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Block MS. Three Factors for Long-Term Dental Implant Success: Up to 40-year Follow-up. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00059-1. [PMID: 39244494 DOI: 10.1016/j.coms.2024.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
This article provides clinicians with 3 main factors that relate to long-term success. Long term in this article represents the lifespan of the patient, often requiring more than 40 years of function on the implant restoration. Literature is reviewed and used to provide evidence for these recommendations. Cases are presented to demonstrate these critical factors.
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Affiliation(s)
- Michael S Block
- Private Practice, Metairie, LA, USA; Department of Oral & Maxillofacial Surgery, LSU School of Dentistry, New Orleans, LA, USA.
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2
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Zaninovich M, Drago C. Prosthodontic criteria for maxillary immediate occlusal loading, surgical classifications of atrophic maxillae, and presentation of a new implant/anatomic classification system for immediate maxillary rehabilitation. J Prosthodont 2024. [PMID: 39008359 DOI: 10.1111/jopr.13898] [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: 12/22/2023] [Accepted: 06/06/2024] [Indexed: 07/16/2024] Open
Abstract
PURPOSE Immediate full-arch occlusal loading for patients with atrophic edentulous maxillae satisfies critical needs for this specific type of edentulous patient after placement of implants with high levels of primary implant stability. The needs include improved aesthetics, limited immediate improved function, and elimination of removable prostheses. Classification systems exist for edentulous maxillae but they do not include specifics regarding posterior implant placement. In conjunction with anterior implants, posterior implants improve Anterior/Posterior (A/P) spreads, decrease cantilevered segments (CLs), and likely will improve implant and prosthetic success rates. The purposes of this article include presenting a new classification system that outlines the different types of implants now available which will likely achieve the requisite primary stability for immediate fixed rehabilitation. This proposed classification system identifies a relationship between different implant options currently available and the remaining quantity of bone in the first and second maxillary molar zones. MATERIALS AND METHODS The available literature regarding current classification systems was reviewed. The benefits and limitations of each system were described. The parameters associated with Immediate Occlusal Loading (IOL) for full arch maxillary prostheses include: posterior cantilever lengths of full arch fixed prostheses; existing A/P spread considerations for full arch prostheses; and introduction of a new classification system for atrophic posterior maxillary edentulous ridges were identified. RESULTS Currently, there are no available classification systems that outline specific implant options for posterior maxillae which will likely achieve the minimum primary stability needed for immediate rehabilitation. A new classification system was proposed where the rationale was to show clinicians that when a certain amount of bone remains in the posterior maxilla, there are specific implants designed to maximize primary stability. High implant primary stability is required for rehabilitation with immediate fixed implant-supported provisional prostheses. The proposed classification system assists clinicians in understanding what implant geometry is available and can be expected to achieve the requisite primary stability for immediate occlusal loading based on the available bone in the posterior maxillary molar zone. CONCLUSIONS This article reviewed current classification systems for edentulous maxillary patients, as well as clinical parameters required for full arch, immediate occlusal loading. It also presented a new classification system to assist clinicians in selecting appropriate implants and surgical techniques for immediate fixed rehabilitation of patients with atrophic maxillae.
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Affiliation(s)
- Michael Zaninovich
- Aria Dental Specialist Implant Centre, Perth, Western Australia, Australia
| | - Carl Drago
- Greenbrook Dental Group, Brookfield, Wisconsin, USA
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Jia P, Yang J. Biofilm accumulation on complete arch subperiosteal implant-supported prostheses: Effect of pontic type. J Prosthet Dent 2024; 131:478.e1-478.e6. [PMID: 38233257 DOI: 10.1016/j.prosdent.2023.12.015] [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: 09/09/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024]
Abstract
STATEMENT OF PROBLEM Complete arch subperiosteal implant-supported prostheses present challenges in terms of effective cleaning, leading to the accumulation of biofilm on their intaglio surfaces. The association between different intaglio surface morphologies and biofilm accumulation on complete arch subperiosteal implant-supported prostheses is unclear. PURPOSE The purpose of this in vitro study was to investigate the correlation between the intaglio surface of complete arch subperiosteal implant-supported prostheses and biofilm accumulation. MATERIAL AND METHODS Sixty-eight complete arch subperiosteal implant-supported prostheses were fabricated with varying interimplant distances and pontic morphologies. Four different types of pontic morphologies were included: saddle, flat, scalloped, and ovate. To simulate biofilm accumulation, a green aerosol was sprayed onto the intaglio surface. Dental floss was used to clean the colored spray from the intaglio surface. The intaglio surfaces of prostheses were then scanned with an intraoral scanner. The biofilm areas were identified and calculated by using a 3-dimensional macroscopical quantification method. The distances between adjacent implants and transmucosal height were measured. The correlation between interimplant distances and biofilm areas, and the correlation between the biofilm areas and transmucosal height, were analyzed using the Spearman test. Furthermore, a generalized estimating equation (GEE) was employed to examine the relationship between pontic morphology and biofilm area, adjusting for location, cantilever, implant distance, and transmucosal height (α=.05). RESULTS A significant correlation was found between the biofilm area and transmucosal height (correlation coefficient=0.208, P<.001). A significant increase in biofilm accumulation was observed in the saddle group compared with the 3 groups in GEE Models I and II. CONCLUSIONS Flat pontics and ovate pontics have significantly lower biofilm retention. Moreover, transmucosal height plays a significant role in biofilm accumulation in the pontic area.
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Affiliation(s)
- Pingyi Jia
- Attending Periodontist, Department of the Fourth Clinical Division, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Jingwen Yang
- Associate Professor, Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China.
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Papaspyridakos P, Bedrossian EA, Ntovas P, Kudara Y, Bokhary A, Chochlidakis K. Reverse scan body: The scan pattern affects the fit of complete-arch prototype prostheses. J Prosthodont 2023; 32:186-191. [PMID: 37721306 DOI: 10.1111/jopr.13772] [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: 06/10/2023] [Revised: 08/23/2023] [Accepted: 09/11/2023] [Indexed: 09/19/2023] Open
Abstract
PURPOSE To assess the effect of different scan patterns on the fit of implant-supported complete-arch prototype prostheses fabricated via a complete digital extraoral protocol with a reverse scan body. MATERIALS AND METHODS A mandibular cast with four multi-unit abutment (MUA) implant analogs with adequate antero-posterior spread served as the reference cast, simulating a common clinical patient situation, and a polymethylmethacrylate interim screw-retained prosthesis was fabricated on it. Novel reverse scan bodies were connected to the interim prosthesis on the intaglio of the MUA abutments and extraoral scanning was performed with a white light intraoral scanner (TRIOS 4; 3 shape) and three different scan patterns: starting from the occlusal surface of the interim prosthesis (O-group), starting from the intaglio (I-group), and helix pattern (H-group). The resulting STL files from the three groups were then imported to computer-aided design (CAD) software and after the digital design, the STL files were exported to a computer-aided manufacturing (CAM) milling machine which generated a total of 15 CAD-CAM milled prototype prostheses per group. Two clinicians assessed the fit of each digitally fabricated prototype prosthesis on the reference cast, utilizing the screw-resistance test and radiographic evaluation. Fisher's exact test was used to test the difference between the three groups, and Cohen's k-score was used to assess the inter-examiner agreement. RESULTS Out of the three different groups, the O-group scan pattern led to 100% prosthesis fit, while the prototype prostheses generated from I- and H-groups had 80% and 53% fit, respectively. The results were statistically significant (p = 0.008). CONCLUSIONS Occlusal scan pattern leads to fitting milled prototype prostheses after extraoral scanning with reverse scan bodies without intraoral implant data acquisition.
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Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Massachusetts, USA
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | - E Armand Bedrossian
- Department of Prosthodontics, University of Washington, Seattle, Washington, USA
| | - Panagiotis Ntovas
- Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Massachusetts, USA
| | - Yukio Kudara
- Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Massachusetts, USA
| | - Abdullah Bokhary
- Department of Dental Public Health, King Abdulaziz University Faculty of Dentistry, Jeddah, Saudi Arabia
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
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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.
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Affiliation(s)
- Michael S Block
- Private Practice, Metairie, LA; Clinical Professor, LSU School of Dentistry, Department of Oral and Maxillofacial Surgery, New Orleans, LA.
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Heller H, Beitlitum I, Goldberger T, Emodi-Perlman A, Levartovsky S. Outcomes and Complications of 33 Soft-Milled Cobalt-Chromium-Ceramic Full-Arch Screw-Retained Implant-Supported Prostheses: A Retrospective Study with up to 10-Year Follow-up. J Funct Biomater 2023; 14:jfb14030157. [PMID: 36976081 PMCID: PMC10053464 DOI: 10.3390/jfb14030157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
This retrospective study assessed outcomes and complications related to implants and prostheses in edentulous patients treated with soft-milled cobalt-chromium-ceramic full-arch screw-retained implant-supported prostheses (SCCSIPs). After the final prosthesis was delivered, patients participated in an annual dental check-up program, including clinical and radiographic assessments. Outcomes of implants and prostheses were evaluated, and biological and technical complications were categorized as major or minor. Implant and prosthesis cumulative survival rates were assessed using the life table analysis. A total of twenty-five participants (mean age 63.6 ± 7.3 years) with 33 SCCSIPs were observed for a mean of 68.9 ± 27.9 months (range 1–10 years). A total of 7 out of 245 implants were lost, with no effect on prosthesis survival, leading to cumulative survival rates of 97.1% for implants and 100% for prostheses. The most recurrent minor and major biological complications were soft tissue recession (9%) and late implant failure (2.8%). Among 25 technical complications, porcelain fracture was the only major technical complication, requiring prosthesis removal (1%). Porcelain chipping was the most frequent minor technical complication, affecting 21 crowns (5.4%), which required polishing only. At the end of the follow-up, 69.7% of the prostheses were free of technical complications. Within the limitations of this study, SCCSIP showed promising clinical performance after 1–10 years.
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Affiliation(s)
- Hadas Heller
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Ilan Beitlitum
- Department of Periodontology and Dental Implantology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Tomer Goldberger
- Department of Endodontics, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Alona Emodi-Perlman
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shifra Levartovsky
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: ; Tel.: +972-52-3515403
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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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Papaspyridakos P, Vazouras K, Gotsis S, Bokhary A, Sicilia E, Kudara Y, Bedrossian A, Chochlidakis K. Complete digital workflow for prosthesis prototype fabrication with double digital scanning: A retrospective study with 45 edentulous jaws. J Prosthodont 2022. [PMID: 36527731 DOI: 10.1111/jopr.13630] [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: 07/09/2022] [Revised: 11/02/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE To assess the accuracy of fit of complete-arch printed prosthesis prototypes generated with a digital workflow protocol for completely edentulous jaws. MATERIALS AND METHODS Forty-five edentulous jaws (35 patients) underwent intraoral complete-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. After STL merging, each master STL file was used for printing a prosthesis prototype. The primary outcome was the accuracy of fit assessment of the printed prototypes on verified master stone casts. Two experienced clinicians tested the accuracy of fit with radiographs and screw-resistance tests. Secondary outcomes were the effect of the scan body shape and implant number on the accuracy of fit. RESULTS Out of the 45 DDS-generated prosthesis prototypes, 39 presented with accurate fit on verified master stone casts, yielding an 86.70% accuracy of fit. Cylindrical scan bodies led to 100% accuracy of fit (25/25), whereas polygonal scan bodies presented with 70% accuracy of fit (14/20). Four implant-supported prostheses yielded 100% accuracy of fit (12/12), compared with 25/29 (86.30%) accuracy of fit for the six-implant-supported ones. Fisher's exact test was used to assess the effect of different scan body shapes (p = 0.005) and implant number on accuracy of fit. Chi-squared test was used to assess the association between the number of implants per arch and the accuracy of fit (p = 0.039). CONCLUSIONS Thirty-nine out of 45 complete-arch prosthesis prototypes generated with a completely digital workflow presented with clinically acceptable fit. The effect of the scan body design and implant number was statistically significant, favoring cylindrical scan bodies and four-implant-supported prostheses.
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Affiliation(s)
- Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, New York, USA
| | - Konstantinos Vazouras
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Sotirios Gotsis
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Abdullah Bokhary
- Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Elena Sicilia
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Yukio Kudara
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Armand Bedrossian
- Department of Prosthodontics, University of Washington, Seattle, Washington, USA
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, New York, USA
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A Retrospective Analysis of Biological Complications of Dental Implants. Int J Dent 2022; 2022:1545748. [PMID: 35990253 PMCID: PMC9391181 DOI: 10.1155/2022/1545748] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/25/2022] [Accepted: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
Methods A retrospective analysis of patients aged ≥18 years and having dental implants placed at Dubai Health Authority in 2010. Relevant information related to systemic-, patient-, implant-, site-, surgical- and prosthesis-related factors were collected. The strength of association between the prevalence of peri-implant mucositis and peri-implantitis and each variable was measured by chi-square analysis. A binary logistic regression analysis was performed to identify possible risk factors. Results A total of 162 patients with 301 implant-supported restorations were included in the study. The age of the patients ranged between 19 and 72 with a mean age of 46.4 ± 11.7 years. The prevalence of peri-implant mucositis at the patient and implant levels were 44.4% and 38.2%, respectively. For peri-implantitis, the prevalence at the patient level was 5.6%, while the prevalence at the implant level was 4.0%. The binary logistic regression identified three risk factors (smoking habits, histories of treated periodontitis and lack of peri-implant maintenance) for peri-implantitis. Conclusion Within the limitations of this study, smoking habits, history of treated periodontitis and lack of peri-implant maintenance were significant risk factors for peri-implantitis. Early detection of these factors would ensure appropriate planning and care of patients at high risk of developing peri-implant diseases.
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Volumetric Evaluations of Full-Arch Implant Supported Restorations and Their Role on Patients’ Quality of Life: A Mixed-Model Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:3640435. [PMID: 35983248 PMCID: PMC9381270 DOI: 10.1155/2022/3640435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 11/25/2022]
Abstract
Introduction Full-arch, implant-supported hybrid restorations, employing tilted implants, can offer an efficient way of treating edentulous patients. Several factors, such as the timing of implant placement and the inclination of the fixture, can have a detrimental effect on their stability. This retrospective study is aimed at discerning the role played by those factors. Materials and Methods Patients treated with full-arch, implant supported restorations were selected for this study; cone-beam computed tomography (CBCT) images, taken 3 months and 3 years after delivery of the final restoration, as well as peri-implant values, were obtained and compared; bone loss was measured on four sites for each implant and then averaged. These patients were recalled, and the OHIP-5 questionnaire was administered. Results 21 patients, with a mean age of 53 years, were included in the present analysis. 108 implants were placed, and 25 Toronto prostheses were delivered. According to a mixed-model analysis, tilted implants (0.51, p < 0.001) had a higher rate of bone loss, while implants placed in a healed ridge suffered less bone loss than immediate implants (-0.21, p < 0.001). Patient-level variables have a significant effect on this variable, as implants coming from the same subject share a similar risk of bone loss. The mean response to the self-administered OHIP-5 questionnaire was 1.53 ± 0.29; other variables did not have a statistically significant effect on this outcome. Discussion/Conclusions. The results of the present study show that Toronto bridges prostheses are an efficient procedure for treating edentulous patients, as their oral-related quality of life is reported as satisfactory even 7 years after delivery of the restoration. Tilted and immediate implants are more at risk of bone loss. Implants coming from the same subject share a similar risk of bone loss.
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11
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Biomechanical analysis of inclined and cantilever design with different implant framework materials in mandibular complete-arch implant restorations. J Prosthet Dent 2022; 127:783.e1-783.e10. [DOI: 10.1016/j.prosdent.2022.02.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 12/29/2022]
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Yoo SY, Kim SK, Heo SJ, Koak JY, Jeon HR. Clinical Performance of Implant Crown Retained Removable Partial Dentures for Mandibular Edentulism-A Retrospective Study. J Clin Med 2021; 10:jcm10102170. [PMID: 34069868 PMCID: PMC8157346 DOI: 10.3390/jcm10102170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 12/31/2022] Open
Abstract
The studies on implant-crown-retained removable partial dentures (IC-RPDs) for edentulism are scarce. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of IC-RPDs compared to implant overdentures (IODs) in mandibular edentulism. Variables that influenced survival and marginal bone loss (MBL) of implants in both treatment modalities were analyzed and the functional/esthetic satisfaction of patients as well as prosthetic complications were also observed. Eighteen IC-RPDs with a total of 60 implant-supported survey crowns and 24 IODs with a total 94 implants retained with magnet attachments were observed. After a median observation period of 46.6 months (up to 149 months), we observed 98.3% implant survival rates for IC-RPDs and 92.5% for IODs. Kaplan–Meier survival curves based on the treatment modality showed that, at 96 months, cumulative survival rates were 98.3% in IC-RPD and 83.1% in IOD. For implant survival rates, no statistical differences were observed according to age, sex, opposing dentition, or implant positions (p = 0.515, 0.666, 0.201, 0.749, respectively). The implant MBL measurements for IC-RPD and IOD groups at the final recall check were 0.93 ± 1.22 mm and 2.12 ± 2.09 mm, respectively. Additionally, there were no significant differences between groups (p = 0.554). The implants with peri-implantitis at year 1 showed significantly higher MBL at final check-up (p < 0.001). The MBL of implants showed significant differences based on age (p = 0.008) and opposing dentition (p = 0.003). No significant differences of implant MBL were observed for the position of placed implants (p = 0.621) or sex (p = 0.666). Patient-reported outcome measures (PROMs) on functional and esthetic satisfaction were significantly improved after IC-RPD or IOD treatment (p < 0.001). The most frequent prosthetic complication of IC-RPD was clasp loosening, while for IOD group, it was attachment dislodgement. Within the limitations of this retrospective study, we concluded that IC-RPDs could be considered as a viable treatment option for edentulous patients who need few fixed abutments for satisfaction.
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Affiliation(s)
- Soo-Yeon Yoo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Seong-Kyun Kim
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
- Correspondence: ; Tel.: +82-2-2072-3860
| | - Seong-Joo Heo
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Jai-Young Koak
- Department of Prosthodontics and Dental Research Institute, Seoul National University Dental Hospital, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; (S.-Y.Y.); (S.-J.H.); (J.-Y.K.)
| | - Hye-Rin Jeon
- Department of Computer Science, Columbia University, New York, NY 10027, USA;
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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.
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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
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Implant survival and biologic complications of implant fixed complete dental prostheses: An up to 5-year retrospective study. J Prosthet Dent 2021; 128:375-381. [PMID: 33618859 DOI: 10.1016/j.prosdent.2020.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
STATEMENT OF PROBLEM Limited information is available on the association between prosthesis-associated risk factors and biologic complications for patients with implant fixed complete dental prostheses (IFCDPs). PURPOSE The purpose of this retrospective study was to assess the implant survival and biologic complications of IFCDPs up to 5 years of follow-up. MATERIAL AND METHODS Patients who had received IFCDPs between August 1, 2009 and August 1, 2014 were identified through an electronic health record review. Those who consented to participate in the study attended a single-visit study appointment. Clinical and radiographic examinations, intraoral photographs, and peri-implant hard and soft tissues parameters were assessed. Only prostheses which could be removed during the study visit were included. Associations between biologic complications and prosthetic factors, such as time with prosthesis in place, prosthesis material, number of implants, cantilever length, and type of prosthesis retention, were assessed. RESULTS A total of 37 participants (mean ±standard deviation age 62.35 ±10.39 years) with 43 IFCDPs were included. None of the implants had failed, leading to an implant survival of 100% at 5.1 ±2.21 years. Ten of the prostheses were metal-ceramic (Group MC) and 33 were metal-acrylic resin (Group MR). Minor complications were more frequent than major ones. Considering minor complications, peri-implant mucositis was found in 53% of the implant sites, more often in the maxilla (P=.001). The most common major biologic complication was peri-implantitis, which affected 4.0% of the implants, more often in the mandible (P=.025). Peri-implant soft tissue hypertrophy was present 2.79 times more often (95% CI: 1.35 - 5.76, P<.003) around implants supporting metal-acrylic resin prostheses than metal-ceramic ones, with the former type also showing significantly more plaque accumulation (P<.003). CONCLUSIONS Biologic complications such as soft tissue hypertrophy and plaque accumulation were more often associated with metal-acrylic resin prostheses. Peri-implant mucositis occurred more often under maxillary IFCDPs, while peri-implantitis appeared more common around mandibular implants.
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15
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Able FB, Campanha NH, Younes IA, Sartori IADM. Evaluation of the intaglio surface shape of implant-supported complete-arch maxillary prostheses and its association with biological complications: An analytical cross-sectional study. J Prosthet Dent 2021; 128:174-180. [PMID: 33563467 DOI: 10.1016/j.prosdent.2020.12.028] [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: 03/20/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Whether the shape of the intaglio surface of fixed implant-supported maxillary prostheses is associated with the occurrence of biological is unclear. PURPOSE The purpose of this cross-sectional study was to evaluate the shape (convex or concave) of the intaglio surface of complete-arch implant-supported maxillary fixed prostheses and to assess the association with biofilm accumulation, hyperemia, bone loss, and patient satisfaction. MATERIAL AND METHODS Study participants consisted of 56 individuals with fixed complete implant-supported maxillary prosthesis attending follow-up appointments. The 56 prostheses supported by 388 implants had been in place for an average of 5.5 years (range 1-14 years). The intaglio surface was divided into areas corresponding to the cantilever regions and between implants (n=442) and was assessed for shape (concave or convex) and biofilm index (0 to 3). Tissue hyperemia (redness) was assessed as absent or present. Bone loss (mm) was measured from digital periapical radiographs by 2 calibrated evaluators (kappa=94.9%). Study participant satisfaction was investigated by using a visual analog scale. Association assessments (α=.05) between the shape of each area and all these parameters were performed with the Friedman, linear regression, and logistic regression tests. RESULTS Of the analyzed areas, 58 (13.1%) were concave, and 384 (86.9%) were convex. Biofilm was absent on 3.5% of the concave and 5.5% of the convex areas. Biofilm was detectable with a probe on 12% of the concave and 22.4% of the convex areas and clinically visible in 58.6% of the concave and 57.8% of the convex areas. Abundant biofilm was seen in 25.9% of the concave and 14.3% of the convex areas and was associated with hyperemia (P=.003). A statistically significant association was found between the shape and biofilm accumulation (P=.009). Hyperemia was present in 199 (45%) areas. The association analysis between the shape of the area and the presence of hyperemia was not significant (P>.05). The mean bone loss was 0.71 mm (0.91 mm). Implants placed near concave areas underwent greater bone loss (P=.001). Study participants reported a high level of satisfaction with the esthetics, mastication, speech, and smile provided by the prosthesis, with satisfaction scores ranging between 8.46 and 8.77. However, in relation to ease of cleaning, only 19.6% were fully satisfied. CONCLUSIONS The shape of the intaglio surface of prostheses influenced the occurrence of biofilm accumulation and bone loss, and concave areas showed greater biofilm accumulation and bone resorption. High rates of satisfaction with treatment were identified.
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Affiliation(s)
- Francine Baldin Able
- Postgraduate student, PhD Program in Dentistry, General Dentistry Area, State University of Ponta Grossa (UEPG), Ponta Grossa, Brazil
| | - Nara Hellen Campanha
- Professor, MSD and PhD Program in Dentistry, General Dentistry Area, State University of Ponta Grossa (UEPG), Ponta Grossa, Brazil.
| | - Ibrahim Abazar Younes
- Postgraduate student, Masters Degree Program in Dentistry, Implantology Area, Faculdade ILAPEO, Curitiba, Brazil
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Barbin T, Silva LDR, Velôso DV, Borges GA, Presotto AGC, Barão VAR, Groppo FC, Ferraz Mesquita M. Biomechanical behavior of CAD/CAM cobalt-chromium and zirconia full-arch fixed prostheses. J Adv Prosthodont 2021; 12:329-337. [PMID: 33489016 PMCID: PMC7790600 DOI: 10.4047/jap.2020.12.6.329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/17/2020] [Accepted: 07/20/2020] [Indexed: 11/15/2022] Open
Abstract
PURPOSE To verify the influence of computer-aided design/computer-aided manufacturing (CAD/CAM) implant-supported prostheses manufactured with cobalt-chromium (Co-Cr) and zirconia (Zr), and whether ceramic application, spark erosion, and simulation of masticatory cycles modify biomechanical parameters (marginal fit, screw-loosening torque, and strain) on the implant-supported system. MATERIALS AND METHODS Ten full-arch fixed frameworks were manufactured by a CAD/CAM milling system with Co-Cr and Zr (n=5/group). The marginal fit between the abutment and frameworks was measured as stated by single-screw test. Screw-loosening torque evaluated screw stability, and strain analysis was explored on the implant-supported system. All analyses were performed at 3 distinct times: after framework manufacturing; after ceramic application in both materials' frameworks; and after the spark erosion in Co-Cr frameworks. Afterward, stability analysis was re-evaluated after 106 mechanical cycles (2 Hz/150-N) for both materials. Statistical analyses were performed by Kruskal-Wallis and Dunn tests (α=.05). RESULTS No difference between the two materials was found for marginal fit, screw-loosening torque, and strain after framework manufacturing (P>.05). Ceramic application did not affect the variables (P>.05). Spark erosion optimized marginal fit and strain medians for Co-Cr frameworks (P<.05). Screw-loosening torque was significantly reduced by masticatory simulation (P<.05) regardless of the framework materials. CONCLUSION Co-Cr and Zr frameworks presented similar biomechanical behavior. Ceramic application had no effect on the biomechanical behavior of either material. Spark erosion was an effective technique to improve Co-Cr biomechanical behavior on the implant-supported system. Screw-loosening torque was reduced for both materials after masticatory simulation.
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Affiliation(s)
- Thaís Barbin
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Letícia Del Rio Silva
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Daniele Valente Velôso
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Guilherme Almeida Borges
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | | | - Francisco Carlos Groppo
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Marcelo Ferraz Mesquita
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
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17
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Jia P, Yang J, Yue Z, Liu J, Liu Q, Liu Z, Tang L, Hou J. Comparison of peri-implant submucosal microbiota in arches with zirconia or titanium implant-supported fixed complete dental prostheses: a study protocol for a randomized controlled trial. Trials 2020; 21:979. [PMID: 33246481 PMCID: PMC7694361 DOI: 10.1186/s13063-020-04853-7] [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: 04/02/2020] [Accepted: 11/01/2020] [Indexed: 12/15/2022] Open
Abstract
Background The success rate of implant-supported prostheses for edentulous patients is relatively high. However, the incidence of biological complications, especially peri-implant mucositis and peri-implantitis, increases yearly after the placement of prostheses. The accumulation of pathogenic bacteria adjacent to a prosthesis is the main cause of biological complications. Titanium, one of the classical materials for implant-supported prostheses, performs well in terms of biocompatibility and ease of maintenance, but is still susceptible to biofilm formation. Zirconia, which has emerged as an appealing substitute, not only has comparable properties, but presents different surface properties that influence the adherence of oral bacteria. However, evidence of a direct effect on oral flora is limited. Therefore, the aim of the present study was to assess the effects of material properties on biofilm formation and composition. Methods The proposed study is designed as a 5-year randomized controlled trial. We plan to enroll 44 edentulous (mandible) patients seeking full-arch, fixed, implant-supported prostheses. The participants will be randomly allocated to one of two groups: group 1, in which the participants will receive zirconia frameworks with ceramic veneering, or group 2, in which the participants will receive titanium frameworks with acrylic resin veneering. Ten follow-up examinations will be completed by the end of this 5-year trial. Mucosal conditions around the implants will be recorded every 6 months after restoration. Peri-implant submucosal plaque will be collected at each reexamination, and bacteria flora analysis will be performed with 16S rRNA gene sequencing technology in order to compare differences in microbial diversity between groups. One week before each visit, periodontal maintenance will be arranged. Each participant will receive an X-ray examination every 12 months as a key index to evaluate the marginal bone level around the implants. Discussion The current study aims to explore the oral microbiology of patients following dental restoration with zirconia ceramic frameworks or titanium frameworks. The features of the microbiota and the mucosal condition around the two different materials will be evaluated and compared to determine whether zirconia is an appropriate material for fixed implant-supported prostheses for edentulous patients. Trial registration International Clinical Trials Registry Platform (ICTRP) ChiCTR2000029470. Registered on 2 February 2020. http://www.chictr.org.cn/searchproj.aspx?
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Affiliation(s)
- Pingyi Jia
- Department of the Fourth Clinical Division, Peking University School and Hospital of Stomatology; National Engineering Laboratory for Digital and Material Technology of Stomatology; Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health; Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Jingwen Yang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology; National Engineering Laboratory for Digital and Material Technology of Stomatology; Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health; Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Zhaoguo Yue
- Department of Periodontology, Peking University School and Hospital of Stomatology; National Engineering Laboratory for Digital and Material Technology of Stomatology; Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health; Beijing Key Laboratory of Digital Stomatology, No. 22, Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Jianzhang Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology; National Engineering Laboratory for Digital and Material Technology of Stomatology; Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health; Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Qi Liu
- BYBO Dental Hospital, Qinian Street, Dongcheng District, Beijing, 100062, People's Republic of China
| | - Zhongning Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology; National Engineering Laboratory for Digital and Material Technology of Stomatology; Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health; Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Lin Tang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology; National Engineering Laboratory for Digital and Material Technology of Stomatology; Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health; Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Jianxia Hou
- Department of Periodontology, Peking University School and Hospital of Stomatology; National Engineering Laboratory for Digital and Material Technology of Stomatology; Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health; Beijing Key Laboratory of Digital Stomatology, No. 22, Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.
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Ben Yehuda D, Weber H, Finkelman M, Sicilia E, Muftu A, Chochlidakis K, Papaspyridakos P. Accuracy of Guided Implant Surgery in 25 Edentulous Arches: A Laboratory Observational Study. J Prosthodont 2020; 29:718-724. [DOI: 10.1111/jopr.13224] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Daniel Ben Yehuda
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Hans‐Peter Weber
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Matthew Finkelman
- Department of Public Health and Community Service Tufts University School of Dental Medicine Boston MA
| | - Elena Sicilia
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | - Ali Muftu
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
| | | | - Panos Papaspyridakos
- Department of Prosthodontics Tufts University School of Dental Medicine Boston MA
- Department of Prosthodontics University of Rochester Eastman Institute for Oral Health Rochester NY
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Cascos-Sanchez R, Molinero-Mourelle P, Ortega R, Agustin-Panadero R, Del Rio Highsmith J, Gomez-Polo M. Comparative In Vitro Study of the Bond Strength of Composite to Carbon Fiber Versus Ceramic to Cobalt-Chromium Alloys Frameworks for Fixed Dental Prostheses. MATERIALS 2020; 13:ma13143173. [PMID: 32708580 PMCID: PMC7411726 DOI: 10.3390/ma13143173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 11/16/2022]
Abstract
Purpose: The aim of this comparative in vitro study was to assess the bond strength and mechanical failure of carbon-fiber-reinforced composites against cobalt–chrome structures with ceramic veneering. Materials and methods: A total of 24 specimens (12 per group) simulating dental prosthetic frameworks were fabricated. The experimental specimens were subjected to a thermocycling aging process and to evaluate bond strength. All specimens were subjected to a three-point bending test to fracture using a universal testing machine. Results: The cobalt–chrome/ceramic group yielded a bond strength value of 21.71 ± 2.16 MPa, while the carbon-fiber-reinforced composite group showed 14.50 ± 3.50 MPa. The failure assessment reported statistical significance between groups. Although carbon-fiber-reinforced composite group showed lower bond strength values, the chipping incidence in this group was as well lower. Conclusions: The chrome–cobalt/ceramic group showed greater bonding strength compared to the carbon-fiber-reinforced composite; most of the fractures within the cobalt–chrome/ceramic group, had no possibility of direct clinical repair.
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Affiliation(s)
- Rocio Cascos-Sanchez
- Department of Conservative Dentistry and Orofacial Prosthetics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthetics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
- Correspondence:
| | - Rocio Ortega
- Department of Prosthetic Dentistry, Faculty of Dentistry, European University of Madrid, 28670 Madrid, Spain;
| | - Ruben Agustin-Panadero
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain;
| | - Jaime Del Rio Highsmith
- Department of Conservative Dentistry and Orofacial Prosthetics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
| | - Miguel Gomez-Polo
- Department of Conservative Dentistry and Orofacial Prosthetics, Faculty of Dentistry, Complutense University of Madrid, 28040 Madrid, Spain; (R.C.-S.); (J.D.R.H.); (M.G.-P.)
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20
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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
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21
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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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22
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Papaspyridakos P, Bordin TB, Kim YJ, El-Rafie K, Pagni SE, Natto ZS, Teixeira ER, Chochlidakis K, Weber HP. Technical Complications and Prosthesis Survival Rates with Implant-Supported Fixed Complete Dental Prostheses: A Retrospective Study with 1- to 12-Year Follow-Up. J Prosthodont 2019; 29:3-11. [PMID: 31650669 DOI: 10.1111/jopr.13119] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2019] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To report the rate of technical complications and prosthesis survival in a cohort of edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of at least 1 year. MATERIALS AND METHODS The single-visit examination included clinical and radiographic assessment, occlusal analysis, photographs and questionnaire assessing patient satisfaction in a cohort of 52 patients rehabilitated with 71 IFCDPs (supported by 457 implants). The IFCDPs were assessed for technical complications, number of implants and cantilever extension, retention type and prosthetic material type. Comparison was made between ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). Kaplan-Meier survival curve analysis was carried out for assessment of prosthesis survival and was done for both Groups 1 and 2 separately. The Cox proportional hazard model was used for survival analysis, adjusting for a number of potential confounders, to evaluate the association between prosthesis survival and several risk factors such as type of opposing occlusion, nightguard use, and presence of bruxism. Responses to patient satisfaction questions were compared with Fisher's exact test. RESULTS Out of 71 edentulous arches (52 patients) restored with IFCDPs, 6 IFCDPs had failed, yielding a cumulative prosthesis survival rate of 91.6 % after a mean observation period of 5.2 years (range: 1-12 years) after definitive prosthesis insertion. Three IFCDPs were lost due to implant failures after 5.8 to 11 years of functional loading. Additionally, 3 metal-resin IFCDPs failed due to technical complications. Minor complications were the most frequent complications observed, namely wear of the prosthetic material (9.8% annual rate) being the most common, followed by decementation of cement-retained IFCDPs (2.9%), and loss of the screw access filing material of the screw-retained IFCDPs (2.7%). The most frequently observed major complication was fracture of the prosthetic material (1.9% annual rate), followed by fracture of occlusal screw (0.3%), and fracture of framework (0.3%). The annual rate of wear of prosthetic material was 7.3% for porcelain IFCDPs (n = 19/55) and 19.4% for metal-resin IFCDPs (n = 13/16), yielding a statistically significant difference between the 2 groups (p = 0.01). CONCLUSIONS After a mean exposure time of 5.2 years, 91.6% prosthesis survival rates were achieved (65 out of 71 IFCDPs). The most frequent minor technical complication was wear of the prosthetic material with estimated 5-year rate of 49.0%, while the most frequent major complication was fracture of the prosthetic material with estimated 5-year dental unit-based rate of 9.5%. The cumulative rates for "prosthesis free of minor complications" at 5- and 10-years were 60.5% (95% CI: 47.2-71.3%) and 8.9% (95% CI: 2.9-18.0%), respectively. The cumulative rates for "prosthesis free of major technical complications" at 5- and 10-years were 85.5% (95% CI: 73.0-92.5%) and 30.1% (95% CI: 12.0-50.6%), respectively. Presence of bruxism, and absence of a nightguard were associated with increased risk for chipping of the prosthetic material of the IFCDPs.
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Affiliation(s)
- Panos Papaspyridakos
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA.,Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY, USA
| | - Thaisa Barizan Bordin
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA.,Department of Prosthodontics, Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Yong-Jeong Kim
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Khaled El-Rafie
- Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
| | - Sarah E Pagni
- Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, MA, USA
| | - 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, USA
| | - Eduardo Rolim Teixeira
- Department of Prosthodontics, Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY, USA
| | - Hans-Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA, USA
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23
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Mori G, Iwai K, Oda Y, Furuya Y, Yajima Y. Full-Arch Implant-Supported Fixed Dental Prosthesis Retained by a Combination of Galvano-Telescopic Copings and Screws: A Clinical Report. J Prosthodont 2019; 28:947-950. [PMID: 31642562 DOI: 10.1111/jopr.13117] [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: 10/07/2019] [Indexed: 11/28/2022] Open
Abstract
Full-arch screw-retained implant-supported fixed dental prostheses have a high long-term success rate and are considered the gold standard by many clinicians. However, accurate fabrication of a passive fit long-span prosthesis can be challenging. A novel intraoral adhesion method using galvano-telescopic copings was proposed as a way of improving prosthetic fit for edentulous patients. This report describes the treatment of a 74-year-old female with a full-arch implant-supported dental prosthesis, supported by a combination of galvano-telescopic copings and screws to prevent retention loss. Four years have passed since this superstructure was placed, during this time she exhibited a good clinical course with no inflammation noted in surrounding tissues. Treatment with an implant-supported fixed dental prosthesis, retained by a combination of galvano-telescopic copings and screws, can be a useful alternative treatment for edentulous patients.
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Affiliation(s)
- Gentaro Mori
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Kazuya Iwai
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Yukari Oda
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Yoshitaka Furuya
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Yasutomo Yajima
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
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24
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Papaspyridakos P, Bordin TB, Natto ZS, El-Rafie K, Pagni SE, Chochlidakis K, Ercoli C, Weber HP. Complications and survival rates of 55 metal-ceramic implant-supported fixed complete-arch prostheses: A cohort study with mean 5-year follow-up. J Prosthet Dent 2019; 122:441-449. [PMID: 30982622 DOI: 10.1016/j.prosdent.2019.01.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 01/23/2019] [Accepted: 01/23/2019] [Indexed: 12/20/2022]
Abstract
STATEMENT OF PROBLEM Long-term outcomes with metal-ceramic (MC) implant-supported fixed complete dental prostheses (IFCDPs) are scarce. PURPOSE The purpose of this retrospective study was to assess the rate of biologic and technical complications in a cohort of edentulous patients treated with MC IFCDPs by residents after a mean clinical follow-up of 5 years (range: 1 to 12 years). MATERIAL AND METHODS Forty-one participants with 55 MC IFCDPs underwent a single-visit comprehensive examination that included a medical and dental history review and clinical and radiographic examinations. All supporting implants and prostheses were examined for biologic and technical complications. Life table analysis and Kaplan-Meier survival curves were calculated. RESULTS Of 359 moderately rough surface dental implants, 2 had failed in 1 patient after 11 years of functional loading, yielding a cumulative implant survival rate of 99.4%. Owing to the implant failure, 1 of 55 edentulous arches restored with IFCDPs failed, yielding a cumulative prosthesis survival rate of 98.2% after mean observation period of 5.0 years. Soft tissue recession was the most frequent minor biologic complication (annual rate 7.8% at the prosthesis level) for both cement and screw-retained IFCDPs (group C and S), and peri-implantitis (annual rate 1.6% at the implant level) the most frequent major biologic complication. Wear of porcelain (annual rate 8.0% at the prosthesis level) was the most frequent minor technical complication for both groups, and fracture of porcelain (annual rate 0.8% at the dental-unit level) was the most frequent major technical complication. Minor complications were the most frequent in both the groups (cement and screw retained). CONCLUSIONS High implant and prosthesis survival rates (above 98%) were achieved, yet substantial complication rates were encountered. The most frequent major biologic complication was peri-implantitis, with a 5-year implant-based rate of 8% (95% confidence interval [CI]: 5.8-11.1), whereas the most frequent major complication was fracture of porcelain with a 5-year dental unit-based rate of 4%. The estimated cumulative rates for "prosthesis free of biologic complications" were 50.4% (95% CI: 36.4% to 63.0%) at 5 years and 10.1% (95% CI: 3.5% to 20.8%) at 10 years, whereas for "prosthesis free of technical complications," they were 56.4% (95% CI: 41.7% to 68.8%) at 5 years and 9.8% (95% CI: 3.2% to 21.0%) at 10 years.
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Affiliation(s)
- Panos Papaspyridakos
- Assistant Professor, Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass; Visiting Assistant Professor, Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY.
| | - Thaisa Barizan Bordin
- Assistant Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass; Instructor, Department of Prosthodontics, Postgraduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Zuhair S Natto
- Assistant Professor, Department of Dental Public Health, King Abdulaziz University, Jeddah, Saudi Arabia; Adjunct Assistant Professor, Department of Periodontology, Tufts University School of Dental Medicine, Boston, Mass
| | - Khaled El-Rafie
- Assistant Professor, Division of Postgraduate Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Sarah E Pagni
- Statistician, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, Mass
| | - Konstantinos Chochlidakis
- Assistant Professor and Program Director, Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Carlo Ercoli
- Professor and Chair, Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Hans-Peter Weber
- Professor, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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