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This technical note aims to present a recently developed computer-guided protocol characterized by titanium-reinforced stackable surgical guides during post-extractive implant placement and subsequent immediate loading. A full maxillary edentulism was rehabilitated with one-piece implants, starting from a pre-existing removable denture. 3D digital scans of the removable denture and upper and lower arches were performed. On this basis, a prototype with ideal esthetic and functional outcomes was realized and replicated into a custom-made radiological stent with markers. The superimposition of STL and DICOM files allowed virtual planning of one-piece implants in the ideal prosthetically driven position. The stackable guides, composed of a fixed base template and additional removable components, were then realized. The fixed template, initially secured with anchor pins to the bone, was no longer removed. The removable components, which were screwed to the base template, were used to perform implant surgery and immediate prosthetic loading. No surgical complications occurred, the implants achieved a minimum insertion torque of 35 Ncm, and immediate prosthetic loading was performed. The base template allowed for the maintenance of a fixed reference during the entire workflow, improving the transition between the digital project, the surgical procedure, and the prosthetic rehabilitation.

The study's main objective was to evaluate the bone density and osseointegration around dental implants with two different implant surfaces with early loading, using a micro-CT device. Twenty-four Fixo® implants (Oxyimplant, Biomec Italy) 3.5 × 8.5 mm with Laser (test group) and acid-etched surface (control group) were placed in six young beagle dog's mandibles. MicroCT (Albira, Germay) evaluation with seven regions of interest was defined in each implant on two different surfaces. A total of 168 sites were studied, and four isocountours were also done in each implant at coronal, transversal, and sagittal scanned areas to evaluate bone density location. The effect on the bone evaluation of two different surfaces variables was evaluated at the mesial and distal positions, showing crestal, medial, and apical types of bone density. Implant positions (P2, P3, P4, and M1) were also analyzed to determine bone density areas. The results of hard tissue density indicated a statistical significance for laser surface at crestal ROIs level (p < 0.001) and position of implants (p = 0.032) related to P3 areas compared to the acid-etched surface in Fixo® implants. Density D4 was the most common type of bone surrounding Fixo® standard implants at three different positions and density D3 was the most found on Fixo® laser surfaces. Micro-CT evaluation was a powerful tool for measuring the type of bone quality and location surrounding dental implants. Micro-CT study revealed that the most common density type found around Fixo® laser surface (test) implants was density D3 at the mesial and distal coronal part and density D4 at the middle and apical part. Fixo® implant with acid-etched surface showed the type of density D4 bone in hole implant at 3 months follow-up. It is a complementary histologic and histomorphometric analysis method for implant surrounding bone density.

Purpose: To evaluate differences in the temperature rise at the cervical area of one-piece vs two-piece implants during the setting of relined provisional crowns. Materials and Methods: A K-type thermocouple was fixed to the coronal thread of 15 one-piece implants and 15 two-piece implants that were mounted on a plexiglass apparatus. Baseline temperature (Bl Temp) was recorded before starting the curing process. The maximum temperature (Max Temp) reached during the process in both implant groups was also recorded. Total heat flux (THF) was calculated as well as the thermal amplitude (Temp-Amp) at the implant surface. Finally, the differences between the implant types were compared using unpaired t test. Results: The increase in temperature from baseline was statistically significantly greater in the one-piece implants than in the two-piece implants (P < .01). Similarly, the THF and Temp-Amp were significantly greater in the one-piece implants compared to two-piece implants (P < .01). Conclusions: The polymerization of PMMA-based resin temporary crowns produces a significant temperature rise in both one-piece and two-piece implants. It is advisable to use two-piece implants to restore immediately loaded implants to reduce the risk to implant surroundings that may occur due to the temperature rise at the implant neck. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the performance of one- and two-piece ceramic implants regarding implant survival and success and patient satisfaction. Materials and Methods: This review followed the PRISMA 2020 guidelines using PICO format and analyzed clinical studies of partially or completely edentulous patients. The electronic search was conducted in PubMed/MEDLINE using Medical Subject Headings (MeSH) keywords related to dental zirconia ceramic implants, and 1,029 records were received for detailed screening. The data obtained from the literature were analyzed by single-arm, weighted meta-analyses using a random-effects model. Forest plots were used to synthesize pooled means and 95% CI for the change in marginal bone level (MBL) for short-term (1 year), mid-term (2 to 5 years), and long-term (over 5 years) follow-up time intervals. Results: Among the 155 included studies, the case reports, review articles, and preclinical studies were analyzed for background information. A meta-analysis was performed for 11 studies for one-piece implants. The results indicated that the MBL change after 1 year was 0.94 ± 0.11 mm, with a lower bound of 0.72 and an upper bound of 1.16. For the mid term, the MBL was 1.2 ± 0.14 mm with a lower bound of 0.92 and an upper bound of 1.48. For the long term, the MBL change was 1.24 ± 0.16 mm with a lower bound of 0.92 and an upper bound of 1.56. Conclusion: Based on this literature review, one-piece ceramic implants achieve osseointegration similar to titanium implants, with a stable MBL or a slight bone gain after an individual initial design depending on crestal remodeling. The risk of implant fracture is low for current commercially available implants. Immediate loading or temporization of the implants does not interfere with the course of osseointegration. Scientific evidence for twopiece implants is rare. Purpose: To evaluate the performance of one- and two-piece ceramic implants regarding implant survival and success and patient satisfaction. Materials and Methods: This review followed the PRISMA 2020 guidelines using PICO format and analyzed clinical studies of partially or completely edentulous patients. The electronic search was conducted in PubMed/MEDLINE using Medical Subject Headings (MeSH) keywords related to dental zirconia ceramic implants, and 1,029 records were received for detailed screening. The data obtained from the literature were analyzed by single-arm, weighted meta-analyses using a random-effects model. Forest plots were used to synthesize pooled means and 95% CI for the change in marginal bone level (MBL) for short-term (1 year), mid-term (2 to 5 years), and long-term (over 5 years) follow-up time intervals. Results: Among the 155 included studies, the case reports, review articles, and preclinical studies were analyzed for background information. A meta-analysis was performed for 11 studies for one-piece implants. The results indicated that the MBL change after 1 year was 0.94 ± 0.11 mm, with a lower bound of 0.72 and an upper bound of 1.16. For the mid term, the MBL was 1.2 ± 0.14 mm with a lower bound of 0.92 and an upper bound of 1.48. For the long term, the MBL change was 1.24 ± 0.16 mm with a lower bound of 0.92 and an upper bound of 1.56. Conclusion: Based on this literature review, one-piece ceramic implants achieve osseointegration similar to titanium implants, with a stable MBL or a slight bone gain after an individual initial design depending on crestal remodeling. The risk of implant fracture is low for current commercially available implants. Immediate loading or temporization of the implants does not interfere with the course of osseointegration. Scientific evidence for twopiece implants is rare. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the influence on peri-implant soft and hard tissues of one-piece implants with a convergent hyperbolic profile collar placed at different depths with respect to the bone crest. Materials and Methods: Six dogs were included in the experiment. Three months after mandibular tooth extractions, two one-piece implants carrying a 2.8-mm--high convergent hyperbolic profile collar were placed in the alveolar crest with the coronal margin of the rough surface either 0.8 mm (test-1) or 1.8 mm (test-2) deeper with respect to the bone crest (Ct0). Two similar implants were instead placed flush to Ct0 as controls (control-1 and control-2, respectively). Healing screws were connected, and nonsubmerged healing was allowed. After 4 months, block sections were harvested, and histologic slides were prepared in a buccolingual plane. Results: In the histologic analyses, both the buccal crest and coronal level of osseointegration were located more coronally at the test compared to the control implants concerning the implant. However, the buccal bone crest with respect to Ct0 presented a loss of 0.8 ± 0.4 mm at the test-1 and 0.5 ± 0.4 mm at the control-1 implants (P = .028), and a loss of 2.0 ± 1.0 mm and 0.7 ± 0.4 mm at the test-2 and control-2 implants (P = .028), respectively. At the control implants, the collars were exposed above the peri-implant mucosa, while those of the test implants were not. However, the coronal level of the peri-implant mucosa with respect to Ct0 was located more apically at the test compared to the control implants. Conclusion: The placement of implants with a hyperbolic convergent profile collar in the subcrestal position resulted in higher buccal bone resorption and more soft tissue recession compared to the crestal implants with respect to the level of the bone crest at placement. [ABSTRACT FROM AUTHOR]

The article offers update on several research on dental implant fracture. Topics of the studies include fractures of titanium implants, fractures that occurred in implant brands that are no longer commercially available, impact of surface modifications on the fracture resistance of aged zirconia implants in vitro, implantoplasty and fracture risk of implants that underwent implantoplasty.

Zirconia ceramic (ZC) implants are becoming more common, but comparisons between preclinical histology and long-term clinical trials are rare. This investigation comprised (1) 8-year clinical follow-up of one-piece ZC or titanium (Ti) implants supporting full overdentures and (2) histomorphometric analysis of the same implants in an animal model, comparing implants with various surface treatments. Methods: (1) Clinical trial: 24 completely edentulous participants (2 groups of N = 12) received 7 implants (one-piece ball-abutment ZC or Ti; maxilla N = 4, mandible N = 3) restored with implant overdentures. Outcomes after 8-years included survival, peri-implant bone levels, soft-tissue responses, and prosthodontic issues. (2) Preclinical trial: 10 New Zealand sheep received 4 implants bilaterally in the femoral condyle: Southern Implants ZC or Ti one-piece implants, identical to the clinical trial, and controls: Southern ITC® two-piece implants with the same surface or Nobel (NBC) anodised (TiUnite™) surface. %Bone-implant contact (%BIC) was measured after 12 weeks of unloaded healing. Results: 8 of 24 participants (33%) of an average age of 75 ± 8 years were recalled; 21% of original participants had died, and 46% could not be contacted. 80.4% of implants survived; excluding palatal sites, 87.5% of Ti and 79% of ZC implants survived. All failed implants were in the maxilla. Three ZC implants had fractured. Bone loss was similar for Ti vs. ZC; pocket depths (p = 0.04) and attachment levels (p = 0.02) were greater for Ti than ZC implants. (1.7 ± 1.6 mm vs. 1.6 ± 1.3 mm). All implants in sheep femurs survived. %BIC was not statistically different for one-piece blasted surface Ti (80 ± 19%) versus ZC (76 ± 20%) or ITC® (75 ± 16 mm); NBC had significantly higher %BIC than ITC (84 ± 17%, p = 0.4). Conclusion: Short-term preclinical results for ZC and Ti one-piece implants showed excellent bone-implant contact in unloaded femoral sites. This differed from the long-term clinical results in older-aged, edentulous participants. While ZC and Ti implants showed equivalent performance, the risks of peri-implantitis and implant loss in older, completely edentulous patients remain a significant factor. [ABSTRACT FROM AUTHOR]

Titanium oral implants are still considered "state of the art" in implant dentistry, with well-documented survival rates. However, their grayish color and high prevalence of peri-implant infections have resulted in controversial discussion as to whether tooth-like-colored, metal-free zirconia ceramic implants provide sufficient potential to be considered equal regarding treatment outcomes. The present position paper has been composed upon invitation by the European Association of Osseointegration in order to provide an update on the current level of evidence regarding zirconia implants in clinical trials. To date, most available and scientifically documented zirconia implant systems are one-piece implants that require an experienced surgeon and prosthodontist due to the restricted flexibility in cases of compromised angulation or vertical positioning. Taking this limitation into account, there is evidence of a comparable outcome for one-piece zirconia implants compared to titanium implants for the fixed replacement of one to three missing teeth. In contrast, currently available clinical data evaluating two-piece zirconia implants with an adhesively bonded implant-abutment interface suggest an inferior outcome. Data evaluating the clinical applicability of screw-retained solutions, even if revealing sufficient fracture resistance in laboratory investigations, are still missing. High survival rates were reported for all-ceramic reconstructions supported by zirconia implants, but with increased technical complications; ie, fractures of the ceramic veneer in the case of bilayered restorations. Sufficient clinical evidence for recommending monolithic approaches is limited to single crowns. [ABSTRACT FROM AUTHOR]

Purpose: To assess the clinical outcomes of zirconia dental implants based on an updated systematic literature review. Methods: An electronic search was performed in three databases, last updated in June 2023, supplemented by hand searching. The eligibility criteria were clinical studies reporting patients rehabilitated with zirconia implants. The cumulative survival rate (CSR) of implants was calculated. A meta-analysis for marginal bone loss (MBL) under different follow-up times and a meta-regression assessing the relationship between mean MBL and follow-up were done. Results: Twenty-five studies were included (4017 implants, 2083 patients). Seven studies had follow-up longer than 60 months. 172 implants failed, after a mean of 12.0 ± 16.1 months (min–max 0.3–86.0), of which 47 early failures, and 26 due to implant fracture, the majority in narrow-diameter implants. The 10-year CSR was 95.1%. Implants with coronal part prepared by drills presented statistically significant lower survival than non-prepared implants (p < 0.001). Two-piece implants presented lower survival than one-piece implants (p = 0.017). Implants discontinued from the market presented lower survival than the commercially available ones (p < 0.001). The difference in survival was not significant between implants in maxilla and mandible (p = 0.637). The mean MBL fluctuated between 0.632 and 2.060 mm over long periods of observation (up until 132 months). There was an estimated MBL increase of 0.005 mm per additional month of follow-up. Conclusion: Zirconia implants present high 10-year CSR and short-term low MBL. The review was registered in PROSPERO (CRD42022342055). Clinical relevance: The clinical outcomes observed for zirconia dental implants are very promising, although these have not yet been extensively studied as titanium alloy implants. [ABSTRACT FROM AUTHOR]

Rehabilitating thin jaws without reconstructive surgery entails using narrow implants. The proposed treatment adopted an innovative implant system, allowing the mini-screws to be parallel and immediately loaded. A mandible, wearing an overdenture, was functionalized contextually to the residual dental extraction and the placement of six 2.4-mm thick one-piece implants. Low-profile intermediate abutments, the LEMs, able to rotate over the spherical heads of the fixtures, were connected after suturing, oriented, and blocked in a mutual parallel position. The copings, engaging with a tapered juncture of the LEMs, resulted in their alignment to be intraorally wedged together. The provisional superstructure enclosed the copings and was immediately connected to the implants, and the definitive prosthesis was delivered after three months. No clinical signs of peri-implantitis or radiographically evident bone loss were recorded after a two-year follow-up without any prosthetic complication. No cases have been published regarding mini-implants bearing fixed prosthesis rehabilitation. [ABSTRACT FROM AUTHOR]

The purpose of this technical report is to present two novel experimental implant designs to boost data generation in preclinical in vivo research. Specifically, the report describes the rationale and the components of (1) a two‐piece experimental implant suitable for a small animal platform (e.g., the rabbit femur/tibial epiphysis model), consisting of a threaded apical‐ and a coronal cylindrical piece, which is intended for collecting two types of biomechanical data, and (2) a three‐piece experimental implant suitable for a large animal platform (e.g., the mini‐pig mandible model), consisting of an apical "wound chamber", which allows the collection of histological/histomorphometrical data, and a middle threaded and coronal cylindrical piece, which also allow the collection of two types of biomechanical data. The increased volume of information generated from a single experiment in a small animal platform, using the proposed two‐piece implant design, may assist in a more qualified decision‐making process, on whether it is relevant to proceed to further assessment using a large animal platform. Furthermore, the increased volume of information generated in a single animal experiment either in a small or large animal platform, using the proposed two‐ and three‐piece implants, respectively, likely decreases the number of animals otherwise needed for collecting the same information with standard one‐piece implants and, thus, contributes to the reduction/refinement elements of the 3R principle. [ABSTRACT FROM AUTHOR]

Background and Objective: One-piece implants were introduced many years ago, however, in the last years, they have gained acceptance as a therapeutic alternative for many clinical cases. The soft tissue surrounding the neck of one-piece implants, particularly in the esthetic zone, is a cause for concern despite the clinical effectiveness of these implants. The purpose of this study is to propose a simple way for optimizing soft tissue around one-piece dental implants. Material and Methods: Between January 2022 and January 2024, a total of 137 patients were treated with single-piece dental implants that were placed in the aesthetic anterior region of the mouth. A temporary crown in the office was created using a flowable composite that was temporary in nature using the mold of the Cervico system (VP Innovato Holdings Ltd, Lemessos, Cyprus). After three months, the patients' rates of success, failure, and complications were evaluated. The Jemt Papillary Index was employed to assess the papilla following the placement of the final prosthesis, a Satisfaction Visual Analog Scale (VAS system) was created to gauge the patient's satisfaction. The data was evaluated by means of descriptive statistics utilizing the SPSS (version 30) package of software. Results: The mean age of all cases was 32.10 years, with 78 (56.9%) male cases and 59 (43.1%) female cases. After 3 months among 137 inserted implants; 97.8% of the implants were successfully osseointegrated. After removal of the temporary crown a very nice anatomical emergence profile created and the results of papilla index after three months showed that the majority of the cases (84 cases comprises 61.3%) ended with score number 3, which means Optimal soft tissue contour and the papillae fill up the entire proximal space. Finaly the results of Satisfaction Visual Analog Scale (VAS) showed that 120 cases (87.6%) were have most positive response to the dental implant treatment. Conclusion and Clinical implications: We concluded that using of a customized composite temporary crown fabricated by Cervico system offers a very simple and time-saving technique for the clinician, aiding in splinting the implants and obtaining nice emergence profile around one-piece implants.

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To investigate whether the lack of keratinized mucosa (KM) affects peri‐implant health after 10 years of loading. Materials and Methods: Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5‐year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri‐implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one‐piece or two‐piece) and compliance. Results: A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri‐implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri‐implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two‐piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two‐piece implants were associated with reduced MBL and MBL changes (p < 0.05). Conclusion: The lack of buccal KM appears to be linked with peri‐implant parameters such as BOP and MBL, but the association is weak. The design of one‐piece implants may account for their increased odds of exhibiting BOP. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare bacterial growth on zirconia vs titanium healing caps. Materials and Methods: Streptococcus sanguinis (Ss) and Ftreptococcus nucleatum (Fn) were grown on titanium and zirconia healing caps that were fixed to the cover of a 96-well microtiter plate. A drop (10 µL) of bacterial suspension was placed on each healing cap and allowed to dry for 1 hour at 37°C. After this time, the cover was replaced on the plate such that the caps were completely immersed in fresh liquid medium. Each plate contained only one bacterial strain, with two control groups. Bacterial growth was monitored over 18 hours by following the optical density (OD) at 650 nm. One-way ANOVA comparison test was used for statistical analysis. Scanning electron microscope (SEM) images of healing caps of each material were taken after 48 hours of incubation with Ss or Fn to assess bacterial attachment and with no bacteria as a negative control. Results: Ss growth was similar in both types of healing cap, with no significant differences between these groups and the control (P = .990). However, there was significantly less growth of Fn on the zirconia caps than on the titanium samples (P < .0001) or the control (P < .0001). SEM imaging revealed obvious differences in the surface characteristics of the titanium and zirconia caps. The number of bacteria attached to the rough apical area was particularly high. Conclusions: The use of zirconia healing caps may reduce the growth of some bacterial species compared to that seen on titanium healing caps. [ABSTRACT FROM AUTHOR]

This comparative cohort study evaluated the survival rate and the marginal bone loss of rootanalogue compared to root-form zirconia dental implants. 28 patients, 35-45 years old, with a free medical history and presenting with a non-restorable mandibular premolar, were selected in this research. Atraumatic tooth extraction and immediate placement of zirconia one-piece implants were performed. The total number of patients were divided according to the type of implants into the zirconia Root-Analogue group (RA, n=14), which was customized to the exact shape of the extracted root. Retentive features were added to the implant surface with the aid of CAD/CAM on Yttria tetragonal zirconia polycrystal blocks (Y-TZP) (Ceramill Zi, Amann Girrbach, Austeria) and prefabricated Root Form group (RF, n=14)(WhiteSky, Bredent, Germany). After 3-5 months of placement, the two groups were then subdivided according to the type of implant supported restorations (n=7) into zirconia crowns (RAZ and RFZ) and PEEK crowns (BioHPP, Bredent, Germany) (RAP and RFP). Clinical survival rates were evaluated in addition to radiographic measuring of marginal bone loss (MBL) in each group at baseline, 3, 6, 12, and 18 months. Early loss of three RA implants before loading resulted in a cumulative survival rate of 79.5%. However, the RF group showed a survival rate of 100% at all follow-up periods of 18 months. The surviving implants showed mean MBL, 1.7mm(1.5-1.8), 1.35mm(1.2-1.5), 1.2mm(1.0-1.2), and 1.0mm(0.9-1.5) for RAZ, RAP, RFZ, and RFP, respectively at 18 months of follow up. Clinical examination during the follow-up periods did not reveal any parameter influencing MBL. RA implants should not be recommended as a substitute for prefabricated RF implants due to the increased incidence of premature failure, however using PEEK crowns as supra structure restorations may influence the outcomes related with marginal bone loss. [ABSTRACT FROM AUTHOR]

Analyzing factors that may have led to fracture of zirconia implants by macro/micro-fractography. Six one-piece and ten two-piece full-ceramic zirconia implants from two manufacturers, Z-Systems and CeraRoot, were retrieved after clinical failure. The time-to-failure ranged from 3 to 49 months. Optical and scanning electron microscopy (SEM) were used to analyze the fracture planes at the macro- and microscopic level. Treatment planning, surgical protocol, fracture-origin location and characteristic fracture features were assessed. The fracture of all implants seemed to have been primarily due to overload in bending mode, while the fracture-initiation sites varied for the one- and two-piece implants. The fracture of all one-piece implants originated in the constriction region between two threads in the endosseous implant part. For two-piece implants, the abutment neck, internal abutment-implant connections and inner threads were found to be the main fracture-initiation sites. Surface defects at the root area for one-piece implants and damages at the abutment surface for two-piece implants were connected to the fracture origins. Importantly, the clinical failures of implants were often found to result from combined effects related to patient aspects, treatment planning/protocols, a high bending moment at the weakest link, implant-surface conditions and specific implant designs. This study provided information to be considered for future optimization of treatment planning and the surgical protocol for zirconia implants. Optimization of the surface conditions and the zirconia-starting powder were also suggested. • Fracture-initiation sites varied for the one- and two-piece implants. • Clinical implant failures resulted from combined effects related to patient-related aspects, treatment planning, surface quality and specific implant designs. • Implant surface conditions and zirconia starting powder can be optimized. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To review experimental peri-implantitis studies using rat models and summarize different peri-implantitis induction techniques and evaluate their effectiveness. Materials and Methods: Electronic searches were conducted by two independent examiners to address the following issues. Meta-analyses explored the marginal bone loss (MBL) of four types of peri-implantitis induction methods in rats. The detailed induction tactics--such as the implant design, implant size, surgical process, time cost, induction methods, and endpoint measurements--were summarized. Results: Of the 18 included studies, 38.9% of the studies placed implants at the maxillary first molar, and 44.4% placed them at the alveolar ridge region anterior to the maxillary first molar. As for the induction method, the numbers of published studies on ligature methods, bacterial inoculation, and bacterial lipopolysaccharide inoculation were equally high among all selected studies. The total implant survival rate at the end was 160 out of 213 implants (75.11%). Eight studies with high pooled heterogeneity (I2 = 98, P < .01) in the meta-analysis reported an overall MBL (µ-CT) of 0.47 mm (95% CI = 0.14 to 0.81). A subgroup analysis estimated an MBL of 0.31 mm (95% CI = 0.12 to 0.50) for bacterial inoculation and 0.66 mm (95% CI = 0.07 to 1.26) for the ligature method. Histopathologic analysis revealed that peri-implantitis in rats was similar to peri-implantitis lesions in humans. Conclusions: Implant placement at the maxillary first molar with bacterial inoculation and the silk ligature method to build peri-implantitis rat models is reliable to use for research on peri-implantitis. [ABSTRACT FROM AUTHOR]

The widely available options of different manufacturers in dental implant systems have complicated the selection criteria process for periodontists, necessitating careful consideration of various factors when selecting suitable solutions for individual patient needs. Optimal implant selection requires careful consideration of the patient-specific factors, implant design, and surgical technique. Understanding the biomechanical behavior of implant–tissue interactions is crucial for achieving successful and long-lasting implant therapy. To adequately address this issue and improve the rigorous selection criteria from a biomechanically numerical approach, this research aims to analyze the stress distribution fields, strain patterns, and load transfer displacements within the implant system and the implant–biological interface (gingival and bony tissues) of titanium three-piece to two–one-piece ceramic implant systems. Thus, three different commercially available dental implants designed to be placed in the jaw molar region were considered for evaluation through the finite element method under both oblique and occlusal loading conditions. The results have exhibited an increasing trend to highlight the outstanding behavior of two-piece ceramic implants to dissipate the stress distribution better (6 and 2 times lower than the three- and one-piece systems under occlusal loads and almost 5 and 1.3 times more efficient for oblique loading, respectively), minimize peak stress values (below 100 MPa), and reduce strain peak patterns compared with the other two evaluated designs. On the other hand, the effects generated in biological tissues are strongly associated with implant geometry features. This biomechanical approach could provide a promising strategy for predicting micro-strains and micromotion in implant system pieces and geometries. Hence, these findings contribute to a deeper understanding of the biomechanics spectrum in the behavior of dental implant systems and emphasize the importance of carefully selecting appropriate material systems for accurate patient-specific biomechanical performance. [ABSTRACT FROM AUTHOR]

Immediate loading implant surgery has emerged as a significant advancement in the rehabilitation of edentulous patients. This approach requires meticulous planning and precise execution to ensure successful outcomes. Transferring established intermaxillary and occlusal relationships to the definitive prostheses can be challenging. However, with a digital approach, this procedure can be standardized in cases of fully guided surgery with a flapless technique or by using disposable guides. Conversely, when extensive open flap implant surgery is required, such as in the treatment of severely atrophic patients (e.g., with zygomatic implants or simultaneous bone augmentation), the digital workflow can be demanding. The impression reference technique was proposed to enhance the digital workflow for immediate loading in zygomatic implant rehabilitation. This study aims to describe the impression reference technique, applied to both upper and lower jaws for immediate loading open flap rehabilitations, using standard implants. [ABSTRACT FROM AUTHOR]

This clinical report details the prosthetic rehabilitation of a patient following maxillary ablation to remove a peripheral giant cell granuloma. After a hemimaxillectomy, the defect was reconstructed with a fasciocutaneous radial free flap. Implant placement was digitally planned using the dual scanning technique, and implants were inserted with the aid of an acrylic surgical guide. After implant osseointegration, a removable implant-supported overdenture with an electroplated secondary structure retained on a titanium bar was fabricated. At the 3-year follow-up, peri-implant tissues remained healthy, showing only mild gingival hyperplasia around the bar, while no prosthesis retention loss or significant technical complications were observed. In conclusion, the reconstruction of the moderate maxillary defect using a soft-tissue flap provided satisfactory functional and esthetic outcomes, significantly enhancing patient satisfaction. However, the limited bone availability necessitated precise implant planning to ensure adequate biomechanical support for the overdenture. [ABSTRACT FROM AUTHOR]

A retrospective chart review was conducted of CBCT images captured between November 2019 and April 2021 on patients who underwent dental implant placement and had a periodontal charting. The buccal and lingual bone thickness around the implants was measured as an average of three measurements taken from the buccal and lingual aspects of implants. Implants with peri-implantitis were placed in Group 1, and implants with peri-implant mucositis or good peri-implant health were placed in Group 2. Wilcoxon rank sum test was used to compare the differences between the bone thicknesses of the groups. In total, 93 CBCT radiographs were screened, and 15 CBCT images with both an implant and corresponding periodontal charting were analyzed. Of the 15 implants examined, 5 presented with peri-implantitis (33%), 1 with peri-implant mucositis, and 9 with good peri-implant health. Within the limitations of this study, buccal bone thickness averaging ≥ 1.10 mm or midlingual probing depths ≥ 3.4 mm correlates with a more favorable peri-implant response. Larger studies are needed to substantiate these findings. [ABSTRACT FROM AUTHOR]

This retrospective clinical study compared two different professional maintenance therapy (MT) approaches (with and without periodic removal and decontamination of prosthetic components) on peri-implant inflammatory clinical and biochemical parameters after 5 years of implant function. A retrospective analysis based on patient records was used to assess inflammatory clinical and biochemical parameters around dental implants placed by the same clinician in a private practice. The Plaque Index (PI), peri-implant probing depth (PPD), mucosal recession (REC), bleeding on probing (BOP), and radiographic marginal bone level were determined at baseline and at each follow-up year. Moreover, at the last follow-up visit, the peri-implant intrasulcular levels of active metalloproteinasis 8 (aMMP-8) were also assessed. All participants were under MT with a 6-month recall interval. A total of 92 patients with 132 implants were selected. At the end of the study period, 12 patients with 12 implants were classified as dropouts. The remaining 80 patients and 120 implants were classified into two groups: Group 1 (42 patients, 62 implants) received MT with periodic removal and decontamination of prosthetic components; Group 2 (38 patients, 58 implants) received MT without periodic removal and decontamination of prosthetic components. No statistical differences were found between the groups regarding PI, PPD, and REC. Group 1 presented a statistically significant higher number of sites with BOP (12.4% vs 6.2%). Marginal bone loss was statistically higher in Group 2 than in Group 1 (0.23 ± 0.6 mm vs 0.78 ± 0.3 mm). Intrasulcular levels of aMMP-8 were statistically higher in Group 1 than in Group 2. The supplemental application of periodic removal and decontamination of prosthetic components during MT had a significantly positive effect on the inflammatory status of periimplant tissues. [ABSTRACT FROM AUTHOR]

Background: To evaluate the clinical and radiographic assessment of customized fusion-sputtered one-piece zirconia implants. Methods: Twenty-eight patients received either fusion sputtered one-piece zirconia implants (n = 14) or one-piece titanium implants (n = 14). All implants were one-piece designs. After 4 months of immediate loading, all implants were restored with a monolithic zirconia crown. All implants were evaluated at baseline, 6 months, 1 year, 2 years, and 5 years. Implant mobility, plaque index, and gingival index evaluations were performed. The measurements of marginal bone level were calculated radiographically. Results: All implants were well maintained through the evaluation period with a 100% survival rate without any clinical complications. Regarding gingival index, there was no statistically significant difference (P =.364) between zirconia (3.3 ± 0.7 mm) and titanium (3.5 ± 0.6 mm) implants, after 5 years. There was no statistically significant difference (P =.470) between zirconia (1.77 ± 0.039 mm) and titanium (1.80 ± 0.28 mm) implants regarding marginal bone loss, after 5 years. Conclusions: One-piece fusion-sputtered zirconia implant represents a reliable treatment modality in replacing a missing tooth in the esthetic zone. [ABSTRACT FROM AUTHOR]

Objective This study aimed to provide an inclusive comparison between the peri-implant phenotype of immediately placed in fresh extraction socket one-piece and two-piece implants with immediate loading in the anterior region. Materials and Methods Twenty-two patients with a mean age of 36 ± 4.6 (4 males and 18 females)) were randomly allocated to the one-piece and the two-piece groups. Each patient had one immediate implant placement with immediate loading by provisional restorations. Gingival Index, Peri-implant Probing depth, Papilla Presence Index, and, Implant Quality Score were recorded at 3, 6, 9 months, and 18 months. Cone beam computerized tomography is utilized to assess peri-implant bone for 1 year. Statistical analysis A two-sample t -test was used to compare the two groups. Results Both groups showed similar clinical presentations. For group two, Gingival Index, Papilla Presence Index, Peri-implant Index, Implant Quality Score, and eri-implant bone level showed statistically significant improvement. Group one showed a non-significant increase in bone density. Conclusions The peri-implant phenotype showed more predictable treatment outcomes in the context of health and esthetics in two-pieces than in one-piece. [ABSTRACT FROM AUTHOR]

Objective: This systematic review assessed the available evidence on the survival and success rate of zirconia and titanium implants. As secondary outcomes, aesthetic, radiographic and clinical parameters, as well as biological and mechanical complications, were considered., Materials and Methods: A systematic search was performed up to March 2022 to identify CCTs/RCTs comparing zirconia and titanium implants with a minimum of 12 months of follow-up. Meta-analysis was performed when ≥ 2 articles with similar characteristics were retrieved., Results: Four published articles with two RCTs (2 different patient populations) with 100 zirconia and 99 titanium implants that were followed up over 12-80 months were selected out of the 6040 articles. A non-statistically significant difference between zirconia and titanium implant survival at 12 months was suggested (P = 0.0938). The success rates were 57.5-93.3% and 57.1-100% for zirconia and titanium implants, respectively. The pink aesthetic score (PES) was higher for zirconia (10.33 ± 2.06 to 11.38 ± 0.92) compared to titanium implants (8.14 ± 3.58 to 11.56 ± 1.0)., Conclusion: Based on the 2 RCTs retrieved in the literature, similar survival rates were reported for zirconia and titanium implants in the short term (12 months of follow-up). Future RCTs are warranted to evaluate the long-term outcomes of zirconia implants., Clinical Relevance: Zirconia implants may be the procedure of choice, particularly in the aesthetic zone, since they show a similar survival and success rate as titanium implants on a short-term follow-up., Trial Registration: Systematic review registration number-CRD42021288704 (PROSPERO)., (© 2023. The Author(s).)

Background: In recent years, advancements in digital dentistry have provided new opportunities for more predictable and efficient treatment options, particularly in patients with failing dentition. This study aimed to evaluate the effectiveness and accuracy of a fully digital workflow using stackable surgical templates for complete dental arch rehabilitation with implant-supported fixed restorations. Methods: Four patients, comprising two males and two females with a mean age of 66 years, were included in this case series. Each patient underwent meticulous digital planning, including CBCT and intraoral scanning, to create a virtual patient for preoperative assessment and virtual treatment planning. The assessment of the trueness of implant positioning was conducted in Geomagic Control X software (version 2017.0.3) by referencing anatomical landmarks from both the preoperative and one-year postoperative CBCT scans. Results: A total of 25 dental implants were placed in the maxilla, followed by the installation of long-term provisional restorations. The results showed minimal deviation between the planned and actual implant positions, with mean 3D coronal, apical, and angular discrepancies of 0.87 mm, 2.04 mm, and 2.67°, respectively. All implants achieved successful osseointegration, and no failures were recorded, resulting in a 100% survival rate at the one-year follow-up. Patients reported high satisfaction with both the esthetic and functional outcomes based on their subjective feedback. Conclusions: The findings suggest that the use of a fully digital workflow with stackable surgical templates is a reliable and effective approach for immediate implant placement and prosthetic rehabilitation, enhancing treatment precision and patient comfort. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this in vitro study was the evaluation of the tensile bond strength of two different cements used for luting zirconia coping to one-piece zirconia implant. Settings and Design: The study was designed in an in vitro study setting. Materials and Methods: A one-piece zirconia implant was scanned on laboratory scanner, and thirty zirconia implants were milled by computer aided manufacturing (CAM). Subsequently, the abutment surface of each zirconia implants were scanned in laboratory scanner and coping with a hole was designed by computer-aided designing software, which was used for milling by computer-aided manufacturing (CAM). After various surface treatments of abutment and intaglio surface of coping, fifteen sets were cemented by glass ionomer cement (Group I) and the other fifteen sets by adhesive resin cement (Group II). All thirty samples after thermocycling were dried and pulled out in a universal testing machine, and tensile retention force is noted in pounds per square inch (psi). Statistical Analysis Used: Values for tensile retention force were tabulated for both the groups. Mean and standard deviation are calculated. Independent t -value and P value were calculated. Results: The least tensile retention force was reported in Group I (165.86 ± 25.74 psi). Maximum tensile retention force was received for Group II (396.81 ± 78.32 psi). Independent t -test was applied from which t -value calculated was 10.85 and P value obtained was 0.001, which means that there exists a very high difference in tensile bond strength of cement in Group I and Group II. Conclusions: Better tensile retention forces were observed in samples cemented with adhesive resin cement when compared to samples cemented with glass ionomer cement. [ABSTRACT FROM AUTHOR]

The All-on-6 technique is a modern and effective solution for complete tooth restoration, using six dental implants to support a fixed denture. This method provides excellent long-term results, with significant benefits in terms of durability, stability, and functionality of the implants. Titanium implants, once integrated into the bone through the osseointegration process, can last for decades, and the prosthesis attached to them provides patients with an experience similar to that of natural teeth. One of the major advantages of the All-on-6 technique is the prevention of bone resorption, a common problem in patients who have lost teeth. The implants stimulate the jawbone, maintaining volume and preventing facial changes associated with bone loss. In the long term, the success of this treatment depends on rigorous oral hygiene and regular visits to the dentist for denture maintenance and monitoring of the condition of the implants. Although the risks of complications such as peri-implantitis or osseointegration failure exist, they are rare and can be prevented with proper care. In conclusion, All-on-6 offers a durable, aesthetic and functional solution for patients with severe tooth loss. [ABSTRACT FROM AUTHOR]