1
|
Szabó ÁL, Matusovits D, Slyteen H, Lakatos ÉI, Baráth Z. Biomechanical Effects of Different Load Cases with an Implant-Supported Full Bridge on Four Implants in an Edentulous Mandible: A Three-Dimensional Finite Element Analysis (3D-FEA). Dent J (Basel) 2023; 11:261. [PMID: 37999025 PMCID: PMC10670282 DOI: 10.3390/dj11110261] [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: 09/13/2023] [Revised: 10/29/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1-LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1-where masticatory forces covered the entire mesio-distal surface of the denture, including the cantilever-was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97-15.87% and 87.96-94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance.
Collapse
Affiliation(s)
- Árpád László Szabó
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
| | - Danica Matusovits
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
| | - Haydar Slyteen
- Department of Structural Mechanics, Faculty of Civil Engineering, University of Technology and Economics, Budapest, Műegyetem rkp. 3., 1111 Budapest, Hungary; (H.S.); (É.I.L.)
| | - Éva Ilona Lakatos
- Department of Structural Mechanics, Faculty of Civil Engineering, University of Technology and Economics, Budapest, Műegyetem rkp. 3., 1111 Budapest, Hungary; (H.S.); (É.I.L.)
| | - Zoltán Baráth
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 64-66., 6720 Szeged, Hungary; (Á.L.S.); (D.M.)
| |
Collapse
|
2
|
Block MS. Maxillary Full Arch Restorations - Biological Complications: A Narrative Review Outlining Criteria for Long Term Success. J Oral Maxillofac Surg 2023; 81:1124-1134. [PMID: 37301227 DOI: 10.1016/j.joms.2023.05.008] [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: 03/06/2023] [Revised: 05/11/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Patients receiving full arch implant borne maxillary prostheses require functional, esthetic, and long term success. The importance of this review is to document the difficulty with implant maintenance, the prevalence of peri-implant disease, and the improvement in biologic health when using a prosthesis that can be maintained to minimize plaque. The objective is to provide surgeons with a reference to optimize surgical procedures that can result in improved hygiene and long term maintenance, as well as acceptable functional and esthetic goals. METHODS Pubmed.gov was the information source. Years reviewed included 1990-2022. Inclusion criteria included only articles in journals referenced in pubmed.gov. The reports excluded were case reports, reports that only included implant survival, and articles without a statistical analysis to generate meaningful conclusions. Biological complications included bone loss, hygiene difficulty, mucositis and recession, the incidence of peri-implantitis, and how complications related to patient co-morbidities. Data collected included outcomes of the study including statistical significance. RESULTS The search identified articles for review using terms which included full arch maxillary restorations (n = 736), long term success with full arch maxillary prostheses (n = 22), ceramic full arch restorations (n = 102), and complications with full arch restorations (n = 231). From this search, 53 articles were collated that satisfied the inclusion criteria. Factors found to be significant contributors to biological complications included bone loss and peri-implant disease, difficulty with daily hygiene access, plaque and biofilm coverage, and the need for continued maintenance for long term implant health. CONCLUSION The surgeon needs to place implants to allow a full arch maxillary prosthesis to be fabricated with full access to the implants for maintenance, which should decrease the incidence of biological complications. With excellent maintenance full arch implant restorations can have limited peri-implant disease.
Collapse
Affiliation(s)
- Michael S Block
- Private Practice, Metairie, LA; Clinical Professor, LSU School of Dentistry, Department of Oral and Maxillofacial Surgery, New Orleans, LA.
| |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Chochlidakis K, Romeo D, Ercoli C, Papaspyridakos P. Complete Digital Workflow for Prosthesis Prototype Fabrication with the Double Digital Scanning (DDS) Technique: A Prospective Study on 16 Edentulous Maxillae. J Prosthodont 2022; 31:761-765. [PMID: 35871300 DOI: 10.1111/jopr.13569] [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: 12/13/2021] [Accepted: 07/08/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To assess the accuracy of fit of milled prosthesis prototypes for completely edentulous patients using a digital workflow. MATERIALS AND METHODS Sixteen patients received intraoral full-arch digital scans with the double digital scanning (DDS) technique and the generated standard tessellation language (STL) files were superimposed and imported into computer-aided design software (Exocad DentalCAD, exocad GmbH, Darmstadt, Germany) for design. After the design, each master STL file was used for computer-aided manufacturing of the prosthesis prototypes through a complete digital workflow. The primary outcome was the accuracy of fit assessment of the digitally fabricated prototypes on verified patient master stone casts. Two blinded clinicians tested the accuracy of fit of the milled prosthesis prototypes on the verified master stone casts utilizing the screw-resistance test and direct observation. RESULTS Out of the 16 digitally fabricated prototypes from intraoral full-arch digital scans, all 16 presented with an accurate fit on verified master stone casts. CONCLUSIONS Digitally fabricated full-arch prosthesis prototypes can be generated with a complete digital workflow leading to clinically acceptable fit.
Collapse
Affiliation(s)
- Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Davide Romeo
- Advanced Oral Surgery Unit, Vita Salute University, San Raffaele Hospital, Milan, Italy
| | - Carlo Ercoli
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Panos Papaspyridakos
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York.,Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Massachusetts
| |
Collapse
|
5
|
La Monaca G, Pranno N, Annibali S, Di Carlo S, Pompa G, Cristalli MP. Immediate flapless full-arch rehabilitation of edentulous jaws on 4 or 6 implants according to the prosthetic-driven planning and guided implant surgery: A retrospective study on clinical and radiographic outcomes up to 10 years of follow-up. Clin Implant Dent Relat Res 2022; 24:831-844. [PMID: 36197040 PMCID: PMC10092257 DOI: 10.1111/cid.13134] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES to retrospectively evaluate clinical and radiographic outcomes of immediate, flapless full-arch prostheses, supported by 4/6 implants according to prosthetic-driven planning and guided surgery. MATERIALS AND METHODS The study involved 28 edentulous patients (20 female/8 males; average age 67.75 ± 8.627 years), 32 prostheses (17 all-on-4/15 all-on-6) and 164 implants. The Implants survival, prostheses success/survival, peri-implant marginal bone loss, incidence of biological and prosthetic complications were evaluated. Multiple linear regression analysis was performed to analyze the influence of implant and patient characteristics on marginal bone loss. RESULTS Cumulative implant survival rate was 89.7% for all-on-four (seven failures) and 99.0% for all-on-six (one failure) after a mean follow-up of 6.46 ± 2.236 years (range 1-10 years). Cumulative prosthesis success rate was 51.5% (58.8% for all-on-four/ 43.8% for all-on-six). Prosthesis survival rate was 88.2% for all-on-four. No failure was registered in all-on-six. Mean value of marginal bone loss was 1.38 ± 0.1.28 mm at 5-year and 2.09 ± 0.56 mm at 10-year follow-up. No difference was found in the mean value of marginal bone resorption between all-on-four (1.56 ± 1.61 mm) and all-on-six (1.20 ± 0.85 mm) (p = 0.104) and between tilted (1.22 ± 1.29 mm) and axial implants (1.44 ± 1.27 mm) (p = 0.385) after 5-year follow-up. The incidence of biological complications was 1.0% in all-on-six (one mucositis) and 10.3% in all-on-four (two peri-implantitis). Prosthetic complications affected teeth of final rehabilitations with 3 detachments, 10 chippings or fractures, and 3 severe occlusal wears. CONCLUSIONS Based on the results and within the limitations of the present study, the implant-supported hybrid prosthesis according to prosthetic-driven planning and guided surgery showed to be an efficient, safe, and effective approach to rehabilitate edentulous jaws.
Collapse
Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Nicola Pranno
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Susanna Annibali
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Stefano Di Carlo
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Giorgio Pompa
- Department of Oral and Maxillofacial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Biotechnologies and Medical Surgical Sciences, Sapienza, University of Rome, Rome, Italy
| |
Collapse
|
6
|
Szabó ÁL, Nagy ÁL, Lászlófy C, Gajdács M, Bencsik P, Kárpáti K, Baráth Z. Distally Tilted Implants According to the All-on-Four ® Treatment Concept for the Rehabilitation of Complete Edentulism: A 3.5-Year Retrospective Radiographic Study of Clinical Outcomes and Marginal Bone Level Changes. Dent J (Basel) 2022; 10:dj10050082. [PMID: 35621535 PMCID: PMC9140184 DOI: 10.3390/dj10050082] [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: 03/23/2022] [Revised: 04/13/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Bone grafting procedures during the use of dental implants may be avoided by the use of tilted implants in the maxilla and the mandible; advantages of angled implants are associated with the extension of the distal cantilever, leading to better implant survival rates. However, the bending effect on the single tilting implants may increase the marginal bone stress. The purpose of the present study was to retrospectively assess the clinical success and proximal bone loss rate following the implantation of distally tilted implants according to the All-on-Four™ prosthetic concept—based on radiographic findings—in a single-center experience, in addition to the assessment of the outcomes in the context of various clinico-epidemiological correlates. During the study period, n = 36 patients (24 males and 12 females) with complete records of periapical radiographs, received a full-arch fixed bridge supported by two axial and two distal tilted implants; overall n = 144 and n = 144 implants (Nobel B) were place in the maxilla and mandibles of patients, respectively. Mean age of patients at the time of fixture installation was 58.75 ± 13.71 years; n =11 patients presented with relevant underlying conditions/habits. To assess peri-implant bone-level changes, matched and calibrated orthopantomogram (OPT) images were taken at follow-ups after 1.5 years, 2.5 years, and 3.5 years post-restoration, and marginal bone levels were assessed on the mesio- (MA) and disto-approximal (DA) aspects. All implants were successful, resulting in a 100% overall survival rate. The radiographic mean bone loss levels at baseline (mean ± SEM) were 0.181 ± 0.011 mm and 0.178 ± 0.017 mm in the maxilla and mandible, respectively, while by the 3.5-year mark, bone loss was 0.770 ± 0.029 mm and 0.713 ± 0.026 mm in the maxilla and mandible (p > 0.05), respectively; bone-level changes were significant over time (p = 0.035 and p = 0.033). Peri-implant bone loss was more aggressive around titled distal implants versus mesial actual position implants. The effect of smoking and other underlying conditions showed significantly higher (p < 0.05) bone resorption levels when assessed on an individual implant-level, while during patient-level analysis, only a tendency was shown for higher bone loss rates for both MA and DA implants (p > 0.05). Within its limitations, our study has concluded that the use of All-on-Four™ prosthetic concept for total arch rehabilitation yields higher bone loss in association with tilted implants and, in some cases, on the MA surfaces at vertically positioned implants after >40 months in function.
Collapse
Affiliation(s)
- Árpád László Szabó
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary; (Á.L.S.); (Á.L.N.)
- Oral Centrum Dental Ltd., Angyalka u. 1/A, 2030 Érd, Hungary
| | - Ádám László Nagy
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary; (Á.L.S.); (Á.L.N.)
| | - Csaba Lászlófy
- Sanoral Healthcare Ltd., Ó utca 6, 1066 Budapest, Hungary;
| | - Márió Gajdács
- Department of Oral Biology and Experimental Dental Research, Faculty of Dentistry, University of Szeged, Tisza Lajos krt. 63., 6720 Szeged, Hungary;
| | - Péter Bencsik
- Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, Dóm tér 12, 6721 Szeged, Hungary;
| | - Krisztina Kárpáti
- Department of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary;
| | - Zoltán Baráth
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, Tisza Lajos körút 62-64, 6720 Szeged, Hungary; (Á.L.S.); (Á.L.N.)
- Correspondence: or ; Tel.: +36-62-545-297
| |
Collapse
|
7
|
Papaspyridakos P, Bedrossian A, De Souza A, Bokhary A, Gonzaga L, Chochlidakis K. Digital Workflow in Implant Treatment Planning For Terminal Dentition Patients. J Prosthodont 2022; 31:543-548. [PMID: 35343618 DOI: 10.1111/jopr.13510] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/21/2022] [Indexed: 12/01/2022] Open
Abstract
Treatment planning for the transition of patients from terminal dentition to full-arch implant rehabilitation poses challenges. Such challenges pertain to achieving the new orientation of the occlusal and esthetic plane as well as the change of vertical dimension of occlusion (VDO), while the fixed provisionalization using a digital workflow, still tends to be considered complex and hard to perform. This article illustrates step-by-step the utilization of a digital workflow protocol in the treatment planning for rehabilitation of terminal dentition patients, simplifying the smile design and ensuring that fixed provisionalization serves both the functional and esthetic requirements. This protocol includes facially-driven, three-dimensional (3D) digital smile design and chairside mock-up restoration workflows that enable prosthetically-driven assessment prior to implant treatment planning and 3D printing of surgical templates, which can predictably reduce chairside time and adjustments at the surgical and fixed provisionalization appointment. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY, USA
| | - Armand Bedrossian
- Department of Prosthodontics, University of Washington, Seattle, WA, USA
| | - Andre De Souza
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Abdullah Bokhary
- Department of Dental Public Health, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Luiz Gonzaga
- Center for Implant Dentistry, University of Florida, Gainsville, FL, USA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY, USA
| |
Collapse
|
8
|
Sinada N, Papaspyridakos P. Digitally Designed and Milled Verification Jigs Generated from Photogrammetry Data Acquisition: A Clinical Report. J Prosthodont 2021; 30:651-655. [PMID: 34296484 DOI: 10.1111/jopr.13409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2021] [Indexed: 11/28/2022] Open
Abstract
The objective of the present report is to illustrate a proof-of-concept protocol for CAD/CAM fabrication of milled verification jigs during full-arch implant rehabilitation using photogrammetry for data acquisition. The present report aims to bridge the gap between analog and digital workflows by introducing a CAD/CAM technique to intraorally verify digitally acquired information without the use of the technique-sensitive and labor-intensive conventional resin verification jig. One patient was treated with a digital prosthodontic protocol where a digitally designed CAD/CAM milled verification jig (generated from intraoral digital scans) was used to confirm implant 3D positioning prior to the fabrication of double full-arch monolithic definitive zirconia prostheses. The procedures are presented step-by-step after clinical and radiographic observation.
Collapse
Affiliation(s)
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| |
Collapse
|
9
|
Gaonkar SH, Aras MA, Chitre V, Mascarenhas K, Amin B, Rajagopal P. Survival rates of axial and tilted implants in the rehabilitation of edentulous jaws using the All-on-four™ concept: A systematic review. J Indian Prosthodont Soc 2021; 21:3-10. [PMID: 33835063 PMCID: PMC8061444 DOI: 10.4103/jips.jips_100_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aim: The aim of this review was to evaluate the survival rate of axial and tilted implants in rehabilitation of edentulous jaws using all on four concept. Setting and Design: Systematic Review. Materials and Methods: A literature review was performed in MEDLINE, PubMed Central (PMC), Google scholar, Embase, Cochrane Central Register of Controlled Trials. Hand searches were conducted of the bibliographic of related journals and systematic reviews. A total of 380 articles were obtained from the intial screening process. Of these articles, 25 articles fulfilled the inclusion criteria. The authors performed evaluation of articles independently as well as data extraction and quality assessment. Statistical Analysis Used: Qualitative analysis. Results: The major prosthetic complication was the fracture of the acrylic prosthesis. The mean cumulative survival rate of implants (72-132 months) were 94% to 98%. The prosthesis survival rate (12 months) was between 99% to 100%. The averaged bone loss was 1.3 ±0.4 mm (12-60 months). No Significant difference was found between survival rates of axial and tilted implants nor between maxilla and mandible. Conclusion: All on four concept can be employed successfully in the edentulous patients with resorbed ridges while improving their quality of life and reducing morbidity. However,randomized clinical trials with large sampling size and long term follow up should be incorporated.
Collapse
Affiliation(s)
| | - Meena Ajay Aras
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Vidya Chitre
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Kennedy Mascarenhas
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Bhavya Amin
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Praveen Rajagopal
- Department of Prosthodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| |
Collapse
|
10
|
de Carvalho LP, de Carvalho AM, Francischone CE, do Amaral FLB, Sotto-Maior BS. Biomechanical behavior of atrophic maxillary restorations using the all-on-four concept and long trans-sinus implants: A finite element analysis. J Dent Res Dent Clin Dent Prospects 2021; 15:106-110. [PMID: 34386181 PMCID: PMC8346716 DOI: 10.34172/joddd.2021.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 01/21/2021] [Indexed: 11/15/2022] Open
Abstract
Background. Maxillary bone atrophy with a considerable amount of pneumatization and anterior expansion of the maxillary sinus might be a situation limiting oral rehabilitation with osseointegrated implants. Therefore, the present study aimed to biomechanically evaluate two rehabilitation techniques for maxillary bone atrophy: all-on-four and long trans-sinus implants. Methods. Two three-dimensional models consisting of atrophic maxilla with four implants were simulated. In the M1 model, two axially inserted anterior implants and two tilted implants, 15 mm in length, placed tangential to the maxillary sinus’s anterior wall were used. In the M2 model, two axially inserted anterior implants and two trans-sinus tilted implants, 24 mm in length, were used. For the finite element analysis (FEA), an axial load of 100 N was applied on the entire extension of the prosthesis, simulating a rehabilitation with immediate loading. The peri-implant bone and the infrastructure were analyzed according to the Mohr-Coulomb and Rankine criteria, respectively. Results. The results were similar when the stresses on peri-implant bone were compared: 0.139 and 0.149 for models 1 and 2, respectively. The tension values were lower in the model with trans-sinus implants (27.99 MPa). Conclusion. It was concluded that the two techniques exhibited similar biomechanical behavior, suggesting that the use of long trans-sinus implants could be a new option for atrophic maxilla rehabilitation.
Collapse
Affiliation(s)
| | | | | | | | - Bruno Salles Sotto-Maior
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Juiz de Fora, Brazil
| |
Collapse
|
11
|
Levartovsky S, Arieli A, Fridenberg N, Matalon S, Pilo R. Survival and success rates of soft-milled cobalt-chromium-ceramic full-arch screw-retained implant-supported prostheses: a 2- to 7-year follow-up retrospective study. Clin Oral Investig 2021; 25:5341-5350. [PMID: 33616806 DOI: 10.1007/s00784-021-03842-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/16/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To retrospectively assess implant and prosthesis survival and success and patient satisfaction in edentulous patients treated with soft-milled cobalt-chromium-ceramic full-arch screw-retained implant-supported prostheses (SCCSIPs) over a mean clinical follow-up period of 4 years. MATERIALS AND METHODS Twenty-one edentulous patients, aged 47-80 years, underwent restoration with 27 SCCSIPs (210 implants, 349 crown units). After definitive prosthesis insertion, patients participated in a yearly dental check-up recall program, including clinical and radiographic examinations. All supporting implants were examined for biological and technical complications, and the restorations were evaluated using modified California Dental Association (CDA) criteria. Life table and Kaplan-Meier survival analyses were performed. Patient satisfaction regarding chewing, esthetics, comfort, and phonetics was evaluated using a visual analog scale (VAS). RESULTS After a mean of 4 years, two implants (3.8%) failed, with no effect on prosthesis survival. The cumulative survival rate was 98.6% and 100% for implants and prostheses, respectively. The most frequent minor biological complication was soft tissue recession (11%). Porcelain fracture was the only major technical complication (0.6% of crown units), while the only minor technical complication was porcelain chipping (4% of crown units), which required only polishing. Overall, 66.7% of the prostheses were free of technical complications. Patient satisfaction was high to very high. Less satisfaction was noted with comfort due to soft tissue recession and food impaction. CONCLUSIONS Within the limitations of this study, we conclude that the survival and success rates of SCCSIPs in edentulous patients were excellent. CLINICAL RELEVANCE SCCSIPs should be considered when planning metal-ceramic implant-supported restorations.
Collapse
Affiliation(s)
- S Levartovsky
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel.
| | - A Arieli
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - N Fridenberg
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - S Matalon
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - R Pilo
- Department of Oral Biology, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| |
Collapse
|
12
|
Esquivel J, Lawson NC, Kee E, Bruggers K, Blatz MB. Wear of resin teeth opposing zirconia. J Prosthet Dent 2020; 124:488-493. [DOI: 10.1016/j.prosdent.2019.11.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/06/2019] [Accepted: 11/07/2019] [Indexed: 11/16/2022]
|
13
|
Werbelow L, Weiss M, Schramm A. Long-term follow-up of full-arch immediate implant-supported restorations in edentulous jaws: a clinical study. Int J Implant Dent 2020; 6:34. [PMID: 32728859 PMCID: PMC7391463 DOI: 10.1186/s40729-020-00232-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND This study aims to show the long-time stability of straight and tilted implants loaded immediately with a provisional resin bridge followed by a definitive prosthodontic rehabilitation in edentulous jaws despite difficult hygiene conditions postoperatively. RESULTS This study included the participation of 23 patients and the restoration of 170 dental implants in 32 edentulous jaws. Patient data was analyzed from the start of treatment with a minimum follow-up period of 6 years in order to determine long-term implant success rates. However, the age of patients at time of surgery significantly affected the BOP to the detriment of younger patients (median 62 years old). CONCLUSION Although there was a higher risk of implant failure due to general disease, all the implants in this study survived successfully. As a replacement for a complete dental arch, the reduced number of implants in combination with the avoidance of augmentations reduces treatment costs. The immediate fixed prosthetic restoration of edentulous jaws thus represents a reliable therapeutic alternative to a two- to three-stage procedure. Optimized aftercare including professional teeth cleaning (PTC) (at least twice a year) can minimize the anamnestic effect of smoking, diabetes mellitus, and osteoporosis on BOP and possible bone loss.
Collapse
Affiliation(s)
- Laura Werbelow
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Michael Weiss
- OPUS Dental Clinic, Neue Straße 72-74, 89073, Ulm, Germany
| | - Alexander Schramm
- Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany.,Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| |
Collapse
|
14
|
de Araújo Nobre M, Moura Guedes C, Almeida R, Silva A, Sereno N. Hybrid Polyetheretherketone (PEEK)-Acrylic Resin Prostheses and the All-on-4 Concept: A Full-Arch Implant-Supported Fixed Solution with 3 Years of Follow-Up. J Clin Med 2020; 9:jcm9072187. [PMID: 32664393 PMCID: PMC7408851 DOI: 10.3390/jcm9072187] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open
Abstract
Background: The aim of this three-year prospective study was to examine the outcome of a solution for full-arch rehabilitation through a fixed implant-supported hybrid prosthesis (polyetheretherketone (PEEK)-acrylic resin) used in conjunction with the All-on-4 concept. Methods: Thirty-seven patients (29 females, 8 males), with an age range of 38 to 78 years (average: 59.8 years) were rehabilitated with 49 full-arch implant-supported prostheses (12 maxillary rehabilitations, 13 mandibular rehabilitations and 12 bimaxillary rehabilitations). The primary outcome measure was prosthetic survival. Secondary outcome measures were marginal bone loss, plaque and bleeding scores, veneer adhesion issues, biological complications, mechanical complications, and the patients’ subjective evaluation. Results: There were two patients (maxillary rehabilitations) lost to follow-up, while one patient withdrew (maxillary rehabilitation). One patient with bimaxillary rehabilitation fractured the mandibular PEEK framework, rendering a 98% prosthetic survival rate. Implant survival was 100%. Average (standard deviation) marginal bone loss at 3-years was 0.40 mm (0.73 mm). Veneer adhesion was the only technical complication (n = 8 patients), resolved for all patients. Nine patients (n = 11 prostheses) experienced mechanical complications (all resolved): fracture of acrylic resin crowns (n = 3 patients), prosthetic and abutment screw loosening (n = 4 patients and 3 patients, respectively), abutment wearing (n = 1 patient). One patient experienced a biological complication (peri-implant pathology), resolved through non-surgical therapy. A 90% satisfaction rate was registered for the patients’ subjective evaluation. Conclusions: Based on the results, the three-year outcome suggests the proposed rehabilitation solution as a legitimate treatment option, providing a potential shock-absorbing alternative that could benefit the implant biological outcome.
Collapse
Affiliation(s)
- Miguel de Araújo Nobre
- MALO CLINIC, Research and Development Department, Av. Combatentes, 43, 11, 1600-042 Lisbon, Portugal
- Correspondence:
| | - Carlos Moura Guedes
- MALO CLINIC, Prosthodontics Department, Av. Combatentes, 43, 10, 1600-042 Lisbon, Portugal; (C.M.G.); (R.A.)
| | - Ricardo Almeida
- MALO CLINIC, Prosthodontics Department, Av. Combatentes, 43, 10, 1600-042 Lisbon, Portugal; (C.M.G.); (R.A.)
| | - António Silva
- MALO CLINIC, Ceramics, Av. Combatentes, 43, 11, 1600-042 Lisbon, Portugal;
| | - Nuno Sereno
- Invibio Biomaterial Solutions & JUVORA, Global Technology Center, Hillhouse International, Thornton, Cleveleys FY5 4QD, UK;
| |
Collapse
|
15
|
Gonzalez-Gonzalez I, deLlanos-Lanchares H, Brizuela-Velasco A, Alvarez-Riesgo JA, Llorente-Pendas S, Herrero-Climent M, Alvarez-Arenal A. Complications of Fixed Full-Arch Implant-Supported Metal-Ceramic Prostheses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124250. [PMID: 32545913 PMCID: PMC7345239 DOI: 10.3390/ijerph17124250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 12/19/2022]
Abstract
We aimed to assess the biological and mechanical-technical complications and survival rate of implants of full-arch metal-ceramic prostheses, during five years of follow-up. 558 implants (of three different brands) retaining 80 full-arch metal-ceramic prostheses were placed in 65 patients, all of whom were examined annually for biological and mechanical-technical complications during the five years of follow-up. Descriptive statistics and univariate logistic regression were calculated. The cumulative survival rate of the implants was 99.8%, and 98.8% prosthesis-based. Mucositis was the most frequent of the biological complications and peri-implantitis was recorded as 13.8% at restoration-level, 16.9% at patient level and 2.0% at implant level. An implant length greater than 10 mm was shown to be a protective factor against biological complications. The mechanical-technical complications were associated with implant diameter, abutment/implant connection and retention system. Loss of screw access filling was the most frequent prosthetic complication, followed by the fracture of the porcelain. Full-arch metal-ceramic prostheses show a high prevalence of implant and prosthesis survival, with few biological and mechanical-technical complications.
Collapse
Affiliation(s)
- Ignacio Gonzalez-Gonzalez
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | - Hector deLlanos-Lanchares
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | - Aritza Brizuela-Velasco
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
- Correspondence: ; Tel.: +34-661-842-026
| | - Jose-Antonio Alvarez-Riesgo
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| | | | | | - Angel Alvarez-Arenal
- Department of Prosthodontics and Occlusion, School of Dentistry, University of Oviedo, C/. Catedratico Serrano s/n., 33006 Oviedo, Spain; (I.G.-G.); (H.d.-L.); (J.-A.A.-R.); (A.A.-A.)
| |
Collapse
|
16
|
Papaspyridakos P, Chochlidakis K, Kang K, Chen Y, Alghfeli A, Kudara Y, Weber H. Digital Workflow for Implant Rehabilitation with Double Full‐Arch Monolithic Zirconia Prostheses. J Prosthodont 2020; 29:460-465. [DOI: 10.1111/jopr.13166] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/14/2020] [Accepted: 03/16/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Panos Papaspyridakos
- Department of ProsthodonticsTufts University School of Dental Medicine Boston MA
- Department of ProsthodonticsUniversity of Rochester Eastman Institute for Oral Health Rochester NY
| | | | - Kiho Kang
- Department of ProsthodonticsTufts University School of Dental Medicine Boston MA
| | - Yo‐wei Chen
- Department of ProsthodonticsTufts University School of Dental Medicine Boston MA
| | - Abdulla Alghfeli
- Department of ProsthodonticsTufts University School of Dental Medicine Boston MA
| | - Yukio Kudara
- Department of ProsthodonticsTufts University School of Dental Medicine Boston MA
| | - Hans‐Peter Weber
- Department of ProsthodonticsTufts University School of Dental Medicine Boston MA
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Scarano A, Stoppaccioli M, Casolino T. Zirconia crowns cemented on titanium bars using CAD/CAM: a five-year follow-up prospective clinical study of 9 patients. BMC Oral Health 2019; 19:286. [PMID: 31856799 PMCID: PMC6921470 DOI: 10.1186/s12903-019-0988-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/11/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The purpose of this prospective clinical study was to evaluate clinical results of the passive fit of the substructure in the Toronto bridge and the chipping or delamination of the ceramic veneering on the zirconia-support, after 5 years, in nine patients rehabilitated with zirconia crowns cemented on titanium bars using CAD/CAM technology. METHODS A total of nine healthy patient fully edentulous in the upper and lower jaws with non-contributory past medical anamnesis needing full fixed total prosthesis maxilla and mandible were included in this clinical study, where a total 9 mandibles and 9 jaws were treated. The inclusion criteria in order for a patient to participate in the study were: a signed consent form, fully edentulous in the upper and lower jaws, required a full fixed total prosthesis restoration. The exclusion criteria were age limitation of less than 18 years old, chemotherapy, head and neck radiation therapy, diabetes or periodontal disease, smoking and severe illness. All patients received zirconia crowns cemented on titanium bars using CAD/CAM technology. The primary outcome of this study was to examine the survival rate of the zirconia crowns cemented on titanium bars using CAD/CAM technology during the observation period. Any chipping or delamination of the zirconia crowns of the restorations was considered as failure. The secondary outcome was to evaluate the passive fit of the substructure on the implants, loose of occlusal screws, implant survival and satisfactory occlusion. RESULTS In 5 years of follow-up no evidence of chipping or delamination of the ceramic veneering on the zirconia crown supported were observed. Fifteen finished protesis (93.75%) showed satisfactory occlusion and only one case (6.25%) required significant occlusal adjustment. During the first year recall all bars were stable (100%) no mobility of protheses was recorded. After 5 years all bars were stable (100%) and no mobility of protheses was recorded. CONCLUSION The computerized workflow for the process of building bar and prosthesis ensures reproducible results and excellent adaptation and passive insertion of them, as well as conditions for avoiding mechanical complications and guarantees stability of screw-implant abutments.
Collapse
Affiliation(s)
- Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti-Pescara, Via Dei Vestini, 31, 66100, Chieti, Italy. .,Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, USA.
| | | | | |
Collapse
|
19
|
Carneiro-Campos LE, Freitas-Fernandes LB, Masterson D, Magno MB, Fernandes CP, Maia LC, Zanetta-Barbosa D. Does the natural maxillary dentition influence the survival rate of mandibular metal-resin implant-supported fixed complete dentures? A systematic review and meta-analysis. J Prosthet Dent 2019; 124:36-45. [PMID: 31753454 DOI: 10.1016/j.prosdent.2019.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 10/25/2022]
Abstract
STATEMENT OF PROBLEM Consensus is lacking regarding the influence of the maxillary dentition on the survival rate of a mandibular metal-resin implant-supported fixed complete denture (MRISFCD) with distal cantilevers. PURPOSE The purpose of this systematic review was to identify whether an opposing natural dentition influences the survival rate of mandibular MRISFCDs. MATERIAL AND METHODS A literature search was performed up to February 2018 from MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, BBO/LILACS databases and also in the non-peer-reviewed literature through Open Grey. Clinical studies regarding natural (ND), removable prostheses (RP), and complete fixed maxillary implant dentitions (ID) with at least a year of follow-up were included. The quality of the included studies was analyzed, and the risk of bias was reported. A meta-analysis comparing the survival rate of ND with RP and ND with ID was performed with a confidence interval (CI) of 95%, and heterogeneity was tested by an I2 index. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to determine the certainty of the evidence. RESULTS From a total of 112 ND, 69 ID, and 204 RP in the maxillary dentition, the overall prevalence of failures was 5.4% (6/112; 95% CI [2.3 to 10.76]) for ND, 13.99% (20/69; 95% CI [0.77 to 39.41]) for ID, and 4.9% (10/204; 95% CI [0.69 to 12.18]) for RP. No statistical differences were detected in the success rates between ND and RP (risk difference = 0.00 [-0.06, 0.06]; P=.93; I2=27%) or between ND and ID (risk difference=0.00 [-0.06, 0.07]; P=.97; I2=0%), both with moderate evidence. CONCLUSION With a moderate certainty of evidence, it is suggested that natural maxillary dentitions do not affect the survival rate of mandibular MRISFCDs differently from other prosthetic designs.
Collapse
Affiliation(s)
- Luis Eduardo Carneiro-Campos
- Professor, Department of Oral and Maxillofacial Surgery and Implantology, Faculty of Dentistry, Federal University of Uberlandia (UFU), Uberlandia, Brazil.
| | - Liana B Freitas-Fernandes
- Researcher, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Daniele Masterson
- Librarian, Health Sciences Center Central Library, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcela Baraúna Magno
- Professor, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Claudio Pinheiro Fernandes
- Professor, Department of Prosthodontics, Faculty of Dentistry, Fluminense Federal University (UFF), Nova Friburgó, Brazil
| | - Lucianne Cople Maia
- Professor, Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Darceny Zanetta-Barbosa
- Professor, Department of Oral and Maxillofacial Surgery and Implantology, Faculty of Dentistry, Federal University of Uberlandia (UFU), Uberlandia, Brazil
| |
Collapse
|
20
|
Papaspyridakos P, Bordin TB, Natto ZS, Kim YJ, El-Rafie K, Tsigarida A, Chochlidakis K, Weber HP. Double Full-Arch Fixed Implant-Supported Prostheses: Outcomes and Complications after a Mean Follow-Up of 5 Years. J Prosthodont 2019; 28:387-397. [PMID: 30806990 DOI: 10.1111/jopr.13040] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2019] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To retrospectively assess complications and clinical and radiographic outcomes of edentulous patients treated with double full-arch implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.1 years. MATERIALS AND METHODS The single-visit clinical and radiographic examination included medical and dental history review and clinical assessment of biologic and technical complications encountered with all implants and IFCDPs. Life table analysis and Kaplan-Meier survival curves were calculated. Analysis was conducted to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. RESULTS Nineteen edentulous patients restored with 38 IFCDPs were included. A total of 249 implants were placed and 2 implants failed after a mean observation period of 5.1 years (range: 1-12 years), yielding an overall implant survival rate of 99.2% and prosthesis survival rate of 92.1%. Three out of 38 IFCDPs were lost, 1 after implant losses and 2 due to technical complications. The most frequent minor biologic complication was soft tissue recession with an estimated 5-year rate of 45.5% (95% CI: 39.4-57.5), while the most frequent major complication was peri-implantitis with an estimated 5-year implant-based rate of 9.5% (95% CI: 6.7-11.3). The most frequent minor technical complication was wear of the prosthetic material with an estimated 5-year rate of 49.0% (95% CI: 37.4-76.4), while the most frequent major technical complication was fracture of the prosthetic material with an estimated 5-year dental unit-based rate of 8.0% (95% CI: 6.6-10.1). CONCLUSIONS After a mean use time of 5.1 years, high implant and prosthesis survival rates were observed. The most frequent major biologic complication was peri-implantitis, and the most frequent major technical complication was fracture of the prosthetic material. The 5-year estimated cumulative rates for "prosthesis free of biologic complications" was 50.7% (95% CI: 33.7-65.4) and for "prosthesis free of technical complications" was 57.1% (95% CI: 39.3-71.5).
Collapse
Affiliation(s)
- Panos Papaspyridakos
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Thaisa Barizan Bordin
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Department of Prosthodontics, Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Zuhair S Natto
- Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA
| | - Yong-Jeong Kim
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Khaled El-Rafie
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Alexandra Tsigarida
- Department of Periodontology, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Hans-Peter Weber
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| |
Collapse
|
21
|
Storelli S, Del Fabbro M, Scanferla M, Palandrani G, Romeo E. Implant-supported cantilevered fixed dental rehabilitations in fully edentulous patients: Systematic review of the literature. Part II. Clin Oral Implants Res 2018; 29 Suppl 18:275-294. [DOI: 10.1111/clr.13310] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Stefano Storelli
- Department of Biomedical; Surgical and Dental Sciences; Clinica Odontoiatrica ASST Santi Paolo e Carlo; University of Milan; Milan Italy
| | - Massimo Del Fabbro
- Department of Biomedical; Surgical and Dental Sciences; IRCCS Orthopedic Institute Galeazzi; University of Milan; Milan Italy
| | - Massimo Scanferla
- Department of Biomedical; Surgical and Dental Sciences; Clinica Odontoiatrica ASST Santi Paolo e Carlo; University of Milan; Milan Italy
| | - Giulia Palandrani
- Department of Biomedical; Surgical and Dental Sciences; Clinica Odontoiatrica ASST Santi Paolo e Carlo; University of Milan; Milan Italy
| | - Eugenio Romeo
- Department of Biomedical; Surgical and Dental Sciences; Clinica Odontoiatrica ASST Santi Paolo e Carlo; University of Milan; Milan Italy
| |
Collapse
|
22
|
Maló P, de Araújo Nobre M, Moura Guedes C, Almeida R, Silva A, Sereno N, Legatheaux J. Short-term report of an ongoing prospective cohort study evaluating the outcome of full-arch implant-supported fixed hybrid polyetheretherketone-acrylic resin prostheses and the All-on-Four concept. Clin Implant Dent Relat Res 2018; 20:692-702. [DOI: 10.1111/cid.12662] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 03/05/2018] [Accepted: 07/12/2018] [Indexed: 01/25/2023]
Affiliation(s)
- Paulo Maló
- Department of Oral Surgery, Maló Clinic; Lisbon Portugal
| | | | | | | | | | - Nuno Sereno
- Invibio Biomaterial Solutions & JUVORA, Global Technology Center; Hillhouse International; Thornton Cleveleys United Kingdom
| | | |
Collapse
|
23
|
Tischler M, Patch C, Bidra AS. Rehabilitation of edentulous jaws with zirconia complete-arch fixed implant-supported prostheses: An up to 4-year retrospective clinical study. J Prosthet Dent 2018; 120:204-209. [PMID: 29559219 DOI: 10.1016/j.prosdent.2017.12.010] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/05/2017] [Accepted: 12/05/2017] [Indexed: 12/21/2022]
Abstract
STATEMENT OF PROBLEM Limited data are available on the clinical outcomes of patients with edentulism treated with zirconia complete-arch fixed implant-supported prostheses (CAFIPs). PURPOSE The primary purpose of this retrospective clinical study was to study the failure rate of dental implants as well as the fracture rate of zirconia CAFIPs. The secondary purpose was to study the survival outcomes of patients with edentulism treated with zirconia CAFIPs as well as the rate of technical complications. MATERIAL AND METHODS This retrospective clinical study from private practice included 128 patients rehabilitated between January 1, 2013, and December 31, 2016, with 1072 implants supporting 191 zirconia CAFIPs for single-jaw as well as double-jaw rehabilitations. All zirconia prostheses were of 1-piece design and were veneered with feldspathic porcelain only at the gingival region and therefore considered as predominantly monolithic. Additionally, all prostheses were bonded to implant manufacturer's titanium cylinders that provided an intimate contact with the implants. The primary outcome measures were implant failure rate and prosthesis fracture rate. The secondary outcome measures were prosthodontic treatment survival rate and the incidence of technical complications with respect to monolithic zirconia CAFIPs. Cumulative survival rate (CSR) for implants and prostheses was calculated after a life-table survival analysis. RESULTS Of the analyzed samples over a 4-year period, at least 288 implants and 49 prostheses had a minimum of 4 years of follow-up. A total of 18 implant failures were noted (13 in maxilla, 5 in mandible), yielding a CSR of 97.6% for implants. One fracture of the zirconia prosthesis was recorded, yielding a CSR of 99.4% for the prostheses over the 4-year period. Another 3 prostheses required remaking because the supporting implants failed, and 1 prosthesis was remade because the lack of passive fit resulted in a CSR of 96.8% for the prosthodontic treatment itself. During the 4-year period, 1 zirconia prosthesis had a technical complication related to the debonding of titanium cylinders, and 2 prostheses had fractured screws, which were resolved successfully. No zirconia prostheses had chipping of the veneered gingival porcelain. CONCLUSIONS Findings from this retrospective clinical study from private practice showed that prosthodontic treatment of edentulous patients with a 1-piece, complete-arch fixed implant-supported zirconia prosthesis with veneered porcelain restricted to the gingival region had high survival rates for implants and prostheses. Minimal technical complications related to this type of treatment for edentulous jaws and no chipping of the veneered gingival porcelain were encountered.
Collapse
|
24
|
Abstract
OBJECTIVE This systematic review evaluated survival rates, marginal bone loss (MBL), and complications of using 2 to 4 implants to support full-arch fixed prostheses in the mandible. MATERIALS AND METHODS An electronic search was performed in PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials to identify relevant articles published until March 2015. Articles were critically reviewed to determine the level of quality. RESULTS The initial search resulted in 910 articles from PubMed/MEDLINE, 162 titles from the Cochrane Central Register of Controlled Trials, and 363 from the Web of Science. After an initial assessment and careful reading, 19 studies published between 1999 and 2014 were included in this review. CONCLUSIONS The results of this review suggest that full-arch fixed dental prosthesis in mandible supported by 2 to 4 implants exhibited a low rate of failures for implants and prostheses, a low rate of MBL, and a low rate of biomechanical and biological complications.
Collapse
|
25
|
Rojas-Vizcaya F. Prosthetically guided bone sculpturing for a maxillary complete-arch implant-supported monolithic zirconia fixed prosthesis based on a digital smile design: A clinical report. J Prosthet Dent 2017; 118:575-580. [PMID: 28478983 DOI: 10.1016/j.prosdent.2017.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 02/03/2017] [Accepted: 02/03/2017] [Indexed: 10/19/2022]
Abstract
A digital smile design was used to create an average smile and to develop a removable interim restoration for an edentulous patient with a high smile line and different bone levels in the maxilla. The interim restoration was used as a guide to perform bone sculpturing to create space for the biological width and to restore a monolithic zirconia implant-supported fixed restoration.
Collapse
Affiliation(s)
- Fernando Rojas-Vizcaya
- Adjunct Assistant Professor, Department of Prosthodontics, School of Dentistry, University of North Carolina at Chapel Hill, NC; and Director, Mediterranean Prosthodontic Institute, Castellon, Spain.
| |
Collapse
|
26
|
Soto-Penaloza D, Zaragozí-Alonso R, Penarrocha-Diago M, Penarrocha-Diago M. The all-on-four treatment concept: Systematic review. J Clin Exp Dent 2017; 9:e474-e488. [PMID: 28298995 PMCID: PMC5347302 DOI: 10.4317/jced.53613] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/16/2016] [Indexed: 12/13/2022] Open
Abstract
Objectives To systematically review the literature on the “all-on-four” treatment concept regarding its indications, surgical procedures, prosthetic protocols and technical and biological complications after at least three years in function. Study Design The three major electronic databases were screened: MEDLINE (via PubMed), EMBASE, and the Cochrane Library of the Cochrane Collaboration (CENTRAL). In addition, electronic screening was made of the ‘grey literature’ using the System for Information on Grey Literature in Europe - Open Grey, covering the period from January 2005 up to and including April 2016. Results A total of 728 articles were obtained from the initial screening process. Of these articles, 24 fulfilled the inclusion criteria. Methodological quality assessment showed sample size calculation to be reported by only one study, and follow-up did not include a large number of participants - a fact that may introduce bias and lead to misleading interpretations of the study results. Conclusions The all-on-four treatment concept offers a predictable way to treat the atrophic jaw in patients that do not prefer regenerative procedures, which increase morbidity and the treatment fees. The results obtained indicate a survival rate for more than 24 months of 99.8%. However, current evidence is limited due the scarcity of information referred to methodological quality, a lack of adequate follow-up, and sample attrition. Biological complications (e.g., peri-implantitis) are reported in few patients after a mean follow-up of two years. Adequate definition of the success / survival criteria is thus necessary, due the high prevalence of peri-implant diseases. Key words:All-on-four, all-on-4, tilted implants, dental prostheses, immediate loading.
Collapse
Affiliation(s)
- David Soto-Penaloza
- Collaborating Lecturer, Master in Oral Surgery and Implant Dentistry, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Regino Zaragozí-Alonso
- Dentist, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - María Penarrocha-Diago
- Assistant Professor of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain
| | - Miguel Penarrocha-Diago
- Professor and Chairman of Oral Surgery, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain
| |
Collapse
|
27
|
Immediate Function of Anodically Oxidized Surface Implants (TiUnite™) for Fixed Prosthetic Rehabilitation: Retrospective Study with 10 Years of Follow-Up. BIOMED RESEARCH INTERNATIONAL 2017; 2016:2061237. [PMID: 28119922 PMCID: PMC5227116 DOI: 10.1155/2016/2061237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 11/23/2016] [Accepted: 12/14/2016] [Indexed: 12/02/2022]
Abstract
Purpose. To report the long-term outcome at 10 years of fixed prosthetic rehabilitation supported by dental implants with anodically oxidized surfaces in immediate function. Materials and Methods. This retrospective cohort study included 75 consecutive patients (44 females and 31 males; 14 bruxers; 21 smokers; 14 systemic compromised), with average age of 60 years, rehabilitated with 264 implants. Outcome measures were implant cumulative survival rates (calculated through life tables) and marginal bone level at 10 years. Results. Twenty-one patients with 66 implants (25%) were lost to follow-up. Six patients lost 12 implants (MkIII implants: n = 9; MkIV implants: n = 3). The overall implant cumulative survival rate at 10 years was 95.2% (maxilla: 95.6%; mandible: 94.7%). The average (standard deviation) marginal bone level at 10 years was 1.96 mm (1.50 mm), with 1.92 mm (1.31 mm) for the maxilla and 2.00 mm (1.71 mm) for the mandible, with a significant difference between nonsmokers (average = 1.60 mm) and smokers (average = 2.95 mm). Conclusions. Within the limitations of this study, it can be concluded that fixed prosthetic rehabilitation supported by implants with anodically oxidized surface in immediate function is a viable and safe treatment option for both jaws.
Collapse
|
28
|
Marques IDSV, Alfaro MF, Saito MT, da Cruz NC, Takoudis C, Landers R, Mesquita MF, Nociti Junior FH, Mathew MT, Sukotjo C, Barão VAR. Biomimetic coatings enhance tribocorrosion behavior and cell responses of commercially pure titanium surfaces. Biointerphases 2016; 11:031008. [PMID: 27514370 PMCID: PMC4982872 DOI: 10.1116/1.4960654] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/25/2016] [Accepted: 07/28/2016] [Indexed: 12/11/2022] Open
Abstract
Biofunctionalized surfaces for implants are currently receiving much attention in the health care sector. Our aims were (1) to create bioactive Ti-coatings doped with Ca, P, Si, and Ag produced by microarc oxidation (MAO) to improve the surface properties of biomedical implants, (2) to investigate the TiO2 layer stability under wear and corrosion, and (3) to evaluate human mesenchymal stem cells (hMSCs) responses cultured on the modified surfaces. Tribocorrosion and cell experiments were performed following the MAO treatment. Samples were divided as a function of different Ca/P concentrations and treatment duration. Higher Ca concentration produced larger porous and harder coatings compared to the untreated group (p < 0.001), due to the presence of rutile structure. Free potentials experiments showed lower drops (-0.6 V) and higher coating lifetime during sliding for higher Ca concentration, whereas lower concentrations presented similar drops (-0.8 V) compared to an untreated group wherein the drop occurred immediately after the sliding started. MAO-treated surfaces improved the matrix formation and osteogenic gene expression levels of hMSCs. Higher Ca/P ratios and the addition of Ag nanoparticles into the oxide layer presented better surface properties, tribocorrosive behavior, and cell responses. MAO is a promising technique to enhance the biological, chemical, and mechanical properties of dental implant surfaces.
Collapse
Affiliation(s)
- Isabella da Silva Vieira Marques
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Maria Fernanda Alfaro
- Department of Restorative Dentistry, University of Illinois at Chicago, College of Dentistry, 801 S Paulina, Chicago, Illinois 60612
| | - Miki Taketomi Saito
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Nilson Cristino da Cruz
- Laboratory of Technological Plasmas, Engineering College, Univ Estadual Paulista (UNESP), Av Três de Março, 511, Sorocaba, São Paulo 18087-180, Brazil
| | - Christos Takoudis
- Departments of Chemical Engineering and Bioengineering, University of Illinois at Chicago, 851 S. Morgan St., SEO 218, Chicago, Illinois 60607
| | - Richard Landers
- Institute of Physics Gleb Wataghin, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Barão Geraldo, Campinas, São Paulo 13083-859, Brazil
| | - Marcelo Ferraz Mesquita
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Francisco Humberto Nociti Junior
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| | - Mathew T Mathew
- Department of Biomedical Sciences, University of Illinois, College of Medicine at Rockford, 1601 Parkview Avenue, Rockford, Illinois 61107
| | - Cortino Sukotjo
- Department of Restorative Dentistry, University of Illinois at Chicago, College of Dentistry, 801 S Paulina, Chicago, Illinois 60612
| | - Valentim Adelino Ricardo Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Av Limeira, 901, Piracicaba, São Paulo 13414-903, Brazil
| |
Collapse
|
29
|
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.
Collapse
Affiliation(s)
- Fernando Rojas Vizcaya
- Department of Prosthodontics, University of North Carolina, Chapel Hill, NC.,Mediterranean Prosthodontic Institute, Castellon, Spain
| |
Collapse
|
30
|
Drago C. Ratios of Cantilever Lengths and Anterior-Posterior Spreads of Definitive Hybrid Full-Arch, Screw-Retained Prostheses: Results of a Clinical Study. J Prosthodont 2016; 27:402-408. [DOI: 10.1111/jopr.12519] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2016] [Indexed: 11/27/2022] Open
Affiliation(s)
- Carl Drago
- Gundersen Health System; LaCrosse WI
- Marquette University School of Dentistry; Milwaukee WI
| |
Collapse
|