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This clinical study retrospectively analyzed cone beam computed tomography (CBCT) images to determine the potential influence of implant inclination on periimplant marginal bone loss after 18 to 24 months of functional loading. Twenty-five consecutive patients presenting with an edentulous or partially edentulous maxilla or mandible and an adequate bone volume for receiving oral implants were selected for analysis of the marginal bone loss around tilted and/or axial implants. The study population included patients rehabilitated with Toronto bridges (TBs), fixed partial dentures (FPDs), or single crowns (SCs) on axial and/or tilted implants. The primary outcome was the CBCT analysis of peri-implant marginal bone level change, depending on inclination of implants and type of prostheses. The secondary outcome was analysis of survival and success rates of tilted and axial implants. A significant difference was observed for peri-implant buccal bone loss (mean of axials 0.42 ± 0.06; mean of tilted 0.70 ± 0.09) (P = .009). The difference in peri-implant lingual/palatal/mesial/distal bone loss was not significant between axial and tilted implants (P > .05). No significant difference was observed between the marginal bone level and the type of prostheses for both tilted and axial implants in all the assessed sites (P > .05). The success rate for both tilted and axial implants was 100%, and no complications were observed for all the prosthetic rehabilitations, with a 100% survival rate. Compared to axial implants, tilted implants showed a significant statistical difference for peri-implant buccal bone loss, but no other differences were observed for peri-implant bone loss or for implant survival and success rate. Fixed partial or total rehabilitation using tilted or axial implants, or with tilted and axial implants, could be a reliable technique with advantages to patients and operators. [ABSTRACT FROM AUTHOR]

Introduction. Full-arch, implant-supported hybrid restorations, employing tilted implants, can offer an efficient way of treating edentulous patients. Several factors, such as the timing of implant placement and the inclination of the fixture, can have a detrimental effect on their stability. This retrospective study is aimed at discerning the role played by those factors. Materials and Methods. Patients treated with full-arch, implant supported restorations were selected for this study; cone-beam computed tomography (CBCT) images, taken 3 months and 3 years after delivery of the final restoration, as well as peri-implant values, were obtained and compared; bone loss was measured on four sites for each implant and then averaged. These patients were recalled, and the OHIP-5 questionnaire was administered. Results. 21 patients, with a mean age of 53 years, were included in the present analysis. 108 implants were placed, and 25 Toronto prostheses were delivered. According to a mixed-model analysis, tilted implants (0.51, p < 0.001) had a higher rate of bone loss, while implants placed in a healed ridge suffered less bone loss than immediate implants (-0.21, p < 0.001). Patient-level variables have a significant effect on this variable, as implants coming from the same subject share a similar risk of bone loss. The mean response to the self-administered OHIP-5 questionnaire was 1.53 ± 0.29 ; other variables did not have a statistically significant effect on this outcome. Discussion/Conclusions. The results of the present study show that Toronto bridges prostheses are an efficient procedure for treating edentulous patients, as their oral-related quality of life is reported as satisfactory even 7 years after delivery of the restoration. Tilted and immediate implants are more at risk of bone loss. Implants coming from the same subject share a similar risk of bone loss. [ABSTRACT FROM AUTHOR]

The digital workflow and the application of Computer-Aided Manufacturing (CAM) to prosthodontics present the clinician with the possibility of adopting new materials that confer several advantages. Especially in the case of zirconia, these innovations have profoundly changed daily practice. This paper compares the satisfaction and perception of patients who received implant-supported single crowns (SC) and fixed partial dentures (FPD) made from zirconia, either monolithic or partially veneered, after 3 years of follow-up; the success and survival rate of these restorations were also measured. Forty patients, who had been previously treated with implant-supported SC or FPD, either monolithic or partially veneered, and submitted to a yearly maintenance program, were recalled 3 years after their treatment and requested to complete an 8-question questionnaire regarding their perceptions of the treatment. Any mechanical or biological complication that had occurred from the time of delivery was also recorded. Patients that experienced ≥1 complication were less likely to be prone to repeat the treatment. The 3-year success rate was 92.6% for monolithic restoration and 92.3% for partially veneered restoration, while the survival rate was 100% for both restorations. The 3-year follow-up found that monolithic and partially veneered zirconia restorations are both well-accepted treatment options, and patients preferred the veneered restorations (0.76, p < 0.05) from an aesthetic point of view. According to our results, monolithic and veneered zirconia restorations are both reliable treatment options and are both equally accepted by patients. [ABSTRACT FROM AUTHOR]

The purpose of this clinical research was to evaluate peri-implant marginal changes around immediate implants placed either with the application of SCTG or XCM or without soft tissue grafting. A total of 48 patients requiring a single implant-supported restoration in the anterior jaw were selected for inclusion. Three surgical procedures were performed, as follows: type 1 implant with subepithelial connective tissue graft (SCTG), type 1 implant with xenogenic collagen matrix (XCM), and type 1 implant without soft tissue augmentation (NG) (control group). The marginal change of peri-implant soft tissue, facial soft tissue thickness (FSTT), peri-implant health status, esthetics, and patient satisfaction were assessed at one year after surgery. All of the placed implants showed a survival rate of 100%. No significant differences in FSTT were recorded between the SCTG group and the XCM group after treatment (P > 0.05), while the NG group presented a significant difference (P < 0.05). Patients in the NG group lost significantly more in the buccal marginal level than did patients in the SCTG group and those in the XCM group (P < 0.05). The favourable success rate recorded in all groups confirmed immediate tooth replacement as a choice of treatment for a missing anterior single tooth. The NG group presented significant changes of FSTT and buccal marginal level, while XCM constituted a viable alternative to SCTG. [ABSTRACT FROM AUTHOR]