center randomized controlled clinical trial was performed to digitally analyze tissue volume changes in immediately and early placed implants with simultaneous bone augmentation restored with two different all-ceramic materials. METHODS A total of 60 patients received 60 bone-level tapered implants (BLT, Straumann AG) immediately (n = 30) or early placed, 8-10 weeks after tooth extraction, (n = 30). Implants were restored with all-ceramic single crowns fabricated out of zirconia (Lava Plus, 3M), or lithium disilicate (E.max CAD, Ivoclar Vivadent AG) bonded to titanium base abutments (Variobase for Cerec, Straumann AG). Impressions were taken at baseline (BL), 6 and 12 months, and STL data were used to define an area of interest (AOI) to analyze peri-implant volume changes and midfacial recessions. RESULTS For immediate placement, a mean volume loss of -5.56 mm3 (±5.83 mm3) was found at 6 months, and of -6.62 mm3 (±6.56 mm3) at 12 months. For early placement, a mean volume loss of -1.99 mm3 (±5.82 mm3) at 6 months, and of -3.7 mm3 (±5.62 mm3) at 12 months was found. The differences in volume loss at 12 months between the two implant placement protocols were significant (p = 0.005). In both groups, mean midfacial recessions of 0.48 mm (±0.52) occurred. CONCLUSIONS A more pronounced peri-implant volume loss can be expected 12 months after immediate implant placement compared with early placement.
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Affiliation(s)
- Malin Strasding
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Yuwon Jeong
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Laurent Marchand
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Stefan P. Hicklin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland;
- Clinic of General, Special Care and Geriatric Dentistry, Center of Dental Medicine, University of Zürich, 8032 Zürich, Switzerland
| | - Irena Sailer
- Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland (I.S.)
| | - Minji Sun
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
| | - Hyeonjong Lee
- Department of Prosthodontics, College of Dentistry, Yonsei University, Seoul 03722, Republic of Korea; (Y.J.); (M.S.)
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Mayinger F, Meinen J, Coldea A, Zimmermann M, Stawarczyk B. Digital versus conventional veneering of zirconia and cobalt chromium crowns: Fracture load before and after thermomechanical aging. J Prosthet Dent 2023; 130:251.e1-251.e8. [PMID: 37244796 DOI: 10.1016/j.prosdent.2023.04.023] [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: 02/09/2023] [Revised: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 05/29/2023]
Abstract
STATEMENT OF PROBLEM To complement the digital workflow for manufacturing fixed dental prostheses, both high-strength frameworks and esthetic veneers should be designed and fabricated digitally. However, how the fracture load of digitally veneered restorations compares with conventionally fabricated restorations is unclear. PURPOSE The purpose of this in vitro study was to examine the fracture load of digitally and conventionally veneered zirconia and cobalt chromium crowns initially and after thermomechanical aging. MATERIAL AND METHODS Milled zirconia and cobalt chromium copings for a maxillary canine were fabricated (N=96). Digital veneers were milled and connected to the copings with a sintered ceramic slurry. The conventional veneers were fabricated by using a master mold, and the crowns were bonded to the cobalt chromium abutments. Half the specimens were subjected to 6000 thermal (5 °C to 55 °C, 60 seconds) and 1 200 000 mechanical (50 N, 1.5 Hz, 0.7 mm lateral movement) cycles opposed by steatite antagonists, and the fracture load was determined. Fracture types were categorized, and scanning electron microscopy performed. The data were analyzed with a 3-way global univariate analysis of variance, t test, the Pearson chi-squared test, and the Weibull modulus (α=.05). RESULTS Unlike the framework material (P=.316) and artificial aging (P=.064), the veneering protocol affected the fracture load (P=.007). Digital veneers (range: 2242 to 2929 N) led to lower values than conventional veneers (range: 2825 to 3166 N), which was significant for aged cobalt chromium copings (P=.024; 2242 versus 3107 N). Conventionally veneered crowns showed lower Weibull moduli after thermomechanical aging (range: 3.2 to 3.5) than initially (range: 7.8 to 11.4). The copings of all the zirconia specimens fractured, while chipping occurred with the cobalt chromium specimens. CONCLUSIONS The high fracture load values of the veneered crowns, even after simulated 5-year aging, indicated sufficient mechanical properties (nearly 4-fold the average occlusal force of 600 N) for the successful clinical application of digitally veneered zirconia and cobalt chromium copings.
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Affiliation(s)
- Felicitas Mayinger
- Research Associate, Department of Prosthetic Dentistry, Dental School, Ludwig Maximilian University of Munich, Munich, Germany.
| | - John Meinen
- Dental Technician, Department of Prosthetic Dentistry, Dental School, Ludwig Maximilian University of Munich, Munich, Germany
| | - Andrea Coldea
- Research Associate, Department of Prosthetic Dentistry, Dental School, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marcus Zimmermann
- Dental Technician, Division of Computerized Restorative Dentistry, Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland
| | - Bogna Stawarczyk
- Professor, Department of Prosthetic Dentistry, Dental School, Ludwig Maximilian University of Munich, Munich, Germany
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Graf T, Schweiger J, Stimmelmayr M, Erdelt K, Schubert O, Güth JF. Influence of monolithic restorative materials on the implant-abutment interface of hybrid abutment crowns: An in vitro investigation. J Prosthodont Res 2023; 67:450-459. [PMID: 36517017 DOI: 10.2186/jpr.jpr_d_22_00115] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Purpose This in vitro study aimed to investigate the long-term performance, stability, and fracture mode of monolithic hybrid abutment crowns, and the effect of different materials on the implant-abutment interface (IAI).Methods Eighty monolithic hybrid abutment crowns luted on titanium bases were manufactured from 3Y-TZP zirconia (ZY3), "Gradient Technology" zirconia (ZY35), 5Y-TZP zirconia (ZY5), lithium disilicate ceramic (LDS), zirconia-reinforced lithium silicate ceramic (ZLS), polymer-infiltrated ceramic network (MHY), polymethylmethacrylate (PMA), and 3D-printed hybrid composite (PHC) (n = 10 for each material). Eighty implants (Camlog Progressive-Line, diameter: 3.8 mm) were embedded in accordance with ISO standard 14801, and crowns were mounted. After artificial aging (1.2 × 106 cycles, 50 N, thermocycling), intact specimens were loaded 30° off-axis in a universal testing machine until failure.Results Seven specimens in the PHC group failed during artificial aging, and all the others survived. There were two subgroups based on the one-way analysis of variance and Dunnett's test (P < 0.05) of the mean fracture load values. The first comprised Z3Y, ZY35, Z5Y, and LDS, with mean fracture loads between 499.4 and 529.7 N, while the second included ZLS, MHY, and PMA, with values in the 346.2-416.0 N range. ZY3, ZY35, ZY5, and LDS exhibited irreversible, visible deformations of the implant shoulders with varying dimensions after load-to-fracture tests.Conclusions Crowns made of LDS, ZLS, MHY, and PMA may act as potential stress breakers, and prevent possible deformation at IAIs. Further clinical studies need to assess if these materials also withstand relevant loads in-vivo.
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Affiliation(s)
- Tobias Graf
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Germany
| | - Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Michael Stimmelmayr
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Kurt Erdelt
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Oliver Schubert
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Germany
| | - Jan-Frederik Güth
- Department of Prosthodontics, Center for Dentistry and Oral Medicine (Carolinum), Goethe University Frankfurt am Main, Germany
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Abbasi M, Ebadian B, Aminianpour N. Shear Bond Strength of Colored and Sandblasted Zirconia to Ceramic Veneers Fabricated by the Pressing and Layering Techniques: An In Vitro Study. Int J Dent 2023; 2023:4949867. [PMID: 37496833 PMCID: PMC10368495 DOI: 10.1155/2023/4949867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction Porcelain-veneered zirconia (PVZ) restorations are increasingly used due to their optimal esthetics and high strength. However, chipping of porcelain limits the application of PVZ restorations. The aim of this study was to assess the shear bond strength (SBS) of colored and sandblasted zirconia to ceramic veneers fabricated by the pressing and layering techniques. Materials and Methods Sixty cubic zirconia specimens (10 × 10 × 2 mm) were assigned to three groups according to their surface treatment: (I) control, (II) sandblasting with 50 μm alumina particles (S), and (III) coloring (C). Each group was subsequently divided into two subgroups according to the porcelain-veneering technique: (I) layering (L) and (II) pressing (P). The specimens underwent 10,000 thermal cycles between 5 and 55°C, and their biaxial SBS was measured in an electromechanical universal test machine (0.5 mm/min with 2.5 kN load cell). The failure mode was also assessed under a stereomicroscope. Three samples were randomly selected from each subgroup (n = 18) for examination of zirconia-phase transformation by X-ray diffraction (XRD). Two-way and one-way ANOVA followed by the post hoc Tukey test were used to analyze statistical differences among the groups and subgroups (α = 0.05). Results The sandblasted zirconia with press porcelain (SP) subgroup showed the highest (24.40 ± 8.16 MPa) and the colored zirconia with press porcelain (CP) subgroup showed the lowest (13.76 ±3.62 MPa) SBS. All failures were cohesive. Rate of phase transformation in layered porcelain was significantly lower than that in pressed porcelain (P < 0.01). Conclusion The sandblasted group showed the highest and the colored group showed the lowest SBS; the layered group showed higher SBS than the pressed group.
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Affiliation(s)
- Mahsa Abbasi
- Department of Prosthodontics, School of Dentistry, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Behnaz Ebadian
- Department of Prosthodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negin Aminianpour
- Dental Research Center, Dentistry Research Institute and Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Abd Alraheam I, Al-Asmar A, Hasan N, Asoleihat F, Alkayed A. Clinical evaluation of cemented and adhesively resin-bonded monolithic and partially layered zirconia and lithium disilicate crowns. Saudi Dent J 2023; 35:508-514. [PMID: 37520593 PMCID: PMC10373076 DOI: 10.1016/j.sdentj.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose Zirconia and lithium disilicate crowns are very popular dental restorations. The cement type and layering technique used can profoundly affect the clinical performance of these crowns.This retrospective study is designed to investigate the success rate of cemented and adhesively bonded monolithic and partially layered zirconia and lithium disilicate crowns placed in faculty practice settings. Materials and Methods Patients who had received zirconia or lithium disilicate crowns at the faculty practice were invited for clinical examination. The examiner used the modified United States Public Health Service (MUSPHS) evaluation criteria to evaluate the crowns. The crowns were either glass ionomer cemented zirconia (GIC-Zr), resin-bonded zirconia (Adh-Zr), or resin-bonded lithium disilicate (Adh-LD). The crowns were also divided into monolithic and layered groups. Inferential analysis was used to examine the differences through bivariate analysis using t-testing and one-way ANOVA. Results Thirty-five patients, with a combined total of 218 single crowns, agreed to participate in the study. No statistically significant differences in the quality outcome variables considered were found between the groups, except for marginal adaptation, where Adh-Zr achieved significantly higher scores compared to GIC-Zr and Adh-LD. Layered zirconia and lithium disilicate crowns have significantly higher quality outcomes in terms of anatomic form, marginal adaptation, and color match compared to monolithic zirconia and lithium disilicate crowns. Conclusions Conventionally cemented zirconia and adhesively bonded zirconia and lithium disilicate crowns are reliable treatment options with high short-term success rates. Clinical studies with longer follow-up times are needed to investigate their long-term success rates.
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Affiliation(s)
- Islam Abd Alraheam
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Aya Al-Asmar
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Noor Hasan
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Firas Asoleihat
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
| | - Awni Alkayed
- Department of Restorative Dentistry, University of Jordan, Amman, Jordan
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Tajti P, Solyom E, Czumbel LM, Szabó B, Fazekas R, Németh O, Hermann P, Gerber G, Hegyi P, Mikulás K. Monolithic zirconia as a valid alternative to metal-ceramic for implant-supported single crowns in the posterior region: A systematic review and meta-analysis of randomized controlled trials. J Prosthet Dent 2023:S0022-3913(23)00336-0. [PMID: 37349158 DOI: 10.1016/j.prosdent.2023.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/24/2023]
Abstract
STATEMENT OF PROBLEM Technical complication rates of standard metal-ceramic implant-supported posterior restorations are relatively high. Whether monolithic zirconia crowns represent a more successful alternative is unclear. PURPOSE The purpose of this systematic review and meta-analysis was to compare the clinical outcomes of posterior monolithic zirconia and metal-ceramic implant-supported single crowns. MATERIAL AND METHODS A search was conducted in MEDLINE, Scopus, Embase, Web of Science, and CENTRAL databases for randomized controlled trials up to April 2023 with a follow-up time of at least 1 year. Restoration and implant survival and failure rates, marginal bone loss (MBL), bleeding on probing (BOP), and technical complications were analyzed by 2 reviewers. Statistical analyses were conducted using the R-statistics software program. The risk of bias was assessed by the Cochrane Risk of Bias Tool 2 (RoB 2), and the certainty of evidence by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS A total of 11 out of 2030 records were identified by title and abstract, and 4 records were included after full-text analysis. The statistical analysis revealed no significant difference in MBL (MD -0.11, 95% CI: [-0.25; 0.03]), BOP (OR 0.66, 95% CI: [0.25; 1.77]), or implant failure (OR 1.30, 95% CI: [0.24; 7.08]). Monolithic zirconia presented significantly less chipping over 1 year (OR 0.17, 95% CI: [0.03; 0.99]). The chipping rate was 0% for monolithic zirconia and 7.61% for metal-ceramic. Based on a narrative review, the restoration survival rate was 97.5% in the monolithic zirconia group and 99.1% in the metal-ceramic group. CONCLUSIONS Monolithic zirconia showed favorable short-term survival rates and had significantly less chipping over 1 year. Regarding MBL, BOP, and failure rates, both restoration types presented similar results at the 1-year follow-up.
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Affiliation(s)
- Péter Tajti
- Resident, Department of Prosthodontics, Semmelweis University, Budapest, Hungary; PhD student, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eleonora Solyom
- Clinical Specialist, Department of Periodontology, Semmelweis University, Budapest, Hungary; PhD student, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - László Márk Czumbel
- Resident, Department of Periodontology, Semmelweis University, Budapest, Hungary; Scientific Methodology Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Biostatistician, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Réka Fazekas
- Assistant Professor, Department of Conservative Dentistry, Semmelweis University, Budapest, Hungary; Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Orsolya Németh
- Director, Associate Professor, Department of Community Dentistry, Semmelweis University, Budapest, Hungary; Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Director, Full Professor, Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Gábor Gerber
- Associate Professor, Department of Anatomy, Histology and Embryology, Semmelweis University, Budapest, Hungary; Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Strategic Director, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Strategic Director, Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Krisztina Mikulás
- Assistant Professor, Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Supervisor, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
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Alenezi A, Aloqayli S. Technical complications with tooth-supported fixed dental prostheses (FDPs) of different span lengths: an up to 15-year retrospective study. BMC Oral Health 2023; 23:393. [PMID: 37316922 DOI: 10.1186/s12903-023-03121-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 06/08/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUNDS Long-span dental bridges may cause excessive load on abutment teeth and the periodontal area, which may lead to bridge fractures or periodontal problems. However, some reports have revealed that short- and long-span bridges can provide a similar prognosis. This clinical study aimed to investigate the technical complications associated with fixed dental prostheses (FDPs) of different span lengths. METHODS All patients with previously cemented FDPs were clinically examined during their follow-up visits. Several data related to FDPs were registered, such as design, material type, location, and type of complication. The main clinical factors analyzed were technical complications. Life table survival analyses were performed to calculate the cumulative survival rate of FDPs when technical complications were detected. RESULTS The study examined 229 patients with a total number of 258 prostheses and an average of 98 months of follow-up. Seventy-four prostheses suffered from technical complications, and the most common complication was ceramic fracture or chipping (n = 66), while loss of retention occurred in 11 prostheses. The long-term evaluation of long-span prostheses revealed a significantly higher technical complication rate compared to short-span prostheses (P = ,003). The cumulative survival rate for short-span FDPs was 91% in year 5, 68% in year 10, and 34% in year 15. For long-span FDPs, the cumulative survival rate was 85% in year 5, 50% in year 10, and 18% in year 15. CONCLUSION Long-span prostheses (5 units or more) can be associated with a higher technical complication rate compared to short-span prostheses after long-term evaluation.
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Affiliation(s)
- Ali Alenezi
- Department of Prosthodontics, College of Dentistry, Qassim University, P.O. Box 6700, Buraydah, Saudi Arabia.
| | - Sarah Aloqayli
- Intern, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
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Hickel R, Mesinger S, Opdam N, Loomans B, Frankenberger R, Cadenaro M, Burgess J, Peschke A, Heintze SD, Kühnisch J. Revised FDI criteria for evaluating direct and indirect dental restorations-recommendations for its clinical use, interpretation, and reporting. Clin Oral Investig 2023; 27:2573-2592. [PMID: 36504246 PMCID: PMC10264483 DOI: 10.1007/s00784-022-04814-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The FDI criteria for the evaluation of direct and indirect dental restorations were first published in 2007 and updated in 2010. Meanwhile, their scientific use increased steadily, but several questions from users justified some clarification and improvement of the living document. MATERIALS AND METHODS An expert panel (N = 10) initiated the revision and consensus process that included a kick-off workshop and multiple online meetings by using the Delphi method. During and after each round of discussion, all opinions were collected, and the aggregated summary was presented to the experts aiming to adjust the wording of the criteria as precisely as possible. Finally, the expert panel agreed on the revision. RESULTS Some categories were redefined, ambiguities were cleared, and the descriptions of all scores were harmonized to cross-link different clinical situations with possible management strategies: reviewing/monitoring (score 1-4), refurbishment/reseal (score 3), repair (score 4), and replacement (score 5). Functional properties (domain F: fracture of material and retention, marginal adaptation, proximal contact, form and contour, occlusion and wear) were now placed at the beginning followed by biological (domain B: caries at restoration margin, hard tissue defects, postoperative hypersensitivity) and aesthetic characteristics (domain A: surface luster and texture, marginal staining, color match). CONCLUSION The most frequently used eleven categories of the FDI criteria set were revised for better understanding and handling. CLINICAL RELEVANCE The improved description and structuring of the criteria may help to standardize the evaluation of direct and indirect restorations and may enhance their acceptance by researchers, teachers, and dental practitioners.
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Affiliation(s)
- Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - Sabine Mesinger
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Niek Opdam
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas Loomans
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Marburg, Germany
| | - Milena Cadenaro
- Department of Medical Sciences, University of Trieste, Trieste, Italy and Children's Hospital "Burlo Garofolo," Institute for Maternal and Child Health, Trieste, Italy
| | - John Burgess
- Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Arnd Peschke
- IvoclarVivadent AG, Research & Development, Schaan, Liechtenstein
| | | | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University of Munich, Munich, Germany
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Aswal GS, Rawat R, Dwivedi D, Prabhakar N, Kumar V. Clinical Outcomes of CAD/CAM (Lithium disilicate and Zirconia) Based and Conventional Full Crowns and Fixed Partial Dentures: A Systematic Review and Meta-Analysis. Cureus 2023; 15:e37888. [PMID: 37213959 PMCID: PMC10199723 DOI: 10.7759/cureus.37888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 05/23/2023] Open
Abstract
Although CAD/CAM (computer-aided design/computer-aided manufacturing) restorations act as a favorable alternative to conventional metal-ceramic restorations for fixed dental prostheses, little is known about their intermediate and persistent clinical performance. This systematic review and meta-analysis aimed to assess the clinical performance in terms of biological, technical, and esthetic aspects and the survival and success ratios for single full crowns (SFCs) and fixed partial dentures (FPDs) fabricated by CAD/CAM and conventional techniques and according to the materials used (zirconia {ZC} and lithium disilicate {LD}). The population, intervention, control, outcome, and study design (PICOS) strategy was used to electronically search key terms in the PubMed, Cochrane Library, Embase, and Wiley Online databases for randomized control trials (RCTs) and cohort studies. The bias risks for RCTs and cohort studies were assessed using the Cochrane collaboration tool and the Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using Rev5 from Cochrane. A total of 13 studies reporting on 1598 restorations in 1161 patients with a mean observation period of 3.6 years (minimum-maximum: 1-9.3 years) met the inclusion criteria. Meta-analysis of the included studies indicated that CAD/CAM manufacturing resulted in 1.17, 1.14, and 16.88 (95% CI: 0.64-2.17, 0.86-1.52, 7.59-37.56) higher biological, technical, and esthetic complications than conventional manufacturing of restorations. However, the difference was significant for esthetic complications only (p<0.00001). A significant difference was observed for all biological, technical, and aesthetic aspects between SFCs and FPDs (odds ratio {OR} = 2.61 vs. 1.78, 95% CI: 1.92-3.56 vs. 1.33-2.38; p<0.00001). The survival ratio of SFCs was 2.69 (95% CI: 1.98-3.65), significantly higher compared to the 1.76 (95% CI: 1.31-2.36) of FPDs (p<0.00001). The success ratio of FPDs at 1.18 (95% CI: 0.83-1.69) was significantly lower compared to SFCs at 2.36 (95% CI: 1.68-3.33). The clinical performance of LD with 2.42 (CI: 1.16-5.03) was significantly higher compared to ZC with 2.22 (CI: 1.78-2.77) (p<0.00001). The biological, technical, and aesthetic behaviors showed similar clinical outcomes between the CAD/CAM and conventional groups. LD could be a good alternative to zirconia, but its intermediate or persistent clinical performance needs to be evaluated. Overall, zirconia and CAD/CAM techniques must evolve further to outclass the conventional techniques used in the fabrication of SFCs and FPDs.
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Affiliation(s)
- Gunjan S Aswal
- Dentistry, The University of the West Indies, St. Augustine, TTO
| | - Renu Rawat
- Dentistry, The University of the West Indies, St. Augustine, TTO
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Görgen CI, Sagheb K, Lehmann KM, Schmidtmann I, Wentaschek S. Influence of cold atmospheric-pressure-plasma in combination with different pretreatment methods on the pull-off tensile load in two-piece abutment-crowns: an in-vitro study. BMC Oral Health 2023; 23:186. [PMID: 36997908 PMCID: PMC10064688 DOI: 10.1186/s12903-023-02880-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/13/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND In implant prosthetic dentistry, the adhesive connection of individualized ceramic crowns and prefabricated titanium bases leads to several benefits. However, the durability of the bonding could be a weak point and especially depends on sufficient surface pretreatment. Cold atmospheric-pressure plasma (CAP) is a pretreatment method that should improve the surface properties without physical damage. Thus, the purpose of this study was to investigate the influence of CAP treatment on pull-off tensile load in two-piece abutment crowns. METHODS Eighty zirconia crowns and titanium bases were divided into eight groups (n = 10) according to their surface pretreatment prior to cementation with Panavia V5: no treatment (A); sandblasting (B); 10-MDP primer (C); sandblasting and primer (D); CAP (AP); sandblasting and CAP (BP); CAP and primer (CP); sandblasting, CAP and primer (DP). The specimens were thermocycled (5°/55°, 5000 cycles), and then the pull-off tensile load (TL) was measured. Statistical analyses were performed using three-way ANOVA with Tukey post-hoc and Fisher's exact tests. RESULTS The results showed that the TL was highest in group D (p < 0.0001). Some combinations of different treatments led to effects that were greater than the sum of the individual effects. These effects were modified by interactions. Only in combination with primer, CAP treatment had a small but positive significant effect (group CP vs. C and CP vs. AP, p < 0.0001) which however did not come close to the strong interaction effect that resulted from the combination of sandblasting and primer. CONCLUSION Within the limitations of this study, CAP treatment cannot be recommended in this specific field of indication due to its unreliable influence on TL in combination with other pretreatment methods.
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Affiliation(s)
- Carolin-Isabel Görgen
- Department for Prosthetic Dentistry and Materials, University Medical Centre, Augustusplatz 2, 55131, Mainz, Germany.
| | - Kawe Sagheb
- Department for Prosthetic Dentistry and Materials, University Medical Centre, Augustusplatz 2, 55131, Mainz, Germany
| | - Karl Martin Lehmann
- Department for Prosthetic Dentistry and Materials, University Medical Centre, Augustusplatz 2, 55131, Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Obere Zahlbacher Str. 69, 55131, Mainz, Germany
| | - Stefan Wentaschek
- Department for Prosthetic Dentistry and Materials, University Medical Centre, Augustusplatz 2, 55131, Mainz, Germany
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Bukhari A, Dahshan S, Kotina E, Zhao N, Almujel S, Gallucci GO, Hamilton A. Application of 3D-printed guide for locating screw access channels in cement-retained complete arch implant-supported zirconia restorations. J Prosthet Dent 2023:S0022-3913(22)00489-9. [PMID: 36959002 DOI: 10.1016/j.prosdent.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 03/25/2023]
Abstract
Removal of cement-retained complete arch implant-supported zirconia restorations can be challenging. A predictable and minimally invasive technique combining cone beam computed tomography (CBCT) and intraoral scans with a virtual implant planning software program is described to identify the location of the screw access channels during the retrieval, thus minimizing damage to the existing restoration and allowing reuse.
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Affiliation(s)
- Asmaa Bukhari
- Demonstrator, Department of Prosthodontics, King Abdulaziz University, Jeddah, Saudi Arabia; AGE Implant program, Harvard School of Dental Medicine, Boston, Mass.
| | - Samantha Dahshan
- AGE Implant program, Harvard School of Dental Medicine, Boston, Mass
| | - Elli Kotina
- ITI Scholar Implant program, Harvard School of Dental Medicine, Boston, Mass
| | - Na Zhao
- AGE Implant program, Harvard School of Dental Medicine, Boston, Mass
| | - Saad Almujel
- Demonstrator, Department of Prosthodontics, King Saud University, Riyadh, Saudi Arabia; AGE Implant program, Harvard School of Dental Medicine, Boston, Mass
| | - German O Gallucci
- Associate Professor and Chairman, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Adam Hamilton
- Discipline Lead in Prosthodontics and Graduate Program Convenor University of Western Australia Dental School, Nedland, Western Australia, Australia; Lecturer, Division of Regenerative and Implant Science, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
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Barile G, Capodiferro S, Muci G, Carnevale A, Albanese G, Rapone B, Corsalini M. Clinical Outcomes of Monolithic Zirconia Crowns on Posterior Natural Abutments Performed by Final Year Dental Medicine Students: A Prospective Study with a 5-Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2943. [PMID: 36833639 PMCID: PMC9966316 DOI: 10.3390/ijerph20042943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/03/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
The conventional metal-ceramic is still considered the gold standard in fixed prosthetics especially in terms of longevity. Among alternative materials used, Monolithic Zirconia has shown the capability to reconcile excellent biomechanical properties with acceptable aesthetic performance and to overcome several inconveniences related to veneer restorations. This study aims to clinically evaluate Monolithic Zirconia prosthetic crowns on natural abutments in the posterior sectors, performed by final-year dental medicine students (undoubtedly with less experience in the management of such material) by the standardized California Dental Association score system evaluation, to better understand the viability of Monolithic Zirconia. This prospective study was carried out at the Dental School of the University of Bari "Aldo Moro", Italy. Prosthetic rehabilitation included single crowns or a short pontic prosthesis with maximum one intermediate. Final-year dental students performed tooth reduction under the supervision of three expert tutors. The California Dental Association systematics (based on color, surface, anatomical shape, and marginal integrity) were adopted to evaluate the prosthetic maintenance status over time. Annual follow-up visits were re-evaluated by the same parameters each year. Univariate logistic regression analysis was performed to evaluate outcomes and the Kaplan-Meier plot to report survival. The sample consists of 40 crowns performed on 31 patients, 15 males (48.4%) and 16 females (51.6%) with an average age of 59.3 years. The clinical cases subjected to experimental study were found to be "Excellent" (1a/2a/3a/4a) in 34 cases (85%), "Acceptable" in 4 cases (10%), and "To be re-done" in 2 cases (failures) (5%). Our conclusive data support the predictability of Monolithic Zirconia restorations on natural posterior abutments at a long-term follow-up of five years, even when performed by less-experienced clinicians.
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Affiliation(s)
- Giuseppe Barile
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giovannino Muci
- Dental School, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | | | - Giovanni Albanese
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Biagio Rapone
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Massimo Corsalini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
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Jadaan O, Esquivel-Upshaw J, Nemeth NN, Baker E. Proof testing to improve the reliability and lifetime of ceramic dental prostheses. Dent Mater 2023; 39:227-234. [PMID: 36707313 DOI: 10.1016/j.dental.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/28/2022] [Accepted: 01/15/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Ceramic dental prostheses exhibit increasing failure rates with service time. In particular, veneered crowns and bridges are susceptible to chipping and other fracture modes of failure. The purpose of this manuscript is to introduce a computational methodology and associated software that can predict the time-dependent probability of failure for ceramic prostheses and subsequently design proof test protocols to significantly enhance their reliabilities and lifetimes. METHODS Transient reliability and corresponding proof testing theories are introduced. These theories are coded in the Ceramic Analysis and Reliability Evaluation of Structures (CARES/Life) code. This software will be used to demonstrate the predictive capability of the theory as well as its use in designing proof test protocols to significantly improve the reliability (survival probability) and lifetime for dental prostheses. A three-unit fixed dental prosthesis (FDP) with zirconia core (ZirCAD) and veneering ceramic (ZirPress) are used to compare the predicted probabilities of failure to general clinical results. In addition, the capability to use proof testing to significantly improve the performance (reliability and lifetime) for this restoration is demonstrated. RESULTS The probability of failure, Pf, after five years without proof testing is predicted to be 0.337. This compares to clinical studies showing the failure rate to be between 0.2 and 0.23 after 5 years. After 10 years, reference 18 found the clinical failure rate for similar bridges (but not the same) to be up to 0.28 compared to the predicted Pf of 0.38. The difference may be due to the analysis applying the load at an inclination of 75° which is more critical than vertical loading. In addition, clinical studies often report a simple survival rate instead of using Kaplan-Meier analysis to properly account for late enrollees. Therefore, true clinical failure rates may be higher than reported and may more closely match the predictions of this manuscript. The effectiveness of proof testing increases with selecting materials less susceptible to slow crack growth (higher SCG exponent, N). For example, proof testing the ZirPress glass-veneered bridges with N = 43.4 analyzed in this manuscript at 400 N bite force for 1 s which induces a failure rate during proof testing of 0.31, reduces the Pf of bridges not proof tested from 0.45 to an attenuated-proof-tested probability of failure Pfa of 0.21 after 20 years of usage. If another material is selected with improved resistance to SCG of N = 60 and the same loading conditions, the failure rate for the proof tested bridges after 20 years of service drops to 2 in 10,000 from 2.4 in 100 had they been not proof tested. The failure rate during proof testing for this material would be 5.1 in 100. Proof testing a material with absolutely no susceptibility to SCG at the same service load (in this case 285 N, not even the 400 N load used above) results in 0 % failure rate and is of course independent of time. SIGNIFICANCE The transient reliability and proof test theory presented in this paper and associated computational software CARES/Life were successful in predicting the performance of ceramic dental restorations when compared to clinical data. Well-designed proof test protocols combined with proper material selection can significantly enhance the reliabilities and lifetimes of ceramic prostheses. This proof test capability can be a translational technology if properly applied to dental restorations.
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Affiliation(s)
- Osama Jadaan
- Department of Mechanical Engineering, University of North Florida, Jacksonville, FL, USA.
| | | | | | - Eric Baker
- Connecticut Reserve Technologies, Inc., Cleveland, OH, USA
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