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Teng WS, Yew HZ, Jamadon NH, Qamaruz Zaman J, Meor Ahmad MI, Muchtar A. Effect of porcelain veneering technique in bilayered zirconia on bond strength and residual stress distribution. J Mech Behav Biomed Mater 2024; 151:106361. [PMID: 38176199 DOI: 10.1016/j.jmbbm.2023.106361] [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: 11/09/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
The use of all porcelain materials in dentistry has significantly increased in recent years. However, chipping has remained a common problem that affects bilayered zirconia restorations. Bonding between porcelain and the underlying zirconia framework is crucial to the success of the restoration. The bond strength may be affected by such factors as residual thermal stress and the veneering technique. This research focuses on investigating the potential and constraints of materials through an examination of the porcelain veneering technique, particularly hand-layering and heat-pressing. Forty-two cylindrical disc samples of zirconia (n = 7/group) were fabricated in the dimensions of 10 × 1.2 mm (diameter [D] × height [H]). The zirconia specimens were milled from IPS e.max® ZirCad [Z] block and Luxen Zr [L] block (n = 21/zirconia). The zirconia cores were layered with IPS e.max® Zirliner and heat-pressed with IPS e.max® ZirPress to produce a final veneer dimension of 5 × 3 mm (D × H). Conventional layering was performed for the rest of the zirconia cores using IPS e.max® Ceram and Shofu Vintage Zr. The final study groups were Luxen-Vintage (LV), Luxen-Ceram (LC), Luxen Zirpress (LP), ZirCad-Vintage (ZV), ZirCad-Ceram (ZC) and ZirCad-Zirpress (ZP). Five samples were subjected to shear bond testing (SBS) with a universal testing machine with a 5 kN load cell and 0.5 mm/min crosshead speed (n = 5/group). A sample underwent nanoindentation, and another was sectioned using Isomet machine to study the bonding interface. One-way ANOVA was used to run the statistical analyses of the SBS test. Statistical differences were found between ZV with LC and LP (p < 0.05). Residual stress is estimated to be higher in the middle of the porcelain compared with that on the surface and the interface. FESEM imaging reveals portions of visible bare zirconia on Luxen zirconia, whilst crack propagation occurred through voids in all hand-layered groups. Heat-pressed veneering showed comparable but not superior results to conventional hand-layered veneering. Heat-pressed veneering produced similar stress distribution profiles compared with hand-layered veneering.
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Affiliation(s)
- Wen Sheng Teng
- Restorative Department, Faculty of Dentistry, National University of Malaysia, Malaysia
| | - Hsu Zenn Yew
- Restorative Department, Faculty of Dentistry, National University of Malaysia, Malaysia.
| | - Nashrah Hani Jamadon
- Department of Mechanical & Manufacturing Engineering, Faculty of Engineering & Built Environment, National University of Malaysia, Malaysia
| | - Jasmina Qamaruz Zaman
- Restorative Department, Faculty of Dentistry, National University of Malaysia, Malaysia
| | - Meor Iqram Meor Ahmad
- Department of Mechanical & Manufacturing Engineering, Faculty of Engineering & Built Environment, National University of Malaysia, Malaysia
| | - Andanastuti Muchtar
- Department of Mechanical & Manufacturing Engineering, Faculty of Engineering & Built Environment, National University of Malaysia, Malaysia
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Velasco-Ortega E, Carretero-Barrado L, Moreno-Muñoz J, Ortiz-García I, Núñez-Márquez E, Rondón-Romero JL, López-López J, Jiménez-Guerra Á, Monsalve-Guil L. Immediate Loading of Implants with Fixed Rehabilitations in Geriatric Edentulous Patients; Biological Complications. J Clin Med 2023; 12:6548. [PMID: 37892686 PMCID: PMC10607342 DOI: 10.3390/jcm12206548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND This study aimed to report the outcomes of the immediate loading of implants with fixed rehabilitations in edentulous geriatric patients. METHODS Edentulous geriatric patients were diagnosed with an oral examination, radiographic evaluation, and intermaxillary relations and treated with fixed rehabilitation over several implants. After immediate surgery, the implants were immediately loaded with a fully fixed prosthesis. RESULTS Twenty-four patients (20 females and 4 males) were treated using a total 210 implants. All patients (100%) had a previous history of periodontitis. Eleven patients (45.8%) were smokers. Eleven patients (45.8%) suffered from chronic medical diseases (i.e., diabetes, cardiovascular diseases). The study's clinical follow-up period extended for three years, during which thirty-three fixed prostheses were installed over the implants in 24 patients. The average marginal bone loss measured was 1.33 ± 0.17 mm. The success rate of the implants and prosthodontics being placed in this study yielded 98.5% and 97%, respectively. One patient (4.2%) showed some kind of technical complications. Eleven patients (45.8%) showed mucositis, and 25 implants (11.9%) in 10 patients (41.7%) were associated with peri-implantitis. CONCLUSIONS This study shows that the treatment of edentulous geriatric patients by immediate loading of implants with fixed rehabilitations is a clinically successful protocol but with a high prevalence of peri-implant diseases.
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Affiliation(s)
- Eugenio Velasco-Ortega
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Laura Carretero-Barrado
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Jesús Moreno-Muñoz
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Ivan Ortiz-García
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Enrique Núñez-Márquez
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - José Luis Rondón-Romero
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - José López-López
- Faculty of Medicine and Health Sciences (Dentistry) & Dentistry Hospital, University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Álvaro Jiménez-Guerra
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
| | - Loreto Monsalve-Guil
- Faculty of Dentistry, University of Seville, 41004 Sevilla, Spain; (E.V.-O.); (L.C.-B.); (J.M.-M.); (I.O.-G.); (E.N.-M.); (J.L.R.-R.); (L.M.-G.)
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Stoilov M, Shafaghi R, Stark H, Marder M, Kraus D, Enkling N. Influence of Implant Macro-Design, -Length, and -Diameter on Primary Implant Stability Depending on Different Bone Qualities Using Standard Drilling Protocols-An In Vitro Analysis. J Funct Biomater 2023; 14:469. [PMID: 37754883 PMCID: PMC10531925 DOI: 10.3390/jfb14090469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 09/28/2023] Open
Abstract
(1) Background: Primary implant stability is vital for successful implant therapy. This study explores the influence of implant shape, length, and diameter on primary stability in different bone qualities. (2) Methods: Three implant systems (two parallel-walled and one tapered) with various lengths and diameters were inserted into polyurethane foam blocks of different densities (35, 25, 15, and 10 PCF) using standard drilling protocols. Primary stability was assessed through insertion torque (IT) and resonance frequency analysis (RFA). Optimal ranges were defined for IT (25 to 50 Ncm) and RFA (ISQ 60 to 80). A comparison of implant groups was conducted to determine adherence to the optimal ranges. (3) Results: Implant macro-design, -length, and -diameter and bone block density significantly influenced IT and RFA. Optimal IT was observed in 8/40 and 9/40 groups for the parallel-walled implants, while the tapered implant achieved optimal IT in 13/40 groups (within a 25-50 Ncm range). Implant diameter strongly impacted primary stability, with sufficient stability achieved in only one-third of cases despite the tapered implant's superiority. (4) Conclusions: The findings highlight the need to adapt the drilling protocol based on diverse bone qualities in clinical practice. Further investigations should explore the impact of these adapted protocols on implant outcomes.
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Affiliation(s)
- Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Ramin Shafaghi
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland;
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (M.S.); (H.S.); (M.M.)
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland;
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Martakoush-Saleh S, Salgado-Peralvo AO, Peña-Cardelles JF, Kewalramani N, Gallucci GO. Evaluating the clinical behavior of veneered zirconia in comparison with monolithic zirconia complete arch implant-supported prostheses: A systematic review and meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00497-3. [PMID: 37696747 DOI: 10.1016/j.prosdent.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/25/2023] [Accepted: 07/27/2023] [Indexed: 09/13/2023]
Abstract
STATEMENT OF PROBLEM Because the use of zirconia in dentistry is relatively new, the number of published studies on the subject is scarce, even though material selection is an important factor in clinical performance. Therefore, a systematic assessment of the impact of the prosthetic material, framework design, veneering material, and manufacturing process is required. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the survival and success rates of feldspathic porcelain veneered zirconia (VZir) in comparison with monolithic zirconia (MZir) complete arch implant-supported prostheses (CAISPs). A secondary objective was to assess the influence of the type of loading, the presence or absence of a cantilever, the type of zirconia used, the location, and the opposing arch on complications rates and patient satisfaction. MATERIAL AND METHODS An electronic search of the MEDLINE database (via PubMed), Scopus, Science Direct, Cochrane Library, and OpenGrey was carried out. The criteria described in the preferred reporting items for systematic reviews and meta-analyses statement were used. The search was restricted from January 2000 to January 2022. RESULTS The systematic search resulted in 20 articles that met the established criteria. In total, 751 patients (VZir=302; MZir=449) with 3038 CAISPs (VZir=368; MZir=2670) were analyzed. Higher prosthetic survival and success rates were found in MZir compared with VZir CAISPs (100% and 95.45%, respectively). The meta-analysis found significantly fewer complications related to MZir (9.4% [4.8%-14.1%]) compared with VZir (33.7% [17.5%-49.9%]). CONCLUSIONS Based on the findings of this systematic review, MZir CAISPs had higher survival and success rates than VZir CAISPs, with significantly fewer prosthetic complications. The influence of factors such as the type of functional loading, the presence of a cantilever, the material used in the prosthodontic workflow, the location of the CAISP, and the type of antagonist arch on the performance of Zir CAISPs remains unclear.
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Affiliation(s)
- Sara Martakoush-Saleh
- Postgraduate student, Department of Dental Clinical Specialties, Complutense University of Madrid, Spain
| | - Angel-Orión Salgado-Peralvo
- Professor, Department of Dental Clinical Specialties, Faculty of Odontology, Complutense University of Madrid, Spain.
| | - Juan-Francisco Peña-Cardelles
- Professor, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
| | - Naresh Kewalramani
- Professor, Department of Nursery and Stomatology, Faculty of Dentistry, Rey Juan Carlos University, Madrid, Spain
| | - German O Gallucci
- Professor and Department Chair, Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, Mass
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Velasco-Ortega E, Cracel-Lopes JL, Matos-Garrido N, Jiménez-Guerra A, Ortiz-Garcia I, Moreno-Muñoz J, Núñez-Márquez E, Rondón-Romero JL, López-López J, Monsalve-Guil L. Immediate Functional Loading with Full-Arch Fixed Implant-Retained Rehabilitation in Periodontal Patients: Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13162. [PMID: 36293738 PMCID: PMC9602498 DOI: 10.3390/ijerph192013162] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 10/09/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
(1) Background. The immediate functional loading of implants is a clinical procedure used for treating periodontal edentulous patients. This clinical study aimed to evaluate the clinical outcomes of the immediate functional loading of implants with fully fixed rehabilitations in compromised periodontal patients. (2) Methods. Three hundred and five implants IPX screw implants were placed in 27 periodontal patients using an immediate functional loading protocol with fixed rehabilitations. All patients had a previous history of periodontitis, four patients (14.8%) were smokers and seven patients (25.9%) suffered from chronic medical conditions. (3) Results. Implant and prosthetic clinical findings were evaluated during a mean period of 41.3 ± 19.6 months. No implants were lost during the clinical follow-up. The cumulative survival rate for all implants was 100%. Regarding the prostheses designed, a total of 54 fixed prostheses were placed in the 27 patients immediately after the surgery. Forty-four hybrid fixed prostheses (81.5%) and 10 fixed rehabilitations (18.5%) were placed in the patients. The mean marginal bone loss was 1.51 ± 1.16 mm, ranging from 0 to 3.5 mm during the follow-up evaluation. Thirty-one implants (10.2%) in 10 patients (37%) were associated with peri-implantitis. Five patients (18.5%) showed some kind of technical complications (loss/fracture of the prosthetic screw, acrylic resin fracture, ceramic chipping). (4) Conclusions. The clinical outcomes of this study demonstrate that fixed rehabilitation by immediate functional loading of implants is considered a predictable procedure.
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Affiliation(s)
- Eugenio Velasco-Ortega
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Joao Luis Cracel-Lopes
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Nuno Matos-Garrido
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Alvaro Jiménez-Guerra
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Ivan Ortiz-Garcia
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Jesús Moreno-Muñoz
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - Enrique Núñez-Márquez
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - José Luis Rondón-Romero
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
| | - José López-López
- Department of Odontoestomatology (Dentistry), Service of the Medical-Surgical Area of Dentistry Hospital, University of Barcelona, 08907 L’Hospitalet de Llobregat, Spain
| | - Loreto Monsalve-Guil
- Department of Comprehensive Dentistry for Adults and Gerodontology, Faculty of Dentistry, University of Seville, 41018 Seville, Spain
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Marinis A, Papaspyridakos P, Sicilia E, Bernandes SR, Touloumi F, Chochlidakis K, Weber HP. Digital Workflow for Double Complete Arch Zirconia Prostheses Utilizing a Novel Scan Body. J Prosthodont 2021; 31:4-8. [PMID: 34453373 DOI: 10.1111/jopr.13417] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/01/2022] Open
Abstract
The purpose of this clinical report is to present a complete digital workflow for the fabrication of complete arch fixed zirconia implant restorations. An intraoral scanner was used to capture the implants' position at the abutment level and also the patient's existing interim prostheses with the double digital scanning technique. A novel scan body and impression pin were utilized throughout the scanning process which allowed for the accurate and reproducible superimposition of the generated Standard Tesselation Language (STL) files. Prosthesis prototypes were digitally designed and fabricated, tried in, and verified intraorally. The definitive zirconia prostheses were then fabricated and delivered to the patient. This technique can be utilized in both arches overcoming the absence of stable intraoral landmarks for superimposition of STL files.
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Affiliation(s)
| | - 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
| | - Elena Sicilia
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA
| | - Sergio Rocha Bernandes
- The Latin American Institute of Dental Research and Education, Head of New Product Development and Clinical Practice at Neodent, Curitiba, Brazil
| | - Foteini Touloumi
- Division of Prosthodontics, University of Connecticut Health Center, Farmington, CT
| | - Konstantinos Chochlidakis
- Department of Prosthodontics, University of Rochester Eastman Institute for Oral Health, Rochester, NY
| | - Hans-Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, MA.,Clear Choice Dental Implant Center, Quincy, MA
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