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Li J, Teixeira W, Saglik B, Liu F. A three-dimensionally printed template for locating the screw channel in a cement-retained implant-supported crown: A digital workflow. J Prosthet Dent 2024; 132:301-305. [PMID: 36123186 DOI: 10.1016/j.prosdent.2022.06.025] [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: 06/02/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022]
Abstract
Locating the screw channel in a cement-retained implant-supported crown is challenging. This article describes a fully digital workflow for fabricating a 3D printed template which can accurately guide the dentist to find the screw channel. A definitive implant cast from the patient and an implant planning software program are used in the workflow. This technique provides precise guidance for finding the location and angulation of the abutment screw access hole.
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Affiliation(s)
- Junying Li
- Clinical Assistant Professor, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Wendel Teixeira
- Research Fellow, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Berna Saglik
- Clinical Associate Professor, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Fei Liu
- Associate Professor, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich.
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2
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Josephraj F, Kumar N A, Nandini V V, S S, Karthik V. Performance evaluation of carbon quantum dots impregnated glass ionomer cement to avoid peri-implant disease. Biomed Mater 2024; 19:035040. [PMID: 38636498 DOI: 10.1088/1748-605x/ad407b] [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: 12/01/2023] [Accepted: 04/18/2024] [Indexed: 04/20/2024]
Abstract
Dental cement residues exacerbate peri-implant tissue irritation and peri-implantitis. The present study aims to evaluate the cytotoxicity, physiochemical, optical, and rheological properties of carbon quantum dots (CQDs) impregnated glass ionomer cement (GIC). Surface passivated fluorescent CQDs were synthesized using citric acid via thermal decomposition and blended with GIC. Characterization studies and rheological measurements were made to evaluate their performance. 3D-printed dental implant models cemented with GIC and GIC-CQD were compared to analyze excess cement residues. MTT assay was performed with human dental pulp stem cells (hDPSCs) and statistically analyzed using ANOVA and Tukey's test. CQDs with a particle dimension of ∼2 nm were synthesized. The amorphous property of GIC-CQD was confirmed through XRD. The fluorescence properties of GIC-CQD showed three times higher emission intensity than conventional GIC. GIC-CQD attained maturation with a setting time extended by 64 s than GIC. Cement residue of size 2 mm was detected with a UV light excitation at a distance between 5 to 10 cm. Biocompatibility at 0.125 mg ml-1dilution concentrations of GIC-CQD showed viability greater than 80% to hDPSCs. For the first time, we report that CQDs-impregnated GIC is a unique and cost-effective strategy for in-situ detection of excess cement rapidly using a hand-held device. A novel in-situ rapid detection method enables the dentist to identify residual cement of size less than 2 mm during the implantation. Therefore, GIC-CQD would replace conventional GIC and help in the prevention of peri-implant diseases.
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Affiliation(s)
- Febina Josephraj
- Department of Biomedical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India
| | - Ashwin Kumar N
- Department of Biomedical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India
| | - Vidyashree Nandini V
- Department of Prosthodontics and Implantology, SRM Kattankulathur Dental College and Hospital, Kattankulathur, Chengalpattu, Tamilnadu, India
| | - Sujatha S
- Department of Biotechnology, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India
| | - Varshini Karthik
- Department of Biomedical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chengalpattu, Tamilnadu, India
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Guarnieri R, Reda R, Di Nardo D, Pagnoni F, Zanza A, Testarelli L. Prevalence of Peri-Implant Mucositis, Peri-Implantitis and Associated Risk Indicators of Implants with and without Laser-Microgrooved Collar Surface: A Long-Term (≥20 Years) Retrospective Study. J Pers Med 2024; 14:342. [PMID: 38672969 PMCID: PMC11050992 DOI: 10.3390/jpm14040342] [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: 02/16/2024] [Revised: 03/10/2024] [Accepted: 03/24/2024] [Indexed: 04/28/2024] Open
Abstract
The aim of the current study was to retrospectively investigate the prevalence of peri-implant mucositis (PIM) and peri-implantitis (P) in a long-term follow-up (≥20 years) of implants with the same body design and body surface but different collar surfaces with laser-microtextured grooves (LMGSs) vs. no laser-microtextured grooves (no-LMGSs) in private practice patients. Furthermore, several patient-related, implant-related, site-, surgical-, and prosthesis-related potential disease risk factors were analyzed. A chart review of patients receiving at least one pair of implants (one with an LMGS and the other without LMGS) in the period 1993-2002 was used. Chi-square analysis was used to determine if a statistically significant difference between the investigated variables and PIM/P was present. Possible risk factors were statistically evaluated by a binary logistic regression analysis. A total of 362 patients with 901 implant-supported restorations (438 with LMGS and 463 no-LMGS) were included in the study. The cumulative survival rates of implants at 5, 10, 15, and 20 years were 98.1%, 97.4%, 95.4%, and 89.8%, respectively, for the LMGS group, and 93.2%, 91.6%, 89.5%, and 78.3% for the no-LMGS group. The difference was statistically significant at all timepoints (p < 0.05). In total, at the end of the follow-up period, 45.7% of patients and 39.8% of implants presented PIM, and 15.6% of patients and 14% of implants presented P. A total of 164 LMGS implants (37.4%) and 195 no-LMGS implants (42.1%) presented peri-implant mucositis, while 28 (6.3%) of LMGS implants and 98 (21.1%) no-LMGS implants demonstrated peri-implantitis. Differences between LMGS implants and no-LMGS implants were statistically significant (p < 0.05). The binary logistic regression identified collar surface, cigarette smoking, histories of treated periodontitis, and lack of peri-implant maintenance as risk factors for P. After at least 20 years of function in patients followed privately, LMGS implants compared to no-LMGS implants presented a statistically and significantly lower incidence of P. Implant collar surface, cigarette smoking, previously treated periodontitis, and lack of peri-implant maintenance are factors with significant association to P.
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Affiliation(s)
| | - Rodolfo Reda
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (A.Z.); (L.T.)
| | - Dario Di Nardo
- Dentistry Department, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, Via Álvaro del Portillo 5, 00128 Rome, Italy;
| | - Francesco Pagnoni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (A.Z.); (L.T.)
| | - Alessio Zanza
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (A.Z.); (L.T.)
| | - Luca Testarelli
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, 00161 Rome, Italy; (F.P.); (A.Z.); (L.T.)
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Bollen C, Hakobayan G, Jörgens M. One-piece versus two-piece ceramic dental implants. Br Dent J 2024; 236:383-387. [PMID: 38459309 PMCID: PMC10923691 DOI: 10.1038/s41415-024-7123-3] [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: 06/10/2023] [Revised: 09/05/2023] [Accepted: 09/18/2023] [Indexed: 03/10/2024]
Abstract
In this narrative review, a structured comparison between one-piece and two-piece zirconia dental implants is highlighted. Ceramic dental implants have long ceased to be hype; on the contrary, they can offer a significant addition to the daily dental implant practice. Not only do their favourable aesthetics play a significant role, but their ability to work completely metal-free is of added value, particularly for patients with a proven allergy for Grade 5 titanium. Furthermore, the fact that peri-implantitis seems to appear only incidentally is an important supporting argument for their use as well. Whereas the original design of zirconia implants was formerly always of a one-piece/one-phase structure (the monobloc design), nowadays, two-piece/two-phase designs (the so-called hybrid concept) are also widely utilised to restore missing teeth. Both concepts have advantages and disadvantages, scientifically as well as clinically.For this paper, relevant articles from the recent scientific literature were selected from PubMed. The aim was to identify and summarise what has previously been published on one-piece versus two-piece ceramic implants. This article will compare the benefits and drawbacks of one-piece versus two-piece ceramic implants based on clinical- (design, different sizes, surgical protocol, prosthetics), scientific- (loading and eventual complications) and patient-related (costs and long-time perspectives) criteria.
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Affiliation(s)
- Curd Bollen
- Professor, Ulster University, College of Medicine and Dentistry, Birmingham, UK.
| | - Gagik Hakobayan
- Professor and Head of Department of Oral and Maxillofacial Surgery, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Martin Jörgens
- Professor, University of Sevilla, Spain; MUHAS University, Dar es Salaam, Tanzania
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Knipper A, Kuhn K, Luthardt RG, Schnutenhaus S. Accuracy of Dental Implant Placement with Dynamic Navigation-Investigation of the Influence of Two Different Optical Reference Systems: A Randomized Clinical Trial. Bioengineering (Basel) 2024; 11:155. [PMID: 38391641 PMCID: PMC10886004 DOI: 10.3390/bioengineering11020155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
This randomized prospective clinical study aims to analyze the differences between the computer-assisted planned implant position and the clinically realized implant position using dynamic navigation. In the randomized prospective clinical study, 30 patients were recruited, of whom 27 could receive an implant (BLT, Straumann Institut AG, Basel, Switzerland) using a dynamic computer-assisted approach. Patients with at least six teeth in their jaws to be implanted were included in the study. Digital planning was performed using cone beam tomography imaging, and the visualization of the actual situation was carried out using an intraoral scan. Two different workflows with differently prepared reference markers were performed with 15 patients per group. The actual clinically achieved implant position was recorded with scan bodies fixed to the implants and an intraoral scan. The deviations between the planned and realized implant positions were recorded using evaluation software. The clinical examinations revealed no significant differences between procedures A and B in the mesiodistal, buccolingual and apicocoronal directions. For the mean angular deviation, group B showed a significantly more accurate value of 2.7° (95% CI 1.6-3.9°) than group A, with a value of 6.3° (95% CI 4.0-8.7°). The mean 3D deviation at the implant shoulder was 2.35 mm for workflow A (95% CI 1.92-2.78 mm) and 1.62 mm for workflow B (95% CI 1.2-2.05 mm). Workflow B also showed significantly higher accuracy in this respect. Similar values were determined at the implant apex. The clinical examination shows that sufficiently accurate implant placement is possible with the dynamic navigation system used here. The use of different workflows sometimes resulted in significantly different accuracy results. The data of the present study are comparable with the published findings of other static and dynamic navigation procedures.
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Affiliation(s)
- Anne Knipper
- Center for Dentistry, Dr. Schnutenhaus Community Health Center (CHC) GmbH, Breiter Wasmen 10, 78247 Hilzingen, Germany
| | - Katharina Kuhn
- Department for Dentistry, Clinic for Prosthodontics, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Ralph G Luthardt
- Department for Dentistry, Clinic for Prosthodontics, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
| | - Sigmar Schnutenhaus
- Center for Dentistry, Dr. Schnutenhaus Community Health Center (CHC) GmbH, Breiter Wasmen 10, 78247 Hilzingen, Germany
- Department for Dentistry, Clinic for Prosthodontics, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany
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Alhamad M, Barão VA, Sukotjo C, Mathew MT. The effect of three dental cement types on the corrosion of dental implant surfaces. Heliyon 2024; 10:e23626. [PMID: 38192807 PMCID: PMC10772628 DOI: 10.1016/j.heliyon.2023.e23626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 11/23/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024] Open
Abstract
Statement of problem One of the main challenges facing dental implant success is peri-implantitis. Recent evidence indicates that titanium (Ti) corrosion products and undetected-residual cement are potential risk factors for peri-implantitis. The literature on the impact of various types of dental cement on Ti corrosion is very limited. Purpose This study aimed to determine the influence of dental cement on Ti corrosion as a function of cement amount and type. Materials and methods Thirty commercially pure Ti grade 4 discs (19 × 7mm) were polished to mirror-shine (Ra ≈ 40 nm). Samples were divided into 10 groups (n = 3) as a cement type and amount function. The groups were no-cement as control, TempBond NE (TB3mm, TB5mm, and TB8mm), FujiCEM-II (FC3mm, FC5mm, and FC8mm), and Panavia-F-2.0 (PC3mm, PC5mm, and PC8mm). Tafel's method estimated corrosion rate (icorr) and corresponding potential (Ecorr) from potentiodynamic curves. Electrochemical Impedance Spectroscopy (EIS) data was utilized to obtain Nyquist and Bode plots. An equivalent electrical circuit estimated polarization resistance (Rp) and double-layer capacitance (Cdl). Inductively coupled plasma mass spectrometry (ICP-MS) analysis was conducted to analyze the electrolyte solution after corrosion. pH measurements of the electrolyte were recorded before and after corrosion tests. Finally, the corroded surface was characterized by a 3D white-light microscope and scanning electron microscope. Statistical analysis was conducted using either one-way ANOVA followed by Tukey's Post Hoc test or Kruskal-Wallis followed by Dunn's test based on data distribution. Results Based on cement amount, FC and PC significantly increased icorr in higher amounts (FC8mm-icorr = 8.22 × 10-8A/cm2, PC8mm-icorr = 5.61 × 10-8A/cm2) compared to control (3.35 × 10-8A/cm2). In contrast, TB3mm decreased icorr significantly compared to the control. As a function of cement type, FC increased icorr the most. EIS data agrees with these observations. Finally, corroded surfaces had higher surface roughness (Ra) compared to non-corroded surfaces. Conclusion The study indicated that cement types FC and PC led to increased Ti-corrosion as a function of a higher amount. Hence, the implant stability could be impacted by the selection, excessive cement, and a potentially increased risk of peri-implantitis.
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Affiliation(s)
- Mostafa Alhamad
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Valentim A.R. Barão
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Cortino Sukotjo
- Department of Restorative Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
| | - Mathew T. Mathew
- Department of Restorative Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, IL, USA
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Farah RI, Alblihed IA, Aljuoie AA, Alresheedi B. Light Polymerization through Glass-ceramics: Influence of Light-polymerizing Unit's Emitted Power and Restoration Parameters (Shade, Translucency, and Thickness) on Transmitted Radiant Power. Contemp Clin Dent 2024; 15:35-43. [PMID: 38707663 PMCID: PMC11068246 DOI: 10.4103/ccd.ccd_124_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 01/30/2024] [Accepted: 02/08/2024] [Indexed: 05/07/2024] Open
Abstract
Background This in vitro study assessed light transmission through ceramic discs varying in shade, translucency, and thickness using light-polymerizing units with different radiant power/flux (RP) outputs. Methods Disc-shaped specimens (0.5 mm, 1.0 mm, and 2.0 mm) were made from high and low-translucency glass-ceramic ingots (IPS e.max Press) in shades A1 and A4, totaling 60 discs. Two light-polymerizing units with different power outputs were used, and their emission spectra were verified. The transmitted RP values for each ceramic specimen were measured and irradiance and radiant energy influx were calculated. Differences between the light-polymerizing units and the influence of the three ceramic parameters were evaluated using an independent-samples t-test and three-way analysis of variance (ANOVA) tests (α = 0.05). Results A statistically significant difference was observed in the mean transmitted RP values between the two light-polymerizing units. Furthermore, the three-way ANOVA test showed a significant effect of shade, translucency, and thickness, as well as a significant interaction between each pair of variables and all three variables on the transmitted RP (P < 0.05). Conclusions Despite the significant attenuation in the transmitted RP, especially in ceramics with higher shade chromaticity and thickness and lower translucency, the calculated minimal irradiance values for both light-polymerizing units (their emitted power ≥ 500 mW) were greater than the minimum recommended irradiance threshold (100 mW/cm2). However, the exposure duration needs to be increased to provide the resin with sufficient radiant exposure for adequate polymerization.
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Affiliation(s)
- Ra’fat I. Farah
- Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, Al-Mulaydah, Qassim, Saudi Arabia
| | - Ibrahim A. Alblihed
- Medical City, College of Dentistry, Qassim University, Al-Mulaydah, Qassim, Saudi Arabia
| | - Alhareth A. Aljuoie
- Medical City, College of Dentistry, Qassim University, Al-Mulaydah, Qassim, Saudi Arabia
| | - Bandar Alresheedi
- Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, Al-Mulaydah, Qassim, Saudi Arabia
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Xu Z, Zhang K, Cheng K, Sun G, Zhang Y, Jia J. A meta-analysis comparing the effects of cemented and uncemented prostheses on wound infection and pain in patients with femoral neck fractures. Int Wound J 2023; 20:4122-4129. [PMID: 37555547 PMCID: PMC10681411 DOI: 10.1111/iwj.14306] [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: 05/29/2023] [Revised: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 08/10/2023] Open
Abstract
To providing evidence-based recommendations for surgery in patients with femoral neck fractures, a meta-analysis was conducted to comprehensively evaluate the effects of cemented and uncemented prostheses on postoperative surgical site wound infection and pain in these patients. Relevant studies on the use of cemented prostheses in femoral neck fractures were retrieved from PubMed, EMBASE, Cochrane Library, Ovid, CNKI, and Wanfang databases from the time of their establishment until March 2023. Two authors independently screened and extracted data from the included and excluded literature according to predetermined criteria. Review Manager 5.4 software was used to perform meta-analyses on the collected data. A total of 27 articles comprising 34 210 patients (24 646 cases in the cemented group and 9564 cases in the uncemented group) were included in the final analysis. The results of the meta-analysis showed that, compared with the uncemented group, cemented prostheses significantly reduced the incidence of surgical site wound infections (odds ratio [OR]: 0.75, 95% confidence interval [CI]: 0.64-0.88, p < 0.001) and relieved surgical site wound pain (standardised mean difference: -0.76, 95% CI: -1.12-0.40, p < 0.001), but did not reduce the incidence of pressure ulcers after surgery (OR: 0.50, 95% CI: 0.20-1.26, p = 0.140). Therefore, existing evidence suggests that the use of cemented prostheses in femoral neck fracture surgery can significantly reduce the incidence of surgical site wound infections and relieve surgical site wound pain, which is worthy of clinical recommendation.
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Affiliation(s)
- Ze Xu
- Department of OsteologyLinfen People's Hospital of Shanxi Medical UniversityLinfenChina
| | - Ke Zhang
- Department of OsteologyLinfen People's Hospital of Shanxi Medical UniversityLinfenChina
| | - Kai Cheng
- Department of OsteologyLinfen People's Hospital of Shanxi Medical UniversityLinfenChina
| | - Guangwei Sun
- Department of OsteologyLinfen People's Hospital of Shanxi Medical UniversityLinfenChina
| | - Yaning Zhang
- Department of OsteologyLinfen People's Hospital of Shanxi Medical UniversityLinfenChina
| | - Jian Jia
- Department of OsteologyLinfen People's Hospital of Shanxi Medical UniversityLinfenChina
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Kui A, Manziuc M, Petruțiu A, Buduru S, Labuneț A, Negucioiu M, Chisnoiu A. Translucent Zirconia in Fixed Prosthodontics-An Integrative Overview. Biomedicines 2023; 11:3116. [PMID: 38137337 PMCID: PMC10740999 DOI: 10.3390/biomedicines11123116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/12/2023] [Accepted: 11/15/2023] [Indexed: 12/24/2023] Open
Abstract
Over the past two decades, dental ceramics have experienced rapid advances in science and technology, becoming the fastest-growing field of dental materials. This review emphasizes the significant impact of translucent zirconia in fixed prosthodontics, merging aesthetics with strength, and highlights its versatility from single crowns to complex bridgework facilitated by digital manufacturing advancements. The unique light-conducting properties of translucent zirconia offer a natural dental appearance, though with considerations regarding strength trade-offs compared to its traditional, opaque counterpart. The analysis extends to the mechanical attributes of the material, noting its commendable fracture resistance and durability, even under simulated physiological conditions. Various zirconia types (3Y-TZP, 4Y-TZP, 5Y-TZP) display a range of strengths influenced by factors like yttria content and manufacturing processes. The study also explores adhesive strategies, underlining the importance of surface treatments and modern adhesives in achieving long-lasting bonds. In the realm of implant-supported restorations, translucent zirconia stands out for its precision, reliability, and aesthetic adaptability, proving suitable for comprehensive dental restorations. Despite its established benefits, the review calls for ongoing research to further refine the material's properties and adhesive protocols and to solidify its applicability through long-term clinical evaluations, ensuring its sustainable future in dental restorative applications.
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Affiliation(s)
- Andreea Kui
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Manuela Manziuc
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Adrian Petruțiu
- Oral Rehabilitation Department, Iuliu Hatieganu University of Medicine and Pharmacy, 13 Victor Babes Street, 400008 Cluj-Napoca, Romania
| | - Smaranda Buduru
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Anca Labuneț
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Marius Negucioiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
| | - Andrea Chisnoiu
- Prosthetic Dentistry and Dental Materials Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Street, 400006 Cluj-Napoca, Romania; (A.K.); (A.C.)
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10
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Obădan ME, Mitruț I, Ionescu M, Obădan F, Târtea DA, Popescu MA, Popescu SM, Smarandache AM, Manolea HO. Clinical Efficacy Analysis of the Personalization of Prosthetic Abutments in Implant Supported Restorations in Comparison to Available Standard Titanium Abutments. J Pers Med 2023; 13:1402. [PMID: 37763169 PMCID: PMC10532739 DOI: 10.3390/jpm13091402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/15/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
Personalized medicine has become an important direction to offer better solutions for health problems. In implantology, this trend was materialized through customizing dental abutments to each clinical situation. The demands for better esthetics and function of implant-supported restorations have imposed a more personalized variety of prosthetic abutments. This retrospective study compared clinical efficiency of personalized implant abutments with standard implant abutments in multiple implant restorations. Clinical data of patients who were admitted in a private clinic between 2011 and 2022 and received dental implant treatments were collected. All complications and undesired events from the patients' medical record charts were statistically analyzed. The implants were loaded using either standard or customized abutments. For complete arch rehabilitations with the SKY Fast & Fixed protocol, standard titanium prosthetic abutments were used. Our results suggest that the abutments choice for patients has moved throughout the years more towards the use of customized abutments. The number of customized abutments (414) was higher compared with the number of standard abutments (293). In our database, the most used abutments for the anterior area implants were made of titanium and zirconia, whereas for the posterior area, the preferred abutments were mostly titanium. The standard abutments were used almost entirely for immediate loading and implantation in both anterior and posterior areas (Fast & Fixed protocol). Complications were encountered mainly in restorations with standard abutments (9.22%) compared to customized abutments (2.7%), with titanium abutments being the most reliable, having only 1.79% complications.
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Affiliation(s)
- Magdalena Eugenia Obădan
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ioana Mitruț
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Florian Obădan
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Daniel Adrian Târtea
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Marcel Adrian Popescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Sanda Mihaela Popescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Andreea Maria Smarandache
- Department of Dental Prosthetics, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
| | - Horia Octavian Manolea
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Xu L, Zhang S, Chen Y, Yu F, Han C, Wu D, He D. The relationship between labial soft tissue changes and jumping spaces after immediate implant placement and restoration in the anterior maxilla: A prospective study. BIOMOLECULES & BIOMEDICINE 2023; 23:848-865. [PMID: 37004240 PMCID: PMC10494844 DOI: 10.17305/bb.2023.8652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 05/02/2023]
Abstract
Oral implants have been increasingly used in the treatment of edentulous patients or those with dentition defects due to reliable treatment procedure and favorable long-term prognosis. We investigated the changes of labial soft tissue contours with different jumping spaces after immediate implant placement and restoration (IIPR) in the maxillary esthetic area and also provided a long-term stability measurement for the changing trend of soft tissue contour. All patients had been separated into three groups based on the jumping space: group A (horizontal defect dimension [HDD] 2 mm), group B (2 mm < HDD 3 mm), and group C (HDD > 3 mm) and the digital impressions were obtained in the first, third, and sixth month after the operation. The changes of gingival mucosa levels, the average thickness of soft tissue contour volume, and the linear change of submarginal level decreased gradually across the three groups, with the largest change of submarginal level being at 5mm. The size of the jumping space was moderately negatively correlated with the level and average thickness of gingival mucosa and the linear changes of 3 mm and 5 mm under gingival margin, while there was no significant correlation with pink esthetic score (PES) and the linear change of the 1 mm under the gingival margin. Generally, IIPR of upper anterior teeth can achieve esthetic satisfaction, and the level of soft tissue around the implant can be well preserved.
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Affiliation(s)
- Linkun Xu
- Department of Implantology, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Sui Zhang
- Department of Oral Implantology, Xiangyang Stomatological Hospital, Xiangyang, China
| | - Yue Chen
- Department of Implantology, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Feiyan Yu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Chong Han
- Department of Implantology, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Dongchao Wu
- Department of Implantology, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Dongning He
- Department of Implantology, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
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Huraib WM, Pullishery F, Al-Ghalib TA, Niyazi AAT, Binhuraib H, El Homossany M, Bamigdad MS. Influence of rough micro-threaded and laser micro-textured implant-neck on peri-implant tissues: A systematic review. Saudi Dent J 2023; 35:602-613. [PMID: 37817785 PMCID: PMC10562115 DOI: 10.1016/j.sdentj.2023.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 05/25/2023] [Accepted: 05/28/2023] [Indexed: 10/12/2023] Open
Abstract
Background and objective This systematic review aimed to explore clinical outcomes of marginal or crestal bone level (MBL) and soft tissue status around implants, following the placement of rough micro-threaded/laser-microtextured surface (LMS) implants. These outcomes are compared with those following the placement of smooth machined-neck implants. Materials and methods Using EBSCO Information Services, we conducted a web-based search of databases such as the PubMed, Scopus, and EMBASE, for relevant English-language scientific papers published between January 2013 and August 2022. Prospective or retrospective controlled cohort studies and randomized controlled trials (RCTs) investigating the role of rough micro-threaded/LMS implant necks on MBL, sulcular probing depth (PD), and/or clinical attachment loss, were included in this review. Results From a comprehensive literature search of 247 articles, 6 RCTs, 5 prospective studies, and 4 retrospective studies (n = 15) fulfilled the eligibility criteria. MBL with rough micro-threaded implant necks ranged from 0.12 ± 0.17 mm to 3.25 ± 0.4 mm after loading. The smooth machined-neck implants without a micro-threaded neck had a loading MBL of 0.38 ± 0.51 mm to 3.75 ± 0.4 mm. Micro-threaded implant necks showed much lower MBL than machined-neck implants. LMS implant necks had a lower peri-implant PD than machined-neck implants after 3 years of early loading (2.3 ± 0.7 mm vs. 3.8 ± 0.8 mm). The experimental and control groups showed similar gingival recessions (1.08 ± 0.4 mm vs. 2.46 ± 0.3 mm). Meta-analysis was not feasible owing to heterogeneity of the studies. Conclusion Under functional loading, a roughened micro-threaded design for the implant neck could significantly lower MBL. Furthermore, PD and MBL were much lower around LMS neck implants than those around machined-neck or micro-threaded implants.
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Affiliation(s)
- Wayel Mohammed Huraib
- Department of Prosthodontics, Dentistry Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Fawaz Pullishery
- Division of Dental Public Health, Dentistry Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | | | | | - Haitham Binhuraib
- Consultant in Prosthodontics, North Jeddah Specialized Dental Center, King Abdullah Medical Complex, Jeddah, Saudi Arabia
| | - Mahmoud El Homossany
- Department of Removable Prosthodontics, Ain Shams University, Egypt and Batterjee Medical College, Jeddah 21442, Saudi Arabia
| | - Malak Saeed Bamigdad
- Department of Prosthodontics, Dentistry Program, Batterjee Medical College, Jeddah 21442, Saudi Arabia
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Assessment of the Accuracy of Two Different Dynamic Navigation System Registration Methods for Dental Implant Placement in the Posterior Area: An In Vitro Study. J Pers Med 2023; 13:jpm13010139. [PMID: 36675800 PMCID: PMC9865499 DOI: 10.3390/jpm13010139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
Purpose: To compare the U-tube and cusp dynamic navigation system registration methods in the use of dental implant placement, and to assess the influence of the location of missing teeth on these registrations. Methods: 32 resin mandible models and 64 implants were utilized, with implants being placed using one of the two registration methods selected at random. Accuracy was measured through the superimposition of the final and planned implant positions. Angular deviation, 3D entry deviation, and 3D apex deviation were analyzed. Results: The overall mean 3D deviation was 1.089 ± 0.515 mm at the entry point and 1.174 ± 0.531 mm at the apex point, and mean angular deviation was 1.970 ± 1.042 degrees. No significant difference (p > 0.05) was observed when comparing these two registration methods. However, the U-tube method showed significant difference when assessing the location of missing teeth (without distal-extension absence and distal-extension absence), whereas cusp registration was unaffected. Conclusions: Both the U-tube and cusp dynamic navigation system registration methods are accurate when implemented in vitro. Besides, the cusp registration technique can also overcome several of the limitations of the U-tube approach and the accuracy of it was not influenced by the location of the missing teeth, highlighting it as a method worthy of further clinical research.
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Shichman I, Oakley CT, Beaton G, Davidovitch RI, Schwarzkopf R, Rozell JC. Are we getting better at cementing femoral stems in total hip arthroplasty? A 5-year institutional trend. Arch Orthop Trauma Surg 2023:10.1007/s00402-022-04751-4. [PMID: 36593365 DOI: 10.1007/s00402-022-04751-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Femoral stem cementation provides excellent implant longevity with a low periprosthetic fracture rate among patients with compromised bone quality or abnormal anatomy. We radiologically evaluated the quality of the femoral cement mantle in patients undergoing THA to examine whether cementation quality improved with increased institutional experience. METHODS A retrospective study of 542 primary elective THAs performed using cemented stems from 2016 to 2021 at a high-volume orthopedic specialty center was conducted. Immediate post-operative anterior-posterior (AP) and lateral radiographs were evaluated to assess cement mantle quality based on the Barrack classification. Cement mantles were deemed satisfactory (Barrack A and B) or unsatisfactory (Barrack C and D). Regression was performed to identify predictors of unsatisfactory cementation quality. RESULTS The annual cemented primary THA volume increased throughout the study period from 14 cases in 2016 to 201 cases in 2021. Overall, the majority of cement mantles were deemed satisfactory; 91.7% on AP radiographs and 91.0% on lateral radiographs. Satisfactory cementation on AP radiograph achievement rates improved during the study period, which coincided with greater annual volume (p < 0.001). No association was found between posterior and direct anterior surgical approaches and satisfactory cementation quality on both AP and lateral radiographs. CONCLUSION Majority of femoral stems had satisfactory cementation quality. Higher institutional annual cemented THA volume was associated with improved cementation quality. Residency and fellowship training programs should place greater emphasis on the importance of femoral stem cementation for appropriately indicated patients. LEVEL OF EVIDENCE III, retrospective cohort study.
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Affiliation(s)
- Ittai Shichman
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Center, 333 East 38th Street, 4th Floor, New York, NY, USA.,Division of Orthopedic Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Christian T Oakley
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Center, 333 East 38th Street, 4th Floor, New York, NY, USA
| | - Geidily Beaton
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Center, 333 East 38th Street, 4th Floor, New York, NY, USA
| | - Roy I Davidovitch
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Center, 333 East 38th Street, 4th Floor, New York, NY, USA
| | - Ran Schwarzkopf
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Center, 333 East 38th Street, 4th Floor, New York, NY, USA
| | - Joshua C Rozell
- Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Center, 333 East 38th Street, 4th Floor, New York, NY, USA.
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Implant Survival Rate and Prosthetic Complications of OT Equator Retained Maxillary Overdenture: A Cohort Study. PROSTHESIS 2022. [DOI: 10.3390/prosthesis4040057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
(1) Background: The overdenture is a complete denture, an implant-supported prosthesis, that the patient can remove at home for the usual oral hygiene procedures, thanks to a simple and intuitive anchoring system. Clinically, the execution of this rehabilitation for the lower arch is often favored, but when it is necessary to limit the extension of the palate in the upper arch, it can represent the least invasive and economic solution. The aim of the study is to analyze post-loading implant loss for implant-supported prostheses in the edentulous upper jaw. (2) Methods: This retrospective study was carried out on patients who received a superior overdenture on four implants for rehabilitation. A total of 42 patients were included in this study and initially evaluated clinically and radiographically. The follow-up period for patients after delivery of the upper overdenture is between 48 and 72 months. A total of 168 implants were inserted and monitored in this period. Clinical and radiographic tests were carried out on all 168 implants, with constant re-evaluation. (3) Results: The overall implant survival rate is 92.9%, a value that corresponds to those present in the literature in previously published studies. There were few prosthetic complications, mainly the detachment of anterior prosthetic teeth. (4) Conclusions: Most of these complete prostheses, which as antagonist had another previously made overdenture on four or on two implants, achieved excellent success rates in this study at 72 months.
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Bjelopavlovic M, Weyhrauch M, Scheller H, Wentaschek S, Lehmann KM. Retentive Strength of CAD/CAM-Fabricated All-Ceramic Crowns Luted on Titanium Implant Abutments Using Different Ceramic Materials and Luting Agents: An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2022; 15:6968. [PMID: 36234309 PMCID: PMC9571208 DOI: 10.3390/ma15196968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
Objectives: This study aimed to determine the retentive strength of monolithic hybrid-all-ceramic crowns luted on titanium implant abutments. Material and Methods: In total, 450 crowns (75 each of Mark II, Empress CAD, e.max CAD, Suprinity, Enamic, Celtra Duo) were milled using a CAD/CAM system. The crowns were cemented onto sandblasted titanium implant abutments using five luting agents (Multilink Implant, Variolink II, RelyX Unicem, Fujicem, and Panavia 2.0). After thermocycling was performed (5000 cycles: 5−55 °C, 30-s dwell time), the crowns were removed using a universal testing machine. The location of luting-agent residue on the abutment and inner crown surfaces was evaluated. Analyses of variance (ANOVA) with the Bonferroni correction were performed to evaluate differences of retentive strength depending on the crown material and the kind of the luting agent. Results: The retentive strengths for the different ceramic materials were Vita Mark II: 652N-759N (SD:134N-146N), Empress CAD: 681N-822N (SD: 89N-146N), e.max CAD: 784N-1044N (SD: 109N-176N), Vita Enamic: 716N-1177N (SD: 132N-220N), Vita Suprinity: 867N-1488N (SD: 202N-278N), and Celtra Duo 772N-1335N (SD:151N-229N). After the removal trials, the visual documentation showed different adhesive residue location depending on the ceramic materials. Furthermore, the pull-off force was dependent on the choice of adhesives. No significant differences were found between different luting agents and the ceramic material Vita Mark II and Empress CAD. EmaxCAD showed significant differences with Unicem and FujiCem compared to Panavia, as did VitaSuprinity, VitaEnamic, and Celtra Duo (p < 0.001). Conclusions: The ceramic material used seems to influence the retentive strength and the use of certain luting agents results in a higher retentive strength for some ceramic materials.
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Pagnoni F, Bramucci C, Bhandi S, Nardo DD. An Update of the Different Effects on Peri-implant Tissues by Screw- or Cement-retained Implant Restorations. J Contemp Dent Pract 2022; 23:859-860. [PMID: 37282989 DOI: 10.5005/jp-journals-10024-3355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Francesco Pagnoni
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy, Phone: +39 3282177087, e-mail:
| | - Chiara Bramucci
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
| | - Shilpa Bhandi
- Department of Restorative Dental Sciences, Jazan University, Jazan, Saudi Arabia; Department of Cardiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Dario Di Nardo
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
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Carvalho PCK, Almeida CCMS, Souza ROA, Tango RN. The Effect of a 10-MDP-Based Dentin Adhesive as Alternative for Bonding to Implant Abutment Materials. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15155449. [PMID: 35955383 PMCID: PMC9369591 DOI: 10.3390/ma15155449] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 05/14/2023]
Abstract
Bonding to different dental restorative materials is challenging. This study aimed to evaluate the effect of a 10-MDP-based dentin adhesive on the shear bond strength (SBS) of self-adhesive resin cement (RC) to implant abutment materials. One hundred and twenty specimens were obtained from zirconia (ZO), cobalt-chromium alloy (CoCr), and commercially pure titanium (Ti), which were treated as follows (n = 10): control group-non-treated (CG), 10-MDP-based dentin adhesive (SB), light-cured SB (SB-LC), and zirconia primer (ZP). Blocks of RC were buildup and, after 24 h, were tested for bond strength. Data of SBS (MPa) were submitted to two-way ANOVA and Tukey test (α = 0.05). There was no difference in SBS among materials for CG and ZP, higher SBS were recorded for Ti SB and Ti SB-LC compared to ZO upon the same surface treatments. For the comparisons among treatments, SB-LC showed the highest SBS for CoCr. For ZO and Ti, higher SBS were recorded with SB and SB-LC. No cohesive failures were observed. It was concluded that the surface treatment with 10-MDP-based materials increased the bond strength of the resin cement to abutment materials, which showed to be material dependent.
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Affiliation(s)
- Paula C. K. Carvalho
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology of São José dos Campos, São Paulo State University, São José dos Campos 12245-000, Brazil
| | | | - Rodrigo O. A. Souza
- Dentistry Department, Federal University of Rio Grande do Norte, Natal 59056-000, Brazil
| | - Rubens Nisie Tango
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology of São José dos Campos, São Paulo State University, São José dos Campos 12245-000, Brazil
- Correspondence: ; Tel.: +55-123-947-9369
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Applications and Clinical Behavior of BioHPP in Prosthetic Dentistry: A Short Review. JOURNAL OF COMPOSITES SCIENCE 2022. [DOI: 10.3390/jcs6030090] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
(1) Background: BioHPP® (Bredent, UK) is a partially crystalline poly ether ether ketone (PEEK) that is strengthened using ceramic. PEEK and its various formulations represent a very interesting alternative, and has been in-depth with its literature in recent years; (2) Methods: A PubMed and Scopus search for the term “BioHPP” yielded 73 results and 42 articles which were included in this short review. Considering the scarce literature on the subject, each article was considered in this review; (3) Results: the articles analyzed are very recent, all published in the last 5 years. Their clinical evaluation of BioHPP® highlights many positive aspects, and few articles have highlighted critical issues in its multiple clinical applications; (4) Conclusions: this material is not only extremely interesting for the future, but possesses characteristics suitable for clinical application today, for endocrowns, small adhesive bridges, temporary prostheses and for immediate loads on implant restorations. The excellent aesthetics and the possibility of simple reprocessing of the restorations made with this material invite its clinical application.
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