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Aim: The aim of the present study was (i) to evaluate the clinical performance of reduced‐diameter implants placed in the molar area and (ii) to test whether monolithic zirconia implant‐supported crowns lead to similar clinical outcomes compared to porcelain‐fused‐to‐metal crowns. Materials and Methods: A total of 76 patients needing a single implant crown in the posterior region were recruited. All patients received a titanium–zirconium reduced‐diameter implant (Straumann Roxolid, Tissue Level, Standard Plus, diameter 3.3 mm, regular neck) randomly allocated to receive either a (1) monolithic zirconia crown (test) or (2) porcelain‐fused‐to‐metal crown (control). Implant survival, prosthetic outcomes, and patient‐reported outcomes were assessed at crown delivery and after 3 years of follow‐up. Marginal bone levels (MBL) as well as clinical parameters including probing depth (PD), bleeding on probing (BOP), and plaque levels (PCR) were also recorded. Results: A total of 59 patients were available at the 3‐year follow‐up; 32 patients with a monolithic zirconia crown (TEST) and 27 patients with a porcelain‐fused‐to‐metal crown (CONTROL). 14 implants (11 implant fractures/3 aseptic losses) were lost leading to an estimated implant survival rate of 80% ± 5.1% (95% CI 70.8%–90.8%). Prosthetic complications were limited to the control group and involved minor chippings. Conclusions: This type of reduced‐diameter implant to support single implant molar crowns in the molar area cannot be recommended. Monolithic zirconia crowns appear to be a viable option in the posterior region showing similar prosthetic outcomes to porcelain‐fused‐to‐metal crowns. [ABSTRACT FROM AUTHOR]

Aim: To assess in vitro the workflow for alveolar ridge augmentation with customised 3D printed block grafts and simultaneous computer‐assisted implant planning and placement. Methods: Twenty resin mandible models with an edentulous area and horizontal ridge defect in the region 34–36 were scanned with cone beam computed tomography (CBCT). A block graft for horizontal ridge augmentation in the region 34–36 and an implant in the position 35 were digitally planned. Twenty block grafts were 3D printed out of resin and one template for guided implant placement were stereolithographically produced. The resin block grafts were positioned onto the ridge defects and stabilised with two fixation screws each. Subsequently, one implant was inserted in the position 35 through the corresponding template for guided implant placement. Optical scans of the study models together with the fixated block graft were performed prior to and after implant placement. The scans taken after block grafting were superimposed with the virtual block grafting plan through a best‐fit algorithm, and the linear deviation between the planned and the achieved block positions was calculated. The precision of the block fixation was obtained by superimposing the 20 scans taken after grafting and calculating the deviation between the corresponding resin blocks. The superimposition between the scans taken after and prior to implant placement was performed to measure a possible displacement in the block position induced by guided implant placement. The (98–2%)/2 percentile value was determined as a parameter for surface deviation. Results: The mean deviation in the position of the block graft compared to the virtual plan amounted to 0.79 ± 0.13 mm. The mean deviation between the positions of the 20 block grafts measured 0.47 ± 0.2 mm, indicating a clinically acceptable precision. Guided implant placement induced a mean shift of 0.16 ± 0.06 mm in the position of the block graft. Conclusions: Within the limitations of this in vitro study, it can be concluded that customised block grafts fabricated through CBCT, computer‐assisted design and 3D printing allow alveolar ridge augmentation with clinically acceptable predictability and reproducibility. Computer‐assisted implant planning and placement can be performed simultaneously with computer‐assisted block grafting leading to clinically non‐relevant dislocation of block grafts. [ABSTRACT FROM AUTHOR]

The aim of the present study was to evaluate whether 6-mm dental implants in the posterior segments of either jaw perform equally well in terms of clinical and radiographic outcomes when compared with 10-mm implants after 5 y of loading. Patients with single-tooth gaps in the posterior area who were scheduled for implant therapy were randomly assigned to a group receiving either a 6- or 10-mm implant. After a healing period of 10 wk, implants were loaded with a screw-retained single crown and followed up at yearly intervals. Of 96 patients, 86 could be recalled after 5 y. The implant survival rates amounted to 91% (95% confidence interval: 0.836 to 0.998) for the 6-mm group and 100% for the 10-mm group ( P = 0.036). Median crown-to-implant (C/I) ratios were 1.75 (interquartile range [IQR], 1.50 to 1.90) for the 6-mm group and 1.04 (IQR, 0.95 to 1.15) for the 10-mm group, whereas the median marginal bone levels measured -0.29 mm (IQR, -0.92 to 0.23) for the 6-mm group and -0.15 mm (IQR: -0.93 - 0.41) for the 10-mm group after 5 y. The C/I ratio turned out to be statistically significant ( P < 0.001), whereas marginal bone levels showed no significant difference between the groups. The 6-mm implants exhibited significantly lower survival rates than the 10-mm implants over 5 y, whereas there was no difference between upper and lower jaws in terms of survival ( P = 0.58). Lost implants did not show any sign of marginal bone loss or peri-implant infection previous to loss of osseointegration. High C/I ratio and implant length had no significant effect on marginal bone level changes or technical and biological complications (German Clinical Trials Registry: DRKS00006290). [ABSTRACT FROM AUTHOR]

Copyright of International Journal of Computerized Dentistry is the property of Quintessence Publishing Company Inc. 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.)

The aim of the study was to test whether implants of 6 mm in length perform equally well as 10-mm implants in terms of survival and marginal bone-level changes when supporting single crowns. Patients with a posterior single-tooth gap were randomly allocated to either the placement of a 6-mm (test) or 10-mm implant (control). The treatment protocol allowed for internal sinus lift but not for lateral bone augmentation. After a healing period of 10 wk, implants were loaded with screw-retained single crowns. Survival rates, number of pockets ≥5 mm, and bleeding-on-probing were assessed clinically. The change of marginal bone level and crown-to-implant ratios were analyzed by 2 examiners. Longitudinal intragroup analyses for marginal bone levels were performed applying the Wilcoxon signed rank test. Intergroup differences at baseline and at 3 y were compared using the Mann-Whitney U test. The effect of implant length and crown-to-implant ratio on changes of marginal bone level also was determined. Of 94 implants placed (47 test and 47 control), 78 implants (40 test and 38 control) were available for follow-up examination at 3 y of loading. One test implant was lost during the second year. Hence, implant survival was not significantly different between the 2 groups after 3 y (98% test; 100% control). We found no significant change in the crestal bone level from baseline to 3 y for test and control implants with -0.19 ± 0.62 mm and -0.33 ± 0.71 mm, respectively. The intergroup difference was not significant. Crown-to-implant ratios were not associated with a statistically significant difference in marginal bone loss. However, the number of sites with pockets ≥5 mm was significantly higher in the test group. Based on the 3-y assessment, the use of 6-mm implants can be considered a viable option when reconstructing posterior single tooth gaps (German Clinical Trials Registry: DRKS00006290). [ABSTRACT FROM AUTHOR]

Objectives To test whether or not vascularized interpositional periosteal-connective tissue grafts are as successful as free subepithelial connective tissue grafts in augmenting volume defects in the anterior maxilla. Material and methods Twenty subjects with Seibert class 1 ridge defects in the anterior maxilla were randomly, equally assigned to augmentation by vascularized interpositional periosteal-connective tissue graft (test) or free subepithelial connective tissue graft (control). Clinical periodontal parameters at teeth adjacent to the gap were recorded, and conventional impressions were taken prior to surgery (baseline = t0) and 1 (t1), 3 (t3) and 6 (t6) months after surgery. The casts were optically scanned, digitized and analyzed for ridge contour changes in the augmented area. Data were subjected to nonparametric statistics. Results The contour changes in labial distance between baseline and follow-up for the control group were (median, range) 1 mm, 0.37-1.45 (t0-t1); 1.18 mm, 0.39-1.40 (t0-t3); and 0.63 mm, 0.28-1.22 (t0-t6) and for test group 1.21 mm, 0.74-2.47 (t0-t1); 1.26 mm, 0.50-1.71 (t0-t3); and 1.18 mm, 0.16-1.75 (t0-t6). Significantly less shrinkage of the graft was observed in the test group after 6 months ( P = 0.03). Clinical periodontal parameters at the neighboring teeth were stable over the follow-up period and did not differ between groups. Conclusions Augmentation of single tooth gaps with moderate ridge defects in the anterior maxilla was successfully performed using both techniques. However, after 6 months, sites treated by the pediculated graft were superior in maintaining the initially augmented volume and showed less shrinkage of the graft. This could be attributed to better perfusion of the pediculated graft. [ABSTRACT FROM AUTHOR]

Objectives. The aims of this study were to test whether the bond strength of a hybrid composite and a PMMA-based veneer to CAD/CAM polymers would improve after pre-treatment and to evaluate the failure types after debonding. Materials and methods. Three types of PMMA-based (CAD-Temp, artBloc Temp and TelioCAD) CAD/CAM blocks were obtained ( N = 360, n = 15 per test group). They were divided into four groups to be conditioned with the following methods: (a) no-treatment, (b) air-abrasion (50 μm Al2O3), (c) air-abrasion (50 μm Al2O3) + MPS-Silane (Monobond S) + Adhesive resin (StickResin) (for Gradia)/MMA (for Integral Esthetic Press) application, (d) Silica coating and silanization (CoJet-System). The conditioned surfaces were veneered with a hybrid composite (Gradia) or a PMMA-based resin (Integral esthetic press). After water storage (1 week, 37°C), the bond strength was measured. Data were analyzed using 3-way ANOVA and post-hoc Scheffé test ( α = 0.05). Results. Surface-conditioning method, veneer type and CAD/CAM polymers significantly affected the results. Hybrid composite did not bond to non-conditioned CAD/CAM polymers. Regardless of the conditioning method, PMMA-based resin showed significantly higher bond strength to all CAD/CAM polymers compared to hybrid composite. Air-abrasion increased the bond strength in all tested groups. Additional silane application after air-abrasion did not significantly increase the bond strength of hybrid composite. While exclusively adhesive failures were observed between the hybrid composite and the CAD/CAM polymers, PMMA veneer demonstrated cohesive failures in the CAD/CAM polymers. Conclusion. CAD/CAM polymers could be veneered with only a PMMA-based veneer with and without air-abrasion. [ABSTRACT FROM AUTHOR]

This study tested the impact of Gluma Desensitizer on the shear bond strength (SBS) of two conventional (RelyX ARC, Panavia 21) and two self-adhesive (RelyX Unicem, G-Cem) resin luting cements after water storage and thermocycling. Human third molars (N=880) were embedded in acrylic resin. The buccal dentin was exposed. Teeth were randomly divided into four main groups, and the following cements were adhered: 1) RelyX ARC, 2) Panavia 21, 3) RelyX Unicem, and 4) G-Cem. In half of the teeth in each group, dentin was treated with Gluma Desensitizer. In the conventional cement groups, the corresponding etchant and adhesive systems were applied. SBS of the cements was tested after 1 hour (initial); at 1, 4, 9, 16, and 25 days of water storage; and at 1, 4, 9, 16, and 25 days of thermocycling. SBS data were analyzed by one-way analysis of variance (ANOVA); this was followed by the post hoc Scheffé test and a t-test. Overall, the highest mean SBS (MPa) was obtained by RelyX ARC (ranging from 14.6 ± 3.9 to 17.6 ± 5.2) and the lowest by Panavia 21 in combination with Gluma Desensitizer (ranging from 0.0 to 2.9 ± 1.0). All tested groups with and without desensitizer showed no significant decrease after aging conditions compared with baseline values (p>0.05). Only the Panavia 21/Gluma Desensitizer combination showed a significant decrease after 4 days of thermocyling compared with initial values and 1 day thermocycling. Self-adhesive cements with Gluma Desensitizer showed increased SBS after aging conditions (ranging from 7.4 ± 1.4 to 15.2 ± 3) compared with groups without desensitizer (ranging from 2.6 ± 1.2 to 8.8 ± 2.9). No cohesive failures in dentin were observed in any of the test groups. Although self-adhesive cements with and without desensitizer presented mainly adhesive failures after water storage (95.8%) and thermocyling (100%), conventional cement (RelyX ARC) showed mainly mixed failures (90.8% and 89.2%, after water storage and thermocyling, respectively). Application of the Gluma Desensitizer to dentin before cementation had a positive effect on the SBS of self-adhesive cements. [ABSTRACT FROM AUTHOR]

Due to interhuman differences in the perception of color, visual shade assessment of human teeth is lacking standardization that may be improved by the use of a spectrophotometer. In this study, we tested the hypothesis that spectrophotometric assessment of tooth color is comparable with human visual determination. On 30 patients, three operators with unreported visual color deficiency independently selected the best match to the middle third of unrestored maxillary central incisors, using a Vita Classical Shade Guide. The same teeth were measured by means of a reflectance spectrophotometer. In the human group, all 3 visual shade selections matched in only 26.6%. In the spectrophotometric group, all 3 shade selections matched in 83.3%. In 93.3%, ΔE values of visually assessed tooth shades were higher than spectrophotometrically assessed ΔE values (p < 0.0001). The results suggest that spectrophotometric shade analysis is more accurate and more reproducible compared with human shade assessment. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the remodelling of alveolar bone adjacent to periodontal sites following therapy according to the principles of guided tissue regeneration (GTR) using computer-assisted densitometric image analysis (CADIA), and to compare the radiographic results to traditional clinical parameters. As required for digital subtraction analyses, periodically reproducible radiographs were obtained using a modification of the Rinn System and individual acrylic bite blocks for periodical identical radiographs. Ideally, a digital subtraction image from a site where absolutely no change in density had occurred would show a perfect cancellation of the structures. An average grey level value of 128 (the middle of the digitizer grey level range set by software) would show up at each pixel. Areas with grey levels < 128 in the subtraction image would indicate loss in density and grey levels > 128 would indicate increase in density. Within the subtraction images, areas were defined using the cursor to draw "regions of interest" (ROI) projected on the bony defect exposed to GTR covering the crestal bone as well as the region of potential "bonefill". The mean, median, the standard deviation and range of the grey levels of pixels within a particular ROI were calculated. Similarly sized ROI were drawn in bone areas not exposed to the GTR procedure serving as controls. The differences in the mean grey levels of all pixels within a particular ROI between the baseline, 3 and 12 months images were calculated for documentation of gain or loss in density. From 14 patients, standardized radiographs were available from baseline, 3 months and 12 months postsurgically, depicting one infraosseous defect before and after treatment according to the principles of GTR. The densitometric changes observed in these defects were compared to the clinically assessed changes measured at the site with the deepest baseline pocket depth. A mean clinical attachment gain of 2.36 mm after 3 and 3.22 mm after 12 months was measured. This was associated with a mean reduction in the PPD amounting to 3.36 mm and 3.79 mm, respectively. The changes in the level of the FGM were rather small considering the deep original mean PPD of 7.07 mm. Over the first months, a mean recession of 1.14 mm was observed which was followed by a coronal displacement of 0.43 mm. With respect to the remodelling of the alveolar bone adjacent to the defects assessed by means of CADIA, the most pronounced changes occurred when comparing the baseline to the 12 months radiographs. In the resulting subtraction images, the mean grey level was elevated over 128 when ROIs were evaluated projected on the test sites. The mean increase in density was not only indicated by the differences in the mean grey levels but also by their high standard deviations in the test ROI in such subtraction images. When ROIs projected on alveolar bone sites distant from the GTR procedures were evaluated over time, the mean grey levels were constant near 128 and the standard deviations were smaller compared to the test sites. The data obtained from the control sites represent the density changes measured due to physiologic remodelling and/or changes due to the sum of the methodological errors. When correlations between the changes in density and the traditional periodontal parameters were calculated, rather low correlation coefficients were obtained, stressing the different characters of information provided by the radiographic and by the clinial probing diagnostic procedures. In summary, the soft periodontal tissues demonstrated a fast repopulation of the previously diseased root surface which was followed by a slow delayed reorganisation of the soft tissue structures. The alveolar bone adjacent to sites exposed to GTR demonstrated a slow consolidation of the tissues represented by mineralization occurring delayed, compared to the changes in the probing attachment levels. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Periodontology is the property of Wiley-Blackwell 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.)

The article discusses the prospective randomised controlled clinical study on membranes for guided bone regeneration. The study reportedly involved patients with a single tooth gap that needs implant treatment who were recruited at the University of Zurich's Clinic for Fixed and Removable Prosthodontics and Dental Material Science. Also explored are the clinical parameters, histological analysis, and clinical bone dimensions.

Objective: Resin infiltration is considered as a treatment option for initial caries lesions. As cavitated early lesions might require additional restorative intervention, a caries infiltrant might be also used for enamel conditioning prior to composite insertion. This study aimed to analyse the shear bond strength of a flowable composite to sound and demineralised enamel pretreated with a caries infiltrant, a conventional adhesive or a combination of both.Methods: Flattened bovine enamel specimens (n=120) were either demineralised (14 d, acidic buffer, pH 5) or remained untreated. Sound and demineralised specimens (each n=20) were then treated with: (1) 35% phosphoric acid, conventional adhesive, (2) 15% hydrochloric acid, caries infiltrant or (3) 15% hydrochloric acid, caries infiltrant, conventional adhesive. Shear bond strength of a flowable composite was tested after 24 h water storage (37°C) and statistically analysed (ANOVA, p≤0.05). The mode of failure was assessed microscopically at 25× magnification.Results: On demineralised enamel, the combination of caries infiltrant and conventional adhesive showed significantly higher shear bond strength values than the conventional adhesive alone, while both being not significantly different from group 2. No significant differences between the groups could be detected on sound specimens. A higher percentage of cohesive failures could be observed in demineralised samples of group 2 (40%) and 3 (65%), while all other specimens presented almost only adhesive failures.Conclusion: The use of a caries infiltrant before application of a conventional adhesive did not impair bonding to sound and demineralised enamel and might be beneficial as a pretreatment in demineralised enamel. [ABSTRACT FROM AUTHOR]