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Lv X, Pu Y, Zhang X, Jiang X, Zhang X, Shi J, Lai H. One-piece versus two-piece zirconia abutment supported single implant crown in the esthetic region: 3-Year results from a split-mouth randomized controlled clinical trial. Clin Oral Implants Res 2023; 34:1330-1341. [PMID: 37655630 DOI: 10.1111/clr.14173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 08/06/2023] [Accepted: 08/13/2023] [Indexed: 09/02/2023]
Abstract
OBJECTIVES To compare the clinical, radiographic, and immunological outcomes between one-piece versus two-piece zirconia abutments supported single implant crowns in the esthetic region. MATERIALS AND METHODS The study followed a split-mouth, double-blind, and randomized controlled clinical design for a duration of 3 years. Twenty-two eligible patients with 44 implants were randomly assigned to two groups: Group 1 (one-piece zirconia abutment with zirconia base, n = 22) and Group 2 (two-piece zirconia abutment with titanium base, n = 22). The primary outcome was the technical complication rate. Additionally, survival rates, cytokines concentrations in peri-implant crevicular fluid (PICF), peri-implant conditions, marginal bone loss, and pink/white esthetics score (PES/WES) were assessed as secondary outcomes. RESULTS Twelve of 22 patients attended the 1-year follow-up (due to the COVID pandemic), and 19 patients attended the 3-year examination. Two abutments in Group 1 were fractured after 10 and 12 months in function. Additionally, one screw loosening occurred in Group 1 at 1-year follow-up. The 3-year technical complication rate was significantly higher in Group 1 than that in Group 2 (15.79% vs. 0%, p < .001). The 3-year implant survival rate was 100% in both groups. The concentration of IFN-γ in PICF was significantly upregulated in Group 2 (p = .018). Furthermore, the IL-6 concentration was positively correlated with BOP% (p = .020). CONCLUSIONS Two-piece zirconia abutments exhibited superior technical performance compared to one-piece designs during a 3-year follow-up in the anterior region. However, further long-term research is necessary to verify the immunological stability of two-piece zirconia abutments.
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Affiliation(s)
- Xiaolei Lv
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yiping Pu
- Department of Oral Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillo-facial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China
| | - Xiaomeng Zhang
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xue Jiang
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xiao Zhang
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Junyu Shi
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Hongchang Lai
- Department of Oral and Maxillo-facial Implantology, Shanghai Key Laboratory of Stomatology, National Clinical Research Center for Stomatology, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
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Suzumura T, Matsuura T, Komatsu K, Sugita Y, Maeda H, Ogawa T. Vacuum Ultraviolet (VUV) Light Photofunctionalization to Induce Human Oral Fibroblast Transmigration on Zirconia. Cells 2023; 12:2542. [PMID: 37947620 PMCID: PMC10647316 DOI: 10.3390/cells12212542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
Soft tissue adhesion and sealing around dental and maxillofacial implants, related prosthetic components, and crowns are a clinical imperative to prevent adverse outcomes of periodontitis and periimplantitis. Zirconia is often used to fabricate implant components and crowns. Here, we hypothesized that UV treatment of zirconia would induce unique behaviors in fibroblasts that favor the establishment of a soft tissue seal. Human oral fibroblasts were cultured on zirconia specimens to confluency before placing a second zirconia specimen (either untreated or treated with one minute of 172 nm vacuum UV (VUV) light) next to the first specimen separated by a gap of 150 µm. After seven days of culture, fibroblasts only transmigrated onto VUV-treated zirconia, forming a 2.36 mm volume zone and 5.30 mm leading edge. Cells migrating on VUV-treated zirconia were enlarged, with robust formation of multidirectional cytoplastic projections, even on day seven. Fibroblasts were also cultured on horizontally placed and 45° and 60° tilted zirconia specimens, with the latter configurations compromising initial attachment and proliferation. However, VUV treatment of zirconia mitigated the negative impact of tilting, with higher tilt angles increasing the difference in cellular behavior between control and VUV-treated specimens. Fibroblast size, perimeter, and diameter on day seven were greater than on day one exclusively on VUV-treated zirconia. VUV treatment reduced surface elemental carbon and induced superhydrophilicity, confirming the removal of the hydrocarbon pellicle. Similar effects of VUV treatment were observed on glazed zirconia specimens with silica surfaces. One-minute VUV photofunctionalization of zirconia and silica therefore promotes human oral fibroblast attachment and proliferation, especially under challenging culture conditions, and induces specimen-to-specimen transmigration and sustainable photofunctionalization for at least seven days.
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Affiliation(s)
- Toshikatsu Suzumura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Takanori Matsuura
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Keiji Komatsu
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
| | - Yoshihiko Sugita
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Hatsuhiko Maeda
- Department of Oral Pathology/Forensic Odontology, School of Dentistry, Aichi Gakuin University, Nagoya 464-8650, Japan
| | - Takahiro Ogawa
- Weintraub Center for Reconstructive Biotechnology, Division of Regenerative and Reconstructive Sciences, UCLA School of Dentistry, Los Angeles, CA 90095-1668, USA
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Del Castillo R, Gutiérrez-Garrido L, Padial-Molina M, Galindo-Moreno P. Screw-retained internal connection zirconia CAD-CAM abutments in single implant reconstructions: Results of a 1-year prospective case series study. J Prosthodont 2023; 32:679-688. [PMID: 36882991 DOI: 10.1111/jopr.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 03/09/2023] Open
Abstract
PURPOSE To evaluate the clinical and radiographic outcomes of single-tooth implant restorations using one-piece, internally connected, screw-retained, computer-aided design and computer-aided manufactured monolithic zirconia restorations fabricated on regular diameter implants. MATERIAL AND METHODS Following a 2-stage surgical procedure, 22 implants placed in anterior and posterior areas in 21 partially edentulous patients (mean age of 55 years; 9 males/12 females) were evaluated in terms of plaque index, pocket probing depth, bleeding on probing, level of oral hygiene (OH), signs of mucositis/peri-implantitis, esthetic score (ES), gingival zenith position (GZP), papilla index score, the thickness of peri-implant gingiva, radiographic marginal bone loss, and technical complications. Implants and restorations were prospectively followed from the insertion of the restoration (baseline), up to 12-months post-loading. RESULTS A 100% implant survival rate resulted after loading; one implant was lost before loading. Clinically, patients performed an adequate OH, and tissues were kept healthy. Probing depth showed a slightly lower value at baseline compared to any follow-up examination (2.26 [0.94] at baseline vs. 2.53 [0.66] mm at 12 months). ES, GZP, and the thickness of the peri-implant gingiva improved throughout the course of the study. Radiographically, average marginal bone level (MBL) was 0.40 (0.40) mm after 1-year follow-up with no differences in average MBL at all time points. Technically, after 1 year of clinical function, neither abutment fracture nor any other serious complications occurred. Hence, prosthetic reconstruction survival rate was 100%. CONCLUSIONS Clinical outcomes of single-tooth implant restorations using internally connected, screw-retained, computer-aided design and computer-aided manufacturing monolithic zirconia abutments can be considered a reliable treatment alternative after 1-year clinical observation.
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Affiliation(s)
- Rafael Del Castillo
- Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York, USA
| | | | - Miguel Padial-Molina
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria., IBS, University of Granada., Granada, Spain
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria., IBS, University of Granada., Granada, Spain
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Huang C, Miao X, Li J, Liang J, Xu J, Wu Z. Promoted Abutment-Soft Tissue Integration Around Self-Glazed Zirconia Surfaces with Nanotopography Fabricated by Additive 3D Gel Deposition. Int J Nanomedicine 2023; 18:3141-3155. [PMID: 37333732 PMCID: PMC10276606 DOI: 10.2147/ijn.s404047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/01/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Improving the biological sealing around dental abutments could promote the long-term success of implants. Although titanium abutments have a wide range of clinical applications, they incur esthetic risks due to their color, especially in the esthetic zone. Currently, zirconia has been applied as an esthetic alternative material for implant abutments; however, zirconia is purported to be an inert biomaterial. How to improve the biological activities of zirconia has thus become a popular research topic. In this study, we presented a novel self-glazed zirconia (SZ) surface with nanotopography fabricated by additive 3D gel deposition and investigated its soft tissue integration capability compared to that of clinically used titanium and polished conventional zirconia surfaces. Materials and Methods Three groups of disc samples were prepared for in vitro study and the three groups of abutment samples were prepared for in vivo study. The surface topography, roughness, wettability and chemical composition of the samples were examined. Moreover, we analyzed the effect of the three groups of samples on protein adsorption and on the biological behavior of human gingival keratinocytes (HGKs) and human gingival fibroblasts (HGFs). Furthermore, we conducted an in vivo study in which the bilateral mandibular anterior teeth of rabbits were extracted and replaced with implants and corresponding abutments. Results The surface of SZ showed a unique nanotopography with nm range roughness and a greater ability to absorb protein. The promoted expression of adhesion molecules in both HGKs and HGFs was observed on the SZ surface compared to the surfaces of Ti and PCZ, while the cell viability and proliferation of HGKs and the number of HGFs adhesion were not significant among all groups. In vivo results showed that the SZ abutment formed strong biological sealing at the abutment-soft tissue interface and exhibited markedly more hemidesmosomes when observed with a transmission electron microscope. Conclusion These results demonstrated that the novel SZ surface with nanotopography promoted soft tissue integration, suggesting its promising application as a zirconia surface for the dental abutment.
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Affiliation(s)
- Chaoyi Huang
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, People’s Republic of China
| | - Xinchao Miao
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, People’s Republic of China
| | - Jiang Li
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, People’s Republic of China
| | - Jieyi Liang
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, People’s Republic of China
| | - Junxi Xu
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, People’s Republic of China
| | - Zhe Wu
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, People’s Republic of China
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Takano R, Honda J, Kobayashi T, Kubochi K, Takata H, Komine F. Fracture strength of implant-supported hybrid abutment crowns in premolar region fabricated using different restorative CAD/CAM materials. Dent Mater J 2023; 42:187-192. [PMID: 36476684 DOI: 10.4012/dmj.2022-165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The present study investigated the fracture strength of hybrid abutment crowns (HACs) in the premolar region that were fabricated with different restorative computer-aided design/computer-aided manufacturing (CAD/CAM) materials. The abutment-implant structures were randomly assigned into four groups (n=11 per group): bi-layered zirconia restorations (BL), translucent zirconia (4Y-PSZ) restorations (TZ), lithium disilicate ceramic restorations (LD), and dispersed nanoparticle-filled composite resin restorations (CM). All restorations were adhesively bonded to the titanium abutments. After the restoration-abutment complex was tightened onto the implant, the fracture strength was measured. The TZ (2.06 kN) and LD (1.87 kN) groups had significantly higher median fracture strengths than the BL (1.12 kN) and CM (1.10 kN) groups. In terms of fracture resistance, the 4Y-PSZ and lithium disilicate ceramic monolithic restorations would be superior to bi-layered 3Y-TZP and composite resin monolithic restorations for HACs in the premolar region.
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Affiliation(s)
- Ryoki Takano
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Junichi Honda
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Tatsuro Kobayashi
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Kei Kubochi
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Hiroki Takata
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
| | - Futoshi Komine
- Department of Fixed Prosthodontics, Nihon University School of Dentistry
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Saponaro PC, Karasan D, Donmez MB, Johnston WM, Yilmaz B. Prosthetic complications with monolithic or micro-veneered implant-supported zirconia single-unit, multiple-unit, and complete-arch prostheses on titanium base abutments: A single center retrospective study with mean follow-up period of 72.35 months. Clin Implant Dent Relat Res 2023; 25:99-106. [PMID: 36321480 DOI: 10.1111/cid.13149] [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: 06/29/2022] [Revised: 09/13/2022] [Accepted: 10/14/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The influence of prosthetic design on prosthetic complications when monolithic or micro-veneered zirconia prostheses are supported with titanium base (ti-base) abutments is not well-known. PURPOSE The purpose of this single center, retrospective study was to assess the prevalence of prosthetic complications with monolithic or micro-veneered single-unit, multi-unit, and complete-arch zirconia prostheses supported with ti-base abutments (implant level or multi-unit abutment level). MATERIAL AND METHODS This study retrospectively evaluated the electronic health record (EHR) of participants who received either monolithic or micro-veneered implant-supported single-unit, multi-unit, and/or complete-arch prostheses supported by ti-base or zirconia-ti-base hybrid abutments delivered between the years 2010 and 2021. Data were analyzed by using logistic regression and Exact Mantel-Haenszel chi-square test (α = 0.05) to assess the clinical performance of prostheses and complications including crown decementation, feldspathic porcelain chipping, prosthesis fracture, zirconia-ti-base hybrid abutment decementation, abutment screw loosening, screw fracture, abutment fracture, implant loss, and prosthesis remake. RESULTS The study included 94 participants (50 female, 44 male) with a mean age of 59.5 years (range: 24-101 years of age). The retrospective EHR evaluation yielded 82 single-unit, 51 multi-unit, and 20 complete-arch prostheses on 325 implants. Among 153 prostheses delivered, 108 were micro-veneered (47 single-unit, 41 multi-unit, and 20 complete-arch prostheses) and 45 were monolithic. The average duration was 72.35 months (6.02 years) with a follow-up period of 5-132 months. From the time of insertion to the time of EHR review, of 153 prostheses, 78.43% did not exhibit any prosthetic complication. However, 33 prostheses (21.57%) from 29 participants (30.85%) had at least one prosthetic complication. Only four patients (4.25%) experienced two or more prosthetic complications. Prosthetic design affected the probability of having a complication (p = 0.005); complete-arch prostheses had higher probability (p ≤ 0.028). Single-unit prostheses had lower probability of complication than multi-unit prostheses (p = 0.005). The most commonly observed complication was fracture of veneering material (5.88%) followed by prosthetic screw loosening (4.57%) and decementation between the zirconia and the ti-base abutment (2.61%). Micro-veneered complete-arch prostheses had higher probability of having chipping than that of not having (p < 0.001), and other micro-veneered prosthetic designs had similar probability of chipping with that of complete-arch prostheses (p ≥ 0.082). Frequency of chipping was affected by veneering (p < 0.001). Monolithic prostheses had lower probability of chipping than micro-veneered prostheses, regardless of the prosthetic design (p < 0.001). CONCLUSIONS The frequency of prosthetic complications varied depending on prosthetic design. Complete-arch prostheses had the highest probability of complications while the single-unit prostheses had the lowest. Micro-veneered prostheses had higher probability for chipping than monolithic prostheses. Probability of chipping was similar for micro-veneered single-unit, multi-unit, and complete-arch zirconia prostheses.
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Affiliation(s)
- Paola C Saponaro
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Duygu Karasan
- Division of Fixed Prosthodontics and Biomaterials, University Clinics for Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Mustafa Borga Donmez
- Department of Prosthodontics, Faculty of Dentistry, Istinye University, Istanbul, Turkey.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - William Michael Johnston
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA
| | - Burak Yilmaz
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, Ohio, USA.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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Duan C, Ye L, Zhang M, Yang L, Li C, Pan J, Wu Y, Cao Y. Clinical performance of zirconium implants compared to titanium implants: a systematic review and meta-analysis of randomized controlled trials. PeerJ 2023; 11:e15010. [PMID: 36949758 PMCID: PMC10026713 DOI: 10.7717/peerj.15010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/16/2023] [Indexed: 03/19/2023] Open
Abstract
Purpose To quantitatively assess and compare the clinical outcomes, including survival rate, success rate, and peri-implant indices of titanium and zirconium implants in randomized controlled trials. Methods The electronic databases searched included the Cochrane Central Register of Controlled Trials (CENTRAL), Medline via Ovid, EMBASE, and Web of Science. Randomized controlled trials (RCTs) that reported the effects of zirconium implants on primary outcomes, such as survival rate, success rate, marginal bone loss (MBL), and probing pocket depth (PPD), compared to titanium implants were included in this review. Two reviewers independently screened and selected the records, assessed their quality, and extracted the data from the included studies. Results A total of four studies from six publications reviewed were included. Two of the comparative studies were assessed at minimal risk of bias. Zirconium implants may have a lower survival rate (risk ratio (RR) = 0.91, CI [0.82-1.02], P = 0.100, I 2 = 0%) and a significantly lower success rate than titanium implants (RR = 0.87, CI [0.78-0.98], P = 0.030, I 2 = 0%). In addition, there was no difference between the titanium and zirconium implants in terms of MBL, PPD, bleeding on probing (BOP), plaque index (PI), and pink esthetic score (PES) (for MBL, MD = 0.25, CI [0.02-0.49], P = 0.033, I 2 = 0%; for PPD, MD = -0.07, CI [-0.19-0.05], P = 0.250, I 2 = 31%). Conclusion Zirconium implants may have higher failure rates due to their mechanical weakness. Zirconium implants should be strictly assessed before they enter the market. Further studies are required to confirm these findings.
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Affiliation(s)
- Chengchen Duan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China College of Stomatology, Sichuan University, Chengdu, China
| | - Li Ye
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Mengyun Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China College of Stomatology, Sichuan University, Chengdu, China
| | - Lei Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China College of Stomatology, Sichuan University, Chengdu, China
| | - Chunjie Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jian Pan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yingying Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yubin Cao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Halim FC, Pesce P, De Angelis N, Benedicenti S, Menini M. Comparison of the Clinical Outcomes of Titanium and Zirconia Implant Abutments: A Systematic Review of Systematic Reviews. J Clin Med 2022; 11:jcm11175052. [PMID: 36078982 PMCID: PMC9456707 DOI: 10.3390/jcm11175052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Dental implants are widely used and in order to answer to esthetic demands, zirconia has been introduced as an abutment material as an alternative to titanium. Several studies have been published on this topic, but the results have been often inconsistent. The objective of the present study is to systematically analyze the existing literature comparing clinical outcomes of titanium and zirconia implant abutments. The study was designed as a systematic review of systematic reviews. Methods: This systematic review is in accordance with the Transparent Reporting of Systematic Reviews and Meta-analyses. A MEDLINE/PubMed, Cochrane Database of Systematic Reviews and SCOPUS literature search was performed up to and including June 2021. Data were extracted independently by two reviewers and tAMSTAR2 was used to assess the quality of the systematic reviews. Results: The electronic search identified 1146 papers, and 175 duplicates were removed. After manual screening, 954 studies were excluded and the final analysis was conducted on 11 papers. Both mechanical and esthetic outcomes and biological complications were analyzed. Conclusions: It can be concluded that titanium abutments have a better mechanical resistance than zirconia ones. Plaque accumulation is reported to be slightly higher on titanium but without any significant inflammatory process. The esthetic outcomes seem to be more related to the thickness (>3 mm) of the soft tissues than to the abutment material.
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Affiliation(s)
| | - Paolo Pesce
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
| | - Nicola De Angelis
- Division of Restorative Dentistry and Endodontics, Department of Surgical Sciences (DISC), University of Genoa, 16126 Genoa, Italy
- Dental Department, University Tunku Abdul Raman, Sungai Buloh 47000, Malaysia
- Dental Department, University Trisakti, Jakarta 11440, Indonesia
- Correspondence:
| | - Stefano Benedicenti
- Division of Restorative Dentistry and Endodontics, Department of Surgical Sciences (DISC), University of Genoa, 16126 Genoa, Italy
| | - Maria Menini
- Division of Prosthodontics and Implant Prosthodontics, Department of Surgical Sciences (DISC), University of Genoa, 16132 Genoa, Italy
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9
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Enkling N, Marder M, Bayer S, Götz W, Stoilov M, Kraus D. Soft tissue response to different abutment materials: A controlled and randomized human study using an experimental model. Clin Oral Implants Res 2022; 33:667-679. [PMID: 35467040 DOI: 10.1111/clr.13932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 02/01/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Aim of this study was to compare the soft-tissue response to implant abutments made of titanium, zirconia, zirconia veneered with feldspar ceramics and PEEK by various clinical, histological, microbiological and molecular biological markers in an experimental model. MATERIALS AND METHODS 40 experimental one-piece healing abutments of four different materials were mounted on bone-level implants in 20 volunteering patients (split-mouth design). After a three months period of open healing, clinical parameters at the abutments were assessed and adjacent mucosa was sampled for inflammatory cytokine mRNA-concentrations and histological analysis by a novel method. In addition, PISF-samples were obtained for the analysis of periodonto-pathogenic bacteria counts and active MMP-8 levels. Marginal bone level change was measured by intra oral radiographs. RESULTS Abutments of the different materials did not exhibit significant differences regarding clinical parameters, pathogenic bacteria counts or pro-inflammatory cytokine concentrations. Likewise, no significant differences were detected regarding soft tissue morphology or bone level change. Compared to titanium abutments, significantly less mononuclear inflammatory cells were detected in the mucosa at abutments made of zirconia veneered with feldspar ceramics. CONCLUSIONS All examined abutment materials exhibited a similar soft tissue response compared to titanium and histological data did not reveal early signs of elevated inflammation caused by PEEK- and feldspar-veneered zirconia abutments. Due to the short observation period and the small sample size, a final conclusion on the long term suitability of those abutment materials cannot be drawn. However, based on the presented data, we consider further studies on that subject as appropriate.
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Affiliation(s)
- Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Material Sciences, University of Bonn.,Department of Reconstructive Dentistry and Gerodontology, University of Bern
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Material Sciences, University of Bonn
| | - Stefan Bayer
- Department of Prosthodontics, Preclinical Education and Material Sciences, University of Bonn
| | - Werner Götz
- Department of Orthodontics, University of Bonn
| | - Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Material Sciences, University of Bonn
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Material Sciences, University of Bonn
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Shear Bond Strength of Lithium Disilicate Bonded with Various Surface-Treated Titanium. Int J Dent 2022; 2022:4406703. [PMID: 35437442 PMCID: PMC9013295 DOI: 10.1155/2022/4406703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/01/2022] [Accepted: 03/28/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose Retention is one of the most important factors for fixed dental prostheses, especially in implant dentistry. Accordingly, the goal of this study was to evaluate the level of shear bond strength between titanium (Ti) subjected to different surface treatments and lithium disilicate glass-ceramics. Materials and Methods In this work, 90 titanium alloy specimens were divided into six groups as follows: the control group (CT), 50 μm alumina airborne-particle abrasion group (SB), silica-coated group (CJ), anodization group (AN), anodization followed by alumina 50 μm airborne-particle abrasion group (ANSB), and anodization followed by silica coating group (ANCJ). Titanium specimens were bonded to lithium disilicate specimens with resin cement (Multilink N). The specimens were restored in water at 37°C for 24 h, and then, shear bond strength (SBS) tests were performed using a universal testing machine (Shimadzu, Japan). The SBS values were statistically analyzed. The failure mode of the debonded titanium was classified after viewing the samples under a stereoscope. Results The results demonstrated that the mean SBSs of CT and AN were significantly lower than those of the other groups (p < 0.05). The SB group showed the highest SBS (29.47 ± 2.41 MPa); however, there was no significant difference between SB, ANSB, ANCJ, and CJ. The stereoscopic analysis demonstrated that the failure mode of AN was predominantly adhesive failure; whereas, the other groups showed cohesive and mixed failures. Conclusions In this study, it was found that the surface treatment with 50 μm alumina airborne-particle abrasion, silica coating with Cojet™ sand, anodization followed by 50 μm alumina airborne-particle abrasion, and anodization followed by silica coating with Cojet™ sand improved the SBS between titanium and lithium disilicate luted with Multilink N resin cement.
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11
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Wear particle release at the interface of dental implant components: Effects of different material combinations. An in vitro study. Dent Mater 2022; 38:508-516. [DOI: 10.1016/j.dental.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022]
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Hanes B, Feitosa S, Phasuk K, Levon JA, Morton D, Lin WS. Fracture Resistance Behaviors of Titanium-Zirconium and Zirconia Implants. J Prosthodont 2021; 31:441-446. [PMID: 34632673 DOI: 10.1111/jopr.13440] [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: 10/03/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the fracture resistance behaviors of titanium-zirconium, one-piece zirconia, and two-piece zirconia implants restored by zirconia crowns and different combinations of abutment materials (zirconia and titanium) and retention modes (cement-retained and screw-retained zirconia crowns). MATERIAL AND METHODS Three research groups (n=12) were evaluated according to combinations of abutment material, retention mode, and implant type. In the control group (TTC), titanium-zirconium implants (∅ 4.1 mm RN, 12 mm, Roxolid; Straumann USA, Andover, MA) and prefabricated titanium abutments (RN synOcta Cementable Abutment, H 5.5 mm; Straumann USA) were used to support cement-retained zirconia crowns. In the second group (ZZC), one-piece zirconia implants (PURE Ceramic Implant Monotype, ∅ 4.1 mm RD, 12 mm, AH 5.5 mm; Straumann USA) were used to support cement-retained zirconia crowns. In the third group (ZTS), two-piece zirconia implants (PURE Ceramic Implant, ∅ 4.1 mm RD, 12 mm) and prefabricated titanium abutments (CI RD PUREbase Abutment, H 5.5 mm) were used to support screw-retained zirconia crowns. All zirconia crowns were manufactured in the same anatomic contour with a 5-axis dental mill and blended 3 and 5 mol% yttria-stabilized zirconia (LayZir A2). Implants were inserted into specimen holders made of epoxy resin-glass fiber composite. All specimens were then subject to artificial aging in an incubator at 37°C for 90 days. Fracture resistance of specimen assemblies was tested under static compression load using the universal testing machine based on ISO14801 specification. The peak fracture loads were recorded. All specimens were examined at the end of the test microscopically at 5× and 10× magnification to detect any catastrophic failures. Comparisons between groups for differences in peak fracture load were made using Wilcoxon Rank Sum tests and Weibull and Kaplan-Meier survival analyses (α = 0.05). RESULTS The TTC group (942 ± 241 N) showed significantly higher peak fracture loads than the ZZC (645 ± 165 N) and ZTS (650 ± 124 N) groups (p < 0.001), while there was no significant difference between ZZC and ZTS groups (p = 0.940). The survival probability based on the Weibull and Kaplan-Meier models demonstrated different failure molds between titanium-zirconium and zirconia implants, in which the TTC group remained in the plastic strain zone for a longer period before fracture when compared to ZZC and ZTS groups. Catastrophic failures, with implant fractures at the embedding level or slightly below, were only observed in the ZZC and ZTS groups. CONCLUSIONS Cement-retained zirconia crowns supported by titanium-zirconium implants and prefabricated titanium abutments showed superior peak fracture loads and better survival probability behavior. One-piece zirconia implants with cement-retained zirconia crowns and two-piece zirconia implants with screw-retained zirconia crowns on prefabricated titanium abutment showed similar peak fracture loads and survival probability behavior. Titanium-zirconium and zirconia implants could withstand average intraoral mastication loads in the incisor region. This study was conducted under static load, room temperature (21.7°C), and dry condition, and full impacts of intraoral hydrothermal aging and dynamic loading conditions on the zirconia implants should be considered and studied further.
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Affiliation(s)
- Brenda Hanes
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN
| | - Sabrina Feitosa
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, IN
| | - Kamolphob Phasuk
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN
| | - John A Levon
- Department of Prosthodontic Dentistry, Indiana University School of Dentistry, Indianapolis, IN
| | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN
| | - Wei-Shao Lin
- Advanced Education Program in Prosthodontics, Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, IN
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Totou D, Naka O, Mehta SB, Banerji S. Esthetic, mechanical, and biological outcomes of various implant abutments for single-tooth replacement in the anterior region: a systematic review of the literature. Int J Implant Dent 2021; 7:85. [PMID: 34494174 PMCID: PMC8423965 DOI: 10.1186/s40729-021-00370-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background The choice of the appropriate implant abutment is a critical step for a successful outcome. Titanium abutments have demonstrated high survival rates, due to their excellent biocompatibility and high mechanical strength, although they often result in a grayish discoloration of the peri-implant mucosa. This esthetic concern culminated in the introduction of ceramic abutments. The aim of this review was to assess the esthetic, mechanical, and biological outcomes as well as the survival of the different types of abutments used for single-implant restorations in the anterior area. Material and methods An electronic search was conducted in Medline, Embase, and Cochrane Central databases using the appropriate Mesh terms and predetermined eligibility criteria. The quality of the studies was assessed using the ROB 2 tool. The last search was conducted on 18th of March 2020. Results From the 2074 records initially identified, 23 randomized controlled trials (32 publications) were included for qualitative analysis. Data were classified based on study information, specific characteristics of the intervention and comparator, and information related to the outcome measures. Seven studies exhibited an overall low risk of bias, while twelve studies raised some concerns. Conclusions The rate of abutment failure was low and was associated with the ceramic abutments, especially those with internal connection. Limited correlation was noted between soft tissue thickness and color difference. Titanium abutments caused significantly more discoloration to the soft tissues than ceramic abutments, while hueing (gold or pink) slightly improved their color performance. Zirconia allowed a better color match than titanium or gold abutments, still discolored slightly the soft tissues. The submucosally modified zirconia abutments exhibited encouraging results. No significant difference was reported between materials or different types of retention on recession, papillary fill, and biological outcomes.
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Affiliation(s)
- Dimitra Totou
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
| | - Olga Naka
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK. .,School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Shamir B Mehta
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
| | - Subir Banerji
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
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Lorusso F, Noumbissi S, Francesco I, Rapone B, Khater AGA, Scarano A. Scientific Trends in Clinical Research on Zirconia Dental Implants: A Bibliometric Review. MATERIALS 2020; 13:ma13235534. [PMID: 33291827 PMCID: PMC7730252 DOI: 10.3390/ma13235534] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/29/2020] [Accepted: 12/02/2020] [Indexed: 12/13/2022]
Abstract
Background: The clinical use of zirconia implants has been shown to increase steadily due to their biological, aesthetic, and physical properties; therefore, this bibliometric study aimed to review the clinical research and co-authors in the field of zirconia dental implant rehabilitation. Methods: We searched Scopus and Web of Science databases using a comprehensive search strategy to 5 October 2020, and independently paired reviewers who screened studies, and collected data with inclusion criteria restricted to clinical research only (either prospective or retrospective). Data on article title, co-authors, number of citations received, journal details, publication year, country and institution involved, funding, study design, marginal bone loss, survival rate, failure, follow-up, and the author’s bibliometric data were collected and evaluated. Results: A total of 29 clinical studies were published between 2008 and 2020 as 41.4% were prospective cohort studies and 48.3% originated from Germany. Most of the included studies had been published in Clinical Oral Implant Research (n = 12), and the most productive institution was the Medical Center of University of Freiburg. The author with the largest number of clinical studies on zirconia implants was Kohal R.J. (n = 10), followed by Spies B.C. (n = 8). Conclusions: This study revealed that zirconia implants have been more prominent in the last ten years, which is a valuable option for oral rehabilitation with marginal bone loss and survival rate comparable to titanium dental implants.
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Affiliation(s)
- Felice Lorusso
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy; (F.L.); (S.N.)
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA
| | - Sammy Noumbissi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy; (F.L.); (S.N.)
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA
| | - Inchingolo Francesco
- Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Biagio Rapone
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, 70121 Bari, Italy;
| | - Ahmad G. A. Khater
- Faculty of Oral and Dental Medicine, Ahram Canadian University, 6th of October City, 8655 Giza, Egypt;
| | - Antonio Scarano
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Via dei Vestini, 31, 66100 Chieti, Italy; (F.L.); (S.N.)
- Zirconia Implant Research Group (Z.I.R.G), International Academy of Ceramic Implantology, Silver Spring, MD 20910, USA
- Correspondence: ; Tel.: +39-0871-355-4084; Fax: +39-0871-355-4099
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de Paula Miranda RB, Leite TP, Pedroni ACF, Marques MM, de Lima NB, Marchi J, Cesar PF. Effect of titania addition and sintering temperature on the microstructure, optical, mechanical and biological properties of the Y-TZP/TiO 2 composite. Dent Mater 2020; 36:1418-1429. [PMID: 32958310 DOI: 10.1016/j.dental.2020.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/16/2020] [Accepted: 08/29/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aims of this study were: 1) to evaluate the effect of sintering temperature on microstructure, density and flexural strength of a 3Y-TZP/TiO2 composite containing 12.5 wt% of TiO2 compared to 3Y-TZP specimens (control); 2) to compare 3Y-TZP with the experimental 3Y-TZP/TiO2 composite, both sintered at 1400 °C, with respect to the following parameters: optical properties, characteristic strength, Weibull modulus, fatigue behavior, induction of osteoblasts proliferation and differentiation (mineralization nodules formation). METHODS The 3Y-TZP and 3Y-TZP/TiO2 powders were uniaxially pressed and sintered at 1200 °C, 1300 °C, 1400 °C or 1500 °C for one hour in a furnace. The microstructural analysis consisted of X-ray diffraction and scanning electron microscopy. The density was measured by the Archimedes' principle and the flexural strength was obtained by the biaxial flexure test. The optical properties were measured using a spectrophotometer operating in the visible light wavelength range. The step-stress accelerated life testing was performed by the pneumatic mechanical cycler and the biological behavior achieved by using osteoblast-like cells (Osteo-1 cell line). RESULTS Tetragonal zirconia was identified in all groups and cubic zirconia was identified only at 3Y-TZP group. The addition of TiO2 decreased the values of density and flexural strength of the composite 3Y-TZP/TiO2 in relation to 3Y-TZP regardless of the sintering temperature. The color difference between the two materials was not significant regarding L*a*b* parameters. The composite showed higher probability of failure, and induced higher proliferation and differentiation than control. SIGNIFICANCE The composite developed have good aesthetic and biologics properties. However, its microstructure and mechanical properties need to be improved for future dental implant applications.
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Affiliation(s)
| | - Tayná Paula Leite
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Ana Clara Fagundes Pedroni
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Márcia Martins Marques
- Programa de Pós-Graduação em Odontologia, Universidade Ibirapuera, São Paulo, SP, Brazil
| | - Nelson Batista de Lima
- Centro de Ciência e Tecnologia de Materiais, Instituto de Pesquisas Energéticas e Nucleares, São Paulo, SP, Brazil
| | - Juliana Marchi
- Centro de Ciências Naturais e Humanas, Universidade Federal do ABC, Santo André, SP, Brazil
| | - Paulo Francisco Cesar
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, SP, Brazil.
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Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2020; 124:274-349. [PMID: 32811666 DOI: 10.1016/j.prosdent.2020.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/20/2023]
Abstract
This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.
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Alqahtani F. Role of oral yeasts in the etiopathogenesis of peri-implantitis: An evidence-based literature review of clinical studies. Arch Oral Biol 2020; 111:104650. [DOI: 10.1016/j.archoralbio.2020.104650] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/27/2019] [Accepted: 01/04/2020] [Indexed: 12/11/2022]
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