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Aim of the study is to analyse the mechanical problems of implant restorations: the precise passive fit, the fracture resistance-aging, the micro fractures, the change in colour and the design of both infrastructure and superstructure. Material and methods We evaluate the same full arch restoration with the five most used material combinations and a mechanical failure test and numeric design simulations of forces at bone level. Results: Generally, two extensions failed faster than the single extension. Conclusions The patients’ expectations on the success of the implant and the predictability are high compared to their reluctance towards treatment costs and duration; it is particularly important to clarify this aspect from the beginning of the treatment.

This article, published in the Romanian Journal of Oral Rehabilitation, provides a comprehensive analysis of mechanical problems associated with full arch implant superstructures in implantology. The study examines factors such as precise fit, fracture resistance, micro fractures, color changes, and design of infrastructure and superstructure. The results indicate that single extensions outperformed two extensions in terms of failure rates. The article emphasizes the importance of managing patient expectations and predicting implant success at the beginning of treatment. It also discusses the impact of occlusal forces, bruxism, and crown materials on implant prostheses. The text presents empirical data, statistical analysis, and regression models to explore the relationships between variables. It highlights the significance of material selection and patient-specific factors in dental restorations. The conclusions suggest the best-performing materials and call for further research and clinical follow-up. The text compiles various research studies and statistical data on dental implants and prosthetic materials, covering topics such as shock absorption capacity, occlusal concepts, bruxism, and monolithic zirconia crowns. The findings indicate that certain materials and occlusal concepts may impact the performance and longevity of dental implants. [Extracted from the article]

This article will describe the technique for the fabrication of the telescoping implant prostheses with a very precise fit, achieved by luting intraorally the galvano mesostructures. The main result is the strain reduction, similar to the cemented fixed prostheses (12, 21). By the use of galvano-telescopic copings, the advantages of retrievability can be combined with the improved fit of a cemented superstructure. The telescopic system permits simple retrievability for peri-implant hygiene, and repair procedures, if necessary. The precision of implant superstructures is determined by the entire clinical and laboratory fabrication process. Errors may occur during the impression making, fabrication of the definitive cast, casting of the framework and ceramic veneering (14). Also, after extended edentulous periods, the replacement of hard and soft tissues is often necessary for esthetic or phonetic reasons. To compensate for the resorptive processes of the maxilla, a buccal flange may be required for adequate support of the lips and the facial profile. In these situations, a removable prosthesis may be given preference over a cemented fixed prosthesis or a screw retained prothesis.

Different types of internal implant–abutment connections, namely hexagon and conical, have been used for implant restoration. However, data regarding the benefits of these internal connections in terms of clinical outcomes are scarce. Accordingly, the aim of this study was to compare radiographic marginal bone loss (RMBL) and associated implant complications between implants with internal hexagon (IH) connections and those with internal conical (IC) connections. Forty-nine patients with 98 implants (2 per patient) placed in the posterior mandible were recruited. All implants were inserted in pairs into solid D2 bone according to a randomized sequence; the first patient received an IH connection implant on the mesial side, while the second patient received an IC connection implant on the mesial side. Each patient received 1 implant with an IH connection and 1 with an IC connection, placed side by side. Four months after placement, all implants were loaded with single screw-retained ceramic restorations with IH or IC connections. RMBL and complications, including implant/prosthesis failure, were recorded at the time of implant loading (baseline) and at 6, 12, and 36 months after loading. The results revealed no significant between-group differences in RMBL (P =.74), gingival bleeding on probing (P =.29), and complications (P =.32). Thus, the type of internal implant–abutment connection did not affect clinical outcomes, including RMBL and implant/prosthesis failure. Future studies should additionally evaluate long-term prosthesis-related complications, such as screw loosening and fracture, between the 2 types of internal connections. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate, in a case control study, the esthetic and functional clinical performance of ceramic inlays used for covering the screw access hole in single monolithic lithium disilicate full-contour crowns bonded on computer-aided design/computer-aided manufacturing (CAD/CAM) prefabricated titanium abutments in order to eliminate the drawbacks of alternative restorative methods. Materials and Methods: Twenty-eight patients with missing teeth in the lateral areas (premolars and molars) received screw-retained implant restorations. In half of the restorations (n = 14), composite fillings were used to seal the access hole (control group), while the other half was sealed with ceramic inlays (test group). To determine the restoration occlusal wear, impressions were obtained after the restorations were finalized, at 1 year, and at 2 years follow-up. The casts were scanned with a 3D Scanner Design System recording the anatomical surfaces of the white model replicates. Wear amounts (µm) were calculated as the maximum loss in height of the occlusal surface. The clinical evaluation was carried out using a kit specifically designed for assessing the FDI criteria. Statistics were performed using analysis of variance (ANOVA). Results: A total of 58 restorations were delivered, and after 2 years of follow-up, the wear values were 228.20 ± 54.68 µm for the control group and 65.20 ± 7.24 µm for the ceramic inlay group. One-way ANOVA showed significant differences among the vertical loss between these two groups (P < .001). Clinical outcomes according to the FDI score for assessing dental restorations revealed substantial deterioration within 2 years of follow-up. Conclusion: The use of ceramic inlays appears to be a predictable, esthetic, and successful method of sealing the screw holes of the screw-retained implant restorations. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to examine the influence of a short drilling protocol on peri-implant crestal bone levels. Materials and Methods: Forty implants were placed in the posterior mandibles of 20 patients. The implants (diameter, 4.2 mm; length, 10 to 11.5 mm) were inserted in pairs: one implant was inserted using the standard drilling protocol (five drills in sequence), while the other was inserted using the short drilling protocol sequence (three drills). All implants received healing abutments and were restored with single-unit restorations after 3 months of healing. Analysis of crestal bone level was based on radiographs taken at insertion and at 3, 6, and 12 months after insertion. The results were analyzed using software Image J 1.46r (National Institutes of Health). Crestal bone level was measured in millimeters at the distal aspect of each implant. Results: None of the implants in either group was lost during the 12-month follow-up period, and all patients completed the follow-up examination. The drilling time for the insertion of one implant with the short drilling protocol was 1.03 ± 3.63 minutes compared to 1.57 ± 2.88 minutes for the standard protocol. The mean values of crestal bone loss at 12 months were 0.94 ± 0.43 mm for implants placed using the standard protocol and 0.90 ± 0.33 mm for implants placed using the short drilling protocol. No statistically significant differences were noted. Conclusion: Using the short drilling protocol reduced the surgery time by approximately 50% and did not affect crestal bone remodeling during the first year postinsertion. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate (1) the association between implant diameter and marginal bone loss (MBL) of short (6 mm) implants and (2) the survival rates of short implants. Materials and Methods: Thirty-three 6-mm implants were placed in the mandibles of 16 qualified patients. The selected sites had > 5 mm ridge width and < 9 mm bone height. None of the implant sites required bone augmentation procedures. All implants were uncovered 3 months after placement, and all patients were rehabilitated with 2- or 3-unit implant-supported fixed partial dentures. Standardized periapical films were taken after 24 months of function. Radiographs were digitalized, and MBL was assessed. Results: For all implants, the mean MBL was 0.17 mm at the point of uncovering. At the 2-year follow-up, all implants were immobile and functional. Implants with 4.2-mm diameters had significantly more MBL (1.95 mm) than wider implants (0.47 mm and 0.35 mm for 5.0-mm and 6.0-mm implants, respectively). Conclusion: This 2-year study illustrated that short implants are a viable option in selected clinical scenarios. Short implants with wider diameters are preferred because they have less marginal implant bone loss. [ABSTRACT FROM AUTHOR]