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The article discusses studies which show that full-ceramic prosthetic restorations for single crowns (SCs) and fixed dental prostheses (FDPs) are high quality and have a satisfactory survival rate comparable to porcelain-fused-to-metal (PFM). These studies include the survival outcome and complications in a retrospective clinical study of complete-arch fixed implant-supported prostheses (CAFIPs), the prevalence of prosthetic complications, and clinical performance of implant-supported FDPs.

Purpose: The aims of the study were to evaluate the clinical performance and the complications of combined tooth-/implant-supported three-unit fixed partial dentures (FPDs) in the posterior mandible. Materials and Methods: A total of 78 partially edentulous patients in the posterior mandible were recruited for the study (n = 26/group). Group 1 served as the control group and received two dental implants to support a three-unit FPD. Groups 2 and 3 were the experimental groups in which one implant was placed in conjunction with support from an adjacent tooth to support a three-unit FPD. Standard implants (= 8 mm) were included in Group 2, while short implants (< 8 mm) were included in Group 3. Periapical radiographs were taken for evaluation of crestal bone loss (CBL). Modified plaque index (MPI), bleeding index (BI), and sulcus depth values of the abutment teeth were recorded at the time of FPD delivery, 6 months after FPD delivery, and annually thereafter. Recorded complications included abutment tooth intrusions, cementation failures of the restorations, porcelain chipping/delamination, framework fracture, abutment screw loosening, abutment and abutment screw fracture, and implant fracture. Results: Statistically significant differences were observed between Group 1 (0.06 ± 0.17) and Group 2 (0.18 ± 0.32) and between Group 1 and Group 3 (0.17 ± 0.30) in terms of MPI (P = .05). No difference was observed between Group 2 (0.11 ± 0.34) and Group 3 (0.14 ± 0.36) or between Group 1 (0.04 ± 0.22) and Group 2 in terms of BI. There were statistically significant differences in terms of CBL between Group 1 (0.259 ± 0.05 mm) and Group 3 (0.11 ± 0.03 mm) and between Group 2 (0.03 ± 0.03 mm) and Group 3 (P = .05). The mean abutment tooth sulcus depth was 1.11 ± 0.31 mm for Group 2 and 1.20 ± 0.46 mm for Group 3. Conclusions: Within the limitations of the current study, it was concluded that combined tooth/implant-supported prostheses (CTISPs) are a predictable treatment choice in the posterior mandible. When a CTISP is planned, it is more predictable to use a short implant than a standard-length implant. [ABSTRACT FROM AUTHOR]

Purpose: To generate data on the long-term survival of metal-ceramic resin-bonded fixed partial dentures (RBFPDs). Materials and Methods: A total of 89 patients received 94 RBFPDs, 5 of whom (women n = 1; men n = 4) received 2 RBFPDs each. All RBFPDs were fabricated as two-retainer end-abutment metal-ceramic restorations. Clinical follow-ups were performed 6 months after cementation and then annually thereafter. The mean observation time was 7.5 years. Cox regression was performed to test the effects of the variables: gender, location, arch, design, use of rubber dam, and adhesive luting system. Survival and success were calculated using Kaplan-Meier curves. As a secondary objective, patient and dentist satisfaction with the esthetics and function of the RBFPDs was evaluated. The significance level was set at α = .05 for all calculations. Results: Estimated Kaplan-Meier failure-free survival was 97.5% (standard error [SE] 1.7) after 5 years and 83.3% (SE 5.3) after 10 years. Calculated intervention-free survival (success) was 90.1% (SE 3.4) after 5 years and 65.5% (SE 6.7) after 10 years. Debonding-free survival was 92.6% (SE 2.9) after 5 years and 80.6% (SE 5.4) after 10 years. Cox regression revealed that none of the four tested variables had a significant effect on the incidence of complications in RBFPDs. Patient and dentist satisfaction with RBFPD esthetics and function was consistently high throughout the observation period. Conclusions: Within the limitations of an observational study, RBFPDs achieved clinically successful outcomes over a mean observational period of 7.5 years. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate peri-implant tissue health and bone resorption in patients with implant-supported fixed partial rehabilitations. In particular, possible correlations between plaque accumulation and bone loss, as well as other periimplant health parameters, were investigated. Materials and Methods: A total of 44 patients rehabilitated with fixed implant-supported partial rehabilitations were included. The following parameters were recorded: spontaneous bleeding (SB), suppuration, bleeding on probing (BOP), plaque index (PI), and probing depth (PD). Periapical radiographs were taken to measure crestal bone loss (BL). A nonparametric test (Spearman rank coefficient; rs) was used to identify possible correlations between the clinical parameters recorded. Results: A total of 121 implants were analyzed. Global PI and BOP were 49.58% and 20.25%, respectively. There were no cases of suppuration, and only 2 implants showed spontaneous bleeding. Mean BL was 1.53 mm (SD: 0.98). No implants showed peri-implantitis. There was a weak, statistically significant correlation between PI and BL (rs = 0.27, P [2-tailed] = .99) and between PI and the other peri-implant parameters (BOP: rs = 0.14, P = .14; PD: rs = 0.04, P = .65; SB: rs = --0.08, P = .34). A very weak correlation was also found between BL and BOP (rs = 0.1, P = .2) and between BL and PD (rs = 0.02, P = .7). Correlation was found between BL and age (rs = 0.13, P = .81) and between the other peri-implant parameters and age using dichotomization (> or < 65 years; PI: rs = --0.14, P = .11; PD: rs = --0.21, P = .01; BOP: rs = --0.21, P = .01; SB: rs = 0.05, P = .53). No statistically significant correlations were found between the clinical parameters evaluated and the sex or the dental arch treated (maxilla vs mandible). In contrast, the correlation between periodontal parameters and years elapsed since surgery (follow-up) was significant. Conclusions: The present research suggests that in implant-supported fixed partial rehabilitations, dental implants with greater plaque accumulation are more likely to present augmented probing depth, peri-implant inflammation, and bone loss, although the correlation is statistically very weak. Patient age and time of follow-up also significantly affected peri-implant health parameters. [ABSTRACT FROM AUTHOR]

The article discusses the results of a study which evaluated the effectiveness and accuracy of a proposed duplication technique in terms of one- and three-dimensional discrepancies between an original abutment and polyurethane duplicates obtained through a conventional workflow in single-implant rehabilitation. Topics covered include master cast with the Giroform System, abutment duplication and the influence of duplication on crown marginal and internal adaptation.

The article discusses a study which compared the fit and fracture load of temporary fixed partial prostheses fabricated by means of a conventional direct technique, milling or 3D printing. Topics covered include the strength of the fixed dental prostheses, the values of the fracture test, and the maximum mastication forces in the molar region.

The present study assessed the impact of a fixed prosthetic rehabilitation on masticatory function in patients diagnosed with stage IV periodontitis. Eligible participants were adults in need of complex rehabilitation due to masticatory dysfunction. Masticatory function was evaluated using the two‐ colored chewing gum mixing ability test (VOH) at the diagnostic phase (T0), 1 week after delivery of the prosthetic prototype (T1), and 1 week after delivery of the final prosthetic solution (T2). Ten subjects were treated with a fixed prosthesis following periodontal and implant surgery using an individualized, fully digital workflow. Full-mouth plaque and bleeding scores, pocket depth, and clinical attachment level improved significantly. VOH was 0.472 ± 0.168 at T0, 0.358 ± 0.166 at T1, and 0.250 ± 0.123 at T2. A significant improvement in VOH was observed from T0 to T1 (difference: –0.114; 95% CI: –0.199 to –0.029; P = .014) and from T1 to T2 (difference: –0.108; 95% CI: –0.200 to –0.015; P = .027). From T0 to T2, VOH increased by 44.3%. Self-perceived assessment of masticatory function also improved from T0 to T2 (P = .002). The fixed prosthetic rehabilitation in patients with stage IV periodontitis allowed for a significant improvement in objective and subjective measurements of masticatory function. [ABSTRACT FROM AUTHOR]

The use of conventional scan bodies (SBs) with an intraoral scanner (IOS) to capture the position of a complete arch of dental implants has proven to be challenging. The literature is unclear about the accuracy of intraoral scanning techniques using SBs that are connected vertically to multiunit abutments (MUAs) for numerous adjacent implants in the same arch. Recently, there has been a paradigm shift from vertical SBs to horizontal SBs, which are positioned perpendicular to the long axis of the MUAs. Most IOSs available today can capture these horizontal SBs, called scan gauges (SGs), with better accuracy and consequently acquire the position of multiple adjacent implants using an effective scan path, thus reducing stitching and the number of images. The key to implementing this novel technology is to strategically arrange the SGs to optimize horizontal overlap of multiple adjacent SGs without touching each other. By superimposing two high-resolution intraoral scans of the SGs, an artificial intelligence (AI) algorithm is employed to produce a calibrated digital best-fit model on which a passive complete-arch prosthesis can be designed and fabricated. The advantages and disadvantages of SBs and SGs are discussed, and a case report using a digital workflow is presented. [ABSTRACT FROM AUTHOR]

Purpose: To examine and compare the fracture strength of implant-cemented fixed partial denture (FPD) prostheses fabricated with digital vs conventional chairside methods. Materials and Methods: Three groups of seven specimens each were produced: group A (3D printing); group B (milling); and group C (conventional chairside manufacturing), which served as a control. All groups were cemented to standard implant abutments placed in artificial bone blocks. Fracture strength testing was performed using a universal testing machine. Statistical analysis of the resultant maximum forces was performed using SPSS version 25 software (Mann-Whitney U test, P < .05). Results: The mean fracture load value of the group A FPDs was 260.14 N ± 28.88, for group B was 663.57 N ± 140.55, and for group C was 266.65 N ± 63.66. Conclusions: Milled provisional FPDs showed a higher fracture resistance compared to 3D-printed and control groups. However, no such difference could be detected between the 3D-printed and control groups. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate and compare the changes in brain activity for individuals with a single missing mandibular molar replaced with a removable dental prosthesis (RPD) and a fixed tooth-supported implant prosthesis in the static and postmasticatory phases. Materials and Methods: In total, 24 patients with a unilateral missing mandibular first molar were rehabilitated with a removable dental prosthesis and divided into two groups of 12 each; Group A was rehabilitated with implants and Group B with 3-unit toothsupported fixed partial dentures (FPDs). An electroencephalogram (EEG) was taken during the three phases of assessment: (1) before insertion of any prosthesis (N0), (2) after insertion of an RPD (N1), and (3) after cementation of an FPD or implant crown (F2). The effect of bite force with RPD (N1M) and FPD or implant prosthesis (F2M) on alpha waves was evaluated by recording EEG immediately after chewing gum for 30 seconds. Results: The improvement of the amplitude of alpha waves before and after prosthesis insertion showed a significant difference between Group As and B (P < .05) with the highest mean values of 158.3 µV, 147.9 µV, and 182.1 µV occurring in pairs F2-N0, F2-N1, and F2M-N1M, respectively, for Group A. Similarly, for the power of alpha waves between group A and B, a statistically significant difference (P < .05) with the highest mean values of 30.3 dB, 28.9 dB, 36.9 dB, and 11.2 dB in pairs F2-N0, F2-N1, F2M-N1M, and F2M-F2, respectively, was observed for Group A. There was no statistically significant increase in pair N0-N1 (P > .05). Conclusions: Replacement of a single missing tooth enhanced brain activity and was highest with an implant-supported crown. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the 3-year success and survival rates of fixed prostheses supported by 4-mm extra-short implants splinted to 10-mm implants in patients with shortened maxillary arches and low maxillary sinus floors. Methods: A total of 11 patients with reduced alveolar bone heights due to low maxillary sinus floors received two or three titaniumzirconium tissue-level implants: one or two extra-short (4 mm) implants, and one implant 10 mm in length. After 6 months, prosthetic rehabilitation with splinted crowns connecting the 4- and 10-mm implants was performed. Follow-up visits and maintenance protocols were implemented every 4 to 6 months. Results: The 11 patients were treated with 11 10-mm implants and 17 4-mm implants. One extra-short implant failed and was removed before loading, and its planned design was modified from three splinted crowns to a bridge between the 10- and 4-mm implants. After 36 months, all (11/11) prosthetic rehabilitations connecting the 10-mm (11/11) and 4-mm (16/16) implants were functional. At the 10-mm implant sites, the median (interquartile range [IQR]) probing depth and marginal bone loss measured 2.9 mm (2.3 to 3.2) and 1.3 mm (1.0 to 1.5), respectively. At the 4-mm implant sites, the median (IQR) probing depth and marginal bone loss measured 2.9 mm (2.4 to 3.1) and 0.3 mm (0.1 to 0.5), respectively. Conclusion: Prosthetic rehabilitation with splinted crowns connecting 4-mm and 10-mm implants showed promising outcomes in shortened maxillary dental arches after 3 years. Additional studies are needed to further validate these findings. [ABSTRACT FROM AUTHOR]

Partial extraction therapy (PET) is a group of surgical techniques that preserve the periodontium and peri-implant tissues during restorative and implant therapy by conserving a portion of the patient's own root structure to maintain the blood supply, derived from the periodontal ligament complex. PET includes the socket shield technique (SST), proximal shield technique (PrST), pontic shield technique (PtST), and root submergence technique (RST). Although their clinical success and benefits have been demonstrated, several studies report possible complications. The focus of this article is to highlight management strategies for the most common complications associated with PET, including internal root fragment exposure, external root fragment exposure, and root fragment mobility. [ABSTRACT FROM AUTHOR]

Objective: The correlation between crestal bone loss at teeth and probing pocket depth (PPD) has been established. Whether these findings can also be applied to implants is not known. The objective of this study was to determine the correlation between crestal bone loss and PPD at teeth and implants. Method and materials: Thirty-one periodontitis-susceptible patients were rehabilitated with fixed implant-supported single crowns and fixed partial dentures. Each patient was examined over a 5- to 20-year period in a 3- to 6-month strict recall program. At each session, periodontal clinical parameters were recorded at teeth and implants. In addition, standardized periapical radiographs were taken after superstructure insertion (baseline) and then at 1,3,5,10,15, and 20 years. Results: The survival rate of implants (94.0%) and teeth (97.3%) did not significantly differ in all patients after 20 years (P = .68). Almost all patients had a PPD >5 mm at implants and teeth throughout the observation period. The crestal bone loss at implants and teeth increased continuously, especially in patients with advanced periodontitis, without a correlation with PPD. A few patients (n = 5) had a PPD>5 mm and annual bone loss >0.2 mm at one implant, with a correlation between bone loss and PPD. Conclusion: In healthy implants and teeth, moderate crestal bone loss is present without correlation with PPD. A few patients showed progressive crestal bone loss at only one implant, with a correlation with PPD. [ABSTRACT FROM AUTHOR]

Introduction: In complete dentures, the final impression plays a pivotal role in the success of the treatment. Advancements in impression materials have been the primary influence on the evolution of complete denture impression procedures. Aim: To compare and evaluate the retention of complete dentures fabricated on resorbed ridges using three different border moulding techniques. Materials and Methods: This non randomised clinical study was conducted in the Department of Prosthodontics and Crown and Bridge at KVG Dental College and Hospital, Sullia, Karnataka, India. The study included 10 patients with resorbed ridges who sought treatment from the Department of Prosthodontics during the period from January 2022 to December 2023. The study participants were selected from Dakshina Kannada and Kasargod, aged between 40 to 70 years, and included both males and females. For each patient, three custom trays were fabricated. The first tray was used for border moulding with putty and light body impression paste recorded using a Transcutaneous Electrical Stimulation (TENS) machine (Group A). The second tray was used for border moulding with putty and light body impression paste (Group B), while the third tray utilised a tissue conditioner as the secondary impression material (Group C). Retention was checked using a force gauge after the secondary impression, and heat-cured dentures were fabricated for each patient. The retention values were statistically analysed using Analysis of Variance (ANOVA), with the significance level set at p≤0.05. Results: The measurements indicated significantly higher mean retentive values in Group-A (2.58±0.56 kgf and 2.49±0.99 kgf for the secondary impression and final denture, respectively) compared to the other two groups (p<0.001). Comfort was reported to be better in Group-B. Both Groups A and B exhibited a good fit for the dentures. Conclusion: Within the limitations of the study, it can be inferred that border moulding with TENS using polyvinyl siloxane putty and light body secondary impressions provided higher retention compared to functional border moulding using tissue conditioner. [ABSTRACT FROM AUTHOR]

Objective: This study is aimed at detailing a technique for digitally fabricated fixed restoration for both immediate replacement after extraction and splinting of the adjacent mobile teeth. Clinical Considerations: Demand for a fixed restoration of the missing teeth in the mandibular anterior region is very common but sometimes problematic for dentists. It often happens that there is significant loosening of the remaining teeth adjacent to the missing tooth, which should be splinted. This case report describes a digitally fabricated fixed restoration for both replacing lost teeth and splinting periodontally compromised mobile teeth. With the CAD‐CAM technique, patients can receive the restoration immediately after the extraction. The digital design and fabrication of the restoration were elaborated using the restorative process of a patient with a mandibular anterior tooth to be extracted and multiple loose lower anterior teeth. The immediate restoration process and the pontic modification when the extraction socket had healed were also described. Conclusions: The digital process avoids the nudging of the loose tooth by the traditional impression technique, improves the accuracy of the restoration, and avoids undue stress on the loose tooth when the restoration is in place. In addition, this method allows the patient to obtain a fixed restoration immediately after extraction, and if damage occurs after the restoration has been cemented, such as fracture or debonding, a new restoration can be prepared before the patient's return visit. Clinical Significance: This minimally invasive restorative method achieved the fixation of loose teeth while restoring the missing teeth, but the success of the treatment needed long‐time observation. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusion Clinical Significance To report on soft tissue contour changes at pontic sites with or without soft tissue grafting over an observation period of 15 years.Fourteen patients received a fixed dental prosthesis (FDP) in the posterior zone in a controlled clinical study and were available at the 15‐year follow‐up. Eight patients received a subepithelial connective tissue graft in the pontic area (test) while six received the FDP without soft tissue grafting (control). Impressions were taken after FDP cementation and at 15 years. Casts were digitized and a profilometric analysis was performed (mean distance) and the pontic height (PH) and ridge width (RW) were analyzed at the mid‐buccal area. A descriptive analysis and Wilcoxon‐Mann–Whitney test was performed (level of significance: 5%).Profilometric changes (mean distance) from baseline to 15 years amounted to −0.68 mm (test) and to −0.33 mm (control) (p = 0.208), 95% CI for group difference (0.290; −0.750). PH measured −0.47 mm (test) and 0.0 mm (control) (p = 0.079) and RW amounted to −1.05 mm (test) and −0.38 mm (control) (p = 0.138).Remodeling of the soft tissue contour at pontic sites of FDPs was evident in both groups, but slightly more accentuated following soft tissue grafting.This study is the first to report on soft tissue changes at pontic sites over more than 10 years. It investigates whether tissue contour changes with and without soft tissue grafting before the insertion of FDPs. Remodeling of the soft tissue contour at pontic sites was observed over 15 years, with more pronounced changes when soft tissues were augmented with SCTGs before FDP insertion. The volume loss at the augmented site must be considered in relation to the overall tissue changes over long periods. Connective tissue grafts reliably improve shape and esthetics around the pontic unit. Further long‐term studies with more patients are needed to evaluate the initial gains and long‐term performance of these augmentations. [ABSTRACT FROM AUTHOR]

Background: The passive fit of 3-unit implant supported prefabricated metal screw-retained prosthesis before implant placement might be difficult. Hence, we aim to evaluate the passive fit and time efficiency of CAD/CAM 3-unit implant supported fixed prostheses that were constructed based on virtual versus those based on actual implant positions in Kennedy Class I models. Methods: A sample of 5 Kennedy class I models with thin wiry ridges were restored by 20 frameworks bilaterally, 10 based on actual (group A) and 10 based on virtual (group V) implant positions. The models were imaged using cone beam computed tomography and scanned using an intraoral scanner. The STL (Standard Tessellation Language files) and the DICOM (Digital Imaging and Communications in Medicine) files were registered on a 3D planning software. A CAD/CAM surgical guide was planned, resin printed and used for installing 6 implants bilaterally. In group V, the framework was designed based on the virtual scan bodies and virtual multi-unit abutments, while in group A intra-oral scanning of the model after attaching the scan bodies was necessary. Frameworks of both groups were milled and tested for passive fit using 8 clinical tests. McNemar and Wilcoxon signed rank tests were used to study the effect of the group on passive fit and time efficiency, respectively. The significance level was set at P ≤ 0.05. Results: No statistically significant difference was found between group V and group A frameworks regarding passive fit (p-value = 1, OR = 0.5) and time efficiency (P = 0.179, Effect size = 0.948). Conclusion: Within the limitations of this study, it can be concluded that in free end saddle cases, prefabricated CAD\CAM 3-unit implant-supported cobalt chromium screw retained prostheses can achieve an adequate passive fit. However, their fit might be negatively affected in thin ridges and they might require some adjustments. [ABSTRACT FROM AUTHOR]

Objective: This clinical study aimed to evaluate the difference in the time of application phase, employing the conventional and modified direct orthodontic bonding method. Materials and Methods: Thirty patients who needed orthodontic therapy with fixed appliances were randomly divided into two equal groups (n = 15): the control and experimental group, according to the bonding method applied. A total of 600 metal brackets inch slot 0.022 (Mini Sprint®, Forestadent, Germany) were bonded to incisors, canines, and premolars using the light‐cured adhesive Transbond XT (3M Unitek, Monrovia, CA, USA). The failure rates of the brackets were evaluated within 12 months. The independent samples t‐test was applied. The Chi‐square test and Fisher exact test were used for statistical analysis. Results: The initial bonding time using the modified method was significantly shorter (3.27 min or 17.1% per patient) compared with the conventional bonding method (p < 0.001). Number of failed brackets between the two methods did not differ significantly (p = 0.226). Conclusion: The time of the application phase in initial bonding using the modified method (experimental group) was shorter than in control group. There was no statistically significant difference in the number of bond failures between the two methods. Clinical Significance: The modified application phase of direct orthodontic bracket placement shortens the total bonding time and facilitates the manual work of orthodontists. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this review was to assess clinical trials that have examined the materials, design, and bonding of ceramic cantilevered resin‐bonded fixed dental prostheses (RBFDPs) as a potential option for replacing missing anterior teeth. The evaluation primarily focuses on the rate of restoration failure and clinical complications. Materials and Methods: A thorough search of databases including PubMed/MEDLINE, Scopus, and the Cochrane Library, was conducted. The most recent search was performed in October 2023. Clinical studies that compared ceramic cantilevered RBFDPs with double retainers or cantilevered RBFDPs using different ceramic materials or bonding systems were included. The outcome measures considered were restoration failure and complication rates. Results: Twelve studies met the eligibility criteria. The pooled data showed a statistically significant decrease in complication events when using cantilever designs compared with double retainer designs (p < 0.05); however, there were no differences found between the two designs in terms of restoration failure. The complication and failure rate of cantilever RBFDPs did not show a statistically significant difference with or without ceramic primer application before luting with phosphate monomer‐containing luting resin (p > 0.05). Conclusions: Ceramic cantilevered RBFDPs have lower complication rates compared with those with double retainers. The use of a ceramic primer prior to luting composite resin for ceramic cantilevered RBFDPs decreases the occurrence of complications and failures, although this effect was not statistically significant. Additional research is required to confirm these findings. Glass ceramic cantilever RBFDPs showed a decrease in success after 6 years, requiring ongoing monitoring, but both zirconia and glass‐infiltrated alumina cantilever RBFDPs have demonstrated durability with excellent long‐term success and survival rates for up to 10 and 15 years. Clinical Significance: Cantilever ceramic RBFDPs in the anterior region are a less invasive and valuable treatment option, providing good esthetic results. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the marginal and internal misfit of fixed partial denture zirconia frameworks developed from conventional impression and intraoral scanning, before and after being subjected to the thermal cycle of the covering ceramic. Methods: A three-elements fixed partial denture was prepared, molded, and poured with polyurethane. Group CI (n= 7) was impressed by the conventional technique with polyvinyl siloxane material, and the plaster models scanned on the inEosX5 bench scanner. Group DI (n=07) was scanned using the CEREC Bluecam intraoral scanner. The models and images obtained were sent to the laboratory and the frameworks were made using zirconia blocks. After this, they were subjected to the ceramic thermal cycle, simulating the ceramic application. Marginal and internal misfits of the frameworks were measured before (Tl) and after (T2) thermal cycle simulation using the replica technique in an optical microscope. Statistical analysis was performed using the mixed effects of linear model tests and comparisons. Results: There were no statistical differences for axial misfit. Significant differences were found between the groups for occlusal, vertical, horizontal, and absolute misfit, where group CI had higher values than group Dl (P< 0.001). At the time, there was a statistical difference only in the absolute misfit, where Tl had lower values than T2. The misfit in group CI was greater than in group DI; however, the average misfit values found are low and considered clinically acceptable. [ABSTRACT FROM AUTHOR]

PURPOSE. Studies about success of FPDs (fixed partial dentures) mostly include restorations built by different clinicians. This results in limited comparability of the data. The aim of this study was to evaluate complications of all-ceramic FPDs built by 1 dentist between 2011 to 2023. MATERIALS AND METHODS. 342 all-ceramic FPDs were observed during follow-up care. 48 patients received 262 single crowns, 59 bridges and 21 veneers. Because of the different lengths of the bridges, units were defined as restored or replaced tooth. 465 units performed by the same dentist from Nov 2011 to Nov 2022 were included. Influencing factors "restoration", "construction", "abutment", "localization", "vitality" and "application period" were evaluated using Kaplan-Meier Analysis and Log-Rank Tests. RESULTS. 406 units (87.3 %) showed no complication. 7 correctable chippings (1.5 %) and 10 recementable decementations (2.1 %) occurred. Six decemented units got lost (1.3 %). 21 units failed due to fatal fracture (4.5 %). Crown margin complications, such as secondary caries, occurred in 15 units (3.2 %). Comparing the influencing factors resulted in higher complication rates of veneers (P < .001), of monolithic ceramics (P = .050) and of molar-restorations (P = .047). The application period had no influence on the success and survival rate. CONCLUSION. Overall, all-ceramic FPDs showed good clinical results. Although less complications were observed with modern restorations, these more often led to complete failure. To generate evidence-based recommendations, further studies are needed to evaluate the mid- and short-term success and survival of current all-ceramic restorations. [ABSTRACT FROM AUTHOR]

Background: Failure to restore missing teeth in time can easily lead to the mesial tilting of the distal abutment teeth. However, a fixed partial denture (FPD) can improve stress conduction and distribution and prevent periodontal injuries. In these more complex cases, it is necessary to consider various factors comprehensively to improve conventional treatment planning and achieve better results. Methods: We selected a patient with a missing first molar and a mesial inclination of the second molar, leaving inadequate space or bone mass for implant denture restoration, necessitating an FPD for restoration. Three-dimensional finite element analysis (3D-FEA) combined with photoelastic analysis were used to explore how the inclination angle (0 ‒ 30°) and different dental restoration materials (zirconia, lithium disilicate, polymer-infiltrated ceramic network, and resin composite) affect the biomechanical behaviour of FPD‒abutments‒periodontal tissue complex. Results: The stress was easily concentrated in the FPD connectors, enamel shoulder collar, periapical area, and root bifurcation. The stress on FPD and the periodontal ligament (PDL) of the second premolar increased with an increase in the elastic modulus of FPD, with an opposite trend in the abutments, the alveolar bone, and the PDL of the second molar. The stress on the FPD and alveolar bone increased with increased inclination angle of the distal abutment. The stress on two abutments and their PDL were positively correlated with the inclination angle in two stages; however, when the inclination angle > 12°, the second premolar and its PDL showed a negative correlation. Conclusions: FPDs can be used for restoration within 24° of distal abutment inclination, but protecting the abutments (< 12° especially) and the periodontal tissue (> 12° especially) must be taken seriously. For this purpose, an FPD material with higher strength is recommended. [ABSTRACT FROM AUTHOR]

This review presents various interpenetrating phase composite (IPC) materials currently used in computer-aided design/computer-aided manufacturing (CAD/CAM) systems and to evaluates how the optical properties of those materials are affected by various factors. In the field of dentistry, selecting materials compatible with dental tissues is key to clinical success of restorative materials. Understanding the optical properties of a restorative material aids in material selection and provides insights into the material's clinical performance and esthetic longevity. Such knowledge can in turn help clinicians select the best treatment option for their patients. Interpenetrating phase composite materials combine the optical and mechanical properties of ceramics and composite resins; they are often used in direct/indirect restorative options such as inlays, onlays, veneers, single crowns, implant-supported crowns, and short-span fixed partial dentures with esthetically favorable outcomes. The color of a material, which plays an essential role in the esthetic outcome, can change over time depending on different intrinsic and extrinsic factors. Those intrinsic factors include chemical composition, resin-matrix structure, and filler particle sizes; extrinsic factors include surface treatment protocols, the patient's smoking status, and the consumption of beverages such as coffee, tea, red wine, fruit juice, cola, etc. To fabricate restorations that complement a person's natural teeth, it is essential to determine the color properties of these materials (e.g., translucence, hue, chroma, and opalescence). [ABSTRACT FROM AUTHOR]

The literature presents insufficient data evaluating the displacement and micromotion effects resulting from the combined use of tooth-implant connections in fixed partial dentures. Analyzing the biomechanical behavior of tooth-implant fixed partial denture (FPD) prothesis is vital for achieving an optimum design and successful clinical implementation. The objective of this study was to determine the relative significance of connector design on the displacement and micromotion of tooth-implant-supported fixed dental prostheses under occlusal vertical loading. A unilateral Kennedy class I mandibular model was created using a 3D reconstruction from CT scan data. Eight simulated designs of tooth-implant fixed partial dentures (FPDs) were split into two groups: Group A with rigid connectors and Group B with non-rigid connectors. The models were subjected to a uniform vertical load of 100 N. Displacement, strain, and stress were computed using finite element analysis. The materials were defined as isotropic, homogeneous, and exhibiting linear elastic properties. This study focused on assessing the maximum displacement in various components, including the bridge, mandible, dentin, cementum, periodontal ligament (PDL), and implant. Displacement values were predominantly higher in Group B (non-rigid) compared to Group A (rigid) in all measured components of the tooth-implant FPDs. Accordingly, a statistically significant difference was observed between the two groups at the FPD bridge (p value = 0.021 *), mandible (p value = 0.021 *), dentin (p value = 0.043 *), cementum (p value = 0.043 *), and PDL (p value = 0.043 *). Meanwhile, there was an insignificant increase in displacement values recorded in the distal implant (p value = 0.083). This study highlighted the importance of connector design in the overall stability and performance of the prosthesis. Notably, the 4.7 mm × 10 mm implant in Group B showed a displacement nearly 92 times higher than its rigid counterpart in Group A. Overall, the 5.7 mm × 10 mm combination of implant length and diameter showcased the best performance in both groups. The findings demonstrate that wider implants with a proportional length offer greater resistance to displacement forces. In addition, the use of rigid connection design provides superior biomechanical performance in tooth-implant fixed partial dentures and reduces the risk of micromotion with its associated complications such as ligament overstretching and implant overload, achieving predictable prognosis and enhancing the stability of the protheses. [ABSTRACT FROM AUTHOR]

Choosing an appropriate prosthetic material for the superstructure of an implant-supported or tooth-implant supported fixed partial denture (FPD) is crucial for the success of the prostheses. The objective of this study was to examine the effect of prosthetic material type and tooth-to-implant support on stress distribution of FPDs using three-dimensional finite element analysis (3D FEA). Two FEA models were generated, distinguished by their support configurations: Model I representing an FPD supported by implants, and Model II depicting an FPD supported by both a tooth and an implant. Two different restorative materials, porcelain-fused-to-metal (PFM) and monolithic zirconia, were evaluated for stress distribution under axial and oblique loads of 300 N applied to the pontic. Under both axial and oblique loading conditions, the maximum von Mises stress values were observed to be higher in the implant-abutment complex of both zirconia implant-supported and tooth-implant-supported FPDs compared to PFM FPDs. In the case of axial loading, comparable stress values were found in the cortical bone for PFM (12.65 MPa) and zirconia implant-supported FPDs (12.71 MPa). The zirconia tooth-implant-supported FPD exhibited the highest stress values in the implant-abutment system. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the influence of occlusal interference using finite element analysis (FEA). Materials and Methods: The FEA model designed for this study centered on an all-ceramic, bilayered, fixed partial denture (FPD) retained on the maxillary first premolar and first molar, with the second premolar replaced by a pontic. The surrounding structures--such as the neighboring teeth, antagonists, and periodontium--were modeled. Four different loading cases were designed at occlusal interferences of 0, 8, 12, and 24 µm and were loaded by a simulated bite force of 300 N. Principal and von Mises stresses, as well as strain, were evaluated for all included structures. Results: For interferences of 12 and 24 µm, failure-relevant tensile stresses in the veneering layer were observed at the occlusal surfaces. Stress found in the zirconia FPD did not reach fatigue or flexural strength for any test load. Conclusion: Peak tensile stress was observed in close proximity to occlusal contact points, increasing with increasing occlusal interference. The FEA results suggest that the majority of occlusal stress is absorbed by the deformation of the periodontal ligament. Framework failure caused by the simulated interferences was not expected. Surface defects may ultimately lead to failure due to fracture or chipping, especially in cases of weaker ceramics or veneering. [ABSTRACT FROM AUTHOR]

Purpose: To report on the follow-up of two previously published RCTs on the performance of screw-retained monolithic zirconia restorations on titanium (ti)-base abutments based on either digital scans through intraoral optical scanning (IOS) or conventional impressions. Materials and Methods: A total of 54 patients receiving 89 restorations (44 solitary crowns [SC], 21 splinted crowns [2-FDP], and 24 three-unit fixed partial dentures [3-FDP]) were included for the 1- to 3-year follow-up period. Restoration survival and technical complications were documented. Results: In total, 50 patients with 84 restorations completed the 3-year follow-up. One 3-FDP from the digital group was lost. This resulted in a survival rate of 97.9% for the digital group and 100% for the conventional group and an overall survival rate of 98.8% for screw-retained monolithic zirconia restorations on implants after 3 years. There was no statistically significant survival difference between the digital and conventional restorations (P = .362). When evaluated separately, a 100% survival rate of SCs and 97.7% for 2-FDPs could be reported. One decementation and three screw loosenings occurred in the 1- to 3-year follow-up. The multiple-implant restorations showed higher (23.3%) complication rates at the restoration level than the SCs (4.9%) after 3 years of function (P = .026). Conclusions: Screw-retained monolithic zirconia restorations on ti-base abutments show promising survival rates after 3 years of function. Restorative complications in screw-retained monolithic zirconia restorations on Ti-base abutments are more likely to happen in the first year of function and are more common in multiple-implant restorations than SCs. The impression type (digital or conventional) does not seem to influence these results. [ABSTRACT FROM AUTHOR]

Digital technologies represent new alternatives in prosthetic rehabilitation of all kinds of maxillary or mandibular spans. This article is composed of two parts, in which different technological aspects will be presented regarding the prosthetic restoration of frontal maxillary areas using the CAD-CAM technology, but using different material for resistance framework, both veneered with ceramic materials to restore the aesthetics. The main materials that will be used are: Co-Cr dental alloy and zirconium dioxide (zirconia). [ABSTRACT FROM AUTHOR]

Objective: To determine the median event-free survival and relative complication rates of monolithic and minimally layered full-arch zirconia prostheses, as well as to identify risk factors for prosthesis complications. Materials and Methods: In this retrospective cohort study, a total of 129 subjects (173 prostheses) were included in the chart review and 56 subjects (75 prostheses) participated in a clinical follow-up visit. All subjects had either single- or dual-arch monolithic or minimally layered zirconia implant-supported prostheses. Data related to patient, implant, and prosthesis factors were extracted from charts. The subgroup that presented for a clinical visit were asked to complete a satisfaction questionnaire. For this subgroup, the following clinical measures were assessed: routine intraoral examination, number of occluding units, cantilever length on each side of the prosthesis (right and left), prosthesis height, occlusal scheme, and oral hygiene methods. Periapical radiographs were obtained when the last radiographs of the patient were taken more than 12 months prior. Results: The follow-up period ranged from 12 months to 7.1 years (mean: 1.9 years). Observed complications included implant loss, peri-implantitis, mucositis, purulence, sinus tract formation, oroantral communication, implant fracture, titanium base debonding, ceramic chipping, prosthetic screw fracture or loosening, damage to opposing teeth, and clicking sounds. There was an insufficient number of complications to evaluate the effect of covariates on the risk of specific complications, such as titanium base debonding (eight events), ceramic chipping (nine events), and peri-implantitis (eight events). The unadjusted event-free median survival time was 5.8 years. The proportion of all prostheses with at least one complication was 30%. There were no observed prosthesis losses during the follow-up period. Conclusion: Monolithic and minimally layered zirconia full-arch implant-supported prostheses demonstrate an acceptable median event-free survival time. Event-free survival times were increased and the number of complications was reduced in prostheses with five to eight implants and conventional (as opposed to zygomatic) implants. There was a reduced hazard of complications with a regular recall regimen. Patient satisfaction with these prostheses was high. [ABSTRACT FROM AUTHOR]

The loss of teeth causes inevitable resorption of the alveolar bone. In the anterior arches, the curved anatomy further adds to the challenge of rehabilitation. These areas often require the shaping of membranes and multiple bone blocks through complex surgery to compensate for the curvature. The split bone block technique (SBBT) has been successfully used in complicated cases. However, the inability to create curves from the blocks means that larger quantities of bone or membranes are needed to compensate for this. Bone bending based on an ancient woodbending technique known as kerfing is proposed to shape rigid SBB plates to recreate the natural anatomy of anterior arches. Three patients presenting with bone destruction of the anterior maxilla underwent bone augmentation before implant placement using the SBBT combined with kerfing. The plates were successfully bent to the shape of each maxilla without any deleterious effects. All bone grafts healed uneventfully, and the bone curvature was successfully reconstructed. No complications were reported. Implant placement took place after 4 months and definitive restorations after 7 to 9 months. Clinical and radiographic assessments were performed at 1 year. Full customization of autogenous bone plates was possible through kerfing. This approach resulted in an ideal bone curve and shape in the facial and palatal aspects of the anterior maxilla. In addition, it enabled ideal implant placement with reduced bone harvesting volumes and decreased the need for soft tissue augmentation to recreate the curved shape. This technique promoted close-fitting autologous osseous plates that followed the anatomical curvature of the anterior maxilla, leading to optimal healing and excellent regeneration of the ridge width. This principle can be valuable when dealing with complex anatomical defects. [ABSTRACT FROM AUTHOR]

Objective: The aim of this case report was to present a minimally invasive and esthetic treatment approach for the replacement of missing teeth removable partial dentures retained by zirconia ceramic resin-bonded attachments. Method and materials: The resin-bonded attachments were digitally designed and milled using CAD/CAM technology from monolithic 3Y-TZP zirconia ceramic. The resin-bonded attachments had an optimized attachment design approved for zirconia ceramic. The preparation was based on general preparation guidelines for resin-bonded attachments and resin-bonded fixed dental prostheses (RBFDPs). After placement of rubber dam, the resin-bonded attachments were bonded with a phosphate monomer-containing luting resin. Results: The presented resin-bonded attachment-retained removable partial denture was successful over 30 months of clinical observation without any complications. The patient was satisfied with the minimally invasive treatment procedure. Conclusion: Zirconia ceramic resin-bonded attachments fabricated with a special attachment design are an esthetic and minimally invasive treatment approach. However, clinical data on the long-term outcome of zirconia resin-bonded attachments are still needed. [ABSTRACT FROM AUTHOR]

Photogrammetry (PG) appeared as an alternative for multiple implant impressions. Stereo-photogrammetry is a more sophisticated alternative to PG, which estimates the 3D coordinates of the points of an object, making the process quicker and more precise. A search in PubMed MEDLINE, PMC, and Google Scholar was conducted to find systematic reviews published in the last 10 years. The PICdental® camera (IDITEC NORTH WEST, SL; Torrelodones, Spain) is a stereocamera that records implant positions in the mouth by means of photogrammetry with the objective of registering and obtaining a viable, reliable, and direct digital impression of the positions of the multiple implants. The use of photogrammetry via PiCdental® camera as an alternative to digital impression for multiple implants is an easy and trustworthy technique that permits an adequate fit without prosthetic complications. [ABSTRACT FROM AUTHOR]

Dental rehabilitation with implants is a clinical reality in clinical practice. The Interproximal Contact Loss (ICL) between implant-supported prostheses adjacent to natural teeth is a relatively common occurrence. This systematic review and meta-analysis aims to evaluate the possible clinical effects of the periodontium regarding the ICL between teeth and implanted-supported prostheses. We also identified the main ICL assessment tools described in the literature. This study was registered on the PROSPERO (CRD42023446235), was based on the PICO strategy, and followed the PRISMA guidelines. An electronic search was carried out in the PubMed, B-on, Google Scholar, and Web of Science databases without setting a time limit for publications. Only systematic reviews and comparative clinical trials were included and analyzed. Nineteen publications were eligible for meta-analysis, with thirteen retrospective and six prospective clinical trials. A total of 2047 patients and 7319 prostheses in function were evaluated, and ICL was found in 51% with a confidence interval of 0.40 to 0.61. As ICL assessment tools, dental floss was used in 65%, matrices were used in 30%, and X-ray images were used in 5% of cases. The clinical follow-up ranged from 1 to 21 years, with 50% between 1 and 3 years, 25% between 3 and 10 years, and 25% between 10 and 21 years. ICL was found to occur more frequently in the mandible. No statistically significant difference existed between the anterior (55%) and posterior (47%) oral regions. On the mesial surface, ICL ranged from 13% to 81.4%, possibly due to the different follow-up periods and the diversity of methods used in the assessment. No differences were found for ICL between single or multiple implanted-supported prostheses. Food impaction was the most common effect of ICL and was more prevalent on the implant-supported prosthesis's mesial surface in the mandible's posterior region. There was evidence of peri-implant mucositis but without progression to peri-implantitis, and the form of retention or the number of elements was not relevant. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this in vitro study was to investigate whether and to what extent different scenarios of rotational freedom in different IAC designs affect the vertical dimension of a three‐part fixed partial denture (FPD). At the same time, the experimental setup should simulate all clinical and laboratory steps of the implementation of such an FPD as accurately as possible. Material and Methods: Twenty identical pairs of jaw models were fabricated from aluminum, each lower‐jaw model holding two implants with conical or flat IACs. Three impressions of each model were taken to fabricate stone casts and three‐unit FPDs. Three assembly scenarios were compared for the vertical position stability they offered for these FPDs, differing by how the sequential implant components (impression posts > laboratory analogs > abutments 1 > abutments 2) were aligned with the positional index of the IAC. In this way, a total of 60 stone casts and FPDs were fabricated and statistically analyzed for changes in vertical dimension (p < 0.05). Results: Regardless of whether a conical/flat IAC was used (p > 0.05), significantly greater mean changes in vertical dimension were consistently (all comparisons p < 0.0001) found in a "worst‐case scenario" of component alignment alternating between the left‐ and right‐limit stop of the positional index (0.286/0.350 mm) than in a "random scenario" of 10 dentists and 10 technicians with varying levels of experience freely selecting the alignment (0.003/0.014 mm) or in a "best‐case scenario" of all components being aligned with the right‐limit stop (−0.019/0.005 mm). Conclusions: The likelihood of integrating a superstructure correctly in terms of vertical dimension appears to vary considerably more with assembly strategies than with IAC designs. Specifically, our findings warrant a recommendation that all implant components should be aligned with the right‐limit stop of the positioning index. Summary: What is Known: Tiny vertical deviations can result in substantial clinical problems.Little is known about the impact of implant‐abutment connection (IAC) designs and rotational freedom on the vertical dimension of implant‐supported restorations.Past experimental setups, rather than simulating the entire clinical process from impression‐taking to intraoral delivery, have remained confined to specific steps. What This Study Adds: A comprehensive experimental setup is introduced to analyze the vertical impact of IAC designs and rotational freedom on implant‐supported fixed restorations.We can recommend a consistent strategy of assembling implant components that will increase the chances of maintaining a correct vertical dimension. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare the microgap size between engaging (E) and non-engaging (NE) abutments and screw morphology changes between E and NE abutments using scanning electron microscopy (SEM) before and after cyclic loading (CL). Methods: Thirty-six implants were arranged into four groups as follows: Group 1, single units with E abutments; Group 2, single units with NE abutments; Group 3, three-unit fixed partial dentures with a hemi-engaging design; and Group 4, three-unit FPDs with two NE abutments. The microgap was evaluated using a stereomicroscope. SEM was used to qualitatively evaluate screw morphology. The specimens were subjected to axial loading first and then lateral loading (30°) using the settings; one million cycles (1.0 × 106 cycles) for each loading axis. Results: There were no significant differences detected in the microgap sizes between the E and NE abutment groups. In addition, there were no significant changes in the microgap sizes after CL in the E or NE abutment specimens. More damage to the screws was noticed after CL compared to before, with no difference in the patterns of damage detected between the E and NE abutments. Conclusions: No significant difference in microgap size was detected between the E and NE abutments. Furthermore, there was no significant difference in microgap size between the different prosthetic designs. From the SEM qualitative evaluation, there were similar screw morphology changes after CL between the E and NE abutments. [ABSTRACT FROM AUTHOR]

Background: For dental graduates, internships are a vital transitional phase that gives them the invaluable opportunity to close the gap between their academic studies and the reality of professional dentistry. Research on dental internships remains limited and most of the existing studies focus on the clinical aspects of dental internships with little attention given to dental interns' experiences overall. This study aims to bridge this gap in the literature by gaining an in-depth understanding of Saudi dental graduates' range of experiences as dental interns. Methods: To achieve the research objective, this study adopted a qualitative approach. Using purposive and snowball sampling, the study recruited 23 dental interns from Riyadh Province, Saudi Arabia, who had completed at least nine months of their internship. Data was gathered across three months via diaries and virtual semi-structured interviews based on participants' preferences. The data was then analysed thematically using an inductive analytical strategy. Results: The data analysis revealed three major themes and four sub-themes regarding the experiences of dental interns. The core three themes were "activities", "autonomy" and "transitioning to a balanced life" whereby interns have the time and freedom to explore their interests, rekindle their social lives and focus on self-care, resulting in a better work-life balance. Conclusion: This study suggests that dental interns will benefit from the retention and strengthening of key internship activities such as research, community work and clinical rotations. Additionally, the experiences of dental interns can be improved by encouraging interns to progress in their clinical training with a high level of autonomy. Also, due to the limited research in this area, further studies are required to improve our understanding of the lived experiences of dental interns and dental internships in general. [ABSTRACT FROM AUTHOR]

Avulsion of permanent teeth is a complex traumatic dental injury (TDI) where a tooth is completely displaced out of its socket without fracturing. The resultant esthetic and functional compromises are distressing for the patient and require immediate attention. The emergency management of an avulsed permanent tooth is to replant it in its socket or preserve it in suitable storage media (saliva, milk, Hanks' Balanced Salt Solution) within 60 minutes of injury. However, if the tooth is lost or is not replanted within 60 minutes, alternative methods to address the patient's esthetic concerns must be sought. This case report describes the replacement of a lost avulsed permanent tooth with a chairside fabricated resin composite pontic and a 6-month follow-up period. [ABSTRACT FROM AUTHOR]

BACKGROUND: Prosthodontics are often performed to treat patients with malocclusion and dentition defects. However, single prosthodontics cannot properly correct the disharmony of teeth, dental arch and other parts affected by malocclusion, and some patients may have difficulty in recovering the occlusal function due to poor prosthodontics. OBJECTIVE: This study aims to investigate the effect of orthodontics combined with fibre-reinforced composite resin-bonded fixed partial denture (FRC-RBFPD) on anterior dentition defects with minimal vertical intermaxillary space. METHODS: Sixty-two patients with anterior dentition defects with minimal vertical mandibular space admitted to our hospital between March 2021 and May 2023 were enrolled in this study. The participants were divided into the observation group (31 cases) and the control group (31 cases), according to the treatment plan. The control group was treated with traditional therapy, and the observation group was treated with orthodontic combined FRC-RBFPD therapy. Periodontal conditions (periodontal pocket depth [PD], the plaque index [PLI], the sulcus bleeding index [SBI]), levels of inflammatory factors in gingival crevicular fluid (high mobility group box 1 [HMGB1]), myeloid cell triggering receptor-1 (TREM-1), monocyte chemoattractant protein-1 (MCP-1), pain (visual analogue scale [VAS]), the clinical response rate and the incidence of adverse reactions were collected and compared. RESULTS: After 1, 3, 5 and 9 months following treatment, the scores of the PD, PLI, SBI, HMGB1, VAS, TREM-1 and MCP-1 in the observation group were found to be lower than those in the control group ( F PD treatment = 352.532, F PLI score treatment = 112.341, F SBI score treatment = 79.479, F VAS score treatment = 96.132, F HMGB1 treatment = 52.532, F TREM-1 score treatment = 64.593, F MCP-1 score treatment = 53.582, and they were all statistically significant P < 0.05). There was a statistically significant difference in the response rate between the two groups (97.77% vs. 80.65%, χ 2 = 4.026, P = 0.045). No statistically significant difference was observed in the incidence of adverse reactions between the two groups (6.45% vs. 16.13%, χ 2 = 1.449, P = 0.229). CONCLUSION: Orthodontics combined with FRC-RBFPD shows an ideal restorative effect on patients with anterior dentition defects and minimal vertical intermaxillary space. [ABSTRACT FROM AUTHOR]

Purpose: This review aims to summarize the available technologies, material categories, and prosthodontic applications of additive manufacturing (AM) dental ceramics, evaluate the achievable accuracy and mechanical properties in comparison with current mainstream computer-aided design/computer-aided manufacturing (CAD/CAM) subtractive manufacturing (SM) methods, and discuss future prospects and directions. Study selection: This paper is based on the latest reviews, state-of-the-art research, and existing ISO standards on AM technologies and prosthodontic applications of dental ceramics. PubMed, Web of Science, and ScienceDirect were amongst the sources searched for narrative reviews. Results: Relatively few AM technologies are available and their applications are limited to crowns and fixed partial dentures. Although the accuracy and strength of AM dental ceramics are comparable to those of SM, they have the limitations of relatively inferior curved surface accuracy and low strength reliability. Furthermore, functionally graded additive manufacturing (FGAM), a potential direction for AM, enables the realization of biomimetic structures, such as natural teeth; however, specific studies are currently lacking. Conclusions: AM dental ceramics are not sufficiently developed for large-scale clinical applications. However, with additional research, it may be possible for AM to replace SM as the mainstream manufacturing technology for ceramic restorations. [ABSTRACT FROM AUTHOR]

Few studies have established the relationship between connector widths, cuspal angulation, loading forces, and supporting structures of zirconia fixed dental prosthesis (FDP). The objective of the study was to compare the stress distribution in implant- and tooth-supported zirconia FDP with different connector designs, and cuspal angulations of replaced teeth under diverse angulations of forces. Finite element (FE) analysis was done by simulating a 3-unit implant- and tooth-supported FDP. FE models with varying cuspal angulations 0°, 20°, and 33° and connector designs 2 mm, 2.5 mm, and 3 mm was generated. The simulated models were loaded with 100 N of forces under different axial and non-axial angulations. The graphical and numerical stresses were observed, recorded, and statistically analyzed. Higher stress of 245.55 MPa in implant-supported FDP and lower stress value of 28.22 MPa in tooth-supported FDP was observed at 0-cuspal inclination for 3 mm connector width. The data were statistically analyzed with unpaired t test to eliminate the differences. The inter-group, intra-group tests, p and t values for various connector, and tooth angulations of tooth- and implant-supported FDP were statistically insignificant. (p > 0.05) There was no statistically significant difference in stress was observed between tooth- and implant-supported FDP for different connector widths, cuspal inclination, and diverse angulation of forces. [ABSTRACT FROM AUTHOR]

Implant-supported fixed partial dentures (IFPDs) are a treatment option for partially edentulous dentition with missing posterior-most molars despite the concept of a shortened dental arch (SDA). This study aimed to evaluate the effect of IFPD treatment on oral health-related quality of life (OHRQoL) in patients with unilateral SDA missing two adjacent molars and to compare the effects of single- and two-unit IFPDs. Forty patients with unilateral SDA missing two adjacent molars (Kennedy Class II) participated in this study; 11 patients received one implant placement in the first molar and were treated with a single-unit IFPD (single-unit group), and 29 received two implant placements and were treated with a two-unit IFPD (two-unit group). The Oral Health Impact Profile (OHIP) questionnaire for OHRQoL assessment and the gummy jelly test for objective masticatory performance were administered before and after IFPD treatment. The Wilcoxon signed-rank test for all patients and Mann–Whitney U test were performed for pre- and post-treatment comparisons and between-group comparisons, respectively. The OHIP summary score and gummy jelly glucose concentration in all patients showed significant improvements after treatment (all P < 0.05). No significant differences were observed between the single- and two-unit groups for any of the items. Using the minimal important difference in the OHIP summary score, 63.6 % and 58.6 % of patients in the single- and two-unit groups, respectively, showed improvement by 6 points or more. IFPD treatment for patients with SDA missing two adjacent molars may provide clinically meaningful improvements in OHRQoL. [ABSTRACT FROM AUTHOR]

In cases of missing posterior teeth, treatment modalities based on the shortened dental arch (SDA) concept may be a viable alternative. However, the association between oral health-related quality of life (OHRQoL) and patients' treatment decisions remains unclear. This study aimed to investigate the association between OHRQoL and the decision to be treated with implant-supported fixed partial dentures (IFPDs) or take a wait-and-see approach in patients with an SDA missing a single second molar and to clarify the impact of IFPD treatment on the OHRQoL. The Oral Health Impact Profile (OHIP) questionnaire was administered twice (pre- and post-treatment) and once to 41 patients with a unilateral SDA missing a single second molar who chose IFPD treatment (IFPD group, n = 22) and the wait-and-see approach (no treatment group, n = 19), respectively. Logistic regression analysis was performed with IFPD treatment choice as the objective variable and the four OHIP dimension scores, age, and sex as covariates. The pre- and post-treatment values of the OHIP summary and four-dimension scores were compared using a paired t -test. The IFPD treatment choice was significantly associated with sex (male), higher Oral Function dimension scores, and lower Psychosocial Impact dimension scores (all P < 0.05). The OHIP summary and four-dimension scores were significantly lower following IFPD treatment (all P < 0.05). IFPD treatment for a single missing second molar may be clinically beneficial for improving the OHRQoL of patients with an SDA who experience a decline in masticatory function. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate and determine clinical outcomes and survival rates of straight and extended length subcrestal angulated (ELSA) implants (20–24 mm lengths) placed for immediate (up to 72 h post‐operative) or delayed rehabilitation (4 months post‐operative) of severely atrophic maxillae. Prosthetic treatment consisted of interim and definitive implant‐supported fixed implant‐supported prostheses with up to 3 years of function. Materials and Methods: A retrospective analysis was conducted of 38 patients (five dropped out; final total was 33), treated between 2017 and 2019 in a private practice. Extended length subcrestal angulated (ELSA) implants and conventional endosseous straight implants (Southern Implants, Irene, South Africa) with (fixed) full arch prostheses were used to restore patients with edentulous maxillae immediately (within 72 hs) or delayed (4 months). ELSA implants have subcrestal angulations of 24° and 36° of the restorative platforms, external hexagon crestal anti‐rotation abutment connections, and lengths between 18 and 26 mm. Implant loading was determined by implant insertion torque values (as determined on the surgical units); 120 Ncm was the threshold level for immediate loading. Clinical and radiographic examinations were done that recorded the clinical outcomes of implants and prostheses. SPSS was used to process the data. Results: Thirty‐three patients and 187 implants were included with follow‐up periods of at least 12 months (range 12–36 months). The mean age of the study population was 62.6 ± 8.4 years old (at the time of implant placement). Thirty‐three patients (86.8%) were followed for 12 months; 13 patients (39.4%) were followed for 24–35 months; 9 patients (27.3%) were followed for 36 months. In total, 13 implants in six patients failed secondary to sinus infections. Mean bone levels (MBLs) were respectively: 0.88 ± 2.12 mm at loading, –1.53 ± 2.03 mm at 12 months, –2.26 ± 1.45 mm at 24 months, and –2.54 ± 1.46 mm at 36 months. The ELSA implants showed significantly lower (p = 0.014) MBL at 36 months than did the conventional implants. One hundred thirty‐seven implants were placed and loaded within 72 h; 50 implants were placed and loaded 4 months post placement. The combined implant survival rates were 93.0% at 12 months, 91.1% at 24 months, and 100% at 36 months. The ELSA implants showed significantly lower (p = 0.014) MBLs at 36 months when compared to the conventional implants. Conclusions: The results of this retrospective clinical chart review indicated that the use of ELSA implants placed into anterior maxillae and nasal crests with accentuated distal tilts (>30°) and simultaneous sinus augmentation provided favorable outcomes for prosthetic rehabilitation in patients with severe atrophic maxillae. ELSA implants placed with simultaneous sinus augmentation are an alternative option to zygomatic implants (ZI) when immediate loading is prescribed. Sinus infections were thought to be the proximate causes of all implant failures. Further long‐term clinical studies are warranted with larger patient populations. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the vertical misfit, stress distribution around dental implants, and cantilever fracture strength of 3‐unit implant‐supported cantilever fixed partial dentures (FPDs) using frameworks made from different materials and manufacturing techniques. Materials and Methods: Forty FPDs were fabricated and divided into 5 groups (n = 8) based on the framework material used: LAS Co‐Cr (Conventional casting—laser welding); TIG Co‐Cr (Conventional casting –TIG welding); OP Co‐Cr (Conventional casting—one‐piece); CAD Co‐Cr (CAD‐CAM); and CAD Zr (CAD‐CAM ZrO2). The vertical misfit was evaluated before porcelain application (T1) and before (T2), and after thermomechanical cycling (T3) by stereomicroscopy. Cantilever fracture strength was tested with a 50 kN (5000 kgf) load cell at a crosshead speed of 0.5 mm/min. Qualitative and quantitative photoelastic analysis was performed to evaluate stress distribution at seven specific points in five FPDs (n = 1/group) subjected to occlusal loading. Results: Only the molar showed interaction among the three factors (G × S × T; F(20.932) = 1.630; p = 0.044). Thermomechanical cycling (T2 vs. T3) had a significant effect on intra‐group vertical misfit in molar, especially in LAS Co‐Cr (Δ = 5.87; p = 0.018) and OP Co‐Cr (Δ = 5.39; p = 0.007), with no significant effect in premolar (p > 0.05). Ceramic application combined with thermomechanical cycling (T1 vs. T3) caused a significant intra‐group increase in vertical misfit in all groups, both in the molar and premolar (p < 0.05). OP Co‐Cr was associated with greater vertical misfit and stress concentration. Frameworks manufactured by the CAD‐CAM system exhibited lower vertical misfit and better stress distribution. FPDs with metal frameworks (>410.83 ± 72.26 N) showed significantly higher fracture strength (p < 0.05) than zirconia (277.47 ± 39.10 N), and the first signs of ceramic veneering fracture were observed around 900 N. Conclusions: FPDs with frameworks manufactured using a CAD‐CAM system appear to be associated with lower vertical misfit and better stress distribution, although the section of the frameworks followed by welding may be a viable alternative. In addition, metal frameworks exhibit high fracture strength. [ABSTRACT FROM AUTHOR]

Oral rehabilitation is a crucial aspect of dental medicine, focusing on restoring and enhancing the function, aesthetics, and overall quality of life for patients with missing or compromised teeth. The use of technology in restorative dentistry has significantly advanced the field, offering various options for dental prostheses, including implant-supported caps, micro-supported dentures, fixed partial dentures, and removable dentures. Increasing the performance of restorations was the major objective of these digital techniques. Computer-aided design and manufacturing (CAD/CAM) technology is utilized for the production of dentures, record bases, radiographic guides, conversion dentures, and verification jigs. This technology has revolutionized the fabrication process, offering precision and efficiency in creating dental prostheses. [ABSTRACT FROM AUTHOR]

Objectives: The objectives were to investigate the association between oral functional status (defined by the number of functional teeth and functional occluding units [FOUs]) on oral health‐related quality of life (OHRQoL). It also aimed to determine if dentures could compensate for the loss of FOUs in terms of OHRQoL in community‐dwelling older adults in Singapore. Methods: Community‐dwelling older adults, aged 60 years and above, were recruited from a community‐based oral health functional screening programme from 1 May 2018 to 31 December 2019. During the screening, an Oral Health Impact Profile‐14 (OHIP‐14) questionnaire and oral examination were administered. Statistical analysis was performed using the chi‐square test, univariate logistic regression and multivariate predictive modelling. Results: Data from 1037 participants were analysed (52% female; mean age 71.5 (SD 7.15)). The mean OHIP‐14 score was 4.5 ± 7.2. The OHIP‐14 scores were significantly associated with the number of functional teeth and the number of FOUs (p <.001). Having at least 20 functional teeth or 10 FOUs was associated with a significantly lower OHIP‐14 score. Those with no FOUs had higher OHIP‐14 scores compared to those with at least 10 FOUs, even in the presence of a satisfactory denture. Conclusion: Maintaining at least 20 functional teeth or 10 FOUs was associated with better OHRQoL among community‐dwelling older adults in Singapore. Dentures may have limited compensatory ability in terms of replacing natural functional occlusal units and maintaining OHRQoL. [ABSTRACT FROM AUTHOR]

This report outlines 2 digitally planned cases in which the teeth underwent magnetic extrusion to preserve the supracrestal tissue attachment and regain the ferrule, followed by their restoration. Case 1: A 42-year-old man with the chief concern of a fractured right maxillary second premolar. Following the completion of root canal treatment, the remaining tooth structure was insufficient to create a ferrule for tooth restoration. For this scenario, a rapid magnetic extrusion technique was performed on tooth #4 to obtain an approximate 3-mm ferrule. The condition of both the dentition and the restorative margin was acceptable 18 months following treatment. Case 2: A 62-year-old man with the chief complaint of mobility on both sides of the maxillary arch in relation to a tooth-supported fixed partial denture (FPD). Following removal of the FPD, multiple extractions were carried out and tooth #6 was subjected to magnetic extrusion in 3 stages to a maximum of 4 mm to obtain a ferrule. At the 18-month and 3-year follow-up appointments, the tooth had no symptoms and the gingiva around the restorations had optimal architecture and margins. The 3-dimensional digital planning was helpful in precisely positioning the magnets within the tooth and the provisional restorations to facilitate axial extrusion. The extruded teeth were restored with zirconia crowns in both cases. The beneficial outcomes observed from these cases provides evidence that the integration of digital planning and magnetic extrusion holds promise as a method for reconstructing teeth with crowns that are significantly compromised. [ABSTRACT FROM AUTHOR]

This study evaluated the clinical survival rates of 170 Morse taper implants through clinical and mechanical parameters in different therapeutic approaches such as single crowns, fixed partial prostheses, and fixed full-arch prostheses. Patients referred to the Center on Education and Research on Dental Implants from May 2017 to July 2018 with the indication for dental implant therapy, aged >18 years, without periodontal disease, recent evidence of inflammatory activity or other oral disorders, current pregnancy, uncontrolled diabetes mellitus or heavy smoking habit were included in this study. After 12 weeks of healing since the implants were placed in the mandible and after 16 weeks following implants placed in the maxilla, patients returned to the Center for prosthetic rehabilitation. After implant therapy, all patients underwent periodical, clinical, and prosthetic examinations every 6 months. Prosthetic restorations involved 109 fixed reconstructions in function. Few prosthetic complications were reported (6.55%). Twenty implants were rehabilitated with cemented prostheses; from those, 1 crown suffered a loss in retention/decementation. Of the 148 implants rehabilitated with screwed-retained prostheses, 6.76% suffered prosthetic screw loosening. The cumulative implant survival rate was 98.2%. When peri-implant tissue health was evaluated, the keratinized mucosa band appeared related to peri-implant tissue stability. Thus, Morse taper implants represented a successful procedure for implant rehabilitation, with a high cumulative implant survival rate, low prevalence of biological and prosthetic complications, and good stability of peri-implant tissues over the assessed period. [ABSTRACT FROM AUTHOR]

Purpose: To compare screw surface characteristics between hemi‐engaging and non‐engaging implant‐supported fixed partial denture (FPD) designs after cyclic loading. Materials and Methods: Twenty‐four implants measuring 4.3 × 10 mm were mounted on acrylic resin blocks. Specimens were divided into two groups. An experimental group included twelve 3‐unit FPD with a hemi‐engaging design; a control group included twelve 3‐unit FPDs with the conventional design of two non‐engaging abutments. Both groups were subjected to two types of cycling loading (CL), first axial loading, and then lateral loading at 30°. Load was applied to the units one million times (1.0 × 106 cycles) for each loading axis. Data on screw surface roughness in three locations and screw thread depth were collected before (BL) and after (AL) each loading type. Screw surface roughness was measured in μm using a mechanical digital surface profilometer and optical profiler. To evaluate screw thread depth in μm, an upright optical microscope Axio‐imager 2 was used. To confirm readings made from the optical microscope, four random samples were selected from each group for scanning electron microscopy (SEM) analysis. The effect of cyclic loading was evaluated by averaging values across the two screws within each specimen, then calculating difference scores (DL) between BL and AL (DL = AL – BL). Additional difference scores were computed between the non‐engaging screws in each experimental group specimen, and one randomly selected non‐engaging screw in each control specimen. This difference was referred to as the non‐engaging DL. Statistical significance was assessed using Mann‐Whitney U tests (α = 0.05). Results: Comparisons of DL and non‐engaging DL by loading type revealed one significant difference regarding surface roughness at the screw thread. Significantly greater mean changes were observed after axial loading compared to lateral loading regarding both DL (axial M = ‐0.36 ± 0.08; lateral M = ‐0.21 ± 0.09; U = 20; p = 0.003) and non‐engaging DL (axial M = ‐0.40 ± 0.22; lateral M = ‐0.21 ± 0.11; U = 29; p = 0.013). No significant differences in screw surface roughness in other sites or thread depth were found between the experimental and control abutment designs in DL or in non‐engaging DL. No significant differences were found for DL (axial U = 13, p = 0.423; lateral U = 9, p = 0.150;) or non‐engaging DL (axial U = 13, p = 0.423; lateral U = 18, p = 1.00). Conclusions: Results suggest that overall, changes in screw surface physical characteristics did not differ between hemi‐engaging and non‐engaging designs after evaluating screw surface roughness and thread depth before and after axial and lateral cyclic loading. [ABSTRACT FROM AUTHOR]

Laser, an acronym for Light Amplification by Stimulated Emission of Radiation, is a powerful tool with diverse applications in modern dentistry. It emits monochromatic, coherent light resulting from photon-induced chain reactions. Available dental lasers include diode, argon, Er,Cr:YSGG, Er:YAG, Nd:YAG, and CO2. The unique property of these lasers, allowing them to be effectively used on both soft and hard tissues based on the operational parameters, positions them as particularly suited for a wide range of dental procedures. Compared to traditional methods, lasers offer advantages such as improved hemostasis and quicker wound healing. Such benefits stress the shift towards laser technology in dental treatment. In the realm of dental prosthodontics, which focuses on esthetics, functionality, and the physiological aspects of dental prostheses, lasers provide promising outcomes. Among the prosthetic options, fixed partial dentures stand out for their ability to mimic natural teeth, offering both esthetic and functional features, leading to satisfactory long-term outcomes if managed properly. This review paper delves into the specific application of laser technology in the context of prosthetic rehabilitation involving fixed partial dentures. By investigating intraoral laser procedures, it contributes to understanding laser's role in improving patients' satisfaction and clinical efficiency in this field. [ABSTRACT FROM AUTHOR]