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Goodrick AM, Nadjmi S. Worn denture teeth of a full-arch implant-supported fixed dental prosthesis: A technique to restore. J Prosthodont 2024; 33:105-109. [PMID: 37493265 DOI: 10.1111/jopr.13740] [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: 05/07/2023] [Revised: 07/23/2023] [Accepted: 07/24/2023] [Indexed: 07/27/2023] Open
Abstract
Worn denture teeth continue to be a significant complication with implant-supported prostheses. This article discusses a case report that used an intraoral scanning system to restore an existing maxillary implant-supported prosthesis with significant posterior occlusal wear. IPS e.max (Ivoclar Vivadent, Schaan, Liechtenstein) restorations were fabricated and cemented to the prepared posterior denture teeth to re-establish the occlusal vertical dimension and to help prevent further wear of the occlusal surfaces.
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Affiliation(s)
- Adam M Goodrick
- Dental Services, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
| | - Sassan Nadjmi
- Dental Services, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
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2
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Sinha N, Thompson GA, Drago C, An H. Shear bond strength characteristics on surface treatment modalities of CAD-CAM resin polymers. J Prosthodont 2023. [PMID: 37940565 DOI: 10.1111/jopr.13790] [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: 01/30/2023] [Accepted: 11/05/2023] [Indexed: 11/10/2023] Open
Abstract
PURPOSE The purpose of this in vitro study was to analyze the shear bond strength of composite resin to a commercially available high-performance polymer material for fixed, screw-retained full arch restorations. MATERIAL AND METHODS A total of 135 computer-aided design and computer-aided manufacturing, high-performance polymer (HPP) blocks were cut and obtained from discs (Trilor 95, Harvest Dental, Brea, CA). The samples were 10 mm × 10 mm × 10 mm. The specimen surfaces were grouped as untreated (Group A), 50 μm Al2O3 (Group B), 110 μm Al2O3 (Group C), Rocatec (3 M, St. Paul, MN) activated with silica-modified alumina oxide treatment (Group D); and trimmed coarsely with a carbide bur (Group E). Group A samples were used as controls. After surface treatments, the specimens were gently cleansed with oil-free steam and alcohol wipes. Surface conditioning was performed on all physically treated samples. The manufacturer's recommendations were followed for bonding composite resin to the samples with light-cured Visio.link (Bredent, Chesterfield, UK). Cylinders were veneered with composite resins (diameter 5 mm, height 4 mm) and polymerized on the specimen surfaces through plastic tubes. Twenty-seven specimens were used for each testing group and aging tests were performed. The experimental samples were thermocycled. Shear bond strength and scanning electron microscopic tests were performed. Means and standard deviations were calculated. Statistical analysis was performed with post-hoc Tukey tests. RESULTS Statistical analysis revealed that there was a significant difference between the groups (p<0.001). The highest shear bond strengths were achieved for the specimens bonded with Visio.link without physical surface treatments (270.47 MPa). The lowest bond strengths were found for specimen surfaces abraded with 110 μm Al2O3 (117.03 Mpa) CONCLUSIONS: The results of this laboratory study indicated that the specimens used with Visio.link as provided by the manufacturer had the highest shear bond strengths between the composite resin and high-performance polymer test specimens. Modifications of the high-performance polymer surfaces with carbide burs did not change bonding strengths with the composite materials.
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Affiliation(s)
- Nikita Sinha
- Department of Prosthodontics, Creighton University School of Dentistry, Omaha, Nebraska, USA
| | - Geoffrey A Thompson
- Department of Prosthodontics, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Carl Drago
- Department of Prosthodontics, Marquette University School of Dentistry, Milwaukee, Wisconsin, USA
| | - Hongseok An
- Department of Restorative Dentistry, Graduate Prosthodontics OHSU, Portland, Oregon, USA
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Martakoush-Saleh S, Salgado-Peralvo AO, Peña-Cardelles JF, Kewalramani N, Gallucci GO. Evaluating the clinical behavior of veneered zirconia in comparison with monolithic zirconia complete arch implant-supported prostheses: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00497-3. [PMID: 37696747 DOI: 10.1016/j.prosdent.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 09/13/2023]
Abstract
STATEMENT OF PROBLEM Because the use of zirconia in dentistry is relatively new, the number of published studies on the subject is scarce, even though material selection is an important factor in clinical performance. Therefore, a systematic assessment of the impact of the prosthetic material, framework design, veneering material, and manufacturing process is required. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the survival and success rates of feldspathic porcelain veneered zirconia (VZir) in comparison with monolithic zirconia (MZir) complete arch implant-supported prostheses (CAISPs). A secondary objective was to assess the influence of the type of loading, the presence or absence of a cantilever, the type of zirconia used, the location, and the opposing arch on complications rates and patient satisfaction. MATERIAL AND METHODS An electronic search of the MEDLINE database (via PubMed), Scopus, Science Direct, Cochrane Library, and OpenGrey was carried out. The criteria described in the preferred reporting items for systematic reviews and meta-analyses statement were used. The search was restricted from January 2000 to January 2022. RESULTS The systematic search resulted in 20 articles that met the established criteria. In total, 751 patients (VZir=302; MZir=449) with 3038 CAISPs (VZir=368; MZir=2670) were analyzed. Higher prosthetic survival and success rates were found in MZir compared with VZir CAISPs (100% and 95.45%, respectively). The meta-analysis found significantly fewer complications related to MZir (9.4% [4.8%-14.1%]) compared with VZir (33.7% [17.5%-49.9%]). CONCLUSIONS Based on the findings of this systematic review, MZir CAISPs had higher survival and success rates than VZir CAISPs, with significantly fewer prosthetic complications. The influence of factors such as the type of functional loading, the presence of a cantilever, the material used in the prosthodontic workflow, the location of the CAISP, and the type of antagonist arch on the performance of Zir CAISPs remains unclear.
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Affiliation(s)
- Sara Martakoush-Saleh
- Postgraduate student, Department of Dental Clinical Specialties, Complutense University of Madrid, Spain
| | - Angel-Orión Salgado-Peralvo
- Professor, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University of Madrid, Spain.
| | - Juan-Francisco Peña-Cardelles
- Professor, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Naresh Kewalramani
- Professor, Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, Madrid, Spain
| | - German O Gallucci
- Professor and Department Chair, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
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Cinquini C, Alfonsi F, Marchio V, Gallo F, Zingari F, Bolzoni AR, Romeggio S, Barone A. The Use of Zirconia for Implant-Supported Fixed Complete Dental Prostheses: A Narrative Review. Dent J (Basel) 2023; 11:144. [PMID: 37366667 DOI: 10.3390/dj11060144] [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: 03/03/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
The success of implant-supported fixed complete dental prostheses (ISFCDPs) depends on multiple factors: some are related to the fixtures, such as fixture material, surface characteristics, positioning, and type of connection to prosthetic components; others are related to the prostheses, such as design and materials used. Zirconia is a material widely used in fixed prosthodontics, whether on natural teeth or on implants, with excellent results over time. Regarding the use of zirconia for ISFCDPs, the 2018 ITI Consensus Report stated that "implant-supported monolithic zirconia prostheses may be a future option with more supporting evidence". Since CAD/CAM technology and zirconia are being continuously innovated to achieve better results and performances over time, a narrative review of the literature seems necessary to focus research efforts towards effective and durable solutions for implant-supported, full-arch rehabilitations. The objective of the present narrative review was to search the literature for studies regarding the clinical performance of zirconia-based ISFCDPs. According to the results of this review, the use of zirconia for ISFCDPs showed good clinical outcomes, with high survival rates ranging from 88% to 100% and prosthetic complications that were restorable by the clinicians in most cases.
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Affiliation(s)
- Chiara Cinquini
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Fortunato Alfonsi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Vincenzo Marchio
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
| | - Francesco Gallo
- Department of Maxillofacial Surgery, Istituto Stomatologico Italiano, 20122 Milan, Italy
| | - Francesco Zingari
- Department of Maxillofacial Surgery, Galeazzi Hospital, 20157 Milan, Italy
| | - Alessandro Remigio Bolzoni
- Maxillo-Facial Surgery and Dental Unit, Department of Biomedical, Surgical and Dental Sciences, University of Milano, 20122 Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, University of Milano, 20122 Milan, Italy
| | | | - Antonio Barone
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy
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Nikellis T, Lampraki E, Romeo D, Tsigarida A, Barmak AB, Malamou C, Ercoli C, Papaspyridakos P, Kotsailidi EA, Chochlidakis K. Survival rates, patient satisfaction, and prosthetic complications of implant fixed complete dental prostheses: a 12-month prospective study. J Prosthodont 2023; 32:214-220. [PMID: 35964246 DOI: 10.1111/jopr.13593] [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: 04/11/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To determine the survival rate, incidence of prosthetic complications, and patient satisfaction of implant fixed complete dental prostheses (IFCDPs) after a mean observation period of 1.4 years. MATERIALS AND METHODS Twenty-eight (28) eligible participants were recruited according to specific inclusion and exclusion criteria. The definitive metal-acrylic resin IFCDPs consisted of titanium bars veneered with acrylic resin and acrylic denture teeth. Prosthodontic complications, divided into major and minor, were monitored. Parameters such as gender, jaw location, bruxism, and occlusal scheme were evaluated. Moreover, a questionnaire was administered throughout the study to assess patient satisfaction. Poisson regression as well as repeated measures ANOVA were used for statistical analysis. RESULTS Fourteen (14) males and 14 females were enrolled and followed-up at 3, 6, and 12 months. All IFCDPs survived (100% survival rate). The most frequent minor complication was the loss of material used to close the screw access hole (20% out of total complications). The most frequent major complication was chipping of the acrylic denture teeth (77.14% out of total complications). Gender (p = 0.008) and bruxism (p = 0.030) were significant predictors for the total major complications (major wear and major chipping) while occlusal scheme was a significant predictor for major chipping events (p = 0.030). CONCLUSIONS While IFCDPs demonstrated high prosthetic survival rates, they also exhibited a high number of chipping events of the acrylic veneering material, especially in males, bruxers, and individuals with canine guidance occlusion. However, the occurrence of these prosthetic complications did not negatively affect patient satisfaction.
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Affiliation(s)
| | | | - Davide Romeo
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY.,Advanced Oral Surgery Unit, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Alexandra Tsigarida
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Abdul Basir Barmak
- Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | | | - Carlo Ercoli
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Panos Papaspyridakos
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.,Department of Prosthodontics, Tufts School of Dental Medicine, Boston, MA
| | - Elli Anna Kotsailidi
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Konstantinos Chochlidakis
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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D'Albis G, D'Albis V, Susca B, Palma M, Al Krenawi N. Implant-supported zirconia fixed partial dentures cantilevered in the lateral-posterior area: A 4-year clinical results. J Dent Res Dent Clin Dent Prospects 2022; 16:258-263. [PMID: 37560497 PMCID: PMC10407873 DOI: 10.34172/joddd.2022.041] [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] [Received: 04/21/2022] [Accepted: 09/23/2022] [Indexed: 08/11/2023] Open
Abstract
Background Implant-supported cantilever prostheses enable a more straightforward rehabilitation and may be a therapeutic option to reduce treatment morbidity, costs, and time. This study evaluated the clinical outcomes of fixed implant-supported partial dentures made of monolithic zirconia with a cantilever design to replace missing posterior teeth. Methods Fifteen partially edentulous patients received 34 implants and were provided with 16 zirconia fixed partial prostheses (FPPs) with one cantilever extension replacing mandibular or maxillary missing posterior and lateral teeth. Patients were re-examined for up to 4 years. Patient ages ranged from 41 to 65 years, with a mean age of 53±12 years; 47% were female, and 53% were male. The patients were observed for a mean period of 42±6 months with a minimum of 3 years and a maximum of 4 years. Results Peri-implantitis was observed in two cases. No chipping or fracture of any FPP was detected. Loosening of the abutment screw was a technical complication in one case. The rehabilitation survival rate was 100%. Implant-supported zirconia FPP with one mesial cantilever extension provides an aesthetic, functional treatment alternative to replace missing molars, premolars, and canines. These excellent clinical outcomes occurred over a mean observation time of 42±6 months. Conclusion Using monolithic zirconia milled with CAD-CAM technology might be an alternative to the metal-ceramic restoration in implant-supported FPP with one cantilever.
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Affiliation(s)
- Giuseppe D'Albis
- Periodontology and Implantology Department, University of Federico II of Naples, Naples, Italy
| | - Vincenzo D'Albis
- Department of Orthodontics, University of Rome “Tor Vergata”, Rome, Italy
| | - Bart Susca
- Dental Technician, Mola di Bari (BA), Italy
| | - Micol Palma
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - Nizar Al Krenawi
- Periodontology and Implantology Department, University of Federico II of Naples, Naples, Italy
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7
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Alqutaibi AY, Ghulam O, Krsoum M, Binmahmoud S, Taher H, Elmalky W, Zafar MS. Revolution of Current Dental Zirconia: A Comprehensive Review. Molecules 2022; 27:1699. [PMID: 35268800 PMCID: PMC8911694 DOI: 10.3390/molecules27051699] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/16/2022] [Accepted: 03/02/2022] [Indexed: 01/27/2023] Open
Abstract
The aim of this article is to comprehensively review the revolution of dental zirconia (Zir), including its types, properties, applications, and cementation procedures. A comprehensive search of PubMed and Embase was conducted. The search was limited to manuscripts published in English. The final search was conducted in October 2021. Newly developed monolithic Zir ceramics have substantially enhanced esthetics and translucency. However, this material must be further studied in vitro and in vivo to determine its long-term ability to maintain its exceptional properties. According to the literature, monolithic translucent Zir has had promising results and a high survival rate. Thus, the utilization of this material is indicated when strength and esthetics are needed. Both the materials and methods used for cementation of monolithic Zir have significantly improved, encouraging dentists to use this material, especially when a conservative approach is required. Zir restorations showed promising outcomes, particularly for monolithic Zir crowns supported with implant and fixed dental prostheses.
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Affiliation(s)
- Ahmed Yaseen Alqutaibi
- Department of Prosthodontics, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia;
- Department of Prosthodontics, College of Dentistry, Ibb University, Ibb 70270, Yemen
| | - Omar Ghulam
- Dental Department, Prince Mohammad bin Abdulaziz Hospital (Ministry of National Guard-Health Affairs), Madinah 42324, Saudi Arabia; (O.G.); (M.K.); (H.T.)
| | - Majid Krsoum
- Dental Department, Prince Mohammad bin Abdulaziz Hospital (Ministry of National Guard-Health Affairs), Madinah 42324, Saudi Arabia; (O.G.); (M.K.); (H.T.)
| | - Suhail Binmahmoud
- Dental Department, Prince Sultan Armed Forces Hospital, Madinah 42375, Saudi Arabia;
| | - Hasan Taher
- Dental Department, Prince Mohammad bin Abdulaziz Hospital (Ministry of National Guard-Health Affairs), Madinah 42324, Saudi Arabia; (O.G.); (M.K.); (H.T.)
| | - Wael Elmalky
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia;
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
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8
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Gennai S, Izzetti R, Pioli MC, Music L, Graziani F. Impact of rehabilitation versus edentulism on systemic health and quality of life in patients affected by periodontitis: A systematic review and meta-analysis. J Clin Periodontol 2021; 49 Suppl 24:328-358. [PMID: 34761419 DOI: 10.1111/jcpe.13526] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/27/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022]
Abstract
AIM To investigate the effect of rehabilitation in fully/partially edentulous patients with stage IV periodontitis on oral-health-related quality of life (OHRQoL) and systemic health. MATERIALS AND METHODS A systematic electronic and manual search was conducted. Three authors independently reviewed, selected, and extracted the data. Outcomes were OHRQoL (Oral Health Impact Profile 14 [OHIP-14] and OHIP-49, General Oral Health Assessment Index [GOHAI], visual analogue scale, symptoms registration) and systemic health-related outcomes (incidence and prevalence of systemic diseases, values of systemic disease indicators). Qualitative data were synthesized for OHRQoL and systemic health-related outcomes. Meta-analysis was conducted on available quantitative data. RESULTS The search identified 59 articles (6724 subjects in total). OHRQoL improved across all the studies, irrespective of the number of missing teeth, their location, or treatment modality. Meta-analysis showed significant improvement of OHIP-49 (36.86, p < .01) in manuscripts including subjects affected by periodontitis, consistently with the remaining literature (reduction of score points post rehabilitation: OHIP-14 = 10.52, OHIP-49 = 56.02, GOHAI = 5.40, p < .01 for all). Non-rehabilitated subjects exhibited inferior cognitive status, higher medication intake, and frailty. However, our data are limited and should be interpreted with caution. CONCLUSIONS Oral rehabilitation improves OHRQoL and, potentially, systemic health in edentulous patients. It is unclear whether these findings may be extrapolated to patients with stage IV periodontitis.
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Affiliation(s)
- Stefano Gennai
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Rossana Izzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Maria C Pioli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Larisa Music
- Department of Periodontology, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
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Technical and Biological Complications of Screw-Retained (CAD/CAM) Monolithic and Partial Veneer Zirconia for Fixed Dental Prostheses on Posterior Implants Using a Digital Workflow: A 3-Year Cross-Sectional Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5581435. [PMID: 34307657 PMCID: PMC8279852 DOI: 10.1155/2021/5581435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/10/2021] [Accepted: 06/28/2021] [Indexed: 01/31/2023]
Abstract
Objective The introduction of CAD/CAM and the development of zirconia-based restorations have allowed clinicians to use less expensive materials and faster manufacturing procedures. The purpose of the study was to analyze the differences, in terms of mechanical and biological complication, in multiunit zirconia fixed dental prosthesis (FPDs) on posterior implants produced using a digital workflow. Method and Materials. This study was a retrospective investigation, and patients treated with screw-retained monolithic or partial veneer FPDs on dental implants were selected. Periapical radiographs were taken at baseline and at the 3-year follow-up. Complications were recorded and classified as technical and biological ones. Results The study population included 25 patients. The occlusal and interproximal corrections were not clinically significant. In the study sample, the survival rate and success rate of the FPDs after 3 years were 100% and 96%, respectively. One implant failed immediately after placement. Conclusion Monolithic zirconia FPDs and partial veneer FPDs showed a 100% survival rate, presenting an interesting alternative to metal ceramic restorations. The partial veneer FPDs had a higher technical complication rate than the monolithic FPDs; however, no statistically significant difference was found.
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10
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Tirone F, Salzano S, Rolando E, Pozzatti L, Rodi D. Framework Fracture of Zirconia Supported Full Arch Implant Rehabilitation: A Retrospective Evaluation of Cantilever Length and Distal Cross-Sectional Connection Area in 140 Patients Over an Up-To-7 Year Follow-Up Period. J Prosthodont 2021; 31:121-129. [PMID: 33963652 DOI: 10.1111/jopr.13388] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To evaluate the relationship between different dimensional parameters in implant-supported monolithic zirconia fixed complete dental prostheses (IFCDPs) and the incidence of framework fracture in a large sample of cases in vivo. MATERIALS AND METHODS This retrospective observational study evaluated all patients rehabilitated with screw-retained zirconia IFCDPs between January 2013 and April 2019 at a private practice. The minimum follow-up period was 1 year after occlusal loading. Fractures were classified as: type I-fractures that happened between but not involving the two most posterior screw-access openings (SAOs) and type II-fractures of the distal cantilever. Cantilever length, distal connector cross-sectional area, and screw access opening length were measured using data obtained from digital scans. Logistic regression was performed to evaluate the relationship between types I and II fractures and the independent variables (dimensional parameters). Using the receiver operating characteristic curves, two parameters were identified to be useful for establishing a cut-off and predicting type II fractures. RESULTS A total of 180 prostheses delivered to 140 patients were analyzed. Five implants failed in three patients: three before delivery of the definitive prostheses and two after. Ten prostheses failed (5.6% prosthetic failure rate): 2 because of implant failures, and 8 because of framework fractures. Five fractures were classified as type I and three as type II. Significant associations were found between cantilever length and type I fractures (Wald = 5.772, df = 1, p = 0.016), distal connector cross-sectional area and type II fractures (Wald = 3.806, df = 1, p = 0.051), and cantilever length and the total number of fractures (Wald = 6.117, df = 1, p = 0.013). CONCLUSION Zirconia IFCDPs may be reliable medium-term solutions if some dimensional parameters are followed. The ratios between the cantilever length and cross-sectional connector area should be <0.51, while the ratio between the cantilever length and screw access opening length should be <1.48.
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Affiliation(s)
| | | | - Erik Rolando
- Laboratorio Odontoprotesico Rolando Cerato, Cuneo, Italy
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11
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Dmd CS, Bidra AS. Management of Fractured Zirconia Complete Arch Fixed Implant-Supported Prosthesis Caused by Misfit Due to Diverse Implant Components: A Case Report. J Prosthodont 2021; 30:465-472. [PMID: 33570229 DOI: 10.1111/jopr.13348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 11/27/2022] Open
Abstract
Recently, monolithic zirconia complete-arch fixed implant-supported prosthesis (CAFIP) has been shown to be an effective means of managing patients with edentulism or terminal dentition. Prosthetic complications have been reported to be rare, as long as there is proper treatment planning, prosthetic space and careful attention during fabrication of the prosthesis. Few reports exist in the literature that have described the management of patients with fractured zirconia CAFIP. This case report describes the successful management of a female patient with a midline fracture of a monolithic zirconia CAFIP supported by 6 dental implants in the mandibular arch. The fractured prosthesis had adequate prosthesis thickness with no distal cantilever, and opposed a similar prosthesis in the maxilla. However, upon careful analysis, diverse implant components were identified as the primary contributory factor to prosthetic misfit, and subsequent fracture. This is a new factor that requires attention by clinicians and dental laboratory technicians due to the increased prevalence of patients with preexisting dental implants. This article describes the considerations related to diverse implant components and connections from different implant manufacturers, choice of favorable implant-abutment design, technique for mitigation, and importance of passive fit for zirconia CAFIP.
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Affiliation(s)
| | - Avinash S Bidra
- Department of Reconstructive Sciences, University of Connecticut Health Center, Farmington, CT, USA
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12
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Sánchez-Torres A, Cercadillo-Ibarguren I, Figueiredo R, Gay-Escoda C, Valmaseda-Castellón E. Mechanical complications of implant-supported complete-arch restorations and impact on patient quality of life: A retrospective cohort study. J Prosthet Dent 2020; 125:279-286. [PMID: 32165011 DOI: 10.1016/j.prosdent.2020.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 01/10/2023]
Abstract
STATEMENT OF PROBLEM Mechanical complications (for example, fractures) in implant-supported complete-arch restorations may affect the social and professional activities of the patient. However, most studies seem to overlook patient perceptions and generally do not assess the changes in the quality of life (QoL) of patients who experience these complications. PURPOSE The purpose of this retrospective cohort study was to assess the influence of technical or mechanical complications of complete-arch implant-supported prostheses on patient perception and QoL by using the Oral Health Impact Profile (OHIP)-14. MATERIAL AND METHODS A retrospective cohort study was formed of patients treated consecutively at a private clinic with immediately loaded complete-arch prostheses supported by a minimum of 4 implants (Replace Tapered; Nobel Biocare AB) and Multi-Unit conical abutments (Multi-Unit abutments; Nobel Biocare AB). OHIP-14 and questions regarding self-reported satisfaction were used to evaluate the influence of mechanical complications on QoL. RESULTS Fifty-six participants (26 men and 30 women) with a mean age of 64 ±11.1 years, and 72 restored arches were included. The mean ±standard deviation follow-up time was 52 ±26 months. The prosthetic success rate was 38.8%, and the survival rate was 100% (no failure was registered). The most common complications were abutment screw loosening (43%), chipping or fracture of the veneering material (25%), and screw loosening (21%). The OHIP-14 scores were close to zero, without differences between participants with or without mechanical complications. Overall, the participants reported that the prostheses allowed good oral hygiene (94.6%) and met their expectations (89%) and that they would repeat the treatment (87.5%) and would recommend it to others (93%). CONCLUSIONS Minor mechanical complications such as screw loosening and chipping or fracture of the veneering material were frequent events but had no impact on the satisfaction and QoL of patients with immediately loaded complete-arch implant-supported prostheses.
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Affiliation(s)
- Alba Sánchez-Torres
- Associate Professor of Oral Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Researcher, IDIBELL Institute, Barcelona, Spain
| | - Iñaki Cercadillo-Ibarguren
- Associate Professor of Oral Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Researcher, IDIBELL Institute, Barcelona, Spain
| | - Rui Figueiredo
- Associate Professor of Oral Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Researcher, IDIBELL Institute, Barcelona, Spain.
| | - Cosme Gay-Escoda
- Chairman and Professor of Oral and Maxillofacial Surgery, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Director of the Master's Degree Program in Oral Surgery and Implantology (EFHRE International University/FUCSO), Belize City, Belize; Coordinator/Researcher, IDIBELL Institute, Barcelona, Spain; Head of the Department of Oral Surgery, Implantology and Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain
| | - Eduard Valmaseda-Castellón
- Professor of Oral Surgery, Professor of the Master's Degree Program in Oral Surgery and Implantology, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Researcher, IDIBELL Institute, Barcelona, Spain
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Chochlidakis K, Einarsdottir E, Tsigarida A, Papaspyridakos P, Romeo D, Barmak AB, Ercoli C. Survival rates and prosthetic complications of implant fixed complete dental prostheses: An up to 5-year retrospective study. J Prosthet Dent 2020; 124:539-546. [PMID: 31982146 DOI: 10.1016/j.prosdent.2019.11.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 11/25/2019] [Accepted: 11/26/2019] [Indexed: 11/25/2022]
Abstract
STATEMENT OF PROBLEM Implant fixed complete dental prostheses (IFCDPs) are widely used in the rehabilitation of completely edentulous patients, yet limited information is available on the relationship between prosthetic complications and patient-associated and prosthesis-associated risk factors. PURPOSE The purpose of this retrospective study was to assess the prosthetic complication and survival rates of IFCDPs after a mean observational period of 3.5 years. MATERIAL AND METHODS Eligible participants were identified by an electronic health record review. The study consisted of a review of the dental record and a single-visit study appointment when a comprehensive examination was performed, including a review of the medical and dental history, clinical and radiographic examination, intraoral photographs, patient satisfaction questionnaire, and occlusal analysis. Prosthodontic parameters and risk factors were assessed, including time with the prosthesis in place, bruxism, occlusal device use, prosthesis material, number of implants, cantilever length, and mode of prosthesis retention. Association between these prosthodontic parameters and risk factors and the observed prosthetic complications was assessed. RESULTS A total of 37 participants (mean age 62.35 ±10.39 years) with 48 IFCDPs were included. Thirty-eight prostheses were metal-acrylic resin (MR group), whereas 10 were metal-ceramic (MC group). Five of the 48 prostheses failed during the follow-up period, a cumulative prosthesis survival rate of 88%. Minor complications were more frequent than major complications. The most frequent minor complication was loss of screw access hole material (5.18%/year), whereas the most frequently observed major complication was major wear of the prosthetic material (5.85%/year). A significant association was found between not wearing an occlusal device and minor chipping, loss of access hole material, and framework fracture. Minor chipping was significantly associated with bruxism, whereas the opposing dentition significantly affected the total number of prosthetic complications. CONCLUSIONS High survival rates were observed with both MR and MC IFCDPs. No significant difference was found between MR and MC groups in terms of patient satisfaction, as well as total number of prosthetic complications.
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Affiliation(s)
- Konstantinos Chochlidakis
- Associate Professor, Program Director, Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, N.Y.
| | | | - Alexandra Tsigarida
- Associate Professor, Program Director, Department of Periodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, N.Y
| | - Panos Papaspyridakos
- Assistant Professor, Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Mass
| | - Davide Romeo
- Resident, Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, N.Y
| | - Abdul Basir Barmak
- Assistant Professor, Eastman Institute for Oral Health, University of Rochester, Rochester, N.Y
| | - Carlo Ercoli
- Professor, Prosthodontics and Periodontics, Chair, Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, N.Y
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14
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Kontonasaki E, Rigos AE, Ilia C, Istantsos T. Monolithic Zirconia: An Update to Current Knowledge. Optical Properties, Wear, and Clinical Performance. Dent J (Basel) 2019; 7:dj7030090. [PMID: 31480688 PMCID: PMC6784470 DOI: 10.3390/dj7030090] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/22/2019] [Accepted: 08/20/2019] [Indexed: 01/09/2023] Open
Abstract
The purpose of this paper was to update the knowledge concerning the wear, translucency, as well as clinical performance of monolithic zirconia ceramics, aiming at highlighting their advantages and weaknesses through data presented in recent literature. New ultra-translucent and multicolor monolithic zirconia ceramics present considerably improved aesthetics and translucency, which, according to the literature reviewed, is similar to those of the more translucent lithium disilicate ceramics. A profound advantage is their high strength at thin geometries preserving their mechanical integrity. Based on the reviewed articles, monolithic zirconia ceramics cause minimal wear of antagonists, especially if appropriately polished, although no evidence still exists regarding the ultra-translucent compositions. Concerning the survival of monolithic zirconia restorations, the present review demonstrates the findings of the existing short-term studies, which reveal promising results after evaluating their performance for up to 5 or 7 years. Although a significant increase in translucency has been achieved, new translucent monolithic zirconia ceramics have to be further evaluated both in vitro and in vivo for their long-term potential to preserve their outstanding properties. Due to limited studies evaluating the wear properties of ultra-translucent material, no sound conclusions can be made, whereas well-designed clinical studies are urgently needed to enlighten issues of prognosis and long-term survival.
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Affiliation(s)
- Eleana Kontonasaki
- Department of Prosthodontics, School of Dentistry, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
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AlTarawneh S, Abu-Awwad M, Riyal S, Samara R, Hattar S. A multi-center retrospective assessment of monolithic zirconia restorations on posterior teeth and implants. JOURNAL OF ORAL RESEARCH 2019. [DOI: 10.17126/joralres.2019.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: the purpose of this multicenter retrospective study was to report on survival, success, and complication rates in monolithic zirconia restorations on teeth and implants. Materials and Methods: data on 671 monolithic zirconia restorations was collected by five prosthodontists from three different specialty practice centers, including a dental school and two private practice centers. Restorations included single crowns and multiple-unit fixed dental prostheses on teeth and implants in the posterior area (premolar and molars). Follow-up time was up to 62 months. Results: mean follow-up time was 28.1±12.9 months. A total of 671 units, 534 single crowns, and 137 multi-unit restorations. Cumulative survival and success rates at 5 years were 97.4%, and 93.8% respectively. Complications presented in 11 restorations out of 671 and included: decementation, abutment screw loosening, restoration crack, restoration fracture, and tooth fracture. No significant differences were observed between tooth-supported and implant-supported restoration (p=0.42), single crowns and multiple-unit restorations (p=0.07), bruxers and non-bruxers (p=0.57). Patients with group function occlusal scheme had significantly less survival rates (p=0.001). Conclusion: the use of monolithic zirconia for restorations on the posterior teeth and implants seems to be promising as it provides a durable solution with a low rate of complications.
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16
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Shah KC, Linsley CS, Wu BM. Evaluation of a shape memory implant abutment system: An up to 6-month pilot clinical study. J Prosthet Dent 2019; 123:257-263. [PMID: 31227233 DOI: 10.1016/j.prosdent.2018.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/10/2018] [Accepted: 11/12/2018] [Indexed: 11/27/2022]
Abstract
STATEMENT OF PROBLEM Screw- and cement-based retention mechanisms are used to attach prostheses to dental implants; however, each approach can lead to clinical complications such as crown fracturing or peri-implantitis. A novel abutment and prosthesis retention system has been engineered to achieve the esthetics and retention force of cement-based fixation while maintaining the retrievability of screw-retained restorations. PURPOSE The purpose of this pilot clinical study was to evaluate the effectiveness of this innovative retention system on posterior tooth restorations. MATERIAL AND METHODS This clinical study, with up to 6 months of follow-up, included 8 participants with posterior osseointegrated implants who met the eligibility criteria to receive the abutment and shape memory sleeve. Radiographs were used to evaluate crown seating. Crown stability was measured using the Periotest, and occlusal analysis was performed using the Tekscan system and shimstock. Peri-implant health was evaluated by probing, and the plaque and gingival indices were recorded. In addition, patient-reported outcomes were recorded. RESULTS Minimal differences were observed between baseline and endpoint assessment of the plaque and gingival indices, probing depth, and proximal and occlusal contacts. There were no patient-reported problems or complaints about discomfort. The overall peri-implant health remained unchanged from the baseline evaluations for all participants. Proximal contact around the restoration was present at the baseline and at the conclusion of the study for 7 of the participants. Occlusal contact was observed to be either light (5 participants) or holding (3 participants). In addition, visual inspection of retrieved crowns revealed clean surfaces free of macroparticle ingress, and bacterial accumulation at the coping-abutment interface was not detected. CONCLUSIONS The safety and efficacy findings of this pilot clinical study suggest that this new shape memory alloy-based retention system may provide a suitable alternative for implant prosthodontics. The retention system allowed for easy prosthesis seating and retrieval.
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Affiliation(s)
- Kumar C Shah
- Associate Clinical Professor, Division of Advanced Prosthodontics and Director, Advanced Prosthodontics Residency Program, University of California Los Angeles School of Dentistry, Los Angeles, Calif.
| | - Chase S Linsley
- Assistant Adjunct Professor, Bioengineering, University of California Los Angeles, Los Angeles, Calif
| | - Benjamin M Wu
- Professor and Chair, Division of Advanced Prosthodontics and Bioengineering, Materials, Science, and Orthopedic Surgery, University of California Los Angeles, Los Angeles, Calif
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17
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Güngör MB, Nemli SK, Bal BT, Tamam E, Yılmaz H, Aydın C. Fracture resistance of monolithic and veneered all-ceramic four-unit posterior fixed dental prostheses after artificial aging. J Oral Sci 2019; 61:246-254. [PMID: 31006735 DOI: 10.2334/josnusd.18-0060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This study compared the fracture resistance of monolithic and veneered all-ceramic four-unit posterior fixed dental prostheses (FDPs) generated by computer-aided design/computer-aided manufacturing (CAD/CAM) after aging in a mastication simulator. Four-unit FDPs were designed from six different all-ceramic systems: 1) monolithic lithium disilicate (M-E), 2) monolithic zirconia (M-TZI), 3) veneered zirconia by conventional layering (V-L), 4) veneered zirconia by lithium disilicate pressing (V-P), 5) veneered zirconia by lithium disilicate fusing (CAD-F-E), and 6) veneered zirconia by feldspathic ceramic cementing (CAD-C-CB). The specimens were divided into control and aging groups (n = 10 per group). The aging process included both thermocycling and mechanical loading and was followed by fracture resistance testing. All specimens in the M-E, M-TZI, and V-L groups survived; however, all specimens in the V-P group were fractured during artificial aging. The highest fracture resistance values were observed in the M-TZI group. According to the fracture resistance test, connector fractures were the most frequent type of failure. M-TZI and M-E FDPs revealed no failures during aging and showed higher fracture resistance than the veneered groups. Among the veneered zirconia framework groups, V-L FDPs showed the highest success rate during aging, while the fracture resistance was similar among all the veneered zirconia groups.
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Affiliation(s)
- Merve B Güngör
- Department of Prosthodontics, Faculty of Dentistry, Gazi University
| | - Seçil K Nemli
- Department of Prosthodontics, Faculty of Dentistry, Gazi University
| | - Bilge T Bal
- Department of Prosthodontics, Faculty of Dentistry, Gazi University
| | - Evşen Tamam
- Department of Prosthodontics, Faculty of Dentistry, Gazi University
| | - Handan Yılmaz
- Department of Prosthodontics, Faculty of Dentistry, Gazi University
| | - Cemal Aydın
- Department of Prosthodontics, Faculty of Dentistry, Gazi University
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18
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Pieralli S, Kohal RJ, Rabel K, von Stein-Lausnitz M, Vach K, Spies BC. Clinical outcomes of partial and full-arch all-ceramic implant-supported fixed dental prostheses. A systematic review and meta-analysis. Clin Oral Implants Res 2019; 29 Suppl 18:224-236. [PMID: 30306694 DOI: 10.1111/clr.13345] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the survival and technical complication rate of partial and full-arch all-ceramic implant-supported fixed dental prostheses (P-FDP/FA-FDP) and supporting implants. MATERIALS AND METHODS An electronic search through three databases (MEDLINE/Pubmed, Cochrane Library, Embase) was conducted to identify relevant clinical studies with an observation period of at least 12 months, including ≥15 patients. Reconstruction and implant survival rates, technical complications and confounding variables such as processed/installed materials, retention mode and location in the mouth were obtained. Failure and complication rates were analyzed using standard Poisson regression models to calculate 5-year survival and complication estimates. RESULTS A total of five studies for the P-FDP group and seven studies for the FA-FDP group were included, throughout evaluating veneered zirconia reconstructions. In the P-FDP group, reconstructions were located in posterior regions. Meta-analysis indicated survival estimates on the reconstruction level of 98.3% and 97.7% for P- and FA-FDPs after 5 years. However, chipping of the veneering ceramic was frequent, resulting in estimated 5-year complication rates of 22.8% (P-FDPs) and 34.8% (FA-FDPs). Five-year survival estimates of implants supporting P-FDPs and FA-FDPs of 98.5% and 99.4% were calculated, respectively. Including a total of 540 FDPs, one screw-loosening and 11 de-cementations were reported. Confounding variables were not found to have a significant influence on survival and complication rates. CONCLUSIONS All-ceramic implant-supported P- and FA-FDPs comprising veneered zirconia frameworks showed high survival but clinically inacceptable fracture rates of the veneering ceramic. Their suitability with regard to this indication and a successful long-term outcome needs to be further evaluated.
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Affiliation(s)
- Stefano Pieralli
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Ralf-Joachim Kohal
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Kerstin Rabel
- Medical Center - University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Manja von Stein-Lausnitz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Kirstin Vach
- Medical Center - University of Freiburg, Center for Medical Biometry and Medical Informatics, Institute for Medical Biometry and Statistics, Faculty of Medicine - University of Freiburg, Freiburg, Germany
| | - Benedikt Christopher Spies
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
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19
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Caramês J, Marques D, Malta Barbosa J, Moreira A, Crispim P, Chen A. Full-arch implant-supported rehabilitations: A prospective study comparing porcelain-veneered zirconia frameworks to monolithic zirconia. Clin Oral Implants Res 2018; 30:68-78. [DOI: 10.1111/clr.13393] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 11/14/2018] [Accepted: 11/24/2018] [Indexed: 12/01/2022]
Affiliation(s)
- João Caramês
- Department of Oral Surgery and Implant Dentistry; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- LIBPhys-FCT UID/FIS/04559/201; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- Department of Oral Surgery and Implant Dentistry; Implantology Institute; Lisbon Portugal
| | - Duarte Marques
- LIBPhys-FCT UID/FIS/04559/201; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- Department of Morfo-Functional Sciences; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- Department of Oral Rehabilitation; Implantology Institute; Lisbon Portugal
| | - João Malta Barbosa
- Department of Oral Rehabilitation; Implantology Institute; Lisbon Portugal
- Department of Biomaterials and Biomimetics; New York University College of Dentistry; New York New York
| | - André Moreira
- Department of Oral Rehabilitation; Implantology Institute; Lisbon Portugal
| | - Pedro Crispim
- Department of Oral Rehabilitation; Implantology Institute; Lisbon Portugal
- Department of Occlusion and Oral Rehabilitation; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
| | - André Chen
- Department of Oral Surgery and Implant Dentistry; Faculdade de Medicina Dentária da Universidade de Lisboa; Lisbon Portugal
- Department of Oral Surgery and Implant Dentistry; Implantology Institute; Lisbon Portugal
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20
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Wong CKK, Narvekar U, Petridis H. Prosthodontic Complications of Metal-Ceramic and All-Ceramic, Complete-Arch Fixed Implant Prostheses with Minimum 5 Years Mean Follow-Up Period. A Systematic Review and Meta-Analysis. J Prosthodont 2018; 28:e722-e735. [DOI: 10.1111/jopr.12797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 10/17/2022] Open
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21
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Cheng CW, Chien CH, Chen CJ, Papaspyridakos P. Randomized Controlled Clinical Trial to Compare Posterior Implant-Supported Modified Monolithic Zirconia and Metal-Ceramic Single Crowns: One-Year Results. J Prosthodont 2018. [PMID: 29528175 DOI: 10.1111/jopr.12767] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The purpose of this randomized controlled clinical trial was to investigate the prosthetic outcomes of posterior implant-supported single crowns (SCs) with a modified monolithic zirconia or metal-ceramic design at 1 year of loading. MATERIALS AND METHODS Forty participants with 73 dental implants in need of at least 1 maxillary or mandibular posterior implant-supported SC were consecutively selected for this study. The included participants were randomly divided into modified monolithic zirconia (MMZ) and metal-ceramic (MC) groups. The implant-supported SCs were examined after 1 year for survival and technical complications. Descriptive statistics were used to illustrate the data, and the association associated risks of complications were estimated using the logistic regression model with Firth's approach for rare outcome (α = 0.05). RESULTS During the observation period, 2 participants in the MC group were lost to follow-up. A total of 38 participants with 70 posterior implant-supported SCs (36 and 34 SCs in the MMZ and MC groups respectively) completed the 1-year follow-up examination. One implant failed in the MMZ group. The 1-year survival rates for implants and crowns were both 97.2% in the MMZ group. The survival rates for implants and crowns were both 100% in the MC group. One screw loosening event was observed in one screw-retained SC in the MMZ group; however, 8 complication events occurred in 7 SCs in the MC group. Therefore, the complication-free rates were 97.1% and 79.4% in the MMZ and MC SCs respectively. The most common complication in the MC group was screw loosening (14.7%), followed by loss of retention (5.9%), and ceramic fracture (2.9%). Significantly more technical complications were observed in the MC SCs than MMZ SCs (p = 0.0432). CONCLUSION The modified monolithic zirconia design applied to the posterior implant-supported SCs had a significantly lower technical complication rate than did the metal-ceramic one.
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Affiliation(s)
- Chih-Wen Cheng
- Division of Prosthodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Chia-Hui Chien
- Division of Prosthodontics, Department of Dentistry, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chun-Jung Chen
- Division of Periodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Panos Papaspyridakos
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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22
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Box VH, Sukotjo C, Knoernschild KL, Campbell SD, Afshari FS. Patient-Reported and Clinical Outcomes of Implant-Supported Fixed Complete Dental Prostheses: A Comparison of Metal-Acrylic, Milled Zirconia, and Retrievable Crown Prostheses. J ORAL IMPLANTOL 2018; 44:51-61. [DOI: 10.1563/aaid-joi-d-17-00184] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this retrospective study was to assess the incidence of biologic and technical complications for implant-supported fixed complete dental prostheses (IFCDPs) and their relationship to oral health-related quality of life (OHQoL) and patient-reported outcomes. Metal-acrylic (MA), retrievable crown (RC), monolithic zirconia (MZ), and porcelain veneered zirconia (PVZ) prostheses were included. Patients who received an IFCDP at least 1 year prior to recall were identified. Exclusion criteria were: (1) an opposing complete denture and (2) time in service >70 months. A total of 37 patients with 49 prostheses, including 22 MA, 14 RC, 7 MZ, and 6 PVZ prostheses were recalled. Patient-reported outcomes were assessed via OHIP-49 (Oral Health Impact Profile) and a scripted interview with open-ended questions. All designs had high complication rates (12 of 22 MA, 10 of 14 RC, 2 of 7 MZ, and 5 of 6 PVZ). The most common complications were: (1) MA: posterior tooth wear, (2) RC: chipping and fracturing of the restorations, (3) MZ: wear of opposing restorations, and (4) PVZ: chipping of opposing restorations. Average OHIP-49 scores ranged from 7 to 29, indicating high OHQoL, patient satisfaction, regardless of prosthetic design (P = .16). The standardized interview highlighted that although most patients were extremely satisfied (73%), some continued to be bothered by material bulk (14%) and felt that maintenance of oral hygiene was excessively time-consuming (16%). In the context of this study, despite high complication rates and maintenance needs, all IFCDP designs resulted in high OHQoL and patient satisfaction.
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Affiliation(s)
- Virginia Hogsett Box
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
- Private practice, Dallas, Tex
| | - Cortino Sukotjo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
| | - Kent L. Knoernschild
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
| | - Stephen D. Campbell
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
| | - Fatemeh S. Afshari
- Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
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Gunge H, Ogino Y, Kihara M, Tsukiyama Y, Koyano K. Retrospective clinical evaluation of posterior monolithic zirconia restorations after 1 to 3.5 years of clinical service. J Oral Sci 2018; 60:154-158. [DOI: 10.2334/josnusd.17-0176] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Hiroto Gunge
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Yoichiro Ogino
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Masafumi Kihara
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Yoshihiro Tsukiyama
- Section of Dental Education, Division of Oral Biological Sciences, Faculty of Dental Science, Kyushu University
| | - Kiyoshi Koyano
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
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Cheng CW, Chien CH, Chen CJ, Papaspyridakos P. Clinical Results and Technical Complications of Posterior Implant-Supported Modified Monolithic Zirconia Single Crowns and Short-Span Fixed Dental Prostheses: A 2-Year Pilot Study. J Prosthodont 2017; 27:108-114. [PMID: 29086467 DOI: 10.1111/jopr.12682] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The purpose of this clinical trial was to investigate the clinical outcomes of implant-supported modified monolithic zirconia single crowns (SCs) and short-span fixed dental prostheses (FDPs) after a follow-up of 2 years. MATERIALS AND METHODS Twenty-seven patients in need of implant-supported SCs or 3-unit FDPs in the posterior maxilla or mandible were consecutively selected for this study. A total of 56 modified monolithic zirconia prostheses including 44 SCs (8 screw-retained, 36 cement-retained) and twelve 3-unit FDPs (5 screw-retained, 7 cement-retained) were included in this study. All patients were followed at 6 months, 12 months, 18 months, and 2 years after placement of the modified monolithic zirconia prostheses. During the follow-up period, all prostheses were evaluated with clinical and radiographic examinations. The following technical parameters were assessed: framework fracture, fracture of veneering porcelain, screw loosening, loss of retention because of prosthesis de-cementation and opposing tooth fracture. RESULTS No implant was lost during the follow-up period, yielding a 2-year implant survival of 100%. One FDP failed because of framework fracture. The overall prosthesis survival rate was 98.2% after 2 years of clinical service. During the study, 5 complication events were observed in 3 SCs and one FDP, including one fracture of veneering porcelain and 2 screw loosenings in 3 SCs, and loss of retention and opposing tooth fracture in the same FDP. Therefore, the complication-free rate of prostheses was 91.1%. CONCLUSION According to the results of this study, the modified monolithic zirconia design used in this study resulted in a favorable short-term outcome for posterior implant-supported SCs and 3-unit FDPs.
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Affiliation(s)
- Chih-Wen Cheng
- Division of Prosthodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Chia-Hui Chien
- Division of Prosthodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Chun-Jung Chen
- Division of Periodontics, Department of Dentistry, Chi Mei Medical Center, Tainan, Taiwan
| | - Panos Papaspyridakos
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
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Park CJ, Phark JH, Chee WW. Evaluation of Fracture Resistance of Varying Thicknesses of Zirconia Around Implant Abutment Cylinders. J ORAL IMPLANTOL 2017; 43:328-332. [DOI: 10.1563/aaid-joi-d-16-00204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Zirconia is becoming increasingly used as a restorative material for implant-supported restorations; however, information is lacking with respect to the minimum thickness of zirconia surrounding the implant components. The purpose of this study is to evaluate the resistance to fracture of different thicknesses of zirconia luted to implant components. Thirty cylinders of zirconia (Prettau, Zirkonzahn) with 13-mm height, designed with indented occlusal surface for loading, and varying wall thicknesses (0.5 mm, 1 mm, 1.5 mm; n = 10/group) were milled using a computer-aided design/computer-aided manufacturing system (Modellier, Zirkonzahn), after which they were sintered. Titanium temporary cylinders (ITCS41, Biomet3i) were attached to 30 implant analogs (ILA20, Biomet3i) that were embedded into polymethylmethacrylate blocks (Palapress Vario, Heraeus Kulzer) with dimensions of 4.5 × 1.8 × 2 cm. Zirconia specimens were cemented to the titanium cylinders using a self-adhesive, dual-cure resin cement (Panavia SA, Kuraray). Load to failure test was performed under compression until fracture using a universal testing machine (Instron5965, Instron) at a crosshead speed of 0.5 mm/min and measured in N (Newton). Statistical analysis was performed using 1-way analysis of variance and Tukey B test at α = .05 (SPSS19, IBM). Mean load to failure was 1059.94 N, 2019.46 N, and 4074.79 N for groups 0.5 mm, 1 mm, and 1.5 mm, respectively. Values were significantly different between the groups (P < .05). Study limitations are that it is in vitro, specimens do not replicate tooth dimensions, and forces are static and directed toward the occlusal portion of each specimen. Within these limitations and considering the average human bite force, a thickness of 0.5 mm to 1 mm of this particular type of zirconia around this type of implant component can avoid fracture with these dimensions.
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Affiliation(s)
| | | | - Winston W. Chee
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif
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Papaspyridakos P, Kang K, DeFuria C, Amin S, Kudara Y, Weber HP. Digital workflow in full-arch implant rehabilitation with segmented minimally veneered monolithic zirconia fixed dental prostheses: 2-year clinical follow-up. J ESTHET RESTOR DENT 2017; 30:5-13. [DOI: 10.1111/jerd.12323] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Panos Papaspyridakos
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
- Department of Prosthodontics; University of Rochester Eastman Institute for Oral Health; Rochester New York
| | - Kiho Kang
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
| | - Catherine DeFuria
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
| | - Sarah Amin
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
| | - Yukio Kudara
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
| | - Hans-Peter Weber
- Postgraduate Prosthodontics, Tufts University School of Dental Medicine; Boston Massachusetts
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Tang YL, Kim JH, Shim JS, Kim S. The effect of different cooling rates and coping thicknesses on the failure load of zirconia-ceramic crowns after fatigue loading. J Adv Prosthodont 2017; 9:152-158. [PMID: 28680545 PMCID: PMC5483400 DOI: 10.4047/jap.2017.9.3.152] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 10/16/2016] [Accepted: 11/17/2016] [Indexed: 12/04/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the influence of different coping thicknesses and veneer ceramic cooling rates on the failure load of zirconia-ceramic crowns. MATERIALS AND METHODS Zirconia copings of two different thicknesses (0.5 mm or 1.5 mm; n=20 each) were fabricated from scanning 40 identical abutment models using a dental computer-aided design and computer-aided manufacturing system. Zirconia-ceramic crowns were completed by veneering feldspathic ceramics under different cooling rates (conventional or slow, n=20 each), resulting in 4 different groups (CONV05, SLOW05, CONV15, SLOW15; n=10 per group). Each crown was cemented on the abutment. 300,000 cycles of a 50-N load and thermocycling were applied on the crown, and then, a monotonic load was applied on each crown until failure. The mean failure loads were evaluated with two-way analysis of variance (P=.05). RESULTS No cohesive or adhesive failure was observed after fatigue loading with thermocycling. Among the 4 groups, SLOW15 group (slow cooling and 1.5 mm chipping thickness) resulted in a significantly greater mean failure load than the other groups (P<.001). Coping fractures were only observed in SLOW15 group. CONCLUSION The failure load of zirconia-ceramic crowns was significantly influenced by cooling rate as well as coping thickness. Under conventional cooling conditions, the mean failure load was not influenced by the coping thickness; however, under slow cooling conditions, the mean failure load was significantly influenced by the coping thickness.
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Affiliation(s)
- Yu Lung Tang
- Nonsan Yonsei Suite Dental Clinic, Nonsan, Chungnam, Republic of Korea
| | - Jee-Hwan Kim
- Department of Prosthodontics, Yonsei University Dental Hospital, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - June-Sung Shim
- Department of Prosthodontics, Yonsei University Dental Hospital, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Sunjai Kim
- Department of Prosthodontics, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Republic of Korea
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Abstract
AIM To evaluate the resistance to axial forces of screw-retained monolithic high translucency zirconia (mHTZr) crowns compared with high translucency zirconia + feldspathic ceramic (HTZrC) crowns, low translucency zirconia + feldspathic ceramic (LTZrC) crowns, and metal-ceramic (MC) crowns, and also to observe the different fracture patterns between all groups. METHODS Twenty-four crowns were fabricated (6 of each group) and loaded until failure, using a testing machine with a 5.0-kN load cell. RESULTS Mean fracture results varied between 1092.7 N (LTZrC group) and 3439.7 N (mHTZr group). No statistically significant differences were found between the HTZrC, LTZrC, and MC groups. However, statistically significant differences (P < 0.05) were found between mHTZr and the other 3 groups. In the MC group, only chipping of the ceramic veneering occurred. In the mHTZr group, when fracturing occurred, it was of the whole structure. Finally, the LTZrC and HTZrC groups suffered both chipping and core fractures. CONCLUSION High translucency monolithic zirconia implant-supported crowns proved to be the toughest group studied when an axial force was applied. Fracture patterns varied between different materials, chipping being the most common occurrence.
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Rojas Vizcaya F. Retrospective 2- to 7-Year Follow-Up Study of 20 Double Full-Arch Implant-Supported Monolithic Zirconia Fixed Prostheses: Measurements and Recommendations for Optimal Design. J Prosthodont 2016; 27:501-508. [PMID: 27570943 DOI: 10.1111/jopr.12528] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2016] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To measure the extension of cantilever lengths, thicknesses, and heights of zirconia prostheses in the lingual and facial areas of the distal screw access openings, and to evaluate the clinical performance regarding chipping or fracture of the distal cantilevered sections of double full-arch CAD/CAM screw-retained, stained, monolithic zirconia, gingival-colored ceramic implant-supported fixed prostheses (MZ-FPs). MATERIALS AND METHODS Ten edentulous patients were provided with a total of 20 CAD/CAM double full-arch MZ-FPs. The zirconia thicknesses around distal screw access openings at three different levels (crown height space, screw access opening lengths, and dimensions of the cantilevered segments) were measured in the resin prototypes. Patients were evaluated clinically (visually) without magnification, with intraoral digital photography, and radiologically by the author, approximately every 6 months. Ten patients with 20 MZ-FPs were evaluated. Twenty resin prototypes with 35 cantilevered segments (15 maxillary, 20 mandibular) were measured. The lingual and facial thicknesses of the resin frameworks and the crown height spaces of 35 distal access openings were measured. RESULTS The average extension of the maxillary cantilever segments was 7.72 mm; the mandibular cantilever average was 13.72 mm. The average crown height space for maxillary prostheses was 13.27 mm, for the mandibular prostheses it was 11.89 mm. Zirconia thickness around distal screw access openings at the middle of the crowns, margins and middle of the gingival areas (buccal side of maxillary prostheses) was 4.29, 3.79, and 3.87 mm, respectively. On the lingual sides the thicknesses were 3.13, 2.85, and 3.15 mm, respectively. For mandibular prostheses the thicknesses were 3.56, 3.08, and 3.15 mm, respectively, on the buccal sides, and 2.07, 2.00, and 2.99 mm, respectively, on the lingual sides. No implant failure or changes in the occlusal surface, chipping of the cuspid or incisal edges, or prosthesis distal extension fractures were observed during follow-up periods ranging from 2 to 7 years. The survival rate was 100% for implants and prostheses. In one of the patients, chipping of the pink ceramic was noted in the maxillary prosthesis 36 months after placement. CONCLUSIONS The results of this study indicated that full-arch MZ-FPs without cutback, or with partial digital cutback and veneering ceramic, were a therapeutic option. Recommendations regarding the thickness of zirconia at the level of the distal screw access openings, the crown height spaces, and the lengths of the cantilever segments were recorded. Additional in vitro and clinical studies will be required for more scientific analysis of the criteria for design of this type of prosthesis to minimize prosthetic complications. Long-term and multicenter studies are needed to corroborate the findings discussed in this report.
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Affiliation(s)
- Fernando Rojas Vizcaya
- Department of Prosthodontics, University of North Carolina, Chapel Hill, NC.,Mediterranean Prosthodontic Institute, Castellon, Spain
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30
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Malkondu Ö, Tinastepe N, Akan E, Kazazoğlu E. An overview of monolithic zirconia in dentistry. BIOTECHNOL BIOTEC EQ 2016. [DOI: 10.1080/13102818.2016.1177470] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Özlem Malkondu
- Faculty of Dentistry, Department of Prosthodontics, Yeditepe University, Istanbul, Turkey
| | - Neslihan Tinastepe
- Faculty of Dentistry, Department of Prosthodontics, Yeditepe University, Istanbul, Turkey
| | - Ender Akan
- Faculty of Dentistry, Department of Prosthodontics, İzmir Katip Çelebi University, Izmir, Turkey
| | - Ender Kazazoğlu
- Faculty of Dentistry, Department of Prosthodontics, İzmir Katip Çelebi University, Izmir, Turkey
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Zhou J, Huang Q, Wang X, Peng D, Li Y, Zhang L, Liu J, Zhang S, Zhao K, Jiang X, Zhou Y. Early loading of splinted implants in the posterior mandible: a prospective multicentre case series. J Clin Periodontol 2016; 43:298-304. [PMID: 26790007 DOI: 10.1111/jcpe.12513] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2016] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the 12-months clinical and radiological outcomes with the OsseoSpeed(™) TX implant using an early loading protocol in patients with missing teeth in the posterior mandible. MATERIAL AND METHODS Forty-five subjects, with Kennedy class I or II edentulism in the mandible, were enrolled at three centres in China. Two or three implants were placed in one edentulous region using a one-stage procedure. Patients received a screw-retained splinted fixed permanent restoration in one edentulous region 6-8 weeks after surgery. Follow-up took place at 6 and 12 months after loading. Marginal bone level alteration, implant survival and clinical findings were assessed using descriptive statistics. The data were analysed on a patient level, implying that the mean overall implants by patient was used as the statistical unit. The data from the three centres were pooled in the statistical analyses. RESULTS A total of 107 implants were inserted in 45 patients. Twelve months after loading, the implant survival rate was 100%, with a mean (± std) marginal bone gain of 0.08 ± 0.411 mm and healthy soft tissue status. CONCLUSIONS Early loading of splinted OsseoSpeed(™) TX implants was an effective and safe treatment for partial edentulism of the posterior mandible. CLINICAL TRIAL REGISTRATION NUMBER ON CLINICALTRIALS.GOV: NCT01346683.
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Affiliation(s)
- Jianfeng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qingfeng Huang
- Department of Prosthodontics, The Ninth People's Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Xiaodong Wang
- Department of Prosthodontics, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Dong Peng
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yan Li
- Department of Prosthodontics, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Lei Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jianzhang Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Songmei Zhang
- Department of Prosthodontics, The Ninth People's Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Ke Zhao
- Department of Prosthodontics, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xinquan Jiang
- Department of Prosthodontics, The Ninth People's Hospital affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Engineering Lab for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, China
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Abdulmajeed AA, Lim KG, Närhi TO, Cooper LF. Complete-arch implant-supported monolithic zirconia fixed dental prostheses: A systematic review. J Prosthet Dent 2016; 115:672-677.e1. [PMID: 26809220 DOI: 10.1016/j.prosdent.2015.08.025] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 01/08/2023]
Abstract
STATEMENT OF PROBLEM Monolithic zirconia prostheses are emerging as a promising option in the implant-based rehabilitations of edentulous patients, yet their clinical performance is not fully documented. PURPOSE The purpose of this systematic review was to assess the clinical performance of complete-arch implant-supported monolithic zirconia fixed dental prostheses. MATERIAL AND METHODS The electronic databases PubMed, Science Direct, and Cochrane Library were searched for clinical studies on complete-arch implant-supported monolithic zirconia fixed dental prostheses. Human studies with a mean follow-up of at least 1 year and published in an English-language peer-reviewed journal up to June 2015 were included. Two independent examiners conducted the search and the review process. RESULTS The search generated 903 titles. Eighteen qualifying studies were retrieved for full-text evaluation. Nine studies were included on the basis of preestablished criteria. Eight studies reported satisfactory clinical and esthetic outcomes. One study demonstrated prosthesis failure. Clinical studies are lacking on the long-term outcome of complete-arch implant-supported monolithic zirconia prostheses. CONCLUSIONS Complete-arch dental implant restoration with monolithic zirconia is associated with high short-term success. Despite the many advantages and short-term favorable reports, studies of longer duration are necessary to validate the broad application of this therapy.
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Affiliation(s)
- Aous A Abdulmajeed
- Assistant Professor, Department of Prosthetic Dentistry, Institute of Dentistry, University of Turku, Turku, Finland; and Adjunct Assistant Professor, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Kevin G Lim
- Resident, Department of Prosthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC
| | - Timo O Närhi
- Professor, Department of Prosthetic Dentistry, Institute of Dentistry, University of Turku, Turku, Finland
| | - Lyndon F Cooper
- Associate Dean for Research and Department Head, Oral Biology, University of Illinois at Chicago, College of Dentistry, Chicago, Ill.
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Clinical Advantages and Limitations of Monolithic Zirconia Restorations Full Arch Implant Supported Reconstruction: Case Series. Int J Dent 2015; 2015:392496. [PMID: 26124835 PMCID: PMC4466384 DOI: 10.1155/2015/392496] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 09/23/2014] [Indexed: 11/25/2022] Open
Abstract
Purpose. The purpose of this retrospective case series is to evaluate the clinical advantages and limitations of monolithic zirconia restorations for full arch implant supported restorations and report the rate of complications up to 2 years after insertion. Materials and Methods. Fourteen patients received implant placement for monolithic zirconia full arch reconstructions. Four implants were placed in seven arches, eleven arches received six implants, two arches received seven implants, two arches received eight implants, and one arch received nine implants. Results. No implant failures or complications were reported for an implant survival rate of 100% with follow-up ranging from 3 to 24 months. Conclusions. Monolithic zirconia CAD-/CAM-milled framework restorations are a treatment option for full arch restorations over implants, showing a 96% success rate in the present study. Some of the benefits are accuracy, reduced veneering porcelain, and minimal occlusal adjustments. The outcome of the present study showed high success in function, aesthetics, phonetics, and high patient satisfaction.
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